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Mahamat‐Saleh Y, Rinaldi S, Kaaks R, Biessy C, Gonzalez‐Gil EM, Murphy N, Le Cornet C, Huerta JM, Sieri S, Tjønneland A, Mellemkjær L, Guevara M, Overvad K, Perez‐Cornago A, Tin Tin S, Padroni L, Simeon V, Masala G, May A, Monninkhof E, Christakoudi S, Heath AK, Tsilidis K, Agudo A, Schulze MB, Rothwell J, Cadeau C, Severi S, Weiderpass E, Gunter MJ, Dossus L. Metabolically defined body size and body shape phenotypes and risk of postmenopausal breast cancer in the European Prospective Investigation into Cancer and Nutrition. Cancer Med 2023; 12:12668-12682. [PMID: 37096432 PMCID: PMC10278526 DOI: 10.1002/cam4.5896] [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: 10/24/2022] [Revised: 03/06/2023] [Accepted: 03/23/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Excess body fatness and hyperinsulinemia are both associated with an increased risk of postmenopausal breast cancer. However, whether women with high body fatness but normal insulin levels or those with normal body fatness and high levels of insulin are at elevated risk of breast cancer is not known. We investigated the associations of metabolically defined body size and shape phenotypes with the risk of postmenopausal breast cancer in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition. METHODS Concentrations of C-peptide-a marker for insulin secretion-were measured at inclusion prior to cancer diagnosis in serum from 610 incident postmenopausal breast cancer cases and 1130 matched controls. C-peptide concentrations among the control participants were used to define metabolically healthy (MH; in first tertile) and metabolically unhealthy (MU; >1st tertile) status. We created four metabolic health/body size phenotype categories by combining the metabolic health definitions with normal weight (NW; BMI < 25 kg/m2 , or WC < 80 cm, or WHR < 0.8) and overweight or obese (OW/OB; BMI ≥ 25 kg/m2 , or WC ≥ 80 cm, or WHR ≥ 0.8) status for each of the three anthropometric measures separately: (1) MHNW, (2) MHOW/OB, (3) MUNW, and (4) MUOW/OB. Conditional logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Women classified as MUOW/OB were at higher risk of postmenopausal breast cancer compared to MHNW women considering BMI (OR = 1.58, 95% CI = 1.14-2.19) and WC (OR = 1.51, 95% CI = 1.09-2.08) cut points and there was also a suggestive increased risk for the WHR (OR = 1.29, 95% CI = 0.94-1.77) definition. Conversely, women with the MHOW/OB and MUNW were not at statistically significant elevated risk of postmenopausal breast cancer risk compared to MHNW women. CONCLUSION These findings suggest that being overweight or obese and metabolically unhealthy raises risk of postmenopausal breast cancer while overweight or obese women with normal insulin levels are not at higher risk. Additional research should consider the combined utility of anthropometric measures with metabolic parameters in predicting breast cancer risk.
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Affiliation(s)
| | - S. Rinaldi
- International Agency for Research on CancerLyonFrance
| | - R. Kaaks
- Division of Cancer EpidemiologyGerman Cancer Research Center (DFKZ)HeidelbergGermany
| | - C. Biessy
- International Agency for Research on CancerLyonFrance
| | | | - N. Murphy
- International Agency for Research on CancerLyonFrance
| | - C. Le Cornet
- Division of Cancer EpidemiologyGerman Cancer Research Center (DFKZ)HeidelbergGermany
| | - J. M. Huerta
- Department of EpidemiologyMurcia Regional Health CouncilMurciaSpain
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - S. Sieri
- Epidemiology and Prevention UnitFondazione IRCCS Istituto Nazionale dei Tumori20133MilanItaly
| | - A. Tjønneland
- Danish Cancer Society Research CenterCopenhagenDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - L. Mellemkjær
- Danish Cancer Society Research CenterCopenhagenDenmark
| | - M. Guevara
- Navarra Public Health Institute31003PamplonaSpain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)28029MadridSpain
- Navarra Institute for Health Research (IdiSNA)31008PamplonaSpain
| | - K. Overvad
- Department of Public Health, Section for EpidemiologyAarhus UniversityAarhusDenmark
| | - A. Perez‐Cornago
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - S. Tin Tin
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - L. Padroni
- Department of Clinical and Biological SciencesUniversity of TurinTurinItaly
| | - V. Simeon
- Dipartimento di Salute Mentale e Fisica e Medicina PreventivaUniversità degli Studi della Campania 'Luigi Vanvitelli'80121NaplesItaly
| | - G. Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO)FlorenceItaly
| | - A. May
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - E. Monninkhof
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - S. Christakoudi
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Inflammation BiologySchool of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - A. K. Heath
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - K. Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - A. Agudo
- Unit of Nutrition and CancerCatalan Institute of Oncology – ICOL'Hospitalet de LlobregatSpain
- Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care ProgramBellvitge Biomedical Research Institute – IDIBELLL'Hospitalet de LlobregatSpain
| | - M. B. Schulze
- Department of Molecular EpidemiologyGerman Institute of Human Nutrition Potsdam‐RehbrueckeNuthetalGermany
- Institute of Nutritional ScienceUniversity of PotsdamNuthetalGermany
| | - J. Rothwell
- Paris‐Saclay UniversityUVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - C. Cadeau
- Paris‐Saclay UniversityUVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - S. Severi
- Paris‐Saclay UniversityUVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - E. Weiderpass
- International Agency for Research on CancerLyonFrance
| | - M. J. Gunter
- International Agency for Research on CancerLyonFrance
| | - L. Dossus
- International Agency for Research on CancerLyonFrance
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Yammine SG, Huybrechts I, Biessy C, Dossus L, Panico S, Sánchez MJ, Benetou V, Turzanski-Fortner R, Katzke V, Idahl A, Skeie G, Olsen KS, Tjønneland A, Halkjaer J, Colorado-Yohar S, Heath AK, Sonestedt E, Sartor H, Schulze MB, Palli D, Crous-Bou M, Dorronsoro A, Overvad K, Gurrea AB, Severi G, Vermeulen RCH, Sandanger TM, Travis RC, Key T, Amiano P, Van Guelpen B, Johansson M, Sund M, Tumino R, Wareham N, Sacerdote C, Krogh V, Brennan P, Riboli E, Weiderpass E, Gunter MJ, Chajès V. Dietary fatty acids and endometrial cancer risk within the European Prospective Investigation into Cancer and Nutrition. BMC Cancer 2023; 23:159. [PMID: 36797668 PMCID: PMC9936701 DOI: 10.1186/s12885-023-10611-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Diet may impact important risk factors for endometrial cancer such as obesity and inflammation. However, evidence on the role of specific dietary factors is limited. We investigated associations between dietary fatty acids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS This analysis includes 1,886 incident endometrial cancer cases and 297,432 non-cases. All participants were followed up for a mean of 8.8 years. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of endometrial cancer across quintiles of individual fatty acids estimated from various food sources quantified through food frequency questionnaires in the entire EPIC cohort. The false discovery rate (q-values) was computed to control for multiple comparisons. RESULTS Consumption of n-6 γ-linolenic acid was inversely associated with endometrial cancer risk (HR comparing 5th with 1st quintileQ5-Q1=0.77, 95% CI = 0.64; 0.92, ptrend=0.01, q-value = 0.15). This association was mainly driven by γ-linolenic acid derived from plant sources (HRper unit increment=0.94, 95%CI= (0.90;0.98), p = 0.01) but not from animal sources (HRper unit increment= 1.00, 95%CI = (0.92; 1.07), p = 0.92). In addition, an inverse association was found between consumption of n-3 α-linolenic acid from vegetable sources and endometrial cancer risk (HRper unit increment= 0.93, 95%CI = (0.87; 0.99), p = 0.04). No significant association was found between any other fatty acids (individual or grouped) and endometrial cancer risk. CONCLUSION Our results suggest that higher consumption of γ-linolenic acid and α-linoleic acid from plant sources may be associated with lower risk of endometrial cancer.
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Affiliation(s)
- S G Yammine
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS) , Nutritional Epidemiology Research Team (EREN), F-93017, Bobigny, France.
| | - I Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - C Biessy
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - L Dossus
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - S Panico
- Dipartimento di medicina clinica e chirurgia, Federico II University, Naples, Italy
| | - M J Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - V Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Grèce
| | | | - V Katzke
- The German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - G Skeie
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, N - 9037, Tromsø, Norway
| | - K Standahl Olsen
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, N - 9037, Tromsø, Norway
| | - A Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Halkjaer
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - S Colorado-Yohar
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - A K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - E Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - H Sartor
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - M B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam- Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - D Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - M Crous-Bou
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO) - Bellvitge Biomedical Research Institute (IDIBELL). L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 02115, Boston, MA, USA
| | - A Dorronsoro
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
| | - K Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - A Barricarte Gurrea
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - G Severi
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Research in Epidemiology and Population Health, INSERM U1018, Université Paris-Saclay, Villejuif, France
- Human Genetics Foundation, Turin, Italy
| | - R C H Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
- Institute for Risk Assessment Sciences (IRAS), Department of Population Health Sciences, Utrecht University, Utrecht, The Netherlands
| | - T M Sandanger
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, N - 9037, Tromsø, Norway
| | - R C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - T Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - P Amiano
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
| | - B Van Guelpen
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - M Johansson
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - M Sund
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - R Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7), Ragusa, Italy
| | - N Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, England, U.K
| | - C Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Via Santena 7, 10126, Turin, Italy
| | - V Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di, Milano, Italy
| | - P Brennan
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - E Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - M J Gunter
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - V Chajès
- International Agency for Research on Cancer, World Health Organization, Lyon, France
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Cairat M, Al Rhamoun M, Gunter M, Severi G, Dossus L, Fournier A. Utilisation d’anti-inflammatoires non stéroïdiens et risque de cancer du sein dans une cohorte prospective de femmes ménopausées. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.04.046] [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: 10/26/2022] Open
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Cairat M, Al Rhamoun M, Gunter M, Severi G, Dossus L, Fournier A. Utilisation d’aspirine faible dose et risque de cancer du sein dans une cohorte prospective de femmes ménopausées. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.04.018] [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: 10/26/2022] Open
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Schoemaker MJ, Nichols HB, Wright LB, Brook MN, Jones ME, O'Brien KM, Adami HO, Baglietto L, Bernstein L, Bertrand KA, Boutron-Ruault MC, Chen Y, Connor AE, Dorronsoro M, Dossus L, Eliassen AH, Giles GG, Gram IT, Hankinson SE, Kaaks R, Key TJ, Kirsh VA, Kitahara CM, Koh WP, Larsson SC, Linet MS, Ma H, Masala G, Merritt MA, Milne RL, Overvad K, Ozasa K, Palmer JR, Riboli E, Rohan TE, Sadakane A, Sund M, Tamimi RM, Trichopoulou A, Ursin G, Van Gils CH, Visvanathan K, Weiderpass E, Willett WC, Wolk A, Yuan JM, Zeleniuch-Jacquotte A, Sandler DP, Swerdlow AJ. Abstract P1-08-01: Withdrawn. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-08-01] [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
This abstract was withdrawn by the authors.
Citation Format: Schoemaker MJ, Nichols HB, Wright LB, Brook MN, Jones ME, O'Brien KM, Adami H-O, Baglietto L, Bernstein L, Bertrand KA, Boutron-Ruault M-C, Chen Y, Connor AE, Dorronsoro M, Dossus L, Eliassen AH, Giles GG, Gram IT, Hankinson SE, Kaaks R, Key TJ, Kirsh VA, Kitahara CM, Koh W-P, Larsson SC, Linet MS, Ma H, Masala G, Merritt MA, Milne RL, Overvad K, Ozasa K, Palmer JR, Riboli E, Rohan TE, Sadakane A, Sund M, Tamimi RM, Trichopoulou A, Ursin G, Van Gils CH, Visvanathan K, Weiderpass E, Willett WC, Wolk A, Yuan J-M, Zeleniuch-Jacquotte A, Sandler DP, Swerdlow AJ. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-08-01.
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Affiliation(s)
- MJ Schoemaker
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - HB Nichols
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - LB Wright
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - MN Brook
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - ME Jones
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - KM O'Brien
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - H-O Adami
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - L Baglietto
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - L Bernstein
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - KA Bertrand
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - M-C Boutron-Ruault
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - Y Chen
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - AE Connor
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - M Dorronsoro
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - L Dossus
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - AH Eliassen
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - GG Giles
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - IT Gram
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - SE Hankinson
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - R Kaaks
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - TJ Key
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - VA Kirsh
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - CM Kitahara
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - W-P Koh
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - SC Larsson
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - MS Linet
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - H Ma
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - G Masala
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - MA Merritt
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - RL Milne
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - K Overvad
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - K Ozasa
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - JR Palmer
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - E Riboli
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - TE Rohan
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - A Sadakane
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - M Sund
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - RM Tamimi
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - A Trichopoulou
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - G Ursin
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - CH Van Gils
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - K Visvanathan
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - E Weiderpass
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - WC Willett
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - A Wolk
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - J-M Yuan
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - A Zeleniuch-Jacquotte
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - DP Sandler
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
| | - AJ Swerdlow
- The Institute of Cancer Research, London, United Kingdom; University of North Carolina Gillings School of Global Public Health, Chapel Hill; National Institute of Environmental Health Sciences, Durham; Harvard T.H. Chan School of Public Health, Boston; University of Pisa, Pisa, Italy; Beckman Research Institute of City of Hope, Duarte; Slone Epidemiology Center at Boston University, Boston; CESP Center for Research in Epidemiology and Population Health, Paris, France; New York University School of Medicine, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore; Public Health Direction and Biodonostia Research Institute and Ciberesp, San Sebastian, Spain; International Agency for Research on Cancer, Lyon, France; The University of Melbourne, Melbourne, Australia; University of Tromsø (UiT) The Arctic University of Norway, Tromsø, Norway; University of Massachusetts, Amherst; German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Oxford, Oxford, United Kingdom; University of To
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6
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Sahrai M, Huybrechts I, Gunter M, Torres-Mejia G, Romieu I, Dossus L. Dietary determinants of obesity among Mexican women. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.307] [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: 10/28/2022] Open
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7
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Dossus L, Rinaldi S, Biessy C, Hernandez M, Lajous M, Monge A, Ortiz-Panozo E, Yunes E, Lopez-Ridaura R, Torres-Mejía G, Romieu I. Circulating leptin and adiponectin, and breast density in premenopausal Mexican women: the Mexican Teachers' Cohort. Cancer Causes Control 2017; 28:939-946. [PMID: 28677026 DOI: 10.1007/s10552-017-0917-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 02/09/2017] [Accepted: 06/21/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE Leptin and adiponectin are produced by the adipose tissue. Mammographic density (MD) is one of the strongest predictors of breast cancer (BC) and is highly influenced by adiposity. How the interplay between MD, obesity, and obesity-related biomarkers influences BC risk, however, is still unknown, especially in premenopausal women, where adiposity seems to be protective for BC. The aim of the present study was to explore the association between circulating leptin, adiponectin, and their ratio, with MD in Mexican premenopausal women who are part of the large Mexican Teachers' Cohort (MTC). METHODS A subsample of 2,084 women from the MTC participated in a clinical evaluation. Of them, 574 premenopausal women were randomly selected, from four MD strata. Serum leptin and adiponectin concentrations were measured by immunoassays. Multivariate regression analyses were performed to compare means of MD by quartiles of adipokines and their ratio. RESULTS High leptin and leptin/adiponectin ratio levels were significantly associated with lower percentage MD and higher absolute and non-absolute dense tissue areas. High adiponectin levels were significantly associated with lower absolute dense and non-dense tissue areas, but not with percentage MD. After adjustment for BMI, only the associations between percentage MD and absolute non-dense tissue area with leptin remained statistically significant. CONCLUSIONS Leptin, adiponectin, and their ratio were associated with MD; however, only the positive association with leptin seemed to be independent from overall obesity.
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Affiliation(s)
- L Dossus
- International Agency for Research on Cancer [IARC], Lyon, France
| | - S Rinaldi
- International Agency for Research on Cancer [IARC], Lyon, France
| | - C Biessy
- International Agency for Research on Cancer [IARC], Lyon, France
| | - M Hernandez
- International Agency for Research on Cancer [IARC], Lyon, France
| | - M Lajous
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico.
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
| | - A Monge
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - E Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - E Yunes
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - R Lopez-Ridaura
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - G Torres-Mejía
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
| | - I Romieu
- International Agency for Research on Cancer [IARC], Lyon, France
- Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante # 50, Mexico, 14000, Mexico
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8
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Brand JS, Onland-Moret NC, Eijkemans MJC, Tjønneland A, Roswall N, Overvad K, Fagherazzi G, Clavel-Chapelon F, Dossus L, Lukanova A, Grote V, Bergmann MM, Boeing H, Trichopoulou A, Tzivoglou M, Trichopoulos D, Grioni S, Mattiello A, Masala G, Tumino R, Vineis P, Bueno-de-Mesquita HB, Weiderpass E, Redondo ML, Sánchez MJ, Castaño JMH, Arriola L, Ardanaz E, Duell EJ, Rolandsson O, Franks PW, Butt S, Nilsson P, Khaw KT, Wareham N, Travis R, Romieu I, Gunter MJ, Riboli E, van der Schouw YT. Diabetes and onset of natural menopause: results from the European Prospective Investigation into Cancer and Nutrition. Hum Reprod 2015; 30:1491-8. [PMID: 25779698 PMCID: PMC6284789 DOI: 10.1093/humrep/dev054] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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: 07/07/2014] [Accepted: 12/05/2014] [Indexed: 01/10/2023] Open
Abstract
STUDY QUESTION Do women who have diabetes before menopause have their menopause at an earlier age compared with women without diabetes? SUMMARY ANSWER Although there was no overall association between diabetes and age at menopause, our study suggests that early-onset diabetes may accelerate menopause. WHAT IS KNOWN ALREADY Today, more women of childbearing age are being diagnosed with diabetes, but little is known about the impact of diabetes on reproductive health. STUDY DESIGN, SIZE, DURATION We investigated the impact of diabetes on age at natural menopause (ANM) in 258 898 women from the European Prospective Investigation into Cancer and Nutrition (EPIC), enrolled between 1992 and 2000. PARTICIPANTS/MATERIALS, SETTING, METHODS Determinant and outcome information was obtained through questionnaires. Time-dependent Cox regression analyses were used to estimate the associations of diabetes and age at diabetes diagnosis with ANM, stratified by center and adjusted for age, smoking, reproductive and diabetes risk factors and with age from birth to menopause or censoring as the underlying time scale. MAIN RESULTS AND THE ROLE OF CHANCE Overall, no association between diabetes and ANM was found (hazard ratio (HR) = 0.94; 95% confidence interval (CI) 0.89-1.01). However, women with diabetes before the age of 20 years had an earlier menopause (10-20 years: HR = 1.43; 95% CI 1.02-2.01, <10 years: HR = 1.59; 95% CI 1.03-2.43) compared with non-diabetic women, whereas women with diabetes at age 50 years and older had a later menopause (HR = 0.81; 95% CI 0.70-0.95). None of the other age groups were associated with ANM. LIMITATIONS, REASONS FOR CAUTION Strengths of the study include the large sample size and the broad set of potential confounders measured. However, results may have been underestimated due to survival bias. We cannot be sure about the sequence of the events in women with a late age at diabetes, as both events then occur in a short period. We could not distinguish between type 1 and type 2 diabetes. WIDER IMPLICATIONS OF THE FINDINGS Based on the literature, an accelerating effect of early-onset diabetes on ANM might be plausible. A delaying effect of late-onset diabetes on ANM has not been reported before, and is not in agreement with recent studies suggesting the opposite association. STUDY FUNDING/COMPETING INTERESTS The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ) and Federal Ministry of Education and Research (BMMF) (Germany); Ministry of Health and Social Solidarity, Stavros Niarchos Foundation and Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skåne and Västerbotten (Sweden); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (UK). None of the authors reported a conflict of interest.
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Affiliation(s)
- J S Brand
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - N C Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M J C Eijkemans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - N Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - K Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - G Fagherazzi
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France
| | - F Clavel-Chapelon
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France
| | - L Dossus
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France
| | - A Lukanova
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany Department of Medical Biosciences, University of Umeå, Umeå, Sweden
| | - V Grote
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - M M Bergmann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - A Trichopoulou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75 M. Asias Street, Goudi GR-115 27, Athens, Greece Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
| | - M Tzivoglou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
| | - D Trichopoulos
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA Bureau of Epidemiologic Research, Academy of Athens, 28 Panepistimiou Street, Athens GR-106 79, Greece
| | - S Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - G Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, 'Civic - M.P. Arezzo' Hospital, ASP Ragusa, Italy
| | - P Vineis
- School of Public Health, Imperial College, London, UK HuGeF Foundation, Torino, Italy
| | - H B Bueno-de-Mesquita
- Dt. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands Dt. of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands Dt. of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom Dt. of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway Cancer Registry of Norway, Oslo, Norway Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Samfundet Folkhälsan, Helsinki, Finland
| | | | - M J Sánchez
- Andalusian School of Public Health, Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J M Huerta Castaño
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
| | - L Arriola
- Public Health Department of Gipuzkoa, Instituto BIO-Donostia, Basque Government, CIBERESP, San Sebastian, Spain
| | - E Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Navarre Public Health Institute, Pamplona, Spain
| | - E J Duell
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - O Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine Umeå University, 901 87 Umeå, Sweden
| | - P W Franks
- Department of Clinical Sciences, Genetic & Molecular Epidemiology Unit, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden Department of Medicine, Umeå University, Umeå, Sweden
| | - S Butt
- Department of Surgery, Institute of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
| | - P Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmo, Sweden
| | - K T Khaw
- University of Cambridge, Cambridge, UK
| | - N Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - R Travis
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - I Romieu
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - M J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Y T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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9
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Li K, Hüsing A, Fortner RT, Tjønneland A, Hansen L, Dossus L, Chang-Claude J, Bergmann M, Steffen A, Bamia C, Trichopoulos D, Trichopoulou A, Palli D, Mattiello A, Agnoli C, Tumino R, Onland-Moret NC, Peeters PH, Bueno-de-Mesquita HB, Gram IT, Weiderpass E, Sánchez-Cantalejo E, Chirlaque MD, Duell EJ, Ardanaz E, Idahl A, Lundin E, Khaw KT, Travis RC, Merritt MA, Gunter MJ, Riboli E, Ferrari P, Terry K, Cramer D, Kaaks R. An epidemiologic risk prediction model for ovarian cancer in Europe: the EPIC study. Br J Cancer 2015; 112:1257-65. [PMID: 25742479 PMCID: PMC4385951 DOI: 10.1038/bjc.2015.22] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/22/2014] [Accepted: 12/29/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Ovarian cancer has a high case-fatality ratio, largely due to late diagnosis. Epidemiologic risk prediction models could help identify women at increased risk who may benefit from targeted prevention measures, such as screening or chemopreventive agents. METHODS We built an ovarian cancer risk prediction model with epidemiologic risk factors from 202,206 women in the European Prospective Investigation into Cancer and Nutrition study. RESULTS Older age at menopause, longer duration of hormone replacement therapy, and higher body mass index were included as increasing ovarian cancer risk, whereas unilateral ovariectomy, longer duration of oral contraceptive use, and higher number of full-term pregnancies were decreasing risk. The discriminatory power (overall concordance index) of this model, as examined with five-fold cross-validation, was 0.64 (95% confidence interval (CI): 0.57, 0.70). The ratio of the expected to observed number of ovarian cancer cases occurring in the first 5 years of follow-up was 0.90 (293 out of 324, 95% CI: 0.81-1.01), in general there was no evidence for miscalibration. CONCLUSION Our ovarian cancer risk model containing only epidemiological data showed modest discriminatory power for a Western European population. Future studies should consider adding informative biomarkers to possibly improve the predictive ability of the model.
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Affiliation(s)
- K Li
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Hüsing
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - R T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - L Hansen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - L Dossus
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France
- University Paris Sud, UMRS 1018, F-94805 Villejuif, France
| | - J Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Bergmann
- German Institute of Human Nutrition in Potsdam-Rehbruecke, Potsdam, Germany
| | - A Steffen
- German Institute of Human Nutrition in Potsdam-Rehbruecke, Potsdam, Germany
| | - C Bamia
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - D Trichopoulos
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
- Hellenic Health Foundation, Athens, Greece
| | - A Trichopoulou
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
- Hellenic Health Foundation, Athens, Greece
| | - D Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute—ISPO, Florence, Italy
| | - A Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, University of Naples Federico II, Naples, Italy
| | - C Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, ‘Civic—M.P. Arezzo' Hospital, Ragusa, Italy
| | - N C Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - H B(as) Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - I T Gram
- Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - E Sánchez-Cantalejo
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M-D Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain
| | - E J Duell
- Unit of Nutrition, Environment and Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - E Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarre Public Health Institute, Pamplona, Spain
| | - A Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology and Department of Public Health and Clinical Medicine, Nutritional Research Umeå University, Umeå, Sweden
| | - E Lundin
- Department of Medical Biosciences, Pathology Umeå University, Umeå, Sweden
| | - K-T Khaw
- University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - R C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, Oxford, UK
| | - M A Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - M J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - P Ferrari
- International Agency for Research on Cancer, Lyon, France
| | - K Terry
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - D Cramer
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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10
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Ose J, Fortner RT, Schock H, Peeters PH, Onland-Moret NC, Bueno-de-Mesquita HB, Weiderpass E, Gram IT, Overvad K, Tjonneland A, Dossus L, Fournier A, Baglietto L, Trichopoulou A, Benetou V, Trichopoulos D, Boeing H, Masala G, Krogh V, Matiello A, Tumino R, Popovic M, Obón-Santacana M, Larrañaga N, Ardanaz E, Sánchez MJ, Menéndez V, Chirlaque MD, Travis RC, Khaw KT, Brändstedt J, Idahl A, Lundin E, Rinaldi S, Kuhn E, Romieu I, Gunter MJ, Merritt MA, Riboli E, Kaaks R. Insulin-like growth factor I and risk of epithelial invasive ovarian cancer by tumour characteristics: results from the EPIC cohort. Br J Cancer 2015; 112:162-6. [PMID: 25349976 PMCID: PMC4453611 DOI: 10.1038/bjc.2014.566] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/24/2014] [Accepted: 10/08/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Prospective studies on insulin-like growth factor I (IGF-I) and epithelial ovarian cancer (EOC) risk are inconclusive. Data suggest risk associations vary by tumour characteristics. METHODS We conducted a nested case-control study in the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate IGF-I concentrations and EOC risk by tumour characteristics (n=565 cases). Multivariable conditional logistic regression models were used to estimate associations. RESULTS We observed no association between IGF-I and EOC overall or by tumour characteristics. CONCLUSIONS In the largest prospective study to date was no association between IGF-I and EOC risk. Pre-diagnostic serum IGF-I concentrations may not influence EOC risk.
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Affiliation(s)
- J Ose
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
| | - R T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
| | - H Schock
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
| | - P H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - N C Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 Utrecht, The Netherlands
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), 3720 Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, 3542 Utrecht, The Netherlands
- Department of Epidemiology and Statistics, the School of Public Health, Imperial College London, SW72AZ London, UK
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, 90109 Tromsø, Norway
- Cancer Registry of Norway, 0304 Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Stockholm, Sweden
- Department of Genetic Epidemiology, Folkhälsan Research Center, 00014 Helsinki, Finland
| | - I T Gram
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - K Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, 8000 Aarhus, Denmark
| | - A Tjonneland
- Institute of Cancer Epidemiology, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark
| | - L Dossus
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France
- Univ Paris Sud, UMRS 1018, F-94805 Villejuif, France
- IGR, F-94805 Villejuif, France
| | - A Fournier
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France
- Univ Paris Sud, UMRS 1018, F-94805 Villejuif, France
- IGR, F-94805 Villejuif, France
| | - L Baglietto
- Cancer Epidemiology Centre, Cancer Council of Victoria, Melbourne, 3004 Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, 3004 Victoria, Australia
| | - A Trichopoulou
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
| | - V Benetou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75M Asias Street, Goudi, Athens GR-115 27, Greece
| | - D Trichopoulos
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition (DIfE) 14558 Potsdam-Rehbrücke, Nuthetal, Germany
| | - G Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute—ISPO, 50139 Florence, Italy
| | - V Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Instituto Nazionale dei Tumori, Via Veneziani 1, 20133 Milano, Italy
| | - A Matiello
- Department of Clinical and Experimental Medicine, Federico II University, 80131 Naples, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, ‘Civic - M.P. Arezzo' Hospita, ASP 97100 Ragusa, Italy
| | - M Popovic
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, Department of Medical Sciences, University of Turin and Center for Cancer Prevention (CPO-Piemonte), 10126 Turin, Italy
| | - M Obón-Santacana
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), 08908 Barcelona, Spain
| | - N Larrañaga
- Public Health Division of Gipuzkoa-BIODonostia Research Institute, Basque Regional Health Department, 20013 San Sebastian, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), 28029 Madrid, Spain
| | - E Ardanaz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), 28029 Madrid, Spain
- Navarre Public Health Institute, 31006 Pamplona, Spain
| | - M-J Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), 28029 Madrid, Spain
- Andalusian School of Public Health, 18011 Granada, Spain
| | - V Menéndez
- Public Health Directorate, 33006 Asturias, Spain
| | - M-D Chirlaque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), 28029 Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Authority, 30008 Murcia, Spain
| | - R C Travis
- Cancer Epidemiology Unit, University of Oxford, OX30NR Oxford, UK
| | - K-T Khaw
- Department of Public Health and Primary Care, University of Cambridge, CB22QQ Cambridge, UK
| | - J Brändstedt
- Medical Department of Surgery, Malmö University Hospital, 20502 Malmö, Sweden
| | - A Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology and Department of Public Health and Clinical Medicine, Nutritional Research Umeå University, 90185 Umeå, Sweden
| | - E Lundin
- Department of Medical Biosciences, Pathology Umeå University, 90185 Umeå, Sweden
| | - S Rinaldi
- International Agency for Research on Cancer, 69372 Lyon, France
| | - E Kuhn
- International Agency for Research on Cancer, 69372 Lyon, France
| | - I Romieu
- International Agency for Research on Cancer, 69372 Lyon, France
| | - M J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, SW72AZ London, UK
| | - M A Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, SW72AZ London, UK
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, SW72AZ London, UK
| | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
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His M, Fagherazzi G, Mesrine S, Boutron-Ruault MC, Clavel-Chapelon F, Dossus L. Corpulence et survie après cancer du sein : les résultats de la cohorte prospective E3N, France. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.06.143] [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: 11/25/2022] Open
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Fournier A, Mesrine S, Dossus L, Boutron-Ruault MC, Clavel-Chapelon F, Chabbert-Buffet N. Risque de cancer du sein après arrêt d’un traitement hormonal de la ménopause. Cohorte E3N, France. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.06.078] [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: 11/30/2022] Open
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13
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Obón-Santacana M, Kaaks R, Slimani N, Lujan-Barroso L, Freisling H, Ferrari P, Dossus L, Chabbert-Buffet N, Baglietto L, Fortner RT, Boeing H, Tjønneland A, Olsen A, Overvad K, Menéndez V, Molina-Montes E, Larrañaga N, Chirlaque MD, Ardanaz E, Khaw KT, Wareham N, Travis RC, Lu Y, Merritt MA, Trichopoulou A, Benetou V, Trichopoulos D, Saieva C, Sieri S, Tumino R, Sacerdote C, Galasso R, Bueno-de-Mesquita HB, Wirfält E, Ericson U, Idahl A, Ohlson N, Skeie G, Gram IT, Weiderpass E, Onland-Moret NC, Riboli E, Duell EJ. Dietary intake of acrylamide and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort. Br J Cancer 2014; 111:987-97. [PMID: 24937665 PMCID: PMC4150262 DOI: 10.1038/bjc.2014.328] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/12/2014] [Accepted: 05/14/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Three prospective studies have evaluated the association between dietary acrylamide intake and endometrial cancer (EC) risk with inconsistent results. The objective of this study was to evaluate the association between acrylamide intake and EC risk: for overall EC, for type-I EC, and in never smokers and never users of oral contraceptives (OCs). Smoking is a source of acrylamide, and OC use is a protective factor for EC risk. METHODS Cox regression was used to estimate hazard ratios (HRs) for the association between acrylamide intake and EC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Acrylamide intake was estimated from the EU acrylamide monitoring database, which was matched with EPIC questionnaire-based food consumption data. Acrylamide intake was energy adjusted using the residual method. RESULTS No associations were observed between acrylamide intake and overall EC (n=1382) or type-I EC risk (n=627). We observed increasing relative risks for type-I EC with increasing acrylamide intake among women who both never smoked and were non-users of OCs (HRQ5vsQ1: 1.97, 95% CI: 1.08-3.62; likelihood ratio test (LRT) P-value: 0.01, n=203). CONCLUSIONS Dietary intake of acrylamide was not associated with overall or type-I EC risk; however, positive associations with type I were observed in women who were both non-users of OCs and never smokers.
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Affiliation(s)
- M Obón-Santacana
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Avda Gran Via Barcelona 199-203, 08908L'Hospitalet de Llobregat, Barcelona, Spain
| | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany
| | - N Slimani
- Dietary Exposure Assessment Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon 69372, France
| | - L Lujan-Barroso
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Avda Gran Via Barcelona 199-203, 08908L'Hospitalet de Llobregat, Barcelona, Spain
| | - H Freisling
- Dietary Exposure Assessment Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon 69372, France
| | - P Ferrari
- Nutritional Epidemiology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon 69372, France
| | - L Dossus
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France
- Paris-Sud University, UMRS 1018, F-94805 Villejuif, France
- Institut Gustave Roussy, F-94805 Villejuif, France
| | - N Chabbert-Buffet
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France
- Paris-Sud University, UMRS 1018, F-94805 Villejuif, France
- Institut Gustave Roussy, F-94805 Villejuif, France
- Obstetrics and Gynecology Department AP-HP, Hopital Tenon, F-75020 Paris, France
| | - L Baglietto
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, VIC, Australia
| | - R T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, Heidelberg 69120, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114/116, Nuthetal 14558, Germany
| | - A Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | - A Olsen
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | - K Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Nordre Ringgade 1, Aarhus 8000, Denmark
| | - V Menéndez
- Public Health and Participation Directorate, Ciriaco Miguel Vigil 9, Asturias 33009, Spain
| | - E Molina-Montes
- CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain
| | - N Larrañaga
- CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain
- Public Health Division of Gipuzkoa-BIODONOSTIA, Basque Regional Health Department, Avda. Navarra, 4, San Sebastian 20013, Spain
| | - M-D Chirlaque
- CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain
- Department of Epidemiology, Murcia Regional Health Authority, Ronda de Levante, 11, Murcia 30008, Spain
| | - E Ardanaz
- CIBER Epidemiology and Public Health CIBERESP, Melchor Fernández Almagro 3-5, Madrid 28029, Spain
- Navarre Public Health Institute, Polígono de Landaben C/F, Pamplona 31012, Spain
| | - K-T Khaw
- University of Cambridge School of Clinical Medicine, Robinson Way, Cambridge CB2 0SR, UK
| | - N Wareham
- MRC Epidemiology Unit, University of Cambridge, 184 Hills Road, Cambridge CB2 8PQ, UK
| | - R C Travis
- Cancer Epidemiology Unit, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK
| | - Y Lu
- Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - M A Merritt
- Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - A Trichopoulou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
| | - V Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75M. Asias Street, Goudi GR-115 27, Athens, Greece
| | - D Trichopoulos
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - C Saieva
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute—ISPO, Ponte Nuovo, Via delle Oblate n.2, Florence 50141, Italy
| | - S Sieri
- Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Venezian, 1, Milano 20133, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, "Civic-M.P.Arezzo" Hospital, Via Civile, Ragusa 97100, Italy
| | - C Sacerdote
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention (CPO-Piemonte), Via Santena 7, 10126 Turin, Italy
- Human Genetics Foundation (HuGeF), Via Nizza 52, 10126 Turin, Italy
| | - R Galasso
- Unit of Clinical Epidemiology, Biostatistics and Cancer Registry IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture (Pz), Italy
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
- The School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - E Wirfält
- Department of Clinical Sciences, Nutrition Epidemiology, Lund University, Box 117, Malmö 205 02, Sweden
| | - U Ericson
- Department of Clinical Sciences, Diabetes and Cardiovascular Disease, Genetic Epidemiology, Lund University, Clinical Research Centre, Box 117, Malmö 205 02, Sweden
| | - A Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, 1A, 9 tr, Kirurgcentrum, 952, Umeå 901 85, Sweden
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, 1A, 9 tr, Kirurgcentrum, 952, Umeå 901 85, Sweden
| | - N Ohlson
- Departament of Medical Biosciences, Pathology, Umeå University, 1A, 9 tr, Kirurgcentrum, 952, Umeå 901 85, Sweden
| | - G Skeie
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Breivika N-9037, Norway
| | - I T Gram
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Breivika N-9037, Norway
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Breivika N-9037, Norway
- Department of Research, Cancer Registry of Norway, P.O. box 5313 Majorstuen Oslo, N-0304 Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, Stockholm 171 77, Sweden
- Public Health Research Center, Public Health Association, Topeliusgatan 20 (PB 211), 00250 Helsinki, Finland
| | - N C Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center, Huispost Str. 6.131, 3508GA Utrecht, The Netherlands
| | - E Riboli
- Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - E J Duell
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Avda Gran Via Barcelona 199-203, 08908L'Hospitalet de Llobregat, Barcelona, Spain
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Tikk K, Sookthai D, Johnson T, Rinaldi S, Romieu I, Tjønneland A, Olsen A, Overvad K, Clavel-Chapelon F, Baglietto L, Boeing H, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Pala V, Tumino R, Rosso S, Panico S, Agudo A, Menéndez V, Sánchez MJ, Amiano P, Huerta Castaño JM, Ardanaz E, Bueno-de-Mesquita HB, Monninkhof E, Onland-Moret C, Andersson A, Sund M, Weiderpass E, Khaw KT, Key TJ, Travis RC, Gunter MJ, Riboli E, Dossus L, Kaaks R. Circulating prolactin and breast cancer risk among pre- and postmenopausal women in the EPIC cohort. Ann Oncol 2014; 25:1422-1428. [PMID: 24718887 DOI: 10.1093/annonc/mdu150] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [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] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Experimental and epidemiological evidence suggests that prolactin might play a role in the etiology of breast cancer. We analyzed the relationship of prediagnostic circulating prolactin levels with the risk of breast cancer by menopausal status, use of postmenopausal hormone replacement therapy (HRT) at blood donation, and by estrogen and progesterone receptor status of the breast tumors. PATIENTS AND METHODS Conditional logistic regression was used to analyze the data from a case-control study nested within the prospective European EPIC cohort, including 2250 invasive breast cancer and their matched control subjects. RESULTS Statistically significant heterogeneity in the association of prolactin levels with breast cancer risk between women who were either pre- or postmenopausal at the time of blood donation was observed (Phet = 0.04). Higher serum levels of prolactin were associated with significant increase in the risk of breast cancer among postmenopausal women [odds ratio (OR)Q4-Q1 = 1.29 (95% confidence interval, CI, 1.05-1.58), Ptrend = 0.09]; however, this increase in risk seemed to be confined to women who used postmenopausal HRT at blood donation [ORQ4-Q1 = 1.45 (95% CI 1.08-1.95), Ptrend = 0.01], whereas no statistically significant association was found for the non-users of HRT [ORQ4-Q1 = 1.11 (95%CI 0.83-1.49), Ptrend = 0.80] (Phet = 0.08). Among premenopausal women, a statistically non-significant inverse association was observed [ORQ4-Q1 = 0.70 (95% CI 0.48-1.03), Ptrend = 0.16]. There was no heterogeneity in the prolactin-breast cancer association by hormone receptor status of the tumor. CONCLUSION Our study indicates that higher circulating levels of prolactin among the postmenopausal HRT users at baseline may be associated with increased breast cancer risk.
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Affiliation(s)
- K Tikk
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ) Heidelberg, Heidelberg, Germany
| | - D Sookthai
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ) Heidelberg, Heidelberg, Germany
| | - T Johnson
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ) Heidelberg, Heidelberg, Germany
| | - S Rinaldi
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - I Romieu
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - A Tjønneland
- Danish Cancer Society Research Center, Copenhagen
| | - A Olsen
- Danish Cancer Society Research Center, Copenhagen
| | - K Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - F Clavel-Chapelon
- INSERM, Centre for Research in Epidemiology and Population Health [CESP], Nutrition, Hormones and Women's Health Team, Villejuif; University of Paris Sud, UMRS, Villejuif; IGR, Villejuif, France
| | - L Baglietto
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne; Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Australia
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Nuthetal, Germany
| | - A Trichopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens; Hellenic Health Foundation, Athens, Greece
| | - P Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens; Department of Epidemiology, Harvard School of Public Health, Boston, USA; Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
| | - D Trichopoulos
- Hellenic Health Foundation, Athens, Greece; Department of Epidemiology, Harvard School of Public Health, Boston, USA; Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
| | - D Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy
| | - V Pala
- Epidemiology and Prevention Unit, National Tumor Institute (IRCCS), Milano
| | - R Tumino
- Cancer Registry and Histopathology Unit, 'Civic-M. P. Arezzo' Hospital ASP, Ragusa
| | - S Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Torino
| | - S Panico
- Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy
| | - A Agudo
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology-ICO, IDIBELL, Barcelona
| | | | - M-J Sánchez
- Granada Cancer Registry, Andalusian School of Public Health, Granada; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid
| | - P Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid; Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian
| | - J M Huerta Castaño
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid; Department of Epidemiology, Murcia Regional Health Authority, Murcia
| | - E Ardanaz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid; Navarre Public Health Institute, Pamplona, Spain
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands; School of Public Health, Imperial College, London, UK
| | - E Monninkhof
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - C Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - A Andersson
- Department of Radiation Sciences, University of Umeå, Umeå
| | - M Sund
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø; Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Society of Public Health, Helsinki, Finland
| | - K-T Khaw
- School of Clinical Medicine, University of Cambridge, Cambridge
| | - T J Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - R C Travis
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - M J Gunter
- School of Public Health, Imperial College, London, UK
| | - E Riboli
- School of Public Health, Imperial College, London, UK
| | - L Dossus
- INSERM, Centre for Research in Epidemiology and Population Health [CESP], Nutrition, Hormones and Women's Health Team, Villejuif; University of Paris Sud, UMRS, Villejuif; IGR, Villejuif, France
| | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ) Heidelberg, Heidelberg, Germany.
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Rinaldi S, Kaaks R, Friedenreich CM, Key TJ, Travis R, Biessy C, Slimani N, Overvad K, Østergaard JN, Tjønneland A, Olsen A, Mesrine S, Fournier A, Dossus L, Lukanova A, Johnson T, Boeing H, Vigl M, Trichopoulou A, Benetou V, Trichopoulos D, Masala G, Krogh V, Tumino R, Ricceri F, Panico S, Bueno-de-Mesquita HB, Monninkhof EM, May AM, Weiderpass E, Quirós JR, Travier N, Molina-Montes E, Amiano P, Huerta JM, Ardanaz E, Sund M, Johansson M, Khaw KT, Wareham N, Scalbert A, Gunter MJ, Riboli E, Romieu I. Physical activity, sex steroid, and growth factor concentrations in pre- and post-menopausal women: a cross-sectional study within the EPIC cohort. Cancer Causes Control 2014; 25:111-24. [PMID: 24173534 DOI: 10.1007/s10552-013-0314-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 07/03/2013] [Accepted: 10/14/2013] [Indexed: 01/13/2023]
Abstract
PURPOSE Increased physical activity (PA) is associated with a reduced risk of several cancers. PA may reduce cancer risk by changing endogenous hormones levels, but relatively little research has focused on this topic. The purpose of this study was to elucidate the relation between PA and endogenous hormone concentrations. METHODS A cross-sectional analysis of 798 pre- and 1,360 post-menopausal women included as controls in case-control studies on endogenous hormones (steroids, progesterone, sex-hormone-binding globulin (SHBG), and growth factors) levels, and cancer risk nested within European Prospective Investigation into Cancer and Nutrition cohort was performed. Multivariate regression analyses were performed to compare geometric mean levels of hormones and SHBG by categories of PA. RESULTS In pre-menopausal women, active women had 19 % significantly lower concentrations of androstenedione, 14 % lower testosterone, and 20 % lower free testosterone than inactive women, while no differences were observed for estrogens, progesterone, SHBG, and growth factors. In post-menopausal women, active women had 18 % significantly lower estradiol and 20 % lower free estradiol concentrations than inactive women, while no differences were observed for the other hormones and SHBG. More vigorous forms of physical activity were associated with higher insulin-like growth factor-I concentrations. Adjustment for body mass index did not alter the associations. Overall, the percentage of variance in hormone concentrations explained by PA levels was <2 %. CONCLUSIONS Our results support the hypothesis of an influence, although small in magnitude, of PA on sex hormone levels in blood, independent of body size.
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Affiliation(s)
- S Rinaldi
- International Agency for Research on Cancer (IARC), Lyon, France,
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Key TJ, Appleby PN, Reeves GK, Travis RC, Alberg AJ, Barricarte A, Berrino F, Krogh V, Sieri S, Brinton LA, Dorgan JF, Dossus L, Dowsett M, Eliassen AH, Fortner RT, Hankinson SE, Helzlsouer KJ, Hoff man-Bolton J, Comstock GW, Kaaks R, Kahle LL, Muti P, Overvad K, Peeters PHM, Riboli E, Rinaldi S, Rollison DE, Stanczyk FZ, Trichopoulos D, Tworoger SS, Vineis P. Sex hormones and risk of breast cancer in premenopausal women: a collaborative reanalysis of individual participant data from seven prospective studies. Lancet Oncol 2013; 14:1009-19. [PMID: 23890780 DOI: 10.1016/s1470-2045(13)70301-2] [Citation(s) in RCA: 239] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Associations between circulating concentrations of oestrogens, progesterone, and androgens with breast cancer and related risk factors in premenopausal women are not well understood. We aimed to characterise these associations with a pooled analysis of data from seven studies. METHODS Individual participant data for prediagnostic sex hormone and sex hormone-binding globulin (SHBG) concentrations were contributed from seven prospective studies. We restricted analyses to women who were premenopausal and younger than 50 years at blood collection, and to women with breast cancer diagnosed before age 50 years. We estimated odds ratios (ORs) with 95% CIs for breast cancer associated with hormone concentrations by conditional logistic regression in cases and controls matched for age, date of blood collection, and day of cycle, with stratification by study and further adjustment for cycle phase. We examined associations of hormones with risk factors for breast cancer in control women by comparing geometric mean hormone concentrations in categories of these risk factors, adjusted for study, age, phase of menstrual cycle, and body-mass index (BMI). All statistical tests were two-sided. FINDINGS We included data for up to 767 women with breast cancer and 1699 controls in the risk analyses. Breast cancer risk was associated with a doubling in concentrations of oestradiol (OR 1·19, 95% CI 1·06-1·35), calculated free oestradiol (1·17, 1·03-1·33), oestrone (1·27, 1·05-1·54), androstenedione (1·30, 1·10-1·55), dehydroepiandrosterone sulphate (1·17, 1·04-1·32), testosterone (1·18, 1·03-1·35), and calculated free testosterone (1·08, 0·97-1·21). Breast cancer risk was not associated with luteal phase progesterone (doubling in concentration OR 1·00, 95% CI 0·92-1·09), and adjustment for other factors had little effect on any of these ORs. Cross-sectional analyses in control women showed several associations of sex hormones with breast cancer risk factors. INTERPRETATION Circulating oestrogens and androgens are positively associated with the risk for breast cancer in premenopausal women.
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Grote VA, Rohrmann S, Nieters A, Dossus L, Tjønneland A, Halkjær J, Overvad K, Fagherazzi G, Boutron-Ruault MC, Morois S, Teucher B, Becker S, Sluik D, Boeing H, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Pala V, Tumino R, Vineis P, Panico S, Rodríguez L, Duell EJ, Molina-Montes E, Dorronsoro M, Huerta JM, Ardanaz E, Jeurnink SM, Beulens JWJ, Peeters PHM, Sund M, Ye W, Lindkvist B, Johansen D, Khaw KT, Wareham N, Allen N, Crowe F, Jenab M, Romieu I, Michaud DS, Riboli E, Romaguera D, Bueno-de-Mesquita HB, Kaaks R. Diabetes mellitus, glycated haemoglobin and C-peptide levels in relation to pancreatic cancer risk: a study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Diabetologia 2011; 54:3037-46. [PMID: 21953276 DOI: 10.1007/s00125-011-2316-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 08/31/2011] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS There has been long-standing debate about whether diabetes is a causal risk factor for pancreatic cancer or a consequence of tumour development. Prospective epidemiological studies have shown variable relationships between pancreatic cancer risk and blood markers of glucose and insulin metabolism, overall and as a function of lag times between marker measurements (blood donation) and date of tumour diagnosis. METHODS Pre-diagnostic levels of HbA(1c) and C-peptide were measured for 466 participants with pancreatic cancer and 466 individually matched controls within the European Prospective Investigation into Cancer and Nutrition. Conditional logistic regression models were used to estimate ORs for pancreatic cancer. RESULTS Pancreatic cancer risk gradually increased with increasing pre-diagnostic HbA(1c) levels up to an OR of 2.42 (95% CI 1.33, 4.39 highest [≥ 6.5%, 48 mmol/mol] vs lowest [≤ 5.4%, 36 mmol/mol] category), even for individuals with HbA(1c) levels within the non-diabetic range. C-peptide levels showed no significant relationship with pancreatic cancer risk, irrespective of fasting status. Analyses showed no clear trends towards increasing hyperglycaemia (as marked by HbA(1c) levels) or reduced pancreatic beta cell responsiveness (as marked by C-peptide levels) with decreasing time intervals from blood donation to cancer diagnosis. CONCLUSIONS/INTERPRETATION Our data on HbA(1c) show that individuals who develop exocrine pancreatic cancer tend to have moderate increases in HbA(1c) levels, relatively independently of obesity and insulin resistance-the classic and major risk factors for type 2 diabetes. While there is no strong difference by lag time, more data are needed on this in order to reach a firm conclusion.
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Affiliation(s)
- V A Grote
- Division of Cancer Epidemiology c020, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
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Beckmann L, Hüsing A, Setiawan VW, Amiano P, Clavel-Chapelon F, Chanock SJ, Cox DG, Diver R, Dossus L, Feigelson HS, Haiman C, Hallmans G, Hayes RB, Henderson BE, Hoover RN, Hunter DJ, Khaw K, Kolonel LN, Kraft P, Lund E, Le Marchand L, Peeters PHM, Riboli E, Stram D, Thomas G, Thun MJ, Tumino R, Trichopoulos D, Vogel U, Willett WC, Yeager M, Ziegler R, Hankinson SE, Kaaks R. Comprehensive analysis of hormone and genetic variation in 36 genes related to steroid hormone metabolism in pre- and postmenopausal women from the breast and prostate cancer cohort consortium (BPC3). J Clin Endocrinol Metab 2011; 96:E360-7. [PMID: 21177793 PMCID: PMC3048330 DOI: 10.1210/jc.2010-0912] [Citation(s) in RCA: 27] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Sex steroids play a central role in breast cancer development. OBJECTIVE This study aimed to relate polymorphic variants in 36 candidate genes in the sex steroid pathway to serum concentrations of sex steroid hormones and SHBG. DESIGN Data on 700 genetic polymorphisms were combined with existing hormone assays and data on breast cancer incidence, within the European Prospective Investigation into Cancer and Nutrition (EPIC) and the Nurses' Health Study (NHS) cohorts; significant findings were reanalyzed in the Multiethnic Cohort (MEC). SETTING AND PARTICIPANTS We analyzed data from a pooled sample of 3852 pre- and postmenopausal Caucasian women from EPIC and NHS and 454 postmenopausal women from MEC. MAIN OUTCOME MEASURES Outcome measures were SHBG, testosterone, dehydroepiandrosterone (DHEAS), androstenedione, estrone (E1), and estradiol (E2) as well as breast cancer risk. RESULTS Globally significant associations were found among pre- and postmenopausal women combined between levels of SHBG and the SHBG gene and between DHEAS and the FSHR and AKR1C3 genes. Among postmenopausal women, serum E1 and E2 were significantly associated with the genes CYP19 and FSHR, and E1 was associated with ESR1. None of the variants related to serum hormone levels showed any significant association with breast cancer risk. CONCLUSIONS We confirmed associations between serum levels of SHBG and the SHBG gene and of E1 and E2 and the CYP19 and ESR1 genes. Novel associations were observed between FSHR and DHEAS, E1, and E2 and between AKR1C3 and DHEAS.
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Affiliation(s)
- L Beckmann
- Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
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Lukanova A, Andersson R, Wulff M, Zeleniuch-Jacquotte A, Grankvist K, Dossus L, Afanasyeva Y, Johansson R, Arslan AA, Lenner P, Wadell G, Hallmans G, Toniolo P, Lundin E. Human chorionic gonadotropin and alpha-fetoprotein concentrations in pregnancy and maternal risk of breast cancer: a nested case-control study. Am J Epidemiol 2008; 168:1284-91. [PMID: 18936438 DOI: 10.1093/aje/kwn254] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Pregnancy hormones are believed to be involved in the protection against breast cancer conferred by pregnancy. The authors explored the association of maternal breast cancer with human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP). In 2001, a case-control study was nested within the Northern Sweden Maternity Cohort, an ongoing study in which blood samples have been collected from first-trimester pregnant women since 1975. Cases (n = 210) and controls (n = 357) were matched for age, parity, and date of blood donation. Concentrations of hCG and AFP were measured by immunoassay. No overall significant association of breast cancer with either hCG or AFP was observed. However, women with hCG levels in the top tertile tended to be at lower risk of breast cancer than women with hCG levels in the lowest tertile in the whole study population and in subgroups of age at sampling, parity, and age at cancer diagnosis. A borderline-significant decrease in risk with high hCG levels was observed in women who developed breast cancer after the median lag time to cancer diagnosis (> or =14 years; odds ratio = 0.53, 95% confidence interval: 0.27, 1.03; P = 0.06). These findings, though very preliminary, are consistent with a possible long-term protective association of breast cancer risk with elevated levels of circulating hCG in the early stages of pregnancy.
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20
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Dossus L, McKay JD, Canzian F, Wilkening S, Rinaldi S, Biessy C, Olsen A, Tjonneland A, Jakobsen MU, Overvad K, Clavel-Chapelon F, Boutron-Ruault MC, Fournier A, Linseisen J, Lukanova A, Boeing H, Fisher E, Trichopoulou A, Georgila C, Trichopoulos D, Palli D, Krogh V, Tumino R, Vineis P, Quiros JR, Sala N, Martinez-Garcia C, Dorronsoro M, Chirlaque MD, Barricarte A, van Duijnhoven FJ, Bueno-de-Mesquita H, van Gils CH, Peeters PH, Hallmans G, Lenner P, Bingham S, Khaw KT, Key TJ, Travis RC, Ferrari P, Jenab M, Riboli E, Kaaks R. Polymorphisms of genes coding for ghrelin and its receptor in relation to anthropometry, circulating levels of IGF-I and IGFBP-3, and breast cancer risk: a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC). Carcinogenesis 2008; 29:1360-6. [DOI: 10.1093/carcin/bgn083] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Rinaldi S, Peeters PHM, Bezemer ID, Dossus L, Biessy C, Sacerdote C, Berrino F, Panico S, Palli D, Tumino R, Khaw KT, Bingham S, Allen NE, Key T, Jensen MK, Overvad K, Olsen A, Tjonneland A, Amiano P, Ardanaz E, Agudo A, Martinez-García C, Quirós JR, Tormo MJ, Nagel G, Linseisen J, Boeing H, Schulz M, Grobbee DE, Bueno-de-Mesquita HB, Koliva M, Kyriazi G, Thrichopoulou A, Boutron-Ruault MC, Clavel-Chapelon F, Ferrari P, Slimani N, Saracci R, Riboli E, Kaaks R. Relationship of alcohol intake and sex steroid concentrations in blood in pre- and post-menopausal women: the European Prospective Investigation into Cancer and Nutrition. Cancer Causes Control 2006; 17:1033-43. [PMID: 16933054 DOI: 10.1007/s10552-006-0041-7] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Accepted: 05/11/2006] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Women with a moderate intake of alcohol have higher concentrations of sex steroids in serum, and higher risk of developing breast cancer, compared to non-drinkers. In the present study, we investigate the relationships between alcohol consumption and serum levels of sex steroids and sex-hormone binding globulin (SHBG) in 790 pre- and 1,291 post-menopausal women, who were part of the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS Serum levels of testosterone (T), androstenedione (Delta4), dehydroepiandrosterone sulphate (DHEAS), estrone (E1), estradiol (E2) and SHBG were measured by direct immunoassays. Free T (fT) and free E2 (fE2) were calculated according to mass action laws. Current alcohol intake exposure to alcohol was assessed from dietary questionnaires. RESULTS Pre-menopausal women who consumed more than 25 g/day of alcohol had about 30% higher DHEAS, T and fT, 20% higher Delta4 and about 40% higher E1, concentrations compared to women who were non-consumers. E2, fE2 and SHBG concentrations showed no association with current alcohol intake. In post-menopausal women, DHEAS, fT, T, Delta4, and E1 concentrations were between 10% and 20% higher in women who consumed more than 25 g/day of alcohol compared to non-consumers. E2 or fE2 were not associated with alcohol intake at all. SHBG levels were about 15% lower in alcohol consumers compared to non-consumers. CONCLUSION This study supports the hypothesis of an influence of alcohol intake on sex hormone concentrations in blood.
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Affiliation(s)
- S Rinaldi
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex, France.
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22
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Norat T, Dossus L, Rinaldi S, Overvad K, Grønbaek H, Tjønneland A, Olsen A, Clavel-Chapelon F, Boutron-Ruault MC, Boeing H, Lahmann PH, Linseisen J, Nagel G, Trichopoulou A, Trichopoulos D, Kalapothaki V, Sieri S, Palli D, Panico S, Tumino R, Sacerdote C, Bueno-de-Mesquita HB, Peeters PHM, van Gils CH, Agudo A, Amiano P, Ardanoz E, Martinez C, Quirós R, Tormo MJ, Bingham S, Key TJ, Allen NE, Ferrari P, Slimani N, Riboli E, Kaaks R. Diet, serum insulin-like growth factor-I and IGF-binding protein-3 in European women. Eur J Clin Nutr 2006; 61:91-8. [PMID: 16900085 DOI: 10.1038/sj.ejcn.1602494] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to examine the relationship of diet with serum insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 in women. DESIGN Cross-sectional study. SETTING AND SUBJECTS The population are 2109 women who were control subjects in a case-control study of breast cancer nested in the European Prospective Investigation into Cancer and Nutrition. Control subjects were randomly chosen among risk sets consisting of female cohort members alive and free of cancer (except non-melanoma skin cancer) at the time of diagnosis of the index case. Matching criteria were age at enrolment, follow-up time, time of the day of blood collection and study centre. Diet was measured through validated questionnaires. Serum hormone concentrations were measured by enzyme-linked immunosorbent assays. The relationship between serum IGF-I, IGFBP-3, and intake of nutrients and foods was explored by linear regression in models adjusted for energy intake, age, body mass index, smoking, physical activity, centre and laboratory batch. RESULTS Serum IGF-I levels were positively related to protein intake (P(trend)<0.001), but not related to energy, fat or carbohydrate intake. Positive relationships were observed with the intake of milk (P(trend)=0.007), calcium (P(trend)<0.001), magnesium (P(trend)=0.003), phosphorus (P(trend)<0.001), potassium (P(trend)=0.002), vitamin B6 (P(trend)=0.03), vitamin B2 (P(trend)=0.001) and inverse relationships with vegetables (P(trend)=0.02) and beta-carotene (P(trend)=0.02). IGFBP-3 was not related with most of the nutrients and foods in this study. CONCLUSIONS In this population, circulating IGF-I is modestly related with the intake of protein and minerals, and with milk and cheese, while IGFBP-3 does not appear to be related with diet.
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Affiliation(s)
- T Norat
- International Agency for Research on Cancer, Lyon, France
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23
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Rinaldi S, Peeters PHM, Berrino F, Dossus L, Biessy C, Olsen A, Tjonneland A, Overvad K, Clavel-Chapelon F, Boutron-Ruault MC, Téhard B, Nagel G, Linseisen J, Boeing H, Lahmann PH, Trichopoulou A, Trichopoulos D, Koliva M, Palli D, Panico S, Tumino R, Sacerdote C, van Gils CH, van Noord P, Grobbee DE, Bueno-de-Mesquita HB, Gonzalez CA, Agudo A, Chirlaque MD, Barricarte A, Larrañaga N, Quiros JR, Bingham S, Khaw KT, Key T, Allen NE, Lukanova A, Slimani N, Saracci R, Riboli E, Kaaks R. IGF-I, IGFBP-3 and breast cancer risk in women: The European Prospective Investigation into Cancer and Nutrition (EPIC). Endocr Relat Cancer 2006; 13:593-605. [PMID: 16728585 DOI: 10.1677/erc.1.01150] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Blood concentrations of insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) have recently been associated with breast cancer risk, notably in women who developed breast cancer at a young age. Prospective studies published so far, however, were relatively small and odds ratio (OR) estimates imprecise. We present the results of a large prospective case-control study nested within the European Prospective Investigation into Cancer and Nutrition on total IGF-I, IGFBP-3 and breast cancer risk including 1081 incident cases of invasive breast cancer and 2098 matched control subjects. Increasing IGF-I and IGFBP-3 concentrations were associated with a significant increase in breast cancer risk in women who developed breast cancer after 50 years of age (highest vs lowest quintile OR 1.38 (95% confidence interval (CI) 1.02-1.86), P = 0.01, and 1.44 (95% CI 1.04-1.98), P = 0.01, respectively), but no relationship was observed in younger women (OR = 1.03 (95% CI 0.60-1.77), P = 0.81 for IGF-I, and OR = 0.92 (95% CI 0.50-1.70), P = 0.69 for IGFBP-3). There was, however, significant heterogeneity in the relationship of breast cancer with serum IGF-I and IGFBP-3 levels depending on the time interval between blood donation and tumor diagnosis. A reduction in breast cancer risk with increasing IGF-I concentrations was observed in cases with a diagnosis of cancer less than 2 years after blood donation, (OR = 0.76 (95% CI 0.57-1.03)), while an increase in risk was observed for women with a later diagnosis (above or equal to two years after blood collection, OR = 1.51 (95% CI 1.19-1.91)). A similar pattern was observed for IGFBP-3. This study confirms previous findings for an association of serum IGF-I and IGFBP-3 concentrations with breast cancer risk, particularly for women with a later diagnosis of cancer, but it does not support the hypothesis of an involvement of IGF-I in younger women.
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Affiliation(s)
- S Rinaldi
- International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert Thomas, 69372 Lyon, Cédex 08, France
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24
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Gram IT, Norat T, Rinaldi S, Dossus L, Lukanova A, Téhard B, Clavel-Chapelon F, van Gils CH, van Noord PAH, Peeters PHM, Bueno-de-Mesquita HB, Nagel G, Linseisen J, Lahmann PH, Boeing H, Palli D, Sacerdote C, Panico S, Tumino R, Sieri S, Dorronsoro M, Quirós JR, Navarro CA, Barricarte A, Tormo MJ, González CA, Overvad K, Paaske Johnsen S, Olsen A, Tjønneland A, Travis R, Allen N, Bingham S, Khaw KT, Stattin P, Trichopoulou A, Kalapothaki V, Psaltopoulou T, Casagrande C, Riboli E, Kaaks R. Body mass index, waist circumference and waist–hip ratio and serum levels of IGF-I and IGFBP-3 in European women. Int J Obes (Lond) 2006; 30:1623-31. [PMID: 16552400 DOI: 10.1038/sj.ijo.0803324] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the relationship between body mass index (BMI) and waist-hip ratio (WHR) with serum levels of insulin-like growth factor-I (IGF-I), and its binding protein (IGFBP)-3. DESIGN Cross-sectional study on 2139 women participating in a case-control study on breast cancer and endogenous hormones. Data on lifestyle and reproductive factors were collected by means of questionnaires. Body height, weight, waist and hip circumferences were measured. Serum levels of IGF-I and insulin-like binding protein (IGFBP)-3 were measured by enzyme-linked immunosorbent assays. Adjusted mean levels of IGF-I and IGFBP-3 across quintiles of BMI, waist circumference, and WHR were calculated by linear regression. Results were adjusted for potential confounders associated with IGF-I and IGFBP-3. RESULTS Adjusted mean serum IGF-I values were lower in women with BMI<22.5 kg/m(2) or BMI>29.2 kg/m(2) compared to women with BMI within this range (P(heterogeneity)<0.0001, P(trend)=0.35). Insulin-like growth factor-I was not related to WHR after adjustment for BMI. IGF-binding protein-3 was linearly positively related to waist and WHR after mutual adjustment. The molar ratio IGF-I/IGFBP-3 had a non-linear relation with BMI and a linear inverse relationship with WHR (P (trend)=0.005). CONCLUSIONS Our data confirm the nonlinear relationship of circulating IGF-I to total adiposity in women. Serum IGFBP-3 was positively related to central adiposity. These suggest that bioavailable IGF-I levels could be lower in obese compared to non-obese women and inversely related to central adiposity.
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Affiliation(s)
- I T Gram
- Institute of Community Medicine, School of Medicine, University of Tromsø, Tromsø, Norway
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25
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Canzian F, McKay JD, Cleveland RJ, Dossus L, Biessy C, Rinaldi S, Landi S, Boillot C, Monnier S, Chajès V, Clavel-Chapelon F, Téhard B, Chang-Claude J, Linseisen J, Lahmann PH, Pischon T, Trichopoulos D, Trichopoulou A, Zilis D, Palli D, Tumino R, Vineis P, Berrino F, Bueno-de-Mesquita HB, van Gils CH, Peeters PHM, Pera G, Ardanaz E, Chirlaque MD, Quirós JR, Larrañaga N, Martínez-García C, Allen NE, Key TJ, Bingham SA, Khaw KT, Slimani N, Norat T, Riboli E, Kaaks R. Polymorphisms of genes coding for insulin-like growth factor 1 and its major binding proteins, circulating levels of IGF-I and IGFBP-3 and breast cancer risk: results from the EPIC study. Br J Cancer 2006; 94:299-307. [PMID: 16404426 PMCID: PMC2361124 DOI: 10.1038/sj.bjc.6602936] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.4] [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] [Indexed: 01/12/2023] Open
Abstract
Insulin-like growth factor I (IGF-I) stimulates cell proliferation and can enhance the development of tumours in different organs. Epidemiological studies have shown that an elevated level of circulating IGF-I is associated with increased risk of breast cancer, as well as of other cancers. Most of circulating IGF-I is bound to an acid-labile subunit and to one of six insulin-like growth factor binding proteins (IGFBPs), among which the most important are IGFBP-3 and IGFBP-1. Polymorphisms of the IGF1 gene and of genes encoding for the major IGF-I carriers may predict circulating levels of IGF-I and have an impact on cancer risk. We tested this hypothesis with a case–control study of 807 breast cancer patients and 1588 matched control subjects, nested within the European Prospective Investigation into Cancer and Nutrition. We genotyped 23 common single nucleotide polymorphisms in IGF1, IGFBP1, IGFBP3 and IGFALS, and measured serum levels of IGF-I and IGFBP-3 in samples of cases and controls. We found a weak but significant association of polymorphisms at the 5′ end of the IGF1 gene with breast cancer risk, particularly among women younger than 55 years, and a strong association of polymorphisms located in the 5′ end of IGFBP3 with circulating levels of IGFBP-3, which confirms previous findings. Common genetic variation in these candidate genes does not play a major role in altering breast cancer risk in Caucasians.
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Affiliation(s)
- F Canzian
- International Agency for Research on Cancer, Lyon, France
| | - J D McKay
- International Agency for Research on Cancer, Lyon, France
| | - R J Cleveland
- International Agency for Research on Cancer, Lyon, France
| | - L Dossus
- International Agency for Research on Cancer, Lyon, France
| | - C Biessy
- International Agency for Research on Cancer, Lyon, France
| | - S Rinaldi
- International Agency for Research on Cancer, Lyon, France
| | - S Landi
- International Agency for Research on Cancer, Lyon, France
| | - C Boillot
- International Agency for Research on Cancer, Lyon, France
| | - S Monnier
- International Agency for Research on Cancer, Lyon, France
| | - V Chajès
- Institut Gustave Roussy, Villejuif, France
| | | | - B Téhard
- Institut Gustave Roussy, Villejuif, France
| | | | - J Linseisen
- German Cancer Research Centre, Heidelberg, Germany
| | - P H Lahmann
- German Institute of Human Nutrition, Potsdam, Germany
| | - T Pischon
- German Institute of Human Nutrition, Potsdam, Germany
| | | | | | - D Zilis
- University of Athens Medical School, Athens, Greece
| | - D Palli
- CSPO-Scientific Institute of Tuscany, Florence, Italy
| | - R Tumino
- Cancer Registry, Azienda Ospedaliera ‘Civile MP Arezzo’, Ragusa, Italy
| | - P Vineis
- Imperial College, London, UK
- University of Torino, Turin, Italy
| | - F Berrino
- National Cancer Institute, Milan, Italy
| | | | - C H van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - P H M Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - G Pera
- Catalan Institute of Oncology, Barcelona, Spain
| | - E Ardanaz
- Instituto de Salud Pública, SNS-O, Pamplona, Spain
| | - M-D Chirlaque
- Epidemiology Department, Murcia Health Council, Spain
| | - J R Quirós
- Public Health Directorate, Consejería de Sanidad y Servicios Sociales de Asturias, Oviedo, Spain
| | - N Larrañaga
- Public Health Division of Gipuzkoa, Health Department of the Basque Country, San Sebastián, Spain
| | | | - N E Allen
- Cancer Research UK, Epidemiology Unit, University of Oxford, Oxford, UK
| | - T J Key
- Cancer Research UK, Epidemiology Unit, University of Oxford, Oxford, UK
| | - S A Bingham
- MRC Dunn Human Nutrition Unit, Welcome Trust/MRC Building, Cambridge, UK
| | - K-T Khaw
- Clinical Gerontology Unit, Addenbrooke's Hospital, Cambridge, UK
| | - N Slimani
- International Agency for Research on Cancer, Lyon, France
| | - T Norat
- International Agency for Research on Cancer, Lyon, France
| | - E Riboli
- International Agency for Research on Cancer, Lyon, France
| | - R Kaaks
- International Agency for Research on Cancer, Lyon, France
- Hormones and Cancer Team, International Agency for Research on Cancer, 150, cours Albert-Thomas, F-69372 Lyon, France; E-mail:
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Kaaks R, Berrino F, Key T, Rinaldi S, Dossus L, Biessy C, Secreto G, Amiano P, Bingham S, Boeing H, Bueno de Mesquita H, Chang-Claude J, Clavel-Chapelon F, Fournier A, van Gils C, Gonzalez C, Gurrea A, Critselis E, Khaw K, Krogh V, Lahmann P, Nagel G, Olsen A, Onland-Moret N, Overvad K, Palli D, Panico S, Peeters P, Quiros J, Roddam A, Thiebaut A, Tjonneland A, Chirlaque M, Trichopoulou A, Trichopoulos D, Tumino R, Vineis P, Norat T, Ferrari P, Slimani N, Riboli E. Serum Sex Steroids in Premenopausal Women and Breast Cancer Risk Within the European Prospective Investigation Into Cancer and Nutrition (EPIC). J Urol 2006. [DOI: 10.1016/s0022-5347(05)00120-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- R. Kaaks
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - F. Berrino
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - T. Key
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - S. Rinaldi
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - L. Dossus
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - C. Biessy
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - G. Secreto
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - P. Amiano
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - S. Bingham
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - H. Boeing
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - H.B. Bueno de Mesquita
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - J. Chang-Claude
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - F. Clavel-Chapelon
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - A. Fournier
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - C.H. van Gils
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - C.A. Gonzalez
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - A.B. Gurrea
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - E. Critselis
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - K.T. Khaw
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - V. Krogh
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - P.H. Lahmann
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - G. Nagel
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - A. Olsen
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - N.C. Onland-Moret
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - K. Overvad
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - D. Palli
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - S. Panico
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - P. Peeters
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - J.R. Quiros
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - A. Roddam
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - A. Thiebaut
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - A. Tjonneland
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - M.D. Chirlaque
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - A. Trichopoulou
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - D. Trichopoulos
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - R. Tumino
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - P. Vineis
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - T. Norat
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - P. Ferrari
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - N. Slimani
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - E. Riboli
- Nutrition and Hormones Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France
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27
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Kaaks R, Rinaldi S, Key TJ, Berrino F, Peeters PHM, Biessy C, Dossus L, Lukanova A, Bingham S, Khaw KT, Allen NE, Bueno-de-Mesquita HB, van Gils CH, Grobbee D, Boeing H, Lahmann PH, Nagel G, Chang-Claude J, Clavel-Chapelon F, Fournier A, Thiébaut A, González CA, Quirós JR, Tormo MJ, Ardanaz E, Amiano P, Krogh V, Palli D, Panico S, Tumino R, Vineis P, Trichopoulou A, Kalapothaki V, Trichopoulos D, Ferrari P, Norat T, Saracci R, Riboli E. Postmenopausal serum androgens, oestrogens and breast cancer risk: the European prospective investigation into cancer and nutrition. Endocr Relat Cancer 2005; 12:1071-82. [PMID: 16322344 DOI: 10.1677/erc.1.01038] [Citation(s) in RCA: 355] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Considerable experimental and epidemiological evidence suggests that elevated endogenous sex steroids - notably androgens and oestrogens - promote breast tumour development. In spite of this evidence, postmenopausal androgen replacement therapy with dehydroepiandrosterone (DHEA) or testosterone has been advocated for the prevention of osteoporosis and improved sexual well-being. We have conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition. Levels of DHEA sulphate (DHEAS), (Delta4-androstenedione), testosterone, oestrone, oestradiol and sex-hormone binding globulin (SHBG) were measured in prediagnostic serum samples of 677 postmenopausal women who subsequently developed breast cancer and 1309 matched control subjects. Levels of free testosterone and free oestradiol were calculated from absolute concentrations of testosterone, oestradiol and SHBG. Logistic regression models were used to estimate relative risks of breast cancer by quintiles of hormone concentrations. For all sex steroids -the androgens as well as the oestrogens - elevated serum levels were positively associated with breast cancer risk, while SHBG levels were inversely related to risk. For the androgens, relative risk estimates (95% confidence intervals) between the top and bottom quintiles of the exposure distribution were: DHEAS 1.69 (1.23-2.33), androstenedione 1.94 (1.40-2.69), testosterone 1.85 (1.33-2.57) and free testosterone 2.50 (1.76-3.55). For the oestrogens, relative risk estimates were: oestrone 2.07 (1.42-3.02), oestradiol 2.28 (1.61-3.23) and free oestradiol (odds ratios 2.13 (1.52-2.98)). Adjustments for body mass index or other potential confounding factors did not substantially alter any of these relative risk estimates. Our results have shown that, among postmenopausal women, not only elevated serum oestrogens but also serum androgens are associated with increased breast cancer risk. Since DHEAS and androstenedione are largely of adrenal origin in postmenopausal women, our results indicated that elevated adrenal androgen synthesis is a risk factor for breast cancer. The results from this study caution against the use of DHEA(S), or other androgens, for postmenopausal androgen replacement therapy.
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Affiliation(s)
- R Kaaks
- International Agency for Research on Cancer (IARC-WHO), Lyon, France.
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28
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Lukanova A, Lundin E, Zeleniuch-Jacquotte A, Muti P, Mure A, Rinaldi S, Dossus L, Micheli A, Arslan A, Lenner P, Shore RE, Krogh V, Koenig KL, Riboli E, Berrino F, Hallmans G, Stattin P, Toniolo P, Kaaks R. Body mass index, circulating levels of sex-steroid hormones, IGF-I and IGF-binding protein-3: a cross-sectional study in healthy women. Eur J Endocrinol 2004; 150:161-71. [PMID: 14763914 DOI: 10.1530/eje.0.1500161] [Citation(s) in RCA: 235] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Excess weight has been associated with increased risk of cancer at several organ sites. In part, this effect may be modulated through alterations in the metabolism of sex steroids and IGF-I related peptides. The objectives of the study were to examine the association of body mass index (BMI) with circulating androgens (testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEAS)), estrogens (estrone and estradiol), sex hormone-binding globulin (SHBG), IGF-I and IGF-binding protein (IGFBP)-3, and the relationship between sex steroids, IGF-I and IGFBP-3. DESIGN AND METHODS A cross-sectional analysis was performed using hormonal and questionnaire data of 620 healthy women (177 pre- and 443 post-menopausal). The laboratory measurements of the hormones of interest were available from two previous case-control studies on endogenous hormones and cancer risk. RESULTS In the pre-menopausal group, BMI was not related to androgens and IGF-I. In the post-menopausal group, estrogens, testosterone and androstenedione increased with increasing BMI. The association with IGF-I was non-linear, with the highest mean concentrations observed in women with BMI between 24 and 25. In both pre- and post-menopausal subjects, IGFBP-3 did not vary across BMI categories and SHBG decreased with increasing BMI. As for the correlations between peptide and steroid hormones, in the post-menopausal group, IGF-I was positively related to androgens, inversely correlated with SHBG, and not correlated with estrogens. In the pre-menopausal group, similar but weaker correlations between IGF-I and androgens were observed. CONCLUSIONS These observations offer evidence that obesity may influence the levels of endogenous sex-steroid and IGF-related hormones in the circulation, especially after menopause. Circulating IGF-I, androgens and SHBG appear to be related to each other in post-menopausal women.
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Affiliation(s)
- A Lukanova
- Hormones and Cancer Group, International Agency for Research on Cancer, Lyon, France.
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