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  • Germany  (14)
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  • 1
    Keywords: ENERGIES ; CANCER ; Germany ; human ; MODEL ; MODELS ; FOLLOW-UP ; COHORT ; EPIDEMIOLOGY ; RISK ; RISK-FACTORS ; ASSOCIATION ; BREAST ; breast cancer ; BREAST-CANCER ; TRIAL ; hormone ; HEALTH ; ENERGY ; AGE ; WOMEN ; HORMONE REPLACEMENT THERAPY ; OBESITY ; risk factors ; COUNTRIES ; cancer risk ; RISK FACTOR ; EPIC ; EPIC study ; European Prospective Investigation into Cancer and Nutrition ; nutrition ; POSTMENOPAUSAL WOMEN ; MASS INDEX ; PH ; WEIGHT ; body weight ; fat distribution ; HEIGHT ; ADIPOSITY ; breast neoplasm ; HORMONE-REPLACEMENT THERAPY ; METAANALYSIS
    Abstract: The evidence for anthropometric factors influencing breast cancer risk is accumulating, but uncertainties remain concerning the role of fat distribution and potential effect modifiers. We used data from 73,542 premenopausal and 103,344 postmenopausal women from 9 European countries, taking part in the EPIC study. RRs from Cox regression models were calculated, using measured height, weight, BMI and waist and hip circumferences; categorized by cohort wide quintiles; and expressed as continuous variables, adjusted for study center, age and other risk factors. During 4.7 years of follow-up, 1,879 incident invasive breast cancers were identified. In postmenopausal women, current HRT modified the body size-breast cancer association. Among nonusers, weight, BMI and hip circumference were positively associated with breast cancer risk (all P-trend less than or equal to 0.002); obese women (BMI 〉 30) had a 31% excess risk compared to women with BMI 〈 25. Among HRT users, body measures were inversely but nonsignificantly associated with breast cancer. Excess breast cancer risk with HRT was particularly evident among lean women. Pooled RRs per height increment of 5 cm were 1.05 (95% CI 1.00-1.16) in premenopausal and 1.10 (95% CI 1.05-1.16) in postmenopausal women. Among premenopausal women, hip circumference was the only other measure significantly related to breast cancer (P-trend = 0.03), after accounting for BMI. In postmenopausal women not taking exogenous hormones, general obesity is a significant predictor of breast cancer, while abdominal fat assessed as waist-hip ratio or waist circumference was not related to excess risk when adjusted for BMI. Among premenopausal women, weight and BMI showed nonsignificant inverse associations with breast cancer. (C) 2004 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 15252848
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  • 2
    Keywords: CANCER ; tumor ; Germany ; human ; MODEL ; MODELS ; COHORT ; MORTALITY ; RISK ; ASSOCIATION ; ovarian cancer ; OVARIAN-CANCER ; COUNTRIES ; cancer risk ; DIETARY ; CONSUMPTION ; nutrition ; QUESTIONNAIRE ; questionnaires ; VEGETABLES ; NUTRIENTS ; carotenoids ; DIETARY FACTORS ; DETERMINANTS ; SUBTYPE ; FRUITS ; PART ; PARTICIPANTS ; CANCER INCIDENCE ; ALLIUM VEGETABLES ; FOOD GROUPS
    Abstract: Objective: The association between consumption of fruit and vegetables and risk of ovarian cancer is still unclear from a prospective point of view. Methods: Female participants (n = 325,640) of the European Prospective Investigation into Cancer and Nutrition study, free of any cancer at baseline, were followed on average for 6.3 years to develop ovarian cancer. During 2,049,346 person-years, 581 verified cases of primary, invasive epithelial ovarian cancer were accrued. Consumption of fruits and vegetables as well as subgroups of vegetables, estimated from validated dietary questionnaires and calibrated thereafter, was related to ovarian cancer incidence in multivariable hazard regression models. Histologic subtype specific analyses were done. Results: Total intake of fruit and vegetables, separately or combined, as well as subgroups of vegetables (fruiting, root, leafy vegetables, cabbages) was unrelated to risk of ovarian cancer. A high intake of garlic/onion vegetables was associated with a borderline significant reduced risk of this cancer. The examination by histologic subtype indicated some differential effects of fruit and vegetable intake on ovarian cancer risk. Conclusion: Overall, a high intake of fruits and vegetables did not seem to protect from ovarian cancer. Garlic/onion vegetables may exert a beneficial effect. The study of the histologic subtype of the tumor warrants further investigation
    Type of Publication: Journal article published
    PubMed ID: 16284374
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  • 3
    Keywords: CANCER ; BLOOD ; Germany ; COHORT ; RISK ; MICE ; ASSOCIATION ; BREAST-CANCER ; hormone ; AGE ; ovarian cancer ; OVARIAN-CANCER ; WOMEN ; cancer risk ; case-control studies ; VALIDITY ; nutrition ; dehydroepiandrosterone ; POSTMENOPAUSAL WOMEN ; SERUM ; case-control study ; REGRESSION ; ASSOCIATIONS ; DETERMINANTS ; development ; LEVEL ; case control studies ; SERUM-LEVELS ; SULFATE ; HORMONES ; DEHYDROEPIANDROSTERONE-SULFATE ; TESTOSTERONE ; prospective ; STEROID-HORMONES ; INCREASED RISK ; odds ratio ; CANCER-RISK ; OVARIAN ; BODY-MASS-INDEX
    Abstract: Few epidemiologic studies have examined the hypothesis that circulating androgens are involved in the development of ovarian cancer. We investigated the association between prediagnostic serum levels of androgens and sex hormone-binding globulin (SHBG) and ovarian cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort. One hundred and ninety-two ovarian cancer cases and 346 matched controls not using exogenous hormones at baseline blood donation were eligible for the study. Serum levels of testosterone, androstenedione, dehydroepiandrosterone sulfate, and SHBG were measured by direct immunoassays. Free testosterone (fT) was calculated according to mass action laws. Multivariate conditional logistic regression was used to estimate odds ratios adjusted for possible confounders. Overall, there was no association between serum concentrations of androgens or SHBG and ovarian cancer risk. In postmenopausal women, fT concentrations were inversely related to risk [highest versus lowest tertile odds ratio 0.45 (0.24-0.86); P-trend = 0-01]. Among women diagnosed before the age of 55 years, there was a negative association with SHBG and a positive association with fT and ovarian cancer risk, although these associations were not statistically significant. The present study suggests that circulating androgens and SHBG levels are not strongly associated with ovarian cancer risk, although levels of fT may be associated with an increased risk among women diagnosed at relatively young age. The heterogeneity of results on the associations of fT with ovarian cancer risk in postmenopausal women deserves further investigation
    Type of Publication: Journal article published
    PubMed ID: 17220328
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  • 4
    Keywords: CANCER ; BLOOD ; Germany ; RISK ; METABOLISM ; ASSOCIATION ; BREAST-CANCER ; DESIGN ; NUMBER ; AGE ; WOMEN ; REPRODUCIBILITY ; etiology ; cancer risk ; EPIC ; nutrition ; ESTRADIOL ; POSTMENOPAUSAL WOMEN ; SERUM ; ONCOLOGY ; REGRESSION ; ESTROGEN ; LEVEL ; analysis ; PHASE ; PREMENOPAUSAL ; TESTOSTERONE ; prospective ; STEROID-HORMONES ; VARIABLES ; CANCER-RISK ; BINDING GLOBULIN ; ENGLAND ; steroids ; SEX-HORMONES ; postmenopausal ; androgens ; FREE TESTOSTERONE ; ESTROGENS
    Abstract: Epidemiological data show that reproductive and hormonal factors are involved in the etiology of endometrial cancer, but there is little data on the association with endogenous sex hormone levels. We analyzed the association between prediagnostic serum concentrations of sex steroids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition using a nested case-control design of 247 incident endometrial cancer cases and 481 controls, matched on center, menopausal status, age, variables relating to blood collection, and, for premenopausal women, phase of menstrual cycle. Using conditional regression analysis, endometrial cancer risk among postmenopausal women was positively associated with increasing levels of total testosterone, free testosterone, estrone, total estradiol, and free estradiol. The odds ratios (ORs) for the highest versus lowest tertile were 2.66 (95% confidence interval (CI) 1.50-4.72; P=0.002 for a continuous linear trend) for estrone, 2.07 (95% Cl 1.20-3.60; P=0.001) for estradiol, and 1.66 (95% Cl 0.98-2.82; P=0.001) for free estradiol. For total and free testosterone, ORs for the highest versus lowest tertile were 1.44 (95% Cl 0.88-2.36; P=0.05) and 2.05 (95% Cl 1.23-3.42; P=0.005) respectively. Androstenedione and dehydroepiandrosterone sulfate were not associated with risk. Sex hormone-binding globulin was significantly inversely associated with risk (OR for the highest versus lowest tertile was 0.57, 95% Cl 0.34-0.95; P=0.004). In premenopausal women, serum sex hormone concentrations were not clearly associated with endometrial cancer risk, but numbers were too small to draw firm conclusions. In conclusion, relatively high blood concentrations of estrogens and free testosterone are associated with an increased endometrial cancer risk in postmenopausal women
    Type of Publication: Journal article published
    PubMed ID: 18509001
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  • 5
    Keywords: CANCER ; Germany ; MODEL ; MODELS ; FOLLOW-UP ; COHORT ; EPIDEMIOLOGY ; HISTORY ; RISK ; TIME ; ASSOCIATION ; HEALTH ; CIGARETTE-SMOKING ; smoking ; cancer risk ; ethanol ; NETHERLANDS ; ALCOHOL ; PROJECT ; ALCOHOL-CONSUMPTION ; CONSUMPTION ; EPIC ; nutrition ; pancreatic cancer ; LIFE-STYLE FACTORS ; pancreas ; PANCREATIC-CANCER ; WEIGHT ; DIETARY-INTAKE MEASUREMENTS ; BEER ; prospective ; CANCER-RISK ; MALE SMOKERS ; BEVERAGE CONSUMPTION ; COFFEE CONSUMPTION
    Abstract: To examine the association of baseline and lifetime ethanol intake with cancer of the pancreas in the European Prospective Investigation into Cancer and Nutrition (EPIC). Included in this analysis were 478,400 subjects, of whom detailed information on the intake of alcoholic beverages at baseline and over lifetime was collected between 1992 and 2000. During a median follow-up time of 8.9 years, 555 non-endocrine pancreatic cancer cases were observed. Multivariate Cox proportional hazard models were used to examine the association of ethanol intake at recruitment and average lifetime ethanol intake and pancreatic cancer adjusting for smoking, height, weight, and history of diabetes. Overall, neither ethanol intake at recruitment (relative risk (RR) = 0.94, 95% confidence interval (CI) 0.69-1.27 comparing 30+ g/d vs. 0.1-4.9 g/d) nor average lifetime ethanol intake (RR = 0.95, 95% CI 0.65-1.39) was associated with pancreatic cancer risk. High lifetime ethanol intake from spirits/liquor at recruitment tended to be associated with a higher risk (RR = 1.40, 95% CI 0.93-2.10 comparing 10+ g/d vs. 0.1-4.9 g/d), but no associations were observed for wine and beer consumption. These results suggest no association of alcohol consumption with the risk of pancreatic cancer
    Type of Publication: Journal article published
    PubMed ID: 19145468
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  • 6
    Keywords: CANCER ; BLOOD ; carcinoma ; CELL ; Germany ; human ; FOLLOW-UP ; INFORMATION ; SUPPORT ; COHORT ; MORTALITY ; RISK ; RISKS ; HEALTH ; WOMEN ; OBESITY ; risk factors ; COUNTRIES ; UNITED-STATES ; BLOOD-PRESSURE ; HYPERTENSION ; EPIC ; nutrition ; RELATIVE RISK ; CELL CARCINOMA ; renal cell carcinoma ; INCREASE ; USA ; RISK-FACTOR ; KIDNEY CANCER ; INCREASES ; ANTIHYPERTENSIVE MEDICATION ; antihypertensive agents ; DIURETICS ; FERRIC NITRILOTRIACETATE ; kidney neoplasms ; RISING INCIDENCE
    Abstract: Elevated blood pressure has been implicated as a risk factor for renal cell carcinoma (RCC), but prospective studies were confined to men and did not consider the effect of antihypertensive medication. The authors examined the relation among blood pressure, antihypertensive medication, and RCC in the European Prospective Investigation into Cancer and Nutrition (EPIC). Blood pressure was measured in 296,638 women and men, recruited in eight European countries during 1992-1998, 254,935 of whom provided information on antihypertensive medication. During a mean follow-up of 6.2 years, 250 cases of RCC were identified. Blood pressure was independently associated with risk of RCC. The relative risks for the highest versus the lowest category of systolic (〉= 160 mmHg vs. 〈 120 mmHg) and diastolic (〉= 100 mmHg vs. 〈 80 mmHg) blood pressures were 2.48 (95% confidence interval: 1.53, 4.02) and 2.34 (95% confidence interval: 1.54, 3.55). Risk estimates did not significantly differ according to sex or use of antihypertensive medication. Individuals taking antihypertensive drugs were not at a significantly increased risk unless blood pressure was poorly controlled. These results support the hypothesis that hypertension, rather than its medications, increases the risk of RCC in both sexes, while effective blood pressure control may lower the risk
    Type of Publication: Journal article published
    PubMed ID: 18048375
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  • 7
    Keywords: APOPTOSIS ; CANCER ; proliferation ; BLOOD ; CELL ; CELL-PROLIFERATION ; Germany ; MODEL ; MODELS ; COHORT ; RISK ; RISKS ; SITE ; PROTEIN ; PROTEINS ; colon ; BINDING ; ASSOCIATION ; NO ; resistance ; NUMBER ; AGE ; WOMEN ; colorectal cancer ; OBESITY ; COLORECTAL-CANCER ; COUNTRIES ; RATES ; cancer risk ; BINDING-PROTEINS ; DIET ; case-control studies ; DIABETES-MELLITUS ; EPIC ; nutrition ; FACTOR-I ; REGRESSION-MODELS ; physical activity ; BINDING PROTEIN ; insulin ; SERUM ; IGF-I ; ONCOLOGY ; BINDING-PROTEIN ; case-control study ; REGRESSION ; ASSOCIATIONS ; secretion ; BODY-SIZE ; PHYSICAL-ACTIVITY ; LEVEL ; biomarker ; case control studies ; pancreatic ; BLOOD-GLUCOSE ; INSULIN-RESISTANCE ; rectum ; USA ; prospective ; rectal cancer ; prospective study ; CANCERS ; CANCER-RISK ; C-PEPTIDE ; IGFBP-1 ; colorectal ; BINDING PROTEINS ; LOGISTIC-REGRESSION ; IGFBP-2 ; FACTOR BINDING PROTEIN-1 ; IGF ; insulin resistance ; GROWTH-FACTOR (IGF)-I
    Abstract: Western style diets and lifestyles are associated with increasing rates of obesity, diabetes and insulin resistance. Higher circulating insulin levels may modulate cell proliferation and apoptosis either directly or indirectly by increasing the bioactivity of IGF-I and decreasing the bioactivity of some of its binding proteins. The objective of this study was to determine the association of increasing levels of serum C-peptide, a biomarker of pancreatic insulin secretion, and IGF binding proteins (IGFBP) -1 and -2 with colorectal cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 Western European countries. A total of 1,078 colorectal cancer cases were matched (age, date of blood donation, fasting status, gender, study center) to an equal number of control subjects. Relative cancer risks were estimated using conditional logistic regression models. Serum C-peptide concentration was positively associated with an increased colorectal cancer risk for the highest versus the lowest quintile (OR = 1.56, 95% CI = 1.16-2.09, p(trend) 〈 0.01), which was slightly attenuated after adjustment for BMI and physical activity (OR = 1.37, 95% CI = 1.00-1.88, p(trend) = 0.10). When stratified by anatomical site, the cancer risk was stronger in the colon (OR 1.67, 95% CI = 1.14-2.46, p(trend) 〈 0.01) than in the rectum (OR 1.42, 95% CI = 0.90-2.25, p(trend) = 0.35). The cancer risk estimates were not heterogeneous by gender or fasting status. No clear colorectal cancer risk associations were observed for IGFBP-1 or -2. This large prospective study confirms that hyperinsulinemia, as determined by C-peptide levels, is associated with an increased colorectal cancer risk. (C) 2007 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 17372899
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  • 8
    Keywords: CANCER ; Germany ; human ; MODEL ; MODELS ; SUPPORT ; COHORT ; DEATH ; DISEASE ; MORTALITY ; POPULATION ; RISK ; RISKS ; PATIENT ; ASSOCIATION ; prevention ; MULTIVARIATE ; DIET ; CONSUMPTION ; nutrition ; QUESTIONNAIRE ; EUROPE ; RELATIVE RISK ; REGRESSION ; CARDIOVASCULAR-DISEASE ; ISCHEMIC-STROKE ; PHYSICAL-ACTIVITY ; CORONARY-HEART-DISEASE ; METAANALYSIS ; USA ; cardiovascular ; DEATHS ; COMPETING RISKS
    Abstract: We examined the associations of intake of vegetables, legumes and fruit with all-cause and cause-specific mortality in a population with prevalent diabetes in Europe. A cohort of 10,449 participants with self-reported diabetes within the European Prospective Investigation into Cancer and Nutrition study was followed for a mean of 9 y. Intakes of vegetables, legumes, and fruit were assessed at baseline between 1992 and 2000 using validated country-specific questionnaires. A total of 1346 deaths occurred. Multivariate relative risks (RR) for all-cause mortality were estimated in Cox regression models and FIR for cause-specific mortality were derived in a competing risk model. An increment in intake of total vegetables, legumes, and fruit of 80 g/d was associated with a RR of death from all causes of 0.94 [95% CI 0.90-0.98]. Analyzed separately, vegetables and legumes were associated with a significantly reduced risk, whereas nonsignificant inverse associations for fruit intake were observed. Cardiovascular disease (CVD) mortality and mortality due to non-CVD/non-cancer causes were significantly inversely associated with intake of total vegetables, legumes, and fruit (RR 0.88 [95% CI 0.81-0.95] and 0.90 [0.82-0.99], respectively) but not cancer mortality 0.08 [0.99-1.17]). Intake of vegetables, legumes, and fruit was associated with reduced risks of all-cause and CVD mortality in a diabetic population. The findings support the current state of evidence from general population studies that the protective potential of vegetable and fruit intake is larger for CVD than for cancer and suggest that diabetes patients may benefit from a diet high in vegetables and fruits
    Type of Publication: Journal article published
    PubMed ID: 18356334
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  • 9
    Keywords: CANCER ; Germany ; LUNG ; MODEL ; LUNG-CANCER ; COHORT ; MORTALITY ; RISK ; WOMEN ; CIGARETTE-SMOKING ; MEN ; smoking ; POPULATIONS ; DIET ; NETHERLANDS ; nutrition ; EUROPE ; INEQUALITIES ; prospective ; EUROPEAN COUNTRIES ; CANCER-RISK ; nonsmokers ; SOCIOECONOMIC-STATUS ; SOCIAL-CLASS ; INVESTIGATE ; 11 EUROPEAN COUNTRIES
    Abstract: Studies in many countries have reported higher lung cancer incidence and mortality in individuals with lower socioeconomic status. To investigate the role of smoking in these inequalities, we used data from 391 251 participants in the European Prospective Investigation into Cancer and Nutrition study, a cohort of individuals in 10 European countries. We collected information on smoking (history and quantity), fruit and vegetable consumption, and education through questionnaires at study entry and gathered data on lung cancer incidence for a mean of 8.4 years. Socioeconomic status was defined as the highest attained level of education, and participants were grouped by sex and region of residence (Northern Europe, Germany, or Southern Europe). Relative indices of inequality (RIIs) of lung cancer risk unadjusted and adjusted for smoking were estimated using Cox regression models. Additional analyses were performed by histological type. During the study period, 939 men and 692 women developed lung cancer. Inequalities in lung cancer risk (RIImen = 3.62, 95% confidence interval [CI] = 2.77 to 4.73, 117 vs 52 per 100 000 person-years for lowest vs highest education level; RIIwomen = 2.39, 95% CI = 1.77 to 3.21, 46 vs 25 per 100 000 person-years) decreased after adjustment for smoking but remained statistically significant (RIImen = 2.29, 95% CI = 1.75 to 3.01; RIIwomen = 1.59, 95% CI = 1.18 to 2.13). Large RIIs were observed among men and women in Northern European countries and among men in Germany, but inequalities in lung cancer risk were reverse (RIIs 〈 1) among women in Southern European countries. Inequalities differed by histological type. Adjustment for smoking reduced inequalities similarly for all histological types and among men and women in all regions. In all analysis, further adjustment for fruit and vegetable consumption did not change the estimates. Self-reported smoking consistently explains approximately 50% of the inequalities in lung cancer risk due to differences in education
    Type of Publication: Journal article published
    PubMed ID: 19244178
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  • 10
    Keywords: CANCER ; Germany ; FOLLOW-UP ; COHORT ; cohort study ; DISEASE ; RISK ; ASSOCIATION ; POLYMORPHISMS ; LYMPHOMA ; AGE ; WOMEN ; MEN ; risk factors ; RISK FACTOR ; EPIC ; nutrition ; TRENDS ; education ; MULTIPLE-MYELOMA ; NON-HODGKINS-LYMPHOMA ; ONCOLOGY ; LYMPHOMAS ; prospective ; B-CELL ; SUBGROUPS ; SES ; non-Hodgkin
    Abstract: Lymphomas belong to the few cancer sites with increasing incidence over past decades, and only a few risk factors have been established. We explored the association between education and the incidence of lymphoma in the prospective EPIC study. Within 3,567,410 person-years of follow-up, 1,319 lymphoma cases [1,253 non-Hodgkin lymphomas (NHL) and 66 Hodgkin lymphomas (HL)] were identified. Cox proportional hazard regression was used to examine the association between highest educational level (primary school or less, technical/professional school, secondary school, university) and lymphoma risk. Overall, no consistent associations between educational level and lymphoma risk were observed; however, associations were found for sub-groups of the cohort. We observed a higher risk of B-NHL (HR = 1.31, 95% CI = 1.02-1.68; n = 583) in women with the highest education level (university) but not in men. Concerning sub-classes of B-NHL, a positive association between education and risk of B cell chronic lymphatic leukaemia (BCLL) was observed only in women. In both genders, the risk of diffuse large B cell lymphoma (DLBCL) was significantly lower for subjects with university degree (HR = 0.46, 95% CI = 0.27-0.79) versus lowest educational level. No association was found for HL. We could not confirm an overall consistent association of education and risk of HL or NHL in this large prospective study; although, education was positively related to the incidence of BCLL and B-NHL (in women) but inversely to incidence of DLBCL. Due to limited number of cases in sub-classes and the large number of comparisons, the possibility of chance findings can not be excluded
    Type of Publication: Journal article published
    PubMed ID: 19582474
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