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Caubet M, L'Espérance K, Koushik A, Lefebvre G. An empirical evaluation of approximate and exact regression-based causal mediation approaches for a binary outcome and a continuous or a binary mediator for case-control study designs. BMC Med Res Methodol 2024; 24:72. [PMID: 38509513 PMCID: PMC10953265 DOI: 10.1186/s12874-024-02156-y] [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: 10/16/2023] [Accepted: 01/18/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND In the causal mediation analysis framework, several parametric regression-based approaches have been introduced in past years for decomposing the total effect of an exposure on a binary outcome into a direct effect and an indirect effect through a target mediator. In this context, a well-known strategy involves specifying a logistic model for the outcome and invoking the rare outcome assumption (ROA) to simplify estimation. Recently, exact estimators for natural direct and indirect effects have been introduced to circumvent the challenges prompted by the ROA. As for the approximate approaches relying on the ROA, these exact approaches cannot be used as is on case-control data where the sampling mechanism depends on the outcome. METHODS Considering a continuous or a binary mediator, we empirically compare the approximate and exact approaches using simulated data under various case-control scenarios. An illustration of these approaches on case-control data is provided, where the natural mediation effects of long-term use of oral contraceptives on ovarian cancer, with lifetime number of ovulatory cycles as the mediator, are estimated. RESULTS In the simulations, we found few differences between the performances of the approximate and exact approaches when the outcome was rare, both marginally and conditionally on variables. However, the performance of the approximate approaches degraded as the prevalence of the outcome increased in at least one stratum of variables. Differences in behavior were also observed among the approximate approaches. In the data analysis, all studied approaches were in agreement with respect to the natural direct and indirect effects estimates. CONCLUSIONS In the case where a violation of the ROA applies or is expected, approximate mediation approaches should be avoided or used with caution, and exact estimators favored.
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Affiliation(s)
- Miguel Caubet
- Department of Mathematics, Université du Québec à Montréal, Montreal, Canada
| | - Kevin L'Espérance
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Canada
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Canada
| | - Anita Koushik
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Canada
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Canada
- St. Mary's Research Centre, Montreal, Canada
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Geneviève Lefebvre
- Department of Mathematics, Université du Québec à Montréal, Montreal, Canada.
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Mésidor M, Liu Y, Talbot D, Skowronski DM, De Serres G, Merckx J, Koushik A, Tadrous M, Carazo S, Jiang C, Schnitzer ME. Test negative design for vaccine effectiveness estimation in the context of the COVID-19 pandemic: A systematic methodology review. Vaccine 2024; 42:995-1003. [PMID: 38072756 DOI: 10.1016/j.vaccine.2023.12.013] [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: 06/27/2023] [Revised: 11/23/2023] [Accepted: 12/02/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND During the height of the global COVID-19 pandemic, the test-negative design (TND) was extensively used in many countries to evaluate COVID-19 vaccine effectiveness (VE). Typically, the TND involves the recruitment of care-seeking individuals who meet a common clinical case definition. All participants are then tested for an infection of interest. OBJECTIVES To review and describe the variation in TND methodology, and disclosure of potential biases, as applied to the evaluation of COVID-19 VE during the early vaccination phase of the pandemic. METHODS We conducted a systematic review by searching four biomedical databases using defined keywords to identify peer-reviewed articles published between January 1, 2020, and January 25, 2022. We included only original articles that employed a TND to estimate VE of COVID-19 vaccines in which cases and controls were evaluated based on SARS-CoV-2 laboratory test results. RESULTS We identified 96 studies, 35 of which met the defined criteria. Most studies were from North America (16 studies) and targeted the general population (28 studies). Outcome case definitions were based primarily on COVID-19-like symptoms; however, several papers did not consider or specify symptoms. Cases and controls had the same inclusion criteria in only half of the studies. Most studies relied upon administrative or hospital databases assembled for a different (non-evaluation) clinical purpose. Potential unmeasured confounding (20 studies), misclassification of current SARS-CoV-2 infection (16 studies) and selection bias (10 studies) were disclosed as limitations by some studies. CONCLUSION We observed potentially meaningful deviations from the validated design in the application of the TND during the COVID-19 pandemic.
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Affiliation(s)
- Miceline Mésidor
- Département de médecine sociale et préventive, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Université Laval, Québec, Canada
| | - Yan Liu
- Faculty of Pharmacy, Université de Montréal, Québec, Canada
| | - Denis Talbot
- Département de médecine sociale et préventive, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec - Université Laval, Québec, Canada.
| | - Danuta M Skowronski
- British Columbia Centre for Disease Control, Vancouver, Canada; University of British Columbia, Vancouver, Canada
| | - Gaston De Serres
- Département de médecine sociale et préventive, Université Laval, Québec, Canada; Institut national de santé publique du Québec, Québec, Canada
| | - Joanna Merckx
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Anita Koushik
- Département de médecine sociale et préventive, Université de Montréal, Québec, Canada
| | | | - Sara Carazo
- Institut national de santé publique du Québec, Québec, Canada
| | - Cong Jiang
- Faculty of Pharmacy, Université de Montréal, Québec, Canada
| | - Mireille E Schnitzer
- Faculty of Pharmacy, Université de Montréal, Québec, Canada; Département de médecine sociale et préventive, Université de Montréal, Québec, Canada.
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Pelland-St-Pierre L, Pham MC, Nguyen AQH, Pasquet R, Taylor SA, Bosson-Rieutort D, Koushik A, Ho V. The Influence of Smoking and Occupational Risk Factors on DNA Methylation in the AHRR and F2RL3 Genes. Cancer Epidemiol Biomarkers Prev 2024; 33:224-233. [PMID: 38051301 DOI: 10.1158/1055-9965.epi-23-0828] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/24/2023] [Revised: 09/26/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND AHRR and F2RL3 hypomethylation has been associated with lung cancer. In this study, we investigated the cross-sectional association between smoking and occupational exposures, and AHRR and F2RL3 methylation. METHODS A case-control study was nested in CARTaGENE to examine the association between AHRR and F2RL3 methylation and lung cancer risk (200 cases; 400 controls). A secondary analysis was conducted using the data collected from this nested study; namely, baseline information on participants' smoking behavior and longest-held job was obtained. A cumulative smoking index summarized information on the number of cigarettes smoked, duration of smoking, and time since cessation. Exposure to 13 occupational agents was estimated using the Canadian Job Exposure Matrix. In baseline blood samples, methylation ratios of 40 CpG sites in the AHRR and F2RL3 genes were measured using Sequenom EpiTYPER. Separate least squares regression models were used to estimate the associations between smoking and occupational exposures, and average AHRR and F2RL3 methylation levels, while adjusting for confounders identified from directed acyclic graphs. RESULTS In both genes, smoking was associated with lower average methylation levels. Occupational exposure to aromatic amines, cadmium, and formaldehyde were associated with lower AHRR methylation while, only benzene was associated with F2RL3 hypomethylation; these associations were stronger among ever smokers. CONCLUSIONS Our findings support that smoking and occupational exposures to some agents are associated with AHRR and F2RL3 hypomethylation. IMPACT Our results inform on mechanisms underlying environmental exposures in lung cancer etiology; future studies should prioritize studying joint exposures.
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Affiliation(s)
- Laura Pelland-St-Pierre
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Centre de recherche en santé publique (CReSP), University of Montréal and CIUSSS Centre-Sud, Montréal, Québec, Canada
| | - Michael C Pham
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Alice Quynh Huong Nguyen
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Romain Pasquet
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Sherryl A Taylor
- Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Delphine Bosson-Rieutort
- Centre de recherche en santé publique (CReSP), University of Montréal and CIUSSS Centre-Sud, Montréal, Québec, Canada
- Department of Health Management, Evaluation and Policy, University of Montreal, Montreal, Quebec, Canada
| | - Anita Koushik
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Vikki Ho
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
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L'Espérance K, Abrahamowicz M, O'Loughlin J, Koushik A. Childhood body fatness and the risk of epithelial ovarian cancer: A population-based case-control study in Montreal, Canada. Prev Med 2024; 178:107794. [PMID: 38072312 DOI: 10.1016/j.ypmed.2023.107794] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/14/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE To assess the association between childhood body fatness and epithelial ovarian cancer (EOC), and whether this association differs by type of EOC. METHODS Using data from a population-based case-control study (497 cases and 902 controls) in Montreal, Canada conducted 2011-2016, we examined the association between childhood body fatness and EOC, overall and separately for invasive vs. borderline EOCs. A figure rating scale was used to measure body fatness at ages 5 and 10. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CI). Quantitative bias analyses were conducted to assess the impact of exposure misclassification and non-participation. RESULTS The aOR (95% CI) of overall EOC for high vs. low body fatness was 1.07 (0.85-1.34) at age 5 and 1.28 (0.98-1.68) at age 10. The associations were stronger for invasive EOC, specifically the endometrioid histological type. For borderline cancers, the aORs were below the null value with wide confidence intervals. Bias analyses did not reveal a strong influence of non-participation. Non-differential exposure misclassification may have biased aORs towards the null for invasive cancers but did not appear to have an appreciable influence on the aORs for borderline cancers. CONCLUSIONS Childhood body fatness may be a risk factor for invasive EOC in later adult life. Our study highlights the potential importance of examining early life factors for a comprehensive understanding of EOC development.
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Affiliation(s)
- Kevin L'Espérance
- Université de Montréal Hospital Research Centre (CRCHUM), 850, rue Saint-Denis, Montréal, Québec H2X 0A9, Canada; Department of Social and Preventive Medicine, Université de Montréal, 7101, avenue du Parc, Montréal, Québec H3N 1X9, Canada
| | - Michal Abrahamowicz
- Centre for Outcomes Research and Evaluation and Division of Clinical Epidemiology, 1001, boulevard Décarie, Montréal, Québec H4A 3J1, Canada; Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, 2001, avenue McGill College, Montréal, Québec H3A 1Y7, Canada
| | - Jennifer O'Loughlin
- Université de Montréal Hospital Research Centre (CRCHUM), 850, rue Saint-Denis, Montréal, Québec H2X 0A9, Canada; Department of Social and Preventive Medicine, Université de Montréal, 7101, avenue du Parc, Montréal, Québec H3N 1X9, Canada
| | - Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM), 850, rue Saint-Denis, Montréal, Québec H2X 0A9, Canada; Department of Social and Preventive Medicine, Université de Montréal, 7101, avenue du Parc, Montréal, Québec H3N 1X9, Canada; Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, 5100 de Maisonneuve Blvd. West, Suite 720, Montréal, Québec H4A 3T2, Canada; St. Mary's Research Centre, 3830 Lacombe Ave, Montréal, Québec, H3T 1M5, Canada.
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Leung L, Lavoué J, Siemiatycki J, Guénel P, Koushik A. Occupational environment and ovarian cancer risk. Occup Environ Med 2023; 80:489-497. [PMID: 37429725 DOI: 10.1136/oemed-2022-108557] [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: 07/04/2022] [Accepted: 03/30/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES To investigate employment in an occupation or industry and specific occupational exposures in relation to ovarian cancer risk. METHODS In a population-based case-control study conducted in Montreal, Canada (2011-2016), lifetime occupational histories were collected for 491 cases of ovarian cancer and 897 controls. An industrial hygienist coded the occupation and industry of each participant's job. Associations with ovarian cancer risk were estimated for each of several occupations and industries. Job codes were linked to the Canadian job-exposure matrix, thereby generating exposure histories to many agents. The relationship between exposure to each of the 29 most prevalent agents and ovarian cancer risk was assessed. Odds ratios and 95% confidence intervals (OR (95% CI)) for associations with ovarian cancer risk were estimated using logistic regression and controlling for multiple covariates. RESULTS Elevated ORs (95% CI) were observed for employment ≥10 years as Accountants (2.05 (1.10 to 3.79)); Hairdressers, Barbers, Beauticians and Related Workers (3.22 (1.25 to 8.27)); Sewers and Embroiderers (1.85 (0.77 to 4.45)); and Salespeople, Shop Assistants and Demonstrators (1.45 (0.71 to 2.96)); and in the industries of Retail Trade (1.59 (1.05 to 2.39)) and Construction (2.79 (0.52 to 4.83)). Positive associations with ORs above 1.42 were seen for high cumulative exposure versus never exposure to 18 agents: cosmetic talc, ammonia, hydrogen peroxide, hair dust, synthetic fibres, polyester fibres, organic dyes and pigments, cellulose, formaldehyde, propellant gases, aliphatic alcohols, ethanol, isopropanol, fluorocarbons, alkanes (C5-C17), mononuclear aromatic hydrocarbons, polycyclic aromatic hydrocarbons from petroleum and bleaches. CONCLUSIONS Certain occupations, industries and specific occupational exposures may be associated with ovarian cancer risk. Further research is needed to provide a more solid grounding for any inferences in this regard.
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Affiliation(s)
- Lisa Leung
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
- Inserm U1018, CESP, Team Exposome and Heredity, Université Paris-Saclay, Villejuif, France
- Université de Montréal Hospital Research Centre, CRCHUM, Montreal, Quebec, Canada
| | - Jérôme Lavoué
- Université de Montréal Hospital Research Centre, CRCHUM, Montreal, Quebec, Canada
- Department of Environmental and Occupational Health, Université de Montréal, Montreal, Quebec, Canada
| | - Jack Siemiatycki
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
- Université de Montréal Hospital Research Centre, CRCHUM, Montreal, Quebec, Canada
| | - Pascal Guénel
- Inserm U1018, CESP, Team Exposome and Heredity, Université Paris-Saclay, Villejuif, France
| | - Anita Koushik
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
- Université de Montréal Hospital Research Centre, CRCHUM, Montreal, Quebec, Canada
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L'Espérance K, Grundy A, Abrahamowicz M, Arseneau J, Gilbert L, Gotlieb WH, Provencher D, Koushik A. Alcohol intake and the risk of epithelial ovarian cancer. Cancer Causes Control 2023; 34:533-541. [PMID: 36933150 DOI: 10.1007/s10552-023-01681-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/28/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE To investigate the association between alcohol intake over the lifetime and the risk of overall, borderline, and invasive ovarian cancer. METHODS In a population-based case-control study of 495 cases and 902 controls, conducted in Montreal, Canada, average alcohol intake over the lifetime and during specific age periods were computed from a detailed assessment of the intake of beer, red wine, white wine and spirits. Multivariable logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the association between alcohol intake and ovarian cancer risk. RESULTS For each one drink/week increment in average alcohol intake over the lifetime, the adjusted OR (95% CI) was 1.06 (1.01-1.10) for ovarian cancer overall, 1.13 (1.06-1.20) for borderline ovarian cancers and 1.02 (0.97-1.08) for invasive ovarian cancers. This pattern of association was similarly observed for alcohol intake in early (15- < 25 years), mid (25- < 40 years) and late adulthood (≥ 40 years), as well as for the intake of specific alcohol beverages over the lifetime. CONCLUSIONS Our results support the hypothesis that a higher alcohol intake modestly increases the risk of overall ovarian cancer, and more specifically, borderline tumours.
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Affiliation(s)
- Kevin L'Espérance
- Université de Montréal Hospital Research Centre (CRCHUM), Tour Saint-Antoine, 850 Rue Saint-Denis, 3e étage, Bureau S03.436, Montreal, QC, H2X 0A9, Canada.,Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
| | - Anne Grundy
- Université de Montréal Hospital Research Centre (CRCHUM), Tour Saint-Antoine, 850 Rue Saint-Denis, 3e étage, Bureau S03.436, Montreal, QC, H2X 0A9, Canada
| | - Michal Abrahamowicz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Jocelyne Arseneau
- Department of Pathology, McGill University Health Centre, Montreal, QC, Canada.,Division of Gynecologic Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Lucy Gilbert
- Division of Gynecologic Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Walter H Gotlieb
- Gynecologic Oncology and Colposcopy, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, QC, Canada
| | - Diane Provencher
- Université de Montréal Hospital Research Centre (CRCHUM), Tour Saint-Antoine, 850 Rue Saint-Denis, 3e étage, Bureau S03.436, Montreal, QC, H2X 0A9, Canada.,Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM), Tour Saint-Antoine, 850 Rue Saint-Denis, 3e étage, Bureau S03.436, Montreal, QC, H2X 0A9, Canada. .,Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada.
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Barnett TA, Koushik A, Schuster T. Cross-sectional studies and causal inference - it's complicated. Am J Epidemiol 2023; 192:517-519. [PMID: 36722176 DOI: 10.1093/aje/kwad026] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 01/18/2023] [Accepted: 01/24/2023] [Indexed: 02/02/2023] Open
Abstract
In this issue of the Journal, Savitz and Wellenius (Am J Epidemiol. XXXX;XXX(XX):XXXX-XXXX) discuss the contribution of cross-sectional studies to causal inference when the data are used to address etiologic research questions. We elaborate on their thoughts with a discussion of the conditions needed for addressing etiology with the cross-sectional design, using a modern causal inference lens.
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Affiliation(s)
- Tracie A Barnett
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Centre de recherche du CHU Sainte-Justine, Montreal, QC, Canada
| | - Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Tibor Schuster
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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Nguyen A, Koushik A, Pelland-St-Pierre L, Pham M, Pasquet R, Ho V. 159 - Méthylation d'ADN des gènes F2RL3 et AHRR et le risque du cancer du poumon. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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L'Espérance K, Koushik A, O'Loughlin J. 281 - L'adiposité chez l'enfant et le risque de cancer épithélial de l'ovaire. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Moayedi-Nia S, Pasquet R, Siemiatycki J, Koushik A, Ho V. Occupational Exposures and Lung Cancer Risk-An Analysis of the CARTaGENE Study. J Occup Environ Med 2022; 64:295-304. [PMID: 35019894 DOI: 10.1097/jom.0000000000002481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
OBJECTIVE To determine the associations between prevalent occupational agents and lung cancer risk. METHODS A case-cohort design (ncases= 147; nsub-cohort= 1,032) was nested within the CARTaGENE prospective cohort study. The Canadian Job Exposure Matrix was used to determine the probability of exposure to 27 agents in participants' longest-held jobs. Multivariable logistic regression with robust variance estimators was used to determine the associations between each agent and lung cancer risk while adjusting for established lung cancer risk factors. RESULTS Increased lung cancer risk was observed among those exposed to ashes, calcium sulfate, formaldehyde, cooking fumes, alkanes, aliphatic aldehydes, and cleaning agents. Lower lung cancer risk was found among participants exposed to carbon monoxide and polycyclic aromatic hydrocarbons from petroleum. CONCLUSION Our findings support the role of several occupational agents, for which we have limited knowledge, in contributing to lung cancer risk.
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Affiliation(s)
- Saeedeh Moayedi-Nia
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada (Ms Moayedi-Nia, Dr Siemiatycki, Dr Koushik, Dr Ho); and Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada (Dr Pasquet, Dr Siemiatycki, Dr Koushik, Dr Ho)
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Grundy A, Sandhu S, Arseneau J, Gilbert L, Gotlieb WH, Aronson KJ, Koushik A. Lifetime caffeine intake and the risk of epithelial ovarian cancer. Cancer Epidemiol 2021; 76:102058. [PMID: 34800867 DOI: 10.1016/j.canep.2021.102058] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Caffeine intake has been inconsistently associated with the risk of ovarian cancer in previous studies. The measure of caffeine in these studies has not always distinguished between caffeinated and decaffeinated sources, and the time for which intake was assessed was often for late adulthood and thus may have excluded the etiologic window. We investigated lifetime caffeine intake from caffeinated coffee, black tea, green tea and cola sodas in relation to ovarian cancer risk. METHODS Among 497 cases and 904 controls in a population-based case-control study in Montreal, Canada, lifetime intake of caffeinated coffee, black tea, green tea and cola sodas was assessed and used to calculate lifetime total intake of caffeine. Unconditional multivariable logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the association between caffeine intake and ovarian cancer risk overall, as well as by menopausal status. Multivariable polytomous logistic regression was used to estimate the associations for invasive and borderline ovarian cancers separately. RESULTS Almost all participants (98.4% of cases and 97.5% of controls) had consumed caffeine in their lifetime. The mean (standard deviation) daily consumption of caffeine over the lifetime was of 117 (89) mg/day among cases and 120 (118) mg/day among controls. The OR (95% CI) of ovarian cancer for the highest versus lowest quartile of lifetime caffeine intake was 1.17 (0.83-1.64). According to menopausal status, the OR (95% CI) was 1.56 (0.85-2.86) for premenopausal women and 0.94 (0.66-1.34) for postmenopausal women, comparing the highest to lowest tertiles of intake. Associations for invasive and borderline ovarian cancers separately were similar to that observed for ovarian cancer overall. CONCLUSION Lifetime caffeine intake was not strongly associated with ovarian cancer risk. A difference in relationship by menopausal status is possible.
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Affiliation(s)
- Anne Grundy
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada; Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Simran Sandhu
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada; Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jocelyne Arseneau
- Department of Pathology, McGill University Health Centre, Montreal, Quebec, Canada; Division of Gynecologic Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Lucy Gilbert
- Division of Gynecologic Oncology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Walter H Gotlieb
- Gynecologic Oncology and Colposcopy, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Kristan J Aronson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada; Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, ON, Canada
| | - Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada; Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada.
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Grundy A, Ho V, Abrahamowicz M, Parent MÉ, Siemiatycki J, Arseneau J, Gilbert L, Gotlieb WH, Provencher DM, Koushik A. Lifetime recreational moderate-to-vigorous physical activity and ovarian cancer risk: A case-control study. Int J Cancer 2020; 146:1800-1809. [PMID: 31199510 DOI: 10.1002/ijc.32513] [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] [Received: 02/18/2019] [Revised: 05/02/2019] [Accepted: 05/31/2019] [Indexed: 11/11/2022]
Abstract
Results of epidemiologic studies of physical activity and ovarian cancer risk are inconsistent. Few have attempted to measure physical activity over the lifetime or in specific age windows, which may better capture etiologically relevant exposures. We examined participation in moderate-to-vigorous recreational physical activity (MVPA) in relation to ovarian cancer risk. In a population-based case-control study conducted in Montreal, Canada from 2011 to 2016 (485 cases and 887 controls), information was collected on lifetime participation in various recreational physical activities, which was used to estimate MVPA for each participant. MVPA was represented as average energy expenditure over the lifetime and in specific age-periods in units of metabolic equivalents (METs)-hours per week. Odds ratios (OR) and 95% confidence intervals (CI) for the relation between average MVPA and ovarian cancer risk were estimated using multivariable logistic regression models. Confounding was assessed using directed acyclic graphs combined with a change-in-estimate approach. The adjusted OR (95% CI) for each 28.5 MET-hr/week increment of lifetime recreational MVPA was 1.11 (0.99-1.24) for ovarian cancer overall. ORs for individual age-periods were weaker. When examined by menopausal status, the OR (95% CI) for lifetime MVPA was 1.21 (1.00-1.45) for those diagnosed before menopause and 1.04 (0.89-1.21) for those diagnosed postmenopausally. The suggestive positive associations were stronger for invasive ovarian cancers and more specifically for high-grade serous carcinomas. These results do not support a reduced ovarian cancer risk associated with MVPA.
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Affiliation(s)
- Anne Grundy
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.,Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
| | - Vikki Ho
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.,Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
| | - Michal Abrahamowicz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Montreal, QC, Canada
| | - Marie-Élise Parent
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.,Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada.,INRS-Institut Armand-Frappier, University of Quebec, Laval, QC, Canada
| | - Jack Siemiatycki
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.,Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
| | - Jocelyne Arseneau
- Department of Pathology, McGill University Health Centre, Montreal, QC, Canada.,Gynecologic Oncology Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Lucy Gilbert
- Gynecologic Oncology Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Walter H Gotlieb
- Gynecologic Oncology and Colposcopy, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, QC, Canada
| | - Diane M Provencher
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada.,Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
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L’Espérance K, Datta GD, Qureshi S, Koushik A. Vitamin D Exposure and Ovarian Cancer Risk and Prognosis. Int J Environ Res Public Health 2020; 17:ijerph17041168. [PMID: 32059597 PMCID: PMC7068491 DOI: 10.3390/ijerph17041168] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/07/2020] [Accepted: 02/07/2020] [Indexed: 02/06/2023]
Abstract
Given the poor prognosis of ovarian cancer and limited population-level strategies for early detection and long-term treatment success, knowledge of modifiable risk factors for prevention and improved prognosis is important. Vitamin D has received wide scientific interest in cancer research as having the potential to be one such factor. We carried out a systematic narrative review of the literature on vitamin D and ovarian cancer risk and survival. We included 17 case-control and cohort studies on ovarian cancer incidence. Five analyses were of sun exposure, among which three reported an inverse association. Of 11 analyses of dietary vitamin D, two reported an inverse association. Among five studies of 25(OH)D levels, an inverse association was reported in two. Across all studies the findings were inconsistent, but some recent studies have suggested that vitamin D exposure at earlier ages may be important. Only three studies examining vitamin D exposure in relation to survival among ovarian cancer survivors were identified and the findings were inconsistent. The evidence to date supports a null influence of vitamin D on both ovarian cancer risk and survival. Future research should ensure that exposure assessment captures vitamin D exposure from all sources and for the etiologically or prognostically pertinent period.
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Affiliation(s)
- Kevin L’Espérance
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC H2X 0A9, Canada; (K.L.); (G.D.D.)
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC H2K 1H2, Canada;
| | - Geetanjali D. Datta
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC H2X 0A9, Canada; (K.L.); (G.D.D.)
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC H2K 1H2, Canada;
| | - Samia Qureshi
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC H2K 1H2, Canada;
| | - Anita Koushik
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC H2X 0A9, Canada; (K.L.); (G.D.D.)
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC H2K 1H2, Canada;
- Correspondence: ; Tel.: +514-890-8000-15915
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14
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Malagón T, Louvanto K, Ramanakumar AV, Koushik A, Coutlée F, Franco EL. Viral load of human papillomavirus types 16/18/31/33/45 as a predictor of cervical intraepithelial neoplasia and cancer by age. Gynecol Oncol 2019; 155:245-253. [PMID: 31604665 DOI: 10.1016/j.ygyno.2019.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 07/26/2019] [Revised: 09/03/2019] [Accepted: 09/08/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVE We assessed whether human papillomavirus (HPV) viral load is an independent predictor of underlying cervical disease and its diagnostic accuracy by age. METHODS The Biomarkers of Cervical Cancer Risk study was a case-control study from 2001 to 2010 in Montréal, Canada. Cases were histologically-confirmed cervical intraepithelial neoplasia (CIN), adenocarcinoma in situ (AIS), or cervical cancer cases. Controls were women presenting for routine screening with normal cytology results. We quantified HPV16/18/31/33/45 viral load from exfoliated cervical cells using a real-time PCR assay. Diagnostic accuracy of viral load was assessed using the area under the receiver operating characteristic curve (AUC). We restricted the analysis to the 632 cases and controls who were HPV16/18/31/33/45 positive. RESULTS Geometric mean HPV16/18/31/33/45 viral load increased with severity of lesion grade, ranging from 0.7, 3.1, 4.8, 7.2, and 12.4 copies/cell in normal, CIN1, CIN2, CIN3&AIS, and cervical cancer respectively. The adjusted odds ratio of CIN1+ and CIN2+ increased respectively by 1.3 (95%CI 1.1-1.4) and 1.2 (95%CI 1.1-1.3) per log-transformed viral copy/cell increase of HPV16/18/31/33/45. This association was mainly driven by HPV16, 18, and 31 viral loads. The AUC of HPV16/18/31/33/45 viral load for discriminating between normal and CIN1+ women was 0.70 (95%CI 0.64-0.76) in HPV-positive women, and was 0.76 (95%CI 0.66-0.86) for women ≥30 years and 0.66 (95%CI 0.58-0.74) for women under 30 years. CONCLUSIONS HPV viral load has lower diagnostic accuracy than has been reported for other HPV screening triage tests. However, it may be useful for triaging HPV tests in settings without cytology results such as HPV self-sampling.
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Affiliation(s)
- Talía Malagón
- Division of Cancer Epidemiology, Faculty of Medicine, McGill University, Montréal, Canada.
| | - Karolina Louvanto
- Department of Obstetrics and Gynaecology, Turku University Hospital, University of Turku, Turku, Finland
| | - Agnihotram V Ramanakumar
- Research Institute-McGill University Health Centre, Montréal, Canada; Division of Cancer Epidemiology, Faculty of Medicine, McGill University, Montréal, Canada
| | - Anita Koushik
- Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada
| | - François Coutlée
- Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, Faculty of Medicine, McGill University, Montréal, Canada
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15
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Koushik A, Leung L, Aronson KJ. Shift Work, Chronotype, and Cancer Risk-Response. Cancer Epidemiol Biomarkers Prev 2019; 28:1405. [PMID: 31300414 DOI: 10.1158/1055-9965.epi-19-0524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 05/16/2019] [Accepted: 06/03/2019] [Indexed: 11/16/2022] Open
Affiliation(s)
- Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Lisa Leung
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Kristan J Aronson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada
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16
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Leung L, Grundy A, Siemiatycki J, Arseneau J, Gilbert L, Gotlieb WH, Provencher DM, Aronson KJ, Koushik A. Shift Work Patterns, Chronotype, and Epithelial Ovarian Cancer Risk. Cancer Epidemiol Biomarkers Prev 2019; 28:987-995. [PMID: 30842128 DOI: 10.1158/1055-9965.epi-18-1112] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 10/13/2018] [Revised: 12/03/2018] [Accepted: 02/26/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Shift work causing circadian disruption is classified as a "probable carcinogen" and may contribute to the pathogenesis of hormone-sensitive cancers. This study investigated shift work exposure in relation to epithelial ovarian cancer (EOC) risk. METHODS In a population-based case-control study with 496 EOC cases and 906 controls, lifetime occupational histories were collected and used to calculate cumulative years of shift work exposure, average number of night shifts per month, and average number of consecutive night shifts per month. ORs and 95% confidence intervals (CI) for associations with EOC risk were estimated using logistic regression. Associations were also examined according to chronotype and menopausal status. RESULTS More than half of the cases (53.4%) and controls (51.7%) worked evening and/or night shifts. There was no clear pattern of increasing EOC risk with increasing years of shift work; the adjusted OR of EOC comparing the highest shift work category versus never working shift work was 1.20 (95% CI, 0.89-1.63). This association was more pronounced among those self-identified as having a "morning" chronotype (OR, 1.64; 95% CI, 1.01-2.65). Associations did not greatly differ by menopausal status. CONCLUSIONS These results do not strongly demonstrate a relationship between shift work and EOC risk. IMPACT This study collected detailed shift work information and examined shift work patterns according to shift times and schedules. The findings highlight that chronotype should be considered in studies of shift work as an exposure.
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Affiliation(s)
- Lisa Leung
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Anne Grundy
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Department of Social and Preventative Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Jack Siemiatycki
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Department of Social and Preventative Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Jocelyne Arseneau
- Gynecologic Oncology Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Lucy Gilbert
- Gynecologic Oncology Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Walter H Gotlieb
- Gynecologic Oncology and Colposcopy, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Diane M Provencher
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Kristan J Aronson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada
| | - Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
- Department of Social and Preventative Medicine, Université de Montréal, Montreal, Quebec, Canada
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17
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Yang Y, Wu L, Shu X, Lu Y, Shu XO, Cai Q, Beeghly-Fadiel A, Li B, Ye F, Berchuck A, Anton-Culver H, Banerjee S, Benitez J, Bjørge L, Brenton JD, Butzow R, Campbell IG, Chang-Claude J, Chen K, Cook LS, Cramer DW, deFazio A, Dennis J, Doherty JA, Dörk T, Eccles DM, Edwards DV, Fasching PA, Fortner RT, Gayther SA, Giles GG, Glasspool RM, Goode EL, Goodman MT, Gronwald J, Harris HR, Heitz F, Hildebrandt MA, Høgdall E, Høgdall CK, Huntsman DG, Kar SP, Karlan BY, Kelemen LE, Kiemeney LA, Kjaer SK, Koushik A, Lambrechts D, Le ND, Levine DA, Massuger LF, Matsuo K, May T, McNeish IA, Menon U, Modugno F, Monteiro AN, Moorman PG, Moysich KB, Ness RB, Nevanlinna H, Olsson H, Onland-Moret NC, Park SK, Paul J, Pearce CL, Pejovic T, Phelan CM, Pike MC, Ramus SJ, Riboli E, Rodriguez-Antona C, Romieu I, Sandler DP, Schildkraut JM, Setiawan VW, Shan K, Siddiqui N, Sieh W, Stampfer MJ, Sutphen R, Swerdlow AJ, Szafron LM, Teo SH, Tworoger SS, Tyrer JP, Webb PM, Wentzensen N, White E, Willett WC, Wolk A, Woo YL, Wu AH, Yan L, Yannoukakos D, Chenevix-Trench G, Sellers TA, Pharoah PDP, Zheng W, Long J. Genetic Data from Nearly 63,000 Women of European Descent Predicts DNA Methylation Biomarkers and Epithelial Ovarian Cancer Risk. Cancer Res 2019; 79:505-517. [PMID: 30559148 PMCID: PMC6359948 DOI: 10.1158/0008-5472.can-18-2726] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/16/2018] [Accepted: 12/06/2018] [Indexed: 12/12/2022]
Abstract
DNA methylation is instrumental for gene regulation. Global changes in the epigenetic landscape have been recognized as a hallmark of cancer. However, the role of DNA methylation in epithelial ovarian cancer (EOC) remains unclear. In this study, high-density genetic and DNA methylation data in white blood cells from the Framingham Heart Study (N = 1,595) were used to build genetic models to predict DNA methylation levels. These prediction models were then applied to the summary statistics of a genome-wide association study (GWAS) of ovarian cancer including 22,406 EOC cases and 40,941 controls to investigate genetically predicted DNA methylation levels in association with EOC risk. Among 62,938 CpG sites investigated, genetically predicted methylation levels at 89 CpG were significantly associated with EOC risk at a Bonferroni-corrected threshold of P < 7.94 × 10-7. Of them, 87 were located at GWAS-identified EOC susceptibility regions and two resided in a genomic region not previously reported to be associated with EOC risk. Integrative analyses of genetic, methylation, and gene expression data identified consistent directions of associations across 12 CpG, five genes, and EOC risk, suggesting that methylation at these 12 CpG may influence EOC risk by regulating expression of these five genes, namely MAPT, HOXB3, ABHD8, ARHGAP27, and SKAP1. We identified novel DNA methylation markers associated with EOC risk and propose that methylation at multiple CpG may affect EOC risk via regulation of gene expression. SIGNIFICANCE: Identification of novel DNA methylation markers associated with EOC risk suggests that methylation at multiple CpG may affect EOC risk through regulation of gene expression.
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Affiliation(s)
- Yaohua Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Lang Wu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Xiang Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Yingchang Lu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alicia Beeghly-Fadiel
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Bingshan Li
- Department of Molecular Physiology & Biophysics, Vanderbilt Genetics Institute, Vanderbilt University, Nashville, Tennessee
| | - Fei Ye
- Division of Cancer Biostatistics, Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
| | - Hoda Anton-Culver
- Department of Epidemiology, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, California
| | - Susana Banerjee
- Gynaecology Unit, Royal Marsden Hospital, London, United Kingdom
| | - Javier Benitez
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Line Bjørge
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
- Center for Cancer Biomarkers CCBIO, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Ralf Butzow
- Department of Pathology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Ian G Campbell
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kexin Chen
- Department of Epidemiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Linda S Cook
- University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Daniel W Cramer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Anna deFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Jennifer A Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Diana M Eccles
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Digna Velez Edwards
- Vanderbilt Epidemiology Center, Vanderbilt Genetics Institute, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Peter A Fasching
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, California
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Simon A Gayther
- The Center for Bioinformatics and Functional Genomics at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Graham G Giles
- Cancer Epidemiology & 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
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Ellen L Goode
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Florian Heitz
- Department of Gynecology and Gynecologic Oncology, Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte/Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
| | - Michelle A Hildebrandt
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Estrid Høgdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Claus K Høgdall
- The Juliane Marie Centre, Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - David G Huntsman
- Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
- OVCARE, Vancouver Coastal Health Research Centre, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Siddhartha P Kar
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Linda E Kelemen
- Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Lambertus A Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Susanne K Kjaer
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anita Koushik
- CHUM Research Centre (CRCHUM) and Département de Médicine Sociale et Préventive, Université de Montréal, Montréal, Quebec, Canada
| | - Diether Lambrechts
- VIB Center for Cancer Biology, VIB and Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Nhu D Le
- Cancer Control Research, BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Douglas A Levine
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
- Gynecologic Oncology, Laura and Isaac Pearlmutter Cancer Center, NYU Langone Medical Center, New York, New York
| | - Leon F Massuger
- Department of Gynaecology, Radboud Institute for Molecular Life sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Taymaa May
- Division of Gynecologic Oncology, University Health Network, Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Iain A McNeish
- Department Surgery & Cancer, Imperial College London, London, United Kingdom
- Institute of Cancer Sciences, University of Glasgow, Wolfson Wohl Cancer Research Centre, Beatson Institute for Cancer Research, Glasgow, United Kingdom
| | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, United Kingdom
| | - Francesmary Modugno
- Womens Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, Pennsylvania
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Alvaro N Monteiro
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Patricia G Moorman
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
| | - Kirsten B Moysich
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Roberta B Ness
- School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Houston, Texas
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Håkan Olsson
- Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Utrecht, UMC Utrecht, Utrecht, the Netherlands
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - James Paul
- The Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Celeste L Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Tanja Pejovic
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon
- Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Catherine M Phelan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Malcolm C Pike
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Susan J Ramus
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Elio Riboli
- Imperial College London, London, United Kingdom
| | - Cristina Rodriguez-Antona
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina
| | - Joellen M Schildkraut
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Veronica W Setiawan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Kang Shan
- Department of Obstetrics and Gynaecology, Hebei Medical University, Fourth Hospital, Shijiazhuang, China
| | - Nadeem Siddiqui
- Department of Gynaecological Oncology, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Weiva Sieh
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Meir J Stampfer
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Rebecca Sutphen
- Epidemiology Center, College of Medicine, University of South Florida, Tampa, Florida
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Division of Breast Cancer Research, The Institute of Cancer Research, London, United Kingdom
| | - Lukasz M Szafron
- Department of Immunology, Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - Soo Hwang Teo
- Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
- Breast Cancer Research Unit, Cancer Research Institute, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
- Research Institute and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jonathan P Tyrer
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Emily White
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Yin Ling Woo
- Department of Obstetrics and Gynaecology, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Li Yan
- Department of Molecular Biology, Hebei Medical University, Fourth Hospital, Shijiazhuang, China
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Thomas A Sellers
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
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Brenner DR, Fehringer G, Zhang ZF, Lee YCA, Meyers T, Matsuo K, Ito H, Vineis P, Stucker I, Boffetta P, Brennan P, Christiani DC, Diao N, Hong YC, Landi MT, Morgenstern H, Schwartz AG, Rennert G, Saliba W, McLaughlin JR, Harris CC, Orlow I, Barros Dios JM, Ruano Raviña A, Siemiatycki J, Koushik A, Cote M, Lazarus P, Fernandez-Tardon G, Tardon A, Le Marchand L, Brenner H, Saum KU, Duell EJ, Andrew AS, Consonni D, Olsson A, Hung RJ, Straif K. Alcohol consumption and lung cancer risk: A pooled analysis from the International Lung Cancer Consortium and the SYNERGY study. Cancer Epidemiol 2019; 58:25-32. [PMID: 30445228 PMCID: PMC6662590 DOI: 10.1016/j.canep.2018.10.006] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 10/08/2018] [Accepted: 10/10/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is inadequate evidence to determine whether there is an effect of alcohol consumption on lung cancer risk. We conducted a pooled analysis of data from the International Lung Cancer Consortium and the SYNERGY study to investigate this possible association by type of beverage with adjustment for other potential confounders. METHODS Twenty one case-control studies and one cohort study with alcohol-intake data obtained from questionnaires were included in this pooled analysis (19,149 cases and 362,340 controls). Adjusted odds ratios (OR) or hazard ratios (HR) with corresponding 95% confidence intervals (CI) were estimated for each measure of alcohol consumption. Effect estimates were combined using random or fixed-effects models where appropriate. Associations were examined for overall lung cancer and by histological type. RESULTS We observed an inverse association between overall risk of lung cancer and consumption of alcoholic beverages compared to non-drinkers, but the association was not monotonic. The lowest risk was observed for persons who consumed 10-19.9 g/day ethanol (OR vs. non-drinkers = 0.78; 95% CI: 0.67, 0.91), where 1 drink is approximately 12-15 g. This J-shaped association was most prominent for squamous cell carcinoma (SCC). The association with all lung cancer varied little by type of alcoholic beverage, but there were notable differences for SCC. We observed an association with beer intake (OR for ≥20 g/day vs nondrinker = 1.42; 95% CI: 1.06, 1.90). CONCLUSIONS Whether the non-monotonic associations we observed or the positive association between beer drinking and squamous cell carcinoma reflect real effects await future analyses and insights about possible biological mechanisms.
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Affiliation(s)
- Darren R Brenner
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada; Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Gord Fehringer
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Zuo-Feng Zhang
- Department of Epidemiology, School of Public Health, UCLA, Los Angeles, USA
| | - Yuan-Chin Amy Lee
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, and Huntsman Cancer Institute, Salt Lake City, USA
| | - Travis Meyers
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, and Huntsman Cancer Institute, Salt Lake City, USA
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Japan
| | - Hidemi Ito
- Division of Cancer Information and Contorl, Aichi Cancer Centre Research Institute, Japan
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Isabelle Stucker
- Department of Environmental Epidemiology, INSERM U170, Villejuif, France
| | - Paolo Boffetta
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
| | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - David C Christiani
- Harvard School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, USA
| | - Nancy Diao
- Harvard School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, USA
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Maria T Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH after National Cancer Institute, Bethesda, USA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, USA
| | - Ann G Schwartz
- Karmanos Cancer Institute, Wayne State University, Detroit, USA
| | - Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel
| | - Walid Saliba
- Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel
| | | | - Curtis C Harris
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, USA
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Juan M Barros Dios
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano Raviña
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; CIBER de Epidemiology y Salud Publica, Madrid, Spain
| | - Jack Siemiatycki
- CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Anita Koushik
- CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Michele Cote
- CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, USA
| | | | - Adonina Tardon
- University Institute of Oncology (IUOPA), University of Oviedo, and CIBERESP, Spain
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kai-Uwe Saum
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric J Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncoly (ICO-IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Angeline S Andrew
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United Kingdom
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Ann Olsson
- Environment and Radiation Section, International Agency for Research on Cancer, Lyon, France; Institute of Environmental Medicine, Stockholm, Sweden
| | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Kurt Straif
- IARC Monographs Section, International Agency for Research on Cancer, Lyon, France.
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McInerney M, Ho V, Koushik A, Massarelli I, Rondeau I, McCormack GR, Csizmadi I. Addition of food group equivalents to the Canadian Diet History Questionnaire II for the estimation of the Canadian Healthy Eating Index-2005. Health Promot Chronic Dis Prev Can 2018; 38:125-134. [PMID: 29537770 PMCID: PMC6108030 DOI: 10.24095/hpcdp.38.3.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Poor diet quality has been shown to increase the risk of common chronic diseases that can negatively impact quality of life and burden the healthcare system. Canada's Food Guide evidence-based recommendations provide dietary guidance aimed at increasing diet quality. Compliance with Canada's Food Guide can be assessed with the Canadian Healthy Eating Index (C-HEI), a diet quality score. The recently designed Canadian Diet History Questionnaire II (C-DHQ II), a comprehensive food frequency questionnaire could be used to estimate the C-HEI in Canadian populations with the addition of food group equivalents (representing Canada's Food Guide servings) to the C-DHQ II nutrient database. We describe methods developed to augment the C-DHQ II nutrient database to estimate the C-HEI. METHODS Food group equivalents were created using food and nutrient data from existing published food and nutrient databases (e.g. the Canadian Community Health Survey - Cycle 2.2 Nutrition [2004]). The variables were then added to the C-DHQ II companion nutrient database. C-HEI scores were determined and descriptive analyses conducted for participants who completed the C-DHQ II in a cross-sectional Canadian study. RESULTS The mean (standard deviation) C-HEI score in this sample of 446 adults aged 20 to 83 was 64.4 (10.8). Women, non-smokers, and those with more than high school education had statistically significant higher C-HEI scores than men, smokers and those with high school diplomas or less. CONCLUSION The ability to assess C-HEI using the C-DHQ II facilitates the study of diet quality and health outcomes in Canada.
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Affiliation(s)
- Maria McInerney
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vikki Ho
- CRCHUM (Centre de recherche du CHUM) and Département de médecine sociale et préventive, Université de Montréal, Montréal, Quebec, Canada
| | - Anita Koushik
- CRCHUM (Centre de recherche du CHUM) and Département de médecine sociale et préventive, Université de Montréal, Montréal, Quebec, Canada
| | - Isabelle Massarelli
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Isabelle Rondeau
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ilona Csizmadi
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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20
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Ben Khedher S, Neri M, Papadopoulos A, Christiani DC, Diao N, Harris CC, Olivo-Marston S, Schwartz AG, Cote M, Koushik A, Siemiatycki J, Landi MT, Hung RJ, McLaughlin J, Duell EJ, Andrew AS, Orlow I, Park BJ, Brenner H, Saum KU, Pesatori AC, Stücker I. Menstrual and reproductive factors and lung cancer risk: A pooled analysis from the international lung cancer consortium. Int J Cancer 2017; 141:309-323. [PMID: 28440542 DOI: 10.1002/ijc.30750] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 11/03/2016] [Revised: 03/02/2017] [Accepted: 03/16/2017] [Indexed: 12/28/2022]
Abstract
Many clinical features of lung cancer are different in women and men. Sex steroid hormones exert effects in nonreproductive organs, such as the lungs. The association between menstrual and childbearing factors and the risk of lung cancer among women is still debated. We performed a pooled analysis of eight studies contributing to the International Lung Cancer Consortium (4,386 cases and 4,177 controls). Pooled associations between menstrual or reproductive factors and lung cancer were estimated using multivariable unconditional logistic regression. Subgroup analyses were done for menopause status, smoking habits and histology. We found no strong support for an association of age at menarche and at menopause with lung cancer, but peri/postmenopausal women were at higher risk compared to premenopausal (OR 1.47, 95% CI 1.11-1.93). Premenopausal women showed increased risks associated with parity (OR 1.74, 95% CI 1.03-2.93) and number of children (OR 2.88, 95% CI 1.21-6.93 for more than 3 children; p for trend 0.01) and decreased with breastfeeding (OR 0.54, 95% CI 0.30-0.98). In contrast, peri/postmenopausal subjects had ORs around unity for the same exposures. No major effect modification was exerted by smoking status or cancer histology. Menstrual and reproductive factors may play a role in the genesis of lung cancer, yet the mechanisms are unclear, and smoking remains the most important modifiable risk factor. More investigations in large well-designed studies are needed to confirm these findings and to clarify the underlying mechanisms of gender differences in lung cancer risk.
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Affiliation(s)
- Soumaya Ben Khedher
- Université Paris Saclay, Université Paris Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Monica Neri
- Université Paris Saclay, Université Paris Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Alexandra Papadopoulos
- Risk Assessment Department (DER), French Agency for Food, Environmental and Occupational Health Safety (ANSES), Maisons-Alfort, France
| | - David C Christiani
- Harvard TH Chan School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Nancy Diao
- Harvard TH Chan School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Curtis C Harris
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Susan Olivo-Marston
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Ann G Schwartz
- Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI
| | - Michele Cote
- Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI
| | - Anita Koushik
- CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, QC, Canada
| | - Jack Siemiatycki
- CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, QC, Canada
| | - Maria Teresa Landi
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - John McLaughlin
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Eric J Duell
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College Lebanon, NH
| | - Angeline S Andrew
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College Lebanon, NH
| | - Irene Orlow
- Epidemiology and Biostatistics Department, Memorial Sloan Kettering Cancer Center, NY
| | - Bernard J Park
- Department of Surgery, Memorial Sloan Kettering Cancer Center, NY
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Kai-Uwe Saum
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Angela C Pesatori
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano and IRCCS Ca' Granda Foundation, Milan, Italy
| | - Isabelle Stücker
- Université Paris Saclay, Université Paris Sud, UVSQ, CESP, INSERM, Villejuif, France
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21
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Fehringer G, Brenner DR, Zhang ZF, Lee YCA, Matsuo K, Ito H, Lan Q, Vineis P, Johansson M, Overvad K, Riboli E, Trichopoulou A, Sacerdote C, Stucker I, Boffetta P, Brennan P, Christiani DC, Hong YC, Landi MT, Morgenstern H, Schwartz AG, Wenzlaff AS, Rennert G, McLaughlin JR, Harris CC, Olivo-Marston S, Orlow I, Park BJ, Zauderer M, Barros Dios JM, Raviña AR, Siemiatycki J, Koushik A, Lazarus P, Fernández-Somoano A, Tardon A, Le Marchand L, Brenner H, Saum KU, Duell EJ, Andrew AS, Szeszenia-Dabrowska N, Lissowska J, Zaridze D, Rudnai P, Fabianova E, Mates D, Foretova L, Janout V, Bencko V, Holcatova I, Pesatori AC, Consonni D, Olsson A, Straif K, Hung RJ. Alcohol and lung cancer risk among never smokers: A pooled analysis from the international lung cancer consortium and the SYNERGY study. Int J Cancer 2017; 140:1976-1984. [PMID: 28120396 PMCID: PMC5356930 DOI: 10.1002/ijc.30618] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 08/29/2016] [Revised: 12/15/2016] [Accepted: 12/19/2016] [Indexed: 12/22/2022]
Abstract
It is not clear whether alcohol consumption is associated with lung cancer risk. The relationship is likely confounded by smoking, complicating the interpretation of previous studies. We examined the association of alcohol consumption and lung cancer risk in a large pooled international sample, minimizing potential confounding of tobacco consumption by restricting analyses to never smokers. Our study included 22 case-control and cohort studies with a total of 2548 never-smoking lung cancer patients and 9362 never-smoking controls from North America, Europe and Asia within the International Lung Cancer Consortium (ILCCO) and SYNERGY Consortium. Alcohol consumption was categorized into amounts consumed (grams per day) and also modelled as a continuous variable using restricted cubic splines for potential non-linearity. Analyses by histologic sub-type were included. Associations by type of alcohol consumed (wine, beer and liquor) were also investigated. Alcohol consumption was inversely associated with lung cancer risk with evidence most strongly supporting lower risk for light and moderate drinkers relative to non-drinkers (>0-4.9 g per day: OR = 0.80, 95% CI = 0.70-0.90; 5-9.9 g per day: OR = 0.82, 95% CI = 0.69-0.99; 10-19.9 g per day: OR = 0.79, 95% CI = 0.65-0.96). Inverse associations were found for consumption of wine and liquor, but not beer. The results indicate that alcohol consumption is inversely associated with lung cancer risk, particularly among subjects with low to moderate consumption levels, and among wine and liquor drinkers, but not beer drinkers. Although our results should have no relevant bias from the confounding effect of smoking we cannot preclude that confounding by other factors contributed to the observed associations. Confounding in relation to the non-drinker reference category may be of particular importance.
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Affiliation(s)
- Gordon Fehringer
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | - Darren R. Brenner
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
- International Agency for Research on Cancer, Lyon, France
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Zuo-Feng Zhang
- Department of Epidemiology, School of Public Health, UCLA, Los Angeles, USA
| | - Yuan-Chin Amy Lee
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, USA
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - Paolo Vineis
- Division of Epidemiology, Public Health and Primary Care, Faculty of Medicine, Imperial College London, London, UK
| | | | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Denmark
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College, London, UK
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Piedmont Children Cancer Registry, Città della Salute e della Scienza di Torino Hospital and CPO Piemonte, Turin, Italy
| | - Isabelle Stucker
- Department of Environmental Epidemiology, INSERM U170, Villejuif, France
| | - Paolo Boffetta
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - David. C. Christiani
- Harvard School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, USA
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, USA
| | - Ann G. Schwartz
- Karmanos Cancer Institute, Wayne State University, Detroit, USA
| | | | - Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel
| | | | - Curtis C. Harris
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, USA
| | | | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Bernard J. Park
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Marjorie Zauderer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
- Weill Cornell Medical College, Cornell University, New York, USA
| | - Juan M. Barros Dios
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | - Alberto Ruano Raviña
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | - Jack Siemiatycki
- University of Montreal Hospital Research Center (CRCHUM) and School of Public Health, Montreal, Canada
| | - Anita Koushik
- University of Montreal Hospital Research Center (CRCHUM) and School of Public Health, Montreal, Canada
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, USA
| | | | - Adonina Tardon
- IUOPA, University Institute of Oncology, University of Oviedo, and CIBERESP, Spain
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 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
| | - Kai-Uwe Saum
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric J. Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Angeline S. Andrew
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Lebanon, USA
| | | | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, Cancer Center Maria Sklodowska-Curie Institute of Oncology, Warsaw, Poland
| | - David Zaridze
- Institute of Carcinogenesis, Blokhin Cancer Research Center, Russian Academy of Medical Sciences, Moscow, Russia
| | - Peter Rudnai
- National Institute of Environmental Health, Budapest, Hungary
| | - Eleonora Fabianova
- Specialized Institute of Hygiene and Epidemiology, Banská Bystrica, Slovakia
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | | | - Vladimir Bencko
- Institute of Hygiene and Epidemiology, Charles University, Prague, Czech Republic
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, Charles University, Prague, Czech Republic
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, Milan, Italy
| | - Ann Olsson
- International Agency for Research on Cancer, Lyon, France
- The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kurt Straif
- International Agency for Research on Cancer, Lyon, France
| | - Rayjean J. Hung
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
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22
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Ho V, Parent ME, Pintos J, Abrahamowicz M, Danieli C, Richardson L, Bourbonnais R, Gauvin L, Siemiatycki J, Koushik A. Physical activity and lung cancer risk in men and women. Cancer Causes Control 2017; 28:309-318. [PMID: 28247218 DOI: 10.1007/s10552-017-0872-4] [Citation(s) in RCA: 9] [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: 08/10/2016] [Accepted: 02/14/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Although evidence has accumulated that recreational physical activities (PA) may reduce lung cancer risk, there is little evidence concerning the possible role of a potentially more important source of PA, namely occupational PA. We investigated both recreational and lifetime occupational PA in relation to lung cancer risk in a population-based case-control study in Montreal, Canada (NCASES = 727; NCONTROLS = 1,351). METHODS Unconditional logistic regression was used to estimate odds ratios (OR), separately for men and women, adjusting for smoking, exposure to occupational carcinogens, and sociodemographic and lifestyle factors. RESULTS In both sexes, increasing recreational PA was associated with a lower lung cancer risk (ORMEN = 0.66, 95% confidence interval (CI) 0.47-0.92; ORWOMEN = 0.55, 95% CI 0.34-0.88, comparing the highest versus lowest tertiles). For occupational PA, no association was observed among women, while increasing occupational PA was associated with increased risk among men (ORMEN = 1.96, 95% CI 1.27-3.01). ORs were not modified by occupational lung carcinogen exposure, body mass index, and smoking level; results were similar across lung cancer histological types. CONCLUSIONS Our results support the previous findings for recreational PA and lung cancer risk. Unexpectedly, our findings suggest a positive association for occupational PA; this requires replication and more detailed investigation.
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Affiliation(s)
- Vikki Ho
- Department of Social and Preventive Medicine and CRCHUM (Centre de recherche du CHUM), Université de Montréal, 850 Saint-Denis Street, Montréal, QC, Canada
| | - Marie-Elise Parent
- INRS (Institut Armand-Frappier Research Center), Laval, QC, Canada.,CRCHUM (Centre de recherche du CHUM), Montréal, QC, Canada
| | - Javier Pintos
- CRCHUM (Centre de recherche du CHUM), Montréal, QC, Canada
| | - Michal Abrahamowicz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - Coraline Danieli
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | | | | | - Lise Gauvin
- Department of Social and Preventive Medicine and CRCHUM (Centre de recherche du CHUM), Université de Montréal, 850 Saint-Denis Street, Montréal, QC, Canada
| | - Jack Siemiatycki
- Department of Social and Preventive Medicine and CRCHUM (Centre de recherche du CHUM), Université de Montréal, 850 Saint-Denis Street, Montréal, QC, Canada
| | - Anita Koushik
- Department of Social and Preventive Medicine and CRCHUM (Centre de recherche du CHUM), Université de Montréal, 850 Saint-Denis Street, Montréal, QC, Canada.
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Shareck M, Rousseau MC, Koushik A, Siemiatycki J, Parent ME. Inverse Association between Dietary Intake of Selected Carotenoids and Vitamin C and Risk of Lung Cancer. Front Oncol 2017; 7:23. [PMID: 28293540 PMCID: PMC5328985 DOI: 10.3389/fonc.2017.00023] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 11/04/2016] [Accepted: 02/07/2017] [Indexed: 12/14/2022] Open
Abstract
While diets rich in fruit and vegetables appear to reduce lung cancer risk, the evidence for individual carotenoid and vitamin intakes has been judged too limited to reach firm conclusions. Data from a case-control study of lung cancer (Montreal, QC, Canada, 1996-2002) were used to investigate the role of dietary intakes of β-carotene, α-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene, and vitamin C in lung cancer risk. In-person interviews elicited dietary information from 1,105 incident cases and 1,449 population controls. Usual frequency of consumption of 49 fruits and vegetables 2 years prior to diagnosis/interview was collected. Odds ratios (ORs) and 95% confidence intervals (CIs) between intake variables and lung cancer were estimated using logistic or polytomous regression, adjusting for potential confounding factors including a detailed smoking history. ORs associated with upper versus lower tertiles of intake were 0.66 (95% CI = 0.51-0.84) for β-carotene, 0.70 (95% CI = 0.55-0.90) for α-carotene, 0.65 (95% CI = 0.51-0.84) for β-cryptoxanthin, 0.75 (95% CI = 0.59-0.95) for lycopene, and 0.74 (95% CI = 0.58-0.96) for vitamin C. ORs suggestive of a protective effect were found for elevated intakes of β-carotene, α-carotene, β-cryptoxanthin, and lycopene in male heavy smokers and of vitamin C in female heavy smokers. Selected antioxidants were also associated with a lower risk of lung cancer in female moderate smokers, and of squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. These results suggest that several dietary antioxidants found in common food sources may protect against lung cancer, even among heavy smokers.
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Affiliation(s)
- Martine Shareck
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
- INRS-Institut Armand-Frappier, Laval, QC, Canada
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada
| | - Marie-Claude Rousseau
- INRS-Institut Armand-Frappier, Laval, QC, Canada
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada
| | - Anita Koushik
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada
| | - Jack Siemiatycki
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada
| | - Marie-Elise Parent
- INRS-Institut Armand-Frappier, Laval, QC, Canada
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada
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Koushik A, Grundy A, Abrahamowicz M, Arseneau J, Gilbert L, Gotlieb WH, Lacaille J, Mes-Masson AM, Parent MÉ, Provencher DM, Richardson L, Siemiatycki J. Hormonal and reproductive factors and the risk of ovarian cancer. Cancer Causes Control 2017; 28:393-403. [PMID: 28102526 DOI: 10.1007/s10552-016-0848-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 10/15/2016] [Accepted: 12/28/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE Hormone-related factors have been associated with ovarian cancer, the strongest being parity and oral contraceptive use. Given reductions in birth rates and increases in oral contraceptive use over time, associations in more recent birth cohorts may differ. Furthermore, consideration of ovarian cancer heterogeneity (i.e., Type I/II invasive cancers) may contribute to a better understanding of etiology. We examined hormone-related factors in relation to ovarian cancer risk overall, for Type I and Type II cancers, as well as borderline tumors. METHODS A population-based case-control study was carried out in Montreal, Canada from 2011 to 2016, including 496 cases and 908 controls. For each hormone-related variable, adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression for ovarian cancer overall, and using polytomous logistic regression for associations by tumor behavior and ovarian cancer type. RESULTS Parity was inversely associated with risk overall and by tumor behavior and type, with a stronger OR (95% CI) for Type I [0.09 (0.04-0.24) for ≥3 full-term births vs. nulliparity] vs. Type II [0.66 (0.43-1.02)] invasive cancers; the OR (95% CI) for borderline tumors was 0.41 (0.22-0.77). Oral contraceptive ever use was not associated with risk overall, but ≥10 years of use vs. never use reduced risk, particularly for invasive cancers. A history of endometriosis was most strongly associated with Type I cancers. Associations with other factors were less clear. CONCLUSIONS These results suggest that associations with some hormone-related factors may differ between borderline and invasive Type I and II ovarian cancers.
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Affiliation(s)
- Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada.
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada.
| | - Anne Grundy
- Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
| | - Michal Abrahamowicz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Montreal, QC, Canada
| | - Jocelyne Arseneau
- Department of Pathology, McGill University Health Centre, Montreal, QC, Canada
- Gynecologic Oncology Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Lucy Gilbert
- Gynecologic Oncology Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Walter H Gotlieb
- Gynecologic Oncology and Colposcopy, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, QC, Canada
| | - Julie Lacaille
- Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada
| | - Anne-Marie Mes-Masson
- Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada
- Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Marie-Élise Parent
- Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
- INRS-Institut Armand-Frappier, University of Quebec, Laval, QC, Canada
| | - Diane M Provencher
- Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Lesley Richardson
- Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada
| | - Jack Siemiatycki
- Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
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25
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Tota JE, Jiang M, Ramanakumar AV, Walter SD, Kaufman JS, Coutlée F, Richardson H, Burchell AN, Koushik A, Mayrand MH, Villa LL, Franco EL. Epidemiologic Evaluation of Human Papillomavirus Type Competition and the Potential for Type Replacement Post-Vaccination. PLoS One 2016; 11:e0166329. [PMID: 28005904 PMCID: PMC5178990 DOI: 10.1371/journal.pone.0166329] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 10/26/2016] [Indexed: 11/18/2022] Open
Abstract
Background Millions of women have been vaccinated with one of two first-generation human papillomavirus (HPV) vaccines. Both vaccines remain in use and target two oncogenic types (HPVs 16 and 18); however, if these types naturally compete with others that are not targeted, type replacement may occur following reductions in the circulating prevalence of targeted types. To explore the potential for type replacement, we evaluated natural HPV type competition in unvaccinated females. Methods Valid HPV DNA typing information was available from five epidemiological studies conducted in Canada and Brazil (n = 14,685; enrollment across studies took place between1993 and 2010), which used similar consensus-primer PCR assays, capable of detecting up to 40 HPV types. A total of 38,088 cervicovaginal specimens were available for inclusion in our analyses evaluating HPV type-type interactions involving vaccine-targeted types (6, 11, 16, and 18), and infection with each of the other HPV types. Results Across the studies, the average age of participants ranged from 21.0 to 43.7 years. HPV16 was the most common type (prevalence range: 1.0% to 13.8%), and in general HPV types were more likely to be detected as part of a multiple infection than as single infections. In our analyses focusing on each of the vaccine-targeted HPV types separately, many significant positive associations were observed (particularly involving HPV16); however, we did not observe any statistically significant negative associations. Conclusions Our findings suggest that natural HPV type competition does not exist, and that type replacement is unlikely to occur in vaccinated populations.
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Affiliation(s)
- Joseph E. Tota
- McGill University, Department of Oncology, Montreal, Québec, Canada
- McGill University, Department of Epidemiology, Biostatistics, and Occupational Health, Montreal, Québec, Canada
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, Rockville, Maryland, United States of America
- * E-mail:
| | - Mengzhu Jiang
- McGill University, Department of Oncology, Montreal, Québec, Canada
| | | | - Stephen D. Walter
- McMaster University, Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada
| | - Jay S. Kaufman
- McGill University, Department of Epidemiology, Biostatistics, and Occupational Health, Montreal, Québec, Canada
| | - François Coutlée
- Université de Montréal, Département de Microbiologie et Infectiologie, Montreal, Québec, Canada
- Université de Montréal Hospital Research Centre, Montreal, Québec, Canada
| | - Harriet Richardson
- Queen’s University, Department of Public Health Sciences, Kingston, Ontario, Canada
| | - Ann N. Burchell
- McGill University, Department of Oncology, Montreal, Québec, Canada
- St. Michael’s Hospital, Department of Family and Community Medicine and Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
| | - Anita Koushik
- Université de Montréal Hospital Research Centre, Montreal, Québec, Canada
- Université de Montréal, Département de médecine sociale et préventive, Montreal, Québec, Canada
| | - Marie Hélène Mayrand
- Université de Montréal Hospital Research Centre, Montreal, Québec, Canada
- Université de Montréal, Département d’obstétrique-gynécologie et Médecine Sociale et Préventive, Montreal, Québec, Canada
| | - Luisa L. Villa
- Universidade de São Paulo, Department of Radiology and Oncology, School of Medicine, São Paulo, Brazil
| | - Eduardo L. Franco
- McGill University, Department of Oncology, Montreal, Québec, Canada
- McGill University, Department of Epidemiology, Biostatistics, and Occupational Health, Montreal, Québec, Canada
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26
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Pasquet R, Karp I, Siemiatycki J, Koushik A. The consumption of coffee and black tea and the risk of lung cancer. Ann Epidemiol 2016; 26:757-763.e2. [PMID: 27743642 DOI: 10.1016/j.annepidem.2016.09.001] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 07/16/2016] [Accepted: 09/09/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE Coffee and black tea are among the most consumed beverages worldwide. Although their potential role in lung cancer occurrence has been investigated in several studies, results have been inconclusive. We investigated the associations between intake of coffee and black tea with lung cancer in a population-based case-control study in Montreal, Canada. METHODS These analyses included 1130 cases and 1483 controls. Adjusted odds ratios (ORs) were estimated between four metrics of coffee and black tea consumption (frequency, average daily amount, duration, and cumulative amount) and lung cancer, using unconditional logistic regression. RESULTS The adjusted ORs (95% confidence intervals) for lung cancer comparing daily to never consumers were 0.73 (0.49-1.10) for coffee and 1.05 (0.85-1.31) for black tea. Analyses of other metrics did not reveal any clear patterns of increasing or decreasing risk with increasing amounts or duration of consumption. There was no strong evidence of OR modification by sex or smoking level. The OR estimates did not materially differ by histological subtype for either of the beverages. CONCLUSION Our results do not provide strong support for associations between consumption of coffee and black tea and lung cancer.
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Affiliation(s)
- Romain Pasquet
- Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada; Risks, Prevention, and Health Promotion Research Axis, Université de Montréal Hospital Research Centre (CRCHUM), Montréal, Canada
| | - Igor Karp
- Risks, Prevention, and Health Promotion Research Axis, Université de Montréal Hospital Research Centre (CRCHUM), Montréal, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Jack Siemiatycki
- Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada; Risks, Prevention, and Health Promotion Research Axis, Université de Montréal Hospital Research Centre (CRCHUM), Montréal, Canada
| | - Anita Koushik
- Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada; Risks, Prevention, and Health Promotion Research Axis, Université de Montréal Hospital Research Centre (CRCHUM), Montréal, Canada.
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27
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Pasquet R, Cardis E, Richardson L, Lavoué J, Siemiatycki J, Koushik A. P043 The association between occupational exposure to metals and metalloids and brain cancer risk. Cancer 2016. [DOI: 10.1136/oemed-2016-103951.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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28
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Labonté MÈ, Kirkpatrick SI, Bell RC, Boucher BA, Csizmadi I, Koushik A, L'Abbé MR, Massarelli I, Robson PJ, Rondeau I, Shatenstein B, Subar AF, Lamarche B. Dietary assessment is a critical element of health research - Perspective from the Partnership for Advancing Nutritional and Dietary Assessment in Canada. Appl Physiol Nutr Metab 2016; 41:1096-1099. [PMID: 27608060 DOI: 10.1139/apnm-2016-0146] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 11/22/2022]
Abstract
Challenges and complexities associated with assessing dietary intakes are numerous, but not insurmountable. This opinion paper from Canadian researchers draws attention to the importance of building capacity and providing funding opportunities for research in dietary assessment methods in Canada and elsewhere. Such strategies would contribute to a better understanding of the roles played by diet in human health and better translation of this information into the most meaningful and effective dietary guidelines, policies, and interventions.
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Affiliation(s)
- Marie-Ève Labonté
- a School of Nutrition, Institute of Nutrition and Functional Foods, Laval University, Québec, QC G1V 0A6, Canada
| | - Sharon I Kirkpatrick
- b School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Rhonda C Bell
- c Li Ka Shing Centre for Health Research Innovation, Division of Human Nutrition, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - Beatrice A Boucher
- d Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON M5G 2L7, Canada.,e Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 3E2, Canada
| | - Ilona Csizmadi
- f Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Anita Koushik
- g CRCHUM (Centre de recherche du CHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montréal, QC H2X 0A9, Canada
| | - Mary R L'Abbé
- h Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3E2, Canada
| | - Isabelle Massarelli
- i Bureau of Food Surveillance and Science Integration, Food Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Paula J Robson
- j Cancer Measurement, Outcomes, Research and Evaluation (C-MORE), CancerControl Alberta, Alberta Health Services, Edmonton, AB T5J 3H1, Canada
| | - Isabelle Rondeau
- i Bureau of Food Surveillance and Science Integration, Food Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Bryna Shatenstein
- k Département de nutrition, Université de Montréal, Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
| | - Amy F Subar
- l National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD 20814-9692, USA
| | - Benoît Lamarche
- a School of Nutrition, Institute of Nutrition and Functional Foods, Laval University, Québec, QC G1V 0A6, Canada
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Affiliation(s)
- Marie-Hélène Mayrand
- Department of Obstetrics and Gynaecology, Université de Montréal and CRCHUM, CRCHUM - Tour Saint-Antoine, 850, rue St-Denis, Montreal (Québec) H2X 0A9, Canada Department of Social and Preventive Medicine, Université de Montréal and CRCHUM
| | - Anita Koushik
- Department of Social and Preventive Medicine, Université de Montréal and CRCHUM
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30
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Louvanto K, Franco EL, Ramanakumar AV, Vasiljević N, Scibior-Bentkowska D, Koushik A, Cuzick J, Coutlée F, Lorincz AT. Methylation of viral and host genes and severity of cervical lesions associated with human papillomavirus type 16. Int J Cancer 2015; 136:E638-45. [PMID: 25203794 DOI: 10.1002/ijc.29196] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [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: 03/23/2014] [Revised: 08/06/2014] [Accepted: 08/12/2014] [Indexed: 12/19/2022]
Abstract
Methylation of human papillomavirus (HPV) and host genes may predict cervical cancer risk. We examined the methylation status of selected sites in HPV16 and human genes in DNA extracted from exfoliated cervical cell samples of 244 women harboring HPV16-positive cancer or cervical intraepithelial neoplasia (CIN) or negative for intraepithelial lesions or malignancy (NILM). We quantified the methylation of CpG sites in the HPV16 L1 gene (CpG 6367 and 6389) and in the human genes EPB41L3 (CpG 438, 427, 425) and LMX1 (CpG 260, 262, 266, 274) following bisulfite treatment and pyrosequencing. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic utility of methylation level for the different sites and for a joint predictor score. Methylation in all sites significantly increased with lesion severity (p < 0.0001). Area under the curve (AUC) was highest among the CIN2/3 vs. cancer ranging from 0.786 to 0.853 among the different sites. Site-specific methylation levels strongly discriminated CIN2/3 from NILM/CIN1 and cancer from CIN2/3 (range of odds ratios [OR]: 3.69-12.76, range of lower 95% confidence bounds: 1.03-4.01). When methylation levels were mutually adjusted for each other EPB41L3 was the only independent predictor of CIN2/3 vs. NILM/CIN1 contrasts (OR = 9.94, 95%CI: 2.46-40.27). High methylation levels of viral and host genes are common among precancerous and cancer lesions and can serve as independent risk biomarkers. Methylation of host genes LMX1 and EPB41L3 and of the viral HPV16 L1 sites has the potential to distinguish among precancerous lesions and to distinguish the latter from invasive disease.
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Affiliation(s)
- Karolina Louvanto
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada
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31
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Tota JE, Ramanakumar AV, Villa LL, Richardson H, Burchell AN, Koushik A, Mayrand MH, Coutlée F, Franco EL. Evaluation of human papillomavirus type replacement postvaccination must account for diagnostic artifacts: masking of HPV52 by HPV16 in anogenital specimens. Cancer Epidemiol Biomarkers Prev 2014; 24:286-90. [PMID: 25277793 DOI: 10.1158/1055-9965.epi-14-0566] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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] Open
Abstract
It has been hypothesized that, following a reduction in human papillomavirus (HPV) vaccine-targeted genotypes, an increase in prevalence of other HPV types may occur due to reduced competition during natural infection. Any apparent postvaccination increase must be distinguished from diagnostic artifacts consequent to consensus PCR assays failing to detect HPV types present in low copy numbers in coinfected specimens (under the assumption that with a drop in vaccine-preventable types there may be increased detection of previously "masked" types). We reanalyzed anogenital specimens to evaluate unmasking of HPV52 that may be caused by elimination of HPV16. Using highly sensitive type-specific real-time HPV52 PCR, we retested 1,200 anogenital specimens (all HPV52 negative according to consensus PCR assays) from six epidemiologic studies (200 specimens/study; 100 HPV16(+)/study). Multivariate logistic regression, with adjustment for age and number of sexual partners, was used to evaluate the association between HPV16 positivity and detection of HPV52. In our pooled analysis (n = 1,196), the presence of HPV16 was positively associated with HPV52 detection [adjusted OR, 1.47; 95% confidence interval (CI), 0.76-2.82]. In our separate (study specific) analyses, a statistically significant association was observed in one study that included HIV-infected males (HIPVIRG study; adjusted OR, 3.82; 95% CI, 1.19-12.26). We observed a positive association between HPV16 viral load (tertiles) and detection of HPV52 (P for trend = 0.003). These results indicate that diagnostic artifacts, resulting from unmasking of HPV52, may occur in some settings in the evaluation of HPV type replacement. Additional studies exploring the extent and severity of unmasking are needed.
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Affiliation(s)
- Joseph E Tota
- Department of Oncology (Division of Cancer Epidemiology), McGill University, Montreal, Québec, Canada. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada.
| | - Agnihotram V Ramanakumar
- Department of Oncology (Division of Cancer Epidemiology), McGill University, Montreal, Québec, Canada
| | - Luisa L Villa
- Department of Radiology and Oncology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil. Santa Casa de São Paulo, School of Medicine, São Paulo, Brazil
| | - Harriet Richardson
- Department of Community Health and Epidemiology, Queens University, Kingston, Ontario, Canada
| | - Ann N Burchell
- Department of Oncology (Division of Cancer Epidemiology), McGill University, Montreal, Québec, Canada. Ontario HIV Treatment Network, Toronto, Ontario, Canada
| | - Anita Koushik
- Département de médecine sociale et préventive, Université de Montréal, Montreal, Québec, Canada. Université de Montréal Hospital Research Centre, Montreal, Québec, Canada
| | - Marie-Hélène Mayrand
- Université de Montréal Hospital Research Centre, Montreal, Québec, Canada. Université de Montréal, Département d'obstétrique-gynécologie et Médecine Sociale et Préventive, Montreal, Québec, Canada
| | - François Coutlée
- Université de Montréal Hospital Research Centre, Montreal, Québec, Canada. Université de Montréal, Département de Microbiologie et Infectiologie, Montreal, Québec, Canada
| | - Eduardo L Franco
- Department of Oncology (Division of Cancer Epidemiology), McGill University, Montreal, Québec, Canada. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
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Genkinger JM, Wang M, Li R, Albanes D, Anderson KE, Bernstein L, van den Brandt PA, English DR, Freudenheim JL, Fuchs CS, Gapstur SM, Giles GG, Goldbohm RA, Håkansson N, Horn-Ross PL, Koushik A, Marshall JR, McCullough ML, Miller AB, Robien K, Rohan TE, Schairer C, Silverman DT, Stolzenberg-Solomon RZ, Virtamo J, Willett WC, Wolk A, Ziegler RG, Smith-Warner SA. Dairy products and pancreatic cancer risk: a pooled analysis of 14 cohort studies. Ann Oncol 2014; 25:1106-15. [PMID: 24631943 DOI: 10.1093/annonc/mdu019] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Pancreatic cancer has few early symptoms, is usually diagnosed at late stages, and has a high case-fatality rate. Identifying modifiable risk factors is crucial to reducing pancreatic cancer morbidity and mortality. Prior studies have suggested that specific foods and nutrients, such as dairy products and constituents, may play a role in pancreatic carcinogenesis. In this pooled analysis of the primary data from 14 prospective cohort studies, 2212 incident pancreatic cancer cases were identified during follow-up among 862 680 individuals. Adjusting for smoking habits, personal history of diabetes, alcohol intake, body mass index (BMI), and energy intake, multivariable study-specific hazard ratios (MVHR) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazards models and then pooled using a random effects model. There was no association between total milk intake and pancreatic cancer risk (MVHR = 0.98, 95% CI = 0.82-1.18 comparing ≥500 with 1-69.9 g/day). Similarly, intakes of low-fat milk, whole milk, cheese, cottage cheese, yogurt, and ice-cream were not associated with pancreatic cancer risk. No statistically significant association was observed between dietary (MVHR = 0.96, 95% CI = 0.77-1.19) and total calcium (MVHR = 0.89, 95% CI = 0.71-1.12) intake and pancreatic cancer risk overall when comparing intakes ≥1300 with <500 mg/day. In addition, null associations were observed for dietary and total vitamin D intake and pancreatic cancer risk. Findings were consistent within sex, smoking status, and BMI strata or when the case definition was limited to pancreatic adenocarcinoma. Overall, these findings do not support the hypothesis that consumption of dairy foods, calcium, or vitamin D during adulthood is associated with pancreatic cancer risk.
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Affiliation(s)
- J M Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York
| | - M Wang
- Department of Epidemiology, Harvard School of Public Health, Boston Department of Biostatistics, Harvard School of Public Health, Boston
| | - R Li
- Department of Epidemiology, Harvard School of Public Health, Boston
| | - D Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - K E Anderson
- Division of Epidemiology and Community Health, School of Public Health, Masonic Cancer Center, University of Minnesota, Minneapolis
| | - L Bernstein
- Division of Cancer Etiology, Department of Population Science, Beckman Research Institute and City of Hope National Medical Center, Duarte, USA
| | - P A van den Brandt
- Department of Epidemiology, School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
| | - D R English
- Cancer Epidemiology Centre, Cancer Council of Victoria, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - J L Freudenheim
- Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo
| | - C S Fuchs
- Division of Medical Oncology, Dana-Farber Cancer Institute, Boston Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - S M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, USA
| | - G G Giles
- Cancer Epidemiology Centre, Cancer Council of Victoria, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - R A Goldbohm
- Department of Prevention and Health, TNO Quality of Life, Leiden, The Netherlands
| | - N Håkansson
- Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - P L Horn-Ross
- Cancer Prevention Institute of California, Fremont, USA
| | - A Koushik
- Department of Social and Preventive Medicine, University of Montreal, Montreal
| | - J R Marshall
- Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo
| | - M L McCullough
- Epidemiology Research Program, American Cancer Society, Atlanta, USA
| | - A B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - K Robien
- Department of Epidemiology and Biostatistics, School of Public Health and Health Services, George Washington University, Washington, DC
| | - T E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA
| | - C Schairer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - D T Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - R Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - J Virtamo
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - W C Willett
- Department of Epidemiology, Harvard School of Public Health, Boston Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston Department of Nutrition, Harvard School of Public Health, Boston, USA
| | - A Wolk
- Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - R G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - S A Smith-Warner
- Department of Epidemiology, Harvard School of Public Health, Boston Department of Nutrition, Harvard School of Public Health, Boston, USA
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Ho V, Parent MÉ, Pintos J, Abrahamowicz M, Gauvin L, Siemiatycki J, Koushik A. Abstract A47: Lifetime occupational physical activity and lung cancer risk in men and women. Cancer Prev Res (Phila) 2013. [DOI: 10.1158/1940-6215.prev-13-a47] [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
The majority of epidemiological studies investigating the relationship between physical activity (PA) and lung cancer risk support the role of recreational PA in lung cancer risk reduction. There have been fewer studies that have examined occupational PA in relation to lung cancer risk and inconclusive results have been reported with some evidence supporting a positive association. In most of these studies, the assessment of occupational PA was crude, based either on self-reported cross-sectional assessments or simple job title-based categorizations. Consideration of lifetime occupational PA and occupational PA accrued in different age windows may provide additional information regarding the direction and magnitude of the relationship, as well as the biologically relevant time window, between PA and lung cancer risk.
Methods: The relationship between lifetime occupational PA and lung cancer risk was examined in a population-based case-control study of 1,136 incident lung cancer cases and 1,457 controls conducted in Montreal, Canada. Lifetime job history was collected via in-person interviews; for each job, the main tasks conducted were also obtained. The energy expenditure for each job-related task was determined via expert assessment by an industrial hygienist and an exercise physiologist in units of metabolic equivalent of task (MET). For each job, an average MET value was calculated by weighting the MET values of each job-related task by the hours per week spent in each task. The average lifetime occupational PA level was then computed by weighting the average MET value for each job by the duration spent in that job. The interview also elicited information on the subject's habitual recreational PA.
Unconditional logistic regression was used to estimate adjusted odds ratios (OR) with 95% confidence intervals (CI) for lung cancer risk associated with average lifetime occupational PA and average occupational PA levels in different age windows while controlling for potential confounders. Specifically, average occupational PA in the age windows of 18-24, 24-44 and 45-64 years in relation to lung cancer risk was examined. Confounding was assessed by combining directed acyclic graphs and the change-in-estimate procedure as a novel approach for covariate selection. Effect modification by smoking, body mass index (BMI) and exposure to occupational carcinogens was also assessed. All analyses were conducted separately for men and women.
Results: The OR (95% CI) between average lifetime occupational PA and lung cancer risk, comparing the highest versus lowest quartile, was 1.38 (0.88-2.16) in men and 1.01 (0.58-1.76) in women. These associations were not modified by smoking level, BMI or occupational carcinogen exposure.
Occupational PA in men was not associated with lung cancer in any of the age windows in which exposure was examined. In women, the highest versus lowest quartile of occupational PA was associated with an increased risk of lung cancer in the age window of 18-24 years (OR=1.72: 1.00-2.94); in the age windows of 24-44 (OR=0.89: 0.53-1.48) and 45-64 years (OR=0.63: 0.38-1.02) no increase in lung cancer risk was observed.
When analyses were adjusted for recreational PA, results did not differ appreciably.
Conclusion: These results fail to support the previously reported protective effects of PA on lung cancer risk. To the limited extent that they show a deviation from the null hypothesis of no influence on risk, they actually suggest some increased risk of lung cancer with higher occupational PA, although this relationship was inconsistent between sexes and in different age windows.
This research was funded by the Canadian Cancer Society and the Guzzo-SRC Chair in Environment and Cancer.
Citation Format: Vikki Ho, Marie-Élise Parent, Javier Pintos, Michal Abrahamowicz, Lise Gauvin, Jack Siemiatycki, Anita Koushik. Lifetime occupational physical activity and lung cancer risk in men and women. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr A47.
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Affiliation(s)
- Vikki Ho
- 1Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada,
| | | | - Javier Pintos
- 1Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada,
| | | | - Lise Gauvin
- 1Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada,
| | - Jack Siemiatycki
- 1Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada,
| | - Anita Koushik
- 1Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada,
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Koushik A, Smith-Warner SA. Abstract A42: Intake of vitamins A, C, E, and folate and risk of ovarian cancer in a pooled analysis of 10 cohort studies. Cancer Prev Res (Phila) 2013. [DOI: 10.1158/1940-6215.prev-13-a42] [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
Vitamins A, C, E and folate have properties, such as modulation of DNA synthesis and repair, control of cellular differentiation and proliferation, as well as antioxidation, which are potentially cancer preventive. In a 2007 international panel review of the epidemiological literature published through 2006, the available data on the associations between intake of these vitamins and ovarian cancer risk were judged to be limited and inconclusive. Relatively few studies had been published and statistical power may have been limited in most studies. Among subsequent studies, sample sizes have been large in some though results remain inconsistent. In this project, we examined vitamin intakes from food only (dietary) and from food and supplements together (total) in relation to ovarian cancer risk by pooling the primary data from the following studies: Breast Cancer Detection Demonstration Project Follow-up Study, Canadian National Breast Screening Study, Cancer Prevention Study II Nutrition Cohort, Iowa Women's Health Study, Netherlands Cohort Study, New York State Cohort, New York University Women's Health Study, Nurses' Health Study, Nurses' Health Study II, and Swedish Mammography Cohort. Vitamin intakes were ascertained from a validated food frequency questionnaire administered at baseline in each study. Study-specific relative risks (RR) were estimated using the Cox proportional hazards model, and then combined using a random-effects model. Multivariate models included total energy intake and other potential ovarian cancer risk factors. Among 501,857 women, 1,973 cases of ovarian cancer occurred during a maximum follow-up of 7 to 22 years across studies. When analyzed as continuous variables the RRs for dietary and total intakes of each of the vitamins were not significantly associated with ovarian cancer. For increments of intake defined by the mean of the standard deviation of the mean intake across studies, the pooled multivariate RRs (95% CI) for total intake of each vitamin were 1.02 (0.97-1.07) for each 1300 mcg/day increase in vitamin A, 1.01 (0.99-1.04) for each 400 mg/day increase in vitamin C, 1.02 (0.97-1.06) for each 130 mg/day increase in vitamin E and 1.01 (0.96-1.07) for each 250 mcg/day increase in folate. When vitamin intakes were analyzed as categorical variables defined by study-specific quintiles of intake, the results were consistent with the continuous analyses and indicated no significant association. There was no evidence of statistically significant heterogeneity between studies in any of the analyses. Also, the pooled RRs did not vary greatly by levels of parity, oral contraceptive use, postmenopausal hormone use, smoking status or alcohol consumption, nor did associations greatly differ by histological type. We also examined use of specific vitamin supplements and multivitamins and did not observe a significant association with risk of ovarian cancer overall; the pooled multivariate RR (95% CI) for multivitamin use versus non-use was 1.00 (0.89-1.12). This large pooled analysis suggests that vitamins A, C, E and folate are not associated with the risk of ovarian cancer.
Citation Format: Anita Koushik, Stephanie A. Smith-Warner. Intake of vitamins A, C, E, and folate and risk of ovarian cancer in a pooled analysis of 10 cohort studies. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr A42.
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Affiliation(s)
- Anita Koushik
- 1Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada,
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Aho J, Koushik A, Coutlée F, Diakité SL, Rashed S. Prevalence of HIV, human papillomavirus type 16 and herpes simplex virus type 2 among female sex workers in Guinea and associated factors. Int J STD AIDS 2013; 25:280-8. [DOI: 10.1177/0956462413500242] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Female sex workers are at high risk for HIV infection. Sexually transmitted infections are known to be co-factors for HIV infection. Our aims were (1) to assess the prevalence of HIV and other sexually transmitted infections in this population; (2) to determine the association between sociodemographic characteristics, behavioural variables, and variables related to HIV prevention and HIV infection. A cross-sectional study was conducted in Conakry, Guinea, among a convenience sample of 223 female sex workers. A questionnaire on sociodemographic characteristics, risk factors, and exposure to prevention was administered. Screening for HIV, herpes simplex virus type 2, human papillomavirus type 16, Neisseria gonorrhoeae, and Chlamydia trachomatis was performed. Prevalences of HIV, herpes simplex virus type 2, human papillomavirus type 16, N. gonorrhoeae, and C. trachomatis were 35.3%, 84.1%, 12.2%, 9.0%, and 13.6%, respectively. Having a child, lubricant use, and human papillomavirus type 16 infection were associated with HIV infection. Interventions that promote screening and treatment of sexually transmitted infections are needed in order to achieve successful interventions to prevent HIV among female sex workers in resource-limited settings.
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Affiliation(s)
- Joséphine Aho
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Anita Koushik
- Université de Montreal Hospital Research Center, Montreal, Canada
| | - François Coutlée
- Université de Montreal Hospital Research Center, Montreal, Canada
| | | | - Sélim Rashed
- Département de Pédiatrie, Université de Montréal, Montreal, Canada
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Aho J, Koushik A, Rashed S. Reasons for inconsistent condom use among female sex workers: need for integrated reproductive and prevention services. ACTA ACUST UNITED AC 2013; 14:5-13. [PMID: 23803490 DOI: 10.12927/whp.2013.23442] [Citation(s) in RCA: 5] [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: 10/26/2022]
Abstract
BACKGROUND Interventions for condom use promotion have been undertaken for HIV prevention among female sex workers (FSWs). Our aims are to (1) assess the frequency of inconsistent condom use with clients and with the main regular non-client sex partner (RNCP); and (2) investigate factors associated with inconsistent condom use with the RNCP, particularly the desire to have children and links of the RNCP with commercial sex work. METHODS A cross-sectional study was conducted in Conakry, Guinea, among 223 FSWs. A questionnaire on socio-demographic characteristics, behaviours and desire for children was administered. Descriptive statistics and logistic regression were performed. RESULTS Inconsistent condom use was frequent with the RNCP but rare with the clients (80.4% vs. 1.3%). FSWs' desire for children was strongly associated with inconsistent condom use with the RNCP. CONCLUSION Interventions that take into account reproductive health are needed to prevent HIV among FSWs and their children.
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El-Zein M, Parent ME, Nicolau B, Koushik A, Siemiatycki J, Rousseau MC. Body mass index, lifetime smoking intensity and lung cancer risk. Int J Cancer 2013; 133:1721-31. [PMID: 23553144 DOI: 10.1002/ijc.28185] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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: 12/12/2012] [Accepted: 03/20/2013] [Indexed: 12/16/2022]
Abstract
There is as yet no generally accepted explanation for the common finding that low body mass index (BMI) is associated with an increased risk of lung cancer. We investigated this association in a Canadian population-based case-control study (1996-2002) with a particular view to assessing the hypothesis that the observed association was due to residual confounding by smoking. Analyses were based on 1,076 cases and 1,439 controls who provided their height at enrollment and their weight at two points in time, at age 20 and 2 years before enrollment. BMI, in kg/m(2) , was classified into underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9), and obese (≥30). Smoking history was synthesized into a comprehensive smoking index (CSI) that integrated duration, intensity and time since quitting. Odds ratios (ORs) and 95% confidence intervals (CIs) for BMI-lung cancer associations were estimated, adjusting for CSI as well as several sociodemographic, lifestyle and occupational factors. The normal BMI category was used as the reference. Among those who were underweight at age 20, there was a lower risk of lung cancer (OR = 0.69, 95% CI: 0.50-0.95). Conversely, lung cancer risk was increased among those who were underweight 2 years before enrollment (OR = 2.30, 95% CI: 1.30-4.10). The results were almost identical when stratifying analyses based on smoking history into never/lighter and heavier smokers. The inverse association between recent BMI and lung cancer is unlikely to be largely attributable to residual confounding by smoking. Reverse causality or a true relationship between BMI and lung cancer remain plausible.
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Affiliation(s)
- Mariam El-Zein
- Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada
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38
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Christensen KY, Naidu A, Parent MÉ, Pintos J, Abrahamowicz M, Siemiatycki J, Koushik A. The risk of lung cancer related to dietary intake of flavonoids. Nutr Cancer 2013; 64:964-74. [PMID: 23061904 DOI: 10.1080/01635581.2012.717677] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
It has been hypothesized that flavonoids in foods and beverages may reduce cancer risk through antioxidation, inhibition of inflammation, and other antimutagenic and antiproliferative properties. We examined associations between intake of 5 flavonoid subclasses (anthocyanidins, flavan-3-ols, flavones, flavonols, and flavanones) and lung cancer risk in a population-based case-control study in Montreal, Canada (1061 cases and 1425 controls). Flavonoid intake was estimated from a food frequency questionnaire that assessed diet 2 yr prior to diagnosis (cases) or interview (controls). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Overall, total flavonoid intake was not associated with lung cancer risk, the effect being similar regardless of sex and smoking level. However, low flavonoid intake from food, but not from beverages, was associated with an increased risk. The adjusted ORs (95% CIs) comparing the highest vs. the lowest quartiles of intake were 0.63 (0.47-0.85) for total flavonoids, 0.82 (0.61-1.11) for anthocyanidins, 0.67 (0.50-0.90) for flavan-3-ols, 0.68 (0.50-0.93) for flavones, 0.62 (0.45-0.84) for flavonols, and 0.70 (0.53-0.94) for flavanones. An inverse association with total flavone and flavanone intake was observed for squamous cell carcinoma but not adenocarcinoma. In conclusion, low flavonoid intake from food may increase lung cancer risk.
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Mahboubi A, Koushik A, Siemiatycki J, Lavoué J, Rousseau MC. Assessment of the effect of occupational exposure to formaldehyde on the risk of lung cancer in two Canadian population-based case-control studies. Scand J Work Environ Health 2013; 39:401-10. [PMID: 23329145 DOI: 10.5271/sjweh.3344] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This study aimed to explore the possible association between formaldehyde exposure and lung cancer risk. METHODS Data were collected in two population-based case-control studies conducted in Montreal, Canada. Cases were individuals diagnosed with incident, histologically-confirmed lung cancer. Controls were randomly selected from electoral lists and frequency-matched to cases by age, sex, and electoral district of residence. Interviews for the two studies were conducted in 1979-1986 and 1996-2002, using a virtually identical questionnaire to obtain lifetime occupational and smoking history and several lifestyle covariates. Experts reviewed the detailed work history for each participant to assess exposure to several occupational agents, including formaldehyde. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between several metrics of formaldehyde exposure and lung cancer, adjusting for smoking and occupational and sociodemographic factors. RESULTS In all, 2060 lung cancer cases and 2046 population controls were interviewed and assessed for exposure. About 25% of subjects had ever been occupationally exposed to formaldehyde. The adjusted OR for lung cancer was 1.06 (95% CI 0.89-1.27) comparing ever versus never exposure to formaldehyde. Analyses for age at first exposure, average, and peak intensity of exposure also suggested an absence of association between formaldehyde exposure and lung cancer risk. Results did not vary by sex, lifetime smoking intensity, or histological subtype. CONCLUSIONS No marked increases in lung cancer risk related to workplace formaldehyde exposure were observed. Study participants were mainly exposed at low concentration levels, which should be considered in the interpretation of our findings.
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Affiliation(s)
- Amel Mahboubi
- University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada
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Formentin A, Archambault J, Koushik A, Richardson H, Brassard P, Franco EL, Coutlée F. Human papillomavirus type 52 polymorphism and high-grade lesions of the uterine cervix. Int J Cancer 2012; 132:1821-30. [PMID: 23015309 DOI: 10.1002/ijc.27874] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 09/11/2012] [Indexed: 11/06/2022]
Abstract
The association between polymorphism of human papillomavirus type 52 (HPV52) and high-grade cervical intraepithelial neoplasia (CIN2,3) was investigated in Canadian women. HPV-52-positive endocervical specimens collected from 216 women selected from a total of 3,614 participants recruited in two case-control and two cohort studies conducted in Canada, were further analyzed by PCR-sequencing of the LCR and E6 gene. Overall, the HPV52 LCR prototype was detected more frequently in Caucasian women (69 of 132, 52.3%, 95% confidence interval (CI): 43.8%-60.6%) than in non-Caucasian women (15 of 48, 31.3%, 95% CI 19.9%-45.4%). In two cohort studies, HPV52 prototype was detected in seven of 15 (46.7%, 95% CI 24.8-69.9) HPV52 persistent infections and 14 of 35 (40.0%, 95% CI 25.5-56.5) transient infections (p = 0.76). In two case-control studies, 30 participants did not have CIN, 18 had low-grade CIN (CIN1), 64 had CIN2,3, seven had cervical cancer and the diagnosis was undefined for 27 women. Variant MTL-52-LCR-02 was detected more frequently in women with cancer (28.6%, 95% CI 7.6%-64.8%) than in women without cancer or CIN2,3 (0%, 95% CI 0.0%-9.2%; p = 0.015). CIN2,3 risk was significantly associated with a deletion at nucleotide position 7695 in the LCR (OR 4.9, 95% CI 1.2-20.8), the T7744C variation in the LCR (OR 5.7, 95% CI 1.1-32.0), and the K93R variation in E6 (OR 6.9, 95% CI 1.3-36.8), after adjusting for age, detection of HPV16 or 18 and study site. These findings indicate that HPV52 polymorphism influences risk of CIN-2,3 and possibly invasive cancer.
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Affiliation(s)
- Aurélie Formentin
- Centre de Recherche et Département de Microbiologie Médicale et Infectiologie, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Québec, Canada
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Koushik A, Spiegelman D, Albanes D, Anderson KE, Bernstein L, van den Brandt PA, Bergkvist L, English DR, Freudenheim JL, Fuchs CS, Genkinger JM, Giles GG, Goldbohm RA, Horn-Ross PL, Männistö S, McCullough ML, Millen AE, Miller AB, Robien K, Rohan TE, Schatzkin A, Shikany JM, Stolzenberg-Solomon RZ, Willett WC, Wolk A, Ziegler RG, Smith-Warner SA. Intake of fruits and vegetables and risk of pancreatic cancer in a pooled analysis of 14 cohort studies. Am J Epidemiol 2012; 176:373-86. [PMID: 22875754 DOI: 10.1093/aje/kws027] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [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] [Indexed: 02/06/2023] Open
Abstract
Fruit and vegetable intake may protect against pancreatic cancer, since fruits and vegetables are rich in potentially cancer-preventive nutrients. Most case-control studies have found inverse associations between fruit and vegetable intake and pancreatic cancer risk, although bias due to reporting error cannot be ruled out. In most prospective studies, inverse associations have been weaker and imprecise because of small numbers of cases. The authors examined fruit and vegetable intake in relation to pancreatic cancer risk in a pooled analysis of 14 prospective studies from North America, Europe, and Australia (study periods between 1980 and 2005). Relative risks and 2-sided 95% confidence intervals were estimated separately for the 14 studies using the Cox proportional hazards model and were then pooled using a random-effects model. Of 862,584 men and women followed for 7-20 years, 2,212 developed pancreatic cancer. The pooled multivariate relative risks of pancreatic cancer per 100-g/day increase in intake were 1.01 (95% confidence interval (CI): 0.99, 1.03) for total fruits and vegetables, 1.01 (95% CI: 0.99, 1.03) for total fruits, and 1.02 (95% CI: 0.99, 1.06) for total vegetables. Associations were similar for men and women separately and across studies. These results suggest that fruit and vegetable intake during adulthood is not associated with a reduced pancreatic cancer risk.
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Affiliation(s)
- Anita Koushik
- University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
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42
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Ferguson R, Ramanakumar AV, Koushik A, Coutlée F, Franco E, Roger M. Human leukocyte antigen G polymorphism is associated with an increased risk of invasive cancer of the uterine cervix. Int J Cancer 2012; 131:E312-9. [PMID: 22095460 DOI: 10.1002/ijc.27356] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 10/26/2011] [Indexed: 12/26/2022]
Abstract
Human leukocyte antigen (HLA)-G acts as negative regulator of the immune responses and its expression in tumor cells may enable them to escape immunosurveillance. The purpose of this study was to investigate the influence of HLA-G polymorphism on risk of high-grade cervical intraepithelial neoplasia (HG-CIN) and cervical cancer in a Canadian population. The authors have analyzed 1,372 women from participants recruited between 2001 and 2009 in the ongoing Biomarkers of Cervical Cancer Risk case-control study. A total of 539 women with histologically confirmed HG-CIN and invasive cancer formed the case series, and 833 women with normal cytology served as controls. Cervical specimens were tested for human papillomavirus (HPV) DNA using the MY09/11 PCR protocol and HLA-G alleles where determined using a direct DNA sequencing procedures. HLA-G polymorphisms were not associated with HG-CIN or HPV infection. However, the risk for invasive cancer was significantly increased with the homozygous genotypes HLA-G*01:01:02 [odds ratio (OR) = 3.52, 95% confidence interval (CI): 1.43-8.61, p = 0.006], -G*01:06 (OR = 19.1, 95% CI: 2.29-159, p = 0.005) and -G* 3'UTR 14-bp insertion (OR = 2.17, 95% CI: 1.10-4.27, p = 0.020), whereas, the heterozygotic form of the G*01:01:01 wild-type allele was significantly associated with a reduced risk of invasive cancer (OR = 0.31, 95% CI: 0.16-0.59, p < 0.0001) after adjusting for age, HPV infection and ethnicity. These associations were also observed with progression of disease from HG-CIN to invasive cancer among HPV-positive women. These results suggest that HLA-G polymorphism is an independent risk factor for the development of invasive cervical cancer.
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Affiliation(s)
- Rhea Ferguson
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Canada
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Genkinger JM, Li R, Spiegelman D, Anderson KE, Albanes D, Bergkvist L, Bernstein L, Black A, van den Brandt PA, English DR, Freudenheim JL, Fuchs CS, Giles GG, Giovannucci E, Goldbohm RA, Horn-Ross PL, Jacobs EJ, Koushik A, Männistö S, Marshall JR, Miller AB, Patel AV, Robien K, Rohan TE, Schairer C, Stolzenberg-Solomon R, Wolk A, Ziegler RG, Smith-Warner SA. Coffee, tea, and sugar-sweetened carbonated soft drink intake and pancreatic cancer risk: a pooled analysis of 14 cohort studies. Cancer Epidemiol Biomarkers Prev 2011; 21:305-18. [PMID: 22194529 DOI: 10.1158/1055-9965.epi-11-0945-t] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Coffee has been hypothesized to have pro- and anticarcinogenic properties, whereas tea may contain anticarcinogenic compounds. Studies assessing coffee intake and pancreatic cancer risk have yielded mixed results, whereas findings for tea intake have mostly been null. Sugar-sweetened carbonated soft drink (SSB) intake has been associated with higher circulating levels of insulin, which may promote carcinogenesis. Few prospective studies have examined SSB intake and pancreatic cancer risk; results have been heterogeneous. METHODS In this pooled analysis from 14 prospective cohort studies, 2,185 incident pancreatic cancer cases were identified among 853,894 individuals during follow-up. Multivariate (MV) study-specific relative risks (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models and then pooled using a random-effects model. RESULTS No statistically significant associations were observed between pancreatic cancer risk and intake of coffee (MVRR = 1.10; 95% CI, 0.81-1.48 comparing ≥900 to <0 g/d; 237g ≈ 8oz), tea (MVRR = 0.96; 95% CI, 0.78-1.16 comparing ≥400 to 0 g/d; 237g ≈ 8oz), or SSB (MVRR = 1.19; 95% CI, 0.98-1.46 comparing ≥250 to 0 g/d; 355g ≈ 12oz; P value, test for between-studies heterogeneity > 0.05). These associations were consistent across levels of sex, smoking status, and body mass index. When modeled as a continuous variable, a positive association was evident for SSB (MVRR = 1.06; 95% CI, 1.02-1.12). CONCLUSION AND IMPACT Overall, no associations were observed for intakes of coffee or tea during adulthood and pancreatic cancer risk. Although we were only able to examine modest intake of SSB, there was a suggestive, modest positive association for risk of pancreatic cancer for intakes of SSB.
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Affiliation(s)
- Jeanine M Genkinger
- Mailman School of Public Health, 722 w 168th St, Rm 803, New York, NY 10032, USA.
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Aho J, Nguyen VK, Diakité S, Sow A, Koushik A, Rashed S. High acceptability of HIV voluntary counselling and testing among female sex workers: impact of individual and social factors. HIV Med 2011; 13:156-65. [PMID: 22107342 DOI: 10.1111/j.1468-1293.2011.00951.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Voluntary counselling and testing (VCT) for HIV infection is an important tool for prevention of HIV infection and AIDS in high-risk groups. Our goal was to describe the acceptability and consequences of VCT among a stigmatized and vulnerable group, female sex workers (FSWs), in Conakry, Guinea. METHODS Acceptance of the test and return for test results at baseline and consequences of testing 1 year later were described. The perceived risk of HIV infection and perceived benefits and barriers to testing were examined using quantitative and qualitative methods. RESULTS All 421 FSW participants agreed to undergo VCT and most participants (92%) returned for their results. The main reason cited for VCT acceptance was the wish to know their HIV status. However, some managers of FSW worksites urged FSWs to be tested, curtailing FSWs' free decision-making. One year later, status disclosure was common (90% of the 198 individuals who knew their results among those who participated in the follow-up part of the study). Positive consequences of testing were far more frequently reported than negative consequences (98% vs. 2%, respectively). Negative life events included banishment from the worksite (one case) and verbal abuse (two cases). CONCLUSION Acceptability of VCT appears high in the FSW population in Conakry as a consequence of both perceptions of high individual risk and social pressures.
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Affiliation(s)
- J Aho
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada.
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Coutlée F, Ratnam S, Ramanakumar AV, Insinga RR, Bentley J, Escott N, Ghatage P, Koushik A, Ferenczy A, Franco EL. Distribution of human papillomavirus genotypes in cervical intraepithelial neoplasia and invasive cervical cancer in Canada. J Med Virol 2011; 83:1034-41. [DOI: 10.1002/jmv.22081] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Aho J, Koushik A, Diakité SL, Loua KM, Nguyen VK, Rashed S. Biological validation of self-reported condom use among sex workers in Guinea. AIDS Behav 2010; 14:1287-93. [PMID: 19680799 DOI: 10.1007/s10461-009-9602-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [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: 12/18/2008] [Accepted: 07/27/2009] [Indexed: 11/26/2022]
Abstract
Self-reported condom use may be prone to social desirability bias. Our aim was to assess the validity of self-reported condom use in a population of female sex workers using prostate specific antigen (PSA) as a gold standard biomarker of recent unprotected vaginal intercourse. We collected data on 223 sex-workers in Conakry, Guinea in order to assess the sensitivity and specificity of self-reported condom use as well as to examine the predictors of discordance between self-report and PSA presence. PSA was detected in 38.4% of samples. Sensitivity of self-reported condom use was 14.6% and its specificity was 94.7%. Self-perceived high risk of HIV infection was the only significant independent predictor of misreported condom use. PSA could be useful to validate self-reported condom use in surveys and to allow a better understanding of factors associated with social desirability in sexual behaviour reporting.
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Affiliation(s)
- Joséphine Aho
- Département de médecine sociale et préventive, Université de Montréal, Outremont, Canada.
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Koushik A, Parent MÉ, Siemiatycki J. Characteristics of menstruation and pregnancy and the risk of lung cancer in women. Int J Cancer 2009; 125:2428-33. [DOI: 10.1002/ijc.24560] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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48
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Coutlée F, Trottier H, Gagnon S, Koushik A, Richardson H, Roger M, Ferenczy AS, Franco EL. Low-risk human papillomavirus type 6 DNA load and integration in cervical samples from women with squamous intraepithelial lesions. J Clin Virol 2009; 45:96-9. [DOI: 10.1016/j.jcv.2009.03.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Revised: 03/26/2009] [Accepted: 03/27/2009] [Indexed: 11/29/2022]
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Koushik A, Parent ME, Siemiatycki J. Abstract A126: Characteristics of menstruation and pregnancy and the risk of lung cancer in women. Cancer Prev Res (Phila) 2008. [DOI: 10.1158/1940-6207.prev-08-a126] [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
A126
Differences between men and women in the descriptive epidemiology of lung cancer suggest that hormonal factors may influence lung carcinogenesis in women. Few epidemiological studies have been conducted on hormone-related variables and lung cancer risk and the findings have not been consistent. We investigated the association between characteristics of menstruation and pregnancy in relation to lung cancer risk in a population-based case-control study carried out in Montreal, Canada. Between January 1996 and December 1997, newly diagnosed lung cancer cases were identified and recruited from 18 Montreal-area hospitals that together diagnose 98% of cases that occur among Montreal residents. Population controls from Montreal were identified from the provincial electoral lists and were randomly selected, stratified to the expected age and sex distribution of cases. The participation rate was 81.7% among cases and 69.4% among controls. Among cases, interviews were conducted an average of 12.1 months after diagnosis. For each variable, odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression modeling. Each hormone-related variable was modeled separately. Associations were also examined according to age at diagnosis and level of smoking and by lung cancer histology. All statistical tests were two-sided. Among 422 women with lung cancer and 577 controls, we observed that most characteristics of menstruation and pregnancy were not associated with the risk of lung cancer. However, an increased lung cancer risk was observed for women who had had surgical menopause with bilateral oophorectomy compared to women who had had a natural menopause (OR=1.95, 95% CI: 1.29-3.17). These results did not vary by age at diagnosis or level of smoking, and they were similar for different histological types. Our results suggest that hormonal factors, related to surgical menopause and/or ovary removal, may play a role in the risk of lung cancer. Further studies are needed to confirm these findings, and to assess the possible contribution of hormone replacement therapy.
Citation Information: Cancer Prev Res 2008;1(7 Suppl):A126.
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Affiliation(s)
- Anita Koushik
- Universite de Montreal, Montreal, Canada, INRS - Institut Armand-Frappier, Universite du Quebec, Laval, Canada
| | - Marie-Elise Parent
- Universite de Montreal, Montreal, Canada, INRS - Institut Armand-Frappier, Universite du Quebec, Laval, Canada
| | - Jack Siemiatycki
- Universite de Montreal, Montreal, Canada, INRS - Institut Armand-Frappier, Universite du Quebec, Laval, Canada
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50
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Azizi N, Brazete J, Hankins C, Money D, Fontaine J, Koushik A, Rachlis A, Pourreaux K, Ferenczy A, Franco E, François Coutlée For The Canadian Women's Hiv Study Group. Influence of human papillomavirus type 16 (HPV-16) E2 polymorphism on quantification of HPV-16 episomal and integrated DNA in cervicovaginal lavages from women with cervical intraepithelial neoplasia. J Gen Virol 2008; 89:1716-1728. [PMID: 18559943 DOI: 10.1099/vir.0.83579-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Integrated human papillomavirus type 16 (HPV-16) viral loads are currently estimated by quantification with real-time PCR of HPV-16 E6 (RT-E6 and HPV-16 PG) and E2 (RT-E2-1) DNA. We assessed the influence of HPV-16 E2 polymorphism on quantification of integrated HPV-16 DNA in anogenital specimens. HPV-16 E2 was sequenced from 135 isolates (123 from European and 12 from non-European lineages). An assay targeting conserved HPV-16 E2 sequences (RT-E2-2) was optimized and applied with RT-E6 and RT-E2-1 on 139 HPV-16-positive cervicovaginal lavages collected from 74 women [58 human immunodeficiency virus (HIV)-seropositive and 16 HIV-seronegative]. Ratios of HPV-16 copies measured with RT-E2-2 and RT-E2-1 obtained with African 2 (median=3.23, range=1.92-3.49) or Asian-American (median=3.78, range=1.47-37) isolates were greater than those obtained with European isolates (median=1.02, range=0.64-1.80; P<0.02 for each comparison). The distribution of HPV-16 E2 copies measured in 139 samples with RT-E2-2 (median=6150) and RT-E2-1 (median=8960) were different (P<0.0001). The risk of high-grade cervical intraepithelial neoplasia (CIN-2,3) compared with women without CIN was increased with higher HPV-16 total [odds ratio (OR)=2.17, 95 % confidence interval (CI)=1.11-4.23], episomal (OR=2.14, 95 % CI=1.09-4.19), but not for HPV-16 integrated viral load (OR=1.71, 95 % CI=0.90-3.26), after controlling for age, race, CD4 count, HIV and HPV-16 polymorphism. The proportion of samples with an E6/E2 ratio >2 in women without squamous intraepithelial lesion (7 of 35) was similar to that of women with CIN-2,3 (5 of 11, P=0.24) or CIN-1 (5 of 14, P=0.50). HPV-16 E2 polymorphism was a significant factor that influenced measures of HPV-16 integrated viral load.
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Affiliation(s)
- Naoufel Azizi
- Laboratoire de Virologie Moléculaire, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Jessica Brazete
- Laboratoire de Virologie Moléculaire, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Catherine Hankins
- Department of Epidemiology, Biostatistics and Occupational Health Medicine, McGill University, Montreal, Québec, Canada
| | - Deborah Money
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Julie Fontaine
- Laboratoire de Virologie Moléculaire, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Anita Koushik
- Department of Epidemiology, Biostatistics and Occupational Health Medicine, McGill University, Montreal, Québec, Canada
| | - Anita Rachlis
- Department of Medicine, Sunny Brook Health Science Centre, University of Toronto, Toronto, Ontario, Canada
| | - Karina Pourreaux
- Department of Epidemiology, Biostatistics and Occupational Health Medicine, McGill University, Montreal, Québec, Canada
| | - Alex Ferenczy
- Department of Pathology and Obstetrics & Gynecology, The Sir Mortimer B. Davis-Jewish General Hospital and McGill University, Québec, Canada
| | - Eduardo Franco
- Departments of Oncology, Division of Epidemiology, McGill University, Montreal, Québec, Canada
| | - François Coutlée For The Canadian Women's Hiv Study Group
- Département de Microbiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada.,Departments of Oncology, Division of Epidemiology, McGill University, Montreal, Québec, Canada.,Laboratoire de Virologie Moléculaire, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
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