1
|
Wang TM, Xiao RW, He YQ, Zhang WL, Diao H, Tang M, Mai ZM, Xue WQ, Yang DW, Deng CM, Liao Y, Zhou T, Li DH, Wu YX, Chen XY, Zhang J, Li XZ, Zhang PF, Zheng XH, Zhang SD, Hu YZ, Cai Y, Zheng Y, Zhang Z, Zhou Y, Jin G, Bei J, Mai HQ, Sun Y, Ma J, Hu Z, Liu J, Lung ML, Adami HO, Ye W, Lam TH, Shen H, Jia WH. High-throughput identification of regulatory elements and functional assays to uncover susceptibility genes for nasopharyngeal carcinoma. Am J Hum Genet 2023:S0002-9297(23)00204-5. [PMID: 37352861 DOI: 10.1016/j.ajhg.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/25/2023] Open
Abstract
Large-scale genetic association studies have identified multiple susceptibility loci for nasopharyngeal carcinoma (NPC), but the underlying biological mechanisms remain to be explored. To gain insights into the genetic etiology of NPC, we conducted a follow-up study encompassing 6,907 cases and 10,472 controls and identified two additional NPC susceptibility loci, 9q22.33 (rs1867277; OR = 0.74, 95% CI = 0.68-0.81, p = 3.08 × 10-11) and 17q12 (rs226241; OR = 1.42, 95% CI = 1.26-1.60, p = 1.62 × 10-8). The two additional loci, together with two previously reported genome-wide significant loci, 5p15.33 and 9p21.3, were investigated by high-throughput sequencing for chromatin accessibility, histone modification, and promoter capture Hi-C (PCHi-C) profiling. Using luciferase reporter assays and CRISPR interference (CRISPRi) to validate the functional profiling, we identified PHF2 at locus 9q22.33 as a susceptibility gene. PHF2 encodes a histone demethylase and acts as a tumor suppressor. The risk alleles of the functional SNPs reduced the expression of the target gene PHF2 by inhibiting the enhancer activity of its long-range (4.3 Mb) cis-regulatory element, which promoted proliferation of NPC cells. In addition, we identified CDKN2B-AS1 as a susceptibility gene at locus 9p21.3, and the NPC risk allele of the functional SNP rs2069418 promoted the expression of CDKN2B-AS1 by increasing its enhancer activity. The overexpression of CDKN2B-AS1 facilitated proliferation of NPC cells. In summary, we identified functional SNPs and NPC susceptibility genes, which provides additional explanations for the genetic association signals and helps to uncover the underlying genetic etiology of NPC development.
Collapse
Affiliation(s)
- Tong-Min Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ruo-Wen Xiao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Medical Oncology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yong-Qiao He
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wen-Li Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Hua Diao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Minzhong Tang
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China; Wuzhou Cancer Center, Wuzhou, Guangxi, China
| | - Zhi-Ming Mai
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China; Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Wen-Qiong Xue
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Da-Wei Yang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chang-Mi Deng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ying Liao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ting Zhou
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Dan-Hua Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yan-Xia Wu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xue-Yin Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jiangbo Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xi-Zhao Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Pei-Fen Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiao-Hui Zheng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Shao-Dan Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ye-Zhu Hu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yonglin Cai
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
| | - Yuming Zheng
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China; Wuzhou Cancer Center, Wuzhou, Guangxi, China
| | - Zhe Zhang
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yifeng Zhou
- Department of Genetics, Medical College of Soochow University, Suzhou, China
| | - Guangfu Jin
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Jinxin Bei
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Hai-Qiang Mai
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Zhibin Hu
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Jianjun Liu
- Human Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research (A(∗)STAR), Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Maria Li Lung
- Department of Clinical Oncology, School of Clinical Medicine, University of Hong Kong, Hong Kong S.A.R., China
| | - Hans-Olov Adami
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Health Statistics & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China
| | - Hongbing Shen
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Wei-Hua Jia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China.
| |
Collapse
|
2
|
He YQ, Xue WQ, Li DH, Wang TM, Mai ZM, Yang DW, Deng CM, Liao Y, Zhang WL, Xiao RW, Luo L, Diao H, Tong X, Wu Y, Zhang JB, Zhou T, Li XZ, Zhang PF, Zheng XH, Zhang SD, Hu YZ, Tang M, Zheng Y, Cai Y, Chang ET, Zhang Z, Huang G, Cao SM, Liu Q, Feng L, Sun Y, Lung ML, Adami HO, Ye W, Lam TH, Jia WH. Transcriptome-wide association analysis identified candidate susceptibility genes for nasopharyngeal carcinoma. Cancer Commun (Lond) 2022; 42:887-891. [PMID: 35642693 PMCID: PMC9456698 DOI: 10.1002/cac2.12317] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/09/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yong-Qiao He
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Wen-Qiong Xue
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Dan-Hua Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Tong-Min Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Zhi-Ming Mai
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., 999077, P. R. China.,Center for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., 999077, P. R. China.,Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Da-Wei Yang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P. R. China
| | - Chang-Mi Deng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Ying Liao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Wen-Li Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Ruo-Wen Xiao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Luting Luo
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P. R. China
| | - Hua Diao
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P. R. China
| | - Xiating Tong
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P. R. China
| | - Yanxia Wu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Jiang-Bo Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Ting Zhou
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Xi-Zhao Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Pei-Fen Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Xiao-Hui Zheng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Shao-Dan Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Ye-Zhu Hu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Minzhong Tang
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, 543002, P. R. China.,Wuzhou Cancer Center, Wuzhou, Guangxi, 543002, P. R. China
| | - Yuming Zheng
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, 543002, P. R. China.,Wuzhou Cancer Center, Wuzhou, Guangxi, 543002, P. R. China
| | - Yonglin Cai
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, 543002, P. R. China.,Wuzhou Cancer Center, Wuzhou, Guangxi, 543002, P. R. China
| | - Ellen T Chang
- Center for Health Sciences, Exponent, Inc., Menlo Park, CA, 94025, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94143, USA
| | - Zhe Zhang
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, P. R. China
| | - Guangwu Huang
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, P. R. China
| | - Su-Mei Cao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Qing Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Lin Feng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, Guangdong, 510060, P. R. China
| | - Maria Li Lung
- Center for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., 999077, P. R. China.,Department of Clinical Oncology, The University of Hong Kong, Hong Kong S.A.R., 999077, P. R. China
| | - Hans-Olov Adami
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, 0316, Norway.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 17177, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 17177, Sweden.,Department of Epidemiology and Health Statistics & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian, 350122, P. R. China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., 999077, P. R. China.,Center for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., 999077, P. R. China
| | - Wei-Hua Jia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.,School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P. R. China
| |
Collapse
|
3
|
He YQ, Wang TM, Ji M, Mai ZM, Tang M, Wang R, Zhou Y, Zheng Y, Xiao R, Yang D, Wu Z, Deng C, Zhang J, Xue W, Dong S, Zhan J, Cai Y, Li F, Wu B, Liao Y, Zhou T, Zheng M, Jia Y, Li D, Cao L, Yuan L, Zhang W, Luo L, Tong X, Wu Y, Li X, Zhang P, Zheng X, Zhang S, Hu Y, Qin W, Deng B, Liang X, Fan P, Feng Y, Song J, Xie SH, Chang ET, Zhang Z, Huang G, Xu M, Feng L, Jin G, Bei J, Cao S, Liu Q, Kozlakidis Z, Mai H, Sun Y, Ma J, Hu Z, Liu J, Lung ML, Adami HO, Shen H, Ye W, Lam TH, Zeng YX, Jia WH. A polygenic risk score for nasopharyngeal carcinoma shows potential for risk stratification and personalized screening. Nat Commun 2022; 13:1966. [PMID: 35414057 PMCID: PMC9005522 DOI: 10.1038/s41467-022-29570-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 01/27/2021] [Accepted: 03/23/2022] [Indexed: 12/29/2022] Open
Abstract
Polygenic risk scores (PRS) have the potential to identify individuals at risk of diseases, optimizing treatment, and predicting survival outcomes. Here, we construct and validate a genome-wide association study (GWAS) derived PRS for nasopharyngeal carcinoma (NPC), using a multi-center study of six populations (6 059 NPC cases and 7 582 controls), and evaluate its utility in a nested case-control study. We show that the PRS enables effective identification of NPC high-risk individuals (AUC = 0.65) and improves the risk prediction with the PRS incremental deciles in each population (Ptrend ranging from 2.79 × 10-7 to 4.79 × 10-44). By incorporating the PRS into EBV-serology-based NPC screening, the test's positive predictive value (PPV) is increased from an average of 4.84% to 8.38% and 11.91% in the top 10% and 5% PRS, respectively. In summary, the GWAS-derived PRS, together with the EBV test, significantly improves NPC risk stratification and informs personalized screening.
Collapse
Affiliation(s)
- Yong-Qiao He
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Tong-Min Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Mingfang Ji
- Cancer Research Institute of Zhongshan City, Zhongshan Hospital of Sun Yat-sen University, Zhongshan, China
| | - Zhi-Ming Mai
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China
- Center for Nasopharyngeal Carcinoma Research (CNPCR), The University of Hong Kong, Hong Kong S.A.R., China
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Minzhong Tang
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, P.R. China
- Wuzhou Cancer Center, Wuzhou, Guangxi, P.R. China
| | - Ruozheng Wang
- Key Laboratory of Cancer Immunotherapy and Radiotherapy, Chinese Academy of Medical Sciences, Ürümqi, Xinjiang Uygur Autonomous Region, 830011, P.R. China
| | - Yifeng Zhou
- Department of Genetics, Medical College of Soochow University, Suzhou, China
| | - Yuming Zheng
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, P.R. China
- Wuzhou Cancer Center, Wuzhou, Guangxi, P.R. China
| | - Ruowen Xiao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Dawei Yang
- School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Ziyi Wu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Changmi Deng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Jiangbo Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Wenqiong Xue
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Siqi Dong
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Jiyun Zhan
- Public Health Service Center of Xiaolan Town, Zhongshan City, Guangdong, China
| | - Yonglin Cai
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, P.R. China
| | - Fugui Li
- Cancer Research Institute of Zhongshan City, Zhongshan Hospital of Sun Yat-sen University, Zhongshan, China
| | - Biaohua Wu
- Cancer Research Institute of Zhongshan City, Zhongshan Hospital of Sun Yat-sen University, Zhongshan, China
| | - Ying Liao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Ting Zhou
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Meiqi Zheng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Yijing Jia
- School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Danhua Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Lianjing Cao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Leilei Yuan
- School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Wenli Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Luting Luo
- School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Xiating Tong
- School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China
| | - Yanxia Wu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Xizhao Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Peifen Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Xiaohui Zheng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Shaodan Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Yezhu Hu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Weiling Qin
- Wuzhou Red Cross Hospital, Wuzhou, Guangxi, P.R. China
| | - Bisen Deng
- Public Health Service Center of Xiaolan Town, Zhongshan City, Guangdong, China
| | - Xuejun Liang
- Public Health Service Center of Xiaolan Town, Zhongshan City, Guangdong, China
| | - Peiwen Fan
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Departments of Institute for Cancer Research, The Third Affiliated Hospital of Xinjiang Medical University, Ürümqi, 830011, P.R. China
| | - Yaning Feng
- Key Laboratory of Oncology of Xinjiang Uyghur Autonomous Region, Ürümqi, 830011, China
| | - Jia Song
- Departments of Institute for Cancer Research, The Third Affiliated Teaching Hospital of Xinjiang Medical University, Affiliated Cancer Hospital, Ürümqi, Xinjiang Uyghur Autonomous Region, 830010, P.R. China
| | - Shang-Hang Xie
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Ellen T Chang
- Center for Health Sciences, Exponent, Inc., Menlo Park, CA, USA
- Stanford Cancer Institute, Stanford, CA, USA
| | - Zhe Zhang
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guangwu Huang
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Miao Xu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Lin Feng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Guangfu Jin
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Jinxin Bei
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Sumei Cao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Qing Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Zisis Kozlakidis
- Division of Infection and Immunity, Faculty of Medical Sciences - University College London, London, UK
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Haiqiang Mai
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Zhibin Hu
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Jianjun Liu
- Human Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Maria Li Lung
- Center for Nasopharyngeal Carcinoma Research (CNPCR), The University of Hong Kong, Hong Kong S.A.R., China
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong S.A.R., China
| | - Hans-Olov Adami
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hongbing Shen
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China.
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- Department of Epidemiology and Health Statistics & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China.
- Center for Nasopharyngeal Carcinoma Research (CNPCR), The University of Hong Kong, Hong Kong S.A.R., China.
| | - Yi-Xin Zeng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China
| | - Wei-Hua Jia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
- School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China.
| |
Collapse
|
4
|
Mai ZM, Byrne SN, Little MP, Sargen MR, Cahoon EK. Solar UVR and Variations in Systemic Immune and Inflammation Markers. JID Innov 2021; 1:100055. [PMID: 34909751 PMCID: PMC8659735 DOI: 10.1016/j.xjidi.2021.100055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 11/23/2022] Open
Abstract
The characterization of the effects of solar UVR on a broad set of circulating markers in systemic immunity and inflammation may provide insight into the mechanisms responsible for the UVR associations observed for several benign and malignant diseases. We examined the associations between exposure to solar UVR and circulating levels of 78 markers among 1,819 individuals aged 55–74 years who participated in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial using multiplex assays. Solar UVR was derived by linking the geocoded locations of 10 screening centers across the continental United States and the date of blood draw to the National Solar Radiation Database from 1993 to 2005. We assessed associations between ambient solar UVR and dichotomized marker levels using adjusted weighted logistic regression models and applied a 5% false discovery rate criterion to P-values. UVR exposure was associated (P < 0.05) with 9 of the 78 markers. CCL27, CCL4, FGF2, GM-CSF, IFN-γ, soluble IL4R, IL-7, and IL-11 levels were lower with increasing UVR tertile, with adjusted ORs ranging from 0.66 to 0.80, and the significant association for CCL27 withstood multiple comparison correction. In contrast, CRP levels were elevated with increasing UVR. Solar UVR was associated with alterations in systemic immune and inflammation marker levels.
Collapse
Affiliation(s)
- Zhi-Ming Mai
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| | - Scott N Byrne
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Centre for Immunology and Allergy Research, The Westmead Institute for Medical Research, Westmead, Australia
| | - Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| | - Michael R Sargen
- Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| |
Collapse
|
5
|
Wang L, Mai ZM, Ngan RKC, Ng WT, Lin JH, Kwong DLW, Chiang SC, Yuen KT, Ng AWY, Ip DKM, Chan YH, Lee AWM, Lung ML, Ho SY, Lam TH. Dose-Response Reduction in Risk of Nasopharyngeal Carcinoma From Smoking Cessation: A Multicenter Case-Control Study in Hong Kong, China. Front Oncol 2021; 11:699241. [PMID: 34646762 PMCID: PMC8503184 DOI: 10.3389/fonc.2021.699241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/02/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cigarette smoking is associated with nasopharyngeal cancer (NPC) risk. Whether quitting reduces the risk is unclear. We investigated the associations of NPC with duration of and age at quitting in an endemic region. METHODS We investigated the associations between NPC and quitting in a multicenter case-control study in Hong Kong with 676 newly diagnosed NPC cases and 1,285 hospital controls between 2014 and 2017, using a computer-assisted self-administered questionnaire. Multivariable unconditional logistic regression yielded adjusted odds ratios (AORs) of NPC by quitting status, duration and age of quitting, combinations of duration and age of quitting, and quitting to smoking duration ratio, compared with current smoking. RESULTS Quitting (AOR: 0.72; 95% CI: 0.53-0.98) and never smoking (0.73, 0.56-0.95) were associated with lower NPC risk. NPC risk decreased with (i) longer quitting duration (p < 0.01), reaching significance after 11-20 (0.62, 0.39-0.99) and 21+ years (0.54, 0.31-0.92) of quitting; (ii) younger quitting age (p = 0.01), reaching significance for quitting at <25 years (0.49, 0.24-0.97); and (iii) higher quitting to smoking duration ratio (p < 0.01), reaching significance when the ratio reached 1 (0.60, 0.39-0.93). Quitting younger (age <25) appeared to confer larger reductions (49% for ≤10 years of quitting, 50% for 11+ years) in NPC risk than quitting at older ages (25+) regardless of quitting duration (16% for ≤10 years, 39% for 11+ years). CONCLUSIONS We have shown longer duration and younger age of quitting were associated with lower NPC risk, with dose-response relations. Our findings support including smoking as a cause of NPC. Stronger tobacco control measures and quitting services are needed to prevent NPC.
Collapse
Affiliation(s)
- Lijun Wang
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Zhi-Ming Mai
- School of Public Health, University of Hong Kong, Hong Kong, China
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Roger Kai-Cheong Ngan
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China
| | - Wai-Tong Ng
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, the University of Hong Kong, Hong Kong, China
| | - Jia-Huang Lin
- School of Public Health, University of Hong Kong, Hong Kong, China
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Dora Lai-Wan Kwong
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Shing-Chun Chiang
- School of Public Health, University of Hong Kong, Hong Kong, China
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
| | - Kam-Tong Yuen
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, China
| | - Alice Wan-Ying Ng
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, China
| | - Dennis Kai-Ming Ip
- School of Public Health, University of Hong Kong, Hong Kong, China
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
| | - Yap-Hang Chan
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Department of Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China
| | - Anne Wing-Mui Lee
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Maria Li Lung
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
- Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Sai Yin Ho
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Tai-Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong, China
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, the University of Hong Kong, Hong Kong, China
| |
Collapse
|
6
|
Mai ZM, Ngan RKC, Ng WT, Lin JH, Kwong DLW, Yuen KT, Lee CK, Leung JNS, Ip DKM, Chan YH, Lee AWM, Lung ML, Lam TH, Ho SY. Low vitamin D exposure and risk of nasopharyngeal carcinoma: Observational and genetic evidence from a multicenter case-control study. Clin Nutr 2021; 40:5180-5188. [PMID: 34464857 DOI: 10.1016/j.clnu.2021.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/23/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS Little is known about the risk of nasopharyngeal carcinoma (NPC) in relation to vitamin D exposure. The aim of this study was to examine the associations of NPC risk with serum level of 25-hydroxyvitamin D (25OHD) and genetic predicted 25OHD, and potential effect modification by several putative risk factors of NPC. METHODS Our multicenter case-control study in Hong Kong recruited 815 NPC cases and 1502 frequency-matched (by sex and age) hospital controls from five major regional hospitals, and recruited 299 healthy subjects from blood donation centers (2014-2017). Circulating level of 25-hydroxyvitamin D (25OHD) and genetic predicted 25OHD (rs12785878, rs11234027, rs12794714, rs4588 and rs6013897) were measured by validated enzyme immunoassay and the iPLEX assay on the MassARRAY System, respectively. Data were also collected on demographics, lifestyle factors, ultraviolet radiation exposure, and potential confounders using a computer-assisted, self-administered questionnaire with satisfactory test-retest reliability. Unconditional logistic regression models were used to estimate ORs and 95% CIs. RESULTS Despite no significant association of NPC risk with circulating 25OHD and genetic predicted 25OHD, there was evidence for an inverse association in participants with normal body mass index (between 18.5 and 27.5) across categories of 25OHD (Ptrend = 0.003), and a positive association in those with low socioeconomic status across categories based on the genetic score (Ptrend = 0.005). In addition, risk of NPC diagnosed at an early stage was higher for genetically lower 25OHD level (adjusted OR = 3.09, 95% CI = 1.04-9.21, Ptrend = 0.022). CONCLUSIONS Findings of this first comprehensive study to investigate the positive association of NPC risk with vitamin D deficiency need to be confirmed and be best interpreted with results of further similar studies. Our findings may inform possible etiological mechanisms of the associations with several putative risk/protective factors of NPC.
Collapse
Affiliation(s)
- Zhi-Ming Mai
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China.
| | - Roger Kai-Cheong Ngan
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China; Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Wai-Tong Ng
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China; Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - Jia-Huang Lin
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Dora Lai-Wan Kwong
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China; Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - Kam-Tong Yuen
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China; Department of Oncology, Princess Margaret Hospital, Hong Kong SAR, China
| | - Cheuk Kwong Lee
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong SAR, China
| | | | - Dennis Kai-Ming Ip
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Yap-Hang Chan
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China; Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - Anne Wing-Mui Lee
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China; Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Maria Li Lung
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China.
| | - Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
7
|
Lin JH, Wen CP, Jiang CQ, Yuan JM, Chen CJ, Ho SY, Gao W, Zhang W, Wang R, Chien YC, Xu L, Wu X, Jin YL, Koh WP, Hsu WL, Zhu F, Wen C, Zhu T, Lee JH, Mai ZM, Lung ML, Lam TH. Smoking and nasopharyngeal cancer: individual data meta-analysis of six prospective studies on 334 935 men. Int J Epidemiol 2021; 50:975-986. [PMID: 33787881 PMCID: PMC8271191 DOI: 10.1093/ije/dyab060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 06/02/2020] [Accepted: 03/04/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The role of smoking in nasopharyngeal carcinoma (NPC) remains uncertain, especially in endemic regions. We conducted an individual participant data (IPD) meta-analysis of prospective cohort studies to investigate the associations between smoking exposure and risk of NPC. METHODS We obtained individual participant data of 334 935 male participants from six eligible population-based cohorts in NPC-endemic regions, including two each in Guangzhou and Taiwan, and one each in Hong Kong and Singapore. We used one- and two-stage approaches IPD meta-analysis and Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of NPC for smoking exposure adjusting for age and drinking status. RESULTS During 2 961 315 person-years of follow-up, 399 NPC evens were ascertained. Risks of NPC were higher in ever versus never smokers (HRone-stage = 1.32, 95% CI = 1.07-1.63, P = 0.0088; HRtwo-stage = 1.27, 1.01-1.60, 0.04). These positive associations appeared to be stronger in ever smokers who consumed 16+ cigarettes/day (HRone-stage = 1.67, 95% CI = 1.29-2.16, P = 0.0001), and in those who started smoking at age younger than 16 (2.16, 1.33-3.50, 0.0103), with dose-response relationships (P-values for trend = 0.0028 and 0.0103, respectively). Quitting (versus daily smoking) showed a small reduced risk (stopped for 5+ years: HRone-stage = 0.91, 95% CI = 0.60-1.39, P = 0.66; for former smokers: HRtwo-stage = 0.84, 0.61-1.14, 0.26). CONCLUSIONS This first IPD meta-analysis from six prospective cohorts in endemic regions has provided robust observational evidence that smoking increased NPC risk in men. NPC should be added to the 12-16 cancer sites known to be tobacco-related cancers. Strong tobacco control policies, preventing young individuals from smoking, would reduce NPC risk in endemic regions.
Collapse
Affiliation(s)
- Jia Huang Lin
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, University of Hong Kong, Hong Kong
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Chi Pang Wen
- Institute of Population Health Sciences, National Health Institutes, Zhunan, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | | | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Centre, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chien Jen Chen
- Genomics Research Centre, Academia Sinica, Taipei, Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sai Yin Ho
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Wayne Gao
- Master's Program in Global Health and Development, Taipei Medical University, Taipei, Taiwan
| | | | - Renwei Wang
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Centre, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yin-Chu Chien
- Genomics Research Centre, Academia Sinica, Taipei, Taiwan
| | - Lin Xu
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xifeng Wu
- Centre for Biostatistics Bioinformatics and Big Data, School of Public Health, National Institute for Data Science in Health and Medicine, Zhejiang University, Hangzhou, China
| | - Ya Li Jin
- Guangzhou No.12 Hospital, Guangzhou, China
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Wan-Lun Hsu
- Genomics Research Centre, Academia Sinica, Taipei, Taiwan
| | - Feng Zhu
- Guangzhou No.12 Hospital, Guangzhou, China
| | - Christopher Wen
- Department of Radiology, Long Beach Veterans Administration Hospital, University of California at Irvine, Irvine, CA, USA
| | - Tong Zhu
- Guangzhou No.12 Hospital, Guangzhou, China
| | - June Han Lee
- Institute of Population Health Sciences, National Health Institutes, Zhunan, Taiwan
| | - Zhi-Ming Mai
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, University of Hong Kong, Hong Kong
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Corresponding author. School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong Patrick Manson Building (North Wing), 7 Sassoon Road, Pok Fu Lam, Hong Kong, China. E-mail:
| | - Maria Li Lung
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, University of Hong Kong, Hong Kong
- Department of Clinical Oncology and Centre for Cancer Research, University of Hong Kong, Hong Kong
| | - Tai-Hing Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, University of Hong Kong, Hong Kong
| |
Collapse
|
8
|
Abstract
IMPORTANCE Heated tobacco products (HTPs) are promoted as less harmful than combustible cigarettes but epidemiological evidence is scarce, especially in youth. OBJECTIVE To investigate the associations of persistent respiratory symptoms with HTP use, cigarette use, and dual use among Hong Kong youth. DESIGN, SETTING, AND PARTICIPANTS This was a territorywide cross-sectional school-based survey conducted from October 2018 to July 2019 using an anonymous questionnaire. Schools were randomly invited from a proportionate stratified sample in all 18 districts of Hong Kong. Poisson regression models using generalized estimating equations yielded adjusted prevalence ratios (APRs) of respiratory symptoms in (1) former and current HTP (vs never) users in the whole sample and stratified by cigarette use status and (2) exclusive HTP and dual users vs exclusive cigarette users. Statistical analysis was performed from October 2020 to March 2021. EXPOSURES Former and current use of cigarettes, HTPs, e-cigarettes, and other tobacco products. MAIN OUTCOMES AND MEASURES Respiratory symptoms for 3 consecutive months in the past 12 months. RESULTS The study included 33 627 students with a mean (SD) age of 14.8 (1.9) years; 51.3% (18 171) were boys. Respiratory symptoms were reported by 16.3% (n = 5549) of all students, 29.3% (n = 226) of current users of e-cigarettes, 31.2% (n = 314) of current users of cigarettes, and 33.5% (n = 179) of current users of HTPs. Respiratory symptoms were associated with former (APR, 1.30; 95% CI, 1.06-1.59) and current (APR, 1.59; 95% CI, 1.23-2.06) vs never HTP use and current vs never cigarette use (APR, 1.50; 95% CI, 1.30-1.74) after adjusting for various tobacco use. Associations between respiratory symptoms and current vs never HTP use were observed in never (APR, 1.88; 95% CI, 1.36-2.59) and former (APR, 2.15; 95% CI, 1.12-4.12) cigarette users, but not in current cigarette users (APR, 1.24; 95% CI, 0.97-1.59). Respiratory symptoms were associated with exclusive ever HTP use (APR, 1.46, 95% CI, 1.15-1.86) and ever dual use (APR, 1.29; 95% CI, 1.08-1.54) vs exclusive ever cigarette use. There was no association between exclusive current HTP (vs cigarette) use and respiratory symptoms (1.40; 95% CI, 0.93-2.11). CONCLUSIONS AND RELEVANCE This cross-sectional study found that former and current HTP use were associated with persistent respiratory symptoms among youth, especially among never and former cigarette users. Respiratory symptoms were more prevalent in ever exclusive HTP users and ever dual users than ever exclusive cigarette users. These findings suggest that using HTPs instead of cigarettes may not reduce health risks.
Collapse
Affiliation(s)
- Lijun Wang
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Jianjiu Chen
- School of Public Health, University of Hong Kong, Hong Kong, China
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Lok Tung Leung
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Zhi-Ming Mai
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Sai Yin Ho
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong, China
| |
Collapse
|
9
|
Wang YF, Zhang Y, Lin Z, Zhang H, Wang TY, Cao Y, Morris DL, Sheng Y, Yin X, Zhong SL, Gu X, Lei Y, He J, Wu Q, Shen JJ, Yang J, Lam TH, Lin JH, Mai ZM, Guo M, Tang Y, Chen Y, Song Q, Ban B, Mok CC, Cui Y, Lu L, Shen N, Sham PC, Lau CS, Smith DK, Vyse TJ, Zhang X, Lau YL, Yang W. Identification of 38 novel loci for systemic lupus erythematosus and genetic heterogeneity between ancestral groups. Nat Commun 2021; 12:772. [PMID: 33536424 PMCID: PMC7858632 DOI: 10.1038/s41467-021-21049-y] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [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: 04/26/2020] [Accepted: 01/11/2021] [Indexed: 02/07/2023] Open
Abstract
Systemic lupus erythematosus (SLE), a worldwide autoimmune disease with high heritability, shows differences in prevalence, severity and age of onset among different ancestral groups. Previous genetic studies have focused more on European populations, which appear to be the least affected. Consequently, the genetic variations that underlie the commonalities, differences and treatment options in SLE among ancestral groups have not been well elucidated. To address this, we undertake a genome-wide association study, increasing the sample size of Chinese populations to the level of existing European studies. Thirty-eight novel SLE-associated loci and incomplete sharing of genetic architecture are identified. In addition to the human leukocyte antigen (HLA) region, nine disease loci show clear ancestral differences and implicate antibody production as a potential mechanism for differences in disease manifestation. Polygenic risk scores perform significantly better when trained on ancestry-matched data sets. These analyses help to reveal the genetic basis for disparities in SLE among ancestral groups.
Collapse
Affiliation(s)
- Yong-Fei Wang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Yan Zhang
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Zhiming Lin
- Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Huoru Zhang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Ting-You Wang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
- The Hormel Institute, University of Minnesota, Austin, USA
| | - Yujie Cao
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - David L Morris
- Division of Genetics and Molecular Medicine, King's College London, London, UK
| | - Yujun Sheng
- Department of Dermatology, No.1 Hospital, Anhui Medical University, Hefei, China
| | - Xianyong Yin
- Department of Dermatology, No.1 Hospital, Anhui Medical University, Hefei, China
| | - Shi-Long Zhong
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Xiaoqiong Gu
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yao Lei
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Jing He
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Qi Wu
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jiangshan Jane Shen
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Jing Yang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Jia-Huang Lin
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Zhi-Ming Mai
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Radiation Epidemiology Branch, Division of Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Mengbiao Guo
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Yuanjia Tang
- Shanghai Institute of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanhui Chen
- Department of Pediatrics, Union Hospital Affiliated to Fujian Medical University, Fuzhou, China
| | - Qin Song
- Department of Rheumatology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Chi Chiu Mok
- Department of Medicine, Tuen Mun Hospital, Hong Kong, China
| | - Yong Cui
- Department of Dermatology, China-Japan Friendship Hospital, Chaoyang, China
| | - Liangjing Lu
- Shanghai Institute of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nan Shen
- Shanghai Institute of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pak C Sham
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Chak Sing Lau
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - David K Smith
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Timothy J Vyse
- Division of Genetics and Molecular Medicine, King's College London, London, UK
| | - Xuejun Zhang
- Department of Dermatology, No.1 Hospital, Anhui Medical University, Hefei, China
| | - Yu Lung Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China.
| | - Wanling Yang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China.
- Shenzhen Institute of Research and Innovation, The University of Hong Kong, Hong Kong, China.
| |
Collapse
|
10
|
Mai ZM, Ngan RKC, Kwong DLW, Ng WT, Yuen KT, Ip DKM, Chan YH, Lee AWM, Ho SY, Lung ML, Lam TH. Dietary fiber intake from fresh and preserved food and risk of nasopharyngeal carcinoma: observational evidence from a Chinese population. Nutr J 2021; 20:14. [PMID: 33531022 PMCID: PMC7856716 DOI: 10.1186/s12937-021-00667-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background The role of dietary fiber intake on risk of nasopharyngeal carcinoma (NPC) remains unclear. We examined the associations of dietary fiber intake on the risk of NPC adjusting for a comprehensive list of potential confounders. Methods Using data from a multicenter case-control study, we included 815 histologically confirmed NPC incident cases and 1502 controls in Hong Kong, China recruited in 2014–2017. Odds ratios (ORs) of NPC (cases vs controls) for dietary fiber intake from different sources at different life periods (age 13–18, age 19–30, and 10 years before recruitment) were evaluated using unconditional logistic regression, adjusting for sex, age, socioeconomic status, smoking and drinking status, occupational hazards, family history of cancer, salted fish, and total energy intake in Model 1, Epstein-Barr virus viral capsid antigen serological status in Model 2, and duration of sun exposure and circulating 25-hydroxyvitamin D in Model 3. Results Higher intake of total dietary fiber 10 years before recruitment was significantly associated with decreased NPC risk, with demonstrable dose-response relationship (P-values for trend = 0.001, 0.020 and 0.024 in Models 1–3, respectively). The adjusted ORs (95% CI) in the highest versus the lowest quartile were 0.51 (0.38–0.69) in Model 1, 0.48 (0.33–0.69) in Model 2, and 0.48 (0.33–0.70) in Model 3. However, the association was less clear after adjustment of other potential confounders (e.g. EBV) in the two younger periods (age of 13–18 and 19–30 years). Risks of NPC were significantly lower for dietary fiber intake from fresh vegetables and fruits and soybean products over all three periods, with dose-response relationships observed in all Models (P-values for trend for age 13–18, age 19–30 and 10 years before recruitment were, respectively, 0.002, 0.009 and 0.001 for Model1; 0.020, 0.031 and 0.003 for Model 2; and 0.022, 0.037 and 0.004 for Model 3). No clear association of NPC risk with dietary fiber intake from preserved vegetables, fruits and condiments was observed. Conclusion Our study has shown the protective role of dietary fiber from fresh food items in NPC risk, but no association for total dietary fiber intake was observed, probably because total intake also included intake of preserved food. Further studies with detailed dietary information and in prospective settings are needed to confirm this finding, and to explore the possible underlying biological mechanisms.
Collapse
Affiliation(s)
- Zhi-Ming Mai
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pok Fu Lam, Hong Kong, SAR, China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China
| | - Roger Kai-Cheong Ngan
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.,Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, SAR, China
| | - Dora Lai-Wan Kwong
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Wai-Tong Ng
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.,Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, SAR, China
| | - Kam-Tong Yuen
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China.,Department of Oncology, Princess Margaret Hospital, Hong Kong, SAR, China
| | - Dennis Kai-Ming Ip
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pok Fu Lam, Hong Kong, SAR, China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China
| | - Yap-Hang Chan
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China.,Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR, China
| | - Anne Wing-Mui Lee
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.,Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Sai-Yin Ho
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pok Fu Lam, Hong Kong, SAR, China
| | - Maria Li Lung
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China.,Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Tai-Hing Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pok Fu Lam, Hong Kong, SAR, China. .,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, SAR, China.
| |
Collapse
|
11
|
Sargen MR, Mai ZM, Engels EA, Goldstein AM, Tucker MA, Pfeiffer RM, Cahoon EK. Ambient Ultraviolet Radiation and Sebaceous Carcinoma Incidence in the United States, 2000-2016. JNCI Cancer Spectr 2021; 4:pkaa020. [PMID: 33392442 DOI: 10.1093/jncics/pkaa020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/05/2020] [Accepted: 02/24/2020] [Indexed: 11/13/2022] Open
Abstract
Sebaceous carcinoma (SC) is an aggressive skin tumor. Although ultraviolet radiation (UVR) is an important risk factor for some skin cancer types, no population-level study has evaluated for an association between UVR and SC risk. Herein, we examined satellite-based ambient UVR in relation to SC incidence using Surveillance, Epidemiology, and End Results 18 cancer registry data (2000-2016). There were 3503 microscopically confirmed cases of SC diagnosed during the study period. For non-Hispanic whites, there was an association between increasing ambient UVR and SC risk (incidence rate ratio [per UVR quartile] = 1.15, 95% confidence interval = 1.11 to 1.19; two-sided P < .001) including among individuals with and without putative Muir-Torre syndrome. In contrast, there was no association between ambient UVR and SC risk for other race and ethnicities. Our findings support a role for UVR in SC tumorigenesis, which suggests that photoprotection may reduce SC risk, particularly for high-risk populations (eg, Muir-Torre syndrome).
Collapse
Affiliation(s)
- Michael R Sargen
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Zhi-Ming Mai
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Eric A Engels
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Alisa M Goldstein
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Margaret A Tucker
- Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Ruth M Pfeiffer
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| |
Collapse
|
12
|
Mai ZM, Lin JH, Ngan RKC, Kwong DLW, Ng WT, Ng AWY, Ip KM, Chan YH, Lee AWM, Ho SY, Lung ML, Lam TH. Solar Ultraviolet Radiation and Vitamin D Deficiency on Epstein-Barr Virus Reactivation: Observational and Genetic Evidence From a Nasopharyngeal Carcinoma-Endemic Population. Open Forum Infect Dis 2020; 7:ofaa426. [PMID: 33134413 PMCID: PMC7585328 DOI: 10.1093/ofid/ofaa426] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/11/2020] [Indexed: 12/22/2022] Open
Abstract
Background We investigated the relationship of Epstein-Barr virus viral capsid antigen (EBV VCA-IgA) serostatus with ambient and personal ultraviolet radiation (UVR) and vitamin D exposure. Methods Using data from a multicenter case-control study, we included 1026 controls subjects in 2014–2017 in Hong Kong, China. Odds ratios (ORs) and 95% confidence intervals (CIs) of the association between UVR exposure and EBV VCA-IgA (seropositivity vs seronegativity) were calculated using unconditional logistic regression models adjusted for potential confounders. Results We observed a large increase in seropositivity of EBV VCA-IgA in association with duration of sunlight exposures at both 10 years before recruitment and age 19–30 years (adjusted OR = 3.59, 95% CI = 1.46–8.77; and adjusted OR = 2.44, 95% CI = 1.04–5.73 for ≥8 vs <2 hours/day; P for trend = .005 and .048, respectively). However, no association of EBV VCA-IgA serostatus with other indicators of UVR exposure was found. In addition, both circulating 25-hydroxyvitamin D (25OHD) and genetic predicted 25OHD were not associated with EBV VCA-IgA serostatus. Conclusions Our results suggest that personal UVR exposure may be associated with higher risk of EBV reactivation, but we did not find clear evidence of vitamin D exposure (observational or genetic), a molecular mediator of UVR exposure. Further prospective studies in other populations are needed to confirm this finding and to explore the underlying biological mechanisms. Information on photosensitizing agents, and serological markers of EBV, and biomarkers related to systemic immunity and inflammation should be collected and are also highly relevant in future studies.
Collapse
Affiliation(s)
- Zhi-Ming Mai
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China.,Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China
| | - Jia-Huang Lin
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China.,Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China
| | - Roger Kai-Cheong Ngan
- Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China.,Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China.,Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Dora Lai-Wan Kwong
- Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China.,Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China
| | - Wai-Tong Ng
- Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China.,Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China
| | - Alice Wan-Ying Ng
- Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China.,Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong SAR, China
| | - Kai-Ming Ip
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China.,Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China
| | - Yap-Hang Chan
- Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China.,Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - Anne Wing-Mui Lee
- Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China.,Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China
| | - Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China
| | - Maria Li Lung
- Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China.,Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region (SAR), China.,Centre for Nasopharyngeal Carcinoma Research, Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
13
|
Mai ZM, Sargen MR, Curtis RE, Pfeiffer RM, Tucker MA, Cahoon EK. Ambient ultraviolet radiation and major salivary gland cancer in the United States. J Am Acad Dermatol 2020; 83:1775-1777. [PMID: 32246964 DOI: 10.1016/j.jaad.2020.03.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/17/2020] [Accepted: 03/24/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Zhi-Ming Mai
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland.
| | - Michael R Sargen
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland
| | - Rochelle E Curtis
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland
| | - Ruth M Pfeiffer
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland
| | - Margaret A Tucker
- Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland
| |
Collapse
|
14
|
Mai ZM, Lin JH, Ngan RKC, Kwong DLW, Ng WT, Ng AWY, Yuen KT, Ip DKM, Chan YH, Lee AWM, Ho SY, Lung ML, Lam TH. Milk Consumption Across Life Periods in Relation to Lower Risk of Nasopharyngeal Carcinoma: A Multicentre Case-Control Study. Front Oncol 2019; 9:253. [PMID: 31024854 PMCID: PMC6467951 DOI: 10.3389/fonc.2019.00253] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/20/2019] [Indexed: 11/23/2022] Open
Abstract
Background: The much higher incidence of nasopharyngeal carcinoma (NPC) in men suggests sex hormones as a risk factor, and dairy products contain measurable amounts of steroid hormones. Milk consumption has greatly increased in endemic regions of NPC. We investigated the association between NPC and milk consumption across life periods in Hong Kong. Methods: A multicentre case-control study included 815 histologically confirmed NPC incident cases and 1,502 controls who were frequency-matched on age and sex at five major hospitals in Hong Kong in 2014–2017. Odds ratios (ORs) of NPC (cases vs. controls) for milk consumption at different life periods were estimated by unconditional logistic regression, adjusting for sex, age, socioeconomic status score, smoking and alcohol drinking status, exposure to occupational hazards, family history of cancer, IgA against Epstein-Barr virus viral capsid antigen, and total energy intake. Results: Compared with abstainers, lower risks of NPC were consistently observed in regular users (consuming ≥5 glasses of milk [fresh and powdered combined] per month) across four life periods of age 6–12 (adjusted OR 0.74, 95% CI 0.54–0.86), 13–18 (0.68, 0.55–0.84), 19–30 (0.68, 0.55–0.84), and 10 years before recruitment (0.72, 0.59–0.87). Long-term average milk consumption of ≤2.5, >2.5, and ≤12.5, >12.5 glasses per month yielded adjusted OR (95% CI) of 1.00 (0.80–1.26), 0.98 (0.81–1.18), 0.95 (0.76–1.18), and 0.55 (0.43–0.70), respectively (all P-values for trend < 0.05). Conclusion: Consumption of milk across life periods was associated with lower risks of NPC. If confirmed to be causal, this has important implications for dairy product consumption and prevention of NPC.
Collapse
Affiliation(s)
- Zhi-Ming Mai
- School of Public Health, The University of Hong Kong, Hong Kong, China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China
| | - Jia-Huang Lin
- School of Public Health, The University of Hong Kong, Hong Kong, China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China
| | - Roger Kai-Cheong Ngan
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China.,Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China
| | - Dora Lai-Wan Kwong
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China.,Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China
| | - Wai-Tong Ng
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China.,Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Alice Wan-Ying Ng
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China.,Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, China
| | - Kam-Tong Yuen
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China.,Department of Oncology, Princess Margaret Hospital, Hong Kong, China
| | - Dennis Kai Ming Ip
- School of Public Health, The University of Hong Kong, Hong Kong, China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China
| | - Yap-Hang Chan
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China.,Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Anne Wing-Mui Lee
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China.,Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China.,Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Maria Li Lung
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China.,Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
15
|
Mai ZM, Lin JH, Chiang SC, Ngan RKC, Kwong DLW, Ng WT, Ng AWY, Yuen KT, Ip KM, Chan YH, Lee AWM, Ho SY, Lung ML, Lam TH. Test-retest reliability of a computer-assisted self-administered questionnaire on early life exposure in a nasopharyngeal carcinoma case-control study. Sci Rep 2018; 8:7052. [PMID: 29728581 PMCID: PMC5935670 DOI: 10.1038/s41598-018-25046-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/11/2018] [Indexed: 11/10/2022] Open
Abstract
We evaluated the reliability of early life nasopharyngeal carcinoma (NPC) aetiology factors in the questionnaire of an NPC case-control study in Hong Kong during 2014–2017. 140 subjects aged 18+ completed the same computer-assisted questionnaire twice, separated by at least 2 weeks. The questionnaire included most known NPC aetiology factors and the present analysis focused on early life exposure. Test-retest reliability of all the 285 questionnaire items was assessed in all subjects and in 5 subgroups defined by cases/controls, sex, time between 1st and 2nd questionnaire (2–29/≥30 weeks), education (secondary or less/postsecondary), and age (25–44/45–59/60+ years) at the first questionnaire. The reliability of items on dietary habits, body figure, skin tone and sun exposure in early life periods (age 6–12 and 13–18) was moderate-to-almost perfect, and most other items had fair-to-substantial reliability in all life periods (age 6–12, 13–18 and 19–30, and 10 years ago). Differences in reliability by strata of the 5 subgroups were only observed in a few items. This study is the first to report the reliability of an NPC questionnaire, and make the questionnaire available online. Overall, our questionnaire had acceptable reliability, suggesting that previous NPC study results on the same risk factors would have similar reliability.
Collapse
Affiliation(s)
- Zhi-Ming Mai
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China
| | - Jia-Huang Lin
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China
| | - Shing-Chun Chiang
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China
| | - Roger Kai-Cheong Ngan
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.,Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong S.A.R., China
| | - Dora Lai-Wan Kwong
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.,Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Hong Kong S.A.R., China
| | - Wai-Tong Ng
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.,Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong S.A.R., China
| | - Alice Wan-Ying Ng
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.,Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong S.A.R., China
| | - Kam-Tong Yuen
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.,Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong S.A.R., China
| | - Kai-Ming Ip
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China
| | - Yap-Hang Chan
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.,Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong S.A.R., China
| | - Anne Wing-Mui Lee
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.,Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Hong Kong S.A.R., China
| | - Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China.
| | - Maria Li Lung
- Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.,Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Hong Kong S.A.R., China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China.,Centre for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China
| |
Collapse
|
16
|
Mai ZM, Ho SY, Lam TH. A proportional mortality study on smoking and lung cancer using different causes of deaths for dead controls. Tob Induc Dis 2018. [DOI: 10.18332/tid/84213] [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: 11/24/2022] Open
|
17
|
Mai ZM, Ho SY, Wang MP, Ho LM, Lam TH. Physical activity was associated with unassisted quitting: cross-sectional and prospective findings from the Hong Kong Population Health Survey. Tob Induc Dis 2018. [DOI: 10.18332/tid/84222] [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: 11/24/2022] Open
|
18
|
Mai ZM, Ho SY, Lo CM, Wang MP, Peto R, Lam TH. Mortality reduction from quitting smoking in Hong Kong: population-wide proportional mortality study. Int J Epidemiol 2018; 47:752-759. [PMID: 29438481 DOI: 10.1093/ije/dyx267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/23/2017] [Accepted: 12/11/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The effects of smoking cessation might be different in different populations. Proportional mortality studies of all deaths, relating the certified cause to retrospectively determined smoking habits, have helped assess the hazards of smoking in Hong Kong, and further analyses can help assess the effects of prolonged cessation (although not of recent cessation, as life-threatening disease can itself cause cessation, particularly in old age). METHODS The LIMOR study sought the certified causes of all deaths in 1998, and interviewed 81% of families at death registries to determine the decedent's smoking history. Cases were deaths from pre-defined diseases of interest (N = 15 356); controls were deaths from pre-defined non-smoking-related diseases (N = 5023). Case vs control odds ratios for ex-smokers vs smokers were calculated by age-, sex- and education-standardized logistic regression. These are described as mortality rate ratios (RRs), with a group-specific confidence interval (CI). RESULTS For the aggregate of all deaths from any of the diseases of interest at ages 35-69 years, the RRs for current smoking, quitting 0-4, 5-9 or 10+ years ago and never-smoking were, respectively, RR = 1 (95% CI 0.86-1.17), 0.91 (0.73-1.14), 0.71 (0.49-1.02), 0.66 (0.50-0.87) and 0.43 (0.37-0.48). Younger age of quitting (25-44 or 45-64) appeared to be associated with greater protection: RR = 0.58 (0.38-0.88) and 0.71 (0.54-0.93), respectively. These patterns were less clear at older ages, particularly for death from emphysema. CONCLUSIONS Longer durations of smoking cessation are associated with progressively lower mortality rates from the diseases of interest. For sustainable monitoring of tobacco-attributed mortality, approximate years since last smoked should be recorded during death registration.
Collapse
Affiliation(s)
- Zhi-Ming Mai
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China
| | - Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China
| | - Ching-Man Lo
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China.,Department for International Trade, British Consulate-General, Hong Kong S.A.R., China
| | - Man-Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong S.A.R., China
| | - Richard Peto
- CTSU, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong S.A.R., China
| |
Collapse
|
19
|
Mai ZM, Lo CM, Xu J, Chan KP, Wong CM, Lung ML, Lam TH. Milk consumption in relation to incidence of nasopharyngeal carcinoma in 48 countries/regions. BMC Cancer 2015; 15:994. [PMID: 26690818 PMCID: PMC4687077 DOI: 10.1186/s12885-015-2021-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Decreasing trends of nasopharyngeal carcinoma (NPC) incidence have been consistently reported in endemic populations but the etiology of NPC remains unclear. The objective of our study was to assess the international and local (Hong Kong) correlations of milk and dairy products per capita consumption with NPC incidence. METHODS We conducted an ecological study in 48 countries/regions. Age standardized incidence rates of NPC were obtained from the Cancer Incidence in Five Continents. Dairy product consumption and Human Development Index were obtained from the Food and Agriculture Organization of the United Nations and the United Nations Development Programme. Spearman correlation, multivariate analysis and time-lagged analysis were performed. RESULTS The negative correlations between milk consumption and decreased age standardized incidence rates of NPC were observed in the 48 countries/regions adjusting for Human Development Index in endemic countries/regions. In Hong Kong, multivariate analysis, after adjusting for other potential confounders, including salted fish, cigarette, vegetable consumption and socioeconomic status, showed consistently negative and significant correlations between milk consumption and NPC incidence (The strongest coefficient (β) was observed at 10-year lag in males [β = -0.439; P < 0.01] and in females [β = -0.258; P < 0.01]). CONCLUSIONS Our study showed the correlations on milk consumption per capita and against lower risk of NPC in 48 countries/regions and in Hong Kong. These hypothesis-generating results could support further studies on individual exposures and the disease.
Collapse
Affiliation(s)
- Zhi-Ming Mai
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, William MW Mong Block, 21 Sassoon Road, Hong Kong S.A.R., China. .,Center for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.
| | - Ching-Man Lo
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, William MW Mong Block, 21 Sassoon Road, Hong Kong S.A.R., China. .,Center for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.
| | - Jun Xu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, William MW Mong Block, 21 Sassoon Road, Hong Kong S.A.R., China. .,Center for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.
| | - King-Pan Chan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, William MW Mong Block, 21 Sassoon Road, Hong Kong S.A.R., China.
| | - Chit-Ming Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, William MW Mong Block, 21 Sassoon Road, Hong Kong S.A.R., China.
| | - Maria Li Lung
- Department of Clinical Oncology and Center for Cancer Research, The University of Hong Kong, Hong Kong S.A.R., China. .,Center for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.
| | - Tai-Hing Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, William MW Mong Block, 21 Sassoon Road, Hong Kong S.A.R., China. .,Center for Nasopharyngeal Carcinoma Research (CNPCR), Research Grants Council Area of Excellence Scheme, The University of Hong Kong, Hong Kong S.A.R., China.
| |
Collapse
|
20
|
Lin JH, Jiang CQ, Ho SY, Zhang WS, Mai ZM, Xu L, Lo CM, Lam TH. Smoking and nasopharyngeal carcinoma mortality: a cohort study of 101,823 adults in Guangzhou, China. BMC Cancer 2015; 15:906. [PMID: 26573573 PMCID: PMC4647498 DOI: 10.1186/s12885-015-1902-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 11/03/2015] [Indexed: 11/30/2022] Open
Abstract
Background Nasopharyngeal carcinoma (NPC), also known as Cantonese cancer, is rare worldwide, but has particularly high incidence in North Africa and Southeast Asia, especially in Guangdong, China, such as Guangzhou. Tobacco causes head and neck cancers, but nasopharyngeal carcinoma is not included as causally related to smoking in the 2014 United States Surgeon General’s report. Prospective evidence remains limited. We used Guangzhou Occupational Cohort data to conduct the first and robust prospective study on smoking and NPC mortality in an NPC high-risk region. Methods Information on demographic characteristics and smoking status was collected through occupational health examinations in factories and driver examination stations from March 1988 to December 1992. Vital status and causes of deaths were retrieved until the end of 1999. Cox proportional hazard model was used to assess the association of smoking with NPC mortality. Results Of 101,823 subjects included for the present analysis, 34 NPC deaths occurred during the average 7.3 years of follow up. The mean age (standard deviation) of the subjects was 41 (5.7) years. Compared with never smokers, the hazard ratio (HR) of NPC mortality was 2.95 (95 % confidence interval 1.01–8.68; p = 0.048) for daily smokers and 4.03 (1.29–12.58; p = 0.016) for smokers with more than 10 pack-years of cumulative consumption, after adjusting for age, sex, education, drinking status, occupation and cohort status and accounting for smoking-drinking interaction. The risk of NPC mortality increased significantly with cigarettes per day (p for trend = 0.01) and number of pack-years (p for trend = 0.02). Conclusions In this first and largest cohort in a high NPC risk region, smoking was associated with higher NPC mortality. The findings have shown statistically significant dose–response trend between smoking amount and smoking cumulative consumption and the risk of NPC mortality, but due to the small event number, further studies with larger sample size are needed to confirm the findings in the present study. Our results support that smoking is one of the risk factors likely to be causally associated with NPC mortality. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1902-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jia-Huang Lin
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Chao-Qiang Jiang
- Guangzhou Occupational Diseases Prevention and Treatment Center, No 1 Tianqiang Street, Huang Pu Road West, Tianhe District, Guangzhou, 510620, China.
| | - Sai-Yin Ho
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Wei-Sen Zhang
- Guangzhou Occupational Diseases Prevention and Treatment Center, No 1 Tianqiang Street, Huang Pu Road West, Tianhe District, Guangzhou, 510620, China.
| | - Zhi-Ming Mai
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Lin Xu
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Ching-Man Lo
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| | - Tai-Hing Lam
- School of Public Health, University of Hong Kong, No 21 Sassoon Road, Hong Kong, China.
| |
Collapse
|