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Svanvik T, Marcickiewicz J, Sundfeldt K, Holmberg E, Strömberg U. Sociodemographic disparities in stage-specific incidences of endometrial cancer: a registry-based study in West Sweden, 1995-2016. Acta Oncol 2019; 58:845-851. [PMID: 30849264 DOI: 10.1080/0284186x.2019.1581947] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: For a few types of cancer, lower socioeconomic status (SES) is associated with higher incidence, and for even more cancer types it is associated with having a less favorable tumor stage at diagnosis. For endometrial cancer (EC), however, there is no clear evidence of such associations with SES. There is a need for analysis of sociodemographic disparities in EC incidences according to stage at diagnosis, which may provide support for trying to improve early detection of EC. Material and methods: Stage-specific incidences of endometrioid and non-endometrioid endometrial carcinomas [EECs (∼90% of all EC cases) and NECs (∼10%)] were analyzed for the population of the Western Swedish Healthcare Region, taking into account year (1995-2016), age, educational level (low, intermediate and high), and immigrant status (Swedish-born, foreign-born). All EC cases were identified and data were obtained from population-based registries. Results: Stage distribution of diagnosed EECs differed significantly according to the educational level of patients who were aged between 50 and 74 years at diagnosis, but not in the case of younger or older patients. An analysis based on 3113 EEC cases aged 50-74 years at diagnosis revealed marked disparities in the stage-II to stage-IV EEC incidences but not in the stage-I EEC incidence. Compared to women with a high level of education, the incidence rate ratios of stage-I, stage-II and stage-III and -IV EEC in women with a low level of education were 1.00 (95% CI: 0.90-1.12), 1.65 (1.13-2.42), and 1.82 (1.33-2.49), respectively. For NEC, we found no such association. Conclusions: Elevated incidences of stage-II to stage-IV EEC in 50- to 74-year-old women with a low level of education suggest that there should be targeted health service trials aimed at improving awareness of EC. Well-targeted EC awareness programs might lead to considerable health benefits.
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Affiliation(s)
- Teresia Svanvik
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Janusz Marcickiewicz
- Regional Cancer Centre West, Gothenburg, Sweden
- Department of Obstetrics and Gynaecology, Halland Hospital, Varberg, Sweden
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Erik Holmberg
- Regional Cancer Centre West, Gothenburg, Sweden
- Department of Oncology, Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden
| | - Ulf Strömberg
- Research and Development, Region Halland, Halmstad, Sweden
- Health Metrics Unit, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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102
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Ligibel JA, Basen-Engquist K, Bea JW. Weight Management and Physical Activity for Breast Cancer Prevention and Control. Am Soc Clin Oncol Educ Book 2019; 39:e22-e33. [PMID: 31099634 DOI: 10.1200/edbk_237423] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Observational evidence has consistently linked excess adiposity and inactivity to increased breast cancer risk and to poor outcomes in individuals diagnosed with early-stage, potentially curable breast cancer. There is less information from clinical trials testing the effect of weight management or physical activity interventions on breast cancer risk or outcomes, but a number of ongoing trials will test the impact of weight loss and other lifestyle changes after cancer diagnosis on the risk of breast cancer recurrence. Lifestyle changes have additional benefits beyond their potential to decrease primary or secondary breast cancer risk, including improvements in metabolic parameters, reduction in the risk of comorbidities such as diabetes and heart disease, improvement of physical functioning, and mitigation of side effects of cancer therapy. Despite these myriad benefits, implementation of lifestyle interventions in at-risk and survivor populations has been limited to date. This article reviews the evidence linking lifestyle factors to breast cancer risk and outcomes, discusses completed and ongoing randomized trials testing the impact of lifestyle change in primary and secondary breast cancer prevention, and reviews efforts to implement and disseminate lifestyle interventions in at-risk and breast cancer survivor populations.
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103
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Oruç Z, Kaplan MA. Effect of exercise on colorectal cancer prevention and treatment. World J Gastrointest Oncol 2019; 11:348-366. [PMID: 31139306 PMCID: PMC6522766 DOI: 10.4251/wjgo.v11.i5.348] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/17/2019] [Accepted: 05/06/2019] [Indexed: 02/05/2023] Open
Abstract
In recent years, because of improved cancer screening, detection and treatment modalities, a rapid increase in the population of colorectal and other cancer survivors has been observed. The increasing population has justified the requirement of preventive strategies such as lifestyle modifications with regard to obesity, physical activity, diet and smoking. Physical activity may prevent approximately 15% of the colon cancers. Furthermore, several observational studies have demonstrated the efficacy and dose-dependent and anti-cancer effects of exercise on decreasing the mortality and risk of recurrence before and after the colorectal cancer (CRC) diagnosis. However, the required exercise dose, type and intensity are yet unclear. The results of randomised prospective studies are expected to determine the optimal amount, type and intensity of exercise and formulate the most appropriate exercise plan and guidelines, according to the requirements and comorbidities of the patients. In addition, recent studies have focused on the molecular and genetic mechanisms underlying the effect of physical activity on disease outcomes and recurrence rates. This review aimed to investigate the effects of physical activity and the biological basis of these effects in preventing the risk and recurrence of CRC and decreasing the hazards of cancer and cancer treatment.
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Affiliation(s)
- Zeynep Oruç
- Department of Medical Oncology, Mersin City Hospital, Mersin 33000, Turkey
| | - Muhammed Ali Kaplan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakır 21280, Turkey
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104
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Di Sebastiano KM, Murthy G, Campbell KL, Desroches S, Murphy RA. Nutrition and Cancer Prevention: Why is the Evidence Lost in Translation? Adv Nutr 2019; 10:410-418. [PMID: 30915435 PMCID: PMC6520044 DOI: 10.1093/advances/nmy089] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/27/2018] [Accepted: 10/08/2018] [Indexed: 01/20/2023] Open
Abstract
With the high burden of cancer worldwide, primary prevention has been identified as a key cancer control strategy to reduce this burden. Diet and nutrition are important modifiable factors that may alter the risk of developing cancer, because several dietary components including alcohol consumption, fruit and vegetable intake, and dietary fiber have been shown to significantly impact cancer risk. Consequently, a number of organizations have developed cancer prevention guidelines that highlight the importance of nutrition (and related factors including body size and physical activity) to reduce the risk of cancer. However, there are barriers to the uptake of these guidelines, particularly with respect to diet and nutrition including awareness, communication, and other factors that influence eating behavior. Improved knowledge translation (KT) of recommendations may help facilitate uptake. The purposes of this narrative review are: 1) to examine issues and challenges related to KT of diet and nutrition evidence in the context of cancer prevention, including public awareness and attitudes towards cancer prevention, engagement in cancer prevention strategies, and effects of KT on diet-cancer preventive behaviors; 2) to discuss examples of effective and ineffective KT of diet and nutrition evidence; and 3) to provide recommendations for improving KT to help move the field of diet, nutrition, and cancer prevention forward. Evidence shows that adherence to nutrition recommendations for cancer prevention significantly reduces the risk of cancer; however, engagement in nutrition-based preventative behaviors is low. Skepticism and confusion around evidence linking diet and nutrition with cancer may arise, in part, through ineffective media KT; the primary source of health information for many people. Simple, tailored, targeted KT communication strategies aimed at increasing the general public's awareness, attitudes, and engagement in cancer preventive behavior should be emphasized to encourage cancer control.
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Affiliation(s)
| | | | - Kristin L Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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105
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El Kinany K, Huybrechts I, Kampman E, Boudouaya HA, Hatime Z, Mint Sidi Deoula M, El Asri A, Benslimane A, Nejjari C, Ibrahimi SA, Mrabti H, Abda N, Alaoui R, Gunter MJ, El Rhazi K. Concordance with the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention and colorectal cancer risk in Morocco: A large, population-based case-control study. Int J Cancer 2019; 145:1829-1837. [PMID: 30861106 DOI: 10.1002/ijc.32263] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/10/2019] [Accepted: 02/20/2019] [Indexed: 12/24/2022]
Abstract
The present study aimed to investigate associations between adherence to the recommendations on cancer prevention from the WCRF/AICR and colorectal cancer (CRC) risk in Morocco. Incident CRC cases (n = 1,516) and controls (n = 1,516) matched on age, sex and center, were recruited between September 2009 and February 2017 at five major hospitals located in Morocco. In-person interviews were conducted to assess habitual diet using a validated Food Frequency Questionnaire, physical activity and anthropometric measurements. Adherence to the WCRF/AIRC Recommendations was ranged from 0 (no adherence) to 6 (maximal adherence) and incorporating six WCRF/AICR components (food groups, physical activity and BMI). Multivariable odd ratios (ORA ) and 95% confidence intervals (CI) were calculated using conditional multivariate logistic regression models, with low adherence as referent, adjusting for potential confounding factors. Compared to those with the lowest adherence score, individuals in the highest WCRF/AICR score category had a statistically significant reduced risk for colon cancer (ORA = 0.63, 95% CI 0.53-0.76); rectal cancer (ORA = 0.52, 95% CI 0.43-0.63) and CRC overall (ORA = 0.58, 95% CI 0.51-0.66). For individual score components, when comparing the lowest with the highest adherence category, CRC risk was significantly lower in the highest adherence category for body fatness (ORA = 0.73; 95% CI 0.62-0.85), physical activity (ORA = 0.70; 95% CI 0.60-0.82), plant foods (ORA = 0.50; 95% CI 0.39-0.63) and red/processed meat (ORA = 0.81; 95% CI 0.71-0.92). Our analysis indicated that greater adherence to the WCRF/AICR recommendations for cancer prevention may lower CRC risk in Morocco.
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Affiliation(s)
- Khaoula El Kinany
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Inge Huybrechts
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Hanae Abir Boudouaya
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Zineb Hatime
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Meimouna Mint Sidi Deoula
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Achraf El Asri
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Abdelilah Benslimane
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Chakib Nejjari
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Sidi Adil Ibrahimi
- Department of Hepato-Gastroenterology, Hassan II University Hospital Center, Team Diseases of the Digestive System, Faculty of Medicine and pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Hind Mrabti
- Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco
| | - Naima Abda
- Department of Epidemiology, Clinical Research and Public Health, Mohammed First University, Oujda, Morocco
| | - Rhimou Alaoui
- Department of Medicine B, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Karima El Rhazi
- Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
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106
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Panebianco C, Villani A, Pazienza V. High Levels of Prebiotic Resistant Starch in Diet Modulate Gene Expression and Metabolomic Profile in Pancreatic Cancer Xenograft Mice. Nutrients 2019; 11:nu11040709. [PMID: 30934731 PMCID: PMC6521226 DOI: 10.3390/nu11040709] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/19/2019] [Accepted: 03/25/2019] [Indexed: 12/28/2022] Open
Abstract
Cancer initiation and protection mainly derives from a systemic metabolic environment regulated by dietary patterns. Less is known about the impact of nutritional interventions in people with a diagnosis of cancer. The aim of our study was to investigate the effect of a diet rich in resistant starch (RS) on cell pathways modulation and metabolomic phenotype in pancreatic cancer xenograft mice. RNA-Seq experiments on tumor tissue showed that 25 genes resulted in dysregulated pancreatic cancer in mice fed with an RS diet, as compared to those fed with control diet. Moreover, in these two different mice groups, six serum metabolites were deregulated as detected by LC–MS analysis. A bioinformatic prediction analysis showed the involvement of the differentially expressed genes on insulin receptor signaling, circadian rhythm signaling, and cancer drug resistance among the three top canonical pathways, whilst cell death and survival, gene expression, and neurological disease were among the three top disease and biological functions. These findings shed light on the genomic and metabolic phenotype, contributing to the knowledge of the mechanisms through which RS may act as a potential supportive approach for enhancing the efficacy of existing cancer treatments.
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Affiliation(s)
- Concetta Panebianco
- Gastroenterology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
| | - Annacandida Villani
- Gastroenterology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
| | - Valerio Pazienza
- Gastroenterology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
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107
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Cohen L, Jefferies A. Comprehensive Lifestyle Change: Harnessing Synergy to Improve Cancer Outcomes. J Natl Cancer Inst Monogr 2019; 2017:4617821. [PMID: 29140487 DOI: 10.1093/jncimonographs/lgx006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 08/08/2017] [Indexed: 12/18/2022] Open
Affiliation(s)
- Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX; Vital Matters, LLC, Houston, TX
| | - Alison Jefferies
- The University of Texas MD Anderson Cancer Center, Houston, TX; Vital Matters, LLC, Houston, TX
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108
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Wu DJ, Aktipis A, Pepper JW. Energy oversupply to tissues: a single mechanism possibly underlying multiple cancer risk factors. Evol Med Public Health 2019; 2019:9-16. [PMID: 31893122 PMCID: PMC6379718 DOI: 10.1093/emph/eoz004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/15/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Several major risk factors for cancer involve vascular oversupply of energy to affected tissues. These include obesity, diabetes and chronic inflammation. Here, we propose a potential mechanistic explanation for the association between energy oversupply and cancer risk, which we call the metabolic cancer suppression hypothesis: We hypothesize that oncogenesis is normally suppressed by organismal physiology that regulates and strictly limits normal energy supply to somatic cells, and that this protection is removed by abnormal oversupply of energy. METHODOLOGY We evaluate this hypothesis using a computational model of somatic cell evolution to simulate experimental manipulation of the vascular energy supply to a tissue. The model simulates the evolutionary dynamics of somatic cells during oncogenesis. RESULTS In our simulation experiment, we found that under plausible biological assumptions, elevated energy supply to a tissue led to the evolution of elevated energy uptake by somatic cells, leading to the rapid evolution of both defining traits of cancer cells: hyperproliferation, and tissue invasion. CONCLUSIONS AND IMPLICATIONS Our results support the hypothesis of metabolic cancer suppression, suggesting that vascular oversupply of energetic resources to somatic cells removes normal energetic limitations on cell proliferation, and that this accelerates cellular evolution toward cancer. Various predictions of this hypothesis are amenable to empirical testing, and have promising implications for translational research toward clinical cancer prevention.
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Affiliation(s)
- Daniel J Wu
- Department of Biology, Stanford University, Stanford, CA, USA
- Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
| | - Athena Aktipis
- Arizona State University, Biodesign Institute, Tempe, AZ, USA
| | - John W Pepper
- Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
- Santa Fe Institute, Santa Fe, NM, USA
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109
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Bayo J, Molina R, Pérez J, Pérez-Ruíz E, Aparicio J, Beato C, Berros JP, Bolaños M, Graña B, Santaballa A. SEOM clinical guidelines to primary prevention of cancer (2018). Clin Transl Oncol 2019; 21:106-113. [PMID: 30607789 PMCID: PMC6339664 DOI: 10.1007/s12094-018-02016-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 12/11/2018] [Indexed: 12/29/2022]
Abstract
Cancer is the leading social and healthcare problem of the twenty-first century. The aim of primary prevention is to decrease the incidence of cancer by avoiding the known causes and risk factors. Nevertheless, it has been estimated that cancer diagnoses could be halved through primary prevention measures. A comprehensive review of the scientific evidence regarding the main carcinogens and risk factors and primary prevention recommendations have been put forth based on this evidence. The GRADE scale has been used to classify the grade of evidence. We present the scientific evidence and recommendations for primary prevention of the major modifiable risk factors: smoking, alcohol, diet, obesity, physical activity, occupational and environmental factors, ultraviolet radiation, infections, and socioeconomic factors. Primary prevention is a simple, effective means to lower the incidence of cancer. Preventive measures must be circulated in the fight against cancer.
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Affiliation(s)
- J. Bayo
- Servicio de Oncología Médica, Hospital Juan Ramón Jiménez de Huelva, Ronda Exterior Norte, s/n, 21005 Huelva, Spain
| | - R. Molina
- Servicio de Oncología Médica, Hospital, Universitario Príncipe de Asturias, Madrid, Spain
| | - J. Pérez
- Servicio de Oncología Médica, Hospital Virgen de los Lirios, Alcoy, Spain
| | - E. Pérez-Ruíz
- Servicio de Oncología Médica, Complejo Hospital Costa del Sol, Marbella, Spain
| | - J. Aparicio
- Servicio de Oncología Médica, Hospital Universitari i Politècnic la Fe (Valencia), Valencia, Spain
| | - C. Beato
- Servicio de Oncología Médica, Complejo Hospitalario Regional Virgen Macarena, Seville, Spain
| | - J. P. Berros
- Servicio de Oncología Médica, Hospital, Universitario Central de Asturias, Asturias, Spain
| | - M. Bolaños
- Servicio de Oncología Médica, Hospital Juan Ramón Jiménez de Huelva, Ronda Exterior Norte, s/n, 21005 Huelva, Spain
| | - B. Graña
- Servicio de Oncología Médica, Complexo Hospitalario Universitario A Coruña (CHUAC), Coruna, Spain
| | - A. Santaballa
- Servicio de Oncología Médica, Hospital Universitari i Politècnic la Fe (Valencia), Valencia, Spain
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110
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Anderson AS, Craigie AM, Gallant S, McAdam C, Macaskill EJ, Mutrie N, Neilson AR, O'Carroll RE, Rauchhaus P, Sattar N, Stead M, Treweek S. Randomised controlled trial to assess the impact of a lifestyle intervention (ActWELL) in women invited to NHS breast screening. BMJ Open 2018; 8:e024136. [PMID: 30413516 PMCID: PMC6231585 DOI: 10.1136/bmjopen-2018-024136] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION In Scotland, the incidence of breast cancer is predicted to rise significantly in the next few decades and while there are measures to support reductions in morbidity and mortality, the breast cancer community is currently exploring preventative opportunities including supporting weight management programmes in postmenopausal women. This study aims to assess the effectiveness and cost-effectiveness of a theory-based, community delivered, minimal contact, weight management (diet, physical activity and behaviour change techniques) programme (ActWELL) in women with a body mass index (BMI) >25 kg/m2 attending routine breast cancer screening appointments. METHODS AND ANALYSIS The study will be a four-centre, 1:1 parallel group randomised controlled trial of a 12-month weight management intervention initiated in breast cancer screening centres, delivered by trained Breast Cancer Now lifestyle coaches in community settings. The intervention programme involves two intervention meetings with coaches plus (up to) nine telephone contacts over 12 months. The programme will focus on personalised diet (including alcoholic and sugary drinks) and physical activity habits. Behaviour change techniques include self-monitoring, goal setting, implementation intentions, action and coping plans. The study has a sample size of 414 women with a BMI >25 kg/m2 attending routine National Health Service breast cancer screening appointments. Measures will be taken at baseline, 12 weeks and at 12-month follow-up, complemented by qualitative interviews exploring perceived acceptability and impact on habitual behaviours. The two co-primary outcomes are mean change in measured body weight and change in physical activity between groups to 12 months. Secondary outcomes are changes in eating habits, alcohol intake, sedentary time, quality of life, waist circumference, lipid, haemoglobin A1c and insulin profiles, blood pressure and cost-effectiveness of the intervention. ETHICS AND DISSEMINATION The protocol has been approved by East of Scotland Research Ethics Committee (17/ES/0073). All participants provide written informed consent. Dissemination will be through peer-reviewed publication and conference presentations. TRIAL REGISTRATION NUMBER ISRCTN11057518; Pre-results.
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Affiliation(s)
- Annie S Anderson
- Division of Cancer Research, Centre for Research into Cancer Prevention and Screening, Division of Population Health and Genomics, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Angela Mary Craigie
- Division of Cancer Research, Centre for Research into Cancer Prevention and Screening, Division of Population Health and Genomics, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Stephanie Gallant
- Division of Cancer Research, Centre for Research into Cancer Prevention and Screening, Division of Population Health and Genomics, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Chloe McAdam
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | - E Jane Macaskill
- Department of Breast Surgery, NHS Tayside, Ninewells Hospital & Medical School, Dundee, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Ronan E O'Carroll
- Division of Psychology, School of Natural Sciences, University of Stirling, Stirling, UK
| | - Petra Rauchhaus
- Tayside Clinical Trials Unit, Tayside Medical Sciences Centre, Ninewells Hospital and Medical School, Dundee, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Martine Stead
- Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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111
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Gu Q, Spinelli JJ, Dummer TBJ, McDonald TE, Moore SC, Murphy RA. Metabolic profiling of adherence to diet, physical activity and body size recommendations for cancer prevention. Sci Rep 2018; 8:16293. [PMID: 30390014 PMCID: PMC6214951 DOI: 10.1038/s41598-018-34662-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 10/22/2018] [Indexed: 12/17/2022] Open
Abstract
Maintaining a healthy body weight, eating well and being physically active lowers cancer risk by 30%. However, the biology underlying these relationships is not well understood. We examined cross-sectional associations between metabolites and cancer preventive behaviors as well as the relevance to cancer-related pathways among 120 participants (50% men, mean BMI 26.6 kg/m2, mean age 54 years) with no history of smoking or cancer. Participants completed questionnaires, physical measurements and provided blood samples. Non-targeted nuclear magnetic resonance captured 223 metabolite measures. Factor analysis was performed separately for amino acid, fatty acid and lipoprotein groups. Multivariable-adjusted linear regression was used to evaluate associations between cancer preventive recommendations and metabolite-containing factors (p-value < 0.05, false discovery rate <0.20). An inflammation-related metabolite (glycoprotein acetylation) loaded strongly on a factor that was associated with excess adiposity (body fat ≥25% (men) or ≥30% (women) ß (SE) = 0.74 (0.18)) and not meeting physical activity recommendations (ß (SE) = 0.40 (0.20)). Insulin sensitivity-related metabolites including monounsaturated and polyunsaturated fats were lower among participants not meeting recommendations for adiposity, fruits and vegetables and physical activity while branched chain amino acids were higher. Cancer preventive behaviors were associated with complex metabolic signatures, including alterations in pathways known to be involved in cancer pathogenesis.
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Affiliation(s)
- Qianqian Gu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - John J Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,Cancer Control Research, BC Cancer Agency, Vancouver, BC, Canada
| | - Trevor B J Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - Steven C Moore
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
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112
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Cifu G, Arem H. Adherence to lifestyle-related cancer prevention guidelines and breast cancer incidence and mortality. Ann Epidemiol 2018; 28:767-773.e1. [DOI: 10.1016/j.annepidem.2018.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/02/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
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113
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Impact of adherence to cancer-specific prevention recommendations on subsequent risk of cancer in participants in Alberta's Tomorrow Project. Public Health Nutr 2018; 22:235-245. [PMID: 30345944 PMCID: PMC6390391 DOI: 10.1017/s1368980018002689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) publish recommendations for cancer prevention. The present study aimed to estimate the association between adherence to these cancer-specific prevention recommendations and subsequent development of cancer in a prospective cohort. Design A composite adherence score was constructed based on questionnaire data to reflect overall adherence to WCRF/AICR lifestyle-related recommendations on body fatness, physical activity, diet and alcoholic drinks. Multivariable Cox proportional hazard regression models were used to assess the association (hazard ratio; 95 % CI) between the adherence score and risk of developing cancer. Setting Alberta’s Tomorrow Project, a prospective cohort study. Participants Men and women (n 25 100, mean age at enrolment 50·5 years) recruited between 2001 and 2009 with no previous cancer diagnosis were included in analyses. Results Cancer cases (n 2066) were identified during a mean follow-up of 11·7 years. Participants who were most adherent to the selected WCRF/AICR recommendations (composite score: 4–6) were 13 % (0·87; 0·78, 0·98) less likely to develop cancer compared with those who were least adherent (composite score: 0–2). Each additional recommendation met corresponded to a 5 % (0·95; 0·91, 0·99) reduction in risk of developing cancer. When stratified by sex, the associations remained significant for women, but not for men. Conclusions Adherence to lifestyle-related cancer prevention recommendations was associated with reduced risk of developing cancer over the follow-up term in this Canadian cohort.
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Gardeazabal I, Ruiz-Canela M, Sánchez-Bayona R, Romanos-Nanclares A, Aramendía-Beitia JM, Shivappa N, Hébert JR, Martínez-González MA, Toledo E. Dietary inflammatory index and incidence of breast cancer in the SUN project. Clin Nutr 2018; 38:2259-2268. [PMID: 30344023 DOI: 10.1016/j.clnu.2018.09.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/05/2018] [Accepted: 09/25/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND & AIMS Breast cancer (BC) is the most commonly diagnosed cancer, and diet is suspected to play a role in its development. Dietary factors may mediate this process through modulation of inflammation, though findings from previous studies have not been consistent. We aimed to longitudinally assess the association between the dietary inflammatory index (DII®), a frequently used method to assess the inflammatory potential of the diet, and incident BC. METHODS We included 10,713 middle-aged, Spanish female university graduates from the SUN cohort. DII® scores were derived from a validated 136-item food-frequency questionnaire, and it was based on scientific evidence on the relationship between diet and inflammatory biomarkers. Diagnosis of BC was reported by the participant or, if deceased, by the next of kin or identified from death certificates. Self-reports of BC were confirmed by revision of medical reports by an experienced oncologist. Cox proportional hazard models were used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the association between quartiles of DII® and incident BC. RESULTS After 10.3 years of median follow-up, we identified 100 confirmed and 168 probable incident BC cases. The multivariable-adjusted HR for participants in the 4th quartile to the 1st quartile was 1.44 (95% CI 0.76-2.72; p-trend: 0.339) when confirmed cases were analyzed, and 1.20 (95% CI 0.72-1.99; p-trend: 0.757) for the probable cases. We neither observed statistically significant differences in regard to menopausal status. CONCLUSIONS The apparent increase in risk between DII® scores and BC in our cohort was not statistically significant, which could be partly explained by the small number of observed cases.
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Affiliation(s)
- I Gardeazabal
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Department of Oncology, University of Navarra Clinic, Pamplona, Spain
| | - M Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red Área de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
| | - R Sánchez-Bayona
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Department of Oncology, University of Navarra Clinic, Pamplona, Spain
| | - A Romanos-Nanclares
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | | | - N Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - J R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - M A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red Área de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - E Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red Área de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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Abstract
Cancer is increasing worldwide. Patterns of cancer are also changing. The evidence is summarised in the 2018 World Cancer Research Fund/American Institute for Cancer Research report Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. The plasticity of cancer patterns implicates environmental factors as determinants of cancer, and nutrition influences key cellular and molecular processes that characterise cancer. Epidemiology identifies associations between aspects of diet, nutrition, and physical activity with one or more cancers; there is evidence for plausible mechanisms that imply that these are causal. Some nutritional exposures (alcohol and processed meat) are likely causal factors, but no singular factor protects against cancer (except dietary fibre for colorectal cancer). Cancer protection mainly derives from a systemic metabolic environment that promotes healthy cell replication and tissue integrity. Such a nutritional state reflects avoiding excess adiposity through healthy dietary patterns rich in plant foods (legumes, wholegrains, pulses, vegetables and fruits), with modest meat, fish and dairy, low in alcohol and salt preserved foods, and an active way of life, avoiding sedentary behaviours. Less is known about the impact of nutritional interventions in people with a diagnosis of cancer, but nutrition including adiposity and physical activity predict breast cancer outcome. Promoting healthy ways of life requires public information and education, but alone these do not generate change; a socio-political and cultural environment that is conducive to adopting healthy behaviours is needed. Uncertainties in the evidence offer promising directions for future research, but sufficient is known to act as a basis for public policy and clinical practice.
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116
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Adherence to Nutrition and Physical Activity Cancer Prevention Guidelines and Development of Colorectal Adenoma. Nutrients 2018; 10:nu10081098. [PMID: 30115827 PMCID: PMC6115749 DOI: 10.3390/nu10081098] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 01/27/2023] Open
Abstract
Adherence to the American Cancer Society’s (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines is associated with reductions in overall cancer incidence and mortality, including site-specific cancers such as colorectal cancer. We examined the relationship between baseline adherence to the ACS guidelines and (1) baseline adenoma characteristics and (2) odds of recurrent colorectal adenomas over 3 years of follow-up. Cross-sectional and prospective analyses with a pooled sample of participants from the Wheat Bran Fiber (n = 503) and Ursodeoxycholic Acid (n = 854) trials were performed. A cumulative adherence score was constructed using baseline self-reported data regarding body size, diet, physical activity and alcohol consumption. Multivariable logistic regression demonstrated significantly reduced odds of having three or more adenomas at baseline for moderately adherent (odds ratio [OR] = 0.67, 95% confidence intervals [CI]: 0.46–0.99) and highly adherent (OR = 0.50, 95% CI: 0.31–0.81) participants compared to low adherers (p-trend = 0.005). Conversely, guideline adherence was not associated with development of recurrent colorectal adenoma (moderate adherence OR = 1.16, 95% CI: 0.85–1.59, high adherence OR = 1.23, 95% CI: 0.85–1.79).
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117
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Thompson R, Mitrou G, Brown S, Almond E, Bandurek I, Brockton N, Kälfors M, McGinley-Gieser D, Sinclair B, Meincke L, Wiseman M, Allen K. Major new review of global evidence on diet, nutrition and physical activity: A blueprint to reduce cancer risk. NUTR BULL 2018. [DOI: 10.1111/nbu.12345] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. Thompson
- World Cancer Research Fund International; London UK
| | - G. Mitrou
- World Cancer Research Fund International; London UK
| | - S. Brown
- World Cancer Research Fund International; London UK
| | - E. Almond
- World Cancer Research Fund International; London UK
| | - I. Bandurek
- World Cancer Research Fund International; London UK
| | - N. Brockton
- American Institute for Cancer Research; Washington DC USA
| | - M. Kälfors
- World Cancer Research Fund International; London UK
| | | | - B. Sinclair
- World Cancer Research Fund International; London UK
| | - L. Meincke
- World Cancer Research Fund International; London UK
| | - M. Wiseman
- World Cancer Research Fund International; London UK
| | - K. Allen
- World Cancer Research Fund International; London UK
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118
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Golemis EA, Scheet P, Beck TN, Scolnick EM, Hunter DJ, Hawk E, Hopkins N. Molecular mechanisms of the preventable causes of cancer in the United States. Genes Dev 2018; 32:868-902. [PMID: 29945886 PMCID: PMC6075032 DOI: 10.1101/gad.314849.118] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Annually, there are 1.6 million new cases of cancer and nearly 600,000 cancer deaths in the United States alone. The public health burden associated with these numbers has motivated enormous research efforts into understanding the root causes of cancer. These efforts have led to the recognition that between 40% and 45% of cancers are associated with preventable risk factors and, importantly, have identified specific molecular mechanisms by which these exposures modify human physiology to induce or promote cancer. The increasingly refined knowledge of these mechanisms, which we summarize here, emphasizes the need for greater efforts toward primary cancer prevention through mitigation of modifiable risk factors. It also suggests exploitable avenues for improved secondary prevention (which includes the development of therapeutics designed for cancer interception and enhanced techniques for noninvasive screening and early detection) based on detailed knowledge of early neoplastic pathobiology. Such efforts would complement the current emphasis on the development of therapeutic approaches to treat established cancers and are likely to result in far greater gains in reducing morbidity and mortality.
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Affiliation(s)
- Erica A Golemis
- Program in Molecular Therapeutics, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA
| | - Paul Scheet
- Department of Epidemiology, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA
| | - Tim N Beck
- Program in Molecular Therapeutics, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA
- Molecular and Cell Biology and Genetics Program, Drexel University College of Medicine, Philadelphia, Pennsylvania 19129, USA
| | - Eward M Scolnick
- Eli and Edythe L. Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts 02142, USA
| | - David J Hunter
- Nuffield Department of Population Health, University of Oxford, Medical Sciences Division, Oxford OX3 7LF, United Kingdom
| | - Ernest Hawk
- Division of Cancer Prevention and Population Sciences, University of Texas M.D. Anderson Cancer Center, Houston Texas 77030, USA
| | - Nancy Hopkins
- Koch Institute for Integrative Cancer Research, Biology Department, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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119
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Jayedi A, Emadi A, Shab-Bidar S. Dietary Inflammatory Index and Site-Specific Cancer Risk: A Systematic Review and Dose-Response Meta-Analysis. Adv Nutr 2018; 9:388-403. [PMID: 30032224 PMCID: PMC6054175 DOI: 10.1093/advances/nmy015] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 03/06/2018] [Indexed: 12/12/2022] Open
Abstract
Existing evidence suggests a link between the inflammatory potential of diet and risk of cancer. This study aimed to test the linear and potential nonlinear dose-response associations of the Dietary Inflammatory Index (DII), as being representative of inflammatory features of the diet, and site-specific cancer risk. A systematic search was conducted with the use of PubMed and Scopus from 2014 to November 2017. Prospective cohort or case-control studies reporting the risk estimates of any cancer type for ≥3 categories of the DII were selected. Studies that reported the association between continuous DII score and cancer risk were also included. Pooled RRs were calculated by using a random-effects model. Eleven prospective cohort studies (total n = 1,187,474) with 28,614 incident cases and 29 case-control studies with 19,718 cases and 33,229 controls were identified. The pooled RRs for a 1-unit increment in the DII were as follows: colorectal cancer, 1.06 (95% CI: 1.04, 1.08; I2 = 72.5%; n = 9); breast cancer, 1.03 (95% CI: 1.00, 1.07; I2 = 84.0%; n = 7); prostate cancer, 1.06 (95% CI: 0.97, 1.15; I2 = 56.2%; n = 6); pancreatic cancer, 1.16 (95% CI: 1.05, 1.28; I2 = 61.6%; n = 2); ovarian cancer, 1.08 (95% CI: 1.03, 1.13; I2 = 0%; n = 2); esophageal squamous cell carcinoma, 1.24 (95% CI: 1.10, 1.38; I2 = 64.3%; n = 2); renal cell carcinoma, 1.08 (95% CI: 1.02, 1.13; I2 = 0%; n = 2); and esophageal adenocarcinoma, 1.26 (95% CI: 1.13, 1.39; I2 = 0%; n = 2). A nonlinear dose-response meta-analysis showed that, after a somewhat unchanged risk within initial scores of the DII, the risk of colorectal cancer increased linearly with increasing DII score. In the analyses of breast and prostate cancers, the risk increased with a very slight trend with increasing DII score. In conclusion, the results showed that dietary habits with high inflammatory features might increase the risk of site-specific cancers.
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Affiliation(s)
- Ahmad Jayedi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Emadi
- Department of Information Technologies, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran,Address correspondence to SS-B (e-mail: )
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120
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Allen K. The importance of food, nutrition and physical activity in cancer prevention: an interview with Dr Kate Allen. Future Oncol 2018; 14:1427-1429. [DOI: 10.2217/fon-2018-0230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Kate Allen speaks to Roshaine Wijayatunga, Managing Commissioning Editor. Dr Kate Allen works as an Executive Director in Science and Public Affairs at World Cancer Research Fund International ( http://wcrf.org ), an NGO and leading authority in the field of cancer prevention through diet, weight and physical activity. Kate is responsible for the organization's scientific, policy and conference programs in the areas of food, nutrition, physical activity and weight management. An important aspect of her role is helping to create collaborative relationships and activities across the WCRF national charities (in Europe, America and Asia) in these areas, as well as maintaining and creating external partnerships. Previously, Kate worked at the Institute of Cancer Research, where she set up an award-winning Interactive Education Unit to develop learning materials for scientists, healthcare professionals, students, patients and the general public. Before that she worked at Medi Cine International, a medical education agency, where she developed educational materials across all media, mainly for specialist physician audiences. Kate has a PhD in neuroscience, carried out at the Institute of Neurology and the National Hospital for Neurology and Neurosurgery at Queen Square, London and the Royal College of Surgeons of England. The Third Expert Report that Kate mentions in the interview, featuring the updated World Cancer Research Fund Cancer Prevention Recommendations is launched 24 May 2018. For more information see http://wcrf.org .
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Affiliation(s)
- Kate Allen
- World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1B 3HH
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121
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LoConte NK, Gershenwald JE, Thomson CA, Crane TE, Harmon GE, Rechis R. Lifestyle Modifications and Policy Implications for Primary and Secondary Cancer Prevention: Diet, Exercise, Sun Safety, and Alcohol Reduction. Am Soc Clin Oncol Educ Book 2018; 38:88-100. [PMID: 30231343 DOI: 10.1200/edbk_200093] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Improved cancer treatments and cancer detection methods are not likely to completely eradicate the burden of cancer. Primary prevention of cancer is a logical strategy to use to control cancer while also seeking novel treatments and earlier detection. Lifestyle modification strategies to improve primary prevention and risk reduction for the development of cancer include choosing a healthy diet with an emphasis on plant sources, maintaining a healthy weight throughout life, being physically active, regularly using sunscreen and wearing protective clothing, limiting sun exposure during the hours of 10 AM to 2 PM, avoiding indoor tanning, and reducing or eliminating alcohol use. In addition to continued use of ongoing education of the public, health care providers, and cancer support communities, other policy and public health efforts should be pursued as well. Examples of supported and successful policy approaches are included in this article, including efforts to limit indoor tanning and improve community-wide interventions to reduce ultraviolet radiation exposure as well as to formally support various alcohol policy strategies including increasing alcohol taxes, reducing alcohol outlet density, improving clinical screening for alcohol use disorders, and limiting youth exposure to alcohol marketing and advertising. These prevention strategies are expected to have the largest impact on the development of melanoma as well as breast, colorectal, head and neck, liver, and esophageal cancers. The impact of these strategies as secondary prevention is less well understood. Areas of additional needed research and implementation are also highlighted. Future areas of needed research are the effects of these modifications after the diagnosis of cancer (as secondary prevention).
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Affiliation(s)
- Noelle K LoConte
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jeffrey E Gershenwald
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Cynthia A Thomson
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tracy E Crane
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gil E Harmon
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ruth Rechis
- From the Carbone Cancer Center and University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Surgical Oncology, Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ; Biobehavioral Health Sciences Division, College of Nursing, University of Arizona Cancer Center, Tucson, AZ; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI; Be Well Communities, Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX
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122
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Hansra DM, McIntyre K, Ramdial J, Sacks S, Patrick CS, Cutler J, McIntyre B, Feister K, Miller M, Taylor AK, Farooq F, de Mayolo JA, Ahn E. Evaluation of How Integrative Oncology Services Are Valued between Hematology/Oncology Patients and Hematologists/Oncologists at a Tertiary Care Center. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:8081018. [PMID: 29849727 PMCID: PMC5925032 DOI: 10.1155/2018/8081018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/28/2017] [Accepted: 01/04/2018] [Indexed: 11/20/2022]
Abstract
Evidence regarding opinions on integrative modalities by patients and physicians is lacking. Methods. A survey study was conducted assessing how integrative modalities were valued among hematology/oncology patients and hematologists and oncologists at a major tertiary medical center. Results. 1008 patients and 55 physicians were surveyed. With the exception of support groups, patients valued nutrition services, exercise therapy, spiritual/religious counseling, supplement/herbal advice, support groups, music therapy, and other complimentary medicine services significantly more than physicians (P ≤ 0.05). Conclusion. With the exception of support groups, patients value integrative modalities more than physicians. Perhaps with increasing education, awareness, and acceptance by providers and traditional institutions, integrative modalities could be equally valued between patients and providers. It is possible that increased availability and utilization of integrative oncology modalities at tertiary hospital sites could improve patient satisfaction, quality of life, and other clinical endpoints.
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Affiliation(s)
- D. M. Hansra
- Cancer Treatment Centers of America, Atlanta, GA, USA
- Jackson Memorial Hospital, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - K. McIntyre
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - J. Ramdial
- Jackson Memorial Hospital, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - S. Sacks
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - C. S. Patrick
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - J. Cutler
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - B. McIntyre
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - K. Feister
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - M. Miller
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - A. K. Taylor
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - F. Farooq
- Jackson Memorial Hospital, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | | | - E. Ahn
- Cancer Treatment Centers of America, Atlanta, GA, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
- Miller School of Medicine, University of Miami, Miami, FL, USA
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123
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Buono R, Longo VD. Starvation, Stress Resistance, and Cancer. Trends Endocrinol Metab 2018; 29:271-280. [PMID: 29463451 PMCID: PMC7477630 DOI: 10.1016/j.tem.2018.01.008] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 12/20/2022]
Abstract
Cancer cells are characterized by dysregulation in signal transduction and metabolic pathways leading to increased glucose uptake, altered mitochondrial function, and the evasion of antigrowth signals. Fasting and fasting-mimicking diets (FMDs) provide a particularly promising intervention to promote differential effects in normal and malignant cells. These effects are caused in part by the reduction in IGF-1, insulin, and glucose and the increase in IGFBP1 and ketone bodies, which generate conditions that force cancer cells to rely more on metabolites and factors that are limited in the blood, thus resulting in cell death. Here we discuss the cellular and animal experiments demonstrating the differential effects of fasting on normal and cancer cells and the mechanisms responsible for these effects.
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Affiliation(s)
- Roberta Buono
- Longevity Institute, School of Gerontology, Department of Biological Sciences, University of Southern California, 3715 McClintock Avenue, Los Angeles, CA 90089-0191, USA; IFOM FIRC Institute of Molecular Oncology, Via Adamello 16, 20139 Milan, Italy
| | - Valter D Longo
- Longevity Institute, School of Gerontology, Department of Biological Sciences, University of Southern California, 3715 McClintock Avenue, Los Angeles, CA 90089-0191, USA; IFOM FIRC Institute of Molecular Oncology, Via Adamello 16, 20139 Milan, Italy; Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research at USC, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Safe S, Abbruzzese J, Abdelrahim M, Hedrick E. Specificity Protein Transcription Factors and Cancer: Opportunities for Drug Development. Cancer Prev Res (Phila) 2018; 11:371-382. [PMID: 29545399 DOI: 10.1158/1940-6207.capr-17-0407] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/14/2018] [Accepted: 02/28/2018] [Indexed: 02/06/2023]
Abstract
Specificity protein (Sp) transcription factors (TFs) such as Sp1 are critical for early development but their expression decreases with age and there is evidence that transformation of normal cells to cancer cells is associated with upregulation of Sp1, Sp3, and Sp4, which are highly expressed in cancer cells and tumors. Sp1 is a negative prognostic factor for pancreatic, colon, glioma, gastric, breast, prostate, and lung cancer patients. Functional studies also demonstrate that Sp TFs regulate genes responsible for cancer cell growth, survival, migration/invasion, inflammation and drug resistance, and Sp1, Sp3 and Sp4 are also nononcogene addiction (NOA) genes and important drug targets. The mechanisms of drug-induced downregulation of Sp TFs and pro-oncogenic Sp-regulated genes are complex and include ROS-dependent epigenetic pathways that initially decrease expression of the oncogene cMyc. Many compounds such as curcumin, aspirin, and metformin that are active in cancer prevention also exhibit chemotherapeutic activity and these compounds downregulate Sp TFs in cancer cell lines and tumors. The effects of these compounds on downregulation of Sp TFs in normal cells and the contribution of this response to their chemopreventive activity have not yet been determined. Cancer Prev Res; 11(7); 371-82. ©2018 AACR.
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Affiliation(s)
- Stephen Safe
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, Texas.
| | - James Abbruzzese
- Department of Medicine, Division of Oncology, Duke University School of Medicine, Durham, North Carolina
| | - Maen Abdelrahim
- GI Medical Oncology, Cockrell Center for Advanced Therapeutics, Houston Methodist Cancer Center and Institute of Academic Medicine, Houston, Texas
| | - Erik Hedrick
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, Texas
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Coviello JS. Cardiovascular and Cancer Risk: The Role of Cardio-oncology. J Adv Pract Oncol 2018; 9:160-176. [PMID: 30588351 PMCID: PMC6303003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cardio-oncology is a subspecialty of cardiology. It was created to address oncology data indicating that newly developed drugs for cancer treatment were having unanticipated cardiac side effects. Cardio-oncology designs primary and secondary risk strategies through surveillance as well as interventions to reduce cardiovascular risk (CVR), prevent cardiotoxicities, and manage the side effects that may occur. Rather than discuss in detail the cardiotoxicities of specific therapies or radiation, this review article will explore the interplay of cancer, cancer treatment, and CVR. It will examine the link between CVR and cancer risk, define mechanisms associated with cardiotoxicity, and describe screening and surveillance for patients undergoing cancer treatment. Finally, effective preventative and management strategies used to reduce the incidence of cardiotoxicities in those receiving chemotherapeutics or radiation will be presented.
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Senatorov IS, Moniri NH. The role of free-fatty acid receptor-4 (FFA4) in human cancers and cancer cell lines. Biochem Pharmacol 2018; 150:170-180. [PMID: 29452095 DOI: 10.1016/j.bcp.2018.02.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 02/12/2018] [Indexed: 12/12/2022]
Abstract
A dietary influence on cancer progression has been evident for many decades, and dietary fatty acids, particularly long chain mono- and polyunsaturated fatty acids, have been shown to play significant roles in influencing growth of a variety of human cancers. The discovery of the family of cell-surface free-fatty acid receptors, which include the long-chain fatty acid receptors FFA1 and FFA4, suggest that many of the effects of dietary fats could be receptor-mediated. FFA4 is ubiquitously expressed and has recently been shown to modulate a variety of important anti-inflammatory and metabolic processes. Since FFA4 is currently an attractive drug target for treatment of metabolic disorders such as diabetes and obesity, understanding its role in cancer progression is critical towards the drug discovery process. In this research update, the current body of knowledge on the role of this receptor in regulating cancer cell proliferation, migration, and invasion, as well as in vivo tumorigenesis is reviewed.
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Affiliation(s)
- Ilya S Senatorov
- Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University Health Sciences Center, Mercer University, Atlanta, GA 30341, United States
| | - Nader H Moniri
- Department of Pharmaceutical Sciences, College of Pharmacy, Mercer University Health Sciences Center, Mercer University, Atlanta, GA 30341, United States.
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Høgsbro C, Davidsen M, Sørensen J. Long-term sickness absence from work due to physical inactivity: A registry-based study. Scand J Public Health 2018; 46:306-313. [PMID: 29366394 DOI: 10.1177/1403494817751328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aim of this study was to explore the relationship between leisure-time physical inactivity and long-term sickness absence in a representative sample of individuals aged 16-54 years, within the labour market and in good health. It was hypothesised that physically inactive individuals have a higher risk of long-term sickness absence and longer duration of sickness absence. METHODS The study population was identified from the National Health and Morbidity Survey, 2010. Weekly data on long-term sickness absence were obtained from the National Register on Social Transfer Payments (the DREAM registry). The association of incidence and duration of long-term sickness absence with physical inactivity was explored using logistic and Poisson regression. Data were fitted to models with levels of physical activity, demographic, social and lifestyle characteristics as independent variables. A combined hurdle model was used to estimate the difference in mean number of absence weeks. RESULTS Logistic regression showed that physically inactive individuals had a 27% higher incidence of long-term sickness absence compared with physically active individuals. The Poisson regression showed that long-term sickness absence was only slightly shorter (1 week less) for moderately active individuals compared with inactive individuals. The hurdle model estimated longer absence periods for inactive individuals (additional 2.5 weeks) in comparison with moderately and highly active individuals. CONCLUSIONS The study showed that physically inactive individuals have a higher incidence of long-term absence and that physically inactive individuals have longer periods with sickness absence than moderately and highly active individuals. When adjustments for social and health behaviour were included, the estimated associations became statistically insignificant.
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Affiliation(s)
- Cecilie Høgsbro
- 1 COHERE - Centre for Health Economics Research, University of Southern Denmark, Denmark
| | - Michael Davidsen
- 2 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Jan Sørensen
- 1 COHERE - Centre for Health Economics Research, University of Southern Denmark, Denmark.,3 Healthcare Outcome Research Centre, Royal College of Surgeons in Ireland, Ireland
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Aleksandrova K, Jenab M, Leitzmann M, Bueno-de-Mesquita B, Kaaks R, Trichopoulou A, Bamia C, Lagiou P, Rinaldi S, Freisling H, Carayol M, Pischon T, Drogan D, Weiderpass E, Jakszyn P, Overvad K, Dahm CC, Tjønneland A, Bouton-Ruault MC, Kühn T, Peppa E, Valanou E, La Vecchia C, Palli D, Panico S, Sacerdote C, Agnoli C, Tumino R, May A, van Vulpen J, Benjaminsen Borch K, Oluwafemi Oyeyemi S, Quirós JR, Bonet C, Sánchez MJ, Dorronsoro M, Navarro C, Barricarte A, van Guelpen B, Wennberg P, Key TJ, Khaw KT, Wareham N, Assi N, Ward HA, Aune D, Riboli E, Boeing H. Physical activity, mediating factors and risk of colon cancer: insights into adiposity and circulating biomarkers from the EPIC cohort. Int J Epidemiol 2017; 46:1823-1835. [PMID: 29025032 PMCID: PMC6241846 DOI: 10.1093/ije/dyx174] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 12/11/2022] Open
Abstract
Background There is convincing evidence that high physical activity lowers the risk of colon cancer; however, the underlying biological mechanisms remain largely unknown. We aimed to determine the extent to which body fatness and biomarkers of various biologically plausible pathways account for the association between physical activity and colon cancer. Methods We conducted a nested case-control study in a cohort of 519 978 men and women aged 25 to 70 years followed from 1992 to 2003. A total of 713 incident colon cancer cases were matched, using risk-set sampling, to 713 controls on age, sex, study centre, fasting status and hormonal therapy use. The amount of total physical activity during the past year was expressed in metabolic equivalent of task [MET]-h/week. Anthropometric measurements and blood samples were collected at study baseline. Results High physical activity was associated with a lower risk of colon cancer: relative risk ≥91 MET-h/week vs <91 MET-h/week = 0.75 [95% confidence interval (CI): 0.57 to 0.96]. In mediation analyses, this association was accounted for by waist circumference: proportion explained effect (PEE) = 17%; CI: 4% to 52%; and the biomarkers soluble leptin receptor (sOB-R): PEE = 15%; 95% CI: 1% to 50% and 5-hydroxyvitamin D (25[OH]D): PEE = 30%; 95% CI: 12% to 88%. In combination, these factors explained 45% (95% CI: 20% to 125%) of the association. Beyond waist circumference, sOB-R and 25[OH]D additionally explained 10% (95% CI: 1%; 56%) and 23% (95% CI: 6%; 111%) of the association, respectively. Conclusions Promoting physical activity, particularly outdoors, and maintaining metabolic health and adequate vitamin D levels could represent a promising strategy for colon cancer prevention.
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Affiliation(s)
- Krasimira Aleksandrova
- Nutrition, Immunity and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Mazda Jenab
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany
| | - Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, the Netherlands
- Division of Epidemiology, Public Health and Primary Care, Imperial College, London, United Kingdom
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens (NKUA), Medical School, Athens, Greece
| | - Christina Bamia
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens (NKUA), Medical School, Athens, Greece
| | - Pagona Lagiou
- Hellenic Health Foundation, Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, USA
| | - Sabina Rinaldi
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Heinz Freisling
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Marion Carayol
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Tobias Pischon
- Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine (MDC), Berlin-Buch, Germany
| | - Dagmar Drogan
- Quality and Health Services Research Unit, AOK Research Institute, Berlin, Germany (DD)
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhalsan Research Center, Helsinki, Finland
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, Barcelona, Spain
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Christina C Dahm
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center Copenhagen, Denmark
| | - Marie-Christine Bouton-Ruault
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team,F-94805, Villejuif, France
- Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France
- IGR, F-94805, Villejuif, France
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | | | | | - Carlo La Vecchia
- Hellenic Health Foundation, Athens, Greece
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - Salvatore Panico
- Department of clinical and experimental medicine-Federico II University, Naples, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, “M.P.Arezzo” Hospital, Ragusa, Italy
| | - Anne May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht
| | - Jonna van Vulpen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht
| | - Kristin Benjaminsen Borch
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Sunday Oluwafemi Oyeyemi
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | | | - Catalina Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, Barcelona, Spain
| | - María-José Sánchez
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Spain
| | - Miren Dorronsoro
- Epidemiology and Health Information, Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain
| | - Carmen Navarro
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Aurelio Barricarte
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Spain
- Navarre Public Health Institute, Pamplona, Navarra, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Spain
| | | | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Nicholas Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Nada Assi
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Heather A Ward
- Division of Epidemiology, Public Health and Primary Care, Imperial College, London, United Kingdom
| | - Dagfinn Aune
- Division of Epidemiology, Public Health and Primary Care, Imperial College, London, United Kingdom
| | - Elio Riboli
- Division of Epidemiology, Public Health and Primary Care, Imperial College, London, United Kingdom
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
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Turati F, Bravi F, Di Maso M, Bosetti C, Polesel J, Serraino D, Dalmartello M, Giacosa A, Montella M, Tavani A, Negri E, La Vecchia C. Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations and colorectal cancer risk. Eur J Cancer 2017; 85:86-94. [DOI: 10.1016/j.ejca.2017.08.015] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/26/2017] [Accepted: 08/07/2017] [Indexed: 02/07/2023]
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131
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Helander S, Heinävaara S, Sarkeala T, Malila N. Lifestyle in population-based colorectal cancer screening over 2-year follow-up. Eur J Public Health 2017; 28:333-338. [DOI: 10.1093/eurpub/ckx139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Sanni Helander
- Mass Screening Registry, Finnish Cancer Registry, Helsinki, Finland
| | - Sirpa Heinävaara
- Mass Screening Registry, Finnish Cancer Registry, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tytti Sarkeala
- Mass Screening Registry, Finnish Cancer Registry, Helsinki, Finland
| | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland
- Faculty of Social Sciences (Health sciences), University of Tampere, Tampere, Finland
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Shapira N. The potential contribution of dietary factors to breast cancer prevention. Eur J Cancer Prev 2017; 26:385-395. [PMID: 28746163 PMCID: PMC5553235 DOI: 10.1097/cej.0000000000000406] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/21/2017] [Indexed: 12/30/2022]
Abstract
Breast cancer (BC), the leading cancer in women, is increasing in prevalence worldwide, concurrent with western metabolic epidemics, that is, obesity, metabolic syndrome, and diabetes, and shares major risk factors with these diseases. The corresponding potential for nutritional contributions toward BC prevention is reviewed and related to critical stages in the life cycle and their implications for carcinogenic and pathometabolic trajectories. BC initiation potentially involves diet-related pro-oxidative, inflammatory, and procarcinogenic processes, that interact through combined lipid/fatty acid peroxidation, estrogen metabolism, and related DNA-adduct/depurination/mutation formation. The pathometabolic trajectory is affected by high estrogen, insulin, and growth factor cascades and resultant accelerated proliferation/progression. Anthropometric risk factors - high birth weight, adult tallness, adiposity/BMI, and weight gain - are often reflective of these trends. A sex-based nutritional approach targets women's specific risk in western obesogenic environments, associated with increasing fatness, estrogen metabolism, n-6 : n-3 polyunsaturated fatty acid ratio, and n-6 polyunsaturated fatty acid conversion to proinflammatory/carcinogenic eicosanoids, and effects of timing of life events, for example, ages at menarche, full-term pregnancy, and menopause. Recent large-scale studies have confirmed the effectiveness of the evidence-based recommendations against BC risk, emphasizing low-energy density diets, highly nutritious plant-based regimes, physical activity, and body/abdominal adiposity management. Better understanding of dietary inter-relationships with BC, as applied to food intake, selection, combination, and processing/preparation, and recommended patterns, for example, Mediterranean, DASH, plant-based, low energy density, and low glycemic load, with high nutrient/phytonutrient density, would increase public motivation and authoritative support for early/timely prevention, optimally merging with other dietary/health goals, for lifelong BC prevention.
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Affiliation(s)
- Niva Shapira
- Department of Nutrition, School of Health Professions, Ashkelon Academic College, Ashkelon, Israel
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133
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Affiliation(s)
- M. Wiseman
- University of Southampton; Southampton UK
- World Cancer Research Fund (WCRF) International; London UK
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134
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Trachootham D, Chingsuwanrote P, Yoosadiang P, Mekkriangkrai D, Ratchawong T, Buraphacheep N, Kijanukul S, Saekhow S, Pongpitchayadej O, Vongvachvasin K, Sittikornpaiboon P, Tuntipopipat S. Partial Substitution of Glucose with Xylitol Suppressed the Glycolysis and Selectively Inhibited the Proliferation of Oral Cancer Cells. Nutr Cancer 2017; 69:862-872. [PMID: 28718681 DOI: 10.1080/01635581.2017.1339097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Suitable diet for cancer survivors remains an unresolved challenge. Increased glucose utilization is a hallmark of various cancers. Therefore, alternative carbohydrate supplying normal tissue but retarding cancer growth is needed. This study investigated the effect of sugar alcohols on the proliferation of oral cancer cells compared to nontransformed cells and explored the mechanism. Six oral squamous cell carcinoma (CAL-27, FaDu, SCC4, SCC9, SCC15, and SCC25) and one nontransformed oral keratinocyte (OKF6/TERT2) lines were cultured in media containing 1 mg/ml glucose and 5.8 mg/ml xylitol or sorbitol, yielding equal energy input to control group (4.5 mg/ml glucose). Partial substitution of glucose with sugar alcohols especially xylitol significantly suppressed proliferation of oral cancer but not nontransformed cells. Despite the addition of isocaloric quantities of the sugars, cancer cells exposed to low glucose plus xylitol had retarded ATP generation and decreased activity of phosphofructokinase (PFK), the rate-limiting enzyme in glycolysis. Furthermore, D-xylulose, its key metabolic intermediate, enhanced the anticancer effect of xylitol. These findings suggested a selective anticancer activity of xylitol and the potential mechanism involving inhibition of glucose utilization. Partial substitution of glucose with xylitol may be a proper nutrient for oral cancer survivors, deserving further investigation in animal and clinical settings.
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Affiliation(s)
| | - Pimjai Chingsuwanrote
- b Siriraj Center of Excellence for Stem Cell Research, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | | | | | | | | | | | - Sumrit Saekhow
- h Vichaivej, Nongkhaem Hospital , Nongkhaem, Bangkok , Thailand
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Lucas AR, Levine B, Avis NE. Posttreatment trajectories of physical activity in breast cancer survivors. Cancer 2017; 123:2773-2780. [PMID: 28272835 PMCID: PMC5498227 DOI: 10.1002/cncr.30641] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/18/2017] [Accepted: 02/02/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Breast cancer survivors face a risk of disease recurrence and a higher risk of developing comorbidities such as cardiovascular disease when compared with the general population. Physical activity (PA) has been shown to reduce such risks. The current analyses sought to identify: 1) unique patterns of PA among breast cancer survivors; and 2) characteristics associated with the level of PA. METHODS A total of 548 women reported PA and sociodemographic, health-related, and psychosocial factors at 3 time points, 6 months apart, after primary treatment of breast cancer. Cancer-related factors were obtained from chart reviews. Finite mixture modeling was used to examine trajectory groups of moderate-intensity to vigorous-intensity PA (MVPA) in the early posttreatment period. The authors then examined the characteristics associated with trajectory group membership. RESULTS Three groups with distinct, stable patterns of PA were identified: the low MVPA (42.5% of patients), medium MVPA (45.5% of patients), and high MVPA (12.0% of patients) groups. In a multivariable setting, compared with more active breast cancer survivors, the least active group was found to have a higher body mass index, were less likely to report alcohol consumption, were more likely to smoke cigarettes, and had worse physical functioning and vitality scores. Cancer treatment-related factors did not significantly predict group membership. CONCLUSIONS A large percentage of breast cancer survivors remain physically inactive after treatment, suggesting the need for interventions to reduce morbidity and mortality in this population. Cancer 2017;123:2773-80. © 2017 American Cancer Society.
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Affiliation(s)
- Alexander R. Lucas
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Beverly Levine
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Nancy E. Avis
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
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Reb A, Ruel N, Fakih M, Lai L, Salgia R, Ferrell B, Sampath S, Kim JY, Raz DJ, Sun V. Empowering survivors after colorectal and lung cancer treatment: Pilot study of a Self-Management Survivorship Care Planning intervention. Eur J Oncol Nurs 2017; 29:125-134. [PMID: 28720259 DOI: 10.1016/j.ejon.2017.06.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE This study evaluates the feasibility and acceptability of a Self-Management Survivorship Care Planning (SM-SCP) intervention in colorectal and lung cancer survivors. METHODS This is a single-group, pre- and post-mixed methods study of an advance practice nurse-driven survivorship care intervention that integrates a survivorship care plan with self-management skills coaching. Colorectal and lung cancer survivors with stage I-III disease were enrolled at 3-6 months after completing treatments, and the intervention was administered in one in-person or telephone session. Survivor outcome measures included depression, anxiety, self-efficacy, QOL, and satisfaction. Paired t-tests were used for exploratory evaluations of pre-to post-intervention score changes. Content analysis was conducted to analyze the qualitative data to describe survivors' experience with the intervention. RESULTS Thirty participants (15 colorectal, 15 lung) enrolled and completed the study (73% retention). It took an average of 40 min to complete the TS/CP and 34.2 min to deliver the intervention. Exploratory analysis revealed significant differences from baseline to post-intervention in depression, anxiety, self-efficacy, physical functioning, role limitations-physical, pain, general health, health transition, physical health summary, and total QOL. Three qualitative themes emerged: 1) Feeling empowered about having a plan; 2) Struggling with psychosocial concerns; and 3) Suggestions for intervention content and delivery. CONCLUSIONS The SM-SCP intervention was feasible and acceptable for colorectal and lung cancer survivors after treatment completion. Survivorship care interventions have potential to fulfill the unmet needs of colorectal and lung cancer survivors. Their effectiveness might be greater by integrating conceptually-based models of care, such as self-management skills building.
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Affiliation(s)
- Anne Reb
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Nora Ruel
- Biostatistics Core, Department of Information Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Marwan Fakih
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Lily Lai
- Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Ravi Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Sagus Sampath
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States.
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Park J, Kim JH, Lee HJ, Park SJ, Hong SP, Cheon JH, Kim WH, Park JS, Jeon JY, Kim TI. The Effects of Physical Activity and Body Fat Mass on Colorectal Polyp Recurrence in Patients with Previous Colorectal Cancer. Cancer Prev Res (Phila) 2017; 10:478-484. [PMID: 28584169 DOI: 10.1158/1940-6207.capr-17-0065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/23/2017] [Accepted: 06/01/2017] [Indexed: 11/16/2022]
Abstract
We aimed to identify the effects of physical activity and body composition on colorectal polyp recurrence in patients with previous colorectal cancer. A total of 300 patients were selected randomly from the colorectal cancer survivor cohort of Severance Hospital (Seoul, Korea). Patients reported various recreational physical activities and received surveillance colonoscopy. Body composition was measured with a body composition analyzer. We compared patients who exercised for at least 1 hour/week (active) with those who exercised less frequently or not at all (sedentary). The active exercise group (n = 203) had a lower recurrence of advanced adenoma than the sedentary group (n = 97; 6.4% vs. 14.4%, P = 0.023). The prevalence of advanced adenoma recurrence decreased in an exercise dose-dependent manner (Ptrend = 0.019). In multivariate logistic analysis, the independent factors associated with advanced polyp recurrence were body fat mass [OR, 7.601; 95% confidence interval (CI), 1.583-36.485; P = 0.011] and active exercise (OR, 0.340; 95% CI, 0.143-0.809; P = 0.015). In Cox proportional hazards models, body fat mass (HR, 5.315; 95% CI, 1.173-24.083; P = 0.030) and active exercise (HR, 0.367; 95% CI, 0.162-0.833; P = 0.017) were the independent factors associated with cumulative advanced adenoma recurrence. In conclusion, exercising for at least 1 hour/week and low body fat mass were found to be related to lower rates of colorectal polyp recurrence in the surveillance of colorectal cancer survivors. Cancer Prev Res; 10(8); 478-84. ©2017 AACR.
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Affiliation(s)
- Jihye Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Jae Hyun Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Hyun Jung Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Soo Jung Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Sung Pil Hong
- Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Jae Hee Cheon
- Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Won Ho Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Ji Soo Park
- Cancer Prevention Center, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Justin Y Jeon
- Cancer Prevention Center, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Tae Il Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea. .,Institute of Gastroenterology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.,Cancer Prevention Center, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
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138
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Sauer AG, Siegel RL, Jemal A, Fedewa SA. Updated Review of Prevalence of Major Risk Factors and Use of Screening Tests for Cancer in the United States. Cancer Epidemiol Biomarkers Prev 2017; 26:1192-1208. [DOI: 10.1158/1055-9965.epi-17-0219] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/21/2017] [Accepted: 05/11/2017] [Indexed: 11/16/2022] Open
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Husaini B, Levine R, Lammers P, Hull P, Novotny M, Moonis M. Smoking, depression, and hospital costs of respiratory cancers: Examining race and sex variation. Fam Med Community Health 2017; 5:29-42. [PMID: 29057243 PMCID: PMC5648368 DOI: 10.15212/fmch.2017.0109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The role of smoking and depression relative to hospital cost for lung cancer (LC) remains unknown. METHODS We extracted data on depression, smoking history, demographics, and hospital charges on patients with respiratory cancers (ICD-9 codes 161-163,165) from the 2008 Tennessee Hospital Discharge Data System. The sample (n=6,665) was mostly white (86%) and male (57). Age-adjusted rates were developed per CDC methodology, and hospital costs were compared for LC with vs. without depression and smoking. RESULTS Three findings (p<.001) emerged: (i) LC rate was higher among blacks than whites, and higher among males than females; (ii) While 66% of LC smoked (more males than females without racial variation), 24% had depression (more females and whites were depressed); (iii) The LC hospital cost was 54% higher compared to non-LC, and this cost doubled for LC with depression and smoking vs. those without such characteristics. CONCLUSION While LC is more prevalent among blacks and males, depression is higher among female and white patients. Since depression with higher costs existed among LC patients, our findings point to: (i) possibility of cost savings by diagnosing and treating depression among LC, and (ii) implementing proven smoking cessation programs to reduce LC morbidity and hospital costs.
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Affiliation(s)
- Baqar Husaini
- Tennessee State University, Nashville, Tennessee 37209
| | | | | | - Pam Hull
- Vanderbilt University, Nashville, Tennessee 37240
| | | | - Majaz Moonis
- University of Massachusetts, Worcester, Massachusetts 01655
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140
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van den Brandt PA, Schulpen M. Mediterranean diet adherence and risk of postmenopausal breast cancer: results of a cohort study and meta-analysis. Int J Cancer 2017; 140:2220-2231. [DOI: 10.1002/ijc.30654] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 02/08/2017] [Indexed: 01/13/2023]
Affiliation(s)
- Piet A. van den Brandt
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology; Maastricht University Medical Centre; Maastricht the Netherlands
- Department of Epidemiology, CAPHRI - School for Public Health and Primary Care; Maastricht University Medical Centre; Maastricht the Netherlands
| | - Maya Schulpen
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology; Maastricht University Medical Centre; Maastricht the Netherlands
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141
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Tabung FK, Fung TT, Chavarro JE, Smith-Warner SA, Willett WC, Giovannucci EL. Associations between adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and biomarkers of inflammation, hormonal, and insulin response. Int J Cancer 2017; 140:764-776. [PMID: 27798951 PMCID: PMC5167632 DOI: 10.1002/ijc.30494] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/28/2016] [Accepted: 10/17/2016] [Indexed: 12/26/2022]
Abstract
Adherence to the 2007 WCRF/AICR cancer prevention recommendations has been associated with lower cancer risk but the underlying biological mechanisms have not been elucidated. We utilized dietary and lifestyle data from 11,342 women in the Nurses' Health Study and 8,136 men in the Health Professionals Follow-up Study, to investigate associations between adherence scores and markers of inflammation, hormonal and insulin response. Two scores ranging from 0 to 3 were constructed to assess adherence to the energy balance-related recommendations (weight management, physical activity, energy density); and the plant, animal foods and alcohol intake recommendations; with higher scores indicating greater adherence. The following biomarkers were assessed in plasma samples donated by chronic disease-free women (1990) and men (1994): C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α receptor 2 (TNFαR2) and adiponectin for inflammation; estrone and estradiol for hormonal response in women, C-peptide for hyperinsulinemia; and triglycerides/high density lipoprotein-cholesterol (TG/HDL) ratio for insulin resistance. In multivariable-adjusted linear regression analyses, we estimated relative concentrations of biomarkers across adherence categories. There was a significant trend of lower (higher for adiponectin) biomarker concentrations with higher adherence to the energy balance recommendations (all p trend <0.0001). Comparing the highest (3) to the lowest recommendation category (0-1), the percent difference in relative concentrations of biomarkers was CRP, -69%; IL6, -41%; TNFαR2, -13%; adiponectin, +36%; C-peptide, -43%; TG/HDL, -43%; estrone, -31%; and estradiol, -43%; in women; and CRP, -59%; IL6, -42%; TNFαR2, -10%; adiponectin, +22%; C-peptide, -44%; and TG/HDL, -40%; in men. In contrast, associations between adherence to the plant, animal foods and alcohol intake recommendations and biomarker concentrations were weaker, and mostly nonsignificant. The healthier biomarker profile associated with greater adherence to the WCRF/AICR cancer prevention recommendations is driven mainly by adherence to the energy balance-related recommendations.
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Affiliation(s)
- Fred K Tabung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Teresa T Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Nutrition, Simmons College, Boston, MA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Womens' Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Stephanie A Smith-Warner
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Womens' Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Womens' Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
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142
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Kohler LN, Hibler EA, Harris RB, Oren E, Roe DJ, Jurutka PW, Jacobs ET. Greater Adherence to Cancer Prevention Guidelines Is Associated with Higher Circulating Concentrations of Vitamin D Metabolites in a Cross-Sectional Analysis of Pooled Participants from 2 Chemoprevention Trials. J Nutr 2017; 147:421-429. [PMID: 28122932 DOI: 10.3945/jn.116.243352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 11/28/2016] [Accepted: 01/04/2017] [Indexed: 12/14/2022] Open
Abstract
Background: Several lifestyle factors targeted by the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines are also associated with circulating concentrations of vitamin D metabolites. This suggests that greater adherence to the ACS guidelines may be related to better vitamin D status.Objective: We examined the relation between adherence to the ACS guidelines and circulating concentrations of 2 vitamin D metabolites, 25-hydroxycholecalciferol [25(OH)D] and 1α,25-dihydroxyvitamin D [1,25(OH)2D].Methods: We conducted cross-sectional analyses of pooled participants from the Wheat Bran Fiber (n = 503) and Ursodeoxycholic Acid (n = 854) trials. A cumulative adherence score was constructed with the use of baseline data on body size, diet, physical activity, and alcohol consumption. Continuous vitamin D metabolite concentrations and clinically relevant categories were evaluated with the use of multiple linear and logistic regression models, respectively.Results: The most adherent participants were more likely to be older, white, and nonsmokers than were the least adherent. A statistically significant association was observed between guideline adherence and concentrations of circulating 25(OH)D (means ± SEs-high adherence: 32.0 ± 0.8 ng/mL; low adherence: 26.4 ± 0.7 ng/mL; P-trend < 0.001). For 1,25(OH)2D concentrations, high adherence was again significantly related to greater metabolite concentrations, with mean ± SE concentrations of 36.3 ± 1.3 pg/mL and 31.9 ± 1.0 pg/mL for high- and low-adherers, respectively (P-trend = 0.008). Furthermore, the odds of attaining a sufficient 25(OH)D status were 4.37 times higher for those most adherent than for those least adherent (95% CI: 2.47, 7.71 times).Conclusion: These findings demonstrate that greater adherence to the ACS guidelines is associated with higher circulating concentrations of both of 25(OH)D and 1,25(OH)2D.
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Affiliation(s)
- Lindsay N Kohler
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and
| | - Elizabeth A Hibler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and.,University of Arizona Cancer Center, Tucson, AZ
| | - Eyal Oren
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and
| | - Denise J Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and.,University of Arizona Cancer Center, Tucson, AZ
| | - Peter W Jurutka
- School of Mathematical and Natural Sciences, Arizona State University, Phoenix, AZ; and.,Department of Basic Medical Sciences, University of Arizona College of Medicine, Phoenix, AZ
| | - Elizabeth T Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, and .,Department of Nutritional Sciences, University of Arizona, Tucson, AZ.,University of Arizona Cancer Center, Tucson, AZ
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Racial and Ethnic Differences in Dietary Intake, Physical Activity, and Body Mass Index (BMI) Among Cancer Survivors: 2005 and 2010 National Health Interview Surveys (NHIS). J Racial Ethn Health Disparities 2017; 4:1138-1146. [PMID: 28078657 DOI: 10.1007/s40615-016-0319-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/10/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This paper reports racial/ethnic differences in mean dietary and alcohol intake, physical activity, and body mass index (BMI) among cancer survivors and examines adherence to the American Cancer Society and the US Dietary Guidelines for Americans. METHODS Data are from the cross-sectional 2005 and 2010 National Health Interview Surveys (NHIS). The total sample of cancer survivors (N = 3367) included non-Hispanic Whites (NHW; N = 2698), non-Hispanic Blacks (NHBs; N = 379), and Hispanics (N = 290). We compared mean reported dietary intake, moderate/vigorous physical activity, and BMI among racial/ethnic groups. Predicted marginals and multivariate logistic regression analysis were used to compare prevalence of non-adherence with recommendations among groups. RESULTS Among the three racial/ethnic groups, Hispanics had the highest mean intake of vegetables, fiber, and calcium (p = 0.0003; p < 0.0001; p = 0.001). In the logistic regression model adjusting for sociodemographic covariates, smoking and BMI, Hispanics had lower non-adherence to fiber guidelines (OR = 0.38; CI = 0.24-0.58) than NHWs. NHBs had significantly higher non-adherence to vegetable guidelines (OR = 1.63; CI = 1.07-2.47). NHBs and Hispanics had lower non-adherence with alcohol guidelines than NHWs (OR = 0.35 and 0.38; CI = 0.18-0.69 and 0.19-0.76, respectively). NHBs and Hispanics were more likely to be overweight/obese (OR = 1.66 and 1.57; CI = 1.24-2.23 and CI = 1.11-2.21, respectively). CONCLUSIONS There are racial/ethnic differences in certain health behaviors of cancer survivors. However, non-adherence to guidelines is high in all three racial/ethnic groups. Achieving the recommended guidelines for diet, physical activity, and a healthy BMI is a concern for all cancer survivors, indicating the need for intervention among this growing group of at-risk individuals.
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Arun B, Austin T, Babiera GV, Basen-Engquist K, Carmack CL, Chaoul A, Cohen L, Connelly L, Haddad R, Harrison C, Li Y, Mallaiah S, Nagarathna R, Parker PA, Perkins GH, Reuben JM, Shih YCT, Spelman A, Sood A, Yang P, Yeung SCJ. A Comprehensive Lifestyle Randomized Clinical Trial: Design and Initial Patient Experience. Integr Cancer Ther 2016; 16:3-20. [PMID: 27903842 PMCID: PMC5558265 DOI: 10.1177/1534735416679516] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Although epidemiological research demonstrates that there is an association between lifestyle factors and risk of breast cancer recurrence, progression of disease, and mortality, no comprehensive lifestyle change clinical trials have been conducted to determine if changing multiple risk factors leads to changes in biobehavioral processes and clinical outcomes in women with breast cancer. This article describes the design, feasibility, adherence to the intervention and data collection, and patient experience of a comprehensive lifestyle change clinical trial (CompLife). Methods: CompLife is a randomized, controlled trial of a multiple-behavior intervention focusing on diet, exercise, and mind-body practice along with behavioral counseling to support change. The initial exposure to the intervention takes place during the 4 to 6 weeks of radiotherapy (XRT) for women with stage III breast cancer and then across the subsequent 12 months. The intervention group will have 42 hours of in-person lifestyle counseling during XRT (7-10 hours a week) followed by up to 30 hours of counseling via video connection for the subsequent 12 months (weekly sessions for 6 months and then monthly for 6 months). The primary outcome is disease-free survival. Multiple secondary outcomes are being evaluated, including: (1) biological pathways; (2) overall survival; (3) patient-reported outcomes; (4) dietary patterns/fitness levels, anthropometrics, and body composition; and (5) economic outcomes. Qualitative data of the patient experience in the trial is collected from exit interviews, concluding remarks, direct email correspondences, and web postings from patients. Results: Fifty-five patients have been recruited and randomized to the trial to date. Accrual of eligible patients is high (72%) and dropout rates extremely low (5%). Attendance to the in-person sessions is high (95% attending greater than 80% of sessions) as well as to the 30 hours of video counseling (88% attending more than 70% of sessions). Adherence to components of the behavior change intervention is high and compliance with the intensive amount of data collection is exceptional. Qualitative data collected from the participants reveals testimonials supporting the importance of the comprehensive nature of intervention, especially the mind-body/mindfulness component and social support, and meaningful lifestyle transformations. Conclusion: Conducting a comprehensive, multicomponent, lifestyle change clinical trial for women with breast was feasible and collection of biobehavioral outcomes successful. Adherence to behavior change was high and patient experience was overwhelmingly positive.
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Affiliation(s)
- Banu Arun
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Taylor Austin
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gildy V Babiera
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Cindy L Carmack
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alejandro Chaoul
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lisa Connelly
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robin Haddad
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carol Harrison
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yisheng Li
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Smitha Mallaiah
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Patricia A Parker
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,3 Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - George H Perkins
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - James M Reuben
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ya-Chen Tina Shih
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amy Spelman
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Anil Sood
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Peiying Yang
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sai-Ching J Yeung
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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145
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Printz C. Adherence to prevention guidelines may lower cancer risk. Cancer 2016. [DOI: 10.1002/cncr.30387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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146
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Nomura SJO, Dash C, Rosenberg L, Yu J, Palmer JR, Adams-Campbell LL. Adherence to diet, physical activity and body weight recommendations and breast cancer incidence in the Black Women's Health Study. Int J Cancer 2016; 139:2738-2752. [PMID: 27578546 DOI: 10.1002/ijc.30410] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/27/2016] [Accepted: 08/04/2016] [Indexed: 12/26/2022]
Abstract
Adherence to cancer prevention recommendations has been associated with lower incidence of breast cancer in previous studies, but evidence in African American women is limited. This project evaluated the association between adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and breast cancer incidence among African American women. The Black Women's Health Study (analytic cohort = 49,103) is an ongoing prospective cohort study of African American women, ages 21-69 years at baseline (1995). Adherence scores for seven WCRF/AICR recommendations (adherent = 1, partial adherence = 0.5, non-adherence = 0) were calculated using questionnaire data and summed for overall (maximum = 7) and diet only (maximum = 5) scores. Associations between baseline and time-varying adherence scores and breast cancer incidence (N = 1,827 incident cases through 2011) were evaluated using proportional hazards regression. In this cohort, 8.5% adhered >4 recommendations. Adherence at baseline was not associated with breast cancer incidence. Higher overall time-varying adherence (per 0.5 point increase) was associated with lower breast cancer incidence (HR: 0.90, 95% CI: 0.84-0.96). Adherence to physical activity, sugar beverage and red and processed meat recommendations were also associated with reduced risk. Adherence to the WCRF/AICR recommendations was low and may be associated with lower breast cancer incidence in African American women.
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Affiliation(s)
- Sarah J O Nomura
- Division of Cancer Prevention and Control, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
| | - Chiranjeev Dash
- Division of Cancer Prevention and Control, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Lynn Rosenberg
- Slone Epidemiology Center, Boston University, Boston, MA
| | - Jeffrey Yu
- Slone Epidemiology Center, Boston University, Boston, MA
| | - Julie R Palmer
- Slone Epidemiology Center, Boston University, Boston, MA
| | - Lucile L Adams-Campbell
- Division of Cancer Prevention and Control, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
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