Publications
292 results found
Scoccianti C, Key TJ, Anderson AS, et al., 2015, European Code against Cancer 4th Edition: Breastfeeding and cancer, Cancer Epidemiology, Vol: 39, Pages: S101-S106, ISSN: 1877-7821
Breast cancer is the most frequent cancer in women, and incidence rates have been rising in EuropeanUnion (EU) countries over recent decades due in part to a sharp decline in breastfeeding practices. Evidencefor a protective association between breastfeeding and the risk of breast cancer at all ages is convincing, andmodest protective relationships between breastfeeding and the risk of endometrial and ovarian cancershave been suggested. The reduction in breast cancer risk is estimated at 2% for an increase of 5 months oflifetime breastfeeding. The longer women breastfeed, the more they are protected against breast cancer. Inaddition, breastfeeding is associated with several health benefits for both the mother and the breastfedchild. Taking all this evidence into account, the 4th edition of the European Code against Cancerrecommends: ‘‘Breastfeeding reduces the mother’s cancer risk. If you can, breastfeed your baby’’.
Scoccianti C, Cecchini M, Anderson AS, et al., 2015, European Code against cancer 4th edition: alcohol drinking and cancer, Cancer Epidemiology, Vol: 39, Pages: S67-S74, ISSN: 1877-7821
Alcohol consumption is the third leading risk factor for disease and mortality in Europe. The International Agency for Research on Cancer (IARC) Monographs provide strengthened evidence that the consumption of alcoholic beverages is causally associated with cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast, even for low and moderate alcohol intakes. The risk of cancer increases in a dose-dependent manner, and the higher the amount of alcohol consumed, the higher the risk of developing cancer. Several biological mechanisms explain the carcinogenicity of alcohol; among them, ethanol and its genotoxic metabolite acetaldehyde play a major role. Taking all this evidence into account, a recommendation of the 4th edition of the European Code against Cancer (ECAC) is: “If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention.”
Kuijsten A, Aune D, Schulze MB, et al., 2015, Dietary fibre and incidence of type 2 diabetes in eight European countries: the EPIC-InterAct Study and a meta-analysis of prospective studies, Diabetologia, Vol: 58, Pages: 1394-1408, ISSN: 0012-186X
Aims/hypothesis: Intake of dietary fibre has been associated with a reduced risk of type 2 diabetes, but few European studies have been published on this. We evaluated the association between intake of dietary fibre and type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study and in a meta-analysis of prospective studies. Methods: During 10.8 years of follow-up, 11,559 participants with type 2 diabetes were identified and a subcohort of 15,258 participants was selected for the case-cohort study. Country-specific HRs were estimated using Prentice-weighted Cox proportional hazards models and were pooled using a random effects meta-analysis. Eighteen other cohort studies were identified for the meta-analysis. Results: In the EPIC-InterAct Study, dietary fibre intake was associated with a lower risk of diabetes (HR<inf>Q4 vs Q1</inf> 0.82; 95% CI 0.69, 0.97) after adjustment for lifestyle and dietary factors. Similar inverse associations were observed for the intake of cereal fibre and vegetable fibre, but not fruit fibre. The associations were attenuated and no longer statistically significant after adjustment for BMI. In the meta-analysis (19 cohorts), the summary RRs per 10 g/day increase in intake were 0.91 (95% CI 0.87, 0.96) for total fibre, 0.75 (95% CI 0.65, 0.86) for cereal fibre, 0.95 (95% CI 0.87, 1.03) for fruit fibre and 0.93 (95% CI 0.82, 1.05) for vegetable fibre. Conclusions/interpretation: The overall evidence indicates that the intake of total and cereal fibre is inversely related to the risk of type 2 diabetes. The results of the EPIC-InterAct Study suggest that the association may be partially explained by body weight.
Heine-Broering RC, Winkels RM, Renkema JMS, et al., 2015, Dietary supplement use and colorectal cancer risk: A systematic review and meta-analyses of prospective cohort studies, INTERNATIONAL JOURNAL OF CANCER, Vol: 136, Pages: 2388-2401, ISSN: 0020-7136
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- Citations: 75
Romaguera D, Ward H, Wark PA, et al., 2015, Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study, BMC Medicine, Vol: 13, ISSN: 1741-7015
Chan DSM, Norat T, 2015, Obesity and Breast Cancer: Not Only a Risk Factor of the Disease, CURRENT TREATMENT OPTIONS IN ONCOLOGY, Vol: 16, ISSN: 1527-2729
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- Citations: 56
Bamia C, Lagiou P, Jenab M, et al., 2015, Fruit and vegetable consumption in relation to hepatocellular carcinoma in a multi-centre, European cohort study, British Journal of Cancer, Vol: 112, Pages: 1273-1282, ISSN: 0007-0920
Vegetable and/or fruit intakes in association with hepatocellular carcinoma (HCC) risk have been investigated in case–control studies conducted in specific European countries and cohort studies conducted in Asia, with inconclusive results. No multi-centre European cohort has investigated the indicated associations.methods: In 486 799 men/women from the European Prospective Investigation into Cancer and nutrition, we identified 201 HCC cases after 11 years median follow-up. We calculated adjusted hazard ratios (HRs) for HCC incidence for sex-specific quintiles and per 100 g d−1 increments of vegetable/fruit intakes.results: Higher vegetable intake was associated with a statistically significant, monotonic reduction of HCC risk: HR (100 g d−1 increment): 0.83; 95% CI: 0.71–0.98. This association was consistent in sensitivity analyses with no apparent heterogeneity across strata of HCC risk factors. Fruit intake was not associated with HCC incidence: HR (100 g d−1 increment): 1.01; 95% CI: 0.92–1.11.conclusions: Vegetable, but not fruit, intake is associated with lower HCC risk with no evidence for heterogeneity of this association in strata of important HCC risk factors. Mechanistic studies should clarify pathways underlying this association. Given that HCC prognosis is poor and that vegetables are practically universally accessible, our results may be important, especially for those at high risk for the disease.
Ekelund U, Ward HA, Norat T, et al., 2015, Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC), American Journal of Clinical Nutrition, Vol: 101, Pages: 613-621, ISSN: 0002-9165
Background: The higher risk of death resulting from excess adiposity may be attenuated by physical activity (PA). However, the theoretical number of deaths reduced by eliminating physical inactivity compared with overall and abdominal obesity remains unclear.Objective: We examined whether overall and abdominal adiposity modified the association between PA and all-cause mortality and estimated the population attributable fraction (PAF) and the years of life gained for these exposures.Design: This was a cohort study in 334,161 European men and women. The mean follow-up time was 12.4 y, corresponding to 4,154,915 person-years. Height, weight, and waist circumference (WC) were measured in the clinic. PA was assessed with a validated self-report instrument. The combined associations between PA, BMI, and WC with mortality were examined with Cox proportional hazards models, stratified by center and age group, and adjusted for sex, education, smoking, and alcohol intake. Center-specific PAF associated with inactivity, body mass index (BMI; in kg/m2) (>30), and WC (≥102 cm for men, ≥88 cm for women) were calculated and combined in random-effects meta-analysis. Life-tables analyses were used to estimate gains in life expectancy for the exposures.Results: Significant interactions (PA × BMI and PA × WC) were observed, so HRs were estimated within BMI and WC strata. The hazards of all-cause mortality were reduced by 16–30% in moderately inactive individuals compared with those categorized as inactive in different strata of BMI and WC. Avoiding all inactivity would theoretically reduce all-cause mortality by 7.35% (95% CI: 5.88%, 8.83%). Corresponding estimates for avoiding obesity (BMI >30) were 3.66% (95% CI: 2.30%, 5.01%). The estimates for avoiding high WC were similar to those for physical inactivity.Conclusion: The greatest reductions in mortality risk were observed between the 2 lowest activity groups across levels of general and abdominal adi
Aune D, Rosenblatt DAN, Chan DSM, et al., 2015, Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies, AMERICAN JOURNAL OF CLINICAL NUTRITION, Vol: 101, Pages: 87-117, ISSN: 0002-9165
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- Citations: 188
Vieira AR, Vingeliene S, Chan DSM, et al., 2015, Fruits, vegetables, and bladder cancer risk: a systematic review and meta-analysis, CANCER MEDICINE, Vol: 4, Pages: 136-146, ISSN: 2045-7634
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- Citations: 51
Fassier P, Latino-Martel P, His M, et al., 2015, Cholesterol and breast cancer risk: a systematic review and meta-analysis of prospective studies, ANNALS OF NUTRITION AND METABOLISM, Vol: 67, Pages: 324-325, ISSN: 0250-6807
Roswall N, Freisling H, Bueno-de-Mesquita HBA, et al., 2014, Anthropometric measures and bladder cancer risk: A prospective study in the EPIC cohort, INTERNATIONAL JOURNAL OF CANCER, Vol: 135, Pages: 2918-2929, ISSN: 0020-7136
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- Citations: 22
Ferrari P, Licaj I, Muller DC, et al., 2014, Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study, BMJ Open, Vol: 4, ISSN: 2044-6055
Objectives: To investigate the role of factors thatmodulate the association between alcohol and mortality,and to provide estimates of absolute risk of death.Design: The European Prospective Investigation intoCancer and nutrition (EPIC).Setting: 23 centres in 10 countries.Participants: 380 395 men and women, free ofcancer, diabetes, heart attack or stroke at enrolment,followed up for 12.6 years on average.Main outcome measures: 20 453 fatal events, ofwhich 2053 alcohol-related cancers (ARC, includingcancers of upper aerodigestive tract, liver, colorectal andfemale breast), 4187 cardiovascular diseases/coronaryheart disease (CVD/CHD), 856 violent deaths andinjuries. Lifetime alcohol use was assessed atrecruitment.Results: HRs comparing extreme drinkers (≥30 g/dayin women and ≥60 g/day in men) to moderate drinkers(0.1–4.9 g/day) were 1.27 (95% CI 1.13 to 1.43) inwomen and 1.53 (1.39 to 1.68) in men. Strongassociations were observed for ARC mortality, in menparticularly, and for violent deaths and injuries, in menonly. No associations were observed for CVD/CHDmortality among drinkers, whereby HRs were higher innever compared to moderate drinkers. Overall mortalityseemed to be more strongly related to beer than wineuse, particularly in men. The 10-year risks of overalldeath for women aged 60 years, drinking more than30 g/day was 5% and 7%, for never and currentsmokers, respectively. Corresponding figures in menconsuming more than 60 g/day were 11% and 18%, innever and current smokers, respectively. In competingrisks analyses, mortality due to CVD/CHD was morepronounced than ARC in men, while CVD/CHD and ARCmortality were of similar magnitude in women.Conclusions: In this large European cohort, alcohol usewas positively associated with overall mortality, ARC andviolent death and injuries, but marginally to CVD/CHD.Absolute risks of death observed in EPIC suggest thatalcohol is an important determinant of total mortality.
Aune D, Norat T, Vatten LJ, 2014, Body mass index and the risk of gout: a systematic review and dose-response meta-analysis of prospective studies, EUROPEAN JOURNAL OF NUTRITION, Vol: 53, Pages: 1591-1601, ISSN: 1436-6207
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- Citations: 51
Fedirko V, Romieu I, Aleksandrova K, et al., 2014, Pre-diagnostic anthropometry and survival after colorectal cancer diagnosis in Western European populations, INTERNATIONAL JOURNAL OF CANCER, Vol: 135, Pages: 1949-1960, ISSN: 0020-7136
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- Citations: 39
Aleksandrova K, Pischon T, Jenab M, et al., 2014, Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study, BMC Medicine, Vol: 12, ISSN: 1741-7015
Background: Excess body weight, physical activity, smoking, alcohol consumption and certain dietary factors areindividually related to colorectal cancer (CRC) risk; however, little is known about their joint effects. The aim of thisstudy was to develop a healthy lifestyle index (HLI) composed of five potentially modifiable lifestyle factors –healthy weight, physical activity, non-smoking, limited alcohol consumption and a healthy diet, and to explore theassociation of this index with CRC incidence using data collected within the European Prospective Investigation intoCancer and Nutrition (EPIC) cohort.Methods: In the EPIC cohort, a total of 347,237 men and women, 25- to 70-years old, provided dietary and lifestyleinformation at study baseline (1992 to 2000). Over a median follow-up time of 12 years, 3,759 incident CRC caseswere identified. The association between a HLI and CRC risk was evaluated using Cox proportional hazardsregression models and population attributable risks (PARs) have been calculated.Results: After accounting for study centre, age, sex and education, compared with 0 or 1 healthy lifestyle factors,the hazard ratio (HR) for CRC was 0.87 (95% confidence interval (CI): 0.44 to 0.77) for two factors, 0.79 (95% CI: 0.70to 0.89) for three factors, 0.66 (95% CI: 0.58 to 0.75) for four factors and 0.63 (95% CI: 0.54 to 0.74) for five factors;P-trend <0.0001. The associations were present for both colon and rectal cancers, HRs, 0.61 (95% CI: 0.50 to 0.74; Pfor trend <0.0001) for colon cancer and 0.68 (95% CI: 0.53 to 0.88; P-trend <0.0001) for rectal cancer, respectively(P-difference by cancer sub-site = 0.10). Overall, 16% of the new CRC cases (22% in men and 11% in women) wereattributable to not adhering to a combination of all five healthy lifestyle behaviours included in the index.Conclusions: Combined lifestyle factors are associated with a lower incidence of CRC in European populationscharacterized by western lifestyles. Prevention str
Chan DSM, Vieira AR, Aune D, et al., 2014, Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies, ANNALS OF ONCOLOGY, Vol: 25, Pages: 1901-1914, ISSN: 0923-7534
Fedirko V, Riboli E, Norat T, et al., 2014, Prediagnostic smoking, alcohol intake, physical activity and survival after colorectal cancer diagnosis in Western European populations, 105th Annual Meeting of the American-Association-for-Cancer-Research (AACR), Publisher: AMER ASSOC CANCER RESEARCH, ISSN: 0008-5472
Aune D, Navarro Rosenblatt DA, Chan DS, et al., 2014, Anthropometric factors and ovarian cancer risk: A systematic review and nonlinear dose-response meta-analysis of prospective studies., Int J Cancer
In the World Cancer Research Fund/American Institute for Cancer Research report from 2007 the evidence relating body fatness to ovarian cancer risk was considered inconclusive, while the evidence supported a probably causal relationship between adult attained height and increased risk. Several additional cohort studies have since been published, and therefore we conducted an updated meta-analysis of the evidence as part of the Continuous Update Project. We searched PubMed and several other databases up to 20th of August 2014. Summary relative risks (RRs) were calculated using a random effects model. The summary relative risk for a 5-U increment in BMI was 1.07 (95% CI: 1.03-1.11, I2 = 54%, n = 28 studies). There was evidence of a nonlinear association, pnonlinearity < 0.0001, with risk increasing significantly from BMI∼28 and above. The summary RR per 5 U increase in BMI in early adulthood was 1.12 (95% CI: 1.05-1.20, I2 = 0%, pheterogeneity = 0.54, n = 6), per 5 kg increase in body weight was 1.03 (95% CI: 1.02-1.05, I2 = 0%, n = 4) and per 10 cm increase in waist circumference was 1.06 (95% CI: 1.00-1.12, I2 = 0%, n = 6). No association was found for weight gain, hip circumference or waist-to-hip ratio. The summary RR per 10 cm increase in height was 1.16 (95% CI: 1.11-1.21, I2 = 32%, n = 16). In conclusion, greater body fatness as measured by body mass index and weight are positively associated risk of ovarian cancer, and in addition, greater height is associated with increased risk. Further studies are needed to clarify whether abdominal fatness and weight gain is associated with risk.
Abete I, Romaguera D, Vieira AR, et al., 2014, Association between total, processed, red and white meat consumption and all-cause, CVD and IHD mortality: a meta-analysis of cohort studies, BRITISH JOURNAL OF NUTRITION, Vol: 112, Pages: 762-775, ISSN: 0007-1145
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- Citations: 293
Dossus L, Boutron-Ruault M-C, Kaaks R, et al., 2014, Active and passive cigarette smoking and breast cancer risk: Results from the EPIC cohort, INTERNATIONAL JOURNAL OF CANCER, Vol: 134, Pages: 1871-1888, ISSN: 0020-7136
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- Citations: 98
Druesne-Pecollo N, Keita Y, Touvier M, et al., 2014, Alcohol Drinking and Second Primary Cancer Risk in Patients with Upper Aerodigestive Tract Cancers: A Systematic Review and Meta-analysis of Observational Studies, CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, Vol: 23, Pages: 324-331, ISSN: 1055-9965
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- Citations: 49
Aune D, Norat T, Romundstad P, et al., 2014, Breastfeeding and the maternal risk of type 2 diabetes: A systematic review and doseeresponse meta-analysis of cohort studies, NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES, Vol: 24, Pages: 107-115, ISSN: 0939-4753
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- Citations: 118
Bisschop CNS, van Gils CH, Emaus MJ, et al., 2014, Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study, AMERICAN JOURNAL OF CLINICAL NUTRITION, Vol: 99, Pages: 139-147, ISSN: 0002-9165
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- Citations: 33
Norat T, Aune D, Chan D, et al., 2014, Fruits and Vegetables: Updating the Epidemiologic Evidence for the WCRF/AICR Lifestyle Recommendations for Cancer Prevention, ADVANCES IN NUTRITION AND CANCER, Vol: 159, Pages: 35-50, ISSN: 0927-3042
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- Citations: 97
Ekelund U, Ward H, Luan J, et al., 2013, Physical Activity, General and Abdominal Obesity and Mortality in European Men and Women, Scientific Sessions and Resuscitation Science Symposium of the American-Heart-Association, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322
Aune D, Norat T, Romundstad P, et al., 2013, Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies, EUROPEAN JOURNAL OF EPIDEMIOLOGY, Vol: 28, Pages: 845-858, ISSN: 0393-2990
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- Citations: 368
Chuang S-C, Rota M, Gunter MJ, et al., 2013, Quantifying the Dose-Response Relationship Between Circulating Folate Concentrations and Colorectal Cancer in Cohort Studies: A Meta-Analysis Based on a Flexible Meta-Regression Model, AMERICAN JOURNAL OF EPIDEMIOLOGY, Vol: 178, Pages: 1028-1037, ISSN: 0002-9262
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- Citations: 15
Aune D, Norat T, Romundstad P, et al., 2013, Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies, AMERICAN JOURNAL OF CLINICAL NUTRITION, Vol: 98, Pages: 1066-1083, ISSN: 0002-9165
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- Citations: 311
Murphy N, Norat T, Ferrari P, et al., 2013, Consumption of Dairy Products and Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC), PLOS ONE, Vol: 8, ISSN: 1932-6203
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- Citations: 69
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