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  • cancer risk  (41)
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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: ENERGIES ; CANCER ; MODEL ; COHORT ; EPIDEMIOLOGY ; POPULATION ; RISK ; colon ; ASSOCIATION ; ACID ; ACIDS ; NO ; hormone ; ENERGY ; AGE ; WOMEN ; colorectal cancer ; MEN ; smoking ; COLORECTAL-CANCER ; COUNTRIES ; PROSTATE-CANCER ; cancer risk ; FIBER ; FRANCE ; COLON-CANCER ; MULTIVARIATE ; fatty acids ; FATTY-ACIDS ; DIETARY ; CANCER-RESEARCH ; CONSUMPTION ; European Prospective Investigation into Cancer and Nutrition ; FRUIT ; nutrition ; QUESTIONNAIRE ; CALIBRATION ; FOOD ; ASSOCIATIONS ; colon cancer ; WEIGHT ; CORONARY-HEART-DISEASE ; DIETARY-INTAKE MEASUREMENTS ; EPIC PROJECT ; HEIGHT
    Abstract: A link between unsaturated fatty acids or phytonutrients and reduced risk of colorectal cancer has been suggested. However, the effects of higher intake of dietary sources of these nutrients, such as the nuts and seeds food group, are less clear. The objective of this study was to determine the effects of nut and seed intake on colorectal cancer risk within the European Prospective Investigation into Cancer and Nutrition study, a large prospective cohort study involving 10 European countries. Total nut and seed intake was determined from country-specific dietary questionnaires. The data set included 478,040 subjects (141,988 men, 336,052 women) with a total of 855 (327 men, 528 women) colon and 474 (215 men, 259 women) rectal cancer cases. A multivariate Cox proportional hazards model, stratified by center and controlled for fruit intake, dietary fiber, energy, height, weight, sex, age, physical activity, and smoking, was used. The data show no association between higher intake of nuts and seeds and risk of colorectal, colon, and rectal cancers in men and women combined, but a significant inverse association was observed in subgroup analyses for colon cancer in women at the highest (〉6.2 g/d) versus the lowest (nonconsumers; hazard ratio, 0.69;, 95% confidence interval, 0.50-0.95) category of intake and for the linear effect of log-transformed intake (hazard ratio, 0.89; 95% confidence interval, 0.80-0.98), with no associations in men. It is not evident from this data why there may be a stronger association in women or why it may be limited to the colon, suggesting that much, further research is necessary
    Type of Publication: Journal article published
    PubMed ID: 15466975
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  • 3
    Keywords: CANCER ; BLOOD ; MODEL ; MODELS ; COHORT ; RISK ; RISKS ; PATIENT ; RISK-FACTORS ; BINDING ; CYCLE ; ASSOCIATION ; BREAST ; breast cancer ; BREAST-CANCER ; hormone ; WOMEN ; risk factors ; cancer risk ; case-control studies ; EPIC ; nutrition ; ESTRADIOL ; SERUM ; SINGLE ; DEFICIENCY ; case-control study ; ASSOCIATIONS ; RE ; MAMMARY-GLAND ; ESTROGEN ; case control studies ; INTERVAL ; TESTS ; RANDOMIZED CONTROLLED-TRIAL ; PREMENOPAUSAL WOMEN ; SERUM-LEVELS ; ADRENAL ANDROGENS ; ESTROGEN PLUS PROGESTIN ; FEMALE NOBLE RATS ; HEALTHY POSTMENOPAUSAL WOMEN ; HORMONE LEVELS ; ONE-YEAR PERIOD ; REPLACEMENT THERAPY
    Abstract: Background. Contrasting etiologic hypotheses about the role of endogenous sex steroids in breast cancer development among premenopausal women implicate ovarian androgen excess and progesterone deficiency, estrogen excess, estrogen and progesterone excess, and both an excess or lack of adrenal androgens (dehydroepiandrosterone [DHEA] or its sulfate [DHEAS]) as risk factors. We conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort to examine associations among premenopausal serum concentrations of sex steroids and subsequent breast cancer risk. Methods: Levels of DHEAS, (Delta 4-)androstenedione, testosterone, and sex hormone binding globulin (SHBG) were measured in single prediagnostic serum samples from 370 premenopausal women who subsequently developed breast cancer (case patients) and from 726 matched cancer-free control subjects. Levels of progesterone, estrone, and estradiol were also measured for the 285 case patients and 555 matched control subjects who had provided information about the day of menstrual cycle at blood donation. Conditional logistic regression models were used to estimate relative risks of breast cancer by quartiles of hormone concentrations. All statistical tests were two-sided. Results: Increased risks of breast cancer were associated with elevated serum concentrations of testosterone (odds ratio [OR] for highest versus lowest quartile = 1.73, 95% confidence interval [CI] = 1.16 to 2.57; P-trend =.01), androstenedione (OR for highest versus lowest quartile = 1.569 95% CI = 1.05 to 2.32; P-trend =.01), and DHEAS (OR for highest versus lowest quartile = 1.48, 95% CI = 1.02 to 2.14; P-trend =.10) but not SHBG. Elevated serum progesterone concentrations were associated with a statistically significant reduction in breast cancer risk (OR for highest versus lowest quartile = 0.61, 95% CI = 0.38 to 0.98; P-trend =.06). The absolute risk of breast cancer for women younger than 40 followed up for 10 years was estimated at 2.6% for those in the highest quartile of serum testosterone versus 1.5% for those in the lowest quartile; for the highest and lowest quartiles of progesterone, these estimates were 1.7% and 2.6%, respectively. Breast cancer risk was not statistically significantly associated with serum levels
    Type of Publication: Journal article published
    PubMed ID: 15900045
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  • 4
    Keywords: ENERGIES ; CANCER ; MODEL ; FOLLOW-UP ; POPULATION ; RISK ; ASSOCIATION ; hormone ; ENERGY ; AGE ; WOMEN ; colorectal cancer ; MEN ; PROSPECTIVE COHORT ; smoking ; COLORECTAL-CANCER ; cancer risk ; FISH ; FIBER ; COLON-CANCER ; DOSE-RESPONSE ; Jun ; DIET ; DIETARY ; UNITED-STATES ; ALCOHOL-CONSUMPTION ; nutrition ; ASSOCIATIONS ; RE ; ENERGY-INTAKE ; EPIC CALIBRATION ; PHYSICAL-ACTIVITY ; INTERVAL ; TESTS ; alcohol consumption ; MEAT INTAKE ; DIETARY CARCINOGENS ; GENETIC SUSCEPTIBILITY ; N-NITROSATION ; RED MEAT
    Abstract: Background. Current evidence suggests that high red meat intake is associated with increased colorectal cancer risk. High fish intake may be associated with a decreased risk, but the existing evidence is less convincing. Methods: We prospectively followed 478040 men and women from 10 European countries who were free of cancer at enrollment between 1992 and 1998. Information on diet and lifestyle was collected at baseline. After a mean follow-up of 4.8 years, 1329 incident colorectal cancers were documented. We examined the relationship between intakes of red and processed meat, poultry, and fish and colorectal cancer risk using a proportional hazards model adjusted for age, sex, energy (nonfat and fat sources), height, weight, work-related physical activity, smoking status, dietary fiber and folate, and alcohol consumption, stratified by center. A calibration substudy based on 36994 subjects was used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. All statistical tests were two-sided. Results: Colorectal cancer risk was positively associated with intake of red and processed meat (highest [〉 160 g/day] versus lowest [〈 20 g/day] intake, HR = 1.35, 95% CI = 0.96 to 1.88; P-trend = .03) and inversely associated with intake of fish (〉 80 g/day versus 〈 10 g/day, HR = 0.69, 95% CI = 0.54 to 0.88; P-trend 〈 .001), but was not related to poultry intake. Correcting for measurement error strengthened the associations between colorectal cancer and red and processed meat intake (per 100-g increase HR = 1.25, 95% CI = 1.09 to 1.41, P-trend = .001 and HR = 1.55, 95% CI = 1.19 to 2.02, P-trend = .001 before and after calibration, respectively) and for fish (per 100 g increase HR = 0.70, 95% CI = 0.57 to 0.87, P-trend 〈 .001 and HR = 0.46, 95% CI = 0.27 to 0.77, P-trend = .003; before and after correction, respectively). In this study population, the absolute risk of development of colorectal cancer within 10 years for a study subject aged 50 years was 1.71% for the highest category of red and processed meat intake and 1.28% for the lowest category of intake and was 1.86% for subjects in the lowest category of fish intake and 1.28% for subjects in the highest category of fish intake. Conclusions: Our data confirm that colorectal cancer risk is positively associated with high consumption of red and processed meat and support an inverse association with fish intake
    Type of Publication: Journal article published
    PubMed ID: 15956652
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  • 5
    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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  • 6
    Keywords: CANCER ; FOLLOW-UP ; COHORT ; EXPOSURE ; RISK ; NITRIC-OXIDE ; INFECTION ; ASSOCIATION ; antibodies ; antibody ; PLASMA ; NUMBER ; cancer risk ; DIETARY ; INDIVIDUALS ; CARDIA ; CONSUMPTION ; EPIC ; GASTRIC-CANCER ; HELICOBACTER-PYLORI ; nutrition ; DIETARY-INTAKE ; INCREASE ; IRON ; LEVEL ; prospective ; MEAT INTAKE ; RED MEAT ; CANCER-RISK ; Helicobacter pylori ; N-NITROSO COMPOUNDS ; HEME ; processed meat
    Abstract: The risk of gastric cancer (GC) associated with dietary intake of nitrosodimethylamine (NDMA) and endogenous formation of nitroso compounds (NOCs) was investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC). The study included 521 457 individuals and 314 incident cases of GC that had occurred after 6.6 average years of follow-up. An index of endogenous NOC (ENOC) formation was estimated using data of the iron content from meat intake and faecal apparent total NOC formation according to previous published studies. Antibodies to Helicobacter pylori and vitamin C levels were measured in a sub-sample of cases and matched controls included in a nested case-control within the cohort. Exposure to NDMA was 〈 1 mu g on average compared with 93 mu g on average from ENOC. There was no association between NDMA intake and GC risk (HR, 1.00; 95% CI, 0.7-1.43). ENOC was significantly associated with non-cardia cancer risk (HR, 1.42; 95% CI, 1.14-1.78 for an increase of 40 mu g/day) but not with cardia cancer (HR, 0.96; 95% CI, 0.69-1.33). Although the number of not infected cases is low, our data suggest a possible interaction between ENOC and H.pylori infection (P for interaction = 0.09). Moreover, we observed an interaction between plasma vitamin C and ENOC (P 〈 0.02). ENOC formation may account for our previously reported association between red and processed meat consumption and gastric cancer risk
    Type of Publication: Journal article published
    PubMed ID: 16571648
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  • 7
    Keywords: CANCER ; radiotherapy ; carcinoma ; human ; neoplasms ; DIAGNOSIS ; RISK ; PATIENT ; kidney ; RISK-FACTORS ; CARCINOGENESIS ; colon ; ASSOCIATION ; BREAST ; LYMPHOMA ; AGE ; OVARIAN-CANCER ; risk factors ; CERVICAL-CANCER ; RATES ; cancer risk ; REGISTRATION ; CANCER-PATIENTS ; adenocarcinoma ; TOBACCO ; pancreatic cancer ; LONG-TERM SURVIVORS ; YOUNG ; REGISTRY ; REPRODUCTIVE FACTORS ; ASSOCIATIONS ; ENDOMETRIAL ; PANCREATIC-CANCER ; cancer registries ; TESTICULAR CANCER ; LYMPHOMAS ; cancer registry ; pooled analysis ; RISK-FACTOR ; CANCERS ; REGISTRIES ; CANCER-DIAGNOSIS ; pancreatic neoplasms ; MALIGNANT NEOPLASMS ; neoplasms,second primary
    Abstract: Studies of pancreatic cancer in the setting of second primary malignant neoplasms can provide etiologic clues. An international multicenter study was carried out using data from 13 cancer registries with a registration period up to year 2000. Cancer patients were followed up from the initial cancer diagnosis, and the occurrence of second primary malignant neoplasms was compared with expected values derived from local rates, adjusting for age, sex, and period of diagnosis. Results from individual registries were pooled by use of a fixed-effects model. People were at higher risk of developing pancreatic cancer within 10 years of a diagnosis of cancers of the pharynx, stomach, gallbladder, larynx, lung, cervix, corpus uteri, bladder, and eye and 10 years or later following a diagnosis of cancers of the stomach, colon, gallbladder, breast, cervix, placenta, corpus uteri, ovary, testis, bladder, kidney, and eye, as well as Hodgkin's and non-Hodgkin's lymphomas. Pancreatic cancer was connected with smoking-related cancers, confirming the etiologic role of tobacco. The associations with uterine and ovarian cancers suggest that reproductive factors might be implicated in pancreatic carcinogenesis. The elevated pancreatic cancer risk in young patients observed among several types of cancer implies a role of genetic factors. Radiotherapy is also suggested as a risk factor
    Type of Publication: Journal article published
    PubMed ID: 16421239
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  • 8
    Keywords: CANCER ; MODEL ; MODELS ; FOLLOW-UP ; RISK ; METABOLISM ; INDEX ; CARCINOGENESIS ; ASSOCIATION ; BREAST-CANCER ; NO ; hormone ; PLASMA ; NUMBER ; WOMEN ; OBESITY ; cancer risk ; ORAL-CONTRACEPTIVES ; cholesterol ; LIPOPROTEIN ; LOW-DENSITY-LIPOPROTEIN ; case-control studies ; ABNORMALITIES ; BODY ; DIABETES-MELLITUS ; EPIC ; European Prospective Investigation into Cancer and Nutrition ; nutrition ; ENDOMETRIAL CANCER ; RELATIVE RISK ; REGRESSION-MODELS ; CLUSTER ; POSTMENOPAUSAL WOMEN ; MASS INDEX ; MASSES ; BODIES ; ONCOLOGY ; case control study ; case-control study ; REGRESSION ; ASSOCIATIONS ; ENDOMETRIAL ; RE ; INCREASE ; BODY-SIZE ; PHYSICAL-ACTIVITY ; LEVEL ; case control studies ; INTERVAL ; metabolic syndrome ; HORMONES ; prospective ; UNIT ; CANCER-RISK ; C-PEPTIDE ; SET ; case control ; LOGISTIC-REGRESSION ; BODY-MASS ; BODY-MASS-INDEX ; lipid ; HDL-CHOLESTEROL ; LOW-DENSITY ; SERUM-CHOLESTEROL
    Abstract: To clarify the role of metabolic factors in endometrial carcinogenesis, we conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), and examined the relation between prediagnostic plasma lipids, lipoproteins, and glucose, the metabolic syndrome (MetS; a cluster of metabolic factors) and endometrial cancer risk. Among pre- and postmenopausal women, 284 women developed endometrial cancer during follow-up. Using risk set sampling, 546 matched control subjects were selected. From conditional logistic regression models, high-density lipoprotein cholesterol (HDL-C) levels were inversely associated with risk body mass index (BMI)-adjusted relative risk (FR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38-0.97), P-trend= 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% Cl 0.99-2.90), P-trend, = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom tertile 2.61 (95% Cl 1.46-4.66), P-trend=0.0006, P-heterogeneity=0.13) and never-users of exogenous hormones (P-heterogeneity=0-005 for oral contraceptive (OC) use and 0.05 for hormone replacement therapy-use). The associations of HDL-C and glucose with risk were no longer statistically significant after further adjustment for obesity-related hormones. Plasma total cholesterol, Low-density lipoprotein cholesterol (LDL-C), and triglycerides were not significantly related to overall risk. The presence of MetS was associated with risk (RR 2.12 (95% CI 1.51-2.97)), which increased with the number of MetS factors (P-trend=0.02). An increasing number of MetS factors other than waist circumference, however, was marginally significantly associated with risk only in women with waist circumference above the median (P-interaction=0-01). None of the associations differed significantly by fasting status. These findings suggest that metabolic abnormalities and obesity may act synergistically to increase endometrial cancer risk
    Type of Publication: Journal article published
    PubMed ID: 17914105
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  • 9
    Keywords: CANCER ; MODEL ; MODELS ; THERAPY ; FOLLOW-UP ; COHORT ; cohort studies ; EXPOSURE ; RISK ; RISKS ; INDEX ; ASSOCIATION ; NO ; hormone ; HEALTH ; WOMEN ; HORMONE REPLACEMENT THERAPY ; cancer risk ; FIBER ; MEASUREMENT ERROR ; DIET ; DIETARY ; FAT ; European Prospective Investigation into Cancer and Nutrition ; nutrition ; AUSTRALIA ; ENDOMETRIAL CANCER ; RELATIVE RISK ; dietary fiber ; insulin ; IGF-I ; ASSOCIATIONS ; ENDOMETRIAL ; THERAPIES ; ENERGY-INTAKE ; PHYSICAL-ACTIVITY ; LEVEL ; INTERVAL ; USA ; prospective ; INSULIN SENSITIVITY ; VARIABLES ; CANCER-RISK ; C-PEPTIDE ; FOODS ; Nutrition Assessment ; postmenopausal ; DIANA RANDOMIZED-TRIAL ; dietary carbohydrates ; endometrial neoplasms ; glycemic index ; IOWA WOMENS HEALTH
    Abstract: The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), including 710 incident cases diagnosed during a mean 6.4 years of follow-up. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. There were no statistically significant associations with endometrial cancer risk for increasing quartile intakes of any of the exposure variables. However, in continuous models calibrated by using 24-hour recall values, the multivariable relative risks were 1.61 (95% confidence interval: 1.06, 2.45) per 100 g/day of total carbohydrates, 1.40 (95% confidence interval: 0.99, 1.99) per 50 units/day of total dietary glycemic load, and 1.36 (95% confidence interval: 1.05, 1.76) per 50 g/day of total sugars. These associations were stronger among women who had never used postmenopausal hormone therapy compared with ever users (total carbohydrates P-heterogeneity = 0.04). Data suggest no association of overall glycemic index, total starch, and total fiber with risk, and a possible modest positive association of total carbohydrates, total dietary glycemic load, and total sugars with risk, particularly among never users of hormone replacement therapy
    Type of Publication: Journal article published
    PubMed ID: 17670911
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  • 10
    Keywords: CANCER ; carcinoma ; Germany ; FOLLOW-UP ; INFORMATION ; COHORT ; EPIDEMIOLOGY ; RISK ; INFECTION ; RISK-FACTORS ; ASSOCIATION ; HEALTH ; REDUCED RISK ; risk factors ; cancer risk ; RECRUITMENT ; DIET ; STOMACH ; adenocarcinoma ; case-control studies ; TOBACCO ; ALCOHOL ; CARDIA ; EPIC ; ESOPHAGUS ; GASTRIC-CANCER ; HELICOBACTER-PYLORI ; nutrition ; STOMACH-CANCER ; case-control study ; ASSOCIATIONS ; DIGESTIVE-TRACT ; gastric cancer ; LEVEL ; case control studies ; INTERVAL ; methods ; PROFILES ; prospective ; EVALUATE ; odds ratio ; RISK-FACTOR ; CANCER-RISK ; Helicobacter pylori ; cardia cancer ; socioeconomic position
    Abstract: Objectives To evaluate the association of socioeconomic position with adenocarcinoma of the oesophagus and stomach. Methods The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort comprises about 520000 participants mostly aged 35-70 years. Information on diet and lifestyle was collected at recruitment. After an average follow-up of 6.5 years, 268 cases with adenocarcinoma of the stomach and 56 of the oesophagus were confirmed. We examined the effect of socioeconomic position on cancer risk by means of educational data and a computed Relative Index of Inequality (RII). In a nested case-control study, adjustment for Helicobacter pylori (H. pylori) infection was performed. Results Higher education was significantly associated with a reduced risk of gastric cancer [vs lowest level of education, hazard ratio (HR): 0.64, 95% Confidence intervals (CI): 0.43-0.981. This effect was more pronounced for cancer of the cardia (HR: 0.42, 95% CI: 0.20-0.89) as compared to non-cardia gastric cancer (HR: 0.66, 95% CI: 0.36-1.22). Additionally, the inverse association of educational level and gastric cancer was stronger for cases with intestinal (extreme categories, HR: 0.13, 95% CI: 0.04-0.44) rather than diffuse histological subtype (extreme categories, HR: 0.71 95% CI: 0.37-1.40). In the nested case-control study, inverse but statistically non-significant associations were found after additional adjustment for H. pylori infection [highest vs lowest level of education: Odds ratio (OR) 0.53, 95% CI: 0.24-1.18]. Educational level was non-significantly, inversely associated with carcinoma of the oesophagus. Conclusion A higher socioeconomic position was associated with a reduced risk of gastric adenocarcinoma, which was strongest for cardia cancer or intestinal histological subtype, suggesting different risk profiles according to educational level. These effects appear to be explained only partially by established risk factors
    Type of Publication: Journal article published
    PubMed ID: 17227779
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