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Fritz J, Jochems SHJ, Bjørge T, Wood AM, Häggström C, Ulmer H, Nagel G, Zitt E, Engeland A, Harlid S, Drake I, Stattin P, Stocks T. Body mass index, triglyceride-glucose index, and prostate cancer death: a mediation analysis in eight European cohorts. Br J Cancer 2024; 130:308-316. [PMID: 38087039 PMCID: PMC10803806 DOI: 10.1038/s41416-023-02526-1] [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: 04/07/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Insulin resistance is a hypothesised biological mechanism linking obesity with prostate cancer (PCa) death. Data in support of this hypothesis is limited. METHODS We included 259,884 men from eight European cohorts, with 11,760 incident PCa's and 1784 PCa deaths during follow-up. We used the triglyceride-glucose (TyG) index as indicator of insulin resistance. We analysed PCa cases with follow-up from PCa diagnosis, and the full cohort with follow-up from the baseline cancer-free state, thus incorporating both PCa incidence and death. We calculated hazard ratios (HR) and the proportion of the total effect of body mass index (BMI) on PCa death mediated through TyG index. RESULTS In the PCa-case-only analysis, baseline TyG index was positively associated with PCa death (HR per 1-standard deviation: 1.11, 95% confidence interval (CI); 1.01-1.22), and mediated a substantial proportion of the baseline BMI effect on PCa death (HRtotal effect per 5-kg/m2 BMI: 1.24; 1.14-1.35, of which 28%; 4%-52%, mediated). In contrast, in the full cohort, the TyG index was not associated with PCa death (HR: 1.03; 0.94-1.13), hence did not substantially mediate the effect of BMI on PCa death. CONCLUSIONS Insulin resistance could be an important pathway through which obesity accelerates PCa progression to death.
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Affiliation(s)
- Josef Fritz
- Department of Translational Medicine, Lund University, Malmö, Sweden.
- Institute of Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, Austria.
| | | | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Angela M Wood
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Christel Häggström
- Northern Registry Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Hanno Ulmer
- Institute of Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, Austria
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria
| | - Gabriele Nagel
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria
- Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
| | - Anders Engeland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Chronic Diseases, Norwegian Institute of Public Health, Bergen, Norway
| | - Sophia Harlid
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Isabel Drake
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Tanja Stocks
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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Cussenot O, Fromont G, Cancel-Tassin G, Hamdy FC, Martin RM. Endemic statistical paradoxes in epidemiologic studies distort knowledge on prostate cancer: mitigation and caution of fallacies in prostate cancer causal epidemiological studies. Curr Opin Urol 2023; 33:421-427. [PMID: 37555785 DOI: 10.1097/mou.0000000000001119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
PURPOSE OF REVIEW Many studies on epidemiology of prostate cancer (PCa) are based on a diagnosis of PCa using PSA (prostate-specific antigen) level. However, biases can distort the interpretation of the results, which in turn limits policy and decision making on public health prevention strategies or clinical guidelines. The main confusion is to interpret the posterior probability of the outcome following the exposure as a change in the prevalence of the disease outcome, whereas this change reflects only the predictive values of the PSA test induced by the exposure of interest. RECENT FINDINGS Many studies report potential causal factors involved in PCa risk. However, the lack of integration of how physiological changes in PSA values are associated with the exposures being investigated, they explain in part contradictory and controversial results on PCa risk factors in the literature. SUMMARY A strategy to perform case--control studies based on PSA stratification is suggested to avoid misinterpretation related to PSA misclassification. Real data are analysed, and we show that we can exploit the mechanism of selection biases using different modalities of controls recruitment based on biomarker stratification to distinguish real from false causal factors.
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Affiliation(s)
- Olivier Cussenot
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- CeRePP, Paris, France
| | - Gaelle Fromont
- CeRePP, Paris, France
- Department of Pathology, CHRU Tours, Tours, France
| | | | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Richard M Martin
- Population Health Sciences, Bristol Medical School, University of Bristol
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
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Yuan C, Jian Z, Feng S, Wang M, Xiang L, Li H, Jin X, Wang K. Do Obesity-Related Traits Affect Prostate Cancer Risk through Serum Testosterone? A Mendelian Randomization Study. Cancers (Basel) 2023; 15:4884. [PMID: 37835578 PMCID: PMC10571835 DOI: 10.3390/cancers15194884] [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: 08/21/2023] [Revised: 10/01/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE This study aimed to investigate whether testosterone mediates or confounds the effect of obesity-related traits on prostate cancer (PCa) using Mendelian randomization (MR) analysis. MATERIALS AND METHODS Data of obesity-related traits (body mass index [BMI], waist-to-hip ratio [WHR], and waist-to-hip ratio adjusted for body mass index [WHRadjBMI]) were obtained from up to 806,834 people of European ancestry; data of testosterone (bioavailable testosterone [BT], total testosterone [TT], and sex hormone-binding globulin [SHBG]) were extracted from up to 194,453 participants in the UK Biobank; and the summary-level data of PCa (79,194 cases and 61,112 controls) were obtained from the PRACTICAL consortium. RESULT The results supported the causal relationship between higher BMI and a reduced risk of PCa (OR = 0.91, 95% confidence interval [CI]: 0.86-0.96). Furthermore, increased BT levels were associated with an elevated risk of PCa (OR = 1.15, 95% CI: 1.06-1.24). Importantly, our analysis revealed a unidirectional causal effect-higher BMI was linked to lower BT levels (beta = -0.27, 95% CI: -0.3--0.24), but not the other way around. This suggests that BT may mediate the effect of BMI on PCa rather than confound it. Our multivariable MR results further demonstrated that considering BT as a mediator led to the weakening of BMI's effect on PCa risk (OR = 0.97, 95% CI: 0.90-1.05), while the impact of BT on PCa remained unchanged when accounting for BMI. Moreover, we identified a significant indirect effect of BMI on PCa risk (OR = 0.96, 95% CI: 0.94-0.98). CONCLUSION Our study provided genetic evidence that serum BT can mediate the effect of BMI on the risk of PCa, indicating the possible mechanism by which obesity reduces PCa risk.
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Affiliation(s)
- Chi Yuan
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;
- Department of Urology and Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Z.J.); (S.F.); (M.W.); (L.X.); (H.L.)
| | - Zhongyu Jian
- Department of Urology and Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Z.J.); (S.F.); (M.W.); (L.X.); (H.L.)
- West China Biomedical Big Data Center, Sichuan University, Chengdu 610041, China
| | - Shijian Feng
- Department of Urology and Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Z.J.); (S.F.); (M.W.); (L.X.); (H.L.)
| | - Menghua Wang
- Department of Urology and Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Z.J.); (S.F.); (M.W.); (L.X.); (H.L.)
| | - Liyuan Xiang
- Department of Urology and Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Z.J.); (S.F.); (M.W.); (L.X.); (H.L.)
| | - Hong Li
- Department of Urology and Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Z.J.); (S.F.); (M.W.); (L.X.); (H.L.)
| | - Xi Jin
- Department of Urology and Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Z.J.); (S.F.); (M.W.); (L.X.); (H.L.)
| | - Kunjie Wang
- Department of Urology and Institute of Urology, Laboratory of Reconstructive Urology, West China Hospital, Sichuan University, Chengdu 610041, China; (Z.J.); (S.F.); (M.W.); (L.X.); (H.L.)
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Kobayashi T, Hachiya T, Ikehata Y, Horie S. Genetic association of mosaic loss of chromosome Y with prostate cancer in men of European and East Asian ancestries: a Mendelian randomization study. FRONTIERS IN AGING 2023; 4:1176451. [PMID: 37323536 PMCID: PMC10264619 DOI: 10.3389/fragi.2023.1176451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/22/2023] [Indexed: 06/17/2023]
Abstract
Background: Genomic instability is a significant hallmark of aging and has a major impact on aging biology. Mosaic loss of chromosome Y (mLOY) in blood cells is a common chromosomal abnormality in aging men and is considered an indicator of genomic instability. Previous studies have indicated a connection between mLOY and prostate cancer risk, but the causal relationship has not been fully established. Methods: To determine the causal effect of mLOY on prostate cancer, we conducted a Mendelian Randomization (MR) study in two ancestral groups. We utilized 125 and 42 mLOY-associated variants as instrumental variables (IVs) in European and East Asian GWAS of prostate cancer, respectively. Summary-level data on prostate cancer was obtained from the PRACTICAL consortium (79,148 cases and 61,106 controls of European ancestry) and the Biobank Japan consortium (5,408 cases and 103,939 controls of East Asian ancestry). A single population was used to assess the causal relationship in East Asian ancestry. Our main method for obtaining MR results was inverse-variance weighted (IVW), and we conducted sensitivity analyses to confirm the robustness of our results. Finally, we combined the estimates from both sources using a fixed-effects meta-analysis. Results: Our MR analysis using the IVW method showed that a one-unit increase in genetically predicted mLOY was associated with an increased risk of prostate cancer in the PRACTICAL consortium (OR = 1.09%, 95% CI: 1.05-1.13, p = 1.2 × 10-5), but not in the Biobank Japan consortium (OR = 1.13%, 95% CI: 0.88-1.45, p = 0.34). Sensitivity analyses robustly indicated increased odds ratios for prostate cancer with every one-unit increase in genetically predicted mLOY for the PRACTICAL consortium. Furthermore, mLOY was found to be associated with prostate cancer risk in a meta-analysis of both sources (OR = 1.09%, 95% CI: 1.05-1.13, p = 8.0 × 10-6). Conclusion: Our MR study provides strong evidence that higher mLOY increases the risk of prostate cancer. Preventing mLOY may be a means of reducing the risk of developing prostate cancer.
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Affiliation(s)
- Takuro Kobayashi
- Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Tsuyoshi Hachiya
- Department of Advanced Informatics for Genetic Diseases, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshihiro Ikehata
- Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Shigeo Horie
- Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Advanced Informatics for Genetic Diseases, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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Obesity and main urologic cancers: Current systematic evidence, novel biological mechanisms, perspectives and challenges. Semin Cancer Biol 2023; 91:70-98. [PMID: 36893965 DOI: 10.1016/j.semcancer.2023.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 03/09/2023]
Abstract
Urologic cancers (UC) account for 13.1% of all new cancer cases and 7.9% of all cancer-related deaths. A growing body of evidence has indicated a potential causal link between obesity and UC. The aim of the present review is to appraise in a critical and integrative manner evidence from meta-analyses and mechanistic studies on the role of obesity in four prevalent UC (kidney-KC, prostate-PC, urinary bladder-UBC, and testicular cancer-TC). Special emphasis is given on Mendelian Randomization Studies (MRS) corroborating a genetic causal association between obesity and UC, as well as on the role of classical and novel adipocytokines. Furthermore, the molecular pathways that link obesity to the development and progression of these cancers are reviewed. Available evidence indicates that obesity confers increased risk for KC, UBC, and advanced PC (20-82%, 10-19%, and 6-14%, respectively), whereas for TC adult height (5-cm increase) may increase the risk by 13%. Obese females tend to be more susceptible to UBC and KC than obese males. MRS have shown that a higher genetic-predicted BMI may be causally linked to KC and UBC but not PC and TC. Biological mechanisms that are involved in the association between excess body weight and UC include the Insulin-like Growth Factor axis, altered availability of sex hormones, chronic inflammation and oxidative stress, abnormal secretion of adipocytokines, ectopic fat deposition, dysbiosis of the gastrointestinal and urinary tract microbiomes and circadian rhythm dysregulation. Anti-hyperglycemic and non-steroidal anti-inflammatory drugs, statins, and adipokine receptor agonists/antagonists show potential as adjuvant cancer therapies. Identifying obesity as a modifiable risk factor for UC may have significant public health implications, allowing clinicians to tailor individualized prevention strategies for patients with excess body weight.
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Pereira VS, Alves BDCA, Waisberg J, Fonseca F, Gehrke F. Detection of COX-2 in liquid biopsy of patients with prostate cancer. J Clin Pathol 2023; 76:189-193. [PMID: 34782424 DOI: 10.1136/jclinpath-2021-207755] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/14/2021] [Indexed: 01/10/2023]
Abstract
AIMS To determine the profile of COX-2 gene expression in patients with prostate cancer attended at the ABC University Health Center outpatient clinic and correlate the results with patients' anatomopathological examinations. Prostate cancer is the sixth most common type of cancer worldwide and the second in Brazil. COX-2 expression is associated with an unfavourable prognosis. METHODS 15.0 mL of peripheral blood were collected from 24 patients and 25 healthy men. RNA extraction was performed using the QIAamp RNA Blood Mini Kit. Complementary DNA synthesis was performed using SuperScript II RNAse Reverse Transcriptase. Quantitative real-time PCR was performed with specific COX-2 oligonucleotides and the endogenous GAPDH gene. RESULTS The mean age of the patients was 69 years old. The Gleason scoring system showed 37.5% of patients with Gleason 6 (slow growth, low risk), 45.8% with Gleason 7 (intermediate risk) and 16.7% with Gleason 8 or 9 (risk of high-grade cancer). The median COX-2 expression in the study group was 0.97, while in the control group it was 0.11 (p<0.045). CONCLUSIONS Patients with prostate cancer showed higher COX-2 expression at diagnosis compared with the control group. Since COX-2 detection associated with prostate-specific antigen dosage shows promise as a biomarker for diagnosis and prognosis in patients with prostate cancer, further research is required to confirm these findings.
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Affiliation(s)
| | | | - Jaques Waisberg
- Programa de Pós-Graduação em Ciência Cirúrgica Interdisciplinar, Universidade Federal de São Paulo, UNIFESP/EPM, São Paulo, Brazil.,Cirurgia, Centro Universitário FMABC, Santo André, Brazil
| | - Fernando Fonseca
- Laboratório de Análises Clínicas, Centro Universitário FMABC, Santo André, Brazil.,Ciências Farmacêuticas, Universidade Federal de São Paulo/UNIFESP, Diadema, Brazil
| | - Flavia Gehrke
- Programa de Pós Graduação em Ciências da Saúde, Iamspe, São Paulo, Brazil .,Patologia, Centro Universitário FMABC, Santo André, Brazil
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French AFU Cancer Committee Guidelines - Update 2022-2024: prostate cancer - Diagnosis and management of localised disease. Prog Urol 2022; 32:1275-1372. [DOI: 10.1016/j.purol.2022.07.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
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Purcell SA, Oliveira CLP, Mackenzie M, Robson P, Lewis JD, Prado CM. Body Composition and Prostate Cancer Risk: A Systematic Review of Observational Studies. Adv Nutr 2022; 13:1118-1130. [PMID: 34918023 PMCID: PMC9340980 DOI: 10.1093/advances/nmab153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/13/2021] [Accepted: 12/10/2021] [Indexed: 12/24/2022] Open
Abstract
Body composition parameters are not captured by measures of body mass, which may explain inconsistent associations between body weight and prostate cancer (PC) risk. The objective of this systematic review was to characterize the association between fat mass (FM) and fat-free mass (FFM) parameters and PC risk. A search of PubMed, Embase, and Web of Science identified case-control and cohort studies that measured body composition in relation to PC risk. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Thirteen observational studies were included, of which 8 were case-control studies (n = 1572 cases, n = 1937 controls) and 5 were prospective cohort studies (n = 7854 incident cases with PC). The NOS score was 5.9 ± 1.1 for case-control studies and 8.4 ± 1.3 for cohort studies. The most common body composition technique was bioelectrical impedance analysis (n = 9 studies), followed by DXA (n = 2), computed tomography (n = 2), air displacement plethysmography (n = 1), and MRI (n = 1). No case-control studies reported differences in %FM between PC cases and controls and no consistent differences in FM or FFM (in kilograms) were observed. Two out of 5 cohort studies reported that higher %FM was associated with lower PC risk. Conversely, 3 cohort studies reported a greater risk of being diagnosed with advanced/aggressive PC with higher FM (expressed in kilograms, %FM, or fat distribution). Two out of 4 studies (both case-control and cohort) found that higher abdominal adipose tissue was associated with increased PC risk. In conclusion, although results were inconsistent, there is some evidence that FM may be negatively associated with total PC risk but positively associated with the risk of advanced/aggressive PC; modest evidence suggests that abdominal adipose tissue may increase the risk of PC. Future work should elucidate unique patterns of FM distribution and PC risk to triage men at risk for developing PC. This study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database as CRD42019133388.
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Affiliation(s)
- Sarah A Purcell
- Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Camila L P Oliveira
- Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Mackenzie
- Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Paula Robson
- Cancer Care Alberta and the Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - John D Lewis
- Department of Experimental Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Carla M Prado
- Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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The timing of adiposity and changes in the life course on the risk of cancer. Cancer Metastasis Rev 2022; 41:471-489. [PMID: 35908000 DOI: 10.1007/s10555-022-10054-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/23/2022] [Indexed: 11/02/2022]
Abstract
Excess body weight has been established as a risk factor for at least twelve cancer sites, though questions remain as to the timing of associations for adiposity and cancer risk throughout the life course. We conducted a narrative review summarizing existing evidence to provide insights into the complex timing relationship between adiposity and risk of seven common obesity-related cancers. We considered five types of studies, including traditional epidemiologic studies examining adiposity at different time points, studies examining weight gain in specific life phases, studies examining weight loss over a period including from bariatric surgery, life course trajectory analysis, and Mendelian randomization studies. The results showed that lifetime excess body weight is associated with increased risk of cancers of endometrium, colorectum, liver, kidney, and pancreas. Early life obesity is one of the strongest risk factors for pancreatic cancer but less directly important than adult obesity for endometrial and kidney cancer. Interestingly, heavy weight during childhood, adolescence, and early adulthood is protective against pre- and postmenopausal breast cancer and possibly advanced prostate cancer. It is apparent that preventing weight gain later in adulthood would likely reduce risk of many cancers, including postmenopausal breast cancer, endometrial cancer, colorectal cancer (especially in men), liver cancer, kidney cancer, and probably advanced prostate cancer. Furthermore, weight loss even late in life may confer benefits for cancers of breast, endometrium, colorectum, and liver among patients with obesity, as mostly demonstrated by studies of bariatric surgery. Overall, maintaining a healthy weight throughout the life course will help prevent a large number of cancers.
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Your height affects your health: genetic determinants and health-related outcomes in Taiwan. BMC Med 2022; 20:250. [PMID: 35831902 PMCID: PMC9281111 DOI: 10.1186/s12916-022-02450-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/22/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Height is an important anthropometric measurement and is associated with many health-related outcomes. Genome-wide association studies (GWASs) have identified hundreds of genetic loci associated with height, mainly in individuals of European ancestry. METHODS We performed genome-wide association analyses and replicated previously reported GWAS-determined single nucleotide polymorphisms (SNPs) in the Taiwanese Han population (Taiwan Biobank; n = 67,452). A genetic instrument composed of 251 SNPs was selected from our GWAS, based on height and replication results as the best-fit polygenic risk score (PRS), in accordance with the clumping and p-value threshold method. We also examined the association between genetically determined height (PRS251) and measured height (phenotype). We performed observational (phenotype) and genetic PRS251 association analyses of height and health-related outcomes. RESULTS GWAS identified 6843 SNPs in 89 genomic regions with genome-wide significance, including 18 novel loci. These were the most strongly associated genetic loci (EFEMP1, DIS3L2, ZBTB38, LCORL, HMGA1, CS, and GDF5) previously reported to play a role in height. There was a positive association between PRS251 and measured height (p < 0.001). Of the 14 traits and 49 diseases analyzed, we observed significant associations of measured and genetically determined height with only eight traits (p < 0.05/[14 + 49]). Height was positively associated with body weight, waist circumference, and hip circumference but negatively associated with body mass index, waist-hip ratio, body fat, total cholesterol, and low-density lipoprotein cholesterol (p < 0.05/[14 + 49]). CONCLUSIONS This study contributes to the understanding of the genetic features of height and health-related outcomes in individuals of Han Chinese ancestry in Taiwan.
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Gu D, Tang M, Wang Y, Cui H, Zhang M, Bai Y, Zeng Z, Tan Y, Wang X, Zhang B. The Causal Relationships Between Extrinsic Exposures and Risk of Prostate Cancer: A Phenome-Wide Mendelian Randomization Study. Front Oncol 2022; 12:829248. [PMID: 35237523 PMCID: PMC8882837 DOI: 10.3389/fonc.2022.829248] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background Prostate cancer is the second most common cancer in males worldwide, and multitudes of factors have been reported to be associated with prostate cancer risk. Objectives We aim to conduct the phenome-wide exposed-omics analysis of the risk factors for prostate cancer and verify the causal associations between them. Methods We comprehensively searched published systematic reviews and meta-analyses of cohort studies and conducted another systematic review and meta-analysis of the Mendelian randomization studies investigating the associations between extrinsic exposures and prostate cancer, thus to find all of the potential risk factors for prostate cancer. Then, we launched a phenome-wide two-sample Mendelian randomization analysis to validate the potentially causal relationships using the PRACTICAL consortium and UK Biobank. Results We found a total of 55 extrinsic exposures for prostate cancer risk. The causal effect of 30 potential extrinsic exposures on prostate cancer were assessed, and the results showed docosahexaenoic acid (DHA) [odds ratio (OR)=0.806, 95% confidence interval (CI): 0.661-0.984, p=0.034], insulin-like growth factor binding protein 3 (IGFBP-3) (OR=1.0002, 95%CI: 1.00004-1.0004, p=0.016), systemic lupus erythematosus (SLE) (OR=0.9993, 95%CI: 0.9986-0.99997, p=0.039), and body mass index (BMI) (OR=0.995, 95%CI: 0.990-0.9999, p=0.046) were associated with prostate cancer risk. However, no association was found between the other 26 factors and prostate cancer risk. Conclusions Our study discovered the phenome-wide exposed-omics risk factors profile of prostate cancer, and verified that the IGFBP-3, DHA, BMI, and SLE were causally related to prostate cancer risk. The results may provide new insight into the study of the pathogenesis of prostate cancer.
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Affiliation(s)
- Dongqing Gu
- Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Mingshuang Tang
- Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Yutong Wang
- Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Huijie Cui
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Min Zhang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Ye Bai
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Ziqian Zeng
- Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Yunhua Tan
- Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China
| | - Xin Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ben Zhang
- Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China
- *Correspondence: Ben Zhang,
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Liu Y, Gusev A, Heng YJ, Alexandrov LB, Kraft P. Somatic mutational profiles and germline polygenic risk scores in human cancer. Genome Med 2022; 14:14. [PMID: 35144655 PMCID: PMC8832866 DOI: 10.1186/s13073-022-01016-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 01/24/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The mutational profile of cancer reflects the activity of the mutagenic processes which have been operative throughout the lineage of the cancer cell. These processes leave characteristic profiles of somatic mutations called mutational signatures. Mutational signatures, including single-base substitution (SBS) signatures, may reflect the effects of exogenous or endogenous exposures. METHODS We used polygenic risk scores (PRS) to summarize common germline variation associated with cancer risk and other cancer-related traits and examined the association between somatic mutational profiles and germline PRS in 12 cancer types from The Cancer Genome Atlas. Somatic mutational profiles were constructed from whole-exome sequencing data of primary tumors. PRS were calculated for the 12 selected cancer types and 9 non-cancer traits, including cancer risk determinants, hormonal factors, and immune-mediated inflammatory diseases, using germline genetic data and published summary statistics from genome-wide association studies. RESULTS We found 17 statistically significant associations between somatic mutational profiles and germline PRS after Bonferroni correction (p < 3.15 × 10-5), including positive associations between germline inflammatory bowel disease PRS and number of somatic mutations attributed to signature SBS1 in prostate cancer and APOBEC-related signatures in breast cancer. Positive associations were also found between age at menarche PRS and mutation counts of SBS1 in overall and estrogen receptor-positive breast cancer. Consistent with prior studies that found an inverse association between the pubertal development PRS and risk of prostate cancer, likely reflecting hormone-related mechanisms, we found an inverse association between age at menarche PRS and mutation counts of SBS1 in prostate cancer. Inverse associations were also found between several cancer PRS and tumor mutation counts. CONCLUSIONS Our analysis suggests that there are robust associations between tumor somatic mutational profiles and germline PRS. These may reflect the mechanisms through hormone regulation and immune responses that contribute to cancer etiology and drive cancer progression.
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Affiliation(s)
- Yuxi Liu
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA ,grid.38142.3c000000041936754XProgram in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115 USA
| | - Alexander Gusev
- grid.65499.370000 0001 2106 9910Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02215 USA
| | - Yujing J. Heng
- grid.38142.3c000000041936754XDepartment of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215 USA
| | - Ludmil B. Alexandrov
- grid.266100.30000 0001 2107 4242Department of Cellular and Molecular Medicine, University of California San Diego, La Jolla, CA 92093 USA
| | - Peter Kraft
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA ,grid.38142.3c000000041936754XProgram in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA
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13
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Markozannes G, Kanellopoulou A, Dimopoulou O, Kosmidis D, Zhang X, Wang L, Theodoratou E, Gill D, Burgess S, Tsilidis KK. Systematic review of Mendelian randomization studies on risk of cancer. BMC Med 2022; 20:41. [PMID: 35105367 PMCID: PMC8809022 DOI: 10.1186/s12916-022-02246-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to map and describe the current state of Mendelian randomization (MR) literature on cancer risk and to identify associations supported by robust evidence. METHODS We searched PubMed and Scopus up to 06/10/2020 for MR studies investigating the association of any genetically predicted risk factor with cancer risk. We categorized the reported associations based on a priori designed levels of evidence supporting a causal association into four categories, namely robust, probable, suggestive, and insufficient, based on the significance and concordance of the main MR analysis results and at least one of the MR-Egger, weighed median, MRPRESSO, and multivariable MR analyses. Associations not presenting any of the aforementioned sensitivity analyses were not graded. RESULTS We included 190 publications reporting on 4667 MR analyses. Most analyses (3200; 68.6%) were not accompanied by any of the assessed sensitivity analyses. Of the 1467 evaluable analyses, 87 (5.9%) were supported by robust, 275 (18.7%) by probable, and 89 (6.1%) by suggestive evidence. The most prominent robust associations were observed for anthropometric indices with risk of breast, kidney, and endometrial cancers; circulating telomere length with risk of kidney, lung, osteosarcoma, skin, thyroid, and hematological cancers; sex steroid hormones and risk of breast and endometrial cancer; and lipids with risk of breast, endometrial, and ovarian cancer. CONCLUSIONS Despite the large amount of research on genetically predicted risk factors for cancer risk, limited associations are supported by robust evidence for causality. Most associations did not present a MR sensitivity analysis and were thus non-evaluable. Future research should focus on more thorough assessment of sensitivity MR analyses and on more transparent reporting.
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Affiliation(s)
- Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, St. Mary's Campus, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Afroditi Kanellopoulou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | | | - Dimitrios Kosmidis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Xiaomeng Zhang
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Lijuan Wang
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
- CRUK Edinburgh Centre, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, St. Mary's Campus, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Stephen Burgess
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK
- Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
- Department of Epidemiology and Biostatistics, St. Mary's Campus, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK.
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14
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Rivera-Izquierdo M, Martínez-Ruiz V, Jiménez-Moleón JJ. Recommendations on Weight Loss and Healthy Lifestyle in Prostate Cancer Clinical Guidelines: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031452. [PMID: 35162468 PMCID: PMC8835487 DOI: 10.3390/ijerph19031452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/04/2023]
Abstract
Obesity is associated with negative prostate cancer outcomes (e.g., specific mortality, all-cause mortality, biochemical recurrence, etc.), according to the current scientific literature. Nevertheless, recommendations on weight loss and healthy lifestyles are poorly covered by clinicians. We aimed at identifying these recommendations from clinical practice guidelines (CPGs) for prostate cancer. We systematically searched MEDLINE, EMBASE, Web of Science, Scopus, guideline databases and online sources for CPGs updated from January 2015 to August 2021. The searches were independently conducted by two researchers, without language restrictions. A total of 97 prostate cancer guidelines, including 84 (86.6%) CPGs and 13 (13.4%) consensus statements, were included. Recommendations on reaching and maintaining a healthy weight or healthy lifestyles were provided by 7 (7.2%) and 13 (13.4%) documents, respectively. No differences regarding recommendations were found by type of document, year of publication or country. Our results suggest that professional societies and governments should update prostate cancer guidelines to include these recommendations for improving prostate cancer prognosis.
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Affiliation(s)
- Mario Rivera-Izquierdo
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18016 Granada, Spain; (V.M.-R.); (J.J.J.-M.)
- Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain
- Correspondence:
| | - Virginia Martínez-Ruiz
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18016 Granada, Spain; (V.M.-R.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - José Juan Jiménez-Moleón
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18016 Granada, Spain; (V.M.-R.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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15
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Martin S, Tyrrell J, Thomas EL, Bown MJ, Wood AR, Beaumont RN, Tsoi LC, Stuart PE, Elder JT, Law P, Houlston R, Kabrhel C, Papadimitriou N, Gunter MJ, Bull CJ, Bell JA, Vincent EE, Sattar N, Dunlop MG, Tomlinson IPM, Lindström S, Bell JD, Frayling TM, Yaghootkar H. Disease consequences of higher adiposity uncoupled from its adverse metabolic effects using Mendelian randomisation. eLife 2022; 11:e72452. [PMID: 35074047 PMCID: PMC8789289 DOI: 10.7554/elife.72452] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/21/2021] [Indexed: 12/13/2022] Open
Abstract
Background Some individuals living with obesity may be relatively metabolically healthy, whilst others suffer from multiple conditions that may be linked to adverse metabolic effects or other factors. The extent to which the adverse metabolic component of obesity contributes to disease compared to the non-metabolic components is often uncertain. We aimed to use Mendelian randomisation (MR) and specific genetic variants to separately test the causal roles of higher adiposity with and without its adverse metabolic effects on diseases. Methods We selected 37 chronic diseases associated with obesity and genetic variants associated with different aspects of excess weight. These genetic variants included those associated with metabolically 'favourable adiposity' (FA) and 'unfavourable adiposity' (UFA) that are both associated with higher adiposity but with opposite effects on metabolic risk. We used these variants and two sample MR to test the effects on the chronic diseases. Results MR identified two sets of diseases. First, 11 conditions where the metabolic effect of higher adiposity is the likely primary cause of the disease. Here, MR with the FA and UFA genetics showed opposing effects on risk of disease: coronary artery disease, peripheral artery disease, hypertension, stroke, type 2 diabetes, polycystic ovary syndrome, heart failure, atrial fibrillation, chronic kidney disease, renal cancer, and gout. Second, 9 conditions where the non-metabolic effects of excess weight (e.g. mechanical effect) are likely a cause. Here, MR with the FA genetics, despite leading to lower metabolic risk, and MR with the UFA genetics, both indicated higher disease risk: osteoarthritis, rheumatoid arthritis, osteoporosis, gastro-oesophageal reflux disease, gallstones, adult-onset asthma, psoriasis, deep vein thrombosis, and venous thromboembolism. Conclusions Our results assist in understanding the consequences of higher adiposity uncoupled from its adverse metabolic effects, including the risks to individuals with high body mass index who may be relatively metabolically healthy. Funding Diabetes UK, UK Medical Research Council, World Cancer Research Fund, National Cancer Institute.
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Affiliation(s)
- Susan Martin
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Research, Innovation, Learning and Development building, Royal Devon & Exeter HospitalExeterUnited Kingdom
| | - Jessica Tyrrell
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Research, Innovation, Learning and Development building, Royal Devon & Exeter HospitalExeterUnited Kingdom
| | - E Louise Thomas
- Research Centre for Optimal Health, School of Life Sciences, University of WestminsterLondonUnited Kingdom
| | - Matthew J Bown
- Department of Cardiovascular Sciences, University of LeicesterLeicesterUnited Kingdom
- NIHR Leicester Biomedical Research CentreLeicesterUnited Kingdom
| | - Andrew R Wood
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Research, Innovation, Learning and Development building, Royal Devon & Exeter HospitalExeterUnited Kingdom
| | - Robin N Beaumont
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Research, Innovation, Learning and Development building, Royal Devon & Exeter HospitalExeterUnited Kingdom
| | - Lam C Tsoi
- Department of Dermatology, University of MichiganAnn ArborUnited States
| | - Philip E Stuart
- Department of Dermatology, University of MichiganAnn ArborUnited States
| | - James T Elder
- Department of Dermatology, University of MichiganAnn ArborUnited States
- Ann Arbor Veterans Affairs HospitalAnn ArborUnited States
| | - Philip Law
- The Institute of Cancer ResearchLondonUnited Kingdom
| | | | - Christopher Kabrhel
- Department of Emergency Medicine, Massachusetts General HospitalBostonUnited States
- Department of Emergency Medicine, Harvard Medical SchoolBostonUnited States
| | - Nikos Papadimitriou
- Nutrition and Metabolism Branch, International Agency for Research on CancerLyonFrance
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on CancerLyonFrance
| | - Caroline J Bull
- MRC Integrative Epidemiology Unit at the University of BristolBristolUnited Kingdom
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
- School of Cellular and Molecular Medicine, University of BristolBristolUnited Kingdom
| | - Joshua A Bell
- MRC Integrative Epidemiology Unit at the University of BristolBristolUnited Kingdom
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
| | - Emma E Vincent
- MRC Integrative Epidemiology Unit at the University of BristolBristolUnited Kingdom
- Population Health Sciences, Bristol Medical School, University of BristolBristolUnited Kingdom
- School of Cellular and Molecular Medicine, University of BristolBristolUnited Kingdom
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of GlasgowGlasgowUnited Kingdom
| | - Malcolm G Dunlop
- University of EdinburghEdinburghUnited Kingdom
- Western General HospitalEdinburghUnited Kingdom
| | - Ian PM Tomlinson
- Edinburgh Cancer Research Centre, IGMM, University of EdinburghEdinburghUnited Kingdom
| | - Sara Lindström
- Department of Epidemiology, University of WashingtonSeattleUnited States
- Division of Public Health Sciences, Fred Hutchinson Cancer Research CenterSeattleUnited States
| | | | - Jimmy D Bell
- Research Centre for Optimal Health, School of Life Sciences, University of WestminsterLondonUnited Kingdom
| | - Timothy M Frayling
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Research, Innovation, Learning and Development building, Royal Devon & Exeter HospitalExeterUnited Kingdom
| | - Hanieh Yaghootkar
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Research, Innovation, Learning and Development building, Royal Devon & Exeter HospitalExeterUnited Kingdom
- Research Centre for Optimal Health, School of Life Sciences, University of WestminsterLondonUnited Kingdom
- Centre for Inflammation Research and Translational Medicine (CIRTM), Department of Life Sciences, Brunel University LondonUxbridgeUnited Kingdom
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16
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Amin HA, Kaewsri P, Yiorkas AM, Cooke H, Blakemore AI, Drenos F. Mendelian randomisation analyses of UK Biobank and published data suggest that increased adiposity lowers risk of breast and prostate cancer. Sci Rep 2022; 12:909. [PMID: 35042869 PMCID: PMC8766553 DOI: 10.1038/s41598-021-04401-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 12/08/2021] [Indexed: 12/24/2022] Open
Abstract
Breast (BCa) and prostate (PrCa) cancer are the first and second most common types of cancer in women and men, respectively. We aimed to explore the causal effect of adiposity on BCa and PrCa risk in the UK Biobank and published data. We used Mendelian randomisation (MR) to assess the causal effect of body mass index (BMI), body fat percentage (BFP), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) on BCa and PrCa risk. We found that increased BMI, WC and HC decreased the risk of breast cancer (OR 0.70 per 5.14 kg/m2 [0.59-0.85, p = 2.1 × 10-4], 0.76 per 12.49 cm [60-0.97, p = 0.028] and 0.73 per 10.31 cm [0.59-0.90, p = 3.7 × 10-3], respectively) and increased WC and BMI decreased the risk of prostate cancer (0.68 per 11.32 cm [0.50-0.91, p = 0.01] and 0.76 per 10.23 kg/m2 [0.61-0.95, p = 0.015], respectively) in UK Biobank participants. We confirmed our results with a two-sample-MR of published data. In conclusion, our results suggest a protective effect of adiposity on the risk of BCa and PrCa highlighting the need to re-evaluate the role of adiposity as cancer risk factor.
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Affiliation(s)
- Hasnat A Amin
- Department of Life Sciences, College of Health, Medical and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, Middlesex, UK
| | - Pimpika Kaewsri
- Department of Life Sciences, College of Health, Medical and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, Middlesex, UK
| | - Andrianos M Yiorkas
- Department of Life Sciences, College of Health, Medical and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, Middlesex, UK
| | - Heather Cooke
- Department of Life Sciences, College of Health, Medical and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, Middlesex, UK
| | - Alexandra I Blakemore
- Department of Life Sciences, College of Health, Medical and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, Middlesex, UK
| | - Fotios Drenos
- Department of Life Sciences, College of Health, Medical and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, Middlesex, UK.
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17
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Yin P, Han S, Hu Q, Tong S. The association of statin use and biochemical recurrence after curative treatment for prostate cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28513. [PMID: 35029911 PMCID: PMC8735759 DOI: 10.1097/md.0000000000028513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 12/17/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES : To investigate the association between statin use and biochemical recurrence (BCR) in patients undergoing radical prostatectomy (RP) or radiotherapy (RT) as a curative treatment, a systematic review and meta-analysis was performed. METHODS : We conducted a literature search of online databases for studies assessing BCR associated with statin use in patients with prostate cancer undergoing RP or RT. We performed a pooled analysis of BCR-free survival with subgroup analysis of treatment, cancer risk, and medication. RESULTS : We identified 27 studies and found that statin use was associated with a potential tendency to improve BCR-free survival in patients undergoing curative treatment (P = .05). In addition, we revealed that statin use after curative treatment did not improve BCR-free survival (P = .33), whereas statin use could improve BCR-free survival in high-risk patients (P < .01). CONCLUSIONS : Statin use is associated with a potential tendency to improve BCR-free survival in prostate cancer and could reduce BCR in high-risk patients.
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Affiliation(s)
- Peng Yin
- Department of Urology, Jiaozhou People's Hospital, Jiaozhou, Shangdong, China
| | - Sheng Han
- Department of Urology, Jiaozhou People's Hospital, Jiaozhou, Shangdong, China
| | - Qingfeng Hu
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shijun Tong
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
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18
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Adiposity and cancer: a Mendelian randomization analysis in the UK biobank. Int J Obes (Lond) 2021; 45:2657-2665. [PMID: 34453097 DOI: 10.1038/s41366-021-00942-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/21/2021] [Accepted: 08/11/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Observational and Mendelian randomization (MR) studies link obesity and cancer, but it remains unclear whether these depend upon related metabolic abnormalities. METHODS We used information from 321,472 participants in the UK biobank, including 30,561 cases of obesity-related cancer. We constructed three genetic instruments reflecting higher adiposity together with either "unfavourable" (82 SNPs), "favourable" (24 SNPs) or "neutral" metabolic profile (25 SNPs). We looked at associations with 14 types of cancer, previously suggested to be associated with obesity. RESULTS All genetic instruments had a strong association with BMI (p < 1 × 10-300 for all). The instrument reflecting unfavourable adiposity was also associated with higher CRP, HbA1c and adverse lipid profile, while instrument reflecting metabolically favourable adiposity was associated with lower HbA1c and a favourable lipid profile. In MR-inverse-variance weighted analysis unfavourable adiposity was associated with an increased risk of non-hormonal cancers (OR = 1.22, 95% confidence interval [CI]:1.08, 1.38), but a lower risk of hormonal cancers (OR = 0.80, 95%CI: 0.72, 0.89). From individual cancers, MR analyses suggested causal increases in the risk of multiple myeloma (OR = 1.36, 95%CI: 1.09, 1.70) and endometrial cancer (OR = 1.77, 95%CI: 1.16, 2.68) by greater genetically instrumented unfavourable adiposity but lower risks of breast and prostate cancer (OR = 0.72, 95%CI: 0.61, 0.83 and OR = 0.81, 95%CI: 0.68, 0.97, respectively). Favourable or neutral adiposity were not associated with the odds of any individual cancer. CONCLUSIONS Higher adiposity associated with a higher risk of non-hormonal cancer but a lower risk of some hormone related cancers. Presence of metabolic abnormalities might aggravate the adverse effects of higher adiposity on cancer. Further studies are warranted to investigate whether interventions on adverse metabolic health may help to alleviate obesity-related cancer risk.
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19
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Hybrid algorithm for the classification of prostate cancer patients of the MCC-Spain study based on support vector machines and genetic algorithms. Neurocomputing 2021. [DOI: 10.1016/j.neucom.2019.08.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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20
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Factors Influencing Care Pathways for Breast and Prostate Cancer in a Hospital Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157913. [PMID: 34360204 PMCID: PMC8345796 DOI: 10.3390/ijerph18157913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/11/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022]
Abstract
Breast cancer (BCa) and prostate cancer (PCa) are the most prevalent types of cancers. We aimed to understand and analyze the care pathways for BCa and PCa patients followed at a hospital setting by analyzing their different treatment lines. We evaluated the association between different treatment lines and the lifestyle and demographic characteristics of these patients. Two datasets were created using the electronic health records (EHRs) and information collected through semi-structured one-on-one interviews. Statistical analysis was performed to examine which variable had an impact on the treatment each patient followed. In total, 83 patients participated in the study that ran between January and November 2018 in Beacon Hospital. Results show that chemotherapy cycles indicate if a patient would have other treatments, i.e., patients who have targeted therapy (25/46) have more chemotherapy cycles (95% CI 4.66–9.52, p = 0.012), the same is observed with endocrine therapy (95% CI 4.77–13.59, p = 0.044). Patients who had bisphosphonate (11/46), an indication of bone metastasis, had more chemotherapy cycles (95% CI 5.19–6.60, p = 0.012). PCa patients with tall height (95% CI 176.70–183.85, p = 0.005), heavier (95% CI 85.80–99.57, p < 0.001), and a BMI above 25 (95% CI 1.85–2.62, p = 0.017) had chemotherapy compared to patients who were shorter, lighter and with BMI less than 25. Initial prostate-specific antigen level (PSA level) indicated if a patient would be treated with bisphosphonate or not (95% CI 45.51–96.14, p = 0.002). Lifestyle variables such as diet (95% CI 1.46–1.85, p = 0.016), and exercise (95% CI 1.20–1.96, p = 0.029) indicated that healthier and active BCa patients had undergone surgeries. Our findings show that chemotherapy cycles and lifestyle for BCa, and tallness and weight for PCa may indicate the rest of treatment plan for these patients. Understanding factors that influence care pathways allow a more person-centered care approach and the redesign of care processes.
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21
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Vithayathil M, Carter P, Kar S, Mason AM, Burgess S, Larsson SC. Body size and composition and risk of site-specific cancers in the UK Biobank and large international consortia: A mendelian randomisation study. PLoS Med 2021; 18:e1003706. [PMID: 34324486 PMCID: PMC8320991 DOI: 10.1371/journal.pmed.1003706] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 06/21/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Evidence for the impact of body size and composition on cancer risk is limited. This mendelian randomisation (MR) study investigates evidence supporting causal relationships of body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and height with cancer risk. METHODS AND FINDINGS Single nucleotide polymorphisms (SNPs) were used as instrumental variables for BMI (312 SNPs), FMI (577 SNPs), FFMI (577 SNPs), and height (293 SNPs). Associations of the genetic variants with 22 site-specific cancers and overall cancer were estimated in 367,561 individuals from the UK Biobank (UKBB) and with lung, breast, ovarian, uterine, and prostate cancer in large international consortia. In the UKBB, genetically predicted BMI was positively associated with overall cancer (odds ratio [OR] per 1 kg/m2 increase 1.01, 95% confidence interval [CI] 1.00-1.02; p = 0.043); several digestive system cancers: stomach (OR 1.13, 95% CI 1.06-1.21; p < 0.001), esophagus (OR 1.10, 95% CI 1.03, 1.17; p = 0.003), liver (OR 1.13, 95% CI 1.03-1.25; p = 0.012), and pancreas (OR 1.06, 95% CI 1.01-1.12; p = 0.016); and lung cancer (OR 1.08, 95% CI 1.04-1.12; p < 0.001). For sex-specific cancers, genetically predicted elevated BMI was associated with an increased risk of uterine cancer (OR 1.10, 95% CI 1.05-1.15; p < 0.001) and with a lower risk of prostate cancer (OR 0.97, 95% CI 0.94-0.99; p = 0.009). When dividing cancers into digestive system versus non-digestive system, genetically predicted BMI was positively associated with digestive system cancers (OR 1.04, 95% CI 1.02-1.06; p < 0.001) but not with non-digestive system cancers (OR 1.01, 95% CI 0.99-1.02; p = 0.369). Genetically predicted FMI was positively associated with liver, pancreatic, and lung cancer and inversely associated with melanoma and prostate cancer. Genetically predicted FFMI was positively associated with non-Hodgkin lymphoma and melanoma. Genetically predicted height was associated with increased risk of overall cancer (OR per 1 standard deviation increase 1.09; 95% CI 1.05-1.12; p < 0.001) and multiple site-specific cancers. Similar results were observed in analyses using the weighted median and MR-Egger methods. Results based on consortium data confirmed the positive associations between BMI and lung and uterine cancer risk as well as the inverse association between BMI and prostate cancer, and, additionally, showed an inverse association between genetically predicted BMI and breast cancer. The main limitations are the assumption that genetic associations with cancer outcomes are mediated via the proposed risk factors and that estimates for some lower frequency cancer types are subject to low precision. CONCLUSIONS Our results show that the evidence for BMI as a causal risk factor for cancer is mixed. We find that BMI has a consistent causal role in increasing risk of digestive system cancers and a role for sex-specific cancers with inconsistent directions of effect. In contrast, increased height appears to have a consistent risk-increasing effect on overall and site-specific cancers.
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Affiliation(s)
| | - Paul Carter
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Siddhartha Kar
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Amy M. Mason
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Stephen Burgess
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
- * E-mail:
| | - Susanna C. Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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22
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Fang Z, Song M, Lee D, Giovannucci EL. The Role of Mendelian Randomization Studies in Deciphering the Effect of Obesity on Cancer. J Natl Cancer Inst 2021; 114:361-371. [PMID: 34021349 DOI: 10.1093/jnci/djab102] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/25/2021] [Accepted: 04/22/2021] [Indexed: 11/12/2022] Open
Abstract
Associations of obesity have been established for at least 11 cancer sites in observational studies, though some questions remain as to causality, strength of associations, and timing of associations throughout the life course. In recent years, Mendelian randomization (MR) has provided complementary information to traditional approaches, but the validity requires that the genetic instrumental variables be causally related to cancers only mediated by the exposure. We summarize and evaluate existing evidence from MR studies in comparison with conventional observational studies to provide insights into the complex relationship between obesity and multiple cancers. MR studies further establish the causality of adult obesity with esophageal adenocarcinoma, cancers of the colorectum, endometrium, ovary, kidney, and pancreas, as well as the inverse association of early life obesity with breast cancer. MR studies, which might account for lifelong adiposity, suggest that the associations in observational studies typically based on single measurement may underestimate the magnitude of the association. For lung cancer, MR studies find a positive association with obesity, supporting that the inverse association observed in some conventional observational studies likely reflects reverse causality (loss of lean body mass before diagnosis) and confounding by smoking. However, MR studies have not had sufficient power for gallbladder cancer, gastric cardia cancer, and multiple myeloma. In addition, more MR studies are needed to explore the effect of obesity at different time points on postmenopausal breast cancer and aggressive prostate cancer.
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Affiliation(s)
- Zhe Fang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mingyang Song
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Donghoon Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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23
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Jochems SHJ, Wood AM, Häggström C, Orho-Melander M, Stattin P, Stocks T. Waist circumference and a body shape index and prostate cancer risk and mortality. Cancer Med 2021; 10:2885-2896. [PMID: 33710775 PMCID: PMC8026929 DOI: 10.1002/cam4.3827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/12/2022] Open
Abstract
We recently found a negative association between body mass index (BMI) and the risk of localised prostate cancer (PCa), no association with advanced PCa, and a positive association with PCa‐specific mortality. In a 15% subpopulation of that study, we here investigated the measures of abdominal adiposity including waist circumference (WC) and A Body Shape Index (ABSI) in relation to PCa risk and mortality. We used data from 58,457 men from four Swedish cohorts to assess WC and ABSI in relation to PCa risk according to cancer risk category, including localised asymptomatic and symptomatic PCa and advanced PCa, and PCa‐specific mortality. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). During, on average, 10 years of follow‐up, 3290 men were diagnosed with PCa and 387 died of PCa. WC was negatively associated with the risk of total PCa (HR per 10 cm, 0.95; 95% CI 0.92–0.99), localised PCa (HR per 10 cm, 0.93, 95% CI 0.88–0.96) and localised asymptomatic PCa cases detected through a prostate‐specific antigen (PSA) test (HR per 10 cm, 0.87, 95% CI 0.81–0.94). WC was not associated with the risk of advanced PCa (HR per 10 cm, 1.02, 95% CI 0.93–1.14) or with PCa‐specific mortality (HR per 10 cm, 1.04, 95% CI 0.92–1.19). ABSI showed no associations with the risk of PCa or PCa‐specific mortality. While the negative association between WC and the risk of localised PCa was partially driven by PSA‐detected PCa cases, no association was found between abdominal adiposity and clinically manifest PCa in our population.
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Affiliation(s)
| | - Angela M Wood
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Christel Häggström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Tanja Stocks
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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24
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Joharatnam-Hogan N, Alexandre L, Yarmolinsky J, Lake B, Capps N, Martin RM, Ring A, Cafferty F, Langley RE. Statins as Potential Chemoprevention or Therapeutic Agents in Cancer: a Model for Evaluating Repurposed Drugs. Curr Oncol Rep 2021; 23:29. [PMID: 33582975 PMCID: PMC7882549 DOI: 10.1007/s11912-021-01023-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Repurposing established medicines for a new therapeutic indication potentially has important global and societal impact. The high costs and slow pace of new drug development have increased interest in more cost-effective repurposed drugs, particularly in the cancer arena. The conventional drug development pathway and evidence framework are not designed for drug repurposing and there is currently no consensus on establishing the evidence base before embarking on a large, resource intensive, potential practice changing phase III randomised controlled trial (RCT). Numerous observational studies have suggested a potential role for statins as a repurposed drug for cancer chemoprevention and therapy, and we review the strength of the cumulative evidence here. RECENT FINDINGS In the setting of cancer, a potential repurposed drug, like statins, typically goes through a cyclical history, with initial use for several years in another disease setting, prior to epidemiological research identifying a possible chemo-protective effect. However, further information is required, including review of RCT data in the initial disease setting with exploration of cancer outcomes. Additionally, more contemporary methods should be considered, such as Mendelian randomization and pharmaco-epidemiological research with "target" trial design emulation using electronic health records. Pre-clinical and traditional observational data potentially support the role of statins in the treatment of cancer; however, randomised trial evidence is not supportive. Evaluation of contemporary methods provides little added support for the use of statin therapy in cancer. We provide complementary evidence of alternative study designs to enable a robust critical appraisal from a number of sources of the go/no-go decision for a prospective phase III RCT of statins in the treatment of cancer.
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Affiliation(s)
- Nalinie Joharatnam-Hogan
- MRC Clinical Trials Unit at University College London, 90 High Holborn, London, WC1V 6LJ, UK.
- Royal Marsden Hospital NHS Foundation Trust, Sutton, UK.
| | - Leo Alexandre
- Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - James Yarmolinsky
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Blossom Lake
- The Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | - Nigel Capps
- The Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK
| | - Richard M Martin
- Medical Research Council (MRC) Integrative Epidemiology Unit; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, UK
| | - Alistair Ring
- Royal Marsden Hospital NHS Foundation Trust, Sutton, UK
| | - Fay Cafferty
- MRC Clinical Trials Unit at University College London, 90 High Holborn, London, WC1V 6LJ, UK
| | - Ruth E Langley
- MRC Clinical Trials Unit at University College London, 90 High Holborn, London, WC1V 6LJ, UK
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25
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Burton AJ, Gilbert R, Tilling K, Langdon R, Donovan JL, Holly JMP, Martin RM. Circulating adiponectin and leptin and risk of overall and aggressive prostate cancer: a systematic review and meta-analysis. Sci Rep 2021; 11:320. [PMID: 33431998 PMCID: PMC7801499 DOI: 10.1038/s41598-020-79345-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 12/07/2020] [Indexed: 02/08/2023] Open
Abstract
Obesity is associated with an increased risk of advanced, recurrent and fatal prostate cancer. Adipokines may mediate this relationship. We conducted a systematic review and meta-analysis of associations of leptin and adiponectin with overall and aggressive prostate cancer. Bibliographic databases were systematically searched up to 1st April 2017. Log Odds Ratios (ORs) per 2.5 unit increase in adiponectin or leptin levels were derived and pooled. All analyses were stratified by study type (cross-sectional/prospective). 746 papers were retrieved, 34 eligible studies identified, 31 of these could be included in the meta-analysis. Leptin was not consistently associated with overall prostate cancer (pooled OR 1.00, 95%CI 0.98-1.02, per 2.5 ng/ml increase, prospective study OR 0.97, 95%CI 0.95-0.99, cross-sectional study OR 1.19, 95%CI 1.13-1.26) and there was weak evidence of a positive association with aggressive disease (OR 1.03, 95%CI 1.00-1.06). There was also weak evidence of a small inverse association of adiponectin with overall prostate cancer (OR 0.96, 95%CI 0.93-0.99, per 2.5 µg/ml increase), but less evidence of an association with aggressive disease (OR 0.98, 95%CI 0.94-1.01). The magnitude of any effects are small, therefore levels of circulating adiponectin or leptin alone are unlikely to be useful biomarkers of risk or prognosis.
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Affiliation(s)
- Anya J Burton
- Bristol Medical School, Translational Health Sciences, University of Bristol, Learning and Research Building, Level 2, Southmead Hospital, Bristol, UK.
| | - Rebecca Gilbert
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Kate Tilling
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Ryan Langdon
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Jenny L Donovan
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Jeff M P Holly
- Bristol Medical School, Translational Health Sciences, University of Bristol, Learning and Research Building, Level 2, Southmead Hospital, Bristol, UK
| | - Richard M Martin
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
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26
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Recommandations françaises du Comité de cancérologie de l’AFU – actualisation 2020–2022 : cancer de la prostate. Prog Urol 2020; 30:S136-S251. [DOI: 10.1016/s1166-7087(20)30752-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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27
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Tafuri A, Amigoni N, Rizzetto R, Sebben M, Shakir A, Gozzo A, Odorizzi K, De Michele M, Gallina S, Bianchi A, Ornaghi P, Brunelli M, De Marco V, Verratti V, Migliorini F, Cerruto MA, Artibani W, Antonelli A, Porcaro AB. Obesity strongly predicts clinically undetected multiple lymph node metastases in intermediate- and high-risk prostate cancer patients who underwent robot assisted radical prostatectomy and extended lymph node dissection. Int Urol Nephrol 2020; 52:2097-2105. [PMID: 32607958 DOI: 10.1007/s11255-020-02554-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the association between obesity and risk of multiple lymph node metastases in prostate cancer (PCa) patients with clinically localized EAU intermediate and high-risk classes staged by extended pelvic lymph-node dissection (ePLND) during robot assisted radical prostatectomy (RARP). MATERIALS AND METHODS 373 consecutive PCa intermediate or high-risk patients were treated by RARP and ePLND. According to pathology results, extension of LNI was classified as absent (pN0 status) or present (pN1 status); pN1 was further categorized as one or more than one (multiple LNI) lymph node metastases. A logistic regression model (univariate and multivariate analysis) was used to evaluate the association between significant categorized clinical factors and the risk of multiple lymph nodes metastases. RESULTS Overall, after surgery lymph node metastases were detected in 51 patients (13.7%) of whom 22 (5.9%) with more than one metastatic lymph node and 29 (7.8%) with only one positive node. Comparing patients with one positive node to those without, EAU high-risk class only predicted risk of single LNI (OR = 2.872; p = 0.008). The risk of multiple lymph node metastases, when compared to cases without LNI, was independently predicted by BMI ≥ 30 (OR = 6.950; p = 0.002) together with BPC ≥ 50% (OR = 3.910; p = 0.004) and EAU high-risk class (OR = 6.187; p < 0.0001). Among metastatic patients, BMI ≥ 30 was the only factor associated with the risk of multiple LNI (OR = 5.250; p = 0.041). CONCLUSIONS In patients with clinically localized EAU intermediate and high-risk classes PCa who underwent RARP and ePLND, obesity was a risk factor of multiple LNI.
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Affiliation(s)
- Alessandro Tafuri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy.,Department of Neuroscience, Imaging and Clinical Sciences, ‟G. D'Annunzio″ University, Chieti-Pescara, Italy.,USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Nelia Amigoni
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Riccardo Rizzetto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Marco Sebben
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Aliasger Shakir
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Alessandra Gozzo
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Katia Odorizzi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Mario De Michele
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Sebastian Gallina
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Alberto Bianchi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Paola Ornaghi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Vincenzo De Marco
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Filippo Migliorini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Walter Artibani
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy
| | - Antonio Benito Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Ospedale Civile Maggiore, Polo Chirurgico Confortini, Piazzale Stefani 1, 37126, Verona, Italy.
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28
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Jochems SHJ, Stattin P, Häggström C, Järvholm B, Orho-Melander M, Wood AM, Stocks T. Height, body mass index and prostate cancer risk and mortality by way of detection and cancer risk category. Int J Cancer 2020; 147:3328-3338. [PMID: 32525555 DOI: 10.1002/ijc.33150] [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: 03/14/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/12/2022]
Abstract
Obesity is a risk factor for advanced, but not localised, prostate cancer (PCa), and for poor prognosis. However, the detection of localised PCa through asymptomatic screening might influence these associations. We investigated height and body mass index (BMI) among 431 902 men in five Swedish cohorts in relation to PCa risk, according to cancer risk category and detection mode, and PCa-specific mortality using Cox regression. Statistical tests were two-sided. Height was positively associated with localised intermediate-risk PCa (HR per 5 cm, 1.03, 95% CI 1.01-1.05), while overweight and obesity were negatively associated with localised low- and intermediate-risk PCa (HRs per 5 kg/m2 , 0.86, 95% CI 0.81-0.90, and 0.92, 95% CI 0.88-0.97). However, these associations were partially driven by PCa's detected by asymptomatic screening and, for height, also by symptoms unrelated to PCa. The HR of localised PCa's, per 5 kg/m2 , was 0.88, 95% CI 0.83 to 0.92 for screen-detected PCa's and 0.96, 95% CI 0.90 to 1.01 for PCa's detected through lower urinary tract symptoms. BMI was positively associated with PCa-specific mortality in the full population and in case-only analysis of each PCa risk category (HRs per 5 kg/m2 , 1.11-1.22, P for heterogeneity = .14). More active health-seeking behaviour among tall and normal-weight men may partially explain their higher risk of localised PCa. The higher PCa-specific mortality among obese men across all PCa risk categories in our study suggests obesity as a potential target to improve the prognosis of obese PCa patients.
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Affiliation(s)
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Christel Häggström
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Department of Biobank Research, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Bengt Järvholm
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Angela M Wood
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Tanja Stocks
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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29
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Kazmi N, Haycock P, Tsilidis K, Lynch BM, Truong T, Martin RM, Lewis SJ. Appraising causal relationships of dietary, nutritional and physical-activity exposures with overall and aggressive prostate cancer: two-sample Mendelian-randomization study based on 79 148 prostate-cancer cases and 61 106 controls. Int J Epidemiol 2020; 49:587-596. [PMID: 31802111 DOI: 10.1093/ije/dyz235] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/05/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Prostate cancer is the second most common male cancer worldwide, but there is substantial geographical variation, suggesting a potential role for modifiable risk factors in prostate carcinogenesis. METHODS We identified previously reported prostate cancer risk factors from the World Cancer Research Fund (WCRF)'s systematic appraisal of the global evidence (2018). We assessed whether each identified risk factor was causally associated with risk of overall (79 148 cases and 61 106 controls) or aggressive (15 167 cases and 58 308 controls) prostate cancer using Mendelian randomization (MR) based on genome-wide association-study summary statistics from the PRACTICAL and GAME-ON/ELLIPSE consortia. We assessed evidence for replication in UK Biobank (7844 prostate-cancer cases and 204 001 controls). RESULTS WCRF identified 57 potential risk factors, of which 22 could be instrumented for MR analyses using single nucleotide polymorphisms. For overall prostate cancer, we identified evidence compatible with causality for the following risk factors (odds ratio [OR] per standard deviation increase; 95% confidence interval): accelerometer-measured physical activity, OR = 0.49 (0.33-0.72; P = 0.0003); serum iron, OR = 0.92 (0.86-0.98; P = 0.007); body mass index (BMI), OR = 0.90 (0.84-0.97; P = 0.003); and monounsaturated fat, OR = 1.11 (1.02-1.20; P = 0.02). Findings in our replication analyses in UK Biobank were compatible with our main analyses (albeit with wide confidence intervals). In MR analysis, height was positively associated with aggressive-prostate-cancer risk: OR = 1.07 (1.01-1.15; P = 0.03). CONCLUSIONS The results for physical activity, serum iron, BMI, monounsaturated fat and height are compatible with causality for prostate cancer. The results suggest that interventions aimed at increasing physical activity may reduce prostate-cancer risk, although interventions to change other risk factors may have negative consequences on other diseases.
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Affiliation(s)
- Nabila Kazmi
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Philip Haycock
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Konstantinos Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Physical-Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Therese Truong
- Université Paris-Saclay, Université Paris-Sud, CESP (Center for Research in Epidemiology and Population Health), INSERM, Team Cancer and Environment, Villejuif, France
| | - Richard M Martin
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals NHS Trust and University of Bristol, Bristol, UK
| | - Sarah J Lewis
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Gala H, Tomlinson I. The use of Mendelian randomisation to identify causal cancer risk factors: promise and limitations. J Pathol 2020; 250:541-554. [PMID: 32154591 DOI: 10.1002/path.5421] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/24/2020] [Accepted: 03/03/2020] [Indexed: 12/13/2022]
Abstract
The use of observational analyses, such as classical epidemiological studies or randomised controlled trials (RCTs), to infer causality in cancer may be problematic due to both ethical reasons and technical issues, such as confounding variables and reverse causation. Mendelian randomisation (MR) is an epidemiological technique that uses genetic variants as proxies for exposures in an attempt to determine whether there is a causal link between an exposure and an outcome. Given that genetic variants are randomly assigned during meiosis according to Mendel's first and second laws of heritability, MR may be thought of as a 'natural' RCT and is therefore less vulnerable to the aforementioned problems. MR has the potential to help identify new, and validate or disprove previously implicated, modifiable risk factors in cancer, but it is not without limitations. This review provides a brief description of the history and principles of MR, as well as a guide to basic MR methodology. The bulk of the review then examines various limitations of MR in more detail, discussing some of the proposed solutions to these problems. The review ends with a brief section detailing the practical implementation of MR, with examples of its use in the study of cancer, and an assessment of its utility in identifying cancer predisposition traits. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Harvinder Gala
- Cancer Research UK Edinburgh Centre, Institute of Genetics & Molecular Medicine, The University of Edinburgh, Edinburgh, UK
| | - Ian Tomlinson
- Cancer Research UK Edinburgh Centre, Institute of Genetics & Molecular Medicine, The University of Edinburgh, Edinburgh, UK
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Relationship of self-reported body size and shape with risk for prostate cancer: A UK case-control study. PLoS One 2020; 15:e0238928. [PMID: 32941451 PMCID: PMC7498010 DOI: 10.1371/journal.pone.0238928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/26/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Previous evidence has suggested a relationship between male self-reported body size and the risk of developing prostate cancer. In this UK-wide case-control study, we have explored the possible association of prostate cancer risk with male self-reported body size. We also investigated body shape as a surrogate marker for fat deposition around the body. As obesity and excessive adiposity have been linked with increased risk for developing a number of different cancers, further investigation of self-reported body size and shape and their potential relationship with prostate cancer was considered to be appropriate. OBJECTIVE The study objective was to investigate whether underlying associations exist between prostate cancer risk and male self-reported body size and shape. METHODS Data were collected from a large case-control study of men (1928 cases and 2043 controls) using self-administered questionnaires. Data from self-reported pictograms of perceived body size relating to three decades of life (20's, 30's and 40's) were recorded and analysed, including the pattern of change. The associations of self-identified body shape with prostate cancer risk were also explored. RESULTS Self-reported body size for men in their 20's, 30's and 40's did not appear to be associated with prostate cancer risk. More than half of the subjects reported an increase in self-reported body size throughout these three decades of life. Furthermore, no association was observed between self-reported body size changes and prostate cancer risk. Using 'symmetrical' body shape as a reference group, subjects with an 'apple' shape showed a significant 27% reduction in risk (Odds ratio = 0.73, 95% C.I. 0.57-0.92). CONCLUSIONS Change in self-reported body size throughout early to mid-adulthood in males is not a significant risk factor for the development of prostate cancer. Body shape indicative of body fat distribution suggested that an 'apple' body shape was protective and inversely associated with prostate cancer risk when compared with 'symmetrical' shape. Further studies which investigate prostate cancer risk and possible relationships with genetic factors known to influence body shape may shed further light on any underlying associations.
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Markić D, Oguić R, Krpina K, Vukelić I, Đorđević G, Žuža I, Španjol J. THE ROLE OF LYMPHADENECTOMY IN PROSTATE CANCER PATIENTS. Acta Clin Croat 2019; 58:24-35. [PMID: 34975195 PMCID: PMC8693562 DOI: 10.20471/acc.2019.58.s2.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Prostate cancer is one of the most important men's health issues in developed countries. For patients with prostate cancer a preoperative staging of the disease must be made. Involvement of lymph nodes could be assessed using imaging methods (CT or/and MRI), however, newer methods also exist (PET/CT, PSMA PET/CT). For some patients during radical prostatectomy a pelvic lymphadenectomy is recommended. Pelvic lymphadenectomy is indicated in intermediate- and high-risk group patients and with increased probability of lymph node invasion. The most used prediction tools for preoperative assessment of lymph nodes are Briganti and MSKCC nomograms and Partin tables. Pelvic lymphadenectomy can include different lymph nodes group, but extended lymphadenectomy is the recommended procedure. In 1-20% of patients, the lymph node invasion is present. Pelvic lymphadenectomy is primarily a diagnostic and staging method, and in minority of patients with positive lymph nodes it can be a curative method, too. In other patients with positive lymph nodes adjuvant therapy (radiotherapy and androgen deprivation therapy) can be beneficial.
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Wade KH, Carslake D, Tynelius P, Davey Smith G, Martin RM. Variation of all-cause and cause-specific mortality with body mass index in one million Swedish parent-son pairs: An instrumental variable analysis. PLoS Med 2019; 16:e1002868. [PMID: 31398184 PMCID: PMC6688790 DOI: 10.1371/journal.pmed.1002868] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 07/09/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND High body mass index (BMI) is associated with mortality, but the pervasive problem of confounding and reverse causality in observational studies limits inference about the direction and magnitude of causal effects. We aimed to obtain estimates of the causal association of BMI with all-cause and cause-specific mortality. METHODS AND FINDINGS In a record-linked, intergenerational prospective study from the general population of Sweden, we used two-sample instrumental variable (IV) analysis with data from 996,898 fathers (282,407 deaths) and 1,013,083 mothers (153,043 deaths) and their sons followed up from January 1, 1961, until December 31, 2004. Sons' BMI was used as the instrument for parents' BMI to compute hazard ratios (HRs) for risk of mortality per standard deviation (SD) higher parents' BMI. Using offspring exposure as an instrument for parents' exposure is unlikely to be affected by reverse causality (an important source of bias in this context) and reduces confounding. IV analyses supported causal associations between higher BMI and greater risk of all-cause mortality (HR [95% confidence interval (CI)] per SD higher fathers' BMI: 1.29 [1.26-1.31] and mothers' BMI: 1.39 [1.35-1.42]) and overall cancer mortality (HR per SD higher fathers' BMI: 1.20 [1.16-1.24] and mothers' BMI: 1.29 [1.24-1.34]), including 9 site-specific cancers in men (bladder, colorectum, gallbladder, kidney, liver, lung, lymphatic system, pancreas, and stomach) and 11 site-specific cancers in women (gallbladder, kidney, liver, lung, lymphatic system, ovaries, pancreas, stomach, uterus, cervix, and endometrium). There was evidence supporting causal associations between higher BMI in mothers and greater risk of mortality from kidney disease (HR: 2.17 [1.68-2.81]) and lower risk of mortality from suicide (HR: 0.77 [0.65-0.90]). In both sexes, there was evidence supporting causal associations between higher BMI and mortality from cardiovascular diseases (CVDs), stroke, diabetes, and respiratory diseases. We were unable to test the association between sons' and mothers' BMIs (as mothers' data were unavailable) or whether the instrument was independent of unmeasured or residual confounding; however, the associations between parents' mortality and sons' BMI were negligibly influenced by adjustment for available confounders. CONCLUSIONS Consistent with previous large-scale meta-analyses and reviews, results supported the causal role of higher BMI in increasing the risk of several common causes of death, including cancers with increasing global incidence. We also found positive effects of BMI on mortality from respiratory disease, prostate cancer, and lung cancer, which has been inconsistently reported in the literature, suggesting that the causal role of higher BMI in mortality from these diseases may be underestimated. Furthermore, we expect different patterns of bias in the current observational and IV analyses; therefore, the similarities between our findings from both methods increases confidence in the results. These findings support efforts to understand the mechanisms underpinning these effects to inform targeted interventions and develop population-based strategies to reduce rising obesity levels for disease prevention.
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Affiliation(s)
- Kaitlin H. Wade
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
| | - David Carslake
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
| | - Per Tynelius
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - George Davey Smith
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Richard M. Martin
- Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
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Budna-Tukan J, Świerczewska M, Mazel M, Cieślikowski WA, Ida A, Jankowiak A, Antczak A, Nowicki M, Pantel K, Azria D, Zabel M, Alix-Panabières C. Analysis of Circulating Tumor Cells in Patients with Non-Metastatic High-Risk Prostate Cancer before and after Radiotherapy Using Three Different Enumeration Assays. Cancers (Basel) 2019; 11:cancers11060802. [PMID: 31185699 PMCID: PMC6627099 DOI: 10.3390/cancers11060802] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 05/28/2019] [Accepted: 06/06/2019] [Indexed: 12/14/2022] Open
Abstract
The characterization of circulating tumor cells (CTCs) can lead to a promising strategy for monitoring residual or relapsing prostate cancer (PCa) after local therapy. The aim of this study was to compare three innovative technologies for CTC enumeration in 131 high-risk patients with PCa, before and after radiotherapy, combined with androgen deprivation. The CTC number was tested using the FDA-cleared CellSearch® system, the dual fluoro-EPISPOT assay that only detects functional CTCs, and the in vivo CellCollector® technology. The highest percentage of CTC-positive patients was detected with the CellCollector® (48%) and dual fluoro-EPISPOT (42%) assays, while the CellSearch® system presented the lowest rate (14%). Although the concordance among methods was only 23%, the cumulative positivity rate was 79%. A matched-pair analysis of the samples before, and after, treatment suggested a trend toward a decrease in CTC count after treatment with all methods. CTC tended to be positivity correlated with age for the fluoro-EPISPOT assay and with PSA level from the data of three assays. Combining different CTC assays improved CTC detection rates in patients with non-metastatic high-risk PCa before and after treatment. Our findings do not support the hypothesis that radiotherapy leads to cancer cell release in the circulation.
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Affiliation(s)
- Joanna Budna-Tukan
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-781 Poznan, Poland.
| | - Monika Świerczewska
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-781 Poznan, Poland.
| | - Martine Mazel
- Laboratory of Rare Human Circulating Cells (LCCRH), University Medical Centre of Montpellier, 34093 Montpellier, France.
| | | | - Agnieszka Ida
- Department of Urology, Poznan University of Medical Sciences, 61-285 Poznan, Poland.
| | - Agnieszka Jankowiak
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-781 Poznan, Poland.
| | - Andrzej Antczak
- Department of Urology, Poznan University of Medical Sciences, 61-285 Poznan, Poland.
| | - Michał Nowicki
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-781 Poznan, Poland.
| | - Klaus Pantel
- Department of Tumor Biology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - David Azria
- Radiation Oncology Department, Montpellier Cancer Institute, 34298 Montpellier, France.
| | - Maciej Zabel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland.
- Division of Anatomy and Histology, University of Zielona Góra, 65-046 Zielona Góra, Poland.
| | - Catherine Alix-Panabières
- Laboratory of Rare Human Circulating Cells (LCCRH), University Medical Centre of Montpellier, 34093 Montpellier, France.
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Nimptsch K, Konigorski S, Pischon T. Diagnosis of obesity and use of obesity biomarkers in science and clinical medicine. Metabolism 2019; 92:61-70. [PMID: 30586573 DOI: 10.1016/j.metabol.2018.12.006] [Citation(s) in RCA: 146] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/10/2018] [Accepted: 12/20/2018] [Indexed: 12/19/2022]
Abstract
The global epidemic of obesity is a major public health problem today. Obesity increases the risk of many chronic diseases, such as type 2 diabetes, coronary heart disease, and certain types of cancer, and is associated with lower life expectancy. The body mass index (BMI), which is currently used to classify obesity, is only an imperfect measure of abnormal or excessive body fat accumulation. Studies have shown that waist circumference as a measure of fat distribution may improve disease prediction. More elaborate techniques such as magnetic resonance imaging are increasingly available to assess body fat distribution, but these measures are not readily available in routine clinical practice, and health-relevant cut-offs not yet been established. The measurement of biomarkers that reflect the underlying biological mechanisms for the increased disease risk may be an alternative approach to characterize the relevant obesity phenotype. The insulin/insulin-like growth factor (IGF) axis and chronic low-grade inflammation have been identified as major pathways. In addition, specific adipokines such as leptin, adiponectin and resistin have been related to obesity-associated health outcomes. This biomarker research, which is currently further developed with the application of high throughput methods, gives important insights in obesity-related disease etiology and pathophysiological pathways and may be used to better characterize obese persons at high risk of disease development and target disease-causing biomarkers in personalized prevention strategies.
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Affiliation(s)
- Katharina Nimptsch
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany.
| | - Stefan Konigorski
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany; Digital Health - Machine Learning Group, Hasso-Plattner-Institute for Digital Engineering, Potsdam, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany; Charité Universitätsmedizin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
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36
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Effect of increased body mass index on risk of diagnosis or death from cancer. Br J Cancer 2019; 120:565-570. [PMID: 30733581 PMCID: PMC6462026 DOI: 10.1038/s41416-019-0386-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/03/2019] [Accepted: 01/10/2019] [Indexed: 12/22/2022] Open
Abstract
Background Whether body mass index (BMI) is causally associated with the risk of being diagnosed with or dying from any cancer remains unclear. Weight reduction has clinical importance for cancer control only if weight gain causes cancer development or death. We aimed to answer the question 'does genetically predicted BMI influence my risk of being diagnosed with or dying from any cancer'. Methods We used a Mendelian randomisation (MR) approach to estimate causal effect of BMI in 46,155 white-British participants aged between 40 and 69 years at recruitment (median age at follow-up 61 years) from the UK Biobank, who developed any type of cancer, among whom 6998 died from cancer. To derive MR instruments for BMI, we selected up to 390,628 cancer-free participants. Results For each standard deviation (4.78 units) increase in genetically predicted BMI, we estimated a causal odds ratio (COR) of 1.07 (1.02–1.12) and 1.28 (1.16–1.41) for overall cancer risk and mortality, respectively. The corresponding estimates were similar for males and females, and smokers and non-smokers. Conclusions Higher genetically predicted BMI increases the risk of being diagnosed with or dying from any cancer. These data suggest that increased overall weight may causally increase overall cancer incidence and mortality among Europeans.
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Zhu Y, Wei Y, Zhang R, Dong X, Shen S, Zhao Y, Bai J, Albanes D, Caporaso NE, Landi MT, Zhu B, Chanock SJ, Gu F, Lam S, Tsao MS, Shepherd FA, Tardon A, Fernández-Somoano A, Fernandez-Tardon G, Chen C, Barnett MJ, Doherty J, Bojesen SE, Johansson M, Brennan P, McKay JD, Carreras-Torres R, Muley T, Risch A, Wichmann HE, Bickeboeller H, Rosenberger A, Rennert G, Saliba W, Arnold SM, Field JK, Davies MPA, Marcus MW, Wu X, Ye Y, Le Marchand L, Wilkens LR, Melander O, Manjer J, Brunnström H, Hung RJ, Liu G, Brhane Y, Kachuri L, Andrew AS, Duell EJ, Kiemeney LA, van der Heijden EH, Haugen A, Zienolddiny S, Skaug V, Grankvist K, Johansson M, Woll PJ, Cox A, Taylor F, Teare DM, Lazarus P, Schabath MB, Aldrich MC, Houlston RS, McLaughlin J, Stevens VL, Shen H, Hu Z, Dai J, Amos CI, Han Y, Zhu D, Goodman GE, Chen F, Christiani DC. Elevated Platelet Count Appears to Be Causally Associated with Increased Risk of Lung Cancer: A Mendelian Randomization Analysis. Cancer Epidemiol Biomarkers Prev 2019; 28:935-942. [PMID: 30700444 PMCID: PMC7075698 DOI: 10.1158/1055-9965.epi-18-0356] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/11/2018] [Accepted: 01/17/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Platelets are a critical element in coagulation and inflammation, and activated platelets are linked to cancer risk through diverse mechanisms. However, a causal relationship between platelets and risk of lung cancer remains unclear. METHODS We performed single and combined multiple instrumental variable Mendelian randomization analysis by an inverse-weighted method, in addition to a series of sensitivity analyses. Summary data for associations between SNPs and platelet count are from a recent publication that included 48,666 Caucasian Europeans, and the International Lung Cancer Consortium and Transdisciplinary Research in Cancer of the Lung data consisting of 29,266 cases and 56,450 controls to analyze associations between candidate SNPs and lung cancer risk. RESULTS Multiple instrumental variable analysis incorporating six SNPs showed a 62% increased risk of overall non-small cell lung cancer [NSCLC; OR, 1.62; 95% confidence interval (CI), 1.15-2.27; P = 0.005] and a 200% increased risk for small-cell lung cancer (OR, 3.00; 95% CI, 1.27-7.06; P = 0.01). Results showed only a trending association with NSCLC histologic subtypes, which may be due to insufficient sample size and/or weak effect size. A series of sensitivity analysis retained these findings. CONCLUSIONS Our findings suggest a causal relationship between elevated platelet count and increased risk of lung cancer and provide evidence of possible antiplatelet interventions for lung cancer prevention. IMPACT These findings provide a better understanding of lung cancer etiology and potential evidence for antiplatelet interventions for lung cancer prevention.
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Affiliation(s)
- Ying Zhu
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yongyue Wei
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.,China International Cooperation Center (CICC) for Environment and Human Health, Nanjing Medical University, Nanjing, China
| | - Ruyang Zhang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.,China International Cooperation Center (CICC) for Environment and Human Health, Nanjing Medical University, Nanjing, China
| | - Xuesi Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Sipeng Shen
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts
| | - Yang Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.,China International Cooperation Center (CICC) for Environment and Human Health, Nanjing Medical University, Nanjing, China
| | - Jianling Bai
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Bin Zhu
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Fangyi Gu
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Stephen Lam
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Ming-Sound Tsao
- University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Frances A Shepherd
- University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Adonina Tardon
- University of Oviedo and CIBERESP, Faculty of Medicine, Oviedo, Spain
| | | | | | - Chu Chen
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Matthew J Barnett
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Jennifer Doherty
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Stig E Bojesen
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Mattias Johansson
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Paul Brennan
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - James D McKay
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Thomas Muley
- Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany
| | - Angela Risch
- Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany.,German Center for Lung Research (DZL), Heidelberg, Germany.,University of Salzburg and Cancer Cluster Salzburg, Salzburg, Austria
| | - Heunz-Erich Wichmann
- Research Unit of Molecular Epidemiology, Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Heike Bickeboeller
- Department of Genetic Epidemiology, University Medical Center, Georg-August-University Göttingen, Germany
| | - Albert Rosenberger
- Department of Genetic Epidemiology, University Medical Center, Georg-August-University Göttingen, Germany
| | - Gad Rennert
- Department of Community Medicine and Epidemiology, Clalit National Cancer Control Center at Carmel Medical Center and Technion Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Walid Saliba
- Department of Community Medicine and Epidemiology, Clalit National Cancer Control Center at Carmel Medical Center and Technion Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Susanne M Arnold
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - John K Field
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Michael P A Davies
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Michael W Marcus
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Xifeng Wu
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yuanqing Ye
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | | | - Jonas Manjer
- Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, University of Toronto, Toronto, Ontario, Canada
| | - Geoffrey Liu
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, University of Toronto, Toronto, Ontario, Canada
| | - Yonathan Brhane
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, University of Toronto, Toronto, Ontario, Canada
| | - Linda Kachuri
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, University of Toronto, Toronto, Ontario, Canada
| | - Angeline S Andrew
- Department of Epidemiology, Geisel School of Medicine, Hanover, New Hampshire
| | - Eric J Duell
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Lambertus A Kiemeney
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Erik Hfm van der Heijden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Aage Haugen
- National Institute of Occupational Health, Oslo, Norway
| | | | - Vidar Skaug
- National Institute of Occupational Health, Oslo, Norway
| | - Kjell Grankvist
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Mikael Johansson
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Penella J Woll
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Angela Cox
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Fiona Taylor
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Dawn M Teare
- School of Health and Related Research, University of Sheffield, England, United Kingdom
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Spokane, Washington
| | - Matthew B Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Melinda C Aldrich
- Department of Thoracic Surgery, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | | | - Hongbing Shen
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhibin Hu
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Juncheng Dai
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Christopher I Amos
- Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Younghun Han
- Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Dakai Zhu
- Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | | | - Feng Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China. .,China International Cooperation Center (CICC) for Environment and Human Health, Nanjing Medical University, Nanjing, China
| | - David C Christiani
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China. .,Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.,China International Cooperation Center (CICC) for Environment and Human Health, Nanjing Medical University, Nanjing, China
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Adult height and risk of 50 diseases: a combined epidemiological and genetic analysis. BMC Med 2018; 16:187. [PMID: 30355295 PMCID: PMC6201543 DOI: 10.1186/s12916-018-1175-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/12/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Adult height is associated with risk of several diseases, but the breadth of such associations and whether these associations are primary or due to confounding are unclear. We examined the association of adult height with 50 diseases spanning multiple body systems using both epidemiological and genetic approaches, the latter to identify un-confounded associations and possible underlying mechanisms. METHODS We examined the associations for adult height (using logistic regression adjusted for potential confounders) and genetically determined height (using a two-sample Mendelian randomisation approach with height-associated genetic variants as instrumental variables) in 417,434 individuals of white ethnic background participating in the UK Biobank. We undertook pathway analysis of height-associated genes to identify biological processes that could link height and specific diseases. RESULTS Height was associated with 32 diseases and genetically determined height associated with 12 diseases. Of these, 11 diseases showed a concordant association in both analyses, with taller height associated with reduced risks of coronary artery disease (odds ratio per standard deviation (SD) increase in height ORepi = 0.80, 95% CI 0.78-0.81; OR per SD increase in genetically determined height ORgen = 0.86, 95% CI 0.82-0.90), hypertension (ORepi = 0.83, 95% CI 0.82-0.84; ORgen = 0.88, 95% CI 0.85-0.91), gastro-oesophageal reflux disease (ORepi = 0.85, 95% CI 0.84-0.86; ORgen = 0.94, 95% CI 0.92-0.97), diaphragmatic hernia (ORepi = 0.81, 95% CI 0.79-0.82; ORgen = 0.91, 95% CI 0.88-0.94), but increased risks of atrial fibrillation (ORepi = 1.42, 95% CI 1.38-1.45; ORgen = 1.33, 95% CI 1.26-1.40), venous thromboembolism (ORepi = 1.18, 95% CI 1.16-1.21; ORgen = 1.15, 95% CI 1.11-1.19), intervertebral disc disorder (ORepi = 1.15, 95% CI 1.13-1.18; ORgen = 1.14, 95% CI 1.09-1.20), hip fracture (ORepi = 1.19, 95% CI 1.12-1.26; ORgen = 1.27, 95% CI 1.17-1.39), vasculitis (ORepi = 1.15, 95% CI 1.11-1.19; ORgen = 1.20, 95% CI 1.14-1.28), cancer overall (ORepi = 1.09, 95% CI 1.08-1.11; ORgen = 1.06, 95% CI 1.04-1.08) and breast cancer (ORepi = 1.08, 95% CI 1.06-1.10; ORgen = 1.07, 95% CI 1.03-1.11). Pathway analysis showed multiple height-associated pathways associating with individual diseases. CONCLUSIONS Adult height is associated with risk of a range of diseases. We confirmed previously reported height associations for coronary artery disease, atrial fibrillation, venous thromboembolism, intervertebral disc disorder, hip fracture and cancer and identified potential novel associations for gastro-oesophageal reflux disease, diaphragmatic hernia and vasculitis. Multiple biological mechanisms affecting height may affect the risks of these diseases.
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Wang K, Chen X, Gerke TA, Bird VY, Ghayee HK, Prosperi M. BMI trajectories and risk of overall and grade-specific prostate cancer: An observational cohort study among men seen for prostatic conditions. Cancer Med 2018; 7:5272-5280. [PMID: 30207080 PMCID: PMC6198207 DOI: 10.1002/cam4.1747] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/26/2018] [Accepted: 08/02/2018] [Indexed: 12/29/2022] Open
Abstract
Background Dynamic longitudinal patterns in body mass index (BMI) have been suggested to better predict health outcomes than static measures. Effects of BMI trajectories on prostate cancer (PCa) risk have not been thoroughly explored. Methods Cohort data were derived from electronic medical records of patients who were admitted to a tertiary‐care hospital in the Southeastern USA during 1994‐2016. Patients with a history of urologic clinic visit because of any prostatic condition and with repeatedly measured BMI (n = 4857) were included. BMI trajectories prior to PCa diagnosis were assessed using the developmental trajectory analysis method. Cox proportional hazards regression modeling was used to estimate adjusted hazard ratio (aHR) with 95% confidence intervals (CIs) for overall and grade‐specific PCa. Results The median age (interquartile range, IQR) of the participants at baseline was 63 (54, 72) years. Over a median follow‐up (IQR) of 8.0 (2.0, 13.0) years, 714 (14.7%, 714/4857) were diagnosed with PCa. Men with growing BMI trajectory progressing from normal weight to overweight/obese had a 76% increased PCa risk (aHR = 1.76; 95% CI: 1.25, 2.48), and men being obese and experiencing progressive weight gain had 3.72‐fold increased PCa risk (aHR = 3.72; 95% CI: 1.60, 8.66), compared to men with persistently normal BMI. The associations were more pronounced for PCa with Gleason score ≥7. No significant association of decreasing BMI trajectory progressing from obese to normal BMI was found with PCa risk. Conclusions Progressively body weight gain during middle‐to‐late adulthood was associated with increased PCa risk for both normal weight and overweight men. Further studies are warranted to confirm this finding.
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Affiliation(s)
- Kai Wang
- Department of Epidemiology, University of Florida, Gainesville, Florida
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, Gainesville, Florida
| | - Travis A Gerke
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Victoria Y Bird
- Department of Urology, University of Florida, Gainesville, Florida
| | - Hans K Ghayee
- Department of Internal Medicine, Division of Endocrinology, University of Florida and the Malcom Randall VA Medical Center, Gainesville, Florida
| | - Mattia Prosperi
- Department of Epidemiology, University of Florida, Gainesville, Florida
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Hui X, Hu Y, Sun MA, Shu X, Han R, Ge Q, Wang Y. EBT: a statistic test identifying moderate size of significant features with balanced power and precision for genome-wide rate comparisons. Bioinformatics 2018; 33:2631-2641. [PMID: 28472273 DOI: 10.1093/bioinformatics/btx294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 05/02/2017] [Indexed: 11/14/2022] Open
Abstract
Motivation In genome-wide rate comparison studies, there is a big challenge for effective identification of an appropriate number of significant features objectively, since traditional statistical comparisons without multi-testing correction can generate a large number of false positives while multi-testing correction tremendously decreases the statistic power. Results In this study, we proposed a new exact test based on the translation of rate comparison to two binomial distributions. With modeling and real datasets, the exact binomial test (EBT) showed an advantage in balancing the statistical precision and power, by providing an appropriate size of significant features for further studies. Both correlation analysis and bootstrapping tests demonstrated that EBT is as robust as the typical rate-comparison methods, e.g. χ 2 test, Fisher's exact test and Binomial test. Performance comparison among machine learning models with features identified by different statistical tests further demonstrated the advantage of EBT. The new test was also applied to analyze the genome-wide somatic gene mutation rate difference between lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), two main lung cancer subtypes and a list of new markers were identified that could be lineage-specifically associated with carcinogenesis of LUAD and LUSC, respectively. Interestingly, three cilia genes were found selectively with high mutation rates in LUSC, possibly implying the importance of cilia dysfunction in the carcinogenesis. Availability and implementation An R package implementing EBT could be downloaded from the website freely: http://www.szu-bioinf.org/EBT . Contact wangyj@szu.edu.cn. Supplementary information Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Xinjie Hui
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen 518060, China
| | - Yueming Hu
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen 518060, China
| | - Ming-An Sun
- Epigenomics and Computational Biology Lab, Virginia Bioinformatics Institute, Virginia Tech, Blacksburg, VA 24060, USA
| | - Xingsheng Shu
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen 518060, China
| | - Rongfei Han
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen 518060, China
| | - Qinggang Ge
- Department of Critical Care Unit, Peking University Third Hospital, Beijing 100191, China
| | - Yejun Wang
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Shenzhen University Health Science Center, Shenzhen 518060, China
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Abstract
Purpose of review In this paper, we summarize prior studies that have used Mendelian Randomization (MR) methods to study the effects of exposures, lifestyle factors, physical traits, and/or biomarkers on cancer risk in humans. Many such risk factors have been associated with cancer risk in observational studies, and the MR approach can be used to provide evidence as to whether these associations represent causal relationships. MR methods require a risk factor of interest to have known genetic determinants that can be used as proxies for the risk factor (i.e., "instrumental variables" or IVs), and these can be used to obtain an effect estimate that, under certain assumptions, is not prone to bias caused by unobserved confounding or reverse causality. This review seeks to describe how MR studies have contributed to our understanding of cancer causation. Recent findings We searched the published literature and identified 76 MR studies of cancer risk published prior to October 31, 2017. Risk factors commonly studied included alcohol consumption, Vitamin D, anthropometric traits, telomere length, lipid traits, glycemic traits, and markers of inflammation. Risk factors showing compelling evidence of a causal association with risk for at least one cancer type include alcohol consumption (for head/neck and colorectal), adult body mass index (increases risk for multiple cancers, but decreases risk for breast), height (increases risk for breast, colorectal, and lung; decreases risk for esophageal), telomere length (increases risk for lung adenocarcinoma, melanoma, renal cell carcinoma, glioma, B-cell lymphoma subtypes, chronic lymphocytic leukemia, and neuroblastoma), and hormonal factors (affects risk for sex-steroid sensitive cancers). Summary This review highlights alcohol consumption, body mass index, height, telomere length, and the hormonal exposures as factors likely to contribute to cancer causation. This review also highlights the need to study specific cancer types, ideally subtypes, as the effects of risk factors can be heterogeneous across cancer types. As consortia-based genome-wide association studies increase in sample size and analytical methods for MR continue to become more sophisticated, MR will become an increasingly powerful tool for understanding cancer causation.
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Cole-Clark D, Nair-Shalliker V, Bang A, Rasiah K, Chalasani V, Smith DP. An initial melanoma diagnosis may increase the subsequent risk of prostate cancer: Results from the New South Wales Cancer Registry. Sci Rep 2018; 8:7167. [PMID: 29740153 PMCID: PMC5940665 DOI: 10.1038/s41598-018-25408-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/10/2018] [Indexed: 12/18/2022] Open
Abstract
Emerging evidence suggests that a diagnosis of cutaneous melanoma (CM) may be associated with prostate cancer (PC) incidence. We examined if the incidence of CM was associated with an increased subsequent risk of PC. We used data from the New South Wales Cancer Registry for all CM and PC cases diagnosed between January 1972 and December 2008. We calculated the age standardized incidence ratio (SIR) and 95% confidence intervals (95% CI) for PC incidence following a CM diagnosis, applying age- and calendar- specific rates to the appropriate person years at risk. We determined rate ratio (RR) and 95% CI of PC incidence according to specified socio-demographic categories and disease related characteristics, using a negative binomial model. There were 143,594 men diagnosed with PC or CM in the study period and of these 101,198 and 42,396 were diagnosed with PC and CM, respectively, as first primary cancers. Risk of PC incidence increased following CM diagnosis (n = 2,114; SIR = 1.25; 95% CI:1.20.8-1.31: p < 0.0001), with the increased risk apparent in men diagnosed with localised CM (n = 1,862;SIR = 1.26; 95% CI:1.20-1.32). CM diagnosis increased the subsequent risk of PC incidence. This raises the potential for future PC risk to be discussed with newly diagnosed males with CM.
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Affiliation(s)
- D Cole-Clark
- Department of Surgery, Royal North Shore Hospital, New South Wales, Australia
| | - V Nair-Shalliker
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
| | - A Bang
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
| | - K Rasiah
- Northern Sydney Local Health District, New South Wales, Australia
- Garvan Institute of Medical Research & Kinghorn Cancer Centre, New South Wales, Australia
| | - V Chalasani
- Garvan Institute of Medical Research & Kinghorn Cancer Centre, New South Wales, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Discipline of Surgery, University of Sydney, New South Wales, Australia
| | - D P Smith
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Menzies Health Institute, Queensland, Griffith University, Gold Coast, Queensland, Australia
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Height and overall cancer risk and mortality: evidence from a Mendelian randomisation study on 310,000 UK Biobank participants. Br J Cancer 2018; 118:1262-1267. [PMID: 29581483 PMCID: PMC5943400 DOI: 10.1038/s41416-018-0063-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/28/2018] [Accepted: 03/01/2018] [Indexed: 12/12/2022] Open
Abstract
Background Observational studies have shown that being taller is associated
with greater cancer risk. However, the interpretation of such studies can be
hampered by important issues such as confounding and reporting bias. Methods We used the UK Biobank resource to develop genetic predictors of
height and applied these in a Mendelian randomisation framework to estimate the
causal relationship between height and cancer. Up to 438,870 UK Biobank
participants were considered in our analysis. We addressed two primary cancer
outcomes, cancer incidence by age ~60 and cancer mortality by age ~60 (where age
~60 is the typical age of UK Biobank participants). Results We found that each genetically predicted 9 cm increase in height
conferred an odds ratio of 1.10 (95% confidence interval 1.07–1.13) and 1.09
(1.02–1.16) for diagnosis of any cancer and death from any cancer, respectively.
For both risk and mortality, the effect was larger in females than in
males. Conclusions Height increases the risk of being diagnosed with and dying from
cancer. These findings from Mendelian randomisation analyses agree with
observational studies and provide evidence that they were not likely to have been
strongly affected by confounding or reporting bias.
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Goodarzi MO. Genetics of obesity: what genetic association studies have taught us about the biology of obesity and its complications. Lancet Diabetes Endocrinol 2018; 6:223-236. [PMID: 28919064 DOI: 10.1016/s2213-8587(17)30200-0] [Citation(s) in RCA: 252] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/24/2017] [Accepted: 05/24/2017] [Indexed: 01/01/2023]
Abstract
Genome-wide association studies (GWAS) for BMI, waist-to-hip ratio, and other adiposity traits have identified more than 300 single-nucleotide polymorphisms (SNPs). Although there is reason to hope that these discoveries will eventually lead to new preventive and therapeutic agents for obesity, this will take time because such developments require detailed mechanistic understanding of how an SNP influences phenotype (and this information is largely unavailable). Fortunately, absence of functional information has not prevented GWAS findings from providing insights into the biology of obesity. Genes near loci regulating total body mass are enriched for expression in the CNS, whereas genes for fat distribution are enriched in adipose tissue itself. Gene by environment and lifestyle interaction analyses have revealed that our increasingly obesogenic environment might be amplifying genetic risk for obesity, yet those at highest risk could mitigate this risk by increasing physical activity and possibly by avoiding specific dietary components. GWAS findings have also been used in mendelian randomisation analyses probing the causal association between obesity and its many putative complications. In supporting a causal association of obesity with diabetes, coronary heart disease, specific cancers, and other conditions, these analyses have clinical relevance in identifying which outcomes could be preventable through weight loss interventions.
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Affiliation(s)
- Mark O Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Peñuelas J, Janssens IA, Ciais P, Obersteiner M, Krisztin T, Piao S, Sardans J. Increasing gap in human height between rich and poor countries associated to their different intakes of N and P. Sci Rep 2017; 7:17671. [PMID: 29247185 PMCID: PMC5732171 DOI: 10.1038/s41598-017-17880-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 12/02/2017] [Indexed: 11/24/2022] Open
Abstract
We analyzed mean height of men born in the 1960s, 1970s and 1980s in 80 countries. Both height and the change in height during the last decades were correlated with N and P intake, as well as the N:P intake ratio. Rich countries had higher per capita N and P intake than poor countries (on average 19.5 ± 0.3 versus 9.66 ± 0.18 kg N y-1 and 2.17 ± 0.04 versus 1.35 ± 0.02 kg P y-1), and also larger increases in per capita N intake (12.1 ± 2.0% vs. 7.0 ± 2.1%) and P intake (7.6 ± 1.0% vs 6.01 ± 0.7%), during the period 1961-2009. The increasing gap in height trends between rich and poor countries is associated with an increasing gap in nutrition, so a more varied diet with higher N, P, and N:P intake is a key factor to improve food intake quality in poor countries and thus shorten the gap with rich countries. More N and P are needed with the consequent requirements for a better management of the socioeconomic and environmental associated problems.
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Affiliation(s)
- Josep Peñuelas
- CSIC, Global Ecology Unit CREAF-CEAB-UAB, Cerdanyola del Valles, 08193, Catalonia, Spain.
- CREAF, Cerdanyola del Valles, 08193, Catalonia, Spain.
| | - Ivan A Janssens
- Research Group of Plant and Vegetation Ecology (PLECO), Department of Biology, University of Antwerp, B-2610, Wilrijk, Belgium
| | - Philippe Ciais
- Laboratoire des Sciences du Climat et de l'Environnement, IPSL, 91191, Gif-sur-Yvette, France
| | - Michael Obersteiner
- International Institute for Applied Systems Analysis (IIASA), Ecosystems Services and Management, Schlossplatz 1, A-2361, Laxenburg, Austria
| | - Tamás Krisztin
- International Institute for Applied Systems Analysis (IIASA), Ecosystems Services and Management, Schlossplatz 1, A-2361, Laxenburg, Austria
| | - Shilong Piao
- Sino-French Institute for Earth System Science, College of Urban and Environmental Sciences, Peking University, Beijing, 100871, China
| | - Jordi Sardans
- CSIC, Global Ecology Unit CREAF-CEAB-UAB, Cerdanyola del Valles, 08193, Catalonia, Spain
- CREAF, Cerdanyola del Valles, 08193, Catalonia, Spain
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Lindström S, Finucane H, Bulik-Sullivan B, Schumacher FR, Amos CI, Hung RJ, Rand K, Gruber SB, Conti D, Permuth JB, Lin HY, Goode EL, Sellers TA, Amundadottir LT, Stolzenberg-Solomon R, Klein A, Petersen G, Risch H, Wolpin B, Hsu L, Huyghe JR, Chang-Claude J, Chan A, Berndt S, Eeles R, Easton D, Haiman CA, Hunter DJ, Neale B, Price AL, Kraft P. Quantifying the Genetic Correlation between Multiple Cancer Types. Cancer Epidemiol Biomarkers Prev 2017; 26:1427-1435. [PMID: 28637796 PMCID: PMC5582139 DOI: 10.1158/1055-9965.epi-17-0211] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/03/2017] [Accepted: 06/06/2017] [Indexed: 01/01/2023] Open
Abstract
Background: Many cancers share specific genetic risk factors, including both rare high-penetrance mutations and common SNPs identified through genome-wide association studies (GWAS). However, little is known about the overall shared heritability across cancers. Quantifying the extent to which two distinct cancers share genetic origin will give insights to shared biological mechanisms underlying cancer and inform design for future genetic association studies.Methods: In this study, we estimated the pair-wise genetic correlation between six cancer types (breast, colorectal, lung, ovarian, pancreatic, and prostate) using cancer-specific GWAS summary statistics data based on 66,958 case and 70,665 control subjects of European ancestry. We also estimated genetic correlations between cancers and 14 noncancer diseases and traits.Results: After adjusting for 15 pair-wise genetic correlation tests between cancers, we found significant (P < 0.003) genetic correlations between pancreatic and colorectal cancer (rg = 0.55, P = 0.003), lung and colorectal cancer (rg = 0.31, P = 0.001). We also found suggestive genetic correlations between lung and breast cancer (rg = 0.27, P = 0.009), and colorectal and breast cancer (rg = 0.22, P = 0.01). In contrast, we found no evidence that prostate cancer shared an appreciable proportion of heritability with other cancers. After adjusting for 84 tests studying genetic correlations between cancer types and other traits (Bonferroni-corrected P value: 0.0006), only the genetic correlation between lung cancer and smoking remained significant (rg = 0.41, P = 1.03 × 10-6). We also observed nominally significant genetic correlations between body mass index and all cancers except ovarian cancer.Conclusions: Our results highlight novel genetic correlations and lend support to previous observational studies that have observed links between cancers and risk factors.Impact: This study demonstrates modest genetic correlations between cancers; in particular, breast, colorectal, and lung cancer share some degree of genetic basis. Cancer Epidemiol Biomarkers Prev; 26(9); 1427-35. ©2017 AACR.
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Affiliation(s)
- Sara Lindström
- Department of Epidemiology, University of Washington, Seattle, Washington.
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Hilary Finucane
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Mathematics, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Brendan Bulik-Sullivan
- The Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Fredrick R Schumacher
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
- Seidman Cancer Center, University Hospitals, Cleveland, Ohio
| | - Christopher I Amos
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Kristin Rand
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Stephen B Gruber
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - David Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jennifer B Permuth
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, Florida
- Department of Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Hui-Yi Lin
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Thomas A Sellers
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Laufey T Amundadottir
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, U.S. Department of Health and Human Services, Bethesda, Maryland
| | - Rachael Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, U.S. Department of Health and Human Services, Bethesda, Maryland
| | - Alison Klein
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Gloria Petersen
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Harvey Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Brian Wolpin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Li Hsu
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Jeroen R Huyghe
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andrew Chan
- Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts
| | - Sonja Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, U.S. Department of Health and Human Services, Bethesda, Maryland
| | - Rosalind Eeles
- Division of Genetics and Epidemiology, The Institute of Cancer Research, and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Douglas Easton
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - David J Hunter
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Benjamin Neale
- The Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Alkes L Price
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Kinnunen PTT, Murtola TJ, Talala K, Taari K, Tammela TLJ, Auvinen A. Prostate cancer-specific survival among warfarin users in the Finnish Randomized Study of Screening for Prostate Cancer. BMC Cancer 2017; 17:585. [PMID: 28851310 PMCID: PMC5575900 DOI: 10.1186/s12885-017-3579-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 08/22/2017] [Indexed: 12/17/2022] Open
Abstract
Background Venous thromboembolic events (VTE) are common in cancer patients and associated with higher mortality. In vivo thrombosis and anticoagulation might be involved in tumor growth and progression. We studied the association of warfarin and other anticoagulant use as antithrombotic medication and prostate cancer (PCa) death in men with the disease. Methods The study included 6,537 men diagnosed with PCa during 1995-2009. Information on anticoagulant use was obtained from a national reimbursement registry. Cox regression with adjustment for age, PCa risk group, primary therapy and use of other medication was performed to compare risk of PCa death between warfarin users with 1) men using other types of anticoagulants and 2) non-users of anticoagulants. Medication use was analyzed as a time-dependent variable to minimize immortal time bias. Results In total, 728 men died from PCa during a median follow-up of 9 years. Compared to anticoagulant non-users, post-diagnostic use of warfarin was associated with an increased risk of PCa death (overall HR 1.47, 95% CI 1.13-1.93). However, this was limited to low-dose, low-intensity use. Otherwise, the risk was similar to anticoagulant non-users. Additionally, we found no risk difference between warfarin and other types of anticoagulants. Pre-diagnostic use of warfarin was not associated with the risk of PCa death. Conclusions We found no reduction in risk of PCa death associated with warfarin use. Conversely, the risk was increased in short-term use, which is probably explained by a higher risk of thrombotic events prompting warfarin use in patients with terminal PCa. Electronic supplementary material The online version of this article (10.1186/s12885-017-3579-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pete T T Kinnunen
- University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland.
| | - Teemu J Murtola
- University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland.,Department of Urology, Tampere University Hospital, Tampere, Finland
| | | | - Kimmo Taari
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teuvo L J Tammela
- University of Tampere, Faculty of Medicine and Life Sciences, Tampere, Finland.,Department of Urology, Tampere University Hospital, Tampere, Finland
| | - Anssi Auvinen
- University of Tampere, Faculty of Social Sciences, Tampere, Finland
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48
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Capurso C, Vendemiale G. The Mediterranean Diet Reduces the Risk and Mortality of the Prostate Cancer: A Narrative Review. Front Nutr 2017; 4:38. [PMID: 28884114 PMCID: PMC5573712 DOI: 10.3389/fnut.2017.00038] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 07/18/2017] [Indexed: 12/31/2022] Open
Abstract
Prostate cancer is the second most common cancer in the world among men, and is the fifth most common cause of cancer death among men. The aim of our review was to analyze observational and case–control studies to point out the effects of overweight and diets components on the cancer risk, particularly on risk of prostate cancer, and the effect of the Mediterranean diet (MD) on the reduction of risk and mortality of prostate cancer. It is known that incidence and progression of cancer is multifactorial. Cancer of the large bowel, breast, endometrium, and prostate are due also to a high body mass index and to high consumption of high carcinogenic dietary factors, as red and processed meat or saturated fats rich foods, and to a low consumption of vegetables and fruits. Previous meta-analysis suggested that high adherence to diet model based on the traditional MD pattern gives a significant protection from incidence and mortality of cancer of all types. The main component of the MD is olive oil, consumed in high amount by Mediterranean basin populations. In addition, phenolic compounds exert some strong chemo-preventive effects, which are due to several mechanisms, including both antioxidant effects and actions on cancer cell signaling and cell cycle progression and proliferation. The protective effect of the MD against the prostate cancer is also due to the high consumption of tomato sauce. Lycopene is the most relevant functional component in tomatoes; after activating by the cooking of tomato sauce, it exerts antioxidant properties by acting in the modulation of downregulation mechanisms of the inflammatory response. MD, therefore, represents a healthy dietary pattern in the context of a healthy lifestyle habits. In conclusion, our narrative review allows us to reaffirm how nutritional factors play an important role in cancer initiation and development, and how a healthy dietary pattern represented by MD and its components, especially olive oil, could exert a protective role by the development and progression of prostate cancer.
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Affiliation(s)
- Cristiano Capurso
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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49
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Lophatananon A, Stewart-Brown S, Kote-Jarai Z, Olama AAA, Garcia SB, Neal DE, Hamdy FC, Donovan JL, Giles GG, Fitzgerald LM, Southey MC, Pharoah P, Pashayan N, Gronberg H, Wiklund F, Aly M, Stanford JL, Brenner H, Dieffenbach AK, Arndt V, Park JY, Lin HY, Sellers T, Slavov C, Kaneva R, Mitev V, Batra J, Spurdle A, Clements JA, Easton D, Eeles RA, Muir K. Height, selected genetic markers and prostate cancer risk: results from the PRACTICAL consortium. Br J Cancer 2017; 117:734-743. [PMID: 28765617 PMCID: PMC5572182 DOI: 10.1038/bjc.2017.231] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/07/2017] [Accepted: 06/23/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Evidence on height and prostate cancer risk is mixed, however, recent studies with large data sets support a possible role for its association with the risk of aggressive prostate cancer. METHODS We analysed data from the PRACTICAL consortium consisting of 6207 prostate cancer cases and 6016 controls and a subset of high grade cases (2480 cases). We explored height, polymorphisms in genes related to growth processes as main effects and their possible interactions. RESULTS The results suggest that height is associated with high-grade prostate cancer risk. Men with height >180 cm are at a 22% increased risk as compared to men with height <173 cm (OR 1.22, 95% CI 1.01-1.48). Genetic variants in the growth pathway gene showed an association with prostate cancer risk. The aggregate scores of the selected variants identified a significantly increased risk of overall prostate cancer and high-grade prostate cancer by 13% and 15%, respectively, in the highest score group as compared to lowest score group. CONCLUSIONS There was no evidence of gene-environment interaction between height and the selected candidate SNPs.Our findings suggest a role of height in high-grade prostate cancer. The effect of genetic variants in the genes related to growth is seen in all cases and high-grade prostate cancer. There is no interaction between these two exposures.
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Affiliation(s)
- Artitaya Lophatananon
- Centre of Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Health sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Sarah Stewart-Brown
- Centre of Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Zsofia Kote-Jarai
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - Ali Amin Al Olama
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | - Sara Benlloch Garcia
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | - David E Neal
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Graham G Giles
- Cancer Epidemiology Centre, The Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria 3010, Australia
| | - Liesel M Fitzgerald
- Cancer Epidemiology Centre, The Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Melissa C Southey
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia
| | - Paul Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Strangeways Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
| | - Nora Pashayan
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Strangeways Laboratory, Worts Causeway, Cambridge CB1 8RN, UK
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Henrik Gronberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm 10435, Sweden
| | - Fredrik Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm 10435, Sweden
| | - Markus Aly
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm 10435, Sweden
- Department of Clinical Sciences at Danderyds Hospital, Stockholm 17177, Sweden
| | - Janet L Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Aida K Dieffenbach
- German Cancer Consortium (DKTK), Heidelberg 69120, Germany
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Volker Arndt
- German Cancer Consortium (DKTK), Heidelberg 69120, Germany
| | - Jong Y Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Hui-Yi Lin
- Biostatistics Program, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Thomas Sellers
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Chavdar Slavov
- Department of Urology and Alexandrovska University Hospital, Medical University, Sofia 1431, Bulgaria
| | - Radka Kaneva
- Department of Medical Chemistry and Biochemistry, Molecular Medicine Center, Medical University, Sofia, 2 Zdrave Str., Sofia 1431, Bulgaria
| | - Vanio Mitev
- Department of Medical Chemistry and Biochemistry, Molecular Medicine Center, Medical University, Sofia, 2 Zdrave Str., Sofia 1431, Bulgaria
| | - Jyotsna Batra
- Australian Prostate Cancer Research Centre-Qld, Institute of Health and Biomedical Innovation and School of Biomedical Science, Queensland University of Technology, Brisbane 4006, Australia
| | - Amanda Spurdle
- Molecular Cancer Epidemiology Laboratory, Queensland Institute of Medical Research, Brisbane 4006, Australia
| | - Judith A Clements
- Australian Prostate Cancer Research Centre-Qld, Institute of Health and Biomedical Innovation and School of Biomedical Science, Queensland University of Technology, Brisbane 4006, Australia
| | | | - Douglas Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | - Rosalind A Eeles
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
- Royal Marsden National Health Service (NHS) Foundation Trust, London and Sutton SM2 5PT, UK
| | - Kenneth Muir
- Centre of Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Health sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
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50
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Salgado-Montilla JL, Rodríguez-Cabán JL, Sánchez-García J, Sánchez-Ortiz R, Irizarry-Ramírez M. Impact of FTO SNPs rs9930506 and rs9939609 in Prostate Cancer Severity in a Cohort of Puerto Rican Men. ACTA ACUST UNITED AC 2017; 5. [PMID: 29333375 DOI: 10.21767/2254-6081.1000148] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Obesity is prevalent in PR and has been associated with prostate cancer (PCa) mortality and aggressiveness. Polymorphisms (SNPs) rs9930506 and rs9939609 in the FTO gene have been associated with both obesity and PCa. The aim of this work was to ascertain whether the presence of these SNPs is associated with PCa risk and severity in a cohort of Puerto Rican men. Methods and findings The study population consisted of 513 Puerto Rican men age ranging from 40-79 years old who underwent radical prostatectomy (RP) as the first treatment for PCa and 128 healthy Puerto Rican men age ranging from 40-79 years old. Genomic DNA (gDNA) was extracted and SNPs were determined by Real-Time PCR. PCa severity was defined based on RP stage and Gleason Score. The relationship of FTO SNPs with demographic, clinical characteristics, PCa status and PCa severity were assessed. Logistic regression models with a 95% confidence interval (CI) determined SNPs interaction with PCa risk and severity odds ratio (ORs). Results and discussion BMI, age and PSA were considered as confounders. Hardy-Weinberg equilibrium was present for both SNPs. The heterozygous forms (A/G; T/A) were the most prevalent genotypes and the frequency of alleles and genotypes for both SNPs agreed with those published in 1000 genomes. Results suggest an inverse association between the mutated rs9939609 and the risk of having PCa (OR: 0.53, 95% CI: 0.31-0.92) and a positive association with overweight (OR: 1.05, 95% CI: 0.68-1.62). Importantly, among the cases that were overweight, those with mutated rs9939609 had a greater chance of high severity PCa (OR: 1.39, 95% CI: 0.84-2.32) although these results were not statistical significant upon adjustment. Limitations of the study were the relatively small cohort and lack of access to the weight history of all our subjects. Conclusion Results offer a research line to be followed with an expanded number of subjects that may provide a better statistical significance, to unravel the high mortality rate in this population.
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Affiliation(s)
- Jeannette L Salgado-Montilla
- University of Puerto Rico/MD Anderson Cancer Center Partnership for Excellence in Cancer Research, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Jorge L Rodríguez-Cabán
- School of Health Professions, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Jonathan Sánchez-García
- School of Public Health, Department of Biostatistics and Epidemiology, University of Puerto Rico, Medical Sciences Campus, San Juan, Rico, USA
| | - Ricardo Sánchez-Ortiz
- School of Medicine, Urology Section, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Margarita Irizarry-Ramírez
- School of Health Professions, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA
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