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Ardenkjær-Skinnerup J, Saar D, Christiansen S, Svingen T, Hadrup N, Brown KA, Emanuelli B, Kragelund BB, Ravn-Haren G, Vogel U. Effects of ethanol or ethylene glycol exposure on PPARγ and aromatase expression in adipose tissue. Biochem Biophys Rep 2024; 38:101742. [PMID: 38873224 PMCID: PMC11170351 DOI: 10.1016/j.bbrep.2024.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/15/2024] Open
Abstract
The estrogen-synthesizing enzyme aromatase is expressed in adipose tissue where it controls the local concentration of estrogen. It has been suggested that the organic solvents ethanol and ethylene glycol can induce estrogen synthesis by inhibiting PPARγ activity. Since elevated estrogen synthesis in adipose tissue is a risk factor for breast cancer development, it is of interest to further characterize the mechanisms regulating aromatase expression. Here, we explored the mechanisms by which ethanol and ethylene glycol modulate aromatase mRNA expression and the ultimate conversion of androgens into estrogens. NMR spectroscopy revealed that ethanol and ethylene glycol influence the active state of PPARγ. An inhibitory effect on PPARγ was confirmed by adipogenesis assays and PPARγ target gene expression analysis in adipocytes. However, only ethanol increased aromatase mRNA in differentiated human adipocytes. In contrast, ethylene glycol downregulated aromatase in a PPARγ-independent manner. An animal study using female Wistar rats was conducted to assess the acute effects of ethanol and ethylene glycol on aromatase expression in adipose tissue within a physiological context. No changes in aromatase or PPARγ target gene (Adipoq and Fabp4) levels were observed in adipose tissue or ovary in response to the chemical exposures, suggesting an absence of acute PPARγ-mediated effects in these organs. The results suggest that ethanol and ethylene glycol are weak PPARγ antagonists in mouse and human adipocytes as well as in cell-free NMR spectroscopy. Both compounds seem to affect adipocyte aromatase expression in vitro, where ethanol increased aromatase expression PPARγ-dependently and ethylene glycol decreased aromatase expression independently of PPARγ. No acute effects on aromatase expression or PPARγ activity were observed in adipose tissue or ovary in rats in this study design.
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Affiliation(s)
- Jacob Ardenkjær-Skinnerup
- The National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
| | - Daniel Saar
- REPIN and Structural Biology and NMR Laboratory, Department of Biology, University of Copenhagen, Copenhagen N, Denmark
| | - Sofie Christiansen
- The National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Terje Svingen
- The National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Niels Hadrup
- The National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
| | - Kristy A. Brown
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Brice Emanuelli
- The Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen N, Denmark
| | - Birthe B. Kragelund
- REPIN and Structural Biology and NMR Laboratory, Department of Biology, University of Copenhagen, Copenhagen N, Denmark
| | - Gitte Ravn-Haren
- The National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Ulla Vogel
- The National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
- The National Research Centre for the Working Environment, Copenhagen Ø, Denmark
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Mostofsky E, Lee IM, Buring JE, Mukamal KJ. Impact of Alcohol Consumption on Breast Cancer Incidence and Mortality: The Women's Health Study. J Womens Health (Larchmt) 2024; 33:705-714. [PMID: 38417039 DOI: 10.1089/jwh.2023.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
Background: Alcohol intake is associated with breast cancer (BC) risk, but estimates of greatest public health relevance have not been quantified in large studies with long duration. Materials and Methods: In this prospective cohort study of 39,811 women (median 25 years follow-up), we examined the association between alcohol consumption and BC incidence and mortality with adjusted hazard ratios (HRs), cubic splines, absolute risks, number needed to harm (NNH), and population-attributable fractions. Results: We documented 2,830 cases of BC, including 237 BC deaths. Each additional alcoholic drink/day was associated with a 10% higher rate (HR = 1.10, 95% confidence intervals [CIs]: 1.04-1.16) of total BC in a linear manner (p = 0.0004). The higher rate was apparent for estrogen receptor (ER)+ (HR = 1.12, 95% CI: 1.06-1.18) but not ER- tumors (HR = 0.95, 95% CI: 0.82-1.10), with a statistically significant difference between these associations (p = 0.03). We constructed models comparing BC incidence among 100,000 women followed for 10 years. Compared to a scenario where all women rarely or never consumed alcohol, we expect 63.79 (95% CI: 58.35-69.24) more cases (NNH = 1,567) had all women consumed alcohol at least monthly and 278.66 (95% CI: 268.70-288.62) more cases (NNH = 358) had all women consumed >1 drink/day. Approximately 4.1% of BC cases were attributable to consumption exceeding one drink/month. Conclusion: Alcohol consumption is associated with a linear dose-response increase in BC incidence even within recommended limits of up to one alcoholic drink/day, at least for ER+ tumors. Our estimates of risk differences, attributable fraction, and NNH quantify the burden that alcohol consumption imposes on women in the general population. ClinicalTrials.gov Identifier: NCT00000479.
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Affiliation(s)
- Elizabeth Mostofsky
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Julie Elizabeth Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kenneth Jay Mukamal
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical, School, Boston, Massachusetts, USA
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Koemel NA, Shah S, Senior AM, Severi G, Mancini FR, Gill TP, Simpson SJ, Raubenheimer D, Boutron-Ruault MC, Laouali N, Skilton MR. Macronutrient composition of plant-based diets and breast cancer risk: the E3N prospective cohort study. Eur J Nutr 2024:10.1007/s00394-024-03379-x. [PMID: 38635026 DOI: 10.1007/s00394-024-03379-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/15/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Recent evidence suggests that plant-based diets may reduce the risk of breast cancer (BC). However, the macronutrient composition of plant-based diets and its potential impact on BC risk has not been well explored. This analysis investigated the association of macronutrient composition with BC risk across a spectrum of plant-based diet indexes using a multidimensional approach. DESIGN This study followed 64,655 participants from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) cohort from 1993 to 2014. Diets were evaluated using validated 208-item diet history questionnaires at baseline (1993) and follow-up (2005), to calculate adherence to the overall plant-based diet (PDI), healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI). The association of macronutrient composition with BC risk was assessed via generalized additive time-dependent Cox models across different levels of these indexes. Response surfaces were generated to visualize compositional associations at the 25th, 50th, and 75th percentile of each index (low, moderate, and high). RESULTS A total of 3,932 incident BC cases were identified during the 21-year follow-up. There was a significant association between macronutrient composition and BC risk for hPDI, uPDI, and PDI (all P < 0.001). Akaike information criterion favored the hPDI model for characterizing the association between macronutrients and BC. BC risk was highest for individuals with a lower hPDI score who also consumed a diet containing lower protein (10%), lower carbohydrate (35%), and higher fat (55%). The lowest risk of BC was observed in those with higher hPDI scores with the lowest intake of protein (10%). At higher PDI and uPDI, diets containing higher protein (30%) and fat (45%) had the highest BC risk. CONCLUSION These results demonstrate a complex relationship between macronutrient composition, plant-based diet quality, and BC risk. Further research is needed to examine specific foods that may be driving these associations. REGISTRY The protocol is registered at clinicaltrials.gov as NCT03285230.
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Affiliation(s)
- Nicholas A Koemel
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Sanam Shah
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, CESP, Gustave Roussy, "Exposome and Heredity" team, Inserm, Villejuif, F-94805, France
| | - Alistair M Senior
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Gianluca Severi
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, CESP, Gustave Roussy, "Exposome and Heredity" team, Inserm, Villejuif, F-94805, France
- Department of Statistics, Computer Science, Applications "G. Parenti", University of Florence, Florence, Italy
| | - Francesca R Mancini
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, CESP, Gustave Roussy, "Exposome and Heredity" team, Inserm, Villejuif, F-94805, France
| | - Timothy P Gill
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- Sydney Medical School, The University of Sydney, Sydney, Australia
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - David Raubenheimer
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Marie-Christine Boutron-Ruault
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, CESP, Gustave Roussy, "Exposome and Heredity" team, Inserm, Villejuif, F-94805, France
| | - Nasser Laouali
- Paris-Saclay University, UVSQ, Univ. Paris-Sud, CESP, Gustave Roussy, "Exposome and Heredity" team, Inserm, Villejuif, F-94805, France.
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA.
- Scripps Institution of Oceanography, University of California, San Diego, USA.
- Institute of Biological Sciences (ISSB), UM6P Faculty of Medical Sciences, Mohammed VI Polytechnic University, Ben Guerir, Morocco.
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Floud S, Hermon C, Simpson RF, Reeves GK. Alcohol consumption and cancer incidence in women: interaction with smoking, body mass index and menopausal hormone therapy. BMC Cancer 2023; 23:758. [PMID: 37587405 PMCID: PMC10428611 DOI: 10.1186/s12885-023-11184-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/17/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Alcohol consumption has been associated with increased risks of certain site-specific cancers and decreased risks of some other cancers. There is, however, little reliable evidence as to whether the alcohol-associated risks for specific cancers are modified by smoking, body mass index (BMI) and menopausal hormone therapy (MHT) use. METHODS In the prospective UK Million Women Study, 1,233,177 postmenopausal women without prior cancer, mean age 56 (SD 5) years, reported their alcohol consumption in median year 1998 (IQR 1998-1999), and were followed by record-linkage for incident cancer. 438,056 women who drank no alcohol or < 1 drink/week were excluded. Cox regression yielded adjusted relative risks (RRs) and 95% confidence intervals (CIs) for 21 cancers by alcohol amount; statistical significance of interactions with smoking, BMI and MHT use was assessed after allowing for multiple testing. RESULTS In 795,121 participants, mean consumption was 6.7 (SD 6.4) alcoholic drinks/week. During 17 (SD 5) years of follow-up, 140,203 incident cancers were recorded. There was strong evidence for a substantial association between alcohol intake and risk of upper aero-digestive cancers (oesophageal squamous cell carcinoma, oral cavity, pharynx and larynx; RR per 1 drink/day = 1.38 [95% CI 1.31-1.46]). There was also strong evidence for more moderate positive associations with breast, colorectal and pancreatic cancer (RRs per 1 drink/day = 1.12 [1.10-1.14], 1.10 [1.07-1.13], 1.08 [1.02-1.13] respectively), and moderate negative associations with thyroid cancer, non-Hodgkin's lymphoma, renal cell carcinoma and multiple myeloma (RRs per 1 drink/day = 0.79 [0.70-0.89], 0.91 [0.86-0.95], 0.88 [0.83-0.94], 0.90 [0.84-0.97] respectively). Significant interactions between alcohol and smoking were seen for upper aero-digestive cancers (RRs per 1 drink/day = 1.66 [1.54-1.79], 1.23 [1.11-1.36], 1.12 [1.01-1.25] in current, past, and never smokers respectively). BMI and MHT did not significantly modify any alcohol-associated risks. CONCLUSIONS These findings provide robust evidence that greater alcohol intake, even within relatively moderate ranges, increases the risk of cancers of the aerodigestive tract, breast, colorectal and pancreatic cancer, and probably decreases the risk of thyroid cancer, non-Hodgkin's lymphoma, renal cell carcinoma and multiple myeloma. Associations of alcohol intake with cancer risk were not modified by MHT use, adiposity or smoking, except in the case of upper aero-digestive cancers, where the alcohol-associated risk was largely confined to smokers.
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Affiliation(s)
- Sarah Floud
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Carol Hermon
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Gillian K Reeves
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Agabio R, Madeddu C, Contu P, Cosentino S, Deiana M, Massa E, Mereu A, Politi C, Sardu C, Sinclair JMA. Alcohol Consumption Is a Modifiable Risk Factor for Breast Cancer: Are Women Aware of This Relationship? Alcohol Alcohol 2022; 57:533-539. [PMID: 34155515 DOI: 10.1093/alcalc/agab042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/12/2021] [Accepted: 05/27/2021] [Indexed: 01/04/2023] Open
Abstract
AIMS Despite alcohol consumption being a dose-dependent risk factor for breast cancer, a recent study conducted in the UK found <20% of women attending breast screening programmes were aware of this relationship and proposed proper information campaigns need to be conducted. We aimed to investigate the awareness of this relationship among a related sample of Italian women to evaluate whether similar information campaigns should also be conducted in Italy. METHODS The questionnaire used by the UK study was translated into Italian, slightly modified for the Italian context, validated and submitted to a sample of Italian women. RESULTS Overall 507 women were interviewed. Among them, 160 were classified as breast cancer screening attenders (SG), 44 as symptomatic breast clinic attenders (CAG) and 303 as non-screening group (NSG). Alcohol was correctly identified as a risk factor for breast cancer by 16.9, 11.4 and 14.9% of participants of SG, CAG and NSG, respectively without differences between the three groups. Despite the methodological differences, the rates of participants who correctly identified alcohol as a risk factor among women attending breast screening programmes were surprisingly similar between the study conducted in UK (15.7%) and the present study (16.9%). CONCLUSION The results of the present study confirm the limited awareness of the relationship between alcohol consumption and risk of developing breast cancer among women and suggest the urgent need to conduct proper awareness-raising campaigns to counter this in the Italian female population.
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Affiliation(s)
- Roberta Agabio
- Department of Biomedical Sciences, University of Cagliari, Monserrato (CA), Italy
| | - Clelia Madeddu
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (CA), Italy
| | - Paolo Contu
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (CA), Italy
| | - Sofia Cosentino
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (CA), Italy
| | - Monica Deiana
- Department of Biomedical Sciences, University of Cagliari, Monserrato (CA), Italy
| | - Elena Massa
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (CA), Italy
| | - Alessandra Mereu
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (CA), Italy
| | - Carola Politi
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (CA), Italy
| | - Claudia Sardu
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato (CA), Italy
| | - Julia M A Sinclair
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
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Risk Factors for Female Breast Cancer: A Population Cohort Study. Cancers (Basel) 2022; 14:cancers14030788. [PMID: 35159055 PMCID: PMC8834157 DOI: 10.3390/cancers14030788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/22/2022] [Accepted: 02/01/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary In recent years, it has been emphasized that the development of a healthy lifestyle can prevent the incidence of cancer, and several recent studies on female breast cancer (BC) have also become interested in sedentary behavioral issues. Our prospective cohort study found that, in addition to the currently known risk factors (RFs) such as parity and body mass index (BMI), which affect the probability of developing BC in women, a sedentary lifestyle and drinking sugar-sweetened beverages (SSB) can cause BC. Therefore, we propose that the modifiable risk profiles of sedentary behavior and sugary beverage consumption may also be associated with increased incidence of female BC in the Taiwanese population. Abstract Background: The incidence of female BC among the Eastern and Southeastern Asian populations has gradually increased in recent years. However, epidemiological studies on the relationship between a sedentary lifestyle and female BC are insufficient. In order to determine the association between this lifestyle and the incidence of female BC, we conducted a population-based cohort study on women in Taiwan. Methods: We followed a prospective cohort of 5879 women aged 30 years and over enrolled in the 2001 National Health Interview Survey (NHIS), who developed female BC over a period of 72,453 person years, and we estimated the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) using the Cox proportional hazards model. Results: RFs associated with female BC incidence included parity (adjusted HR = 0.63; 95% CI: 0.44–0.91), body mass index (adjusted HR = 1.34; 95% CI: 1.04–1.71), and ≥3 h/day spent sitting (adjusted HR = 1.89; 95% CI: 1.08–3.32). The incidence of female BC in participants who sat for ≥3 h/day and consumed sugary drinks was 2.5 times greater than that in those who sat for <3 h/day and did not consume sugary drinks (adjusted HR = 2.51; 95% CI: 1.01–6.23). Conclusions: The findings of this study indicate that sedentary behavior and sugary drink intake may increase the risk of developing female BC. These are modifiable RFs; therefore, a healthy lifestyle and diet can reduce the incidence of female BC.
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Yu T, Ye DM. The epidemiologic factors associated with breast density: A review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:53. [PMID: 36092490 PMCID: PMC9450246 DOI: 10.4103/jrms.jrms_962_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/14/2022] [Accepted: 01/26/2022] [Indexed: 11/04/2022]
Abstract
In recent years, some studies have evaluated the epidemiologic factors associated with breast density. However, the variant and inconsistent results exist. In addition, breast density has been proved to be a significant risk factor associated with breast cancer. Our review summarized the published studies and emphasized the crucial factors including epidemiological factors associated with breast density. In addition, we also discussed the potential reasons for the discrepant results with risk factors. To decrease the incidence and mortality rates for breast cancer, in clinical practice, breast density should be included for clinical risk models in addition to epidemiological factors, and physicians should get more concentrate on those women with risk factors and provide risk-based breast cancer screening regimens.
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Ubago-Guisado E, Rodríguez-Barranco M, Ching-López A, Petrova D, Molina-Montes E, Amiano P, Barricarte-Gurrea A, Chirlaque MD, Agudo A, Sánchez MJ. Evidence Update on the Relationship between Diet and the Most Common Cancers from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: A Systematic Review. Nutrients 2021; 13:nu13103582. [PMID: 34684583 PMCID: PMC8540388 DOI: 10.3390/nu13103582] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/30/2021] [Accepted: 10/11/2021] [Indexed: 12/13/2022] Open
Abstract
The European Prospective Investigation into Cancer and Nutrition (EPIC) is a multicentre prospective study conducted in 23 centres in 10 European countries. Here we review the findings from EPIC on the relationship between diet-related exposures and incidence or mortality from the four most frequent cancers in the European population: colorectal, breast, lung, and prostate cancer. We conducted a systematic review following PRISMA guidelines and identified 110 high-quality studies based on the EPIC cohort. Fruit and vegetable consumption had a protective effect against colorectal, breast, and lung cancer, whereas only fruit had a protective effect against prostate cancer. A higher consumption of fish and lower consumption of red and processed meat were related with a lower risk of colorectal cancer; and higher consumption of fatty fish with lower risk of breast cancer. Calcium and yogurt intake were found to protect against colorectal and prostate cancer. Alcohol consumption increased the risk for colorectal and breast cancer. Finally, adherence to the Mediterranean diet emerged as a protective factor for colorectal and breast cancer. The EPIC study results are in agreement with the latest evidence from leading authorities on cancer prevention and help to inform public prevention policies and strategies.
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Affiliation(s)
- Esther Ubago-Guisado
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, 18011 Granada, Spain; (E.U.-G.); (A.C.-L.); (D.P.); (M.-J.S.)
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (E.M.-M.); (P.A.); (A.B.-G.); (M.-D.C.)
- Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Miguel Rodríguez-Barranco
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, 18011 Granada, Spain; (E.U.-G.); (A.C.-L.); (D.P.); (M.-J.S.)
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (E.M.-M.); (P.A.); (A.B.-G.); (M.-D.C.)
- Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Correspondence:
| | - Ana Ching-López
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, 18011 Granada, Spain; (E.U.-G.); (A.C.-L.); (D.P.); (M.-J.S.)
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (E.M.-M.); (P.A.); (A.B.-G.); (M.-D.C.)
- Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Dafina Petrova
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, 18011 Granada, Spain; (E.U.-G.); (A.C.-L.); (D.P.); (M.-J.S.)
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (E.M.-M.); (P.A.); (A.B.-G.); (M.-D.C.)
- Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain
| | - Esther Molina-Montes
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (E.M.-M.); (P.A.); (A.B.-G.); (M.-D.C.)
- Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Department of Nutrition and Food Science, Campus of Cartuja, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA) ‘José Mataix’, Biomedical Research Centre, University of Granada, Avenida del Conocimiento s/n, E-18071 Granada, Spain
| | - Pilar Amiano
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (E.M.-M.); (P.A.); (A.B.-G.); (M.-D.C.)
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, 20014 Donostia-San Sebastian, Spain
| | - Aurelio Barricarte-Gurrea
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (E.M.-M.); (P.A.); (A.B.-G.); (M.-D.C.)
- Navarra Public Health Institute, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - María-Dolores Chirlaque
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (E.M.-M.); (P.A.); (A.B.-G.); (M.-D.C.)
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, 30003 Murcia, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICO, 08908 L’Hospitalet de Llobregat, Spain;
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute—IDIBELL, 08908 L’Hospitalet de Llobregat, Spain
| | - María-José Sánchez
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, 18011 Granada, Spain; (E.U.-G.); (A.C.-L.); (D.P.); (M.-J.S.)
- Epidemiology and Control of Chronic Diseases, CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; (E.M.-M.); (P.A.); (A.B.-G.); (M.-D.C.)
- Cancer Epidemiology Group, Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain
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Donat-Vargas C, Guerrero-Zotano Á, Casas A, Baena-Cañada JM, Lope V, Antolín S, Garcia-Saénz JÁ, Bermejo B, Muñoz M, Ramos M, de Juan A, Jara Sánchez C, Sánchez-Rovira P, Antón A, Brunet J, Gavilá J, Salvador J, Arriola Arellano E, Bezares S, Fernández de Larrea-Baz N, Pérez-Gómez B, Martín M, Pollán M. Trajectories of alcohol consumption during life and the risk of developing breast cancer. Br J Cancer 2021; 125:1168-1176. [PMID: 34483338 PMCID: PMC8505448 DOI: 10.1038/s41416-021-01492-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/10/2021] [Accepted: 07/08/2021] [Indexed: 12/26/2022] Open
Abstract
Background Whether there are lifetime points of greater sensitivity to the deleterious effects of alcohol intake on the breasts remains inconclusive. Objective To compare the influence of distinctive trajectories of alcohol consumption throughout a woman’s life on development of breast cancer (BC). Methods 1278 confirmed invasive BC cases and matched (by age and residence) controls from the Epi-GEICAM study (Spain) were used. The novel group-based trajectory modelling was used to identify different alcohol consumption trajectories throughout women’s lifetime. Results Four alcohol trajectories were identified. The first comprised women (45%) with low alcohol consumption (<5 g/day) throughout their life. The second included those (33%) who gradually moved from a low alcohol consumption in adolescence to a moderate in adulthood (5 to <15 g/day), never having a high consumption; and oppositely, women in the third trajectory (16%) moved from moderate consumption in adolescence, to a lower consumption in adulthood. Women in the fourth (6%) moved from a moderate alcohol consumption in adolescence to the highest consumption in adulthood (≥15 g/day), never having a low alcohol consumption. Comparing with the first trajectory, the fourth doubled BC risk (OR 2.19; 95% CI 1.27, 3.77), followed by the third (OR 1.44; 0.96, 2.16) and ultimately by the second trajectory (OR 1.17; 0.86, 1.58). The magnitude of BC risk was greater in postmenopausal women, especially in those with underweight or normal weight. When alcohol consumption was independently examined at each life stage, ≥15 g/day of alcohol consumption in adolescence was strongly associated with BC risk followed by consumption in adulthood. Conclusions The greater the alcohol consumption accumulated throughout life, the greater the risk of BC, especially in postmenopausal women. Alcohol consumption during adolescence may particularly influence BC risk.
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Affiliation(s)
- Carolina Donat-Vargas
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Ana Casas
- Medical Oncology Unit, Hospital Virgen del Rocío, Sevilla, Spain
| | - José Manuel Baena-Cañada
- Medical Oncology Unit, Hospital Puerta del Mar, Cádiz, Spain.,Instituto de Investigación en Biomedicina de Cádiz (INiBICA), Cádiz, Spain
| | - Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Silvia Antolín
- Medical Oncology Unit, Complejo Hospitalario Universitario, A Coruña, Spain
| | | | - Begoña Bermejo
- Medical Oncology Unit, Hospital Clínico, Valencia, Spain
| | - Montserrat Muñoz
- Medical Oncology Unit, Hospital Clinic i Provincial, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics, Institut d'Investigacions Biomèdiques Pi i Sunyer-IDIBAPS, Barcelona, Spain
| | - Manuel Ramos
- Medical Oncology Unit, Centro Oncológico de Galicia, A Coruña, Spain
| | - Ana de Juan
- Medical Oncology Unit, Hospital Marqués de Valdecilla, Santander, Spain
| | - Carlos Jara Sánchez
- Medical Oncology Unit/Departamento Especialidades Médicas, Hospital Universitario Fundación Alcorcón/Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Antonio Antón
- Medical Oncology Unit, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Joan Brunet
- Medical Oncology Department, Institut Català d'Oncologia, IDIBGi, Girona, Spain.,Medical Sciences Department, Universitat de Girona, Girona, Spain
| | - Joaquín Gavilá
- Medical Oncology Unit, Instituto Valenciano de Oncología, Valencia, Spain
| | - Javier Salvador
- Medical Oncology Unit, Hospital Virgen del Rocío, Sevilla, Spain
| | | | - Susana Bezares
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Miguel Martín
- Medical Oncology Unit, Instituto de Investigación Sanitaria Gregorio Marañón/Universidad Complutense, Madrid, Spain.,Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
| | - Marina Pollán
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain. .,National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. .,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.
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10
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Katuwal S, Jousilahti P, Pukkala E. Causes of death among women with breast cancer: A follow-up study of 50 481 women with breast cancer in Finland. Int J Cancer 2021; 149:839-845. [PMID: 33890290 DOI: 10.1002/ijc.33607] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/22/2021] [Accepted: 04/12/2021] [Indexed: 12/28/2022]
Abstract
Our study aims to assess mortality from causes other than breast cancer among women with breast cancer with focus on indications of joint aetiology. Data on female breast cancer patients were obtained from the Finnish Cancer Registry and their underlying causes of death in 54 categories from the Statistics Finland. Standardised mortality ratios (SMR) and their 95% confidence intervals (CIs) were calculated for 50 481 patients diagnosed between 1971 and 2000 and followed until December 2012, stratified by histology, age at diagnosis and time since diagnosis. The expected numbers of deaths were based on respective mortality rates among the Finnish general population. Hazard ratio (HR) was estimated from Poisson regression model to compare risks of cause of death by histology. 41% of 30 841 deaths were due to causes other than breast cancer. Significant excess mortality was observed for stomach cancer (SMR 1.43, 95% CI 1.26-1.62), circulatory system diseases (SMR 1.17, 95% CI 1.14-1.20) and suicide (SMR 1.51, 95% CI 1.28-1.78). In an age-adjusted analysis, significantly higher relative risk of stomach cancer mortality was observed for lobular vs ductal subtype (HR 2.00, 95% CI 1.32-3.02). Significantly increased SMRs were observed for cancers of respiratory organs among premenopausal women, and for other respiratory system diseases, dementia and Alzheimer disease among postmenopausal women. We conclude that female breast cancer patients are at increased risk of death from causes other than the breast cancer diagnosis including circulatory and respiratory system diseases and cancer of stomach, ovary and respiratory systems. The excess mortality because of different causes varies based on menopausal status and histology. There might be shared aetiological factors between the diagnosis of breast cancer and the causes of death among these patients.
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Affiliation(s)
- Sushmita Katuwal
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Pekka Jousilahti
- Department of Public Health Solutions, Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Eero Pukkala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
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11
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Ong JS, Derks EM, Eriksson M, An J, Hwang LD, Easton DF, Pharoah PP, Berchuck A, Kelemen LE, Matsuo K, Chenevix-Trench G, Hall P, Bojesen SE, Webb PM, MacGregor S. Evaluating the role of alcohol consumption in breast and ovarian cancer susceptibility using population-based cohort studies and two-sample Mendelian randomization analyses. Int J Cancer 2021; 148:1338-1350. [PMID: 32976626 DOI: 10.1002/ijc.33308] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/26/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023]
Abstract
Alcohol consumption is correlated positively with risk for breast cancer in observational studies, but observational studies are subject to reverse causation and confounding. The association with epithelial ovarian cancer (EOC) is unclear. We performed both observational Cox regression and two-sample Mendelian randomization (MR) analyses using data from various European cohort studies (observational) and publicly available cancer consortia (MR). These estimates were compared to World Cancer Research Fund (WCRF) findings. In our observational analyses, the multivariable-adjusted hazard ratios (HR) for a one standard drink/day increase was 1.06 (95% confidence interval [CI]; 1.04, 1.08) for breast cancer and 1.00 (0.92, 1.08) for EOC, both of which were consistent with previous WCRF findings. MR ORs per genetically predicted one standard drink/day increase estimated via 34 SNPs using MR-PRESSO were 1.00 (0.93, 1.08) for breast cancer and 0.95 (0.85, 1.06) for EOC. Stratification by EOC subtype or estrogen receptor status in breast cancers made no meaningful difference to the results. For breast cancer, the CIs for the genetically derived estimates include the point-estimate from observational studies so are not inconsistent with a small increase in risk. Our data provide additional evidence that alcohol intake is unlikely to have anything other than a very small effect on risk of EOC.
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Affiliation(s)
- Jue-Sheng Ong
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Eske M Derks
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Mikael Eriksson
- Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden
| | - Jiyuan An
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Liang-Dar Hwang
- Translational Research Institute, University of Queensland Diamantina Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Douglas F Easton
- The Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Paul P Pharoah
- The Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Andrew Berchuck
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Linda E Kelemen
- Departments of Obstetrics and Gynecology and Public Health Sciences, College of Medicine and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Keitaro Matsuo
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Per Hall
- Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden
| | - Stig E Bojesen
- Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Penelope M Webb
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Stuart MacGregor
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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12
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Tastula A, Jukkola A, Alakokkare AE, Nordström T, Eteläinen S, Karihtala P, Miettunen J. Early-Life Risk Factors for Breast Cancer - Prospective Follow-up in the Northern Finland Birth Cohort 1966. Cancer Epidemiol Biomarkers Prev 2021; 30:616-622. [PMID: 33563646 DOI: 10.1158/1055-9965.epi-20-1442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/15/2020] [Accepted: 02/01/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While some risk factors for breast cancer have been confirmed, less is known about the role of early biological and social risk factors for breast cancer in adult life. METHODS In a prospective follow-up in the Northern Finland Birth Cohort 1966 consisting of 5,308 women, 120 breast cancers were reported via national registers by the end of 2018. Early risk factors were examined with univariate and multivariate analyses using Cox regression analysis. The main results are reported with HRs and their 95% confidence intervals (CI). RESULTS In the multivariate-adjusted models, women whose mothers lived in urban areas (HR, 1.68; 95% CI, 1.13-2.51) during pregnancy, were low educated (HR, 2.40; 95% CI, 1.30-4.45), and had been diagnosed with breast cancer (HR, 1.97; 95% CI, 1.09-3.58) had a higher risk for breast cancer in adult life. Lower BMI at the age of 14 associated nonsignificantly with the risk of breast cancer (Mann-Whitney U test, P = 0.087). No association between birth size and breast cancer risk in adult life was found. CONCLUSIONS Early-life residence and socioeconomic conditions may have an impact on developing breast cancer in women in adult life. All breast cancer cases of this study were relatively young, and most of them are assumed to be premenopausal. IMPACT This study is one of a few prospective birth cohort studies to examine early-life socioeconomic factors and breast cancer risk in adult life. This study is limited due to small number of cases.
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Affiliation(s)
- Anniina Tastula
- Center for Life Course Health Research, University of Oulu, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Arja Jukkola
- Department of Oncology of Medicine and Radiotherapy, Tampere University Hospital, Tampere, Finland.,Tampere Cancer Center, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Anni-Emilia Alakokkare
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tanja Nordström
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sanna Eteläinen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, Oulu, Finland.,PEDEGO Research Unit, University of Oulu, Oulu, Finland
| | - Peeter Karihtala
- Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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13
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Sun Q, Xie W, Wang Y, Chong F, Song M, Li T, Xu L, Song C. Alcohol Consumption by Beverage Type and Risk of Breast Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies. Alcohol Alcohol 2021; 55:246-253. [PMID: 32090238 DOI: 10.1093/alcalc/agaa012] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/09/2020] [Accepted: 01/27/2020] [Indexed: 02/07/2023] Open
Abstract
AIMS Alcohol intake has been shown to increase the risk of breast cancer. However, the dose-response analysis of different alcoholic beverages (spirits, wine and beer) is not clear. Our meta-analysis aims to provide a dose-response estimation between different alcohols and breast cancer risk. METHODS Search of PubMed and Web of Science and manual searches were conducted up to 1 December 2018, and summary relative risks (RRs) and attributable risk percentage (ARP) for alcohol intake on the development of breast cancer were calculated. Dose-response meta-analysis modeled relationships between drinking type and breast cancer risk. Sources of heterogeneity were explored, and sensitivity analyses were conducted to test the robustness of findings. RESULTS In total, 22 cohort studies and 45,350 breast cancer cases were included. Current drinkers for ER+ had an increased risk compared with never drinkers. In dose-response analysis, there was a statistically significant linear trend with breast cancer risk increasing gradually by total alcohol and wine dose: when adding 10 g per day, the risk increased by 10.5% (RR = 1.10, 95%CI = 1.08-1.13) in total alcohol and 8.9% (RR = 1.08, 95%CI = 1.04-1.14) in wine. For postmenopausal women, the risk increases by 11.1% (RR = 1.11, 95%CI = 1.09-1.13) with every 10 g of total alcohol increase. Furthermore, the breast cancer alcohol-attributed percentage is higher in Europe than in North America and Asia. CONCLUSIONS The effect of drinking on the incidence of breast cancer is mainly manifested in ER+ breast cancer. Quantitative analysis showed total drinking had a significant risk for breast cancer, especially for postmenopausal women. However, for different alcohols, just wine intake has the similar results.
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Affiliation(s)
- Qiuyu Sun
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Weihong Xie
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Yanli Wang
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Feifei Chong
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Mengmeng Song
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Tiandong Li
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Linping Xu
- Department of Teaching and Research, Henan Tumor Hospital, No. 127, Dongming Road, Zhengzhou 450003, Henan, China
| | - Chunhua Song
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
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14
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Miricescu D, Totan A, Stanescu-Spinu II, Badoiu SC, Stefani C, Greabu M. PI3K/AKT/mTOR Signaling Pathway in Breast Cancer: From Molecular Landscape to Clinical Aspects. Int J Mol Sci 2020; 22:E173. [PMID: 33375317 PMCID: PMC7796017 DOI: 10.3390/ijms22010173] [Citation(s) in RCA: 306] [Impact Index Per Article: 76.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023] Open
Abstract
Breast cancer is a serious health problem worldwide, representing the second cause of death through malignancies among women in developed countries. Population, endogenous and exogenous hormones, and physiological, genetic and breast-related factors are involved in breast cancer pathogenesis. The phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) is a signaling pathway involved in cell proliferation, survival, invasion, migration, apoptosis, glucose metabolism and DNA repair. In breast tumors, PIK3CA somatic mutations have been reported, located in exon 9 and exon 20. Up to 40% of PIK3CA mutations are estrogen receptor (ER) positive and human epidermal growth factor receptor 2 (HER2) -negative in primary and metastatic breast cancer. HER2 is overexpressed in 20-30% of breast cancers. HER1, HER2, HER3 and HER4 are membrane receptor tyrosine kinases involved in HER signaling to which various ligands can be attached, leading to PI3K/AKT activation. Currently, clinical studies evaluate inhibitors of the PI3K/AKT/mTOR axis. The main purpose of this review is to present general aspects of breast cancer, the components of the AKT signaling pathway, the factors that activate this protein kinase B, PI3K/AKT-breast cancer mutations, PI3K/AKT/mTOR-inhibitors, and the relationship between everolimus, temsirolimus and endocrine therapy.
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Affiliation(s)
- Daniela Miricescu
- Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.M.); (A.T.); (M.G.)
| | - Alexandra Totan
- Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.M.); (A.T.); (M.G.)
| | - Iulia-Ioana Stanescu-Spinu
- Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.M.); (A.T.); (M.G.)
| | - Silviu Constantin Badoiu
- Department of Anatomy and Embryology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania
| | - Constantin Stefani
- Department of Family Medicine and Clinical Base, Dr. Carol Davila Central Military Emergency University Hospital, 134 Calea Plevnei, 010825 Bucharest, Romania;
| | - Maria Greabu
- Department of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania; (D.M.); (A.T.); (M.G.)
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15
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Relationship between particulate matter exposure and female breast cancer incidence and mortality: a systematic review and meta-analysis. Int Arch Occup Environ Health 2020; 94:191-201. [PMID: 32914230 DOI: 10.1007/s00420-020-01573-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 08/28/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The associations of PM with the risk and prognosis of breast cancer have not been determined. This systematic review aimed to provide an updated understanding of the relationship between PM exposure level and breast cancer incidence and mortality. METHODS Articles from Web of Science and PubMed databases were methodically inspected until March 8, 2020. In final, 15 studies were kept for analysis, which provided necessary information to estimate the impact of PM on breast cancer risk and prognosis. These studies were combined for quantitative analyses to evaluate the effect of per 10 μg /m3 increment exposure of PM2.5 (< 2.5 μm in aerodynamic diameter) and PM10 (< 10 μm in aerodynamic diameter) using random-effects model. RESULTS PM2.5 exposure was associated with increased breast cancer mortality (relative risk [RR] = 1.09; 95% confidence interval [CI]: 1.02, 1.16; PQ-test = 0.158). No association of PM2.5 (1.02; 0.97, 1.18; 0.308) and PM10 (1.03; 0.98, 1.09; 0.009) with the increase incidence of breast cancer was observed. Stratified analysis suggested that PM2.5 was associated with the increase mortality of breast cancer (1.10; 1.03, 1.17; 0.529) in subgroup of developed country. PM10 was associated with breast cancer incidence based on studies published after 2017 (1.08; 1.00, 1.15; 0.157) and European studies (1.15; 1.06, 1.25; 0.502). CONCLUSIONS Our study indicated that PM2.5 exposure was related to breast cancer mortality. Further researches in this field are needed to validate the conclusion.
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16
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Peters S, Gallo V, Vineis P, Middleton LT, Forsgren L, Sacerdote C, Sieri S, Kyrozis A, Chirlaque M, Zamora‐Ros R, Hansson O, Petersson J, Katzke V, Kühn T, Mokoroa O, Masala G, Ardanaz E, Panico S, Bergmann MM, Key TJ, Weiderpass E, Ferrari P, Vermeulen R. Alcohol Consumption and Risk of Parkinson's Disease: Data From a Large Prospective European Cohort. Mov Disord 2020; 35:1258-1263. [PMID: 32357270 PMCID: PMC7496254 DOI: 10.1002/mds.28039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/30/2020] [Accepted: 03/03/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) etiology is not well understood. Reported inverse associations with smoking and coffee consumption prompted the investigation of alcohol consumption as a risk factor, for which evidence is inconclusive. OBJECTIVE To assess the associations between alcohol consumption and PD risk. METHODS Within NeuroEPIC4PD, a prospective European population-based cohort, 694 incident PD cases were ascertained from 209,998 PD-free participants. Average alcohol consumption at different time points was self-reported at recruitment. Cox regression hazard ratios were estimated for alcohol consumption and PD occurrence. RESULTS No associations between baseline or lifetime total alcohol consumption and PD risk were observed. Men with moderate lifetime consumption (5-29.9 g/day) were at ~50% higher risk compared with light consumption (0.1-4.9 g/day), but no linear exposure-response trend was observed. Analyses by beverage type also revealed no associations with PD. CONCLUSION Our data reinforce previous findings from prospective studies showing no association between alcohol consumption and PD risk. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Susan Peters
- Institute for Risk Assessment SciencesUtrecht UniversityUtrechtThe Netherlands
- Department of NeurologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Valentina Gallo
- Centre for Primary Care and Public HealthQueen Mary University of LondonLondonUK
| | - Paolo Vineis
- School of Public HealthImperial College LondonLondonUK
| | | | - Lars Forsgren
- Department of Clinical Sciences, NeurosciencesUmeå UniversityUmeåSweden
| | - Carlotta Sacerdote
- Unit of Cancer EpidemiologyCittà della Salute e della Scienza University‐HospitalTurinItaly
- Center for Cancer PreventionTurinItaly
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione Istitutodi Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei TumoriMilanItaly
| | - Andreas Kyrozis
- Hellenic Health FoundationAthensGreece
- First Department of NeurologyNational and Kapodistrian University of AthensAthensGreece
| | - María‐Dolores Chirlaque
- Department of EpidemiologyRegional Health Council, Instituto Murciano de Investigación Biosanitaria (IMIB)‐ArrixacaMurciaSpain
- Centrode Investigación Biomédica en Red (CIBER) in Epidemiology and Public HealthMadridSpain
- Department of Health and Social Sciences, Universidad de MurciaMurciaSpain
| | - Raul Zamora‐Ros
- Unit of Nutrition and Cancer, Epidemiology Research ProgramCatalan Institute of Oncology, Bellvitge Biomedical Research Institute, Hospitalet de LlobregatBarcelonaSpain
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical SciencesLund UniversityMalmöSweden
- Memory ClinicSkåne University HospitalLundSweden
| | - Jesper Petersson
- Department of Neurology, Skåne University HospitalLund UniversityMalmöSweden
| | | | - Tilman Kühn
- German Cancer Research CentreHeidelbergGermany
| | - Olatz Mokoroa
- Public Health Division of GipuzkoaBioDonostia Research InstituteSan SebastianSpain
| | - Giovanna Masala
- Cancer Risk Factors and Life‐Style Epidemiology UnitInstitute for Cancer Research, Prevention and Clinical Network–Cancer Research and Prevention Institute (ISPRO)FlorenceItaly
| | - Eva Ardanaz
- Centrode Investigación Biomédica en Red (CIBER) in Epidemiology and Public HealthMadridSpain
- Navarra Public Health InstitutePamplonaSpain
- Institutode Investigación Sanitaria de Navarra (IdiSNA)Navarra Institute for Health ResearchPamplonaSpain
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e ChirurgiaFederico II University NaplesNaplesItaly
| | | | - Timothy J. Key
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | | | | | - Roel Vermeulen
- Institute for Risk Assessment SciencesUtrecht UniversityUtrechtThe Netherlands
- School of Public HealthImperial College LondonLondonUK
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
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17
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Abstract
Globally, more than 2 million new cases of breast cancer are reported annually. The United States alone has more than 496,000 new cases every year. The worldwide prevalence is approximately 6.8 million cases. Although many risk factors for breast cancer are not modifiable, understanding the role of the factors that can be altered is critical. Alcohol consumption is a modifiable factor. Studies of alcohol in relation to breast cancer incidence have included hundreds of thousands of women. Evidence is consistent that intake, even intake of less than 10–15 grams per day, is associated with increased risk of this disease. In addition, evidence, although less extensive, shows that possible early indicators of risk, such as benign breast disease and increased breast density, are associated with alcohol consumption. Evidence is less strong for differences based on geographic region, beverage type, drinking pattern, or breast cancer subtype. Some studies have examined the association between alcohol and recurrence or survival after a breast cancer diagnosis. These findings are less consistent. Public awareness of alcohol as a risk factor for breast cancer is low, and public health measures to increase that awareness are warranted.
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Affiliation(s)
- Jo L Freudenheim
- School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
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18
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Ferruzzi MG, Tanprasertsuk J, Kris-Etherton P, Weaver CM, Johnson EJ. Perspective: The Role of Beverages as a Source of Nutrients and Phytonutrients. Adv Nutr 2020; 11:507-523. [PMID: 31755901 PMCID: PMC7231580 DOI: 10.1093/advances/nmz115] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/12/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
The Dietary Guidelines for Americans (DGA) provide nutrition advice for Americans >2 y of age. The 2020-2025 DGA proposes a life stage approach, focusing on birth through older adulthood. Limited recommendations for beverages exist except for milk, 100% fruit juice, and alcohol. The goal of this article is to provide a better understanding of the role of beverages in the diet using current scientific evidence. A Medline search of observational studies, randomized controlled trials, and meta-analyses was undertaken using key beverage words. We highlight the role beverages can play as a part of the DGA and considered beverages not traditionally included, such as those that are phytonutrient dense. Our primary consideration for beverage consumption targeted healthy Americans aged ≥2 y. However, with the proposed expansion to the life span for the 2020-2025 DGA, we also reviewed evidence for infants and toddlers from birth to 24 mo. Examples are provided on how minor changes in beverage choices aid in meeting recommended intakes of certain nutrients. Guidance on beverage consumption may aid in development of better consumer products to meet broader dietary advice. For example, beverage products that are nutrient/phytonutrient dense and lower in sugar could be developed as alternatives to 100% juice to help meet the fruit and vegetable guidelines. Although beverages are not meant to replace foods, e.g., it is difficult to meet the requirements for vitamin E, dietary fiber, or essential fatty acids through beverages alone, beverages are important sources of nutrients and phytonutrients, phenolic acids and flavonoids in particular. When considering the micronutrients from diet alone, mean intakes of calcium (in women), potassium, and vitamins A, C, and D are below recommendations and sodium intakes are well above. Careful beverage choices could close these gaps and be considered a part of a healthy dietary pattern.
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Affiliation(s)
- Mario G Ferruzzi
- Plants for Human Health Institute, North Carolina State University, Kannapolis, NC, USA
| | - Jirayu Tanprasertsuk
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Penny Kris-Etherton
- Nutritional Sciences Department, Pennsylvania State University, University Park, PA, USA
| | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Elizabeth J Johnson
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA,Address correspondence to EJJ (e-mail: )
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19
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Sánchez-Bayona R, Gea A, Gardeazabal I, Romanos-Nanclares A, Martínez-González MÁ, Bes-Rastrollo M, Santisteban M, Toledo E. Binge Drinking and Risk of Breast Cancer: Results from the SUN ('Seguimiento Universidad de Navarra') Project. Nutrients 2020; 12:nu12030731. [PMID: 32164388 PMCID: PMC7146187 DOI: 10.3390/nu12030731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 01/26/2023] Open
Abstract
Alcohol intake is associated with the risk of breast cancer. Different patterns of alcohol-drinking may have different effects on breast cancer even when keeping constant the total amount of alcohol consumed. We aimed to assess the association between binge drinking and breast cancer risk. The SUN Project is a Spanish dynamic prospective cohort of university graduates initiated in 1999. In the 556-item lifestyle baseline questionnaire a validated food-frequency questionnaire was embedded. Participants completed biennial follow-up questionnaires. Cox regression models were used to estimate the hazard ratio (HR) for breast cancer associated with the exposure to binge drinking. A stratified analysis was performed according to menopausal status. We included 9577 women (mean age = 34 years, SD = 10 years), with a median follow-up of 11.8 years. Among 104,932 women-years of follow-up, we confirmed 88 incident cases of breast cancer. Women in the binge drinking group showed a higher risk of breast cancer (HR = 1.76; 95% CI: 1.03–2.99) compared to women in the non-binge drinking category. In the stratified analysis, a 2-fold higher risk for premenopausal breast cancer was associated with binge drinking habit (HR = 2.06; 95% CI: 1.11–3.82). This study adds new evidence on the association of binge drinking with breast cancer risk.
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Affiliation(s)
- Rodrigo Sánchez-Bayona
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (R.S.-B.); (I.G.); (A.R.-N.); (M.Á.M.-G.); (M.B.-R.); (E.T.)
- Department of Clinical Oncology, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (R.S.-B.); (I.G.); (A.R.-N.); (M.Á.M.-G.); (M.B.-R.); (E.T.)
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), 28029 Madrid, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Correspondence: ; Tel.: +34-948-425-600 (ext. 806637)
| | - Itziar Gardeazabal
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (R.S.-B.); (I.G.); (A.R.-N.); (M.Á.M.-G.); (M.B.-R.); (E.T.)
- Department of Clinical Oncology, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
| | - Andrea Romanos-Nanclares
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (R.S.-B.); (I.G.); (A.R.-N.); (M.Á.M.-G.); (M.B.-R.); (E.T.)
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (R.S.-B.); (I.G.); (A.R.-N.); (M.Á.M.-G.); (M.B.-R.); (E.T.)
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), 28029 Madrid, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (R.S.-B.); (I.G.); (A.R.-N.); (M.Á.M.-G.); (M.B.-R.); (E.T.)
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), 28029 Madrid, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Marta Santisteban
- Department of Clinical Oncology, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain; (R.S.-B.); (I.G.); (A.R.-N.); (M.Á.M.-G.); (M.B.-R.); (E.T.)
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), 28029 Madrid, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
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20
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Assi N, Rinaldi S, Viallon V, Dashti SG, Dossus L, Fournier A, Cervenka I, Kvaskoff M, Turzanski-Fortner R, Bergmann M, Boeing H, Panico S, Ricceri F, Palli D, Tumino R, Grioni S, José Sánchez Pérez M, Chirlaque MD, Bonet C, Barricarte Gurrea A, Amiano Etxezarreta P, Merino S, Bueno de Mesquita B, van Gils CH, Onland-Moret C, Tjønneland A, Overvad K, Trichopoulou A, Martimianaki G, Karakatsani A, Key T, Chistakoudi S, Ellingjord-Dale M, Tsilidis K, Riboli E, Kaaks R, Gunter MJ, Ferrari P. Mediation analysis of the alcohol-postmenopausal breast cancer relationship by sex hormones in the EPIC cohort. Int J Cancer 2020; 146:759-768. [PMID: 30968961 PMCID: PMC6786903 DOI: 10.1002/ijc.32324] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/11/2019] [Accepted: 03/13/2019] [Indexed: 12/27/2022]
Abstract
Alcohol consumption is associated with higher risk of breast cancer (BC); however, the biological mechanisms underlying this association are not fully elucidated, particularly the extent to which this relationship is mediated by sex hormone levels. Circulating concentrations of estradiol, testosterone, their free fractions and sex-hormone binding globulin (SHBG), were examined in 430 incident BC cases and 645 matched controls among alcohol-consuming postmenopausal women nested within the European Prospective Investigation into Cancer and Nutrition. Mediation analysis was applied to assess whether individual hormone levels mediated the relationship between alcohol intake and BC risk. An alcohol-related hormonal signature, obtained by partial least square (PLS) regression, was evaluated as a potential mediator. Total (TE), natural direct and natural indirect effects (NIE) were estimated. Alcohol intake was positively associated with overall BC risk and specifically with estrogen receptor-positive tumors with respectively TE = 1.17(95%CI: 1.01,1.35) and 1.36(1.08,1.70) for a 1-standard deviation (1-SD) increase of intake. There was no evidence of mediation by sex steroids or SHBG separately except for a weak indirect effect through free estradiol where NIE = 1.03(1.00,1.06). However, an alcohol-related hormonal signature negatively associated with SHBG and positively with estradiol and testosterone was associated with BC risk (odds ratio [OR] = 1.25 [1.07,1.47]) for a 1-SD higher PLS score, and had a statistically significant NIE accounting for a mediated proportion of 24%. There was limited evidence of mediation of the alcohol-BC association by individual sex hormones. However, a hormonal signature, reflecting lower levels of SHBG and higher levels of sex steroids, mediated a substantial proportion of the association.
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Affiliation(s)
- Nada Assi
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Sabina Rinaldi
- Biomarkers Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Vivian Viallon
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - S. Ghazaleh Dashti
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
- Center for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Parkville, VIC, Australia
| | - Laure Dossus
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Agnès Fournier
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
- Nutritional Epidemiology Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Iris Cervenka
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Marina Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | | | - Manuela Bergmann
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, 14558 Nuthetal, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, 14558 Nuthetal, Germany
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco (TO), Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, “Civic -M.P.Arezzo” Hospital, ASP Ragusa, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian 1, 20133, Milan, Italy
| | - María José Sánchez Pérez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria, IBS GRANADA, Universidad de Granada. Granada, Spain
| | - María-Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Institut Català d’Oncologia, Av. Granvia de L’Hospitalet 199-203, 08908 L’Hospitalet de Llobregat, Spain
| | - Aurelio Barricarte Gurrea
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Spain
| | - Pilar Amiano Etxezarreta
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, BioDonostia Research Institue, San Sebastian, Spain
| | | | - Bas Bueno de Mesquita
- Department. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, 50603, Kuala Lumpur, Malaysia
| | - Carla H. van Gils
- Julius Center for Health Sciences and Primary Care, Cancer Epidemiology University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
| | - Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, Cancer Epidemiology University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, DK 2100 Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences,University of Copenhagen, Denmark
| | - Kim Overvad
- The Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark
| | | | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- Pulmonary Medicine Department, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Haidari, Greece
| | - Tim Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - Sofia Chistakoudi
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
- MRC Centre for Transplantation, King’s College London, Great Maze Pond, London SE1 9RT, United Kingdom
| | - Merete Ellingjord-Dale
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
| | - Kostas Tsilidis
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place W2 1PG London, UK
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marc J Gunter
- Nutritional Epidemiology Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
| | - Pietro Ferrari
- Nutritional Methodology and Biostatistics Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France
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21
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Duif M, Thewissen V, Wouters S, Lechner L, Jacobs N. Associations between affect and alcohol consumption in adults: an ecological momentary assessment study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 46:88-97. [PMID: 31430201 DOI: 10.1080/00952990.2019.1635606] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Consuming alcohol for coping with negative affect (NA) or enhancing positive affect (PA) may lead to risky drinking patterns. Previous research has yielded mixed findings regarding these affective drinking associations.Objectives: To examine support for the self-medication and expectancy models of alcohol use in an adult community sample, by examining reciprocal associations between alcohol consumption and NA and PA within and between persons.Methods: During seven consecutive days, 162 adults from the community (109 female) reported their affective experiences and alcohol consumption, following a signal contingent ecological momentary assessment protocol on their smartphones.Results: Within-person daily NA preceding the first drinking event was associated with increased likelihood of same-day alcohol consumption. Within-person momentary NA was associated with a decrease in the amount of next-moment alcohol consumption. Within-person momentary PA was positively associated with likelihood of next-moment alcohol consumption. Between persons, levels of daily and momentary NA and PA were not associated with any index of alcohol consumption. The intercepts and slopes of NA were not significantly different before and after alcohol consumption. The intercept of PA was higher after alcohol consumption, whereas the slope of PA decreased after alcohol consumption.Conclusion: In the current sample affective drinking was a within-person process (i.e. persons were sensitive to their varying levels of affect). Some support was found for the self-medication and expectancy models. People may drink for coping with NA, but may also be at risk for developing affective drinking patterns in response to PA.
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Affiliation(s)
- Mira Duif
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Viviane Thewissen
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Saskia Wouters
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Nele Jacobs
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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22
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Raji Lahiji M, Dehdari T, Shokouhi Shoormasti R, Hosseini AF, Navaei M, Zarrati M. Nutrition knowledge, attitudes, and practice towards breast cancer prevention among the female population of Iran University of medical science students. Nutr Cancer 2019; 71:1355-1364. [PMID: 31058553 DOI: 10.1080/01635581.2019.1607410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Diet plays a measurable role in breast cancer (BC) prevention. The aims of this study were to assess nutrition-related BC prevention Knowledge, attitudes and practice (KAP) of female university students and to examine the relationship between demographic characteristics of students and their KAP. We conducted a cross-sectional study among 500 female students from Iran University of Medical Science (IUMS). A pretested self-administered questionnaires were used to assess the participants' nutrition-related BC prevention KAP. A total of 500 students completed the survey. Students' knowledge with the mean score of 16.97, significantly varied by age (P= 0.03), the field of study (P= 0.001) and family history of BC (P= 0.01). The mean score of attitudes and practice toward nutrition-related BC prevention factors were 24.86 and 39.39, respectively. A significant relationship was observed between nutrition knowledge and attitude (r = 0.27, P < 0.001). Also, Nutrition-related attitudes were positively correlated with the BC prevention dietary practices (r = 0.23, P < 0.001). Nutrition KAP about BC prevention factors was found to be influenced by individual factors such as age, field of study, familial history of BC, job and residency status. Together, our findings confirm that increasing nutrition knowledge is not sufficient for dietary behavior change, but is necessary.
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Affiliation(s)
- Mahsa Raji Lahiji
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences , Tehran , Iran
| | - Tahereh Dehdari
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Science , Tehran , Iran
| | | | - Agha Fatemeh Hosseini
- Department of Biostatistics, School of Public Health, Iran University of Medical Science , Tehran , Iran
| | - Mehraban Navaei
- Department of Nutrition, Student Research Committee, School of Public Health, Iran University of Medical Sciences , Tehran , Iran
| | - Mitra Zarrati
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences , Tehran , Iran
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23
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Johansson A, Palli D, Masala G, Grioni S, Agnoli C, Tumino R, Giurdanella MC, Fasanelli F, Sacerdote C, Panico S, Mattiello A, Polidoro S, Jones ME, Schoemaker MJ, Orr N, Tomczyk K, Johnson N, Fletcher O, Perduca V, Baglietto L, Dugué PA, Southey MC, Giles GG, English DR, Milne RL, Severi G, Ambatipudi S, Cuenin C, Chajès V, Romieu I, Herceg Z, Swerdlow AJ, Vineis P, Flanagan JM. Epigenome-wide association study for lifetime estrogen exposure identifies an epigenetic signature associated with breast cancer risk. Clin Epigenetics 2019; 11:66. [PMID: 31039828 PMCID: PMC6492393 DOI: 10.1186/s13148-019-0664-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 04/09/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND It is well established that estrogens and other hormonal factors influence breast cancer susceptibility. We hypothesized that a woman's total lifetime estrogen exposure accumulates changes in DNA methylation, detectable in the blood, which could be used in risk assessment for breast cancer. METHODS An estimated lifetime estrogen exposure (ELEE) model was defined using epidemiological data from EPIC-Italy (n = 31,864). An epigenome-wide association study (EWAS) of ELEE was performed using existing Illumina HumanMethylation450K Beadchip (HM450K) methylation data obtained from EPIC-Italy blood DNA samples (n = 216). A methylation index (MI) of ELEE based on 31 CpG sites was developed using HM450K data from EPIC-Italy and the Generations Study and evaluated for association with breast cancer risk in an independent dataset from the Generations Study (n = 440 incident breast cancer cases matched to 440 healthy controls) using targeted bisulfite sequencing. Lastly, a meta-analysis was conducted including three additional cohorts, consisting of 1187 case-control pairs. RESULTS We observed an estimated 5% increase in breast cancer risk per 1-year longer ELEE (OR = 1.05, 95% CI 1.04-1.07, P = 3 × 10-12) in EPIC-Italy. The EWAS identified 694 CpG sites associated with ELEE (FDR Q < 0.05). We report a DNA methylation index (MI) associated with breast cancer risk that is validated in the Generations Study targeted bisulfite sequencing data (ORQ4_vs_Q1 = 1.77, 95% CI 1.07-2.93, P = 0.027) and in the meta-analysis (ORQ4_vs_Q1 = 1.43, 95% CI 1.05-2.00, P = 0.024); however, the correlation between the MI and ELEE was not validated across study cohorts. CONCLUSION We have identified a blood DNA methylation signature associated with breast cancer risk in this study. Further investigation is required to confirm the interaction between estrogen exposure and DNA methylation in the blood.
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Affiliation(s)
- Annelie Johansson
- Division of Cancer, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, 4th Floor IRDB, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - Domenico Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research Prevention and Clinical Network-ISPRO, Florence, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research Prevention and Clinical Network-ISPRO, Florence, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Francesca Fasanelli
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, University of Naples Frederico II, Naples, Italy
| | - Amalia Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, University of Naples Frederico II, Naples, Italy
| | | | | | | | - Nick Orr
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Katarzyna Tomczyk
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Nichola Johnson
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | | | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Pierre-Antoine Dugué
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Dallas R English
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Roger L Milne
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Australia
| | - Gianluca Severi
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP, Inserm U1018), Université Paris-Saclay, UPS, UVSQ, Gustave Roussy, Villejuif, France
| | - Srikant Ambatipudi
- International Agency for Research on Cancer (IARC), Lyon, France
- AMCHSS, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - Cyrille Cuenin
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Veronique Chajès
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Zdenko Herceg
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Anthony J Swerdlow
- The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Paolo Vineis
- Italian Institute for Genomic Medicine, Turin, Italy
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - James M Flanagan
- Division of Cancer, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, 4th Floor IRDB, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK.
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Momenimovahed Z, Salehiniya H. Epidemiological characteristics of and risk factors for breast cancer in the world. BREAST CANCER (DOVE MEDICAL PRESS) 2019; 11:151-164. [PMID: 31040712 PMCID: PMC6462164 DOI: 10.2147/bctt.s176070] [Citation(s) in RCA: 317] [Impact Index Per Article: 63.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
AIM Breast cancer is the most common cancer among women and one of the most important causes of death among them. This review aimed to investigate the incidence and mortality rates of breast cancer and to identify the risk factors for breast cancer in the world. MATERIALS AND METHODS A search was performed in PubMed, Web of Science, and Scopus databases without any time restrictions. The search keywords included the following terms: breast cancer, risk factors, incidence, and mortality and a combination of these terms. Studies published in English that referred to various aspects of breast cancer including epidemiology and risk factors were included in the study. Overall, 142 articles published in English were included in the study. RESULTS Based on the published studies, the incidence rate of breast cancer varies greatly with race and ethnicity and is higher in developed countries. Results of this study show that mortality rate of breast cancer is higher in less developed regions. The findings of this study demonstrated that various risk factors including demographic, reproductive, hormonal, hereditary, breast related, and lifestyle contribute to the incidence of breast cancer. CONCLUSION The results of this study indicated that incidence and mortality rates of breast cancer is rising, so design and implementation of screening programs and the control of risk factors seem essential.
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Affiliation(s)
- Zohre Momenimovahed
- Qom University of Medical Sciences, Qom, Iran
- Department of Reproductive Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran,
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
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Hydes TJ, Burton R, Inskip H, Bellis MA, Sheron N. A comparison of gender-linked population cancer risks between alcohol and tobacco: how many cigarettes are there in a bottle of wine? BMC Public Health 2019; 19:316. [PMID: 30917803 PMCID: PMC6437970 DOI: 10.1186/s12889-019-6576-9] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 02/21/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND In contrast to our knowledge about the number of cancers attributed to smoking, the number of cancers attributed to alcohol is poorly understood by the public. We estimate the increase in absolute risk of cancer (number of cases per 1000) attributed to moderate levels of alcohol, and compare these to the absolute risk of cancer attributed to low levels of smoking, creating a 'cigarette-equivalent of population cancer harm'. METHODS Alcohol and tobacco attributable fractions were subtracted from lifetime general population risks of developing alcohol- and smoking-related cancers, to estimate the lifetime cancer risk in alcohol-abstaining non-smokers. This was multiplied by the relative risk of drinking ten units of alcohol or smoking ten cigarettes per week, and increasing levels of consumption. RESULTS One bottle of wine per week is associated with an increased absolute lifetime cancer risk for non-smokers of 1.0% (men) and 1.4% (women). The overall absolute increase in cancer risk for one bottle of wine per week equals that of five (men) or ten cigarettes per week (women). Gender differences result from levels of moderate drinking leading to a 0.8% absolute risk of breast cancer in female non-smokers. CONCLUSIONS One bottle of wine per week is associated with an increased absolute lifetime risk of alcohol-related cancers in women, driven by breast cancer, equivalent to the increased absolute cancer risk associated with ten cigarettes per week. These findings can help communicate that moderate levels of drinking are an important public health risk for women. The risks for men, equivalent to five cigarettes per week, are also of note.
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Affiliation(s)
- Theresa J. Hydes
- Department of Gastroenterology and Hepatology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK
| | - Robyn Burton
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG UK
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, University Hospital Southampton NHS Foundation Trust Tremona Road, Southampton, SO16 6YD UK
- NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust Tremona Road, Southampton, SO16 6YD UK
| | - Mark A. Bellis
- College of Health and Behavioural Sciences, Bangor University, Bangor, LL57 2UW UK
- World Health Organization Collaborating Centre on Investment in Health and Well-being, Public Health Wales, Cardiff, CF10 4BZ UK
| | - Nick Sheron
- Faculty of Medicine, University of Southampton, Mailpoint 81, Level E, South Academic Block, University Hospital Southampton NHS FoundationTrust, Tremona Road, Southampton, SO16 6YD UK
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Sugar-sweetened beverage consumption and incidence of breast cancer: the Seguimiento Universidad de Navarra (SUN) Project. Eur J Nutr 2018; 58:2875-2886. [DOI: 10.1007/s00394-018-1839-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/27/2018] [Indexed: 12/18/2022]
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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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Zakhari S, Hoek JB. Epidemiology of Moderate Alcohol Consumption and Breast Cancer: Association or Causation? Cancers (Basel) 2018; 10:E349. [PMID: 30249004 PMCID: PMC6210419 DOI: 10.3390/cancers10100349] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 02/07/2023] Open
Abstract
Epidemiological studies have been used to show associations between modifiable lifestyle habits and the incidence of breast cancer. Among such factors, a history of alcohol use has been reported in multiple studies and meta-analyses over the past decades. However, associative epidemiological studies that were interpreted as evidence that even moderate alcohol consumption increases breast cancer incidence have been controversial. In this review, we consider the literature on the relationship between moderate or heavy alcohol use, both in possible biological mechanisms and in variations in susceptibility due to genetic or epigenetic factors. We argue that there is a need to incorporate additional approaches to move beyond the associations that are reported in traditional epidemiological analyses and incorporate information on molecular pathologic signatures as a requirement to posit causal inferences. In particular, we point to the efforts of the transdisciplinary field of molecular pathological epidemiology (MPE) to evaluate possible causal relationships, if any, of alcohol consumption and breast cancer. A wider application of the principles of MPE to this field would constitute a giant step that could enhance our understanding of breast cancer and multiple modifiable risk factors, a step that would be particularly suited to the era of "personalized medicine".
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Affiliation(s)
- Samir Zakhari
- Science Office, Distilled Spirits Council, Washington, DC 20005, USA.
| | - Jan B Hoek
- Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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Baglia ML, Cook LS, Mei-Tzu C, Wiggins C, Hill D, Porter P, Li CI. Alcohol, smoking, and risk of Her2-overexpressing and triple-negative breast cancer relative to estrogen receptor-positive breast cancer. Int J Cancer 2018; 143:1849-1857. [PMID: 29708591 DOI: 10.1002/ijc.31575] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/21/2018] [Accepted: 04/17/2018] [Indexed: 02/05/2023]
Abstract
Epidemiological evidence is limited on how alcohol consumption and smoking are associated with risk of different subtypes of breast cancer, such as triple-negative (TN) and human epidermal growth factor receptor 2-overexpressing (H2E) breast cancers, which may have different etiologies from more common luminal (estrogen receptor [ER+]) breast cancers. In this population-based case-case study, we evaluated the association between alcohol, smoking, and risk of H2E and TN breast cancer, compared with ER+ breast cancers, among women aged 20-69 years. Using polytomous regression, associations between alcohol consumption, smoking, and breast cancer risk were evaluated in 909 ER+, 1,290 TN, and 489 H2E breast cancer patients, with ER+ breast cancer patients as the reference group. Current alcohol consumption at diagnosis was associated with a lower risk of H2E breast cancer (odds ratio = 0.74, 95% confidence interval: 0.58-0.92) relative to ER+ cancers. No difference in association was observed by menopausal status. No association between alcohol consumption and TN breast cancer relative to ER+ breast cancer was observed. Women who smoked did not have an altered risk of TN or H2E breast cancer, relative to ER+ cancer. Our results suggest that alcohol is associated with lower risk of H2E breast cancer relative to ER+ breast cancer. This study adds to the body of epidemiologic evidence that breast cancer etiology differs by breast cancer subtype.
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Affiliation(s)
- Michelle L Baglia
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Linda S Cook
- Department of Internal Medicine, University of New Mexico (UNM) and the UNM Comprehensive Cancer Center, Albuquerque, New Mexico
| | - C Mei-Tzu
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Charles Wiggins
- Department of Internal Medicine, University of New Mexico (UNM) and the UNM Comprehensive Cancer Center, Albuquerque, New Mexico
| | - Deirdre Hill
- Department of Internal Medicine, University of New Mexico (UNM) and the UNM Comprehensive Cancer Center, Albuquerque, New Mexico
| | - Peggy Porter
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Christopher I Li
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
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Bliddal M, Liew Z, Pottegård A, Kirkegaard H, Olsen J, Nohr EA. Examining Nonparticipation in the Maternal Follow-up Within the Danish National Birth Cohort. Am J Epidemiol 2018; 187:1511-1519. [PMID: 29346474 PMCID: PMC6030819 DOI: 10.1093/aje/kwy002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/19/2017] [Accepted: 01/03/2018] [Indexed: 12/14/2022] Open
Abstract
A follow-up questionnaire on maternal health was distributed within the Danish National Birth Cohort (established in 1996-2002) 14 years after the index birth. Responses were obtained from 41,466 (53.2%) of 78,010 eligible mothers. To ensure the appropriate use of these data, the possibility of selection bias due to nonparticipation had to be evaluated. We estimated 4 selected exposure-outcome associations (prepregnancy weight-depression; exercise-degenerative musculoskeletal conditions; smoking-heart disease; and alcohol consumption-breast cancer). We adjusted for several factors associated with participation and applied inverse probability weighting. To estimate the degree of selection bias, we calculated relative odds ratios for the relationship between the baseline cohort and the subset participating in the Maternal Follow-up. Participating women were generally healthier, of higher social status, and older than the baseline cohort. However, selection bias in the chosen scenarios was limited; ratios of the odds ratios ranged from -14% to 5% after adjustment for age, parity, social status, and, if the variable was not the exposure variable, prepregnancy body mass index, exercise, smoking, and alcohol consumption. Applying inverse probability weighting did not further reduce bias. In conclusion, while participants differed somewhat from the baseline cohort, selection bias was limited after factors associated with participation status were accounted for.
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Affiliation(s)
| | - Zeyan Liew
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Anton Pottegård
- Research Unit of Clinical Pharmacology and Pharmacy, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Helene Kirkegaard
- Research Unit of Gynecology and Obstetrics, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Ellen A Nohr
- Research Unit of Gynecology and Obstetrics, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Miller ER, Wilson C, Chapman J, Flight I, Nguyen AM, Fletcher C, Ramsey I. Connecting the dots between breast cancer, obesity and alcohol consumption in middle-aged women: ecological and case control studies. BMC Public Health 2018; 18:460. [PMID: 29625601 PMCID: PMC5889566 DOI: 10.1186/s12889-018-5357-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 03/22/2018] [Indexed: 01/30/2023] Open
Abstract
Background Breast cancer (BC) incidence in Australian women aged 45 to 64 years (‘middle-aged’) has tripled in the past 50 years, along with increasing alcohol consumption and obesity in middle-age women. Alcohol and obesity have been individually associated with BC but little is known about how these factors might interact. Chronic psychological stress has been associated with, but not causally linked to, BC. Here, alcohol could represent the ‘missing link’ – reflecting self-medication. Using an exploratory cross-sectional design, we investigated inter-correlations of alcohol intake and overweight/obesity and their association with BC incidence in middle-aged women. We also explored the role of stress and various lifestyle factors in these relationships. Methods We analysed population data on BC incidence, alcohol consumption, overweight/obesity, and psychological stress. A case control study was conducted using an online survey. Cases (n = 80) were diagnosed with BC and controls (n = 235) were women in the same age range with no BC history. Participants reported lifestyle data (including alcohol consumption, weight history) over consecutive 10-year life periods. Data were analysed using a range of bivariate and multivariate techniques including correlation matrices, multivariate binomial regressions and multilevel logistic regression. Results Ecological inter-correlations were found between BC and alcohol consumption and between BC and obesity but not between other variables in the matrix. Strong pairwise correlations were found between stress and alcohol and between stress and obesity. BMI tended to be higher in cases relative to controls across reported life history. Alcohol consumption was not associated with case-control status. Few correlations were found between lifestyle factors and stress, although smoking and alcohol consumption were correlated in some periods. Obesity occurring during the ages of 31 to 40 years emerged as an independent predictor of BC (OR 3.5 95% CI: 1.3–9.4). Conclusions This study provides ecological evidence correlating obesity and alcohol consumption with BC incidence. Case-control findings suggest lifetime BMI may be important with particular risk associated with obesity prior to 40 years of age. Stress was ecologically linked to alcohol and obesity but not to BC incidence and was differentially correlated with alcohol and smoking among cases and controls. Our findings support prevention efforts targeting weight in women below 40 years of age and, potentially, lifelong alcohol consumption to reduce BC risk in middle-aged women.
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Affiliation(s)
- E R Miller
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - C Wilson
- Flinders Centre for Innovation in Cancer, Flinders University , Adelaide, Australia.,Cancer Council of South Australia, Adelaide, Australia
| | - J Chapman
- Flinders Centre for Innovation in Cancer, Flinders University , Adelaide, Australia
| | - I Flight
- Flinders Centre for Innovation in Cancer, Flinders University , Adelaide, Australia
| | - A-M Nguyen
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - C Fletcher
- Flinders Centre for Innovation in Cancer, Flinders University , Adelaide, Australia
| | - Ij Ramsey
- Flinders Centre for Innovation in Cancer, Flinders University , Adelaide, Australia
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Morère JF, Viguier J, Couraud S, Brignoli-Guibaudet L, Lhomel C, Pivot XB, Eisinger F. Awareness and Misconceptions of Breast Cancer Risk Factors Among Laypersons and Physicians. Curr Oncol Rep 2018; 20:15. [DOI: 10.1007/s11912-017-0647-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Seiler A, Chen MA, Brown RL, Fagundes CP. Obesity, Dietary Factors, Nutrition, and Breast Cancer Risk. CURRENT BREAST CANCER REPORTS 2018; 10:14-27. [PMID: 30662586 PMCID: PMC6335046 DOI: 10.1007/s12609-018-0264-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW To synthesize the critical role of obesity-associated inflammation, dietary factors, and nutrition in determining breast cancer risk. RECENT FINDINGS Obesity-associated inflammation is strongly linked to breast cancer risk and progression, largely via two processes: inflammatory pathways and dysregulated metabolism. Cytokine production in excess adipose tissues creates a chronic inflammatory microenvironment, which favors tumor development. Lifestyle factors, including diet, have long been recognized as important determinants of breast cancer risk and mortality. SUMMARY Obesity increases the risk of developing breast cancer in both pre- and postmenopausal women and also negatively affects breast cancer recurrence and survival. Poor dietary habits characterized by the high intake of refined starches, sugar, and both saturated and trans-saturated fats, as well as the low intake of omega-3 fatty acids, natural antioxidants, and fiber, modulate inflammation and, thereby, appear to be linked to increased risk of breast cancer and mortality.
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Affiliation(s)
- Annina Seiler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Haldenbachstrasse 18, 8091 Zurich, Switzerland
| | | | - Ryan L Brown
- Department of Psychology, Rice University, Houston, TX, USA
| | - Christopher P Fagundes
- Department of Psychology, Rice University, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Shield KD, Marant Micallef C, Hill C, Touvier M, Arwidson P, Bonaldi C, Ferrari P, Bray F, Soerjomataram I. New cancer cases in France in 2015 attributable to different levels of alcohol consumption. Addiction 2018; 113:247-256. [PMID: 28833736 DOI: 10.1111/add.14009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/10/2017] [Accepted: 08/15/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Alcohol consumption increases the risk of cancer. Thus, to inform policy decisions, this study estimated the number of new cancer cases in France in 2015 attributable to alcohol consumption generally and to light (< 20 g per day (g/day) among women; < 40 g/day among men), moderate (20 to < 40 g/day among women; 40 to < 60 g/day among men) and heavy drinking (≥ 40 g/day among women; ≥ 60 g/day among men), and the number of cancer cases that would have been prevented assuming a previous 10% decrease in alcohol consumption. DESIGN New cancer cases attributable to alcohol were estimated using a population-attributable fraction methodology, assuming a 10-year latency period between exposure and diagnosis. SETTING AND PARTICIPANTS Population of France, 2015. MEASUREMENTS Alcohol consumption was estimated by coordinating data from the Baromètre santé 2005, a national representative survey (n = 30 455), with data from the Global Information System on Alcohol and Health. Relative risks were obtained from meta-analyses. Cancer data were estimated based on data from the French Cancer Registries Network. Uncertainty intervals (UI) were estimated using a Monte Carlo procedure. FINDINGS In France in 2015, an estimated 27 894 (95% UI = 24 287-30 996) or 7.9% of all new cancer cases were attributable to alcohol. The number of alcohol-attributable new cancer cases was similar for both men and women, with oesophageal squamous cell carcinomas having the largest attributable fraction (57.7%). Light, moderate, heavy and former alcohol drinking were responsible for 1.5, 1.3, 4.4 and 0.6% of all new cancer cases, respectively. Lastly, if there had been a previous 10% reduction in alcohol consumption, 2178 (95% UI = 1687-2601) new cancer cases would have been prevented. CONCLUSIONS Alcohol consumption in France appears to cause almost 8% of new cancer cases, with light and moderate drinking contributing appreciably to this burden. A 10% drop in drinking in France would have prevented more than 2000 (estimated) new cancer cases in 2015.
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Affiliation(s)
- Kevin D Shield
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Claire Marant Micallef
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Catherine Hill
- Biostatistics and Epidemiology Department, Institut Gustave Roussy, Villejuif, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité (CRESS), Paris, France
| | - Pierre Arwidson
- Prévention et promotion de la santé, Santé Publique France, Saint-Maurice, France
| | - Christophe Bonaldi
- Department of Chronic Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Pietro Ferrari
- Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Jacobsen KK, Lynge E, Tjønneland A, Vejborg I, von Euler-Chelpin M, Andersen ZJ. Alcohol consumption and mammographic density in the Danish Diet, Cancer and Health cohort. Cancer Causes Control 2017; 28:1429-1439. [PMID: 28965165 DOI: 10.1007/s10552-017-0970-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 09/22/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE We examined the association between alcohol consumption and mammographic density (MD) considering in detail the time of exposure and the type of alcohol. METHODS Of 5,356 women (4,489 post-menopausal) from the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening in Copenhagen (1993-2001), we used MD (mixed/dense or fatty) assessed at the first screening after cohort entry. Alcohol consumption was assessed at the time of recruitment. Logistic regression was used to estimate associations [odds ratios (OR), 95% confidence intervals (CI)] between alcohol consumption and MD. RESULTS The mean age was 56.2 years, 56.5% of women had mixed/dense MD, and 91.8% were alcohol consumers. There was no association between current alcohol consumption and MD at baseline (age 50-65, on average 1 year before MD assessment) neither between age at drinking initiation and MD, in the fully adjusted model. There was a borderline statistically significantly increased OR of having mixed/dense MD in women who consumed > 7 drinks/week at age 20-29 (1.31, 95% CI 1.00-1.72) compared to non-drinkers in this age group, and no effect of drinking at age 30-39, 40-49 or after > 50 years, when adjusting for current drinking. However, when considering different types of alcohol, drinking spirits at age 20-29 was positively associated with mixed/dense breast (3-7 drinks/week: OR 1.74, 95% CI 1.12-2.72); >7 drinks/week: (OR 1.76, 95% CI 0.73-4.23). No consistent pattern was found with beer, wine, or fortified wine. CONCLUSIONS We found higher MD among women with high alcohol consumption in early adulthood (ages 20-29), in those drinking spirits.
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Affiliation(s)
- Katja Kemp Jacobsen
- Department of Technology, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark.
| | - Elsebeth Lynge
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne Tjønneland
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Ilse Vejborg
- Department of Radiology and Diagnostic Imaging Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - My von Euler-Chelpin
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Zorana J Andersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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36
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Wang J, Heng YJ, Eliassen AH, Tamimi RM, Hazra A, Carey VJ, Ambrosone CB, de Andrade VP, Brufsky A, Couch FJ, King TA, Modugno F, Vachon CM, Hunter DJ, Beck AH, Hankinson SE. Alcohol consumption and breast tumor gene expression. Breast Cancer Res 2017; 19:108. [PMID: 28899409 PMCID: PMC5596493 DOI: 10.1186/s13058-017-0901-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 08/31/2017] [Indexed: 02/07/2023] Open
Abstract
Background Alcohol consumption is an established risk factor for breast cancer and the association generally appears stronger among estrogen receptor (ER)-positive tumors. However, the biological mechanisms underlying this association are not completely understood. Methods We analyzed messenger RNA (mRNA) microarray data from both invasive breast tumors (N = 602) and tumor-adjacent normal tissues (N = 508) from participants diagnosed with breast cancer in the Nurses’ Health Study (NHS) and NHSII. Multivariable linear regression, controlling for other known breast cancer risk factors, was used to identify differentially expressed genes by pre-diagnostic alcohol intake. For pathway analysis, we performed gene set enrichment analysis (GSEA). Differentially expressed genes or enriched pathway-defined gene sets with false discovery rate (FDR) <0.1 identified in tumors were validated in RNA sequencing data of invasive breast tumors (N = 166) from The Cancer Genome Atlas. Results No individual genes were significantly differentially expressed by alcohol consumption in the NHS/NHSII. However, GSEA identified 33 and 68 pathway-defined gene sets at FDR <0.1 among 471 ER+ and 127 ER- tumors, respectively, all of which were validated. Among ER+ tumors, consuming 10+ grams of alcohol per day (vs. 0) was associated with upregulation in RNA metabolism and transport, cell cycle regulation, and DNA repair, and downregulation in lipid metabolism. Among ER- tumors, in addition to upregulation in RNA processing and cell cycle, alcohol intake was linked to overexpression of genes involved in cytokine signaling, including interferon and transforming growth factor (TGF)-β signaling pathways, and translation and post-translational modifications. Lower lipid metabolism was observed in both ER+ tumors and ER+ tumor-adjacent normal samples. Most of the significantly enriched gene sets identified in ER- tumors showed a similar enrichment pattern among ER- tumor-adjacent normal tissues. Conclusions Our data suggest that moderate alcohol consumption (i.e. 10+ grams/day, equivalent to one or more drinks/day) is associated with several specific and reproducible biological processes and pathways, which adds potential new insight into alcohol-related breast carcinogenesis. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0901-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jun Wang
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 N Pleasant Street, Amherst, MA, 01003, USA. .,Present address: Department of Preventive Medicine, University of Southern California, Harlyne J. Norris Research Tower, 1450 Biggy Street, Los Angeles, CA, 90033, USA.
| | - Yujing J Heng
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Aditi Hazra
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA
| | - Vincent J Carey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA
| | - Victor P de Andrade
- Departamento de Patologia, A.C. Camargo Cancer Center, São Paulo, SP, 01509-900, Brazil
| | - Adam Brufsky
- Department of Medicine, University of Pittsburgh Medical Center, 300 Halket Street, Pittsburgh, PA, 15213, USA
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Tari A King
- Dana-Farber Cancer Institute and Brigham and Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA, 15213, USA
| | - Celine M Vachon
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - David J Hunter
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Andrew H Beck
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 N Pleasant Street, Amherst, MA, 01003, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Ellingjord-Dale M, Vos L, Hjerkind KV, Hjartåker A, Russnes HG, Tretli S, Hofvind S, Dos-Santos-Silva I, Ursin G. Alcohol, Physical Activity, Smoking, and Breast Cancer Subtypes in a Large, Nested Case-Control Study from the Norwegian Breast Cancer Screening Program. Cancer Epidemiol Biomarkers Prev 2017; 26:1736-1744. [PMID: 28877889 DOI: 10.1158/1055-9965.epi-17-0611] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/23/2017] [Accepted: 08/31/2017] [Indexed: 11/16/2022] Open
Abstract
Background: To what extent alcohol, smoking, and physical activity are associated with the various subtypes of breast cancer is not clear. We took advantage of a large population-based screening cohort to determine whether these risk factors also increase the risk of the poor prognosis subtypes.Methods: We conducted a matched case-control study nested within the Norwegian Breast Cancer Screening Program during 2006-2014. A total of 4,402 breast cancer cases with risk factor and receptor data were identified. Five controls were matched to each case on year of birth and year of screening. Conditional logistic regression was used to estimate ORs of breast cancer subtypes adjusted for potential confounders.Results: There were 2,761 luminal A-like, 709 luminal B-like HER2-negative, 367 luminal B-like HER2-positive, 204 HER2-positive, and 361 triple-negative cancers. Current alcohol consumption was associated with breast cancer risk overall [OR 1.26; 95% confidence interval (CI), 1.09-1.45] comparing 6+ glasses a week to never drinkers. However, this risk increase was found only for luminal A-like breast cancer. Smoking 20+ cigarettes a day was associated with an OR of 1.41 (95% CI, 1.06-1.89) overall, with significant trends for luminal A-like and luminal B-like HER2-negative cancer. Current physical activity (4+ hours/week compared with none) was associated with 15% decreased risk of luminal A-like cancer, but not clearly with other subtypes.Conclusions: In this large study, alcohol, smoking, and physical activity were predominantly associated with luminal A-like breast cancer.Impact: Alcohol, smoking, and physical activity were associated with luminal A-like breast cancer subtype. Cancer Epidemiol Biomarkers Prev; 26(12); 1736-44. ©2017 AACR.
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Affiliation(s)
| | - Linda Vos
- Cancer Registry of Norway, Oslo, Norway
| | | | - Anette Hjartåker
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Hege G Russnes
- Laboratory of Molecular Pathology, Division of Pathology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Department of Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, University of Oslo, Norway.,Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | | | | | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,University of Southern California, Los Angeles, California
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White AJ, DeRoo LA, Weinberg CR, Sandler DP. Lifetime Alcohol Intake, Binge Drinking Behaviors, and Breast Cancer Risk. Am J Epidemiol 2017; 186:541-549. [PMID: 28486582 DOI: 10.1093/aje/kwx118] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/24/2016] [Indexed: 01/21/2023] Open
Abstract
The prevalence of binge drinking in the United States is rising. While alcohol is a risk factor for breast cancer, less is known about the impact of episodic heavy drinking. In 2003-2009, women aged 35-74 years who were free of breast cancer were enrolled in the Sister Study (n = 50,884). Residents of the United States or Puerto Rico who had a sister with breast cancer were eligible. Multivariable Cox regression was used to estimate adjusted hazard ratios and 95% confidence intervals for breast cancer. During follow-up (mean = 6.4 years), 1,843 invasive breast cancers were diagnosed. Increased breast cancer risk was observed for higher lifetime alcohol intake (for ≥230 drinks/year vs. <60 drinks/year, hazard ratio (HR) = 1.35, 95% confidence interval (CI): 1.15, 1.58). Relative to low-level drinkers (<60 drinks/year), hazard ratios were increased for ever binge drinking (HR = 1.29, 95% CI: 1.15, 1.45) or blacking out (HR = 1.39, 95% CI: 1.17, 1.64). Compared with low-level drinkers who never binged, moderate drinkers (60-229 drinks/year) who binged had a higher risk (HR = 1.25, 95% CI: 1.08, 1.44). There was evidence of effect modification between moderate lifetime drinking and binging (relative excess risk due to interaction = 0.33, 95% CI: 0.10, 0.57). Our findings support the established association between lifetime alcohol intake and breast cancer and provide evidence for an increased risk associated with heavy episodic drinking, especially among moderate lifetime drinkers.
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39
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Kim HJ, Jung S, Eliassen AH, Chen WY, Willett WC, Cho E. Alcohol Consumption and Breast Cancer Risk in Younger Women According to Family History of Breast Cancer and Folate Intake. Am J Epidemiol 2017; 186:524-531. [PMID: 28520842 DOI: 10.1093/aje/kwx137] [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] [Received: 05/29/2016] [Accepted: 10/17/2016] [Indexed: 12/14/2022] Open
Abstract
To evaluate the association between alcohol consumption and breast cancer risk in younger women, overall and by family history of breast cancer and folate intake, we prospectively followed 93,835 US women aged 27-44 years in Nurses' Health Study II who had alcohol consumption data in 1991. Alcohol consumption and folate intake were measured by food frequency questionnaire every 4 years. We documented 2,866 incident cases of invasive breast cancer between 1991 and 2011. Alcohol consumption was not associated with breast cancer risk overall (for intake of ≥10 g/day vs. nondrinking, multivariate hazard ratio = 1.07, 95% confidence interval: 0.94, 1.22). When the association was stratified by family history and folate intake, a positive association between alcohol consumption and breast cancer was found among women with a family history and folate intake less than 400 μg/day (multivariate hazard ratio = 1.82, 95% confidence interval: 1.06, 3.12; P-trend = 0.08). Alcohol consumption was not associated with breast cancer in other categories of family history and folate intake (P-interaction = 0.55). In conclusion, in this population of younger women, higher alcohol consumption was associated with increased risk of breast cancer among those with both a family history of breast cancer and lower folate intake.
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40
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van Leeuwaarde RS, Dreijerink KM, Ausems MG, Beijers HJ, Dekkers OM, de Herder WW, van der Horst-Schrivers AN, Drent ML, Bisschop PH, Havekes B, Peeters PHM, Pijnappel RM, Vriens MR, Valk GD. MEN1-Dependent Breast Cancer: Indication for Early Screening? Results From the Dutch MEN1 Study Group. J Clin Endocrinol Metab 2017; 102:2083-2090. [PMID: 28323962 DOI: 10.1210/jc.2016-3690] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 03/14/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Multiple endocrine neoplasia type 1 (MEN1) is associated with an early-onset elevated breast cancer risk. This finding potentially has implications for breast cancer screening for women with MEN1, and therefore it is necessary to assess whether other risk factors are involved to identify those at greatest risk. DESIGN A cross-sectional case control study was performed using the Dutch MEN1 cohort, including >90% of the adult Dutch MEN1 population. All women with a confirmed MEN1 mutation received a questionnaire regarding cancer family history and breast cancer-related endocrine and general cancer risk factors. RESULTS A total of 138 of 165 (84%) eligible women with MEN1 completed the questionnaire. Eleven of the 138 women had breast cancer. Another 34 relatives with breast cancer were identified in the families of the included women, of whom 11 were obligate MEN1 carriers, 14 had no MEN1 mutation, and 9 had an unknown MEN1 status. The median age at breast cancer diagnosis of women with MEN1 (n = 22) was 45 years (range, 30 to 80 years), in comparison with 57.5 years (range, 40 to 85 years) in female relatives without MEN1 (n = 14; P = 0.03) and 61.2 years in the Dutch reference population. Known endocrine risk factors and general risk factors were not different for women with and without breast cancer. CONCLUSION The increased breast cancer risk in MEN1 carriers was not related to other known breast cancer risk factors or familial cancer history, and therefore breast cancer surveillance from the age of 40 years for all women with MEN1 is justifiable.
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Affiliation(s)
- Rachel S van Leeuwaarde
- Department of Endocrine Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Koen M Dreijerink
- Department of Endocrine Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Margreet G Ausems
- Department of Clinical Genetics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Hanneke J Beijers
- Department of Endocrinology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Olaf M Dekkers
- Department of Endocrinology and Metabolism, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Wouter W de Herder
- Department of Internal Medicine, Erasmus Medical Center, 3000 WB Rotterdam, The Netherlands
| | - Anouk N van der Horst-Schrivers
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, 9700 VG Groningen, The Netherlands
| | - Madeleine L Drent
- Department of Internal Medicine, Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
| | - Peter H Bisschop
- Department of Endocrinology and Metabolism, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
| | - Bas Havekes
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Petra H M Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Ruud M Pijnappel
- Department of Radiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Menno R Vriens
- Department of Endocrine Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Gerlof D Valk
- Department of Endocrine Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
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Romieu I, Ferrari P, Chajès V, de Batlle J, Biessy C, Scoccianti C, Dossus L, Christine Boutron M, Bastide N, Overvad K, Olsen A, Tjønneland A, Kaaks R, Boeing H, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Sieri S, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HBA, Gils CH, Peeters PH, Lund E, Skeie G, Weiderpass E, Ramón Quirós J, Chirlaque MD, Ardanaz E, Sánchez MJ, Duell EJ, Amiano Etxezarreta P, Borgquist S, Hallmans G, Johansson I, Maria Nilsson L, Khaw KT, Wareham N, Key TJ, Travis RC, Murphy N, Wark PA, Riboli E. Fiber intake modulates the association of alcohol intake with breast cancer. Int J Cancer 2017; 140:316-321. [PMID: 27599758 PMCID: PMC6198933 DOI: 10.1002/ijc.30415] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 01/12/2023]
Abstract
Alcohol intake has been related to an increased risk of breast cancer (BC) while dietary fiber intake has been inversely associated to BC risk. A beneficial effect of fibers on ethanol carcinogenesis through their impact on estrogen levels is still controversial. We investigated the role of dietary fiber as a modifying factor of the association of alcohol and BC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). This study included 334,850 women aged 35-70 years at baseline enrolled in the ten countries of the EPIC study and followed up for 11.0 years on average. Information on fiber and alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. Hazard ratios (HR) of developing invasive BC according to different levels of alcohol and fiber intake were computed. During 3,670,439 person-years, 11,576 incident BC cases were diagnosed. For subjects with low intake of fiber (<18.5 g/day), the risk of BC per 10 g/day of alcohol intake was 1.06 (1.03-1.08) while among subjects with high intake of fiber (>24.2 g/day) the risk of BC was 1.02 (0.99-1.05) (test for interaction p = 0.011). This modulating effect was stronger for fiber from vegetables. Our results suggest that fiber intake may modulate the positive association of alcohol intake and BC. Alcohol is well known to increase the risk for BC, while a fiber-rich diet has the opposite effect. Here the authors find a significant interaction between both lifestyle factors indicating that high fiber intake can ease the adverse effects associated with alcohol consumption. Consequently, women with high alcohol intake and low fiber intake (<18.5 g/day) had the highest risk for BC. Specific benefits were associated with fibers from vegetable, warranting further investigations into specific fiber sources and their mechanistic interactions with alcohol-induced BC risk.
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Affiliation(s)
- Isabelle Romieu
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Pietro Ferrari
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Veronique Chajès
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Jordi de Batlle
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Carine Biessy
- International Agency for Research on Cancer (IARC), Lyon, France
| | | | - Laure Dossus
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, Villejuif, F-94805, France
- Univ Paris Sud, UMRS 1018, Villejuif, F-94805, France
- IGR, F-94805, Villejuif, France
| | - Marie Christine Boutron
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, Villejuif, F-94805, France
- Univ Paris Sud, UMRS 1018, Villejuif, F-94805, France
- IGR, F-94805, Villejuif, France
| | - Nadia Bastide
- Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, Villejuif, F-94805, France
- Univ Paris Sud, UMRS 1018, Villejuif, F-94805, France
- IGR, F-94805, Villejuif, France
| | - Kim Overvad
- Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark
| | - Anja Olsen
- Research Diet, Genes and Environment Danish Cancer Society Research Center Strandboulevarden, Copenhagen, Denmark
| | - Anne Tjønneland
- Research Diet, Genes and Environment Danish Cancer Society Research Center Strandboulevarden, Copenhagen, Denmark
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heiner Boeing
- Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke German, Institute of Human Nutrition Potsdam-Rehbrücke
| | - Antonia Trichopoulou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens, GR-115 27, Greece
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Pagona Lagiou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
| | - Dimitrios Trichopoulos
- Department of Epidemiology, Harvard School of Public Health, Boston
- Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
- Hellenic Health Foundation, Athens, Greece
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic - M.P.Arezzo" Hospital, ASP Ragusa, Italy
| | - Paolo Vineis
- School of Public Health, Imperial College London, London, HuGeF Foundation Torino Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia Federico II University, Naples, Italy
| | - H B As Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology University Medical Centre, Utrecht, The Netherlands
- The School of Public Health, Imperial College London, London, United Kingdom
- Department of Social & Preventive Medicine, Faculty of Medicine University of Malaya, Kuala Lumpur, Malaysia
| | - Carla H Gils
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Eiliv Lund
- Department of community medicine, University of Tromsø - the Arctic University of Norway, Tromsø, Norway
| | - Guri Skeie
- Department of community medicine, University of Tromsø - the Arctic University of Norway, Tromsø, Norway
| | - 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, Institute of Population-based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Genetic Epidemiology Group, Folkhalsän Research Center, Samfundet Folkhälsan, Helsinki, Finland
| | | | - María-Dolores Chirlaque
- Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain, CIBER Epidemiology and Public Health CIBERESP, Spain
| | - Eva Ardanaz
- Navarre Public Health Institute, Pamplona, Spain, CIBER Epidemiology and Public Health CIBERESP, Spain
| | - María-José Sánchez
- Escuela Andaluza de Salud Pública, Granada, Spain, CIBERESP, Spain, Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Eric J Duell
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Pilar Amiano Etxezarreta
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
- CIBER Epidemiology and Public Health CIBERESP, Spain
| | - Signe Borgquist
- Division of Oncology, Department of Clinical Sciences, Lund University Lund, Sweden
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | | | - Lena Maria Nilsson
- Public Health and Clinical Medicine/Nutritional research, Umeå university, Umeå, Sweden
| | - Kay-Tee Khaw
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Nick Wareham
- MRC Epidemiology Unit and University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Neil Murphy
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Petra A Wark
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
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Hunt KK, Euhus DM, Boughey JC, Chagpar AB, Feldman SM, Hansen NM, Kulkarni SA, McCready DR, Mamounas EP, Wilke LG, Van Zee KJ, Morrow M. Society of Surgical Oncology Breast Disease Working Group Statement on Prophylactic (Risk-Reducing) Mastectomy. Ann Surg Oncol 2016; 24:375-397. [PMID: 27933411 DOI: 10.1245/s10434-016-5688-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Indexed: 12/15/2022]
Abstract
Over the past several years, there has been an increasing rate of bilateral prophylactic mastectomy (BPM) and contralateral prophylactic mastectomy (CPM) surgeries. Since publication of the 2007 SSO position statement on the use of risk-reducing mastectomy, there have been significant advances in the understanding of breast cancer biology and treatment. The purpose of this manuscript is to review the current literature as a resource to facilitate a shared and informed decision-making process regarding the use of risk-reducing mastectomy.
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Affiliation(s)
- Kelly K Hunt
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | | | | | | | | | | | | | | | | | | | | | - Monica Morrow
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Scoccianti C, Cecchini M, Anderson AS, Berrino F, Boutron-Ruault MC, Espina C, Key TJ, Leitzmann M, Norat T, Powers H, Wiseman M, Romieu I. European Code against Cancer 4th Edition: Alcohol drinking and cancer. Cancer Epidemiol 2016; 45:181-188. [PMID: 27816465 DOI: 10.1016/j.canep.2016.09.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Alcohol consumption is the third leading risk factor for disease and mortality in Europe. As evaluated by the International Agency for Research on Cancer (IARC) Monographs, a causal relationship is established for consumption of alcoholic beverages and cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast, even at low and moderate alcohol intakes. The higher the amount of alcohol consumed, the higher the risk of developing cancer. In Europe, an estimated 10% (95% CI: 7%-13%) of all cancer cases in men and 3% (95% CI: 1%-5%) of all cancer cases in women are attributable to alcohol consumption. Several biological mechanisms explain the carcinogenicity of alcohol; among them, ethanol and its genotoxic metabolite, acetaldehyde, play a major role. Taking all this evidence into account, a recommendation of the 4th edition of European Code against Cancer is: "If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention."
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Michele Cecchini
- Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France
| | - Annie S Anderson
- Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, United Kingdom
| | - Franco Berrino
- Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy
| | | | - Carolina Espina
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
| | - Hilary Powers
- Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Martin Wiseman
- World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1 B 3HH, United Kingdom
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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Tagliabue G, Borgini A, Tittarelli A, van Donkelaar A, Martin RV, Bertoldi M, Fabiano S, Maghini A, Codazzi T, Scaburri A, Favia I, Cau A, Barigelletti G, Tessandori R, Contiero P. Atmospheric fine particulate matter and breast cancer mortality: a population-based cohort study. BMJ Open 2016; 6:e012580. [PMID: 28076275 PMCID: PMC5129133 DOI: 10.1136/bmjopen-2016-012580] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/15/2016] [Accepted: 10/13/2016] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Atmospheric fine particulate matter (PM2.5) has multiple adverse effects on human health. Global atmospheric levels of PM2.5 increased by 0.55 μg/m3/year (2.1%/year) from 1998 through 2012. There is evidence of a causal relationship between atmospheric PM2.5 and breast cancer (BC) incidence, but few studies have investigated BC mortality and atmospheric PM2.5. We investigated BC mortality in relation to atmospheric PM2.5 levels among patients living in Varese Province, northern Italy. METHODS We selected female BC cases, archived in the local population-based cancer registry, diagnosed at age 50-69 years, between 2003 and 2009. The geographic coordinates of each woman's place of residence were identified, and individual PM2.5 exposures were assessed from satellite data. Grade, stage, age at diagnosis, period of diagnosis and participation in BC screening were potential confounders. Kaplan-Meir and Nelson-Aalen methods were used to test for mortality differences in relation to PM2.5 quartiles. Multivariable Cox proportional hazards modelling estimated HRs and 95% CIs of BC death in relation to PM2.5 exposure. RESULTS Of 2021 BC cases, 325 died during follow-up to 31 December 2013, 246 for BC. Risk of BC death was significantly higher for all three upper quartiles of PM2.5 exposure compared to the lowest, with HRs of death: 1.82 (95% CI 1.15 to 2.89), 1.73 (95% CI 1.12 to 2.67) and 1.72 (95% CI 1.08 to 2.75). CONCLUSIONS Our study indicates that the risk of BC mortality increases with PM2.5 exposure. Although additional research is required to confirm these findings, they are further evidence that PM2.5 exposure is harmful and indicate an urgent need to improve global air quality.
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Affiliation(s)
- Giovanna Tagliabue
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Borgini
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Tittarelli
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
- Harvard-Smithsonian Center for Astrophysics, Cambridge, Massachusetts, USA
| | - Martina Bertoldi
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sabrina Fabiano
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Anna Maghini
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tiziana Codazzi
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandra Scaburri
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Imma Favia
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Cau
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giulio Barigelletti
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Paolo Contiero
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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45
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Fazzino TL, Fleming K, Befort C. Alcohol Intake Among Breast Cancer Survivors: Change in Alcohol Use During a Weight Management Intervention. JMIR Cancer 2016; 2:e15. [PMID: 28410181 PMCID: PMC5367843 DOI: 10.2196/cancer.6295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/02/2016] [Accepted: 09/03/2016] [Indexed: 01/17/2023] Open
Abstract
Background Daily alcohol intake in quantities as small as half a drink/day significantly increases the risk of breast cancer recurrence for postmenopausal survivors. Interventions designed to modify alcohol use among survivors have not been studied; however, lifestyle interventions that target change in dietary intake may affect alcohol intake. Objective To evaluate change in alcohol use during a weight loss intervention for obese, rural-dwelling breast cancer survivors. Methods Data were derived from an 18-month trial that included a 6-month weight loss intervention delivered via group conference calls, followed by a 12-month randomized weight loss maintenance phase in which participants received continued group calls or mailed newsletters. Participants who reported regular alcohol use at baseline (N=37) were included in this study. Results Mean daily alcohol intake significantly decreased from baseline to 6 months during the weight loss intervention (19.6-2.3 g; P=.001). Mean alcohol intake did not significantly increase (b=0.99, P=.12) during the weight loss maintenance phase (months 6-18) and did not depend on randomization group (b=0.32, P=.799). Conclusions Findings provide preliminary evidence that a weight loss intervention may address obesity and alcohol use risk factors for cancer recurrence. Minimal mail-based contact post weight loss can maintain alcohol use reductions through 18 months, suggesting durability in these effects. These results highlight a possibility that lifestyle interventions for survivors may modify health behaviors that are not the main foci of an intervention but that coincide with intervention goals. Trial Registration Clinicaltrials.gov NCT01441011; https://clinicaltrials.gov/ct2/show/NCT01441011 (Archived by WebCite at http://www.webcitation.org/6lsJ9dMa9)
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Affiliation(s)
- Tera L Fazzino
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Kimberly Fleming
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, KS, United States
| | - Christie Befort
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, United States
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Mukamal KJ, Clowry CM, Murray MM, Hendriks HFJ, Rimm EB, Sink KM, Adebamowo CA, Dragsted LO, Lapinski PS, Lazo M, Krystal JH. Moderate Alcohol Consumption and Chronic Disease: The Case for a Long-Term Trial. Alcohol Clin Exp Res 2016; 40:2283-2291. [PMID: 27688006 PMCID: PMC5073014 DOI: 10.1111/acer.13231] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 09/01/2016] [Indexed: 12/21/2022]
Abstract
Drinking within recommended limits is highly prevalent in much of the world, and strong epidemiological associations exist between moderate alcohol consumption and risk of several major chronic diseases, including coronary heart disease, diabetes, and breast cancer. In many cases, plausible biological mediators for these associations have been identified in randomized trials, but gold standard evidence that moderate drinking causes or prevents any chronic disease remains elusive and important concerns about available evidence have been raised. Although long-term randomized trials to test the observed associations have been termed impossible, clinical investigators have now successfully completed randomized trials of complex nutritional interventions in a variety of settings, along with trials of alcohol consumption itself of up to 2 years duration. The successful completion of these trials suggests that objections to the execution of a full-scale, long-term clinical trial of moderate drinking on chronic disease are increasingly untenable. We present potential lessons learned for such a trial and discuss key features to maximize its feasibility and value.
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Affiliation(s)
- Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Catherine M Clowry
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Margaret M Murray
- National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | | | - Eric B Rimm
- Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Kaycee M Sink
- Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Clement A Adebamowo
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Lars O Dragsted
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - P Scott Lapinski
- Countway Library of Medicine, Harvard University, Boston, Massachusetts
| | - Mariana Lazo
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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47
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McCartney DMA, Byrne DG, Cantwell MM, Turner MJ. Cancer incidence in Ireland—the possible role of diet, nutrition and lifestyle. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0769-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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48
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Ziembicki S, Zhu J, Tse E, Martin LJ, Minkin S, Boyd NF. The Association between Alcohol Consumption and Breast Density: A Systematic Review and Meta-analysis. Cancer Epidemiol Biomarkers Prev 2016; 26:170-178. [DOI: 10.1158/1055-9965.epi-16-0522] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/01/2016] [Accepted: 09/14/2016] [Indexed: 11/16/2022] Open
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49
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Kromhout D, Spaaij CJK, de Goede J, Weggemans RM. The 2015 Dutch food-based dietary guidelines. Eur J Clin Nutr 2016; 70:869-78. [PMID: 27049034 PMCID: PMC5399142 DOI: 10.1038/ejcn.2016.52] [Citation(s) in RCA: 238] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 02/08/2023]
Abstract
The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food patterns and the risk of 10 major chronic diseases: coronary heart disease, stroke, heart failure, diabetes, breast cancer, colorectal cancer, lung cancer, chronic obstructive pulmonary disease, dementia and depression. The committee also selected three causal risk factors for cardiovascular diseases or diabetes: systolic blood pressure, low-density lipoprotein cholesterol and body weight. Findings were categorized as strong or weak evidence, inconsistent effects, too little evidence or effect unlikely for experimental and observational data separately. Next, the committee selected only findings with a strong level of evidence for deriving the guidelines. Convincing evidence was based on strong evidence from the experimental data either or not in combination with strong evidence from prospective cohort studies. Plausible evidence was based on strong evidence from prospective cohort studies only. A general guideline to eat a more plant food-based dietary pattern and limit consumption of animal-based food and 15 specific guidelines have been formulated. There are 10 new guidelines on legumes, nuts, meat, dairy produce, cereal products, fats and oils, tea, coffee and sugar-containing beverages. Three guidelines on vegetables, fruits, fish and alcoholic beverages have been sharpened, and the 2006 guideline on salt stayed the same. A separate guideline has been formulated on nutrient supplements. Completely food-based dietary guidelines can be derived in a systematic and transparent way.
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Affiliation(s)
- D Kromhout
- The Health Council of the Netherlands, The Hague, The Netherlands
| | - C J K Spaaij
- The Health Council of the Netherlands, The Hague, The Netherlands
| | - J de Goede
- The Health Council of the Netherlands, The Hague, The Netherlands
| | - R M Weggemans
- The Health Council of the Netherlands, The Hague, The Netherlands
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50
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Jayasekara H, MacInnis RJ, Hodge AM, Room R, Milne RL, Hopper JL, Giles GG, English DR. Is breast cancer risk associated with alcohol intake before first full-term pregnancy? Cancer Causes Control 2016; 27:1167-74. [PMID: 27437703 DOI: 10.1007/s10552-016-0789-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/15/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE It is plausible that breast tissue is particularly susceptible to carcinogens, including ethanol, between menarche and the first full-term pregnancy ("first pregnancy"). There is some epidemiological evidence that intake before the first pregnancy is more closely associated with risk of breast cancer than is intake thereafter. We examined this association using lifetime alcohol consumption data from a prospective cohort study. METHODS We calculated usual alcohol intake for age periods 15-19 years and for 10-year period from age 20 to current age (in grams per day) using recalled frequency and quantity of beverage-specific consumption for 13,630 parous women who had their first pregnancy at age 20 years or later, had no cancer history and were aged 40-69 years at enrollment. Cox regression was performed to estimate hazard ratios (HRs) and their 95 % confidence intervals (CIs). RESULTS A total of 651 incident invasive adenocarcinomas of the breast were diagnosed during a mean follow-up of 16.1 years. Alcohol consumption was low overall with only a few drinking ≥40 g/day. Intake before the first pregnancy was markedly lower (mean intake: 2.5 g/day; abstention: 58.8 %) than intake thereafter (mean intake: 6.0 g/day; abstention: 33.6 %). Any alcohol intake before the first pregnancy was associated with an increased risk of breast cancer (HR 1.35, 95 % CI 1.10-1.66 for drinking compared with abstention), whereas any intake after the first pregnancy was not (HR 0.89, 95 % CI 0.72-1.09). CONCLUSIONS Limiting alcohol intake before the first pregnancy might reduce women's risk of breast cancer.
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Affiliation(s)
- Harindra Jayasekara
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia. .,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia.
| | - Robert J MacInnis
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia
| | - Allison M Hodge
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia.,Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3010, Australia.,Centre for Social Research on Alcohol and Drugs, Stockholm University, 106 91, Stockholm, Sweden
| | - Roger L Milne
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia
| | - John L Hopper
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia
| | - Dallas R English
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia
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