The proportion of postmenopausal breast cancer cases in the Netherlands attributable to lifestyle-related risk factors
Gemert, W.A. van; Lanting, C.I. ; Goldbohm, R.A. ; Brandt, P.A. van den; Grooters, H.G. ; Kampman, E. ; Kiemeney, L.A.L.M. ; Leeuwen, F.E. van; Monninkhof, E.M. ; Vries, E. de; Peeters, P.H. ; Elias, S.G. - \ 2015
Breast Cancer Research and Treatment 152 (2015)1. - ISSN 0167-6806 - p. 155 - 162.
Lifestyle-related risk factors - Population attributable fraction - Postmenopausal breast cancer
We aimed to estimate the proportion of Dutch postmenopausal breast cancer cases in 2010 that is attributable to lifestyle-related risk factors. We calculated population attributable fractions (PAFs) of potentially modifiable risk factors for postmenopausal breast cancer in Dutch women aged >50 in 2010. First, age-specific PAFs were calculated for each risk factor, based on their relative risks for postmenopausal breast cancer (from meta-analyses) and age-specific prevalence in the population (from national surveys) around the year 2000, assuming a latency period of 10 years. To obtain the overall PAF, age-specific PAFs were summed in a weighted manner, using the age-specific breast cancer incidence rates (2010) as weights. 95 % confidence intervals for PAF estimates were derived by Monte Carlo simulations. Of Dutch women >40 years, in 2000, 51 % were overweight/obese, 55 % physically inactive (
A metabolic profile is associated with the risk of incident coronary heart disease
Vaarhorst, A. ; Verhoeven, A. ; Weller, C.M. ; Bohringer, S. ; Brandt, P.A. van den; Greevenbroek, M.M. ; Merry, A.H. ; Verschuren, W.M.M. ; Boer, J.M.A. ; Feskens, E.J.M. ; Heijmans, B.T. ; Slagboom, P.E. - \ 2014
American Heart Journal 168 (2014)1. - ISSN 0002-8703 - p. 45 - 52.e7.
artery-disease - cardiovascular events - population - prediction - plasma - phosphatidylcholine - metabonomics - netherlands - mortality - cohort
Background Metabolomics, defined as the comprehensive identification and quantification of low-molecular-weight metabolites to be found in a biological sample, has been put forward as a potential tool for classifying individuals according to their risk of coronary heart disease (CHD). Here, we investigated whether a single-point blood measurement of the metabolome is associated with and predictive for the risk of CHD.
De KWF Kanker Risico Test
Elias, S.G. ; Grooters, H.G. ; Bausch-Goldbohm, S. ; Brandt, P.A. van den; Kampman, E. ; Leeuwen, F.E. van; Peeters, P.H.M. ; Vries, E. de; Wigger, J.G. ; Kiemeney, L.A. - \ 2012
Nederlands Tijdschrift voor Geneeskunde 2012 (2012). - ISSN 0028-2162 - 7 p.
KWF Kankerbestrijding heeft de KWF Kanker Risico Test ontwikkeld om de Nederlandse bevolking beter te informeren over risicofactoren voor kanker. De internettest is in licentie gebaseerd op de Amerikaanse ‘Your disease risk’-test en maakt testgebruikers duidelijk welke risicofactoren een rol spelen bij het ontstaan van 12 veelvoorkomende kankersoorten. De test geeft een globale schatting van het individuele risico op een bepaalde kankersoort en daarnaast gerichte leefstijladviezen om dat risico te verlagen. Dit artikel beschrijft de ontwikkeling en de werking van de test, de sterke punten en de beperkingen.
Markers of endogenous desaturase activity and risk of coronary heart disease in the CAREMA cohort study
Lu, Y. ; Vaarhorst, A. ; Merry, A.H. ; Dolle, M.E.T. ; Hovenier, R. ; Imholz, S. ; Schouten, L.J. ; Heijmans, B.T. ; Muller, M.R. ; Slagboom, P.E. ; Brandt, P.A. van den; Gorgels, A.P. ; Boer, J.M.A. ; Feskens, E.J.M. - \ 2012
PLoS ONE 7 (2012)7. - ISSN 1932-6203
dietary arachidonic-acid - n-6 fatty-acids - genome-wide association - cardiovascular-disease - delta-6 desaturase - genetic-variation - loci - expression - humans - metabolism
Background Intakes of n-3 polyunsaturated fatty acids (PUFAs), especially EPA (C20:5n-3) and DHA (C22:6n-3), are known to prevent fatal coronary heart disease (CHD). The effects of n-6 PUFAs including arachidonic acid (C20:4n-6), however, remain unclear. d-5 and d-6 desaturases are rate-limiting enzymes for synthesizing long-chain n-3 and n-6 PUFAs. C20:4n-6 to C20:3n-6 and C18:3n-6 to C18:2n-6 ratios are markers of endogenous d-5 and d-6 desaturase activities, but have never been studied in relation to incident CHD. Therefore, the aim of this study was to investigate the relation between these ratios as well as genotypes of FADS1 rs174547 and CHD incidence. Methods We applied a case-cohort design within the CAREMA cohort, a large prospective study among the general Dutch population followed up for a median of 12.1 years. Fatty acid profile in plasma cholesteryl esters and FADS1 genotype at baseline were measured in a random subcohort (n = 1323) and incident CHD cases (n = 537). Main outcome measures were hazard ratios (HRs) of incident CHD adjusted for major CHD risk factors. Results The AA genotype of rs174547 was associated with increased plasma levels of C204n-6, C20:5n-3 and C22:6n-3 and increased d-5 and d-6 desaturase activities, but not with CHD risk. In multivariable adjusted models, high baseline d-5 desaturase activity was associated with reduced CHD risk (P for trend = 0.02), especially among those carrying the high desaturase activity genotype (AA): HR (95% CI) = 0.35 (0.15–0.81) for comparing the extreme quintiles. High plasma DHA levels were also associated with reduced CHD risk. Conclusion In this prospective cohort study, we observed a reduced CHD risk with an increased C20:4n-6 to C20:3n-6 ratio, suggesting that d-5 desaturase activity plays a role in CHD etiology. This should be investigated further in other independent studies
Literature-based genetic risk scores for coronary heart disease : the Cardiovascular Registry Maastricht (CAREMA) Prospective Cohort Study
Vaathorst, A.A. ; Lu Yingchang (Kevin), Y. ; Heijmans, B.T. ; Dolle, M.E. ; Bohringer, S. ; Putter, H. ; Imholz, S. ; Merry, A.H. ; Greevenbroek, M.M. ; Jukema, J.W. ; Gorgels, A.P. ; Brandt, P.A. van den; Muller, M.R. ; Schouten, L.J. ; Feskens, E.J.M. ; Boer, J.M.A. ; Slagboom, P.E. - \ 2012
Circulation: Cardiovascular Genetics 5 (2012). - ISSN 1942-325X - p. 202 - 209.
genome-wide association - artery-disease - logistic-regression - blood-pressure - loci - selection - variants - women - model - lasso
Background-Genome-wide association studies (GWAS) have identified many single-nucleotide polymorphisms (SNPs) associated with coronary heart disease (CHD) or CHD risk factors (RF). Using a case-cohort study within the prospective Cardiovascular Registry Maastricht (CAREMA) cohort, we tested if genetic risk scores (GRS) based on GWAS-identified SNPs are associated with and predictive for future CHD. Methods and Results-Incident cases (n=742), that is, participants who developed CHD during a median follow-up of 12.1 years (range, 0.0-16.9 years), were compared with a randomly selected subcohort of 2221 participants selected from the total cohort (n=21 148). We genotyped 179 SNPs previously associated with CHD or CHD RF in GWAS as published up to May 2, 2011. The allele-count GRS, composed of all SNPs, the 153 RF SNPs, or the 29 CHD SNPs were not associated with CHD independent of CHD RF. The weighted 29 CHD SNP GRS, with weights obtained from GWAS for every SNP, were associated with CHD independent of CHD RF (hazard ratio, 1.12 per weighted risk allele; 95% confidence interval, 1.04-1.21) and improved risk reclassification with 2.8% (P=0.031). As an exploratory approach to achieve weighting, we performed least absolute shrinkage and selection operator (LASSO) regression analysis on all SNPs and the CHD SNPs. The CHD LASSO GRS performed equal to the weighted CHD GRS, whereas the Overall LASSO GRS performed slightly better than the weighted CHD GRS. Conclusions-A GRS composed of CHD SNPs improves risk prediction when adjusted for the effect sizes of the SNPs. Alternatively LASSO regression analysis may be used to achieve weighting; however, validation in independent populations is required. (Circ Cardiovasc Genet. 2012;5:202-209.)
Risk prediction of incident coronary heart disease in the Netherlands: re-estimantion and improvement of the SCORE risk function
Merry, A.H. ; Boer, J.M.A. ; Schouten, L.J. ; Ambergen, T. ; Steyerberg, E.W. ; Feskens, E.J.M. ; Verschuren, W.M.M. ; Gorgels, A.P. ; Brandt, P.A. van den - \ 2012
European Journal of Preventive Cardiology 19 (2012)4. - ISSN 2047-4873 - p. 840 - 848.
global cardiovascular risk - c-reactive protein - clinical-practice - myocardial-infarction - roc curve - validation - framingham - reclassification - mortality - models
Aims: To re-estimate the SCORE risk function using individual data on risk factors and coronary heart disease (CHD) incidence from the Dutch Cardiovascular Registry Maastricht (CAREMA) population-based cohort study; to evaluate changes that may improve risk prediction after re-estimation; and to compare the performance of the resulting CAREMA risk function with that of existing risk scores. Methods and results: The cohort consisted of 21,148 participants, born in 1927–1977 and randomly sampled from the Maastricht region in 1987–1997. After follow-up (median 10.9 years), 783 incident CHD cases occurred. Model performance was assessed by discrimination and calibration. The additional value of including other risk factors or current risk factors in a different manner was evaluated using the net reclassification index (NRI). The c statistic of the re-estimated SCORE model was 0.799 (95% CI 0.782–0.816). Separating the total/high-density lipoprotein (HDL) cholesterol ratio into total and HDL cholesterol levels did not improve the c statistic (p = 0.22), but reclassified 6.0% of the participants into a more appropriate risk category (p <0.001) compared with the re-estimated model. The resulting CAREMA function reclassified 28% of the participants into a more appropriate risk category than the Framingham score. Compared with the SCORE functions for high- and low-risk regions, the NRIs were 28% and 35%, respectively, which can largely be explained by the difference in outcome definition (CHD incidence vs. CHD mortality). Conclusion: In this Dutch population, a re-estimated SCORE function with total and HDL cholesterol levels instead of the cholesterol ratio can be used for the risk prediction of CHD incidence.
Co-occurrence of metabolic factors and the risk of coronary heart disease: A prospective cohort study in the Netherlands
Merry, A.H. ; Erkens, P.M.G. ; Boer, J.M.A. ; Schouten, L.J. ; Feskens, E.J.M. ; Verschuren, W.M.M. ; Gorgels, A.P. ; Brandt, P.A. van den - \ 2012
International Journal of Cardiology 155 (2012)2. - ISSN 0167-5273 - p. 223 - 229.
cardiovascular-disease - cholesterol determination - increasing prevalence - atherosclerosis risk - artery-disease - all-cause - mortality - health - hypertension - pathogenesis
Background -Prevalence of metabolic factors such as diabetes, hypertension, obesity, HDL and total cholesterol that are associated with an increased risk of coronary heart disease (CHD) is increasing worldwide. However, less is known about combinations of these factors that are associated with the highest CHD risk. Therefore, the associations between combinations of these metabolic factors and the incidence of CHD, acute myocardial infarction (AMI), and unstable angina pectoris (UAP) were studied in the Cardiovascular Registry Maastricht (CAREMA) cohort study. Methods - The CAREMA study consists of 21,148 participants, born in 1927–1977 and randomly sampled from Maastricht and surrounding communities in 1987–1997. At baseline, all participants completed a self-administered questionnaire. Height, weight, blood pressure, total and HDL cholesterol levels were measured during a physical examination. After follow-up of maximally 16.9 years, 780 CHD, 437 AMI, and 286 UAP cases of first occurrence were registered. Incidence rate ratios (RRs) were estimated using Cox proportional hazards models adjusted for age, sex, smoking, and alcohol consumption. Results - Compared with subjects without any of the metabolic factors, the RRs of CHD were 2.37, 4.34, and 7.36 for subjects with 1, 2, or = 3 metabolic factors, respectively. These RRs were higher for AMI but lower for UAP. Especially combinations of metabolic factors that included diabetes or both a low HDL (= 0.9 mmol/L in men; = 1.0 mmol/L in women) and high total cholesterol (= 6.21 mmol/L) were associated with increased risks. Conclusion - The risk of total CHD, AMI, and UAP varies considerably between different combinations of metabolic factors.
Smoking, alcohol consumption, physical activity, and family history and the risks of acute myocardial infarction and unstable angina pectoris: a prospective cohort study
Merry, A.H. ; Boer, J.M.A. ; Schouten, L.J. ; Feskens, E.J.M. ; Verschuren, M.W.W. ; Gorgels, A.P. ; Brandt, P.A. van den - \ 2011
BMC Cardiovascular Disorders 11 (2011). - ISSN 1471-2261
coronary-heart-disease - cardiovascular-disease - parental history - relative validity - northern-ireland - metaanalysis - validation - prevention - prediction - prime
BACKGROUND: Few studies investigated the association between smoking, alcohol consumption, or physical activity and the risk of unstable angina pectoris (UAP), while the strength of these associations may differ compared to other coronary diseases such as acute myocardial infarction (AMI). Therefore, we investigated whether the associations of these lifestyle factors with UAP differed from those with AMI. Additionally, we investigated whether these effects differed between subjects with and without a family history of myocardial infarction (MI). METHODS: The CAREMA study consists of 21,148 persons, aged 20-59 years at baseline and randomly sampled from the Maastricht region in 1987-1997. At baseline, all participants completed a self-administered questionnaire. After follow-up of maximally 16.9 years, 420 AMI and 274 UAP incident cases were registered. Incidence rate ratios (RRs) were estimated using Cox proportional hazards models. RESULTS: For both diseases, smoking increased the risk while alcohol consumption was associated with a protective effect. Associations with both risk factors were stronger for AMI than UAP, although this difference was only statistically significant for smoking. In men, an inverse association was found with physical activity during leisure time which seemed to be stronger for the risk of UAP than of AMI. On the contrary, physical activity during leisure time was associated with an increased risk of both AMI and UAP in women which seemed to be weaker for UAP than for AMI. Except for occupational physical activity in women, no significant interactions on a multiplicative scale were found between the lifestyle factors and family history of MI. Nevertheless, the highest risks were found in subjects with both a positive family history and the most unfavorable level of the lifestyle factors. CONCLUSIONS: The strength of the associations with the lifestyle factors did not differ between AMI and UAP, except for smoking. Furthermore, the effects of the lifestyle factors on the risk of both coronary diseases were similar for subjects with and without a positive family history.
Validity of coronary heart diseases and heart failure based on hospital discharge and mortality data in the Netherlands using the cardiovascular registry Maastricht cohort study
Merry, A.H. ; Boer, J.M. ; Schouten, L.J. ; Feskens, E.J.M. ; Verschuren, W.M. ; Gorgels, A.P. ; Brandt, P.A. van den - \ 2009
European Journal of Epidemiology 24 (2009)5. - ISSN 0393-2990 - p. 237 - 247.
acute myocardial-infarction - routine mortality - finland - statistics - diagnosis - project - trends - death - morbidity - community
Incidence rates of cardiovascular diseases are often estimated by linkage to hospital discharge and mortality registries. The validity depends on the quality of the registries and the linkage. Therefore, we validated incidence rates of coronary heart disease (CHD), acute myocardial infarction, unstable angina pectoris, and heart failure, estimated by this method, against the disease registry of the cardiovascular registry Maastricht cohort study. The cohort consists of 21,148 persons, born between 1927 and 1977, who were randomly sampled from Maastricht and surrounding communities in 1987–1997. Incident cases were identified by linkage to the Netherlands causes of death registry and either the hospital discharge registry (HDR) or the cardiology information system (CIS) of the University Hospital Maastricht. Sensitivities and positive predictive values were calculated using the CIS-based registry as gold standard. Relatively high sensitivities and positive predictive values were found for CHD (72 and 91%, respectively) and acute myocardial infarction (84 and 97%, respectively). These values were considerably lower for unstable angina pectoris (53 and 78%, respectively) and heart failure (43 and 80%, respectively). A substantial number of cases (14–47%) were found only in the CIS-based registry, because they were missed or miscoded in the HDR-based registry. As a consequence, the incidence rates in the HDR-based registry were considerably lower than in the CIS-based registry, especially for unstable angina pectoris and heart failure. Incidence rates based on hospital discharge and mortality data may underestimate the true incidence rates, especially for unstable angina pectoris and heart failure
|Vier decennia onderzoek rond voeding en kanker
Kampman, E. ; Bausch-Goldbohm, S. ; Brandt, P.A. van den - \ 2008
Voeding Nu 10 (2008)12. - ISSN 1389-7608 - p. 28 - 29.
voedingsonderzoek - neoplasma's - voedselwetenschappen - voedselconsumptie - voedingsgewoonten - humane voeding - epidemiologische onderzoeken - voeding en gezondheid - nutrition research - neoplasms - food sciences - food consumption - feeding habits - human feeding - epidemiological surveys - nutrition and health
Heeft voeding iets met het ontstaan van kanker te maken? Heeft het epidemiologisch onderzoek naar voeding en kanker in de afgelopen 40 jaar iets opgeleverd? Of zijn zowel het kankerproces als onze voedingsgewoonten te complex om te kunnen bestuderen in epidemiologische studies? In dit artikel komen een aantal antwoorden op deze vragen naar voren
|Design characteristics of food frequency questionnaires in relation to their validity
Molag, M.L. ; Vries, J.H.M. de; Ocke, M.C. ; Dagnelie, P.C. ; Brandt, P.A. van den; Jansen, M.C.J.F. ; Staveren, W.A. van; Veer, P. van 't - \ 2007
In: WEON 2007: Methodologische uitdagingen in cohortonderzoek, Maastricht, The Netehrlands, 21 - 22 June, 2007. - - p. 104 - 104.
Design Characteristics of Food Frequency Questionnaires in Relation to Their Validity
Molag, M.L. ; Vries, J.H.M. de; Ocke, M.C. ; Dagnelie, P.C. ; Brandt, P.A. van den; Jansen, S.C. ; Staveren, W.A. van; Veer, P. van 't - \ 2007
American Journal of Epidemiology 166 (2007)12. - ISSN 0002-9262 - p. 1468 - 1478.
dietary assessment methods - doubly-labeled water - energy-intake - nutrient intake - assessment instruments - history questionnaire - biochemical markers - urinary nitrogen - weighed records - womens health
The authors investigated the role of food frequency questionnaire (FFQ) design, including length, use of portion-size questions, and FFQ origin, in ranking subjects according to their nutrient intake. They also studied the ability of the FFQ to detect differences in energy intake between subgroups and to assess energy and protein intake. In a meta-analysis of 40 validation studies, FFQs with longer food lists (200 items) were better than shorter FFQs at ranking subjects for most nutrients; results were statistically significant for protein, energy-adjusted total fat, and energy-adjusted vitamin C. The authors found that FFQs that included standard portions had higher correlation coefficients for energy-adjusted vitamin C (0.80 vs. 0.60, p <0.0001) and protein (0.69 vs. 0.61, p = 0.03) than FFQs with portion-size questions. However, it remained difficult from this review to analyze the effects of using portion-size questions. FFQs slightly underestimated gender differences in energy intake, although level of energy intake was underreported by 23% and level of protein intake by 17%. The authors concluded that FFQs with more items are better able to rank people according to their intake and that they are able to distinguish between subpopulations, even though they underestimated the magnitude of these differences.
Effect of increase vegetable and fruit consumption on plasma folate and homocysteine concentrations
Bogers, R.P. ; Dagnelie, P.C. ; Bast, A. ; Leeuwen, M. van; Klaveren, J.D. van; Brandt, P.A. van den - \ 2007
Nutrition 23 (2007)2. - ISSN 0899-9007 - p. 97 - 102.
folic-acid - controlled-trial - dietary-folate - heart-disease - metaanalysis - humans - bioavailability - questionnaire - carotenoids - validity
OBJECTIVE: We assessed the effects of an intervention aimed at increasing the consumption of fruits and vegetables on plasma folate and homocysteine concentrations. METHODS: Seventy-one healthy non-smoking women (mean +/- SD 41 +/- 4 y of age) were randomized to an intervention or a control group. Participants in the intervention group (n = 36) received weekly packets containing fruits and vegetables free of charge and were asked to consume a daily amount of >/=200 g of vegetables and two pieces of fruit (the Dutch recommended intake level) over a period of 1 mo. Control subjects did not receive any intervention. RESULTS: Compared with the control group, reported fruit and vegetable intakes in the intervention group increased by 133 g/d (95% confidence interval [CI] 87-179, P <0.001) for fruits and juice and 64 g/d (95% CI 37-91, P <0.001) for vegetables and estimated folate intake from fruits and vegetables increased by 40 mug/d (95% CI 22-58, P <0.001). However, no effect was observed on plasma folate concentrations (intervention effect 0.3 nmol/L, 95% CI -1.8 to 2.8, P = 0.77) or homocysteine concentrations (intervention effect 0.26 mumol/L, 95% CI -0.34 to 0.87, P = 0.39). CONCLUSION: The results suggest that 4 wk of increased fruit and vegetable consumption to the recommended amounts may be insufficient to change plasma folate and homocysteine concentrations.
The influence of design characteristics of food frequency questionnaires in their validity to assess energy intake
Molag, M.L. ; Vries, J.H.M. de; Veer, P. van 't; Brandt, P.A. van den; Dagnelie, P. ; Ocke, M.C. ; Jansen, M.C.J.F. ; Staveren, W.A. van - \ 2006
European Journal of Epidemiology 21 (2006)suppl. 13. - ISSN 0393-2990 - p. 91 - 91.
Cigarette smoking and colorectal cancer: APC mutations, hMLH1 Expression and GSTM1 and GSTT1 Polymorphisms
Luchtenborg, M. ; Weijenberg, M.P. ; Kampman, E. ; Muijen, G.N.P. van; Roemen, G.M.J.M. ; Zeegers, M. ; Goldbohm, R.A. ; Veer, P. van 't; Goeij, A.F.P.M. de; Brandt, P.A. van den - \ 2005
American Journal of Epidemiology 161 (2005)9. - ISSN 0002-9262 - p. 806 - 815.
26-year follow-up - microsatellite instability - colon-cancer - epidemiologic research - netherlands cohort - transferase gstm1 - k-ras - risk - gene - smokers
The contribution of cigarette smoking to sporadic colorectal cancer may differ according to molecular aspects of the tumor or according to glutathione S-transferase M1 (GSTM1) or glutathione S-transferase T1 (GSTT1) genotype. In the prospective Netherlands Cohort Study on Diet and Cancer, adjusted incidence rate ratios for 1986-1993 were computed for overall colorectal cancer, tumors with and without adenomatous polyposis coli (APC) mutations, and tumors with and without human mut-L homologue 1 (hMLH1) expression, according to cigarette smoking characteristics (661 cases, 2,948 subcohort members). Case-only analyses were performed to estimate odds ratios for interaction between cigarette smoking and GSTM1 and GSTT1 genotypes. In comparison with never smokers, a high smoking frequency increased the risk of colorectal cancer (for a five-cigarette/day increment, incidence rate ratio (IRR) = 1.07, 95% confidence interval (CI): 1.03, 1.12), and this association was stronger in 371 tumors without a truncating APC mutation (IRR = 1.11, 95% CI: 1.05, 1.17). Long-term smoking was associated with lack of hMLH1 expression in 56 tumors (for a 10-year increment, IRR = 1.17, 95% CI: 1.00, 1.37). No statistically significant interactions between smoking and GSTM1 or GSTT1 genotype were observed. These results indicate that cigarette smoking is associated with risk of colorectal cancer, and this association may depend on molecular characteristics of the tumor as defined by APC mutation and hMLH1 expression status.
Meat and fish consumption, APC gene mutations and hMLH1 expression in colon and rectal cancer: a prospective cohort study (the Netherlands)
Luchtenborg, M. ; Weijenberg, M.P. ; Goeij, A.F.P.M. de; Wark, P.A. ; Brink, M. ; Roemen, G.M.J.M. ; Lentjes, M.H.F.M. ; Bruine, A.P. de; Goldbohm, R.A. ; Veer, P. van 't; Brandt, P.A. van den - \ 2005
Cancer Causes and Control 16 (2005)9. - ISSN 0957-5243 - p. 1041 - 1054.
scale prospective cohort - colorectal-cancer - sporadic colon - microsatellite instability - adenomatous polyposis - k-ras - dietary factors - cluster region - carcinomas - tumors
Objective:The aim of this study was to investigate the associations between meat and fish consumption and APC mutation status and hMLH1 expression in colon and rectal cancer. Methods:The associations were investigated in the Netherlands Cohort Study, and included 434 colon and 154 rectal cancer patients on whom case-cohort analyses (subcohort n = 2948) were performed. Results:Total meat consumption was not associated with the endpoints studied. Meat product (i.e. processed meat) consumption showed a positive association with colon tumours harbouring a truncating APC mutation, whereas beef consumption was associated with an increased risk of colon tumours without a truncating APC mutation (incidence rate ratio (RR) highest versus lowest quartile of intake 1.61, 95% confidence interval (CI) 0.96¿2.71, p-trend = 0.04 and 1.58, 95% CI 1.10¿2.25, p-trend = 0.01, respectively). Consumption of other meat (horsemeat, lamb, mutton, frankfurters and deep-fried meat rolls) was associated with an increased risk of rectal cancer without a truncating APC mutation (RR intake versus no intake 1.79, 95% CI 1.10¿2.90). No associations were observed for meat consumption and tumours lacking hMLH1 expression. Conclusions:Our data indicate that several types of meat may contribute differently to the aetiology of colon and rectal cancer, depending on APC mutation status but not hMLH1 expression of the tumour.
Fruits, vegetables and hMLH1 protein-deficient and-proficient colon cancer: the Netherlands Cohort Study
Wark, P.A. ; Weijenberg, M.P. ; Veer, P. van 't; Wijhe, G. van; Luchtenborg, M. ; Muijen, G.N.P. van; Goeij, A.F.P.M. de; Goldbohm, R.A. ; Brandt, P.A. van den - \ 2005
Cancer Epidemiology Biomarkers and Prevention 14 (2005)7. - ISSN 1055-9965 - p. 1619 - 1625.
sporadic colorectal-cancer - food frequency questionnaire - defective mismatch repair - scale prospective cohort - microsatellite instability - promoter region - proximal colon - methylation - diet - hypermethylation
Clinical and pathologic differences exist between colon carcinomas deficient and proficient in the mismatch repair protein hMLH1. Animal and in vitro studies suggest that fruits, vegetables, folate, and antioxidants are associated with colonic expression of mismatch repair genes.METHODS: Associations between consumption of fruits and vegetables and hMLH1 protein-deficient and -proficient colon cancer were evaluated in the Netherlands Cohort Study on diet and cancer using a case-cohort approach. A self-administered food frequency questionnaire was completed, in 1986, by 120,852 individuals ages 55 to 69 years. Using immunohistochemistry, hMLH1 protein expression was assessed in colon cancer tissue obtained from 441 patients who were identified over 7.3 years of follow-up excluding the initial 2.3 years. Incidence rate ratios (RR) were estimated for hMLH1 protein-deficient and -proficient colon cancer.RESULTS: hMLH1 protein expression was absent in 54 tumors (12.2%) and present in 387 tumors. Fruit consumption was associated with hMLH1 protein-deficient colon cancer [highest versus lowest tertile, RR, 0.46; 95% confidence interval (95% CI), 0.23-0.90; P(trend) = 0.029] but not with hMLH1 protein-proficient tumors (highest versus lowest tertile, RR, 1.03; 95% CI, 0.78-1.35; P(trend) = 0.81). Total consumption of vegetables was not associated with either type of tumor (hMLH1 protein deficient: RR, 0.86; 95% CI, 0.45-1.65; P(trend) = 0.67; hMLH1 protein proficient: RR, 0.94; 95% CI, 0.72-1.23; P(trend) = 0.72). No associations were observed for folate, fiber, antioxidants, or subgroups of vegetables.CONCLUSION: These analyses indicate that an inverse association between consumption of fruits and colon cancer may be confined to the subgroup of tumors with a deficient mismatch repair system.
Consumption of fruits and vegetables, and expression of the mismatch repair gene hMLH1 in human colorectal cancer: a prospective study
Wark, P.A. ; Weijenberg, M.P. ; Veer, P. van 't; Wijhe, G. van; Muijen, G.N.P. van; Goeij, A.F.P.M. de; Goldbohm, R.A. ; Brandt, P.A. van den - \ 2004
In: European Congress of Epidemiology, Porto, 11 September 2004 Porto : - p. a2 (005) - a2 (005).
Introduction: Striking clinical and pathological differences exist between colorectal carcinomas with and without defects in the mismatch repair system. Such defects are mainly due to loss of expression of the hMLH1 gene. Animal and in vitro studies suggest that fruits, vegetables and folate are associated with expression of mismatch repair genes in the colon and rectum. Methods: Associations between consumption of fruits and vegetables and expression of the hMLH1 mismatch repair gene were evaluated in The Netherlands Cohort Study using a case cohort approach. In 1986, 120 852 men and women aged 55–69 years completed a questionnaire on dietary and other postulated risk factors for cancer. After 7.3 years of follow up and with exclusion of the first 2.3 years, hMLH1 protein expression was assessed in colorectal cancer tissue obtained from 725 incident colorectal cancer patients using immunohistochemistry. hMLH1 protein expression was absent in 61 cases (8.4%). Risk ratios (RR) were computed to compare cases with and without hMLH1 expression to the sub cohort. In this abstract, preliminary results based on 38 cases without and 432 with expression of hMLH1 are reported. During the conference, results based on the entire study population will be presented. Results: Consumption of fruits was associated with hMLH1 deficient colorectal carcinomas (RRhighest v lowest tertile 0.28; 95% CI 0.12 to 0.66), but not with carcinomas expressing hMLH1 (RRhighest v lowest tertile 0.96; 95% CI 0.74 to 1.24). Total consumption of vegetables was not associated with both types of tumours (without hMLH1 expression: RR 0.78; 95% CI 0.38 to 1.16; with hMLH1 expression: RR 0.91; 95% CI 0.71 to 1.16). Brassica vegetables, folate, and vitamin C tended to be inversely associated with hMLH1 deficient carcinomas, but not with carcinomas expressing hMLH1. Conclusions: These analyses suggest that inverse associations between consumption of fruits, brassica vegetables, folate, and vitamin C might be confined to the subgroup of hMLH1 deficient colorectal carcinomas.
|Consumption of fruits and vegetables, and expression of the mismatch repair gene hMLH1 in human colorectal cancer: a prospective study
Wark, P.A. ; Weijenberg, M.P. ; Veer, P. van 't; Wijhe, G. van; Luchtenborg, M. ; Muijen, G.N.P. van; Goeij, A.F.P.M. de; Goldbohm, R.A. ; Brandt, P.A. van den - \ 2004
|Consumption of fruits and vegetables, and expression of the mismatch reparair gene hMLH1 in human colorectal cancer: a prospective study
Wark, P.A. ; Weijenberg, M.P. ; Veer, P. van 't; Wijhe, G. van; Muijen, G.N.P. van; Goeij, A.F.P.M. de; Goldbohm, R.A. ; Brandt, P.A. van den - \ 2004