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Botteri E, Peveri G, Berstad P, Bagnardi V, Hoff G, Heath AK, Cross AJ, Vineis P, Dossus L, Johansson M, Freisling H, Matta K, Huybrechts I, Chen SLF, B Borch K, Sandanger TM, H Nøst T, Dahm CC, Antoniussen CS, Tin Tin S, Fournier A, Marques C, Artaud F, Sánchez MJ, Guevara M, Santiuste C, Agudo A, Bajracharya R, Katzke V, Ricceri F, Agnoli C, Bergmann MM, Schulze MB, Panico S, Masala G, Tjønneland A, Olsen A, Stocks T, Manjer J, Aizpurua-Atxega A, Weiderpass E, Riboli E, Gunter MJ, Ferrari P. Lifestyle changes in middle age and risk of cancer: evidence from the European Prospective Investigation into Cancer and Nutrition. Eur J Epidemiol 2024; 39:147-159. [PMID: 38180593 DOI: 10.1007/s10654-023-01059-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/09/2023] [Indexed: 01/06/2024]
Abstract
In this study, we aimed to provide novel evidence on the impact of changing lifestyle habits on cancer risk. In the EPIC cohort, 295,865 middle-aged participants returned a lifestyle questionnaire at baseline and during follow-up. At both timepoints, we calculated a healthy lifestyle index (HLI) score based on cigarette smoking, alcohol consumption, body mass index and physical activity. HLI ranged from 0 (most unfavourable) to 16 (most favourable). We estimated the association between HLI change and risk of lifestyle-related cancers-including cancer of the breast, lung, colorectum, stomach, liver, cervix, oesophagus, bladder, and others-using Cox regression models. We reported hazard ratios (HR) with 95% confidence intervals (CI). Median time between the two questionnaires was 5.7 years, median age at follow-up questionnaire was 59 years. After the follow-up questionnaire, we observed 14,933 lifestyle-related cancers over a median follow-up of 7.8 years. Each unit increase in the HLI score was associated with 4% lower risk of lifestyle-related cancers (HR 0.96; 95%CI 0.95-0.97). Among participants in the top HLI third at baseline (HLI > 11), those in the bottom third at follow-up (HLI ≤ 9) had 21% higher risk of lifestyle-related cancers (HR 1.21; 95%CI 1.07-1.37) than those remaining in the top third. Among participants in the bottom HLI third at baseline, those in the top third at follow-up had 25% lower risk of lifestyle-related cancers (HR 0.75; 95%CI 0.65-0.86) than those remaining in the bottom third. These results indicate that lifestyle changes in middle age may have a significant impact on cancer risk.
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Affiliation(s)
- Edoardo Botteri
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Giulia Peveri
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paula Berstad
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Geir Hoff
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
- Department of Research, Telemark Hospital, Skien, Norway
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Laure Dossus
- International Agency for Research On Cancer (IARC-WHO), World Health Organization, 25, Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
| | - Mattias Johansson
- International Agency for Research On Cancer (IARC-WHO), World Health Organization, 25, Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
| | - Heinz Freisling
- International Agency for Research On Cancer (IARC-WHO), World Health Organization, 25, Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
| | - Komodo Matta
- International Agency for Research On Cancer (IARC-WHO), World Health Organization, 25, Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
| | - Inge Huybrechts
- International Agency for Research On Cancer (IARC-WHO), World Health Organization, 25, Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
| | - Sairah L F Chen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kristin B Borch
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Therese H Nøst
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing , NTNU - Norwegian University of Science and Technology , Trondheim, Norway
| | | | | | - Sandar Tin Tin
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, Oxford, UK
| | - Agnès Fournier
- Université Paris-Saclay, UVSQ, Inserm "Exposome, Heredity, Cancer and Health" Team, CESP U1018, Gustave Roussy, Villejuif, France
| | - Chloé Marques
- Université Paris-Saclay, UVSQ, Inserm "Exposome, Heredity, Cancer and Health" Team, CESP U1018, Gustave Roussy, Villejuif, France
| | - Fanny Artaud
- Université Paris-Saclay, UVSQ, Inserm "Exposome, Heredity, Cancer and Health" Team, CESP U1018, Gustave Roussy, Villejuif, France
| | - Maria-José Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Marcela Guevara
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Salud Pública y Laboral de Navarra, 31003, Pamplona, Spain
- Navarre Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
| | - Carmen Santiuste
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, L'Hospitalet de Llobregat, Spain
- Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Rashmita Bajracharya
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health, University of Turin, Turin, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133, Milan, Italy
| | - Manuela M Bergmann
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anja Olsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Tanja Stocks
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Jonas Manjer
- Department of Surgery, Skåne University Hospital Malmö, Lund University, Malmö, Sweden
| | - Amaia Aizpurua-Atxega
- Epidemiology of Chronic and Communicable Diseases Group, Biodonostia Health Research Institute, San Sebastián, Spain
- Sub Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, San Sebastián, Spain
| | - Elisabete Weiderpass
- International Agency for Research On Cancer (IARC-WHO), World Health Organization, 25, Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- International Agency for Research On Cancer (IARC-WHO), World Health Organization, 25, Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France
| | - Pietro Ferrari
- International Agency for Research On Cancer (IARC-WHO), World Health Organization, 25, Avenue Tony Garnier, CS 90627, 69366, Lyon Cedex 07, France.
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Pla C, Solans M, Ameijide A, Sanvisens A, Carulla M, Rojas MD, Alemán MA, Sáez-Lloret I, Díaz-Del-Campo C, Marcos-Navarro AI, Sainz-de-Aja L, Aizpurua-Atxega A, Lopez-de-Munain A, Sánchez MJ, Perucha J, Franch P, Chirlaque MD, Guevara M, Galceran J, Merino S, Marcos-Gragera R. Incidence and survival of lymphoid neoplasms in Spain, 2002-2013: A population-based study from the Spanish Network of Cancer Registries (REDECAN). Front Oncol 2022; 12:1046307. [PMID: 36508554 PMCID: PMC9731832 DOI: 10.3389/fonc.2022.1046307] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/27/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction The aim of this study was to describe incidence, incidence trends and survival patterns of lymphoid neoplasms (LNs) and its subtypes in Spain in the period 2002-2013 using data from the Spanish Network of Cancer Registries (REDECAN). Materials and Methods Data were extracted from 13 Spanish population-based cancer registries. LNs incident cases were codified using the International Classification of Diseases for Oncology, third edition (ICD-O-3) and grouped according to the WHO 2008 classification. Age-standardized incidence rates to the 2013 European standard population (ASIRe) were obtained. Poisson regression models were used to analyze trends in incidence rates and estimate the annual percentage change (APC) for each subtype. The number of cases in Spain for 2023 was estimated by applying the estimated age-specific rates for the year 2023 to the 2023 Spanish population. Observed survival (OS) was estimated by the Kaplan-Meier method and net survival (NS) by the Pohar-Perme method. Sex- and age-specific estimates of 5-year NS were calculated, as well as its changes according to two periods of diagnosis (2002-2007 and 2008-2013). Results LNs accounted for 69% (n=39,156) of all hematological malignancies (n=56,751) diagnosed during the period of study. Median age at diagnosis was 67 years (interquartile range (IQR) = 52-77). The overall ASIRe was 34.23 (95% confidence interval (CI): 33.89, 34.57) and showed a marked male predominance in almost all subtypes (global sex ratio = 1.45). During the study period, incidence trends of LNs remained stable (APC: 0.3; 95% CI: -0.1, 0.6), nevertheless some subtypes showed statistically significant variations, such as LNs NOS category (APC: -5.6; 95% CI: -6.8, -4.3). Around 17,926 new cases of LNs will be diagnosed in 2023 in Spain. Survival rates differed considerably across age-groups, while they were similar between men and women. Five- year NS was 62.81% (95% CI: 62.1, 63.52) for all LNs, and varied widely across LNs subtypes, ranging from 39.21% to 90.25%. NS for all LNs improved from the first period of diagnosis to the second one, being 61.57% (95% CI: 60.56, 62.61) in 2002-2007 and 64.17% (95% CI: 63.29, 65.07) in 2008-2013. Conclusions This study presents the first complete and extensive population-based analysis of LNs incidence and survival in Spain. These population-based data provide relevant information to better understand the epidemiology of LNs in Southern Europe and it features some useful points for public health authorities and clinicians. However, additional improvements regarding the registration of these hematological neoplasms can be implemented.
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Affiliation(s)
- Clàudia Pla
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Tarragona, Spain
| | - Marta Solans
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Alberto Ameijide
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Tarragona, Spain
| | - Arantza Sanvisens
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona Biomedical Research Institute Dr. Josep Trueta (IDIBGI), Girona, Spain.,Josep Carreras Leukaemia Research Institute, Girona, Spain
| | - Marià Carulla
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Tarragona, Spain
| | - María Dolores Rojas
- Canary Islands Cancer Registry, Public Health Directorate, Canary Islands Government, Las Palmas, Spain
| | - María Araceli Alemán
- Canary Islands Cancer Registry, Public Health Directorate, Canary Islands Government, Las Palmas, Spain
| | - Isabel Sáez-Lloret
- Castellón Cancer Registry, Directorate General of Public Health and Addictions, Valencian Government, Castellón, Spain
| | | | | | - Leire Sainz-de-Aja
- Basque Country Cancer Registry, Basque Government, Vitoria-Gasteiz, Spain
| | | | | | - Maria-José Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Granada Cancer Registry, Andalusian School of Public Health (EASP), Instituto de Investigación Biosanitaria Ibs.GRANADA, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Josefina Perucha
- La Rioja Cancer Registry, Epidemiology and Health Prevention Service, Logroño, Spain
| | - Paula Franch
- Mallorca Cancer Registry, Public Health and Participation Department, Palma de Mallorca, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - María-Dolores Chirlaque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Epidemiology, Regional Health Authority, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, Murcia University, Murcia, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Navarra Cancer Registry, Navarra Public Health Institute, Pamplona, Spain.,Epidemiology and Public Health Area, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Jaume Galceran
- Tarragona Cancer Registry, Cancer Epidemiology and Prevention Service, Sant Joan de Reus University Hospital, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Tarragona, Spain
| | - Susana Merino
- Department of Health, Asturias Cancer Registry, Public Health Directorate, Asturias, Spain
| | - Rafael Marcos-Gragera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology, Girona Biomedical Research Institute Dr. Josep Trueta (IDIBGI), Girona, Spain.,Josep Carreras Leukaemia Research Institute, Girona, Spain.,University of Girona, Girona, Spain
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Gutiérrez-González E, Fernández-Navarro P, Pastor-Barriuso R, García-Pérez J, Castaño-Vinyals G, Martín-Sánchez V, Amiano P, Gómez-Acebo I, Guevara M, Fernández-Tardón G, Salcedo-Bellido I, Moreno V, Pinto-Carbó M, Alguacil J, Marcos-Gragera R, Gómez-Gómez JH, Gómez-Ariza JL, García-Barrera T, Varea-Jiménez E, Núñez O, Espinosa A, Molina de la Torre AJ, Aizpurua-Atxega A, Alonso-Molero J, Ederra-Sanz M, Belmonte T, Aragonés N, Kogevinas M, Pollán M, Pérez-Gómez B. Toenail zinc as a biomarker: Relationship with sources of environmental exposure and with genetic variability in MCC-Spain study. Environ Int 2022; 169:107525. [PMID: 36150295 DOI: 10.1016/j.envint.2022.107525] [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] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Toenails are commonly used as biomarkers of exposure to zinc (Zn), but there is scarce information about their relationship with sources of exposure to Zn. OBJECTIVES To investigate the main determinants of toenail Zn, including selected sources of environmental exposure to Zn and individual genetic variability in Zn metabolism. METHODS We determined toenail Zn by inductively coupled plasma mass spectrometry in 3,448 general population controls from the MultiCase-Control study MCC-Spain. We assessed dietary and supplement Zn intake using food frequency questionnaires, residential proximity to Zn-emitting industries and residential topsoil Zn levels through interpolation methods. We constructed a polygenic score of genetic variability based on 81 single nucleotide polymorphisms in genes involved in Zn metabolism. Geometric mean ratios of toenail Zn across categories of each determinant were estimated from multivariate linear regression models on log-transformed toenail Zn. RESULTS Geometric mean toenail Zn was 104.1 µg/g in men and 100.3 µg/g in women. Geometric mean toenail Zn levels were 7 % lower (95 % confidence interval 1-13 %) in men older than 69 years and those in the upper tertile of fibre intake, and 9 % higher (3-16 %) in smoking men. Women residing within 3 km from Zn-emitting industries had 4 % higher geometric mean toenail Zn levels (0-9 %). Dietary Zn intake and polygenic score were unrelated to toenail Zn. Overall, the available determinants only explained 9.3 % of toenail Zn variability in men and 4.8 % in women. DISCUSSION Sociodemographic factors, lifestyle, diet, and environmental exposure explained little of the individual variability of toenail Zn in the study population. The available genetic variants related to Zn metabolism were not associated with toenail Zn.
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Affiliation(s)
- Enrique Gutiérrez-González
- Spanish Agency for Food Safety and Nutrition, Ministry for Consumer Affairs, Alcala 56 St, 28014 Madrid, Spain
| | - Pablo Fernández-Navarro
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Roberto Pastor-Barriuso
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Javier García-Pérez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Barcelona Institute of Global Health (ISGlobal), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain; University Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Vicente Martín-Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Institute of Biomedicine (IBIOMED), University of León, Campus Universitario de Vegazana, 24071 León, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Sub-Directorate for Public Health and Addictions of Gipuzkoa, Health Department of the Basque Government, Antso Jakituna Hiribidea, 35, 20010 San Sebastian, Spain; Epidemiology and Public Health Area, Biodonostia Health Research Institute, Paseo Dr. Begiristain, 20014 San Sebastian, Spain
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Department of Medical and Surgical Sciences, Faculty of Medicine, University of Cantabria-IDIVAL, Calle Cardenal Herrera Oria, 39011 Santander, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Public Health Institute of Navarra, C. Leyre, 15, 31003 Pamplona, Navarra, Spain; V, C. de Irunlarrea, 3, 31008 Pamplona, Navarra, Spain
| | - Guillermo Fernández-Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Health Research Institute of Asturias (ISPA), University of Oviedo, Av. del Hospital Universitario, 33011 Oviedo, Spain
| | - Inmaculada Salcedo-Bellido
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Av. de la Investigación, 11, 18016 Granada, Spain
| | - Victor Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Avinguda de la Granvia de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Colorectal Cancer Group, ONCOBELL Program, Institut de Recerca Biomedica de Bellvitge (IDIBELL), Avinguda de la Granvia de l'Hospitalet, 199, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Carrer de Casanova, 143, 08036 Barcelona, Spain
| | - Marina Pinto-Carbó
- Cancer and Public Health Area, The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Av. de Catalunya, 21, 46020 Valencia, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Centre for Health and Environmental Research, Huelva University, s, Campus El Carmen, Avda. Andalucía, 21071 Huelva, Spain
| | - Rafael Marcos-Gragera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology (ICO), IDIBGI, Oncology Coordination Plan, Department of Health Government of Catalonia, Carrer del Dr. Castany, 17190 Girona, Spain; University of Girona, Plaça de Sant Domènec, 3, 17004 Girona, Spain
| | - Jesús Humberto Gómez-Gómez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Campus de Ciencias de la Salud, Carretera Buenavista, 30120 El Palmar Murcia, Spain
| | - José Luis Gómez-Ariza
- Department of Chemistry, Faculty of Experimental Sciences, Campus El Carmen, University of Huelva, C/ Menéndez Pelayo, 21002 Huelva, Spain
| | - Tamara García-Barrera
- Department of Chemistry, Faculty of Experimental Sciences, Campus El Carmen, University of Huelva, C/ Menéndez Pelayo, 21002 Huelva, Spain
| | - Elena Varea-Jiménez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
| | - Olivier Núñez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Ana Espinosa
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Barcelona Institute of Global Health (ISGlobal), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain; University Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain
| | - Antonio J Molina de la Torre
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Institute of Biomedicine (IBIOMED), University of León, Campus Universitario de Vegazana, 24071 León, Spain
| | - Amaia Aizpurua-Atxega
- Sub-Directorate for Public Health and Addictions of Gipuzkoa, Health Department of the Basque Government, Antso Jakituna Hiribidea, 35, 20010 San Sebastian, Spain
| | - Jessica Alonso-Molero
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Cantabria-IDIVAL, Calle Cardenal Herrera Oria, 39011 Santander, Spain
| | - María Ederra-Sanz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Public Health Institute of Navarra, C. Leyre, 15, 31003 Pamplona, Navarra, Spain; V, C. de Irunlarrea, 3, 31008 Pamplona, Navarra, Spain
| | - Thalia Belmonte
- Public Health Department, University of Oviedo, Av. Julián Clavería, 6, 33006 Oviedo, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Epidemiology Section, Division of Public Health, Department of Health, C. San Martín de Porres, 6, 28035 Madrid, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Barcelona Institute of Global Health (ISGlobal), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain; University Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Marina Pollán
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Beatriz Pérez-Gómez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain.
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