Imperial College London
Alternate

Heather Ward

Faculty of Medicine, School of Public Health

Honorary Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 5081heather.ward

 
 
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Location

 

150Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Macciotta:2023:10.1158/1055-9965.EPI-22-0777,
author = {Macciotta, A and Catalano, A and Giraudo, MT and Weiderpass, E and Ferrari, P and Freisling, H and Colorado-Yohar, SM and Santiuste, C and Amiano, P and Heath, AK and Ward, HA and Christakoudi, S and Vineis, P and Singh, D and Vaccarella, S and Schulze, MB and Hiensch, AE and Monninkhof, EM and Katzke, V and Kaaks, R and Tumino, R and Lazzarato, F and Milani, L and Agudo, A and Dahm, CC and Baglietto, L and Perduca, V and Severi, G and Grioni, S and Panico, S and Ardanaz, E and Benjaminsen, Borch K and Benebo, FO and Braaten, T and Sánchez, M-J and Giachino, C and Sacerdote, C and Ricceri, F},
doi = {10.1158/1055-9965.EPI-22-0777},
journal = {Cancer Epidemiology, Biomarkers and Prevention},
pages = {132--140},
title = {Mediating role of lifestyle behaviours in the association between education and cancer: results from the European Prospective Investigation into Cancer and Nutrition.},
url = {http://dx.doi.org/10.1158/1055-9965.EPI-22-0777},
volume = {32},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Many studies have shown that socioeconomic position (SEP) is associated with the incidence of malignant tumors at different sites. This study aims to estimate the association between educational level (as proxy for SEP) and cancer incidence and to understand if the observed associations might be partially explained by lifestyle behaviors. METHODS: The analyses were performed on data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, globally and by sex. We used Cox proportional hazards models together with mediation analysis to disentangle the total effect (TE) of educational level (measured through the Relative Index of Inequality (RII)) on cancer incidence into pure direct (PDE) and total indirect (TIE) effect, unexplained and explained by mediators, respectively. PDE and TIE were then combined to compute the proportions mediated (PM). RESULTS: After an average of 14 years of follow-up, 52,422 malignant tumors were ascertained. Low educated participants showed higher risk of developing stomach, lung, kidney (in women), and bladder (in men) cancers, and, conversely, lower risk of melanoma and breast cancer (in post-menopausal women), when compared to more educated participants. Mediation analyses showed that portions of the total effect of RII on cancer could be explained by site-specific related lifestyle behaviors for stomach, lung, and breast (in women). CONCLUSIONS: Cancer incidence in Europe is determined at least in part by a socioeconomically stratified distribution of risk factors. IMPACT: These observational findings support policies to reduce cancer occurrence by altering mediators, such as lifestyle behaviors, particularly focusing on underprivileged strata of the population.
AU  - Macciotta,A
AU  - Catalano,A
AU  - Giraudo,MT
AU  - Weiderpass,E
AU  - Ferrari,P
AU  - Freisling,H
AU  - Colorado-Yohar,SM
AU  - Santiuste,C
AU  - Amiano,P
AU  - Heath,AK
AU  - Ward,HA
AU  - Christakoudi,S
AU  - Vineis,P
AU  - Singh,D
AU  - Vaccarella,S
AU  - Schulze,MB
AU  - Hiensch,AE
AU  - Monninkhof,EM
AU  - Katzke,V
AU  - Kaaks,R
AU  - Tumino,R
AU  - Lazzarato,F
AU  - Milani,L
AU  - Agudo,A
AU  - Dahm,CC
AU  - Baglietto,L
AU  - Perduca,V
AU  - Severi,G
AU  - Grioni,S
AU  - Panico,S
AU  - Ardanaz,E
AU  - Benjaminsen,Borch K
AU  - Benebo,FO
AU  - Braaten,T
AU  - Sánchez,M-J
AU  - Giachino,C
AU  - Sacerdote,C
AU  - Ricceri,F
DO  - 10.1158/1055-9965.EPI-22-0777
EP  - 140
PY  - 2023///
SN  - 1055-9965
SP  - 132
TI  - Mediating role of lifestyle behaviours in the association between education and cancer: results from the European Prospective Investigation into Cancer and Nutrition.
T2  - Cancer Epidemiology, Biomarkers and Prevention
UR  - http://dx.doi.org/10.1158/1055-9965.EPI-22-0777
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36306379
UR  - https://aacrjournals.org/cebp/article/doi/10.1158/1055-9965.EPI-22-0777/711656/Mediating-Role-of-Lifestyle-Behaviors-in-the
UR  - http://hdl.handle.net/10044/1/101166
VL  - 32
ER  -
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