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Zhang X, Ilyas OS, Getz KR, Rozek LS, Taylor JMG, Chinn SB, Wolf GT, Mondul AM. Aspirin use and head and neck cancer survival and recurrence. Cancer Causes Control 2024; 35:605-609. [PMID: 37975972 DOI: 10.1007/s10552-023-01815-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/11/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Head and neck cancer (HNC) has low 5-year survival, and evidence-based recommendations for tertiary prevention are lacking. Aspirin improves outcomes for cancers at other sites, but its role in HNC tertiary prevention remains understudied. METHODS HNC patients were recruited in the University of Michigan Head and Neck Cancer Specialized Program of Research Excellence (SPORE) from 2003 to 2014. Aspirin data were collected through medical record review; outcomes (overall mortality, HNC-specific mortality, and recurrence) were collected through medical record review, Social Security Death Index, or LexisNexis. Cox proportional hazards models were used to evaluate the associations between aspirin use at diagnosis (yes/no) and HNC outcomes. RESULTS We observed no statistically significant associations between aspirin and cancer outcome in our HNC patient cohort (n = 1161) (HNC-specific mortality: HR = 0.91, 95% CI = 0.68-1.21; recurrence: HR = 0.94, 95% CI = 0.73-1.19). In analyses stratified by anatomic site, HPV status, and disease stage, we observed no association in any strata examined with the possible exception of a lower risk of recurrence in oropharynx patients (HR = 0.60, 95% CI 0.35-1.04). CONCLUSIONS Our findings do not support a protective association between aspirin use and cancer-specific death or recurrence in HNC patients, with the possible exception of a lower risk of recurrence in oropharynx patients.
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Affiliation(s)
- Xinman Zhang
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, USA
| | - Omar S Ilyas
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, USA
| | - Kayla R Getz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Laura S Rozek
- School of Medicine, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Jeremy M G Taylor
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Steven B Chinn
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor Michigan, USA
| | - Gregory T Wolf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor Michigan, USA
| | - Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, USA.
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2
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Reay WR, Kiltschewskij DJ, Di Biase MA, Gerring ZF, Kundu K, Surendran P, Greco LA, Clarke ED, Collins CE, Mondul AM, Albanes D, Cairns MJ. Genetic influences on circulating retinol and its relationship to human health. Nat Commun 2024; 15:1490. [PMID: 38374065 PMCID: PMC10876955 DOI: 10.1038/s41467-024-45779-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/04/2024] [Indexed: 02/21/2024] Open
Abstract
Retinol is a fat-soluble vitamin that plays an essential role in many biological processes throughout the human lifespan. Here, we perform the largest genome-wide association study (GWAS) of retinol to date in up to 22,274 participants. We identify eight common variant loci associated with retinol, as well as a rare-variant signal. An integrative gene prioritisation pipeline supports novel retinol-associated genes outside of the main retinol transport complex (RBP4:TTR) related to lipid biology, energy homoeostasis, and endocrine signalling. Genetic proxies of circulating retinol were then used to estimate causal relationships with almost 20,000 clinical phenotypes via a phenome-wide Mendelian randomisation study (MR-pheWAS). The MR-pheWAS suggests that retinol may exert causal effects on inflammation, adiposity, ocular measures, the microbiome, and MRI-derived brain phenotypes, amongst several others. Conversely, circulating retinol may be causally influenced by factors including lipids and serum creatinine. Finally, we demonstrate how a retinol polygenic score could identify individuals more likely to fall outside of the normative range of circulating retinol for a given age. In summary, this study provides a comprehensive evaluation of the genetics of circulating retinol, as well as revealing traits which should be prioritised for further investigation with respect to retinol related therapies or nutritional intervention.
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Affiliation(s)
- William R Reay
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia.
- Precision Medicine Research Program, Hunter Medical Research Institute, New Lambton, NSW, Australia.
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.
| | - Dylan J Kiltschewskij
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
- Precision Medicine Research Program, Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Maria A Di Biase
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- Department of Anatomy and Physiology, The University of Melbourne, Melbourne, VIC, Australia
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Zachary F Gerring
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Kousik Kundu
- Human Genetics, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Praveen Surendran
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
- Health Data Research UK, Wellcome Genome Campus and University of Cambridge, Hinxton, UK
| | - Laura A Greco
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
- Precision Medicine Research Program, Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Erin D Clarke
- School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Clare E Collins
- School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia.
- Precision Medicine Research Program, Hunter Medical Research Institute, New Lambton, NSW, Australia.
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Salvatore M, Kundu R, Shi X, Friese CR, Lee S, Fritsche LG, Mondul AM, Hanauer D, Pearce CL, Mukherjee B. To weight or not to weight? Studying the effect of selection bias in three large EHR-linked biobanks. medRxiv 2024:2024.02.12.24302710. [PMID: 38405832 PMCID: PMC10888982 DOI: 10.1101/2024.02.12.24302710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Objective To explore the role of selection bias adjustment by weighting electronic health record (EHR)-linked biobank data for commonly performed analyses. Materials and methods We mapped diagnosis (ICD code) data to standardized phecodes from three EHR-linked biobanks with varying recruitment strategies: All of Us (AOU; n=244,071), Michigan Genomics Initiative (MGI; n=81,243), and UK Biobank (UKB; n=401,167). Using 2019 National Health Interview Survey data, we constructed selection weights for AOU and MGI to be more representative of the US adult population. We used weights previously developed for UKB to represent the UKB-eligible population. We conducted four common descriptive and analytic tasks comparing unweighted and weighted results. Results For AOU and MGI, estimated phecode prevalences decreased after weighting (weighted-unweighted median phecode prevalence ratio [MPR]: 0.82 and 0.61), while UKB's estimates increased (MPR: 1.06). Weighting minimally impacted latent phenome dimensionality estimation. Comparing weighted versus unweighted PheWAS for colorectal cancer, the strongest associations remained unaltered and there was large overlap in significant hits. Weighting affected the estimated log-odds ratio for sex and colorectal cancer to align more closely with national registry-based estimates. Discussion Weighting had limited impact on dimensionality estimation and large-scale hypothesis testing but impacted prevalence and association estimation more. Results from untargeted association analyses should be followed by weighted analysis when effect size estimation is of interest for specific signals. Conclusion EHR-linked biobanks should report recruitment and selection mechanisms and provide selection weights with defined target populations. Researchers should consider their intended estimands, specify source and target populations, and weight EHR-linked biobank analyses accordingly.
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Affiliation(s)
- Maxwell Salvatore
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
| | - Ritoban Kundu
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Xu Shi
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Christopher R Friese
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
- Center for Improving Patient and Population Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
| | - Seunggeun Lee
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Graduate School of Data Science, Seoul National University, Seoul, Republic of Korea
| | - Lars G Fritsche
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - David Hanauer
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Bhramar Mukherjee
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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Marrone MT, Prizment AE, Couper D, Butler KR, Astor BC, Joshu CE, Platz EA, Mondul AM. Total-, LDL-, and HDL-cholesterol, apolipoproteins, and triglycerides with risk of total and fatal prostate cancer in Black and White men in the ARIC study. Prostate 2023. [PMID: 37154584 DOI: 10.1002/pros.24546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/21/2023] [Accepted: 04/21/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Cholesterol reduction is considered a mechanism through which cholesterol-lowering drugs including statins are associated with a reduced aggressive prostate cancer risk. While prior cohort studies found positive associations between total cholesterol and more advanced stage and grade in White men, whether associations for total cholesterol, low (LDL)- and high (HDL)-density lipoprotein cholesterol, apolipoprotein B (LDL particle) and A1 (HDL particle), and triglycerides are similar for fatal prostate cancer and in Black men, who experience a disproportionate burden of total and fatal prostate cancer, is unknown. METHODS We conducted a prospective study of 1553 Black and 5071 White cancer-free men attending visit 1 (1987-1989) of the Atherosclerosis Risk in Communities Study. A total of 885 incident prostate cancer cases were ascertained through 2015, and 128 prostate cancer deaths through 2018. We estimated multivariable-adjusted hazard ratios (HRs) of total and fatal prostate cancer per 1-standard deviation increments and for tertiles (T1-T3) of time-updated lipid biomarkers overall and in Black and White men. RESULTS Greater total cholesterol concentration (HR per-1 SD = 1.25; 95% CI = 1.00-1.58) and LDL cholesterol (HR per-1 SD = 1.26; 95% CI = 0.99-1.60) were associated with higher fatal prostate cancer risk in White men only. Apolipoprotein B was nonlinearly associated with fatal prostate cancer overall (T2 vs. T1: HR = 1.66; 95% CI = 1.05-2.64) and in Black men (HR = 3.59; 95% CI = 1.53-8.40) but not White men (HR = 1.13; 95% CI = 0.65-1.97). Tests for interaction by race were not statistically significant. CONCLUSIONS These findings may improve the understanding of lipid metabolism in prostate carcinogenesis by disease aggressiveness, and by race while emphasizing the importance of cholesterol control.
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Affiliation(s)
- Michael T Marrone
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Anna E Prizment
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota, USA
- University of Minnesota Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - David Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Kenneth R Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Brad C Astor
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
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5
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Popova LT, Abuzaitoun RO, Abalem MF, Andrews CA, Mondul AM, Lacy GD, Musch DC, Jayasundera KT. Effects of duration and number of symptoms on vision-related anxiety in patients with Inherited Retinal Diseases. Ophthalmic Genet 2023; 44:11-18. [PMID: 36440767 DOI: 10.1080/13816810.2022.2144901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with Inherited Retinal Diseases (IRDs) are at increased risk for vision-related anxiety due to progressive and irreversible vision loss, yet little is known about risk factors for anxiety in these patients. MATERIALS AND METHODS This was a single-center, retrospective cross-sectional study at a large academic center. 128 adults with an IRD and without other significant eye conditions were recruited between December 2016 and March 2020. Participants were asked about the duration and number of symptoms they had in the following vision domains: reading, contrast vision, color vision, glare/light sensitivity, night vision, and peripheral vision. The outcomes of interest were the two domains of the Michigan Vision-Related Anxiety Questionnaire (MVAQ), rod- and cone-function related anxiety. We conducted an adjusted analysis to isolate the independent effect of duration and number of symptoms on vision-related anxiety. RESULTS Of 126 participants had complete data, 62 (49%) were female and 64 (51%) were male, with an average age of 49 years (range: 18-87). Patients with duration of symptoms for greater than 25 years had an adjusted anxiety theta that was one-half standard deviations lower than patients with symptoms for less time. Patients with higher number of symptoms had higher anxiety theta after adjusting for confounding variables (p < 0.0001). CONCLUSIONS The number of symptoms but not the duration of symptoms, is an independent risk factor for vision-related anxiety. Patients with more symptoms are at higher risk for vision-related anxiety. Having symptoms for longer than 25 years may reduce this anxiety.
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Affiliation(s)
- Lilia T Popova
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA.,Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Rebhi O Abuzaitoun
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
| | - Maria Fernanda Abalem
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA.,Department of Ophthalmology and Otolaryngology, University of São Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Chris A Andrews
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Gabrielle D Lacy
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA.,Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - K Thiran Jayasundera
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, USA
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6
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Visvanathan K, Mondul AM, Zeleniuch-Jacquotte A, Wang M, Gail MH, Yaun SS, Weinstein SJ, McCullough ML, Eliassen AH, Cook NR, Agnoli C, Almquist M, Black A, Buring JE, Chen C, Chen Y, Clendenen T, Dossus L, Fedirko V, Gierach GL, Giovannucci EL, Goodman GE, Goodman MT, Guénel P, Hallmans G, Hankinson SE, Horst RL, Hou T, Huang WY, Jones ME, Joshu CE, Kaaks R, Krogh V, Kühn T, Kvaskoff M, Lee IM, Mahamat-Saleh Y, Malm J, Manjer J, Maskarinec G, Millen AE, Mukhtar TK, Neuhouser ML, Robsahm TE, Schoemaker MJ, Sieri S, Sund M, Swerdlow AJ, Thomson CA, Ursin G, Wactawski-Wende J, Wang Y, Wilkens LR, Wu Y, Zoltick E, Willett WC, Smith-Warner SA, Ziegler RG. Circulating vitamin D and breast cancer risk: an international pooling project of 17 cohorts. Eur J Epidemiol 2023; 38:11-29. [PMID: 36593337 PMCID: PMC10039648 DOI: 10.1007/s10654-022-00921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/21/2022] [Indexed: 01/04/2023]
Abstract
Laboratory and animal research support a protective role for vitamin D in breast carcinogenesis, but epidemiologic studies have been inconclusive. To examine comprehensively the relationship of circulating 25-hydroxyvitamin D [25(OH)D] to subsequent breast cancer incidence, we harmonized and pooled participant-level data from 10 U.S. and 7 European prospective cohorts. Included were 10,484 invasive breast cancer cases and 12,953 matched controls. Median age (interdecile range) was 57 (42-68) years at blood collection and 63 (49-75) years at breast cancer diagnosis. Prediagnostic circulating 25(OH)D was either newly measured using a widely accepted immunoassay and laboratory or, if previously measured by the cohort, calibrated to this assay to permit using a common metric. Study-specific relative risks (RRs) for season-standardized 25(OH)D concentrations were estimated by conditional logistic regression and combined by random-effects models. Circulating 25(OH)D increased from a median of 22.6 nmol/L in consortium-wide decile 1 to 93.2 nmol/L in decile 10. Breast cancer risk in each decile was not statistically significantly different from risk in decile 5 in models adjusted for breast cancer risk factors, and no trend was apparent (P-trend = 0.64). Compared to women with sufficient 25(OH)D based on Institute of Medicine guidelines (50- < 62.5 nmol/L), RRs were not statistically significantly different at either low concentrations (< 20 nmol/L, 3% of controls) or high concentrations (100- < 125 nmol/L, 3% of controls; ≥ 125 nmol/L, 0.7% of controls). RR per 25 nmol/L increase in 25(OH)D was 0.99 [95% confidence intervaI (CI) 0.95-1.03]. Associations remained null across subgroups, including those defined by body mass index, physical activity, latitude, and season of blood collection. Although none of the associations by tumor characteristics reached statistical significance, suggestive inverse associations were seen for distant and triple negative tumors. Circulating 25(OH)D, comparably measured in 17 international cohorts and season-standardized, was not related to subsequent incidence of invasive breast cancer over a broad range in vitamin D status.
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Affiliation(s)
- Kala Visvanathan
- Departments of Epidemiology and Oncology, Johns Hopkins Bloomberg School of Public Health and Kimmel Cancer Center, Baltimore, MD, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Anne Zeleniuch-Jacquotte
- Departments of Population Health and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Molin Wang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mitchell H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Shiaw-Shyuan Yaun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nancy R Cook
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Martin Almquist
- Department of Surgery, Skane University Hospital, Lund, Sweden
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Julie E Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Chu Chen
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Tess Clendenen
- Departments of Population Health and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health and Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gary E Goodman
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Marc T Goodman
- Cancer Prevention and Control Research Program, Cedars Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), French National Institute of Health and Medical Research (INSERM), University Paris-Saclay, Villejuif, France
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | | | - Tao Hou
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Corrine E Joshu
- Departments of Epidemiology and Oncology, Johns Hopkins Bloomberg School of Public Health and Kimmel Cancer Center, Baltimore, MD, USA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Marina Kvaskoff
- Center for Research in Epidemiology and Population Health (CESP), French National Institute of Health and Medical Research (INSERM), University Paris-Saclay, Villejuif, France
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yahya Mahamat-Saleh
- Center for Research in Epidemiology and Population Health (CESP), French National Institute of Health and Medical Research (INSERM), University Paris-Saclay, Villejuif, France
| | - Johan Malm
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Jonas Manjer
- Department of Surgery, Skane University Hospital, Lund University, Malmö, Sweden
| | - Gertraud Maskarinec
- Cancer Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Amy E Millen
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Toqir K Mukhtar
- Department of Primary Care and Public Health, Imperial College, London, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Trude E Robsahm
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Sabina Sieri
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Malin Sund
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona and University of Arizona Cancer Center, Tucson, AZ, USA
| | - Giske Ursin
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Lynne R Wilkens
- Population Sciences in the Pacific, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Yujie Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Emilie Zoltick
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie A Smith-Warner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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7
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Huang J, Zhao B, Weinstein SJ, Albanes D, Mondul AM. Metabolomic profile of prostate cancer-specific survival among 1812 Finnish men. BMC Med 2022; 20:362. [PMID: 36280842 PMCID: PMC9594924 DOI: 10.1186/s12916-022-02561-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Abnormal metabolism and perturbations in metabolic pathways play significant roles in the development and progression of prostate cancer; however, comprehensive metabolomic analyses of human data are lacking and needed to elucidate the interrelationships. METHODS We examined the serum metabolome in relation to prostate cancer survival in a cohort of 1812 cases in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study. Using an ultrahigh-performance LC-MS/MS platform, we identified 961 known metabolites in prospectively collected serum. Median survival time from diagnosis to prostate cancer-specific death (N=472) was 6.6 years (interquartile range=2.9-11.1 years). Cox proportional hazards regression models estimated hazard ratios and 95% confidence intervals of the associations between the serum metabolites (in quartiles) and prostate cancer death, adjusted for age at baseline and diagnosis, disease stage, and Gleason sum. In order to calculate risk scores, we first randomly divided the metabolomic data into a discovery set (70%) and validated in a replication set (30%). RESULTS Overall, 49 metabolites were associated with prostate cancer survival after Bonferroni correction. Notably, higher levels of the phospholipid choline, amino acid glutamate, long-chain polyunsaturated fatty acid (n6) arachidonate (20:4n6), and glutamyl amino acids gamma-glutamylglutamate, gamma-glutamylglycine, and gamma-glutamylleucine were associated with increased risk of prostate cancer-specific mortality (fourth versus first quartile HRs=2.07-2.14; P-values <5.2×10-5). By contrast, the ascorbate/aldarate metabolite oxalate, xenobiotics S-carboxymethyl-L-cysteine, fibrinogen cleavage peptides ADpSGEGDFXAEGGGVR and fibrinopeptide B (1-12) were related to reduced disease-specific mortality (fourth versus first quartile HRs=0.82-0.84; P-value <5.2×10-5). Further adjustment for years from blood collection to cancer diagnosis, body mass index, smoking intensity and duration, and serum total and high-density lipoprotein cholesterol did not alter the results. Participants with a higher metabolic score based on the discovery set had an elevated risk of prostate cancer-specific mortality in the replication set (fourth versus first quartile, HR=3.9, P-value for trend<0.0001). CONCLUSIONS The metabolic traits identified in this study, including for choline, glutamate, arachidonate, gamma-glutamyl amino acids, fibrinopeptides, and endocannabinoid and redox pathways and their composite risk score, corroborate our previous analysis of fatal prostate cancer and provide novel insights and potential leads regarding the molecular basis of prostate cancer progression and mortality.
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Affiliation(s)
- Jiaqi Huang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Bin Zhao
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
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8
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Kobayashi LC, Westrick AC, Doshi A, Ellis KR, Jones CR, LaPensee E, Mondul AM, Mullins MA, Wallner LP. Reply to "Noncancer comparators in cancer survivorship studies". Cancer 2022; 128:2995-2996. [PMID: 35503812 DOI: 10.1002/cncr.34254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Lindsay C Kobayashi
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
- Cancer Control and Population Sciences Program, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan
| | - Ashly C Westrick
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Aalap Doshi
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan
| | - Katrina R Ellis
- Cancer Control and Population Sciences Program, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan
- University of Michigan School of Social Work, Ann Arbor, Michigan
| | - Carly R Jones
- University of Michigan School of Social Work, Ann Arbor, Michigan
| | - Elizabeth LaPensee
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
- Cancer Control and Population Sciences Program, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan
| | - Megan A Mullins
- Cancer Control and Population Sciences Program, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan
- Center for Improving Patient and Population Health, University of Michigan, Ann Arbor, Michigan
| | - Lauren P Wallner
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
- Cancer Control and Population Sciences Program, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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9
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Khoja L, Torres HG, Ayyash M, Tariq M, Mondul AM, Meza R, Pearce CL. Abstract 2211: Cervical cancer screening and vaccination acceptability and attitudes amongst Arab American women in southeastern Michigan. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Cervical cancer screening rates among Arab-American women have been consistently shown to be lower than that of non-Hispanic White and Black women in the state of Michigan. Addressing the low cervical cancer screening rates among Arab American women in Michigan requires a deep understanding of the community’s perspective about cervical cancer screening. Thus, we conducted a series of focus groups in Southeastern Michigan to understand the attitudes, acceptability, and barriers of cervical cancer screening among this population.
Four focus groups with a total of 19 women were conducted via Zoom. Participants were recruited through social media channels and community organizations. All focus groups were conducted with self-identifying Arab, Arab American, or Chaldean women aged 30 to 61. The focus groups were conducted in either English, Arabic, or a mixture of both languages. Women completed a brief anchoring survey with demographic questions and a self-assessment of their HPV knowledge (see Table 1). The guided discussion centered around knowledge of cervical cancer, broadly, knowledge of Human papillomavirus (HPV) and its transmission, attitudes towards the HPV vaccination, and attitudes towards cervical cancer screening, which included HPV self-sampling methods. The recorded sessions were transcribed and are being coded using Dedoose Version 8.0.35, a qualitative analysis software. During the focus group, the discussion centered around barriers at the individual and community levels for screening and vaccination, attitudes towards preventive health care including screening, a need for accessible women’s health literature, and health education. The women also discussed vaccine hesitancy related to HPV and COVID19. This suggests the need for targeted community interventions.
General characteristics of participants (N*=19) N Mean Age (N=17) 37.9 8.7 (SD) Married (N=18) 11 61.1% Survey Language Arabic 6 31.6% English 13 68.4% How well would you say the financial needs are met in your household? Just sufficient 9 50% More than sufficiently met 3 16.7% Barely making it 3 16.7% Not met at all 3 16.7% How well informed do you think you are about cervical cancer? Not informed at all 1 5.6% Not well informed 10 55.6% Moderately informed 5 27.8% Well informed 1 5.6% Very well informed 1 5.6% Have you had vaginal sex (intercourse) before? Yes 15 83.3% No 3 16.7% Have you had oral sex before? Yes 8 47.1% No 9 52.9% Do you have any children? Yes 15 83.3% No 3 16.7% *Complete data available for 17 participants, partially complete data for 2 participants, and missing data for 1 participant
Citation Format: Lilah Khoja, Heidi G. Torres, Mariam Ayyash, Madiha Tariq, Alison M. Mondul, Rafael Meza, Celeste L. Pearce. Cervical cancer screening and vaccination acceptability and attitudes amongst Arab American women in southeastern Michigan [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2211.
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Affiliation(s)
| | | | | | - Madiha Tariq
- 3Arab Community Center for Economic and Social Services, Dearborn, MI
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10
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Getz KR, Bellile E, Zarins KR, Chinn SB, Taylor JMG, Rozek LS, Wolf GT, Mondul AM. The association between inflammatory biomarkers and statin use among patients with head and neck squamous cell carcinoma. Head Neck 2022; 44:1393-1403. [PMID: 35338544 PMCID: PMC9088158 DOI: 10.1002/hed.27040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/08/2022] [Accepted: 03/09/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Tumor-infiltrating lymphocytes (TILs) and cytokines are associated with prognosis among patients with head and neck squamous cell carcinoma (HNSCC). Statins (cholesterol-lowering drugs) may improve HNSCC prognosis, particularly in human papillomavirus (HPV)-positive cases, but the mechanism remains unclear. METHODS Statin use was collected from medical records for HNSCC cases (2008-2014). TILs were counted in tumor tissue, and a total weighted score (TILws) was created. Cytokines were measured in blood. The associations between statins and biomarkers were estimated using logistic (biomarker categories: <median, ≥median) and linear regression models (log-transformed continuous biomarkers) adjusted for age, smoking, and comorbidities. RESULTS We observed a positive association between statins and TILs among HPV-positive patients (TILws odds ratio [OR] = 2.80; 95% CI = 1.03-7.61), but no association among HPV-negative patients. We observed no association between statins and cytokines. CONCLUSIONS Statins may influence TILs in HPV-positive patients. This may be the mechanism through which they improve prognosis in HPV-positive HNSCC patients.
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Affiliation(s)
- Kayla R Getz
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Emily Bellile
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Steven B Chinn
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeremy M G Taylor
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.,Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Gregory T Wolf
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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11
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Maino Vieytes CA, Rodriguez-Zas SL, Madak-Erdogan Z, Smith RL, Zarins KR, Wolf GT, Rozek LS, Mondul AM, Arthur AE. Adherence to a priori-Defined Diet Quality Indices Throughout the Early Disease Course Is Associated With Survival in Head and Neck Cancer Survivors: An Application Involving Marginal Structural Models. Front Nutr 2022; 9:791141. [PMID: 35548563 PMCID: PMC9083460 DOI: 10.3389/fnut.2022.791141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
No studies, to date, have scrutinized the role of a priori dietary patterns on prognosis following a head and neck squamous cell carcinoma (HNSCC) diagnosis. The purpose of this analysis was to evaluate the associations between adherence to six a priori defined diet quality indices (including AHEI-2010, aMED, DASH, and three low-carbohydrate indices) throughout the first 3 years of observation and all-cause and cancer-specific mortalities in 468 newly diagnosed HNSCC patients from the University of Michigan Head and Neck Specialized Program of Research Excellence (UM-SPORE). The dietary intake data were measured using a food frequency questionnaire administered at three annual time points commencing at study entry. Deaths and their causes were documented throughout the study using various data sources. Marginal structural Cox proportional hazards models were used to evaluate the role of diet quality, as a time-varying covariate, on mortality. There were 93 deaths from all causes and 74 cancer-related deaths adjudicated throughout the observation period. There was a strong inverse association between adherence to the AHEI-2010, all-cause mortality (HRQ5–Q1:0.07, 95% CI:0.01–0.43, ptrend:0.04), and cancer-specific mortality (HRQ5–Q1:0.15, 95% CI:0.02–1.07, ptrend:0.04). Other more modest associations were noted for the low-carbohydrate indices. In sum, higher adherence to the AHEI-2010 and a plant-based low-carbohydrate index throughout the first 3 years since diagnosis may bolster survival and prognosis in newly diagnosed patients with HNSCC.
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Affiliation(s)
- Christian A Maino Vieytes
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Sandra L Rodriguez-Zas
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Zeynep Madak-Erdogan
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Rebecca L Smith
- Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Department of Pathobiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Gregory T Wolf
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, United States.,Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Anna E Arthur
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, United States
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12
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Weinstein SJ, Mondul AM, Layne TM, Yu K, Huang J, Stolzenberg-Solomon RZ, Ziegler RG, Purdue MP, Huang WY, Abnet CC, Freedman ND, Albanes D. Prediagnostic Serum Vitamin D, Vitamin D Binding Protein Isoforms, and Cancer Survival. JNCI Cancer Spectr 2022; 6:pkac019. [PMID: 35603848 PMCID: PMC8982405 DOI: 10.1093/jncics/pkac019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/01/2021] [Accepted: 01/07/2022] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Higher circulating vitamin D has been associated with improved overall cancer survival, but data for organ-specific cancers are mixed. METHODS We examined the association between prediagnostic serum 25-hydroxyvitamin D [25(OH)D], the recognized biomarker of vitamin D status, and cancer survival in 4038 men and women diagnosed with 1 of 11 malignancies during 22 years of follow-up (median = 15.6 years) within the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Multivariable-adjusted proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for associations between baseline 25(OH)D concentration and subsequent cancer survival; we also stratified on the common vitamin D binding protein isoforms (Gc1f, Gc1s, and Gc2) defined by two single-nucleotide polymorphisms (rs7041 and rs4588) in the vitamin D binding protein gene GC. All P values were 2-sided. RESULTS Higher 25(OH)D concentrations were associated with greater overall cancer survival (HR for cancer mortality = 0.83, 95% CI = 0.70 to 0.98 for highest vs lowest quintile; Ptrend = .05) and lung cancer survival (HR = 0.63, 95% CI = 0.44 to 0.90; Ptrend = .03). These associations were limited to cases expressing the Gc2 isoform (HR = 0.38 for Gc2-2, 95% CI = 0.14 to 1.05 for highest vs lowest quintile; Ptrend = .02; and HR = 0.30 for Gc1-2/Gc2-2 combined, 95% CI = 0.16 to 0.56; Ptrend < .001 for overall and lung cancer, respectively). CONCLUSIONS Higher circulating 25(OH)D was associated with improved overall and lung cancer survival. As this was especially evident among cases with the genetically determined Gc2 isoform of vitamin D binding protein, such individuals may gain a cancer survival advantage by maintaining higher 25(OH)D blood concentrations.
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Affiliation(s)
- Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Tracy M Layne
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rachael Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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13
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Kobayashi LC, Westrick AC, Doshi A, Ellis KR, Jones CR, LaPensee E, Mondul AM, Mullins MA, Wallner LP. New directions in cancer and aging: State of the science and recommendations to improve the quality of evidence on the intersection of aging with cancer control. Cancer 2022; 128:1730-1737. [PMID: 35195912 PMCID: PMC9007869 DOI: 10.1002/cncr.34143] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/27/2021] [Accepted: 01/20/2022] [Indexed: 12/29/2022]
Abstract
Background The global population of older cancer survivors is growing. However, the intersections of aging‐related health risks across the cancer control continuum are poorly understood, limiting the integration of aging into cancer control research and practice. The objective of this study was to review the state of science and provide future directions to improve the quality of evidence in 6 priority research areas in cancer and aging. Methods The authors identified priority research areas in cancer and aging through an evidence‐based Research Jam process involving 32 investigators and trainees from multiple disciplines and research centers in aging and cancer; then, they conducted a narrative review of the state of the science and future directions to improve the quality of evidence in these research areas. Priority research areas were defined as those in which gaps in scientific evidence or clinical practice limit the health and well‐being of older adults with cancer. Results Six priority research areas were identified: cognitive and physical functional outcomes of older cancer survivors, sampling issues in studies of older cancer survivors, risk and resilience across the lifespan, caregiver support and well‐being, quality of care for older patients with cancer, and health disparities. Evidence in these areas could be improved through the incorporation of bias reduction techniques into longitudinal studies of older cancer survivors, novel data linkage, and improved representation of older adults in cancer research. Conclusions The priority research areas and methodologies identified here may be used to guide interdisciplinary research and improve the quality of evidence on cancer and aging. The population of older cancer survivors is growing, yet the effects of aging‐related health risks across the cancer control continuum remain poorly understood. This article identifies research areas that may be used to guide interdisciplinary research and improve the quality of evidence on cancer and aging.
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Affiliation(s)
- Lindsay C Kobayashi
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.,Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan
| | - Ashly C Westrick
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Aalap Doshi
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan
| | - Katrina R Ellis
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan.,University of Michigan School of Social Work, Ann Arbor, Michigan
| | - Carly R Jones
- University of Michigan School of Social Work, Ann Arbor, Michigan
| | - Elizabeth LaPensee
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.,Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan
| | - Megan A Mullins
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan.,Center for Improving Patient and Population Health, University of Michigan, Ann Arbor, Michigan
| | - Lauren P Wallner
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.,Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan.,Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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14
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Salvatore M, Hu MM, Beesley LJ, Mondul AM, Pearce CL, Friese CR, Fritsche LG, Mukherjee B. COVID-19 outcomes by cancer status, site, treatment, and vaccination. Cancer Epidemiol Biomarkers Prev 2022:712829. [PMID: 36626383 DOI: 10.1158/1055-9965.epi-22-0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/12/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Studies have shown an increased risk of severe SARS-CoV-2 related (COVID-19) disease outcome and mortality for cancer patients, but it is not well understood if associations vary by cancer site, cancer treatment, and vaccination status. METHODS Using electronic health record data from an academic medical center, we identified a retrospective cohort of 260,757 individuals tested for or diagnosed with COVID-19 from March 10, 2020, to August 1, 2022. Of these, 52,019 tested positive for COVID-19 of whom 13,752 had a cancer diagnosis. We conducted Firth-corrected logistic regression to assess the association between cancer status, site and treatment, vaccination, and four COVID-19 outcomes: hospitalization, intensive care unit admission, mortality, and a composite "severe COVID" outcome. RESULTS Cancer diagnosis was significantly associated with higher rates of severe COVID, hospitalization, and mortality. These associations were driven by patients whose most recent initial cancer diagnosis was within the past three years. Chemotherapy receipt, colorectal cancer, hematologic malignancies, kidney cancer and lung cancer were significantly associated with higher rates of worse COVID-19 outcomes. Vaccinations were significantly associated with lower rates of worse COVID-19 outcomes regardless of cancer status. CONCLUSIONS Patients with colorectal cancer, hematologic malignancies, kidney cancer or lung cancer or who receive chemotherapy for treatment should be cautious because of their increased risk of worse COVID-19 outcomes, even after vaccination. IMPACT Additional COVID-19 precautions are warranted for people with certain cancer types and treatments. Significant benefit from vaccination is noted for both cancer and cancer-free patients.
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Affiliation(s)
| | - Miriam M Hu
- University of Michigan-Ann Arbor, United States
| | - Lauren J Beesley
- University of Michigan School of Public Health, Ann Arbor, Mi, United States
| | - Alison M Mondul
- University of Michigan School of Public Health, Ann Arbor, MI, United States
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15
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Marrone MT, Mondul AM, Prizment AE, Couper D, Barber JR, Chappidi MR, Joshu CE, Platz EA. Lipid-Lowering Drug Use and Cancer Incidence and Mortality in the ARIC Study. JNCI Cancer Spectr 2021; 5:pkab080. [PMID: 34738072 PMCID: PMC8562700 DOI: 10.1093/jncics/pkab080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/14/2022] Open
Abstract
Background Lipid-lowering drugs, particularly statins, are associated with reduced
incidence of certain cancers in some studies. Associations with cancer
mortality are not well studied, and whether associations are similar across
race is unknown. Methods We conducted a prospective analysis of 12 997 cancer-free participants in the
Atherosclerosis Risk in Communities Study who were never users at visit 1
(1987-1989). Ever use, duration of use, and age at first use were modeled as
time-dependent variables using Cox regression to estimate associations with
total, obesity- and smoking-associated, bladder, breast, colorectal, lung,
and prostate cancer incidence and mortality. Results We ascertained 3869 cancer cases and 1661 cancer deaths in 237 999 or more
person-years. At 6 years of follow-up, 70.8% of lipid-lowering drug
use was a statin. Compared with never use, ever use was associated with
lower total, obesity- and smoking-associated cancer mortality and with
colorectal cancer mortality (hazard ratio [HR] = 0.50, 95%
confidence interval [CI] = 0.32 to 0.79) and incidence (HR =
0.69, 95% CI = 0.53 to 0.92). Inverse associations were
consistent by sex and race. Shorter-term use was associated with bladder
cancer incidence in men (<10 years: HR = 1.67, 95% CI
= 1.02 to 2.73). First use at age 60 years or older was inversely
associated with: total mortality, obesity- and smoking-associated mortality,
and colorectal cancer mortality; and total incidence, obesity- and
smoking-associated incidence, and breast, colorectal, and prostate cancer
incidence. Conclusions This study provides additional evidence for inverse associations between
lipid-lowering drug use and cancer incidence and mortality but a positive
association with bladder cancer incidence in men. Evaluation of the impact
of chemoprevention strategies that include lipid-lowering drugs on
population-level cancer burden is needed.
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Affiliation(s)
- Michael T Marrone
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Anna E Prizment
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA.,University of Minnesota Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - David Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill School of Global Public Health, Chapel Hill, NC, USA
| | - John R Barber
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Meera R Chappidi
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
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16
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kazemian E, Akbari ME, Moradi N, Gharibzadeh S, Amouzegar A, Rozek LS, Mondul AM, Khademolmele M, Zarins KR, Ghodoosi N, Shateri Z, Fallah S, Davoodi SH. Assessment the effect of vitamin D supplementation on plasma vitamin D levels, inflammation, and oxidative stress biomarkers based on vitamin D receptor genetic variation in breast cancer survivors: a protocol for clinical trial. J Health Popul Nutr 2021; 40:46. [PMID: 34727991 PMCID: PMC8561968 DOI: 10.1186/s41043-021-00272-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Both human genes and environmental exposures, due to complex interplay, play important role in the cancer etiology. Vitamin D is associated with a reduced risk of incidence and mortality of several human cancers. This study will aim to investigate the possible effects of individual polymorphisms in vitamin D receptor (VDR) as well as effects of VDR haplotypes on response to vitamin D supplementation in breast cancer survivors. METHODS This is an interventional study in which the effects of vitamin D supplementation on plasma vitamin D levels, inflammatory and antioxidant biomarkers and factors associated with cell proliferation, differentiation, damage, and apoptosis will be investigated stratified by variations in VDR genotype. The present study will be conducted on breast cancer survivors referred to the Shohadaye Tajrish hospital and its associated clinics. One hundred ninety-eight breast cancer survivors will receive 4000 IU of vitamin D3 daily for 12 weeks. VDR Fok1, ApaI, TaqI, BsmI, and Cdx-2 genotype will be determined at the end of the study and responses to vitamin D supplements (inflammatory, antioxidant, cell proliferation, differentiation, damage, and apoptosis biomarkers) will be compared between the three subgroups of each VDR polymorphism as well as different VDR haplotype categories. DISCUSSION Genetic variation is a fundamental factor influencing individuals' divergent responses to diet, nutritional status, metabolic response, and diet-related health disorders. Furthermore, studies of gene and environment interactions will provide a precise and accurate assessments of individuals' dietary requirements by considering both the genetic and environmental aspects simultaneously. The results of the current study, to some extent, will highlight the discrepancies existing in the findings of different studies regarding vitamin D, VDR, and cancer by considering both the genetic and environmental aspects simultaneously. If responses to vitamin D supplementation could be modified by VDR SNPs, determining the distribution of VDR polymorphisms in both breast cancer survivors and healthy populations will provide a new insight into the vitamin D requirements of individuals to prevent cancer and its related mortality based on their genotypes. Trial registration This trial has been registered on Iranian Registry of Clinical Trials (IRCT) under the identification code: IRCT2017091736244N1, registration date: 2017-11-10, http://www.irct.ir/trial/27153.
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Affiliation(s)
- Elham kazemian
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Nariman Moradi
- Department of Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Laura S. Rozek
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI USA
| | - Alison M. Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI USA
| | - Maryam Khademolmele
- Department of Nutrition Science, Faculty of Medical Science and Technology, Science and Research Branch (SRBIAU), Islamic Azad University, Tehran, Iran
| | - Katie R. Zarins
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI USA
| | - Nasim Ghodoosi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Shateri
- Department of Nutrition Science, Faculty of Medical Science and Technology, Science and Research Branch (SRBIAU), Islamic Azad University, Tehran, Iran
| | - Soudabeh Fallah
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sayed Hossein Davoodi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Shahrake Gharb, No. 7, Hafezi St. Farahzadi Blv, Tehran, Iran
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17
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Hektoen HH, Gislefoss RE, Stenehjem JS, Langseth H, Axcrona K, Mondul AM, Robsahm TE, Andreassen BK. Prediagnostic Serum 25-Hydroxyvitamin D and Mortality Among Bladder Cancer Patients in the Janus Serum Bank Cohort. Clin Epidemiol 2021; 13:801-811. [PMID: 34548821 PMCID: PMC8449552 DOI: 10.2147/clep.s319620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/12/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose Circulating 25-hydroxyvitamin D (25(OH)D) is inversely associated with overall cancer mortality and selected cancers, while for urothelial bladder cancer (BC) this relationship is unclear. We aimed to examine the association between 25(OH)D and BC mortality. Materials and Methods We used prediagnostic serum from 378 BC cases within the population-based Janus Cohort. Cox regression models estimated hazard ratios (HRs), with 95% confidence intervals (CIs), for the association between 25(OH)D and BC-specific and all-cause mortality. Restricted cubic splines were assessed to examine non-linear risk associations. Analyses were stratified by tumor invasiveness (non-muscle invasive BC (NMIBC) and muscle invasive BC (MIBC)). Additionally, the association between 25(OH)D and all-cause mortality was assessed for 378 cancer-free matched controls. Results 25(OH)D deficiency (<50 nmol/L) was associated with higher BC-specific mortality (HR 1.87, 95% CI 1.10-3.20), when compared with insufficient levels (50-74 nmol/L). Stratification by tumor invasiveness revealed that this result was evident for NMIBC only, both with respect to BC-specific mortality (HR 2.84, 95% CI 1.14-7.12) and all-cause mortality (HR 1.97, 95% CI 1.06-3.65). No association between 25(OH)D levels and all-cause mortality was found in cancer-free controls. Conclusion 25(OH)D deficiency (<50 nmol/L) prior to a BC diagnosis was associated with increased risk of BC-specific mortality, when compared to insufficient levels (50-74 nmol/L). The results were evident among NMIBC patients only, suggesting a more critical role of vitamin D deficiency in an early stage of the disease.
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Affiliation(s)
- Helga H Hektoen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | | | - Jo S Stenehjem
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Hilde Langseth
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Karol Axcrona
- Department of Urology, Akershus University Hospital, Lørenskog, Norway
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Trude E Robsahm
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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18
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Sessine MS, Das S, Park B, Salami SS, Kaffenberger SD, Kasputis A, Solorzano M, Luke M, Vince RA, Kaye DR, Borza T, Stoffel EM, Cobain E, Merajver SD, Jacobs MF, Milliron KJ, Caba L, van Neste L, Mondul AM, Morgan TM. Initial Findings from a High Genetic Risk Prostate Cancer Clinic. Urology 2021; 156:96-103. [PMID: 34280438 DOI: 10.1016/j.urology.2021.05.078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To improve prostate cancer screening for high-risk men, we developed an early detection clinic for patients at high genetic risk of developing prostate cancer. Despite the rapidly growing understanding of germline variants in driving aggressive prostate cancer and the increased availability of genetic testing, there is little evidence surrounding how best to screen these men. METHODS We are reporting on the first 45 patients enrolled, men between the ages of 35-75, primarily with known pathogenic germline variants in prostate cancer susceptibility genes. Screening consists of an intake lifestyle survey, PSA, DRE, and SelectMDx urine assay. A biopsy was recommended for any of the following indications: 1) abnormal DRE, 2) PSA above threshold, or 3) SelectMDx above threshold. The primary outcomes were number needed to screen, and number needed to biopsy to diagnose a patient with prostate cancer. RESULTS Patients enrolled in the clinic included those with BRCA1 (n=7), BRCA2 (n=16), Lynch Syndrome (n=6), and CHEK2 (n = 4) known pathogenic germline variants. The median age and PSA were 58 (range 35-71) and 1.4 ng/ml (range 0.1-11.4 ng/ml), respectively. 12 patients underwent a prostate needle biopsy and there were 4positive biopsies for prostate cancer. CONCLUSION These early data support the feasibility of opening a dedicated clinic for men at high genetic risk of prostate cancer. This early report on the initial enrollment of our long-term study will help optimize early detection protocols and provide evidence for personalized prostate cancer screening in men with key pathogenic germline variants.
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Affiliation(s)
| | - Sanjay Das
- Department of Urology, Michigan Medicine
| | - Bumsoo Park
- Department of Urology, Michigan Medicine; Department of Family Medicine, Michigan Medicine
| | | | | | | | | | | | | | | | - Tudor Borza
- Department of Urology, University of Wisconsin School of Medicine and Public Health; Division of Urology, William S Middleton Memorial Veterans Hospital
| | | | - Erin Cobain
- Medical Genetics, Rogel Cancer Center, Michigan Medicine
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19
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Hektoen HH, Robsahm TE, Stenehjem JS, Axcrona K, Babigumira R, Mondul AM, Gislefoss RE, Andreassen BK. Vitamin D and Vitamin D-binding protein and risk of bladder cancer: A nested case-control study in the Norwegian Janus Serum Bank Cohort. Cancer Med 2021; 10:4107-4116. [PMID: 34080787 PMCID: PMC8209600 DOI: 10.1002/cam4.3960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 12/24/2022] Open
Abstract
Background High circulating levels of vitamin D (25(OH)D) are suggested to reduce the risk of urinary bladder cancer (BC), but the evidence is weak, and several studies lack sufficient adjustment for potential confounders (e.g., smoking, body mass index (BMI), and physical activity). Moreover, few studies have investigated the role of vitamin D‐binding protein (DBP) in this context. We conducted a matched nested case–control study including 378 cases and 378 controls within the Norwegian population‐based Janus cohort, using serum collected 5–41 years prior to diagnosis, to study 25(OH)D and BC risk, by taking circulating DBP into account. Methods Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), for 25(OH)D, DBP, and the molar ratio of 25(OH)D:DBP, an estimate of unbound (free) 25(OH)D levels. We adjusted for smoking (status and pack‐years), BMI, physical activity, education and (mutually) for 25(OH)D and DBP. Restricted cubic splines were employed to examine nonlinear associations. Results High optimal levels of circulating 25(OH)D (≥100 nmol/L) (HR 0.35, 95% CI 0.19–0.64) were associated with decreased BC risk, when compared with insufficient concentrations (50–74 nmol/L). This association was less pronounced for optimal levels (75–99 nmol/L) (HR = 0.69, 95% CI 0.47–1.01). Moreover, estimated free 25(OH)D, was associated with decreased BC risk for molar ratio 17–21 (HR 0.66, 95% CI 0.44–0.97) and ≥22 (HR 0.50, 95% CI 0.29–0.82), compared to molar ratio 11–16. The HR function for BC risk was not linear, rather reversed u‐shaped, with the highest HR at 62.5 nmol/L and 13.5 molar ratio, respectively. Conclusion High levels of total and estimated free 25(OH)D were associated with reduced risk of BC, compared with insufficient concentrations. DBP was not associated with BC risk. We did not observe any impact of DBP or any of the studied lifestyle factors on the association between 25(OH)D and BC.
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Affiliation(s)
- Helga H Hektoen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Trude E Robsahm
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Jo S Stenehjem
- Department of Research, Cancer Registry of Norway, Oslo, Norway.,Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Karol Axcrona
- Department of Urology, Akershus University Hospital, Lørenskog, Norway
| | | | - Alison M Mondul
- Department of Epidemiology, University of Michigan, School of Public Health, Ann Arbor, MI, USA
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20
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Kazemian E, Davoodi SH, Akbari ME, Moradi N, Gharibzadeh S, Mondul AM, Jamshidi-Naeini Y, Khademolmele M, Zarins KR, Ghodoosi N, Rozek LS, Amouzegar A. Vitamin D Receptor (VDR) Allelic Variants Correlating with Response to Vitamin D3 Supplementation in Breast Cancer Survivors. Nutr Cancer 2021; 74:68-81. [PMID: 34032540 DOI: 10.1080/01635581.2020.1869790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We investigated how vitamin D receptor (VDR) allelic variants affect breast cancer survivors' responses to vitamin D3 supplementation to increase circulating 25-hydroxy vitamin D (25(OH)D) levels. Two hundred and fourteen patients who were diagnosed with breast cancer at least 6 mo, prior to the study and had completed all treatment regimens were assigned to consume 4000 IU of vitamin D3 daily for 12 weeks. Linear and multinomial logistic regression analyses were used to analyze the association of VDR single nucleotide polymorphism (SNPs) with changes in circulating 25(OH)D. The TaqI and BsmI VDR sequence variants modified the effect of vitamin D3 treatment on the plasma 25(OH)D changes (P value = 0.008 for TaqI and P value = 0.0005 for BsmI). Patients with the bb [Q4 vs. Q1 odds ratio(OR) 8.04, 95% confidence interval (CI) 1.55-41.57] and tt [Q4 vs. Q1 OR 4.64 95%CI 1.02-21.02] genotype of BsmI and TaqI had larger increases in plasma 25(OH)D levels compared to those with BB and TT genotype respectively after adjustment for potential confounders. Haplotype analyses suggested the existence of specific combination of alleles that might be associated with circulating 25(OH)D changes. VDR allelic variants modulate vitamin D3 supplementation to increase plasma 25(OH) levels in breast cancer survivors.
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Affiliation(s)
- Elham Kazemian
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Sayed Hossein Davoodi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Basic Sciences and Cellular and Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology and National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nariman Moradi
- Department of Basic Sciences and Cellular and Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology and National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Maryam Khademolmele
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Katie R Zarins
- Department of Nutrition Science, Faculty of Medical Science and Technology, Islamic Azad University, Science and Research Branch (SRBIAU), Tehran, Iran
| | - Nasim Ghodoosi
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Laura S Rozek
- Department of Nutrition Science, Faculty of Medical Science and Technology, Islamic Azad University, Science and Research Branch (SRBIAU), Tehran, Iran
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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21
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Getz KR, Bellile E, Zarins KR, Rullman C, Chinn SB, Taylor JM, Rozek LS, Wolf GT, Mondul AM. Statin use and head and neck squamous cell carcinoma outcomes. Int J Cancer 2021; 148:2440-2448. [PMID: 33320960 PMCID: PMC8203748 DOI: 10.1002/ijc.33441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 02/02/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a morbid cancer with poor outcomes. Statins possess anticancer properties such as immunomodulatory and anti-inflammatory effects. The objective of our study is to identify the association between statin use among untreated HNSCC patients and overall death, disease-specific death and recurrence. HNSCC patients were recruited to participate in the University of Michigan Head and Neck Cancer Specialized Program of Research Excellence (SPORE) from 2003 to 2014. Statin use data were collected through medical record review. Participants were considered a statin user if they used a statin at or after diagnosis. Outcome data were collected through medical record review, Social Security Death Index or LexisNexis. Our analytic cohort included 1638 participants. Cox proportional hazard models were used to estimate the association between ever statin use and HNSCC outcomes. Statin use was seen in 36.0% of participants. We observed a statistically significant inverse association between ever using a statin and overall death (HR = 0.75, 95% CI = 0.63-0.88) and HNSCC-specific death (HR = 0.79, 95% CI = 0.63-0.99) and a nonstatistically significant inverse association for recurrence (HR = 0.85, 95% CI = 0.70-1.04). When investigating the association between statin use and HNSCC outcomes utilizing interaction terms between statin use and human papillomavirus (HPV), statistically significant interactions for HNSCC-specific death and recurrence were identified (HNSCC-specific death: HPV-positive HR = 0.41, 95% CI = 0.21-0.84; HPV-negative HR = 1.04, 95% CI = 0.71-1.51; p-int=0.02; recurrence: HPV-positive HR = 0.49, 95% CI = 0.29-0.84; HPV-negative HR = 1.03, 95% CI = 0.74-1.43; p=int-0.02). Statin use may be protective for adverse outcomes in HNSCC patients, particularly those with HPV-positive disease. If true, these findings could have a meaningful impact on tertiary prevention for this cancer.
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Affiliation(s)
- Kayla R. Getz
- Department of Epidemiology, University of Michigan School
of Public Health, Ann Arbor, Michigan
| | - Emily Bellile
- Department of Biostatistics, University of Michigan School
of Public Health, Ann Arbor, Michigan
| | - Katie R. Zarins
- Department of Environmental Health Sciences, University of
Michigan School of Public Health, Ann Arbor, Michigan
| | - Cailey Rullman
- Department of Epidemiology, University of Michigan School
of Public Health, Ann Arbor, Michigan
| | - Steven B. Chinn
- Department of Otolaryngology-Head and Neck Surgery,
University of Michigan, Ann Arbor Michigan
| | - Jeremy M.G. Taylor
- Department of Biostatistics, University of Michigan School
of Public Health, Ann Arbor, Michigan
| | - Laura S. Rozek
- Department of Environmental Health Sciences, University of
Michigan School of Public Health, Ann Arbor, Michigan
- Department of Otolaryngology-Head and Neck Surgery,
University of Michigan, Ann Arbor Michigan
| | - Gregory T. Wolf
- Department of Otolaryngology-Head and Neck Surgery,
University of Michigan, Ann Arbor Michigan
| | - Alison M. Mondul
- Department of Epidemiology, University of Michigan School
of Public Health, Ann Arbor, Michigan
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22
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Salvatore M, Beesley LJ, Fritsche LG, Hanauer D, Shi X, Mondul AM, Pearce CL, Mukherjee B. Phenotype risk scores (PheRS) for pancreatic cancer using time-stamped electronic health record data: Discovery and validation in two large biobanks. J Biomed Inform 2021; 113:103652. [PMID: 33279681 PMCID: PMC7855433 DOI: 10.1016/j.jbi.2020.103652] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/27/2020] [Accepted: 11/30/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Traditional methods for disease risk prediction and assessment, such as diagnostic tests using serum, urine, blood, saliva or imaging biomarkers, have been important for identifying high-risk individuals for many diseases, leading to early detection and improved survival. For pancreatic cancer, traditional methods for screening have been largely unsuccessful in identifying high-risk individuals in advance of disease progression leading to high mortality and poor survival. Electronic health records (EHR) linked to genetic profiles provide an opportunity to integrate multiple sources of patient information for risk prediction and stratification. We leverage a constellation of temporally associated diagnoses available in the EHR to construct a summary risk score, called a phenotype risk score (PheRS), for identifying individuals at high-risk for having pancreatic cancer. The proposed PheRS approach incorporates the time with respect to disease onset into the prediction framework. We combine and contrast the PheRS with more well-known measures of inherited susceptibility, namely, the polygenic risk scores (PRS) for prediction of pancreatic cancer. METHODOLOGY We first calculated pairwise, unadjusted associations between pancreatic cancer diagnosis and all possible other diagnoses across the medical phenome. We call these pairwise associations co-occurrences. After accounting for cross-phenotype correlations, the multivariable association estimates from a subset of relatively independent diagnoses were used to create a weighted sum PheRS. We constructed time-restricted risk scores using data from 38,359 participants in the Michigan Genomics Initiative (MGI) based on the diagnoses contained in the EHR at 0, 1, 2, and 5 years prior to the target pancreatic cancer diagnosis. The PheRS was assessed for predictability in the UK Biobank (UKB). We tested the relative contribution of PheRS when added to a model containing a summary measure of inherited genetic susceptibility (PRS) plus other covariates like age, sex, smoking status, drinking status, and body mass index (BMI). RESULTS Our exploration of co-occurrence patterns identified expected associations while also revealing unexpected relationships that may warrant closer attention. Solely using the pancreatic cancer PheRS at 5 years before the target diagnoses yielded an AUC of 0.60 (95% CI = [0.58, 0.62]) in UKB. A larger predictive model including PheRS, PRS, and the covariates at the 5-year threshold achieved an AUC of 0.74 (95% CI = [0.72, 0.76]) in UKB. We note that PheRS does contribute independently in the joint model. Finally, scores at the top percentiles of the PheRS distribution demonstrated promise in terms of risk stratification. Scores in the top 2% were 10.20 (95% CI = [9.34, 12.99]) times more likely to identify cases than those in the bottom 98% in UKB at the 5-year threshold prior to pancreatic cancer diagnosis. CONCLUSIONS We developed a framework for creating a time-restricted PheRS from EHR data for pancreatic cancer using the rich information content of a medical phenome. In addition to identifying hypothesis-generating associations for future research, this PheRS demonstrates a potentially important contribution in identifying high-risk individuals, even after adjusting for PRS for pancreatic cancer and other traditional epidemiologic covariates. The methods are generalizable to other phenotypic traits.
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Affiliation(s)
- Maxwell Salvatore
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Lauren J Beesley
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Lars G Fritsche
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States; Rogel Cancer Center, University of Michigan Medicine, Ann Arbor, MI 48109, United States; Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - David Hanauer
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI 48109, United States
| | - Xu Shi
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States.
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23
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Argirion I, Arthur AE, Zarins KR, Bellile E, Crowder SL, Amlani L, Taylor JM, Wolf GT, McHugh J, Nguyen A, Mondul AM, Rozek LS. Pretreatment Dietary Patterns, Serum Carotenoids and Tocopherols Influence Tumor Immune Response in Head and Neck Squamous Cell Carcinoma. Nutr Cancer 2020; 73:2614-2626. [PMID: 33307825 DOI: 10.1080/01635581.2020.1842895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Tumor infiltrating lymphocytes (TILs) aid in informing treatment for head and neck squamous cell carcinoma (HNSCC). Nevertheless, little is known about the role of diet on TILs. METHODS Immunohistologic expression of CD4, CD8, CD68, CD103, CD104 and FOXP3 were assessed in tissue microarrays from 233 previously untreated HNSCC patients. Associations between these markers and pretreatment dietary patterns were evaluated using linear regression. Associations between baseline serum carotenoids, tocopherols and TILs were assessed using logistic regression. Cox models evaluated the association between diet and TILs on overall and recurrence-free survival. RESULTS Consumption of a Western dietary pattern was associated with lower CD8+ and FOXP3+ infiltrates (p-value:0.03 and 0.02, respectively). Multivariable logistic regression models demonstrated significantly higher CD8+ (OR:2.21;p-value:0.001) and FOXP3+ (OR:4.26;p-value:<0.0001) among patients with high gamma tocopherol. Conversely, high levels of xanthophylls (OR:0.12;p-value:<0.0001), lycopene (OR:0.36;p-value:0.0001) and total carotenoids(OR:0.31;p-value: <0.0001) were associated with significantly lower CD68+. Among those with high CD4+ (HR:1.77;p-value:0.03), CD68+ (HR:2.42;p-value:0.004), CD103+ (HR:3.64;p-value:0.03) and FOXP3+ (HR:3.09;p-value:0.05), having a high Western dietary pattern increased the risk of overall mortality when compared to a low Western dietary pattern. CONCLUSION Dietary patterns and serum carotenoids may play an important role in modifying TILs, and ultimately, outcome after diagnosis with HNSCC.
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Affiliation(s)
- Ilona Argirion
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Anna E Arthur
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,Carle Cancer Center, Carle Foundation Hospital, Urbana, Illinois, USA
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily Bellile
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Sylvia L Crowder
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Lahin Amlani
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jeremy Mg Taylor
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Greg T Wolf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jonathan McHugh
- Pathology, The University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Ariane Nguyen
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
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Brouwer AF, He K, Chinn SB, Mondul AM, Chapman CH, Ryser MD, Banerjee M, Eisenberg MC, Meza R, Taylor JMG. Time-varying survival effects for squamous cell carcinomas at oropharyngeal and nonoropharyngeal head and neck sites in the United States, 1973-2015. Cancer 2020; 126:5137-5146. [PMID: 32888317 DOI: 10.1002/cncr.33174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/13/2020] [Accepted: 08/05/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Anatomical site is strongly associated with head and neck cancer etiology, and etiology and patient sociodemographic characteristics are prognostic factors for survival. It is not known whether the effects of these predictors persist over the postdiagnosis period or are strongest proximal to the time of diagnosis. METHODS Using survival times and causes of death for 180,434 patients with head and neck cancer in the Surveillance, Epidemiology, and End Results cancer registry (1973-2015), the empirical cumulative incidences of cancer-specific death and other-cause death were calculated with a competing risks framework, and the time-dependent effects (hazard ratios) of anatomical tumor site (oropharynx, oral cavity, or hypopharynx/larynx), age, sex, race, and year of diagnosis on cancer-specific death and other-cause death, stratified by tumor stage, were estimated. RESULTS All effects were significantly time-varying (P < .001). Patients with nonoropharyngeal cancer had a higher hazard of cancer-specific death but a similar cumulative fraction of deaths because of a higher rate of death from other causes. Cancer-specific survival has not changed for patients with nonoropharyngeal cancer over the past decades but has improved since 2000 for patients with oropharyngeal cancer. The effects of age and sex on cancer survival were strongest proximal to the diagnosis, whereas the effect of race persisted over time. CONCLUSIONS Recent improvements in survival for patients with oropharyngeal cancer may be due more to an increasing fraction of cancers attributable to human papillomavirus than to increasing treatment effectiveness. The prognostic strength of anatomical site and other predictors changes over the postdiagnosis period. LAY SUMMARY It is generally assumed that the effects of tumor and personal characteristics on the survival of patients with head and neck cancer are fixed over time, but this study shows that many factors are most important only in the first few years after diagnosis. Also, recent improvements in the survival of patients with head and neck cancer appear to benefit only patients with cancers of the oropharynx. The improvements may be due more to an increasing fraction of cancers caused by human papillomavirus (which generally have better outcomes) than to advances in head and neck cancer treatment overall.
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Affiliation(s)
- Andrew F Brouwer
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Kevin He
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Steven B Chinn
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Christina H Chapman
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Marc D Ryser
- Department of Population Health Sciences, Duke University, Durham, North Carolina.,Department of Mathematics, Duke University, Durham, North Carolina
| | - Mousumi Banerjee
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Marisa C Eisenberg
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan.,Department of Mathematics, University of Michigan, Ann Arbor, Michigan.,Department of Complex Systems, University of Michigan, Ann Arbor, Michigan
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Jeremy M G Taylor
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
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Kazemian E, Akbari ME, Moradi N, Gharibzadeh S, Amouzegar A, Jamshidi-Naeini Y, Mondul AM, Khademolmele M, Ghodoosi N, Zarins KR, Shateri Z, Davoodi SH, Rozek LS. Effect of vitamin D receptor polymorphisms on plasma oxidative stress and apoptotic biomarkers among breast cancer survivors supplemented vitamin D3. Eur J Cancer Prev 2020; 29:433-444. [PMID: 32740169 DOI: 10.1097/cej.0000000000000576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We investigated whether plasma oxidative stress and apoptotic biomarkers were associated with the VDR polymorphisms in breast cancer survivors supplemented with vitamin D3. Two hundred fourteen breast cancer survivors received 4000 IU of vitamin D3 daily for 12 weeks. Linear regression was used to analyze whether the effect of vitamin D3 supplementation on response variables was associated with the selected VDR single nucleotide polymorphisms executing by 'association' function in the R package 'SNPassoc'. Linear regression analyses adjusted for age, BMI and on-study plasma 25(OH)D changes indicated that the aa genotype of the ApaI [codominant model (aa vs. AA): -0.21 (-0.39 to -0.03); recessive model (aa vs. AA and Aa): -0.20 (-0.37 to -0.03)] and bb genotypes of the BsmI [recessive model (bb vs. BB and Bb): -0.20 (-0.39 to -0.01)] on VDR were associated with greater decrease in plasma Bcl2. Our findings indicated that, the Ff genotype of FokI was accompanied by higher increase in plasma MDA levels [codominant model (Ff vs. FF): 0.64 (0.18-1.11); dominant model (ff and Ff vs. FF): 0.52 (0.09-0.05)]. This observed association was not remained statistically significant after correction for multiple testing. Haplotype score analyses revealed statistically significant association between the FokI BsmI ApaI haplotype and circulating MDA changes (P-value for global score = 0.001) after false-discovery rate correction. Our study suggests that genetic variations in the VDR do not powerfully modify the effects of vitamin D3 intake on biomarkers associated with antioxidant activity, oxidative stress and apoptosis in breast cancer survivors.
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Affiliation(s)
- Elham Kazemian
- Department of Basic Sciences and Cellular and Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology and National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences
| | | | - Nariman Moradi
- Department of clinical Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences
| | | | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Maryam Khademolmele
- Department of Nutrition Science, Faculty of Medical Science and Technology, Islamic Azad University, Science and Research Branch (SRBIAU)
| | - Nasim Ghodoosi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Zahra Shateri
- Department of Nutrition Science, Faculty of Medical Science and Technology, Islamic Azad University, Science and Research Branch (SRBIAU)
| | - Sayed Hossein Davoodi
- Department of Basic Sciences and Cellular and Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology and National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
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26
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Ibrahimovic M, Franzmann E, Mondul AM, Weh KM, Howard C, Hu JJ, Goodwin WJ, Kresty LA. Disparities in Head and Neck Cancer: A Case for Chemoprevention with Vitamin D. Nutrients 2020; 12:E2638. [PMID: 32872541 PMCID: PMC7551909 DOI: 10.3390/nu12092638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/13/2022] Open
Abstract
Blacks experience disproportionate head and neck cancer (HNC) recurrence and mortality compared to Whites. Overall, vitamin D status is inversely associated to HNC pointing to a potential protective linkage. Although hypovitaminosis D in Blacks is well documented it has not been investigated in Black HNC patients. Thus, we conducted a prospective pilot study accessing vitamin D status in newly diagnosed HNC patients stratified by race and conducted in vitro studies to investigate mechanisms associated with potential cancer inhibitory effects of vitamin D. Outcome measures included circulating levels of vitamin D, related nutrients, and risk factor characterization as well as dietary and supplemental estimates. Vitamin D-based in vitro assays utilized proteome and microRNA (miR) profiling. Nineteen patients were enrolled, mean circulating vitamin D levels were significantly reduced in Black compared to White HNC patients, 27.3 and 20.0 ng/mL, respectively. Whites also supplemented vitamin D more frequently than Blacks who had non-significantly higher vitamin D from dietary sources. Vitamin D treatment of HNC cell lines revealed five significantly altered miRs regulating genes targeting multiple pathways in cancer based on enrichment analysis (i.e., negative regulation of cell proliferation, angiogenesis, chemokine, MAPK, and WNT signaling). Vitamin D further altered proteins involved in cancer progression, metastasis and survival supporting a potential role for vitamin D in targeted cancer prevention.
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Affiliation(s)
- Mirela Ibrahimovic
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Elizabeth Franzmann
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL 33136, USA; (E.F.); (J.J.H.); (W.J.G.)
- Department of Otolaryngology, University of Miami School of Medicine, Miami, FL 33136, USA
| | - Alison M. Mondul
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Katherine M. Weh
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Surgery, Thoracic Surgery Section, University of Michigan, Ann Arbor, MI 48109, USA
| | - Connor Howard
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Surgery, Thoracic Surgery Section, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jennifer J. Hu
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL 33136, USA; (E.F.); (J.J.H.); (W.J.G.)
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL 33136, USA
| | - W. Jarrard Goodwin
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL 33136, USA; (E.F.); (J.J.H.); (W.J.G.)
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL 33136, USA
| | - Laura A. Kresty
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Surgery, Thoracic Surgery Section, University of Michigan, Ann Arbor, MI 48109, USA
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Argirion I, Arthur AE, Zarins KR, Bellile E, Amlani L, Taylor JM, Wolf GT, McHugh J, Nguyen A, Mondul AM, Rozek LS. Abstract 4644: Pretreatment diet, serum carotenoids and tocopherols influence tumor immune response in head and neck squamous cell carcinoma. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-4644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Tumor infiltrating lymphocytes (TILs) have recently emerged as an important factor in informing treatment decisions for head and neck squamous cell carcinoma (HNSCC). Nevertheless, little is known about the role of modifiable risk factors, such as diet, on TILs.
Methods: Immunohistologic expression of CD4, CD8, CD68, CD103, CD104 and FOXP3 were assessed in tissue microarrays from 233 previously untreated HNSCC patients. Associations between these markers and pre-treatment dietary patterns were then evaluated using linear regression models. Logistic regression models assessing the associations between baseline serum carotenoids, tocopherols and TILs were conducted on a smaller subset of 70 patients. Cox proportional hazard models were used to evaluate the joint association between diet and TILs on overall and recurrence free survival.
Results: High intake of a Western dietary pattern decreased CD8+ and FOXP3+ infiltrates after adjustment for age, sex and batch (p-value: 0.03 and 0.02, respectively). Multivariate logistic regression models demonstrated significant increases in CD8+ (OR: 2.21; p-value: 0.001) and FOXP3+ (OR: 4.26; p-value: <0.0001) among patients with high gamma tocopherol. Conversely, high levels of xanthophylls (OR: 0.12; p-value:<0.0001), lycopene (OR: 0.36; p-value: 0.0001) and total carotenoids (OR: 0.31; p-value: <0.0001) significantly decreased CD68+. Among those with high CD4+ (HR: 1.77; p-value: 0.03), CD68+ (HR: 2.42; p-value: 0.004), CD103+ (HR: 3.64; p-value: 0.03) and FOXP3+ (HR: 3.09; p-value: 0.05) infiltrates, having a high Western dietary pattern significantly increased the risk of overall mortality when compared to those with a low Western dietary pattern, even after adjusting for age, sex, stage, disease site, HPV status, and TMA; a similar effect was found between the high Western dietary pattern and FOXP3+ (HR: 2.93; p-value: 0.0002) on recurrence free survival in fully adjusted models.
Conclusion: Dietary patterns and serum carotenoids may play an important role in modifying TILs, and ultimately, outcome after diagnosis with HNSCC. The results of this study could inform dietary interventions among high risk individuals in an attempt to moderate risk and improve HNSCC prognosis.
Citation Format: Ilona Argirion, Anna E. Arthur, Katie R. Zarins, Emily Bellile, Lahin Amlani, Jeremy M. Taylor, Greg T. Wolf, Jonathan McHugh, Ariane Nguyen, Alison M. Mondul, Laura S. Rozek, The University of Michigan Head and Neck SPORE Program. Pretreatment diet, serum carotenoids and tocopherols influence tumor immune response in head and neck squamous cell carcinoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4644.
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Affiliation(s)
- Ilona Argirion
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Katie R. Zarins
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | - Emily Bellile
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | - Lahin Amlani
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Greg T. Wolf
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | - Jonathan McHugh
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | - Ariane Nguyen
- 1University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Laura S. Rozek
- 1University of Michigan School of Public Health, Ann Arbor, MI
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Marrone MT, Barber JR, Mondul AM, Prizment AE, Couper D, Joshu CE, Platz EA. Abstract 2357: Lipid-lowering drug use, duration of use, and age at first use is associated with a lower risk of colorectal cancer mortality in men and women in the Atherosclerosis Risk in Communities (ARIC) Study. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-2357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: While lipid-lowering drugs, particularly statins, are associated with a modestly reduced risk of developing colorectal cancer (CRC), the association of lipid-lowering drug use, duration of use, and age at first use with CRC mortality in men and women without the diagnosis at baseline, has not been well studied. Further, whether associations are similar across race is unknown. Thus, we aimed to characterize the association between lipid-lowering drug use and CRC mortality in men and women and by race. We classified lipid-lowering drug use in a time-dependent manner as current use, duration of use, and age at first use.
Methods: We conducted a prospective cohort study of 14,428 cancer-free men and women attending visit 2 (1990-1992) of the Atherosclerosis Risk in Communities (ARIC) Study. Death from CRC was ascertained from the underlying cause on death certificates. Follow-up began at visit 2 and ended at date of death or 12/31/2015, whichever came first. There were 384 incident CRC cases and 144 deaths in 290,249 person-years. Cox regression was used to estimate relative hazards (HR) and 95% confidence intervals (CI) for CRC incidence and death adjusting for age, sex, education, race and field center, BMI, smoking status and pack years, alcohol use, red and processed meat consumption, aspirin use, and family history of any cancer and family history of CRC overall and by gender and race. Current lipid-lowering medication use, duration of use (<15 years, ≥15 years), and age at first use (<50, 50-59, 60-69, and ≥70 years of age) were modeled as time-dependent variables.
Results: Mean age was 57 years and mean BMI was 28.1 kg/m2; 54.9% were women and 27.9% were Black. By visit 4 (1996-98), after an average of 6 years of follow-up, 22% of participants were using lipid-lowering drugs. Compared to never users, current use was associated with 53% lower risk of CRC death (HR 0.47; 95%CI 0.32-0.71). Inverse associations were present in both men (HR 0.59; 95%CI 0.35-0.99) and women (HR 0.37; 95%CI 0.20-0.69) and in Black (HR 0.44; 95%CI 0.19-1.00) and White (HR 0.49; 95%CI 0.31-0.77) participants. Inverse associations were consistent across different patterns of duration of use and was inverse irrespective of age at first use. Current use was also associated with a lower risk of CRC incidence (HR: 0.72; 95%CI 0.57-0.92).
Conclusions: Current use of lipid-lowering drugs was associated with a statistically significant lower risk of dying from CRC in participants without cancer at baseline, including men and women and in Black and white participants, irrespective of the duration (15 year intervals) or age at first use.
Support: NHLBI contracts, NCI grants, NPCR
Citation Format: Michael T. Marrone, John R. Barber, Alison M. Mondul, Anna E. Prizment, David Couper, Corinne E. Joshu, Elizabeth A. Platz. Lipid-lowering drug use, duration of use, and age at first use is associated with a lower risk of colorectal cancer mortality in men and women in the Atherosclerosis Risk in Communities (ARIC) Study [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2357.
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Affiliation(s)
| | - John R. Barber
- 1Johns Hopkins University School of Public Health, Baltimore, MD
| | | | | | - David Couper
- 4University of North Carolina Gillings School of Public Health, Chaple Hill, NC
| | - Corinne E. Joshu
- 1Johns Hopkins University School of Public Health, Baltimore, MD
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Kratzer TB, Weinstein SJ, Albanes D, Mondul AM. Vitamin D binding protein and risk of renal cell carcinoma in the prostate, lung, colorectal and ovarian cancer screening trial. Int J Cancer 2020; 147:669-674. [PMID: 31659740 PMCID: PMC8513125 DOI: 10.1002/ijc.32758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 10/02/2019] [Accepted: 10/21/2019] [Indexed: 11/11/2022]
Abstract
Our group has conducted two previous studies on the association between vitamin D binding protein (DBP) and renal cell carcinoma (RCC), the most common form of kidney cancer, finding strong inverse associations. We undertook the current analysis to replicate our findings in a different study population that included women and nonsmokers. We conducted a nested case-control study in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO). Cases (n = 323) were matched 1:1 to controls on age (±1 year), race/ethnicity, date of blood collection (±30 days) and sex. We performed conditional logistic regression to estimate the odds ratios and 95% confidence intervals for the association between quartiles of circulating DBP and risk of RCC. We observed a statistically significant positive association between DBP and RCC that persisted after adjustment for history of diabetes, history of hypertension, family history of renal cancer, body mass index and smoking status (mv-adj Q4 vs. Q1 OR = 4.1, 95% CI = 2.2-7.8; p-trend <0.0001). These findings were similar when we restricted to cases with at least 2 years of follow-up and no major weight loss, suggesting that our findings are not due to reverse causality. In the present study, those with higher serum concentrations of DBP were at increased risk of RCC, in contrast to previously published findings. Further research is necessary to determine the true association between DBP and risk of RCC, and whether different DBP phenotypes may have different associations with risk of RCC.
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Affiliation(s)
- Tyler B. Kratzer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Stephanie J. Weinstein
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD
| | - Demetrius Albanes
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD
| | - Alison M. Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
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Defever K, Platz EA, Lopez DS, Mondul AM. Differences in the prevalence of modifiable risk and protective factors for prostate cancer by race and ethnicity in the National Health and Nutrition Examination Survey. Cancer Causes Control 2020; 31:851-860. [PMID: 32666408 DOI: 10.1007/s10552-020-01326-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Prostate cancer burden is disproportionate by race. Black men have the highest incidence and mortality rates. Rates for Hispanic men are significantly lower than for non-Hispanic Whites. Whether differences in prevalences of modifiable risk and protective factors for prostate cancer may explain these racial/ethnic differences remains unclear. METHODS We used data from the National Health and Nutrition Examination Surveys (NHANES), which are cross-sectional and nationally representative. We selected factors known or suspected to be associated with prostate cancer and calculated risk scores combining key factors. Age-adjusted means and proportions were calculated for each factor and risk score by race/ethnicity. We estimated odds ratios (OR) using polytomous logistic regression. RESULTS Prevalences of most factors are statistically significantly differed by race/ethnicity. In NHANES III, the prevalence of high risk score (i.e., > 25th percentile for all participants) was lower for all groups (non-Hispanic Black = 59.4%, non-US-born Mexican American = 51.4%, US-born Mexican American = 61.4%) vs. non-Hispanic White men (76.4%). Similar findings were observed for the fatal weighted risk score and for continuous NHANES. CONCLUSIONS Our findings from this nationally representative study suggest that a combination of multiple risk and protective factors may help to explain the lower rates of prostate cancer in Mexican Americans. However, variation in these factors did not explain the higher risk of prostate cancer in non-Hispanic Black men. No one lifestyle change can reduce prostate cancer equally across all racial/ethnic groups, and modifiable factors may not explain the increased risk in black men at all. Secondary prevention strategies may provide the most benefit for black men.
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Affiliation(s)
- Kali Defever
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.,Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David S Lopez
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
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Hada M, Mondul AM, Weinstein SJ, Albanes D. Serum Retinol and Risk of Overall and Site-Specific Cancer in the ATBC Study. Am J Epidemiol 2020; 189:532-542. [PMID: 31612201 DOI: 10.1093/aje/kwz226] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/18/2019] [Accepted: 09/23/2019] [Indexed: 12/29/2022] Open
Abstract
Retinol, the most biologically active form of vitamin A, might influence cancer-related biological pathways. However, results from observational studies of serum retinol and cancer risk have been mixed. We prospectively examined serum retinol and risk of overall and site-specific cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (n = 29,104 men), conducted in 1985-1993, with follow-up through 2012. Serum retinol concentration was measured using reverse-phase high-performance liquid chromatography. Cox proportional hazards models estimated the association between baseline serum retinol quintile and overall and site-specific cancer risk in 10,789 cases. After multivariable adjustment, higher serum retinol was not associated with overall cancer risk (highest vs. lowest quintile: hazard ratio (HR) = 0.97, 95% confidence interval (CI): 0.91, 1.03; P for trend = 0.43). Higher retinol concentrations were, however, associated with increased risk of prostate cancer (highest vs. lowest quintile: HR = 1.28, 95% CI: 1.13, 1.45; P for trend < 0.0001) and lower risk of both liver and lung cancers (highest vs. lowest quintile: for liver, HR = 0.62, 95% CI: 0.42, 0.91; P for trend = 0.004; and for lung, HR = 0.80, 95% CI: 0.72, 0.88; P for trend < 0.0001). No associations with other cancers were observed. Understanding the mechanisms that underlie these associations might provide insight into the role of vitamin A in cancer etiology.
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Affiliation(s)
- Manila Hada
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Stephanie J Weinstein
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Demetrius Albanes
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Huang J, Hodis HN, Weinstein SJ, Mack WJ, Sampson JN, Mondul AM, Albanes D. Serum Metabolomic Response to Low- and High-Dose Vitamin E Supplementation in Two Randomized Controlled Trials. Cancer Epidemiol Biomarkers Prev 2020; 29:1329-1334. [PMID: 32312759 DOI: 10.1158/1055-9965.epi-20-0187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/22/2020] [Accepted: 04/15/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Vitamin E is an essential micronutrient and critical human antioxidant previously tested for cancer preventative effects with conflicting clinical trial results that have yet to be explained biologically. METHODS We examined baseline and on-trial serum samples for 154 men randomly assigned to receive 400 IU vitamin E (as alpha-tocopheryl acetate; ATA) or placebo daily in the Vitamin E Atherosclerosis Prevention Study (VEAPS), and for 100 men administered 50 IU ATA or placebo daily in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC). Over 970 metabolites were identified using ultrahigh-performance LC/MS-MS. Linear regression models estimated the change in serum metabolites of men supplemented with vitamin E versus those receiving placebo in VEAPS as compared with ATBC. RESULTS Serum alpha-carboxyethyl hydrochroman (CEHC) sulfate, alpha-tocopherol, and beta/gamma-tocopherol were significantly altered by ATA supplementation in both trials (all P values ≤5.1 × 10-5, the Bonferroni multiple comparisons corrected statistical threshold). Serum C22 lactone sulfate was significantly decreased in response to the high-dose vitamin E in VEAPS (β = -0.70, P = 8.1 × 10-6), but not altered by the low dose in ATBC (β = -0.17, P = 0.4). In addition, changes in androgenic steroid metabolites were strongly correlated with the vitamin E supplement-associated change in C22 lactone sulfate only in the VEAPS trial. CONCLUSIONS We found evidence of a dose-dependent vitamin E supplementation effect on a novel C22 lactone sulfate compound that was correlated with several androgenic steroids. IMPACT Our data add information on a differential hormonal response based on vitamin E dose that could have direct relevance to opposing prostate cancer incidence results from previous large controlled trials.
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Affiliation(s)
- Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
| | - Howard N Hodis
- Atherosclerosis Research Unit, Department of Preventive Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Wendy J Mack
- Atherosclerosis Research Unit, Department of Preventive Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, California
| | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
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Middha P, Weinstein SJ, Männistö S, Albanes D, Mondul AM. β-Carotene Supplementation and Lung Cancer Incidence in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study: The Role of Tar and Nicotine. Nicotine Tob Res 2020; 21:1045-1050. [PMID: 29889248 DOI: 10.1093/ntr/nty115] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 06/04/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study demonstrated that β-carotene supplementation increases lung cancer incidence in smokers. Further, cigarettes with higher tar and nicotine content are associated with a higher risk of lung cancer. However, no studies have examined whether the increased risk associated with β-carotene supplementation in smokers varies by the tar or nicotine content of cigarettes. METHODS The ATBC Study was a randomized, double-blind intervention trial conducted in southwest Finland. A total of 29 133 male smokers, aged 50-69 years, were enrolled and randomly assigned to one of four groups (α-tocopherol, β-carotene, both, or placebo). Cox proportional hazards models were used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) of lung cancer risk by β-carotene trial assignment stratified by a priori categories of cigarette tar and nicotine content. RESULTS The β-carotene supplementation group had significantly higher risk of developing lung cancer in all categories of tar content (yes vs. no β-carotene supplementation-ultralight cigarettes [≤7 mg tar]: HR = 1.31, 95% CI = 0.91 to 1.89; nonfiltered cigarettes [≥21 mg tar]: HR = 1.22, 95% CI = 0.91 to 1.64; p for interaction = .91). Similarly, there was no interaction with nicotine content (yes vs. no β-carotene supplementation-ventilated cigarettes [≤0.8 µg nicotine]: HR = 1.23, 95% CI = 0.98 to 1.54; nonfiltered cigarettes [≥1.3 µg nicotine]: HR = 1.22, 95% CI = 0.91 to 1.64; p for interaction = .83). CONCLUSION These findings support the conclusion that supplementation with β-carotene increases the risk of lung cancer in smokers regardless of the tar or nicotine content of cigarettes smoked. Our data suggest that all smokers should continue to avoid β-carotene supplementation. IMPLICATIONS Previous studies demonstrated that β-carotene supplementation increases risk of lung cancer in smokers. This study moves the field forward by examining the potential for modification of risk of lung cancer with different levels of tar and nicotine in cigarettes smoked, as interaction with carcinogens in these components of cigarette smoke is hypothesized to be the mechanism by which β-carotene increases risk. Our study provides evidence that the increased risk of lung cancer in smokers who take β-carotene supplements is not dependent upon the tar or nicotine level of cigarettes smoked and suggests that all smokers should continue to avoid β-carotene supplementation.
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Affiliation(s)
- Pooja Middha
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Stephanie J Weinstein
- Department of Health and Human Services, Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD
| | - Satu Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Demetrius Albanes
- Department of Health and Human Services, Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
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Huang J, Weinstein SJ, Moore SC, Derkach A, Hua X, Mondul AM, Sampson JN, Albanes D. Pre-diagnostic Serum Metabolomic Profiling of Prostate Cancer Survival. J Gerontol A Biol Sci Med Sci 2020; 74:853-859. [PMID: 29878065 DOI: 10.1093/gerona/gly128] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Indexed: 12/13/2022] Open
Abstract
Impaired metabolism may play a role in the development and lethality of prostate cancer, yet a comprehensive analysis of the interrelationships appears lacking. We measured 625 metabolites using ultrahigh performance liquid chromatography/mass spectrometry (LC-MS) and gas chromatography/mass spectrometry (GC-MS) of prediagnostic serum from 197 prostate cancer cases in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study (ages at diagnosis, 55-86 years). Cox proportional hazards models estimated associations between circulating metabolites and prostate cancer mortality for 1 SD differences (log-metabolite scale), adjusted for age, year of diagnosis, and disease stage. Associations between metabolite chemical classes and survival were examined through pathway analysis, and Cox models assessed the relationship with a sterol/steroid metabolite principal component analysis factor score. Elevated serum N-oleoyl taurine was significantly associated with prostate cancer-specific mortality (hazard ratios [HR] = 1.72 per 1 SD, p < .00008, Bonferroni-corrected threshold = 0.05/625; HR = 3.6 for highest vs lowest tertile, p < .001). Pathway analyses revealed a statistically significant association between lipids and prostate cancer death (p < .006, Bonferroni-corrected threshold = 0.05/8), and sterol/steroid metabolites showed the strongest chemical sub-class association (p = .0014, Bonferroni-corrected threshold = 0.05/45). In the principal component analysis, a 1-SD increment in the sterol/steroid metabolite score increased the risk of prostate cancer death by 46%. Prediagnostic serum N-oleoyl taurine and sterol/steroid metabolites were associated with prostate cancer survival.
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Affiliation(s)
- Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Andriy Derkach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Xing Hua
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Alvarez CS, Virani S, Meza R, Rozek LS, Sriplung H, Mondul AM. Current and Future Burden of Prostate Cancer in Songkhla, Thailand: Analysis of Incidence and Mortality Trends From 1990 to 2030. J Glob Oncol 2019; 4:1-11. [PMID: 30241231 PMCID: PMC6223432 DOI: 10.1200/jgo.17.00128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Prostate cancer is the second most common malignancy among men worldwide, and it poses a significant public health burden that has traditionally been limited mostly to developed countries. However, the burden of the disease is expected to increase, affecting developing countries, including Thailand. We undertook an analysis to investigate current and future trends of prostate cancer in the province of Songkhla, Thailand, using data from the Songkhla Cancer Registry from 1990 to 2013. METHODS Joinpoint regression analysis was used to examine trends in age-adjusted incidence and mortality rates of prostate cancer and provide estimated annual percent change (EAPC) with 95% CIs. Age-period-cohort (APC) models were used to assess the effect of age, calendar year, and birth cohort on incidence and mortality rates. Three different methods (Joinpoint, Nordpred, and APC) were used to project trends from 2013 to 2030. RESULTS Eight hundred fifty-five cases of prostate cancer were diagnosed from 1990 to 2013 in Songkhla, Thailand. The incidence rates of prostate cancer significantly increased since 1990 at an EAPC of 4.8% (95% CI, 3.6% to 5.9%). Similarly, mortality rates increased at an EAPC of 5.3% (95% CI, 3.4% to 7.2%). The APC models suggest that birth cohort is the most important factor driving the increased incidence and mortality rates of prostate cancer. Future incidence and mortality of prostate cancer are projected to continue to increase, doubling the rates observed in 2013 by 2030. CONCLUSION It is critical to allocate resources to provide care for the men who will be affected by this increase in prostate cancer incidence in Songkhla, Thailand, and to design context-appropriate interventions to prevent its increasing burden.
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Affiliation(s)
- Christian S Alvarez
- Christian S. Alvarez, Shama Virani, Rafael Meza, Laura S. Rozek, and Alison M. Mondul, University of Michigan School of Public Health, Ann Arbor, MI; and Shama Virani and Hutcha Sriplung, Prince of Songkla University, Songkhla, Thailand
| | - Shama Virani
- Christian S. Alvarez, Shama Virani, Rafael Meza, Laura S. Rozek, and Alison M. Mondul, University of Michigan School of Public Health, Ann Arbor, MI; and Shama Virani and Hutcha Sriplung, Prince of Songkla University, Songkhla, Thailand
| | - Rafael Meza
- Christian S. Alvarez, Shama Virani, Rafael Meza, Laura S. Rozek, and Alison M. Mondul, University of Michigan School of Public Health, Ann Arbor, MI; and Shama Virani and Hutcha Sriplung, Prince of Songkla University, Songkhla, Thailand
| | - Laura S Rozek
- Christian S. Alvarez, Shama Virani, Rafael Meza, Laura S. Rozek, and Alison M. Mondul, University of Michigan School of Public Health, Ann Arbor, MI; and Shama Virani and Hutcha Sriplung, Prince of Songkla University, Songkhla, Thailand
| | - Hutcha Sriplung
- Christian S. Alvarez, Shama Virani, Rafael Meza, Laura S. Rozek, and Alison M. Mondul, University of Michigan School of Public Health, Ann Arbor, MI; and Shama Virani and Hutcha Sriplung, Prince of Songkla University, Songkhla, Thailand
| | - Alison M Mondul
- Christian S. Alvarez, Shama Virani, Rafael Meza, Laura S. Rozek, and Alison M. Mondul, University of Michigan School of Public Health, Ann Arbor, MI; and Shama Virani and Hutcha Sriplung, Prince of Songkla University, Songkhla, Thailand
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Maino Vieytes CA, Mondul AM, Li Z, Zarins KR, Wolf GT, Rozek LS, Arthur AE. Dietary Fiber, Whole Grains, and Head and Neck Cancer Prognosis: Findings from a Prospective Cohort Study. Nutrients 2019; 11:nu11102304. [PMID: 31569808 PMCID: PMC6835374 DOI: 10.3390/nu11102304] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/17/2019] [Accepted: 09/25/2019] [Indexed: 02/06/2023] Open
Abstract
No studies, to date, have examined the relationship between dietary fiber and recurrence or survival after head and neck cancer diagnosis. The aim of this study was to determine whether pretreatment intake of dietary fiber or whole grains predicted recurrence and survival outcomes in newly diagnosed head and neck cancer (HNC) patients. This was a prospective cohort study of 463 participants baring a new head and neck cancer diagnosis who were recruited into the study prior to the initiation of any cancer therapy. Baseline (pre-treatment) dietary and clinical data were measured upon entry into the study cohort. Clinical outcomes were ascertained at annual medical reviews. Cox proportional hazard models were fit to examine the relationships between dietary fiber and whole grain intakes with recurrence and survival. There were 112 recurrence events, 121 deaths, and 77 cancer-related deaths during the study period. Pretreatment dietary fiber intake was inversely associated with risk of all-cause mortality (hazard ratio (HR): 0.37, 95% confidence interval (CI): 0.14–0.95, ptrend = 0.04). No statistically significant associations between whole grains and prognostic outcomes were found. We conclude that higher dietary fiber intake, prior to the initiation of treatment, may prolong survival time, in those with a new HNC diagnosis.
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Affiliation(s)
- Christian A Maino Vieytes
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48103, USA.
| | - Zonggui Li
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI 48103, USA.
| | - Gregory T Wolf
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI 48103, USA.
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI 48103, USA.
- Department of Otolaryngology, University of Michigan, Ann Arbor, MI 48103, USA.
| | - Anna E Arthur
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
- Carle Cancer Center, Carle Foundation Hospital, Urbana, IL 61801, USA.
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Crowder SL, Sarma KP, Mondul AM, Chen YT, Li Z, Pepino MY, Zarins KR, Wolf GT, Rozek LS, Arthur AE. Pretreatment Dietary Patterns Are Associated with the Presence of Nutrition Impact Symptoms 1 Year after Diagnosis in Patients with Head and Neck Cancer. Cancer Epidemiol Biomarkers Prev 2019; 28:1652-1659. [PMID: 31315911 DOI: 10.1158/1055-9965.epi-19-0128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/07/2019] [Accepted: 07/10/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Dietary inflammatory potential could impact the presence and severity of chronic adverse treatment effects among patients with head and neck cancer. The objective of this study was to determine whether pretreatment dietary patterns are associated with nutrition impact symptoms (NIS) as self-reported 1 year after diagnosis. METHODS This was a longitudinal study of 336 patients with newly diagnosed head and neck cancer enrolled in the University of Michigan Head and Neck Specialized Program of Research Excellence. Principal component analysis was utilized to derive pretreatment dietary patterns from food frequency questionnaire data. Burden of seven NIS was self-reported 1 year after diagnosis. Associations between pretreatment dietary patterns and individual symptoms and a composite NIS summary score were examined with multivariable logistic regression models. RESULTS The two dietary patterns that emerged were prudent and Western. After adjusting for age, smoking status, body mass index, tumor site, cancer stage, calories, and human papillomavirus status, significant inverse associations were observed between the prudent pattern and difficulty chewing [OR 0.44; 95% confidence interval (CI), 0.21-0.93; P = 0.03], dysphagia of liquids (OR 0.38; 95% CI, 0.18-0.79; P = 0.009), dysphagia of solid foods (OR 0.46; 95% CI, 0.22-0.96; P = 0.03), mucositis (OR 0.48; 95% CI, 0.24-0.96; P = 0.03), and the NIS summary score (OR 0.45; 95% CI, 0.22-0.94; P = 0.03). No significant associations were observed between the Western pattern and NIS. CONCLUSIONS Consumption of a prudent diet before treatment may help reduce the risk of chronic NIS burden among head and neck cancer survivors. IMPACT Dietary interventions are needed to test whether consumption of a prudent dietary pattern before and during head and neck cancer treatment results in reduced NIS burden.
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Affiliation(s)
- Sylvia L Crowder
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Kalika P Sarma
- Carle Cancer Center, Carle Foundation Hospital, Urbana, Illinois
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Yi Tang Chen
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois.,Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Zonggui Li
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - M Yanina Pepino
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan
| | - Gregory T Wolf
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan.,Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan
| | - Anna E Arthur
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois. .,Carle Cancer Center, Carle Foundation Hospital, Urbana, Illinois
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Kazemian E, Akbari ME, Moradi N, Gharibzadeh S, Mondul AM, Jamshidi-Naeini Y, Khademolmele M, Zarins KR, Ghodoosi N, Amouzegar A, Davoodi SH, Rozek LS. Vitamin D Receptor Genetic Variation and Cancer Biomarkers among Breast Cancer Patients Supplemented with Vitamin D3: A Single-Arm Non-Randomized Before and After Trial. Nutrients 2019; 11:E1264. [PMID: 31167402 PMCID: PMC6628022 DOI: 10.3390/nu11061264] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 12/14/2022] Open
Abstract
We investigated whether vitamin D receptor (VDR) polymorphisms were associated with cancer biomarkers, i.e., E-cadherin, matrix metallopeptidase 9 (MMP9), interferon β (IFNβ), soluble intercellular adhesion molecule-1 (s-ICAM-1), soluble vascular cell adhesion molecule-1 (s-VCAM-1), tumor necrosis factorα (TNFα), interleukin 6 (IL6), plasminogen activator inhibitor-1(PAI-1), and human high sensitivity C-reactive protein (hs-CRP), among breast cancer survivors who received vitamin D3 supplementation. In a single-arm non-randomized pre- and post trial, 176 breast cancer survivors who had completed treatment protocol including surgery, radio and chemotherapy were enrolled in the study and received 4000 IU of vitamin D3 daily for 12 weeks. The association between the VDR SNPs (ApaI, TaqI, FokI, BsmI and Cdx2) and response variable changes was assessed using linear regression, utilizing the "association" function in the R package "SNPassoc". We observed that women with AA and GA [codominant model (AA compared to GG) and (GA compared to GG); dominant model (AA & GA compared to GG)] genotypes of Cdx2 showed higher increase in plasma MMP9 levels compared to the GG category. In addition, carriers of BsmI bb showed greater decrease in circulating TNFα levels after vitamin D3 supplementation [recessive model (bb compared to BB & Bb]. Likewise, significant associations were identified between haplotypes of VDR polymorphisms and on-study plasma MMP9 changes. However, our results indicate that VDR genetic polymorphisms were not associated with longitudinal changes in the remaining cancer biomarkers. Overall, our findings suggest that changes in certain inflammatory biomarkers in breast cancer survivors with low plasma 25(OH)D levels, supplemented with vitamin D3, may depend on VDR SNPs and haplotypes.
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Affiliation(s)
- Elham Kazemian
- Department of Basic Sciences and Cellular and Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology and National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 7, Hafezi St. Farahzadi Blv, Shahrake Gharb, Tehran 19816-19573, Iran.
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran.
| | - Mohammad Esmaeil Akbari
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 19899-34148, Iran.
| | - Nariman Moradi
- Department of Clinical Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj 66177-13446, Iran.
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran 14496-14535, Iran.
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran 13169-43551, Iran.
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
| | | | - Maryam Khademolmele
- Department of Nutrition Science, Faculty of Medical Science and Technology, Islamic Azad University, Science and Research Branch (SRBIAU), Tehran 14778-93855, Iran.
| | - Katie R Zarins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, M6529 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
| | - Nasim Ghodoosi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran 14155-6446, Iran.
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19395-4763, Iran.
| | - Sayed Hossein Davoodi
- Department of Basic Sciences and Cellular and Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology and National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 7, Hafezi St. Farahzadi Blv, Shahrake Gharb, Tehran 19816-19573, Iran.
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 19899-34148, Iran.
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan School of Public Health, M6529 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
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Alimujiang A, Wiensch A, Boss J, Fleischer NL, Mondul AM, McLean K, Mukherjee B, Pearce CL. Association Between Life Purpose and Mortality Among US Adults Older Than 50 Years. JAMA Netw Open 2019; 2:e194270. [PMID: 31125099 PMCID: PMC6632139 DOI: 10.1001/jamanetworkopen.2019.4270] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IMPORTANCE A growing body of literature suggests that having a strong sense of purpose in life leads to improvements in both physical and mental health and enhances overall quality of life. There are interventions available to influence life purpose; thus, understanding the association of life purpose with mortality is critical. OBJECTIVE To evaluate whether an association exists between life purpose and all-cause or cause-specific mortality among older adults in the United States. DESIGN, SETTING, AND PARTICIPANTS The Health and Retirement Study (HRS) is a national cohort study of US adults older than 50 years. Adults between the ages of 51 to 61 were enrolled in the HRS, and their spouses or partners were enrolled regardless of age. Initially, individuals born between 1931 and 1941 were enrolled starting in 1992, but subsequent cohort enrichment was carried out. The present prospective cohort study sample was drawn from 8419 HRS participants who were older than 50 years and who had filled out a psychological questionnaire during the HRS 2006 interview period. Of these, 1142 nonresponders with incomplete life purpose data, 163 respondents with missing sample weights, 81 participants lost to follow-up, 1 participant with an incorrect survival time, and 47 participants with missing information on covariates were excluded. The final sample for analysis was 6985 individuals. Data analyses were conducted between June 5, 2018, and April 22, 2019. EXPOSURES Purpose in life was assessed for the 2006 interview period with a 7-item questionnaire from the modified Ryff and Keyes Scales of Psychological Well-being evaluation using a Likert scale ranging from 1 to 6, with higher scores indicating greater purpose in life; for all-cause and cause-specific mortality analyses, 5 categories of life purpose scores were used (1.00-2.99, 3.00-3.99, 4.00-4.99, 5.00-5.99, and 6.00). MAIN OUTCOMES AND MEASURES All-cause and cause-specific mortality were assessed between 2006 and 2010. Weighted Cox proportional hazards models were used to evaluate life purpose and mortality. RESULTS Of 6985 individuals included in the analysis, 4016 (57.5%) were women, the mean (SD) age of all participants was 68.6 (9.8) years, and the mean (SD) survival time for decedents was 31.21 (15.42) months (range, 1.00-71.00 months). Life purpose was significantly associated with all-cause mortality in the HRS (hazard ratio, 2.43; 95% CI, 1.57-3.75, comparing those in the lowest life purpose category with those in the highest life purpose category). Some significant cause-specific mortality associations with life purpose were also observed (heart, circulatory, and blood conditions: hazard ratio, 2.66; 95% CI, 1.62-4.38). CONCLUSIONS AND RELEVANCE This study's results indicated that stronger purpose in life was associated with decreased mortality. Purposeful living may have health benefits. Future research should focus on evaluating the association of life purpose interventions with health outcomes, including mortality. In addition, understanding potential biological mechanisms through which life purpose may influence health outcomes would be valuable.
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Affiliation(s)
- Aliya Alimujiang
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Ashley Wiensch
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Jonathan Boss
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor
| | - Nancy L. Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Alison M. Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Karen McLean
- Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor
| | - Bhramar Mukherjee
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
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Huang J, Mondul AM, Weinstein SJ, Derkach A, Moore SC, Sampson JN, Albanes D. Prospective serum metabolomic profiling of lethal prostate cancer. Int J Cancer 2019; 145:3231-3243. [PMID: 30779128 DOI: 10.1002/ijc.32218] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/28/2019] [Accepted: 02/12/2019] [Indexed: 12/20/2022]
Abstract
Impaired metabolism may play an important role in the pathogenesis of lethal prostate cancer, yet there is a paucity of evidence regarding the association. We conducted a large prospective serum metabolomic analysis of lethal prostate cancer in 523 cases and 523 matched controls nested within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study. Median time from baseline fasting serum collection to prostate cancer death was 18 years (maximum 30 years). We identified 860 known biochemicals through an ultrahigh-performance LC-MS/MS platform. Conditional logistic regression models estimated odds ratios (OR) and 95% confidence intervals of risk associated with 1-standard deviation (s.d.) increases in log-metabolite signals. We identified 34 metabolites associated with lethal prostate cancer with a false discovery rate (FDR) < 0.15. Notably, higher serum thioproline, and thioproline combined with two other cysteine-related amino acids and redox metabolites, cystine and cysteine, were associated with reduced risk (1-s.d. OR = 0.75 and 0.71, respectively; p ≤ 8.2 × 10-5 ). By contrast, the dipeptide leucylglycine (OR = 1.36, p = 8.2 × 10-5 ), and three gamma-glutamyl amino acids (OR = 1.28-1.30, p ≤ 4.6 × 10-4 ) were associated with increased risk of lethal prostate cancer. Cases with metastatic disease at diagnosis (n = 179) showed elevated risk for several lipids, including especially the ketone body 3-hydroxybutyrate (BHBA), acyl carnitines, and dicarboxylic fatty acids (1.37 ≤ OR ≤ 1.49, FDR < 0.15). These findings provide a prospective metabolomic profile of lethal prostate cancer characterized by altered biochemicals in the redox, dipeptide, pyrimidine, and gamma-glutamyl amino acid pathways, whereas ketone bodies and fatty acids were associated specifically with metastatic disease.
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Affiliation(s)
- Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Andriy Derkach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
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McCullough ML, Zoltick ES, Weinstein SJ, Fedirko V, Wang M, Cook NR, Eliassen AH, Zeleniuch-Jacquotte A, Agnoli C, Albanes D, Barnett MJ, Buring JE, Campbell PT, Clendenen TV, Freedman ND, Gapstur SM, Giovannucci EL, Goodman GG, Haiman CA, Ho GYF, Horst RL, Hou T, Huang WY, Jenab M, Jones ME, Joshu CE, Krogh V, Lee IM, Lee JE, Männistö S, Le Marchand L, Mondul AM, Neuhouser ML, Platz EA, Purdue MP, Riboli E, Robsahm TE, Rohan TE, Sasazuki S, Schoemaker MJ, Sieri S, Stampfer MJ, Swerdlow AJ, Thomson CA, Tretli S, Tsugane S, Ursin G, Visvanathan K, White KK, Wu K, Yaun SS, Zhang X, Willett WC, Gail MH, Ziegler RG, Smith-Warner SA. Circulating Vitamin D and Colorectal Cancer Risk: An International Pooling Project of 17 Cohorts. J Natl Cancer Inst 2019; 111:158-169. [PMID: 29912394 PMCID: PMC6376911 DOI: 10.1093/jnci/djy087] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/26/2018] [Accepted: 04/16/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Experimental and epidemiological studies suggest a protective role for vitamin D in colorectal carcinogenesis, but evidence is inconclusive. Circulating 25-hydroxyvitamin D (25(OH)D) concentrations that minimize risk are unknown. Current Institute of Medicine (IOM) vitamin D guidance is based solely on bone health. METHODS We pooled participant-level data from 17 cohorts, comprising 5706 colorectal cancer case participants and 7107 control participants with a wide range of circulating 25(OH)D concentrations. For 30.1% of participants, 25(OH)D was newly measured. Previously measured 25(OH)D was calibrated to the same assay to permit estimating risk by absolute concentrations. Study-specific relative risks (RRs) for prediagnostic season-standardized 25(OH)D concentrations were calculated using conditional logistic regression and pooled using random effects models. RESULTS Compared with the lower range of sufficiency for bone health (50-<62.5 nmol/L), deficient 25(OH)D (<30 nmol/L) was associated with 31% higher colorectal cancer risk (RR = 1.31, 95% confidence interval [CI] = 1.05 to 1.62); 25(OH)D above sufficiency (75-<87.5 and 87.5-<100 nmol/L) was associated with 19% (RR = 0.81, 95% CI = 0.67 to 0.99) and 27% (RR = 0.73, 95% CI = 0.59 to 0.91) lower risk, respectively. At 25(OH)D of 100 nmol/L or greater, risk did not continue to decline and was not statistically significantly reduced (RR = 0.91, 95% CI = 0.67 to 1.24, 3.5% of control participants). Associations were minimally affected when adjusting for body mass index, physical activity, or other risk factors. For each 25 nmol/L increment in circulating 25(OH)D, colorectal cancer risk was 19% lower in women (RR = 0.81, 95% CI = 0.75 to 0.87) and 7% lower in men (RR = 0.93, 95% CI = 0.86 to 1.00) (two-sided Pheterogeneity by sex = .008). Associations were inverse in all subgroups, including colorectal subsite, geographic region, and season of blood collection. CONCLUSIONS Higher circulating 25(OH)D was related to a statistically significant, substantially lower colorectal cancer risk in women and non-statistically significant lower risk in men. Optimal 25(OH)D concentrations for colorectal cancer risk reduction, 75-100 nmol/L, appear higher than current IOM recommendations.
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Affiliation(s)
| | - Emilie S Zoltick
- Departments of Epidemiology
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Molin Wang
- Departments of Epidemiology
- Biostatistics
- Channing Division of Network Medicine
| | - Nancy R Cook
- Departments of Epidemiology
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | | | | | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Matthew J Barnett
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Julie E Buring
- Departments of Epidemiology
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Peter T Campbell
- Behavioral and Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Tess V Clendenen
- Division of Epidemiology and Biostatistics, Department of Population Health, New York University School of Medicine, New York, NY
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Susan M Gapstur
- Behavioral and Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Edward L Giovannucci
- Departments of Epidemiology
- Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine
| | - Gary G Goodman
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Gloria Y F Ho
- Department of Occupational Medicine, Epidemiology and Prevention, Feinstein Institute for Medical Research, Hofstra Northwell School of Medicine, Great Neck, NY
| | | | - Tao Hou
- Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Mazda Jenab
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | | | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - I-Min Lee
- Departments of Epidemiology
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Jung Eun Lee
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
| | - Satu Männistö
- Department of Health National Institute for Health and Welfare, Helsinki, Finland
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK
| | - Trude Eid Robsahm
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Shizuka Sasazuki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Meir J Stampfer
- Departments of Epidemiology
- Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ
| | - Steinar Tretli
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Schoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Giske Ursin
- Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Institute of Basic Medical Sciences, Medical Faculty, University of Oslo, Oslo, Norway
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kami K White
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI
| | - Kana Wu
- Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | | | | | - Walter C Willett
- Departments of Epidemiology
- Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine
| | - Mitchel H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
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Travis RC, Perez-Cornago A, Appleby PN, Albanes D, Joshu CE, Lutsey PL, Mondul AM, Platz EA, Weinstein SJ, Layne TM, Helzlsouer KJ, Visvanathan K, Palli D, Peeters PH, Bueno-de-Mesquita B, Trichopoulou A, Gunter MJ, Tsilidis KK, Sánchez MJ, Olsen A, Brenner H, Schöttker B, Perna L, Holleczek B, Knekt P, Rissanen H, Yeap BB, Flicker L, Almeida OP, Wong YYE, Chan JM, Giovannucci EL, Stampfer MJ, Ursin G, Gislefoss RE, Bjørge T, Meyer HE, Blomhoff R, Tsugane S, Sawada N, English DR, Eyles DW, Heath AK, Williamson EJ, Manjer J, Malm J, Almquist M, Marchand LL, Haiman CA, Wilkens LR, Schenk JM, Tangen CM, Black A, Cook MB, Huang WY, Ziegler RG, Martin RM, Hamdy FC, Donovan JL, Neal DE, Touvier M, Hercberg S, Galan P, Deschasaux M, Key TJ, Allen NE. A Collaborative Analysis of Individual Participant Data from 19 Prospective Studies Assesses Circulating Vitamin D and Prostate Cancer Risk. Cancer Res 2019; 79:274-285. [PMID: 30425058 PMCID: PMC6330070 DOI: 10.1158/0008-5472.can-18-2318] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/04/2018] [Accepted: 11/08/2018] [Indexed: 11/16/2022]
Abstract
Previous prospective studies assessing the relationship between circulating concentrations of vitamin D and prostate cancer risk have shown inconclusive results, particularly for risk of aggressive disease. In this study, we examine the association between prediagnostic concentrations of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] and the risk of prostate cancer overall and by tumor characteristics. Principal investigators of 19 prospective studies provided individual participant data on circulating 25(OH)D and 1,25(OH)2D for up to 13,462 men with incident prostate cancer and 20,261 control participants. ORs for prostate cancer by study-specific fifths of season-standardized vitamin D concentration were estimated using multivariable-adjusted conditional logistic regression. 25(OH)D concentration was positively associated with risk for total prostate cancer (multivariable-adjusted OR comparing highest vs. lowest study-specific fifth was 1.22; 95% confidence interval, 1.13-1.31; P trend < 0.001). However, this association varied by disease aggressiveness (P heterogeneity = 0.014); higher circulating 25(OH)D was associated with a higher risk of nonaggressive disease (OR per 80 percentile increase = 1.24, 1.13-1.36) but not with aggressive disease (defined as stage 4, metastases, or prostate cancer death, 0.95, 0.78-1.15). 1,25(OH)2D concentration was not associated with risk for prostate cancer overall or by tumor characteristics. The absence of an association of vitamin D with aggressive disease does not support the hypothesis that vitamin D deficiency increases prostate cancer risk. Rather, the association of high circulating 25(OH)D concentration with a higher risk of nonaggressive prostate cancer may be influenced by detection bias. SIGNIFICANCE: This international collaboration comprises the largest prospective study on blood vitamin D and prostate cancer risk and shows no association with aggressive disease but some evidence of a higher risk of nonaggressive disease.
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Affiliation(s)
- Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
| | - Paul N Appleby
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Tracy M Layne
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Kathy J Helzlsouer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Petra H Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), BA Bilthoven, the Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, Kuala Lumpur, Malaysia
| | | | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Laura Perna
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | | | - Paul Knekt
- National Institute for Health and Welfare, Helsinki, Finland
| | - Harri Rissanen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Bu B Yeap
- The Medical School, University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
| | - Leon Flicker
- The Medical School, University of Western Australia, Perth, Australia
- Western Australian Centre for Health and Ageing, Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia
- Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia
| | - Osvaldo P Almeida
- The Medical School, University of Western Australia, Perth, Australia
- Western Australian Centre for Health and Ageing, Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia
- Department of Psychiatry, Royal Perth Hospital, Perth, Australia
| | - Yuen Yee Elizabeth Wong
- The Medical School, University of Western Australia, Perth, Australia
- Department of Geriatric Medicine, Fiona Stanley and Fremantle Hospitals Group, Perth, Australia
| | - June M Chan
- Departments of Epidemiology and Biostatistics and Urology, University of California, San Francisco, San Francisco, California
| | - Edward L Giovannucci
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Meir J Stampfer
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Giske Ursin
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Randi E Gislefoss
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Tone Bjørge
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Haakon E Meyer
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Division of Cancer Medicine, Department of Clinical Service, Oslo University Hospital, Oslo, Norway
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Dallas R English
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Darryl W Eyles
- Queensland Brain Institute, University of Queensland, Queensland, Australia
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | - Elizabeth J Williamson
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jonas Manjer
- Department of Translational Medicine, Clinical Chemistry, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Johan Malm
- Department of Translational Medicine, Clinical Chemistry, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Almquist
- Department of Surgery, Endocrine-Sarcoma Unit, Skåne University Hospital, Lund, Sweden
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Christopher A Haiman
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Jeannette M Schenk
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Centre, Seattle, Washington
| | - Cathy M Tangen
- SWOG (Formerly the Southwest Oncology Group) Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Richard M Martin
- Bristol Medical School Department of Population Health Sciences, University of Bristol, Bristol, United Kingdom
- Medical Research Council (MRC) University of Bristol Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- National Institute for Health Research, Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Freddie C Hamdy
- Nuffield Department of Surgery, University of Oxford, Oxford, United Kingdom
| | - Jenny L Donovan
- Bristol Medical School Department of Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - David E Neal
- Nuffield Department of Surgery, University of Oxford, Oxford, United Kingdom
| | - Mathilde Touvier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 University, Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 University, Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 University, Bobigny, France
| | - Mélanie Deschasaux
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 University, Bobigny, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Alvarez CS, Villamor E, Meza R, Rozek LS, Sriplung H, Mondul AM. Differences in prostate tumor characteristics and survival among religious groups in Songkhla, Thailand. BMC Cancer 2018; 18:1175. [PMID: 30482167 PMCID: PMC6260711 DOI: 10.1186/s12885-018-5102-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 11/16/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The incidence and mortality from prostate cancer is expected to increase in the next decade in Thailand. Despite the perceived lower risk in this population vs. developed, western countries, it is becoming an important public health issue. Prostate cancer incidence varies between the most predominant religious groups in Thailand, Buddhists and Muslims. However limited data is available describing the prostate cancer survival in these two populations. Here we examine differences in prostate tumor characteristics and survival between Buddhists and Muslims in the province of Songkhla, Thailand. METHODS 945 incident prostate cancer cases (1990-2014) from the population-based Songkhla Cancer Registry were used in this analysis. Age, grade, stage, and year at diagnosis were compared across religious groups, using Wilcoxon or Chi-square tests. Kaplan Meier methods were used to estimate the median survival time and 5-year survival probabilities. Cox proportional hazards models were used to estimate hazard ratios (HR) between religious groups and 95% confidence intervals (CI) for mortality in age-adjusted and fully-adjusted models. RESULTS Prostate tumor characteristics, age, and year at diagnosis were similar across religious groups. The median survival time after diagnosis of prostate cancer was longer in Buddhists 3.8 years compared with Muslims 3.2 years (p = 0.08). The age-adjusted risk of death after prostate cancer diagnosis was higher in Muslims compared with Buddhists (HR: 1.31; 95%CI: 1.00, 1.72). After adjustment by stage and grade, results were slightly attenuated (HR: 1.27, 95%CI: 0.97, 1.67). CONCLUSION Muslims have shorter survival after prostate cancer diagnosis than do Buddhists in Thailand. The reasons underlying this difference require additional investigation in order to design targeted interventions for both populations.
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Affiliation(s)
- Christian S. Alvarez
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48103 USA
| | - Eduardo Villamor
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48103 USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48103 USA
| | - Laura S. Rozek
- Department of Environmental Health Science, University of Michigan School of Public Health, 1415 Washington Height, Ann Arbor, MI 48103 USA
| | - Hutcha Sriplung
- Epidemiology Unit, Faculty of Medicine Hat Yai, Prince of Songkla University, Hat Yai District, Songkhla, 90110 Thailand
| | - Alison M. Mondul
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48103 USA
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Weinstein SJ, Mondul AM, Yu K, Layne TM, Abnet CC, Freedman ND, Stolzenberg-Solomon RZ, Lim U, Gail MH, Albanes D. Circulating 25-hydroxyvitamin D up to 3 decades prior to diagnosis in relation to overall and organ-specific cancer survival. Eur J Epidemiol 2018; 33:1087-1099. [PMID: 30073448 PMCID: PMC6195863 DOI: 10.1007/s10654-018-0428-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/17/2018] [Indexed: 12/14/2022]
Abstract
While vitamin D has been associated with improved overall cancer survival in some investigations, few have prospectively evaluated organ-specific survival. We examined the accepted biomarker of vitamin D status, serum 25-hydroxyvitamin D [25(OH)D], and cancer survival in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Of 4616 cancer cases with measured serum 25(OH)D, 2884 died of their cancer during 28 years of follow-up and 1732 survived or died of other causes. Proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between pre-diagnostic 25(OH)D and overall and site-specific survival. Serum 25(OH)D was significantly lower among cases who subsequently died from their malignancy compared with those who did not (medians 34.7 vs. 36.5 nmol/L, respectively; p = 0.01). Higher 25(OH)D was associated with lower overall cancer mortality (HR = 0.76, 95% CI 0.67-0.85 for highest vs. lowest quintile, p-trend < 0.0001). Higher 25(OH)D was related to lower mortality from the following site-specific malignancies: prostate (HR = 0.74, 95% CI 0.55-1.01, p-trend = 0.005), kidney (HR = 0.59, 95% CI 0.35-0.98, p-trend = 0.28), and melanoma (HR = 0.39, 95% CI 0.20-0.78, p-trend = 0.01), but increased mortality from lung cancer (HR = 1.28, 95% CI 1.02-1.61, p-trend = 0.19). Improved survival was also suggested for head and neck, gastric, pancreatic, and liver cancers, though not statistically significantly, and case numbers for the latter two organ sites were small. Higher 25(OH)D status years prior to diagnosis was related to improved survival for overall and some site-specific cancers, associations that should be examined in other prospective populations that include women and other racial-ethnic groups.
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Affiliation(s)
- Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA.
| | - Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Tracy M Layne
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Racheal Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Unhee Lim
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Mitchell H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
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Mondul AM, Joshu CE, Barber JR, Prizment AE, Bhavsar NA, Selvin E, Folsom AR, Platz EA. Longer-term Lipid-lowering Drug Use and Risk of Incident and Fatal Prostate Cancer in Black and White Men in the ARIC Study. Cancer Prev Res (Phila) 2018; 11:779-788. [PMID: 30327368 DOI: 10.1158/1940-6207.capr-17-0396] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 08/21/2018] [Accepted: 10/12/2018] [Indexed: 01/22/2023]
Abstract
Lipid-lowering medications, particularly statins, may protect against aggressive prostate cancer. Fatal prostate cancer, the most clinically relevant outcome, remains understudied for this association. We prospectively studied lipid-lowering medication use and both incident and fatal prostate cancer in black and white men in the Atherosclerosis Risk in Communities (ARIC) study. A total of 6,518 men without cancer at visit 2 (1990-1992), the start of the statin era, were followed for prostate cancer incidence and death through 2012. Medication use was collected during study visits and telephone calls at up to nine time points during follow-up. Cox regression was used to estimate HR and 95% confidence intervals (CI) of total (white N = 541, black N = 259) and fatal (white N = 56, black N = 34) prostate cancer overall and by race. Lipid-lowering medication use was modeled as time-dependent current use or duration (never, <10, and ≥10 years). By visit 4 (1996-1998), 21% of white and 11% of black men had used a lipid-lowering medication, mostly statins. There was a suggestion that current users were less likely to die from prostate cancer than nonusers (HR = 0.67, 95% CI = 0.42-1.07) after multivariable adjustment. We observed no statistically significant differences between black and white men. Current use was not associated with incident prostate cancer, although long-term use was statistically significantly inversely associated with incidence (HR = 0.68; 95% CI = 0.50-0.92). Long-term lipid-lowering medication use was associated with lower risk of prostate cancer. Current use was possibly associated with fatal prostate cancer.
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Affiliation(s)
- Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - John R Barber
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Anna E Prizment
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Nrupen A Bhavsar
- Department of Medicine, Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Aaron R Folsom
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Huang J, Weinstein SJ, Moore SC, Derkach A, Hua X, Liao LM, Gu F, Mondul AM, Sampson JN, Albanes D. Serum Metabolomic Profiling of All-Cause Mortality: A Prospective Analysis in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study Cohort. Am J Epidemiol 2018; 187:1721-1732. [PMID: 29390044 DOI: 10.1093/aje/kwy017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/23/2018] [Indexed: 12/12/2022] Open
Abstract
Tobacco use, hypertension, hyperglycemia, overweight, and inactivity are leading causes of overall and cardiovascular disease (CVD) mortality worldwide, yet the relevant metabolic alterations responsible are largely unknown. We conducted a serum metabolomic analysis of 620 men in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (1985-2013). During 28 years of follow-up, there were 435 deaths (197 CVD and 107 cancer). The analysis included 406 known metabolites measured with ultra-high-performance liquid chromatography/mass spectrometry-gas chromatography/mass spectrometry. We used Cox regression to estimate mortality hazard ratios for a 1-standard-deviation difference in metabolite signals. The strongest associations with overall mortality were N-acetylvaline (hazard ratio (HR) = 1.28; P < 4.1 × 10-5, below Bonferroni statistical threshold) and dimethylglycine, 7-methylguanine, C-glycosyltryptophan, taurocholate, and N-acetyltryptophan (1.23 ≤ HR ≤ 1.32; 5 × 10-5 ≤ P ≤ 1 × 10-4). C-Glycosyltryptophan, 7-methylguanine, and 4-androsten-3β,17β-diol disulfate were statistically significantly associated with CVD mortality (1.49 ≤ HR ≤ 1.62, P < 4.1 × 10-5). No metabolite was associated with cancer mortality, at a false discovery rate of <0.1. Individuals with a 1-standard-deviation higher metabolite risk score had increased all-cause and CVD mortality in the test set (HR = 1.4, P = 0.05; HR = 1.8, P = 0.003, respectively). The several serum metabolites and their composite risk score independently associated with all-cause and CVD mortality may provide potential leads regarding the molecular basis of mortality.
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Affiliation(s)
- Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Andriy Derkach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Xing Hua
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Fangyi Gu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Mondul AM, Weinstein SJ, Parisi D, Um CY, McCullough ML, Albanes D. Vitamin D-Binding Protein and Risk of Renal Cell Carcinoma in the Cancer Prevention Study-II Cohort. Cancer Epidemiol Biomarkers Prev 2018; 27:1203-1207. [PMID: 30030213 DOI: 10.1158/1055-9965.epi-18-0263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/04/2018] [Accepted: 07/16/2018] [Indexed: 11/16/2022] Open
Abstract
Background: Kidney cancer has several well-established risk factors, including smoking, obesity, and hypertension. These factors do not, however, completely account for its etiology. One previous study of vitamin D-binding protein (DBP) and risk of renal cell carcinoma found a striking inverse association that warranted replication.Methods: We conducted a nested case-control study in the American Cancer Society Cancer Prevention Study-II Nutrition Cohort to prospectively examine circulating DBP concentration and renal cell carcinoma risk. Cases (n = 87) were matched 1:1 to controls on gender, race, age (±5 years), and date of blood collection (±30 days). ORs and 95% confidence intervals (CIs) were estimated for quartiles of DBP using conditional logistic regression.Results: There was a statistically significant inverse trend across quartiles of DBP such that participants with higher DBP had a markedly decreased risk of renal cell carcinoma (vs. Q1: Q2 OR, 0.93; 95% CI, 0.41-2.11; Q3 OR, 0.42; 95% CI, 0.15-1.15; Q4 OR, 0.33; 95% CI, 0.10-1.06; P trend = 0.03).Conclusions: Our findings demonstrate a strong inverse association between circulating DBP and risk of renal cell carcinoma, supporting the findings from previous research.Impact: This is only the second study to examine DBP and risk of kidney cancer, and one of only a handful of studies to examine circulating DBP and risk of cancer at any site. Our findings support emerging evidence for an etiologic role of DBP in cancer and may provide insights into the etiology of kidney and other cancers. Cancer Epidemiol Biomarkers Prev; 27(10); 1203-7. ©2018 AACR.
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Affiliation(s)
- Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, NIH, Rockville, Maryland
| | - Dominick Parisi
- Information Management Services, Inc., Silver Spring, Maryland
| | - Caroline Y Um
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | | | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, NIH, Rockville, Maryland
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Huang J, Mondul AM, Weinstein SJ, Derkach A, Moore SC, Sampson JN, Albanes D. Abstract 3224: Prospective serum metabolomic profiling of fatal prostate cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Metabolic dysregulation may play a role in the etiology of fatal prostate cancer, yet the association with pre-diagnostic serum metabolites has not been elucidated. We conducted a prospective serum metabolomic analysis of fatal prostate cancer risk in 523 cases and 523 matched controls nested within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study. Median time from baseline fasting serum collection to prostate cancer death was 18 years (interdecile range 10-26 years). We profiled 860 known metabolites through an ultrahigh-performance LC-MS/MS platform, and conditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals of risk associated with 1-standard deviation increases in the log-metabolite signals. Based on a false discovery rate (FDR) of 0.15 or lower, 34 metabolites are identified as being associated with fatal prostate cancer. Notably, increased serum thioproline and the three cysteine-related amino acids combined (thioproline, cysteine and cystine) are associated with lower odds of fatal disease (OR=0.75 and 0.71, respectively; P≤8.2×10-5). In contrast, the serum dipeptide leucylglycine (OR=1.36, P=8.2×10-5), and three gamma-glutamyl amino acids, including gamma-glutamylvaline, gamma-glutamylglycine and gamma-glutamylleucine (OR=1.28-1.30, P≤4.6×10-4), are associated with increased fatal disease risk. Several other dipeptides including histidylalanine, valylglycine and leucylglutamine, as well as the nucleotides dihydroorotate, pseudouridine, 2'-O-methyluridine, 5,6-dihydrouridine and 5-methyluridine (ribothymidine), also have significant positive associations with fatal disease risk. Findings are not materially altered by adjustment for body mass index, smoking, serum total and HDL cholesterol, serum alpha-tocopherol and retinol, or the ATBC trial supplementation. Our results are also similar across strata of time from blood collection to prostate cancer death and age at blood collection. Gene-set analysis (GSA) reveals a significant peptide super-metabolic pathway association with lethal disease (P<0.0001), and the sub-pathways of dipeptides, pyrimidines (uracil containing), gamma-glutamyl amino acids, glycine/serine/threonine, n3 and n6 polyunsaturated fatty acids, amino-sugars, androgenic steroids, dicarboxylate fatty acids, and endocannabinoids are similarly associated with fatal prostate cancer (FDRs ≤ 0.1). Our study demonstrates a serum risk profile up to two decades prior to death of prostate cancer that is characterized by multiple dysregulated biochemical metabolites of redox status and dipeptide, pyrimidine (uracil), and gamma-glutamyl amino acid metabolism. The findings represent novel leads related to the molecular basis of the etiology or subclinical course of fatal prostate cancer that warrant examination in other populations.
Citation Format: Jiaqi Huang, Alison M. Mondul, Stephanie J. Weinstein, Andriy Derkach, Steven C. Moore, Joshua N. Sampson, Demetrius Albanes. Prospective serum metabolomic profiling of fatal prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3224.
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Huang J, Mondul AM, Weinstein SJ, Karoly ED, Sampson JN, Albanes D. Prospective serum metabolomic profile of prostate cancer by size and extent of primary tumor. Oncotarget 2018; 8:45190-45199. [PMID: 28423352 PMCID: PMC5542177 DOI: 10.18632/oncotarget.16775] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/21/2017] [Indexed: 12/14/2022] Open
Abstract
Two recent investigations found serum lipid and energy metabolites related to aggressive prostate cancer up to 20 years prior to diagnosis. To elucidate whether those metabolomic profiles represent etiologic or tumor biomarker signals, we prospectively examined serum metabolites of prostate cancer cases by size and extent of primary tumors in a nested case-control analysis in the ATBC Study cohort that compared cases diagnosed with T2 (n = 71), T3 (n = 51), or T4 (n = 15) disease to controls (n = 200). Time from fasting serum collection to diagnosis averaged 10 years (range 1-20). LC/MS-GC/MS identified 625 known compounds, and logistic regression estimated odds ratios (ORs) associated with one-standard deviation differences in log-metabolites. N-acetyl-3-methylhistidine, 3-methylhistidine and 2'-deoxyuridine were elevated in men with T2 cancers compared to controls (ORs = 1.38-1.79; 0.0002 ≤ p ≤ 0.01). By contrast, four lipid metabolites were inversely associated with T3 tumors: oleoyl-linoleoyl-glycerophosphoinositol (GPI), palmitoyl-linoleoyl-GPI, cholate, and inositol 1-phosphate (ORs = 0.49-0.60; 0.000017 ≤ p ≤ 0.003). Secondary bile acid lipids, sex steroids and caffeine-related xanthine metabolites were elevated, while two Krebs cycle metabolites were decreased, in men diagnosed with T4 cancers. Men with T2, T3, and T4 prostate cancer primaries exhibit qualitatively different metabolite profiles years in advance of diagnosis that may represent etiologic factors, molecular patterns reflective of distinct primary tumors, or a combination of both.
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Affiliation(s)
- Jiaqi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| | | | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
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Yokosawa EB, Arthur AE, Rentschler KM, Wolf GT, Rozek LS, Mondul AM. Vitamin D intake and survival and recurrence in head and neck cancer patients. Laryngoscope 2018; 128:E371-E376. [PMID: 29756240 DOI: 10.1002/lary.27256] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 03/13/2018] [Accepted: 04/04/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVES/HYPOTHESIS With an unacceptably low 5-year survival rate and few identified modifiable factors that affect head and neck cancer (HNC) outcomes, HNC survival remains an important public health problem. Vitamin D has been shown to be associated with immune reactivity and improved outcomes for some cancer sites, but findings are mixed, and few studies have examined vitamin D in relation to HNC. This study aimed to assess the association between vitamin D intake and survival outcomes in HNC patients. STUDY DESIGN Prospective cohort study. METHODS This study utilized data on 434 HNC patients with valid pretreatment food frequency questionnaire data who participated in the University of Michigan Head and Neck Specialized Program of Research Excellence epidemiology project. Cox proportional hazard models were used to estimate the associations between total, dietary, and supplemental vitamin D intake and HNC outcomes, while adjusting for other known prognostic factors. RESULTS After multivariable adjustment, we found a statistically significant inverse trend between total vitamin D intake and recurrence (Q4 vs. Q1 hazard ratio: 0.47, 95% confidence interval: 0.20-1.10, P trend = .048). We observed no association with dietary or supplemental intake separately, and no association was observed with all-cause or HNC-specific mortality. CONCLUSIONS These findings suggest that HNC patients with lower levels of vitamin D intake are at higher risk of recurrence. If borne out in future studies, our results suggest that increased vitamin D intake through dietary intervention or the use of supplements may be a feasible intervention for prevention of recurrence in HNC patients. LEVEL OF EVIDENCE 2b. Laryngoscope, E371-E376, 2018.
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Affiliation(s)
- Eva B Yokosawa
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Anna E Arthur
- Department of Food Science and Human Nutrition, Division of Nutritional Sciences, University of Illinois, Urbana, Illinois.,Department of Medical Oncology, Carle Cancer Center, Carle Foundation Hospital, Urbana, Illinois
| | - Katie M Rentschler
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Gregory T Wolf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.,Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
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