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Daffré E, Porcher R, Iannelli A, Prieto M, Brouchet L, Falcoz PE, Le Pimpec Barthes F, Pages PB, Thomas PA, Dahan M, Alifano M. Protective effect of height on long-term survival of resectable lung cancer: a new feature of the lung cancer paradox. Thorax 2024; 79:316-324. [PMID: 38359923 DOI: 10.1136/thorax-2023-220443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Unlike most malignancies, higher body mass index (BMI) is associated with a reduced risk of lung cancer and improved prognosis after surgery. However, it remains controversial whether height, one of determinants of BMI, is associated with survival independently of BMI and other confounders. METHODS We extracted data on all consecutive patients with resectable non-small cell lung cancer included in Epithor, the French Society of Thoracic and Cardiovascular Surgery database, over a 16-year period. Height was analysed as a continuous variable, and then categorised into four or three categories, according to sex-specific quantiles. Cox proportional hazards regression was used to estimate the association of height with survival, adjusted for age, tobacco consumption, forced expiratory volume in one second (FEV1), WHO performance status (WHO PS), American Society of Anesthesiologists (ASA) score, extent of resection, histological type, stage of disease and centre as a random effect, as well as BMI in a further analysis. RESULTS The study included 61 379 patients. Higher height was significantly associated with better long-term survival after adjustment for other variables (adjusted HR 0.97 per 10 cm higher height, 95% CI 0.95 to 0.99); additional adjustment for BMI resulted in an identical HR. The prognostic impact of height was further confirmed by stratifying by age, ASA class, WHO PS and histological type. When stratifying by BMI class, there was no evidence of a differential association (p=0.93). When stratifying by stage of disease, the prognostic significance of height was maintained for all stages except IIIB-IV. CONCLUSIONS Our study shows that height is an independent prognostic factor of resectable lung cancer.
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Affiliation(s)
- Elisa Daffré
- Thoracic Surgery Department, Cochin Hospital, APHP Centre Université de Paris Cité, Paris, France
| | - Raphaël Porcher
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Center for Clinical Epidemiology, AP-HP, Hôtel Dieu Hospital, Paris, France
| | | | - Mathilde Prieto
- Thoracic Surgery Department, Cochin Hospital, APHP Centre Université de Paris Cité, Paris, France
| | | | | | | | | | | | - Marcel Dahan
- Thoracic Surgery Department, CHU Toulouse, Toulouse, France
| | - Marco Alifano
- Thoracic Surgery Department, Cochin Hospital, APHP Centre Université de Paris Cité, Paris, France
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Gremke N, Griewing S, Kalder M, Kostev K. Positive association between body height and breast cancer prevalence: a retrospective study with 135,741 women in Germany. Breast Cancer Res Treat 2022; 196:349-354. [PMID: 36085535 PMCID: PMC9581809 DOI: 10.1007/s10549-022-06730-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/28/2022] [Indexed: 12/01/2022]
Abstract
Purpose The aim of this study was to analyze the prevalence of breast cancer in relation to body height and to investigate associations between body height and breast cancer in Germany. Methods This retrospective cohort study included 135,741 adult women followed in one of 161 gynecology practices in Germany between January 2019 and December 2021. The 3 year prevalence of breast cancer (ICD-10: C50) during the study period was shown in relation to body height, which was included in this study as a five-category variable for women: ≤ 160 cm, 161–165 cm, 166–170 cm, 171–175 cm, > 175 cm. The associations between height and breast cancer were analyzed using logistic regression models adjusted for age and BMI. Results The prevalence of breast cancer increased from 5.1% in women ≤ 160 cm to 6.8% in women > 175 cm in the age group 51–60, and from 9.2% in women ≤ 160 cm to 12.2% in women 171–175 cm in the age group > 60 years. The OR for breast cancer was 1.18 (95% CI 1.12–1.24) for every 10 cm increase in height. Compared to height ≤ 160 cm, the OR for height 166–170 cm was 1.26 (1.15–1.39), for 171–175 cm 1.43 (1.27–1.61), and for > 175 cm 1.49 (1.28–1.74). Conclusion The results of this study suggest that greater body height in women is significantly related to an increased breast cancer risk.
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Affiliation(s)
- Niklas Gremke
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany.
| | - Sebastian Griewing
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
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Krieg S, Roderburg C, Krieg A, Luedde T, Loosen SH, Kostev K. The association between body height and cancer: a retrospective analysis of 784,192 outpatients in Germany. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04335-0. [PMID: 36066621 DOI: 10.1007/s00432-022-04335-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/26/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Cancer risk is determined by numerous factors. Recently, body height has been linked to different cancer sites in different populations. METHODS This retrospective cohort study included 784,192 adult outpatients with available body height values from 2010 to 2020 using the Disease Analyzer database (IQVIA). The outcome was the incidence of cancer diagnoses within the study period according to body height, stratified by age, sex, and cancer sites. RESULTS Overall cancer incidence rose with increasing body height in both sexes. In women, there was a rise from 10.9 (≤ 160 cm) to 13.6 (> 180 cm) and from 16.6 (≤ 160 cm) to 26.8 (> 180 cm) cases per 1000 patient years in the 51-60 and > 70 years age group, respectively. Among men, cancer incidene increased from 23.9 (≤ 165 cm) to 26.3 (176-185 cm) and from 38.9 (≤ 165 cm) to 43.4 (176-185 cm) cases per 1000 patient years in 61-70 and > 70 years age group, respectively. The hazard ratio (HR) for developing cancer was 1.11 (95% CI 1.09-1.13) for every 10 cm increase in body height among women and 1.06 (95% CI 1.04-1.08) among men. A significant association between body height and cancer incidence was found for certain cancer sites, such as malignant melanoma, in both women (HR 1.21, 95% CI 1.11-1.33) and men (HR 1.29, 95% CI 1.18-1.42). CONCLUSION In this study, we present the first data from a large cohort from Germany that provide strong evidence for a positive association between body height and the overall risk of developing various cancers.
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Affiliation(s)
- Sarah Krieg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Düsseldorf, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Christoph Roderburg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Düsseldorf, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - Andreas Krieg
- Department of Surgery (A), Medical Faculty of Heinrich Heine University Düsseldorf, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Tom Luedde
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Düsseldorf, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Sven H Loosen
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich Heine University Düsseldorf, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
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Nevill AM, Duncan MJ, Myers T. BMI is dead; long live waist-circumference indices: But which index should we choose to predict cardio-metabolic risk? Nutr Metab Cardiovasc Dis 2022; 32:1642-1650. [PMID: 35525679 DOI: 10.1016/j.numecd.2022.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/16/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS There is growing evidence that Body Mass Index (BMI) is unfit for purpose. Waist circumference (WC) indices appear to be the preferred alternative, although it is not clear which WC index is optimal at predicting cardio-metabolic risk (CMR) and associated health outcomes. METHODS AND RESULTS We obtained a stratified random probability sample of 53,390 participants from the Health Survey for England (HSE), 2008-2018. The four available CMR factors were; high-density lipoproteins (HDL) cholesterol, glycated haemoglobin (HbA1c), systolic (SBP) and diastolic blood pressure (DBP). Strength of association between the four cardio-metabolic risk factors and competing anthropometric indicators of weight status [BMI, Waist-to-height ratio (WHTR), unadjusted WC, and a new WC index independent of height, WHT·5R = WC/height0.5] was assessed separately, using simple correlations and ANCOVAs, and together (combined) using MANCOVA, controlling for age, sex and ethnicity. Centile curves for the new index WHT·5R = WC/height0.5were also provided. CONCLUSIONS Waist-circumference indices were superior to BMI when explaining/predicting our CMR factors, before and after controlling for age, sex and ethnicity. No single WC index was consistently superior. Results suggest that WHTR is the strongest predictor of HbA1c, confirming that shorter individuals are at great risk of diabetes. The most appropriate WC index associated with blood pressure was WHT·5R for DBP, or unadjusted WC for SBP. Given HDL cholesterol is independent of height, the best predictor of HDL was WHT.5R. Clearly, "no one size fits all!". MANCOVA identified WHT·5R to be the best single WC index associated with a composite of all four CMR factors.
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Affiliation(s)
- A M Nevill
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall Campus, Walsall, WS1 3BD, UK.
| | - M J Duncan
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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Howe LJ, Brumpton B, Rasheed H, Åsvold BO, Davey Smith G, Davies NM. Taller height and risk of coronary heart disease and cancer, a within-sibship Mendelian randomization study. eLife 2022; 11:72984. [PMID: 35302490 PMCID: PMC8947759 DOI: 10.7554/elife.72984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Taller people have a lower risk of coronary heart disease but a higher risk of many cancers. Mendelian randomization (MR) studies in unrelated individuals (population MR) have suggested that these relationships are potentially causal. However, population MR studies are sensitive to demography (population stratification, assortative mating) and familial (indirect genetic) effects. Methods: In this study, we performed within-sibship MR analyses using 78,988 siblings, a design robust against demography and indirect genetic effects of parents. For comparison, we also applied population MR and estimated associations with measured height. Results: Within-sibship MR estimated that 1 SD taller height lowers the odds of coronary heart disease by 14% (95% CI: 3–23%) but increases the odds of cancer by 18% (95% CI: 3–34%), highly consistent with population MR and height-disease association estimates. There was some evidence that taller height reduces systolic blood pressure and low-density lipoprotein cholesterol, which may mediate some of the protective effects of taller height on coronary heart disease risk. Conclusions: For the first time, we have demonstrated that the purported effects of height on adulthood disease risk are unlikely to be explained by demographic or familial factors, and so likely reflect an individual-level causal effect. Disentangling the mechanisms via which height affects disease risk may improve the understanding of the etiologies of atherosclerosis and carcinogenesis. Funding: This project was conducted by researchers at the MRC Integrative Epidemiology Unit (MC_UU_00011/1) and also supported by a Norwegian Research Council Grant number 295989.
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Affiliation(s)
- Laurence J Howe
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Ben Brumpton
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Humaira Rasheed
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - George Davey Smith
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Neil Martin Davies
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
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Hwang IC, Bae JH, Kim JM, Lee JM, Nguyen QD. Adult body height and age-related macular degeneration in healthy individuals: A nationwide population-based survey from Korea. PLoS One 2020; 15:e0232593. [PMID: 32357183 PMCID: PMC7194362 DOI: 10.1371/journal.pone.0232593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/18/2020] [Indexed: 12/21/2022] Open
Abstract
We sought to evaluate the relationship between adult body height and risk of age-related macular degeneration (AMD) among healthy Koreans using nationwide population-based data. We analyzed data derived from the Korea National Health and Nutrition Examination Survey 2008–2011. Participants over 40 years of age were included in the sample after excluding individuals with systemic comorbidities or missing relevant data. The presence and severity of AMD were graded using fundus photographs. The relationship between body height and risk of AMD was determined using multiple logistic regression analyses. Among a total of 8,435 participants, 544 (6.45%) had AMD: 502 (5.95%) with early AMD and 42 (0.5%) with late AMD. In multivariate-adjusted analyses, taller body height was significantly associated with a lower prevalence of AMD (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.81–0.99), while body mass index (BMI) was not associated with AMD. An inverse association between body height and risk of AMD was observed most frequently in participants under 65 years of age (OR, 0.81; 95% CI, 0.70–0.94). Furthermore, body height showed an inverse association with risk of AMD among obese participants (BMI ≥25.0 kg/m2) (OR, 0.75; 95% CI, 0.60–0.93). Subgroup analysis by AMD type disclosed a significant inverse association between body height and early AMD (OR, 0.87; 95% CI, 0.79–0.97) but not late AMD. Our results suggest that shorter body height is independently associated with increased risk of AMD, especially early AMD, in a dose-response manner in people who are obese or under 65 years of age.
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Affiliation(s)
- In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Jeong Hun Bae
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- * E-mail:
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Min Lee
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Quan Dong Nguyen
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, United States of America
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7
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Benyi E, Linder M, Adami J, Kieler H, Palme M, Sävendahl L. Adult height is associated with risk of cancer and mortality in 5.5 million Swedish women and men. J Epidemiol Community Health 2019; 73:730-736. [PMID: 31053591 DOI: 10.1136/jech-2018-211040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 03/27/2019] [Accepted: 04/08/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Previous studies have indicated that taller individuals are at greater risk of developing cancer. Death from cancer and other specific causes have also been linked to height, but the results have been inconclusive. We aimed to shed further light on the associations between height, cancer incidence and mortality. METHODS We conducted a nationwide, population-based prospective cohort study, including 5.5 million Swedish women and men (aged 20-74). They were followed over a period of up to 54 years. Heights were retrieved from national registers (mainly the Passport Register where heights are most often self-reported). The risks of overall and specific cancers, as well as overall and cause-specific mortality, were presented as HR with 95% CIs per 10 cm increase in height. RESULTS A total of 278 299 cases of cancer and 139 393 cases of death were identified. For overall cancer, HR was 1.19 (1.18-1.20) in women and 1.11 (1.10-1.12) in men for every 10 cm increase in height. All 15 specific cancer types were positively associated with height-most strongly for malignant melanoma in both genders, with HRs of 1.39 (1.35-1.43) in women and 1.34 (1.30-1.38) in men. For overall mortality, HR was 0.98 (0.97-0.99) in women and 0.91 (0.90-0.92) in men for every 10 cm increase in height. Cancer mortality was increased in taller individuals, with HR 1.15 (1.13-1.17) in women and 1.05 (1.03-1.07) in men for every 10 cm increase in height, whereas shorter individuals had increased overall mortality due to a number of other causes, such as cardiovascular disease. CONCLUSION Overall and specific cancer risks, particularly malignant melanoma, were positively associated with height. Cancer mortality also increased with height. In contrast, overall mortality was decreased with height, particularly in men due to inverse associations with height for other causes of death.
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Affiliation(s)
- Emelie Benyi
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Marie Linder
- Department of Medicine-CPE (Centre for Pharmacoepidemiology), Karolinska Institutet, Stockholm, Sweden
| | | | - Helle Kieler
- Department of Medicine-CPE (Centre for Pharmacoepidemiology), Karolinska Institutet, Stockholm, Sweden
| | - Mårten Palme
- Department of Economics, Stockholm University, Stockholm, Sweden
| | - Lars Sävendahl
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Vena GA, Cassano N, Caccavale S, Argenziano G. Association Between Melanoma Risk and Height: A Narrative Review. Dermatol Pract Concept 2019; 9:82-89. [PMID: 31106009 DOI: 10.5826/dpc.0902a02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2019] [Indexed: 02/02/2023] Open
Abstract
The link between anthropometric indices, including height, and cancer risk and/or progression has attracted considerable interest in recent years. Adult height results from the complex interplay between genetic, hormonal, nutritional, and other environmental factors and has been found to contribute to the risk of several selected malignancies, although it has not been implicated as a real cause per se. A number of studies have investigated the height-melanoma relationship, showing controversial results so far. In this review, we summarize the epidemiological data regarding the association between height and melanoma risk and analyze the potential underlying mechanisms.
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Affiliation(s)
- Gino A Vena
- Dermatology and Venereology Private Practice, Bari, Italy.,Dermatology and Venereology Private Practice, Barletta, Italy
| | - Nicoletta Cassano
- Dermatology and Venereology Private Practice, Bari, Italy.,Dermatology and Venereology Private Practice, Barletta, Italy
| | - Stefano Caccavale
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
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9
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Choi YJ, Lee DH, Han KD, Yoon H, Shin CM, Park YS, Kim N. Adult height in relation to risk of cancer in a cohort of 22,809,722 Korean adults. Br J Cancer 2019; 120:668-674. [PMID: 30778143 PMCID: PMC6462046 DOI: 10.1038/s41416-018-0371-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 01/31/2023] Open
Abstract
Background The present study examined whether adult height was associated with all site-combined or site-specific cancers. Methods We used a nationwide claim data of 22,809,722 Korean participants including both men and women (2009–2012). The deciles of height from different age and sex groups were merged into a new quintile. We used Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals. Results During a 5-year follow-up period, 765,651 patients were diagnosed with cancer. Height was positively associated with risk of all site-combined cancers and with malignancy in the oral cavity, larynx, lung, stomach, colorectum, liver, pancreas, biliary tract and gallbladder, breast, ovary, cervix and corpus uteri, prostate, testes, kidney, bladder, central nervous system, thyroid, skin, and lymphatic and haematopoietic systems. The HRs for all-site cancers per 5 cm increment in height was 1.09 and that of each site was the highest in thyroid, breast, lymphoma, testicular, and renal cancers. This association was more prominent in women and male non-smokers than in other counterparts. Conclusions Taller adult height was significantly related to an increased risk of most cancers including neoplasm in the gallbladder or biliary tract and testes, but except for oesophagus.
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Affiliation(s)
- Yoon Jin Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.,Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. .,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hyuk Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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10
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Psaltopoulou T, Sergentanis TN, Ntanasis-Stathopoulos I, Tzanninis IG, Riza E, Dimopoulos MA. Anthropometric characteristics, physical activity and risk of hematological malignancies: A systematic review and meta-analysis of cohort studies. Int J Cancer 2019; 145:347-359. [PMID: 30614529 DOI: 10.1002/ijc.32109] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/02/2018] [Accepted: 12/19/2018] [Indexed: 12/20/2022]
Abstract
Overweight/obesity, adult attained height and physical activity are possible risk factors for hematological malignancies. This meta-analysis aims to evaluate the associations between these factors and hematological cancer risk in adults. Eligible cohort studies were sought in PubMed up to May 31, 2016; overall, 44 studies were included in the present analyses. Pooled relative risk estimates were calculated using random-effects models; separate analyses were conducted for non-Hodgkin lymphoma (NHL) and subtypes (diffuse large B-cell lymphoma, DLBCL; follicular cell lymphoma; small lymphocytic lymphoma/chronic lymphocytic leukemia, SLL/CLL), Hodgkin lymphoma (HL), multiple myeloma (MM), leukemia and subtypes (acute lymphoblastic leukemia, acute myeloid leukemia, AML). Obesity was associated with increased risk of NHL, HL, MM, leukemia overall and AML in both sexes, as well as with higher DLBCL risk in women; the dose-response meta-regression analysis confirmed these associations. Less pronounced effects were observed regarding overweight, as it was associated with increased MM risk in both sexes, NHL risk in males, DLBCL and overall leukemia risk in females. Taller men presented with significantly higher risk of NHL and taller women were affected by higher risk of NHL, DLBCL, FL, CLL/SLL, MM, leukemia and AML. On the other hand, physical activity and abdominal fatness were not associated with the risk of hematological malignancies. In conclusion, this meta-analysis highlights the pivotal role of anthropometric measures in shaping the risk of hematological malignancies in adults. Additional, well-designed studies stemming from all the continents are needed for the further substantiation and generalization of the results.
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Affiliation(s)
- Theodora Psaltopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros N Sergentanis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis-Georgios Tzanninis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Elena Riza
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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11
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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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12
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Nunney L. Size matters: height, cell number and a person's risk of cancer. Proc Biol Sci 2018; 285:rspb.2018.1743. [PMID: 30355711 DOI: 10.1098/rspb.2018.1743] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/05/2018] [Indexed: 12/19/2022] Open
Abstract
The multistage model of carcinogenesis predicts cancer risk will increase with tissue size, since more cells provide more targets for oncogenic somatic mutation. However, this increase is not seen among mammal species of different sizes (Peto's paradox), a paradox argued to be due to larger species evolving added cancer suppression. If this explanation is correct, the cell number effect is still expected within species. Consistent with this, the hazard ratio for overall cancer risk per 10 cm increase in human height (HR10) is about 1.1, indicating a 10% increase in cancer risk per 10 cm; however, an alternative explanation invokes an indirect effect of height, with factors that increase cancer risk independently increasing adult height. The data from four large-scale surveillance projects on 23 cancer categories were tested against quantitative predictions of the cell-number hypothesis, predictions that were accurately supported. For overall cancer risk the HR10 predicted versus observed was 1.13 versus 1.12 for women and 1.11 versus 1.09 for men, suggesting that cell number variation provides a null hypothesis for assessing height effects. Melanoma showed an unexpectedly strong relationship to height, indicating an additional effect, perhaps due to an increasing cell division rate mediated through increasing IGF-I with height. Similarly, only about one-third of the higher incidence of non-reproductive cancers in men versus women can be explained by cell number. The cancer risks of obesity are not correlated with effects of height, consistent with different primary causation. The direct effect of height on cancer risk suggests caution in identifying height-related SNPs as cancer causing.
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Affiliation(s)
- Leonard Nunney
- Department of Evolution, Ecology, and Organismal Biology, University of California Riverside, 900 University Avenue, Riverside, CA 92521, USA
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13
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Poidvin A, Carel J, Ecosse E, Levy D, Michon J, Coste J. Increased risk of bone tumors after growth hormone treatment in childhood: A population-based cohort study in France. Cancer Med 2018; 7:3465-3473. [PMID: 29905027 PMCID: PMC6051149 DOI: 10.1002/cam4.1602] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/13/2018] [Accepted: 05/15/2018] [Indexed: 01/20/2023] Open
Abstract
The association between growth hormone (GH) treatment and cancer risk has not been thoroughly evaluated and there are questions about any increased risk of bone tumors. We examined cancer risk and especially bone tumor risk in a population-based cohort study of 6874 patients treated with recombinant GH in France for isolated GH deficiency, short stature associated with low birth weight or length or idiopathic short stature. Adult mortality and morbidity data obtained from national databases and from questionnaires. Case ascertainment completeness was estimated with capture-recapture methods. Standardized mortality and incidence ratios were calculated using national reference data. 111 875 person-years of observation were analyzed and patients were followed for an average of 17.4 ± 5.3 years to a mean age of 28.4 ± 6.2 years. For cancer overall, mortality and incidence were not different from expected figures. Five patients developed bone tumors (chondrosarcoma, 1, Ewing sarcoma, 1, osteosarcoma, 3) of whom 3 died (Ewing sarcoma, 1, osteosarcoma, 2), whereas only 1.4 case and 0.6 deaths were expected: standardized mortality ratio, 5.0 and standardized incidence ratio from 3.5 to 3.8 accounting or not accounting for missed cases. Most patients received conventional doses of GH, although one patient with osteosarcoma had received high dose GH (60 μg/kg/d). This study confirms an increased risk of bone tumors but not overall cancer risk in subjects treated with GH in childhood for isolated GH deficiency or childhood short stature. Further work is needed to elucidate the mechanisms involved.
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Affiliation(s)
- Amélie Poidvin
- Assistance Publique‐Hôpitaux de Paris (AP‐HP)Hôpital Universitaire Robert‐DebréDepartment of Pediatric Endocrinology and DiabetologyCentre de Référence des Maladies Endocriniennes Rares de la CroissanceParisFrance
- PROTECTINSERMUniversité Paris DiderotSorbonne Paris CitéParisFrance
| | - Jean‐Claude Carel
- Assistance Publique‐Hôpitaux de Paris (AP‐HP)Hôpital Universitaire Robert‐DebréDepartment of Pediatric Endocrinology and DiabetologyCentre de Référence des Maladies Endocriniennes Rares de la CroissanceParisFrance
- PROTECTINSERMUniversité Paris DiderotSorbonne Paris CitéParisFrance
| | - Emmanuel Ecosse
- Assistance Publique‐Hôpitaux de Paris, Biostatistics and Epidemiology UnitHôtel DieuParisFrance
| | | | | | - Joël Coste
- Assistance Publique‐Hôpitaux de Paris, Biostatistics and Epidemiology UnitHôtel DieuParisFrance
- Université Paris DescartesSorbonne Paris CitéParisFrance
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14
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McSkane M, Stintzing S, Heinemann V, Puccini A, Naseem M, Cao S, Lenz HJ, Jelas I. Association Between Height and Clinical Outcome in Metastatic Colorectal Cancer Patients Enrolled Onto a Randomized Phase 3 Clinical Trial: Data From the FIRE-3 Study. Clin Colorectal Cancer 2018; 17:215-222.e3. [PMID: 29880436 DOI: 10.1016/j.clcc.2018.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous studies have found significant relationships between height and colorectal cancer (CRC) risk. Increased growth has been associated with activated pathways such as insulin-like growth factor 1. This study examined the impact of height on outcomes in metastatic CRC patients enrolled onto the FIRE-3 study, a randomized phase 3 clinical trial. PATIENTS AND METHODS A total of 695 patients with metastatic CRC were studied and height was measured in centimeters. Male patients were grouped as ≤ 165, 166-175, 176-185, and ≥ 186 cm in height; female patients were grouped as ≤ 154, 155-164, 165-174, and ≥ 175 cm in height. Primary end point was overall survival (OS); secondary end point was progression-free survival. RESULTS When patients' heights were categorized into 4 groups, the tallest group showed a worse OS compared to the shortest group; however, there was no linear relationship between height and OS. To investigate this, we showed the association between height as a continuous variable and OS. Patients shorter than 172 cm had a worse OS as their height decreased. Patients taller than 172 cm had a worse OS as their height increased. Moreover, patients with heights between 165 and 179 cm had a better OS compared to other patients (P = .05). This effect was independent of treatment arm and gender. CONCLUSION Patients shorter than 165 cm and taller than 179 cm have a worse OS, while those between 165 and 179 cm have a better OS. Hence, clinicians should consider height as an important prognostic factor when treating metastatic CRC patients. Future prospective studies are warranted to shed light on the mechanisms underlying the worse OS in taller patients.
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Affiliation(s)
- Michelle McSkane
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Sebastian Stintzing
- Comprehensive Cancer Center, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Volker Heinemann
- Comprehensive Cancer Center, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Alberto Puccini
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Madiha Naseem
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Shu Cao
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Heinz-Josef Lenz
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA; Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Ivan Jelas
- Comprehensive Cancer Center, Ludwig-Maximilian-University of Munich, Munich, Germany
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15
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Vingeliene S, Chan DSM, Vieira AR, Polemiti E, Stevens C, Abar L, Navarro Rosenblatt D, Greenwood DC, Norat T. An update of the WCRF/AICR systematic literature review and meta-analysis on dietary and anthropometric factors and esophageal cancer risk. Ann Oncol 2018; 28:2409-2419. [PMID: 28666313 PMCID: PMC5834025 DOI: 10.1093/annonc/mdx338] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background In the 2007 World Cancer Research Fund/American Institute for Cancer Research Second Expert Report, the expert panel judged that there was strong evidence that alcoholic drinks and body fatness increased esophageal cancer risk, whereas fruits and vegetables probably decreased its risk. The judgments were mainly based on case–control studies. As part of the Continuous Update Project, we updated the scientific evidence accumulated from cohort studies in this topic. Methods We updated the Continuous Update Project database up to 10 January 2017 by searching in PubMed and conducted dose–response meta-analyses to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) using random effects model. Results A total of 57 cohort studies were included in 13 meta-analyses. Esophageal adenocarcinoma risk was inversely related to vegetable intake (RR per 100 g/day: 0.89, 95% CI: 0.80–0.99, n = 3) and directly associated with body mass index (RR per 5 kg/m2: 1.47, 95% CI: 1.34–1.61, n = 9). For esophageal squamous cell carcinoma, inverse associations were observed with fruit intake (RR for 100 g/day increment: 0.84, 95% CI: 0.75–0.94, n = 3) and body mass index (RR for 5 kg/m2 increment: 0.64, 95% CI: 0.56–0.73, n = 8), and direct associations with intakes of processed meats (RR for 50 g/day increment: 1.59, 95% CI: 1.11–2.28, n = 3), processed and red meats (RR for 100 g/day increment: 1.37, 95% CI: 1.04–1.82, n = 3) and alcohol (RR for 10 g/day increment: 1.25, 95% CI: 1.12–1.41, n = 6). Conclusions Evidence from cohort studies suggested a protective role of vegetables and body weight control in esophageal adenocarcinomas development. For squamous cell carcinomas, higher intakes of red and processed meats and alcohol may increase the risk, whereas fruits intake may play a protective role.
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Affiliation(s)
- S Vingeliene
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK;; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden;.
| | - D S M Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - A R Vieira
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - E Polemiti
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - C Stevens
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - L Abar
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - D Navarro Rosenblatt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - D C Greenwood
- Division of Biostatistics, University of Leeds, Leeds, UK
| | - T Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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16
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Pes GM, Ganau A, Tognotti E, Errigo A, Rocchi C, Dore MP. The association of adult height with the risk of cardiovascular disease and cancer in the population of Sardinia. PLoS One 2018; 13:e0190888. [PMID: 29677219 PMCID: PMC5909893 DOI: 10.1371/journal.pone.0190888] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/21/2017] [Indexed: 12/15/2022] Open
Abstract
The relationship between body height and the risk of non‒communicable diseases such as cardiovascular disease and cancer has been the subject of much debate in the epidemiological literature. Concerns have recently arisen over spurious associations due to confounding factors like birth cohort, especially in the context of epidemiological transition. The population of Sardinia represents an interesting case study, as the average physical stature of inhabitants was the lowest recorded in Europe until a few decades ago. In this population we tested whether height is an independent risk factor for cardiovascular disease and cancer. We analysed the stature of 10,427 patients undergoing endoscopy for any reason, for whom a detailed clinical history of cardiovascular disease and/or malignancies had been documented. Poisson regression modelling was used to test the association between stature and disease risk. When patients were subdivided according to sex and height tertiles, the risk of cardiovascular disease proved significantly greater for subjects in the lowest tertile irrespective of sex (men: 1.87; 95%CI 1.41‒2.47; women: 1.23; 95%CI 0.92‒1.66) and smaller for those in the highest tertile (men: 0.51; 95%CI 0.35‒0.75; women: 0.41; 95%CI 0.27‒0.61). However, after adjusting the risk for birth cohort and established risk factors, it mostly resulted in non-significant values, although the overall trend persisted. Similar results were obtained for all-cancer risk (relative risk for men and women in the lowest tertile: 1.44; 95%CI 1.09–1.90 and 1.17; 95%CI 0.93–1.48, in the highest tertile: 0.51; 95%CI 0.36–0.72 and 0.62; 95%CI 0.47–0.81, respectively) as well as for some of the most common types of cancer. We concluded that the risk of developing cardiovascular disease and malignancies does not vary significantly with stature in the Sardinian population, after adjusting for birth cohort and more obvious risk factors.
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Affiliation(s)
- Giovanni Mario Pes
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
- Sardinia Longevity Blue Zone Observatory, Ogliastra, Italy
- * E-mail:
| | - Antonello Ganau
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Eugenia Tognotti
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandra Errigo
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Chiara Rocchi
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Maria Pina Dore
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
- Baylor College of Medicine, Houston, TX, United States of America
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17
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Pastorino R, Puggina A, Carreras-Torres R, Lagiou P, Holcátová I, Richiardi L, Kjaerheim K, Agudo A, Castellsagué X, Macfarlane TV, Barzan L, Canova C, Thakker NS, Conway DI, Znaor A, Healy CM, Ahrens W, Zaridze D, Szeszenia-Dabrowska N, Lissowska J, Fabianova E, Mates IN, Bencko V, Foretova L, Janout V, Brennan P, Gaborieau V, McKay JD, Boccia S. Genetic Contributions to The Association Between Adult Height and Head and Neck Cancer: A Mendelian Randomization Analysis. Sci Rep 2018; 8:4534. [PMID: 29540730 PMCID: PMC5852094 DOI: 10.1038/s41598-018-22626-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 02/19/2018] [Indexed: 01/02/2023] Open
Abstract
With the aim to dissect the effect of adult height on head and neck cancer (HNC), we use the Mendelian randomization (MR) approach to test the association between genetic instruments for height and the risk of HNC. 599 single nucleotide polymorphisms (SNPs) were identified as genetic instruments for height, accounting for 16% of the phenotypic variation. Genetic data concerning HNC cases and controls were obtained from a genome-wide association study. Summary statistics for genetic association were used in complementary MR approaches: the weighted genetic risk score (GRS) and the inverse-variance weighted (IVW). MR-Egger regression was used for sensitivity analysis and pleiotropy evaluation. From the GRS analysis, one standard deviation (SD) higher height (6.9 cm; due to genetic predisposition across 599 SNPs) raised the risk for HNC (Odds ratio (OR), 1.14; 95% Confidence Interval (95%CI), 0.99-1.32). The association analyses with potential confounders revealed that the GRS was associated with tobacco smoking (OR = 0.80, 95% CI (0.69-0.93)). MR-Egger regression did not provide evidence of overall directional pleiotropy. Our study indicates that height is potentially associated with HNC risk. However, the reported risk could be underestimated since, at the genetic level, height emerged to be inversely associated with smoking.
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Affiliation(s)
- Roberta Pastorino
- Section of Hygiene - Institute of Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito, 1, 00168, Rome, Italy
| | - Anna Puggina
- Section of Hygiene - Institute of Public Health, Università Cattolica del Sacro Cuore, L.go F. Vito, 1, 00168, Rome, Italy.
| | | | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens School of Medicine, Athens, Greece
| | - Ivana Holcátová
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lorenzo Richiardi
- University of Turin, Department of Medical Sciences, Unit of Cancer Epidemiology, Turin, Italy
| | | | - Antonio Agudo
- Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Xavier Castellsagué
- Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Tatiana V Macfarlane
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom
| | | | - Cristina Canova
- Department of Environmental Medicine and Public Health, University of Padova, Padova, Italy
- MRC-HPA Centre for Environment and Health, Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Nalin S Thakker
- University of Manchester, School of Dentistry, Manchester, United Kingdom
| | - David I Conway
- University of Glasgow Dental School, Glasgow, Scotland, United Kingdom
| | - Ariana Znaor
- Croatian National Cancer Registry, Croatian National Institute of Public Health, Zagreb, Croatia
| | - Claire M Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
- Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - David Zaridze
- Institute of Carcinogenesis, Cancer Research Centre, Moscow, Russian Federation
| | | | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | | | - Ioan Nicolae Mates
- Saint Mary General and Esophageal Surgery Clinic, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Vladimir Bencko
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and Masaryk University, Brno, Czech Republic
| | | | - Paul Brennan
- International Agency for Research on Cancer (IARC), Lyon, France
| | | | - James D McKay
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Stefania Boccia
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, IRCCS Fondazione Policlinico 'Agostino Gemelli', Rome, Italy
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18
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Wang F, Xu X, Yang J, Min L, Liang S, Chen Y. Height and lung cancer risk: A meta-analysis of observational studies. PLoS One 2017; 12:e0185316. [PMID: 28949980 PMCID: PMC5614604 DOI: 10.1371/journal.pone.0185316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 09/11/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The association between height and lung cancer risk has been investigated by epidemiological studies but the results are inconsistent. This meta-analysis was to evaluate whether the height is associated with lung cancer. METHODS We identified relevant articles by searching the MEDLINE and EMBASE databases, and reviewed the reference lists of selected papers. A random effect model was used to calculate summary odds ratios (OR) and relative risk (RR) with 95% confidence intervals (95% CI). Publication bias was estimated using Egger's regression asymmetry test. RESULTS We included a total 16 studies (15 prospective studies and one case-control study) on adult height and lung cancer risk in the meta-analysis. Overall, per 10-cm height increases were associated with increased risk of lung cancer (RR 1.06; 95% CI 1.03-1.09, I2 = 43.6%). CONCLUSIONS In this meta-analysis, high adult height is related to increased lung cancer risk. Well-designed, large prospective studies are required to obtain a better indication of the relationship.
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Affiliation(s)
- Fang Wang
- Department of Respiration, Clinical Medical School of Yangzhou University, Northern Jiangsu People’s Hospital, Yangzhou, China
| | - Xingxiang Xu
- Department of Respiration, Clinical Medical School of Yangzhou University, Northern Jiangsu People’s Hospital, Yangzhou, China
- * E-mail:
| | - Junjun Yang
- Department of Respiration, Clinical Medical School of Yangzhou University, Northern Jiangsu People’s Hospital, Yangzhou, China
| | - Lingfeng Min
- Department of Respiration, Clinical Medical School of Yangzhou University, Northern Jiangsu People’s Hospital, Yangzhou, China
| | - Sudong Liang
- Department of Urology, Taizhou People's Hospital of Jiangsu Province, Taizhou, Jiangsu, China
| | - Yong Chen
- Department of Medical Oncology, Clinical Medical School of Yangzhou University, Northern Jiangsu People’s Hospital, Yangzhou, China
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19
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Subramani R, Nandy SB, Pedroza DA, Lakshmanaswamy R. Role of Growth Hormone in Breast Cancer. Endocrinology 2017; 158:1543-1555. [PMID: 28379395 DOI: 10.1210/en.2016-1928] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/28/2017] [Indexed: 12/19/2022]
Abstract
Breast cancer is one of the most common cancers diagnosed in women. Approximately two-thirds of all breast cancers diagnosed are classified as hormone dependent, which indicates that hormones are the key factors that drive the growth of these breast cancers. Ovarian and pituitary hormones play a major role in the growth and development of normal mammary glands and breast cancer. In particular, the effect of the ovarian hormone estrogen has received much attention in regard to breast cancer. Pituitary hormones prolactin and growth hormone have also been associated with breast cancer. Although the role of these pituitary hormones in breast cancers has been studied, it has not been investigated extensively. In this review, we attempt to compile basic information from most of the currently available literature to understand and demonstrate the significance of growth hormone in breast cancer. Based on the available literature, it is clear that growth hormone plays a significant role in the development, progression, and metastasis of breast cancer by influencing tumor angiogenesis, stemness, and chemoresistance.
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Affiliation(s)
- Ramadevi Subramani
- Center of Emphasis in Cancer Research, Department of Biomedical Sciences MSB1, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, Texas 79905
| | - Sushmita B Nandy
- Center of Emphasis in Cancer Research, Department of Biomedical Sciences MSB1, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, Texas 79905
| | - Diego A Pedroza
- Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, Texas 79905
| | - Rajkumar Lakshmanaswamy
- Center of Emphasis in Cancer Research, Department of Biomedical Sciences MSB1, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, Texas 79905
- Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, Texas 79905
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20
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Seidell JC, Doak CM, de Munter JSL, Kuijper LDJ, Zonneveld C. Cross-Sectional Growth References and Implications for the Development of an International Growth Standard for School-Aged Children and Adolescents. Food Nutr Bull 2016; 27:S189-98. [PMID: 17361656 DOI: 10.1177/15648265060274s503] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Normative data are needed to create a reference that indicates optimal development of weight in relation to height and age, particularly in the face of the unfolding obesity epidemic. The body-mass index (BMI) has some serious limitations: it is a relatively poor predictor of current and future fatness. Currently, however, there are few available alternatives, with the possible exception of waist circumference or skinfolds. The use of cross-sectional references to construct a BMI-reference curve is problematic when there are period and cohort effects. Ideally, a reference would be based on longitudinal data in populations with little underweight, overweight, and obesity. In the meantime cross-sectional data in appropriate populations could be used to construct BMI percentiles linking BMI values at age 5 to those at age 18 (or 21) that would correspond with adult BMI values reflecting optimal health (e.g., that would correspond to adult BMI values between 21 and 23 kg/m2).
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Affiliation(s)
- Jacob C Seidell
- The authors are affiliated with the Institute for Health Sciences, Vrije Universiteit Amsterdam, Amsterdam.
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dos-Santos-Silva I, Denholm R. Height and Risk of Adult Cancers: a Review. CURR EPIDEMIOL REP 2016. [DOI: 10.1007/s40471-016-0084-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pyo JH, Hong SN, Min BH, Chang DK, Son HJ, Rhee PL, Kim JJ, Kim YH. Is height a risk factor for colorectal adenoma? Korean J Intern Med 2016; 31:653-9. [PMID: 26701232 PMCID: PMC4939489 DOI: 10.3904/kjim.2014.313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/06/2014] [Accepted: 01/08/2015] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Although it is generally known that the risk for all types of cancer increases with adult height, combined and for several common site-specific cancers (including colon and rectal), evidence is limited for adenomas, which are precursors to colorectal cancer. We evaluated the association between height and risk of colorectal adenoma at various stages of the adenoma-carcinoma pathway. METHODS We conducted a retrospective study using data from patients who had undergone a complete colonoscopy as part of a health examination at the Health Promotion Center of Samsung Medical Center between October 13, 2009 and December 31, 2011. A total of 1,347 male subjects were included in our study. Multivariate logistic regression analysis was used to evaluate the association between height and colorectal adenoma. RESULTS Each 5-cm increase in height was associated with 1.6% and 5.3% higher risks of advanced colorectal adenoma and high-risk colorectal adenoma, respectively, but associations were not significant after adjusting for age, body mass index, metabolic syndrome, alcohol intake, smoking, family history of colorectal cancer, and regular aspirin use (p = 0.840 and p = 0.472, respectively). CONCLUSIONS No clear association was found between colorectal adenoma risk and height. Unlike other site-specific tumors reported to have a consistent relationship with height, the association between colorectal tumor and height remains controversial.
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Affiliation(s)
- Jeung Hui Pyo
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Noh Hong
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung-Hoon Min
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Kyung Chang
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jung Son
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Poong-Lyul Rhee
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae J. Kim
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Ho Kim
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Correspondence to Young-Ho Kim, M.D. Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel: +82-2-3410-3409 Fax: +82-2-3410-6983 E-mail:
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Samaras T. Are 20th-century recommendations for growth and height correct? A review. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2009.11734245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Adult Height in Relation to the Incidence of Cancer at Different Anatomic Sites: the Epidemiology of a Challenging Association. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0152-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Russ TC, Starr JM, Stamatakis E, Kivimäki M, Batty GD. Pulmonary function as a risk factor for dementia death: an individual participant meta-analysis of six UK general population cohort studies. J Epidemiol Community Health 2015; 69:550-6. [DOI: 10.1136/jech-2014-204959] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 12/30/2014] [Indexed: 01/22/2023]
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26
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Jiang Y, Marshall RJ, Walpole SC, Prieto-Merino D, Liu DX, Perry JK. An international ecological study of adult height in relation to cancer incidence for 24 anatomical sites. Cancer Causes Control 2015; 26:493-9. [PMID: 25575587 DOI: 10.1007/s10552-014-0520-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 12/22/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Anthropometric indices associated with childhood growth and height attained in adulthood, have been associated with an increased incidence of certain malignancies. To evaluate the cancer-height relationship, we carried out a study using international data, comparing various cancer rates with average adult height of women and men in different countries. METHODS An ecological analysis of the relationship between country-specific cancer incidence rates and average adult height was conducted for twenty-four anatomical cancer sites. Age-standardized rates were obtained from GLOBOCAN 2008. Average female (112 countries) and male (65 countries) heights were sourced and compiled primarily from national health surveys. Graphical and weighted regression analysis was conducted, taking into account BMI and controlling for the random effect of global regions. RESULTS A significant positive association between a country's average adult height and the country's overall cancer rate was observed in both men and women. Site-specific cancer incidence for females was positively associated with height for most cancers: lung, kidney, colorectum, bladder, melanoma, brain and nervous system, breast, non-Hodgkin lymphoma, multiple myeloma, corpus uteri, ovary, and leukemia. A significant negative association was observed with cancer of the cervix uteri. In males, site-specific cancer incidence was positively associated with height for cancers of the brain and nervous system, kidney, colorectum, non-Hodgkin lymphoma, multiple myeloma, prostate, testicular, lip and oral cavity, and melanoma. CONCLUSION Incidence of cancer was associated with tallness in the majority of anatomical/cancer sites investigated. The underlying biological mechanisms are unclear, but may include nutrition and early-life exposure to hormones, and may differ by anatomical site.
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Affiliation(s)
- Yannan Jiang
- Department of Statistics, University of Auckland, Auckland, 1023, New Zealand
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Abstract
BACKGROUND Previous studies have shown an association between height and colorectal cancer (CRC). None of those studies adjusted the association for known risk factors, such as diabetes mellitus and chronic exposure to aspirin/NSAIDs. Only two studies evaluated the risk among male individuals. METHODS We conducted a nested case-control study using a large population-based medical record database from the UK. Studied cases had any CRC code after the age of 40 years. Participants with a known family history of CRC syndromes or inflammatory bowel disease were excluded from the study. For every case, up to four eligible controls matched for age, sex, practice site, and duration of follow-up before the index date were selected by incidence-density sampling. Height was defined as the last measurement before the index date. The odds ratios (ORs) and 95% confidence intervals (CIs) for CRC were calculated for height quartiles, as well as for every 10-cm increase in height, using conditional logistic regression analysis, and adjusted for potential confounders. RESULTS A total of 9978 cases and 26 847 controls were identified. The adjusted OR for CRC in the participants at the highest compared with the lowest height quartiles was 1.25 for male (95% CI 1.14-1.37) and 1.25 for female (95% CI 1.12-1.39) individuals. The adjusted OR associated with each 10-cm increase in height was 1.10 (95% CI 1.05-1.15) for male and 1.16 (95% CI 1.10-1.23) for female individuals. The risk remained persistent when analyzing different age groups. CONCLUSION Height is an independent risk factor for CRC in both male and female individuals.
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Perelman J. Are chronic diseases related to height? Results from the Portuguese National Health Interview Survey. ECONOMICS AND HUMAN BIOLOGY 2014; 15:56-66. [PMID: 25062533 DOI: 10.1016/j.ehb.2014.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 06/18/2014] [Accepted: 06/21/2014] [Indexed: 05/29/2023]
Abstract
This paper analyze the association between height and chronic diseases in Portugal and the extent to which this relationship is mediated by education. The sample upon which the analysis is based comprised those participants in the 2005/2006 Portuguese National Health Interview Survey (n=28,433) aged 25-79. Logistic regressions measured the association of height with ten chronic diseases, adjusting for age, lifestyle, education, and other socioeconomic factors. Among women, an additional centimeter in stature significantly decreased the prevalence of asthma, chronic pain, and acute cardiac disease, by 0.057, 0.221, and 0.033 percentage points, respectively. Also, mental disorders were significantly less prevalent in the last quartile of height. Among men, an additional centimeter in height was associated with a 0.074 lower prevalence of asthma, and men in the last quartile of height were significantly less at risk of acute cardiovascular disease. There was no significant association between height and the risk of diabetes, high blood pressure, cancer, and pulmonary diseases. As for the impact of education, women with a tertiary level were on average 5.3cm taller than those with no schooling; among men, the difference was almost 9cm. Adjusting for education reduced the height-related excess risk of ill health by 36% on average among men, and by 7% among women. The analysis indicates that there is a significant association of height with several chronic conditions, and that education plays a mediating role in the height-health connection. By emphasizing the role of height and education as determinants of chronic conditions, this paper also highlights the role of conditions related to childhood health and socioeconomic background.
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Affiliation(s)
- Julian Perelman
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal.
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Height and kidney cancer risk: a meta-analysis of prospective studies. J Cancer Res Clin Oncol 2014; 141:1799-807. [DOI: 10.1007/s00432-014-1870-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 11/02/2014] [Indexed: 02/07/2023]
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Russ TC, Kivimäki M, Starr JM, Stamatakis E, Batty GD. Height in relation to dementia death: individual participant meta-analysis of 18 UK prospective cohort studies. Br J Psychiatry 2014; 205:348-54. [PMID: 25368359 PMCID: PMC4217025 DOI: 10.1192/bjp.bp.113.142984] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND That risk factors measured in middle age may not fully explain future dementia risk implicates exposures acting earlier in life. Height may capture early-life illness, adversity, nutrition and psychosocial stress. AIMS To investigate the little-explored association between height and dementia death. Method Individual participant meta-analysis using 18 prospective general population cohort studies with identical methodologies (1994-2008; n = 181 800). RESULTS Mean follow-up of 9.8 years gave rise to 426 and 667 dementia deaths in men and women respectively. The mean heights were 174.4 cm (s.d. = 7.3) for men and 161.0 cm (s.d. = 6.8) for women. In analyses taking into account multiple covariates, increasing height was related to lower rates of death from dementia in a dose-response pattern (P ⩽ 0.01 for trend). There was evidence of a differential effect by gender (P = 0.016 for interaction). Thus, the association observed in men (hazard ratio per s.d. decrease in height 1.24, 95% CI 1.11-1.39) was markedly stronger than that apparent in women (HR = 1.13, 95% CI 1.03-1.24). CONCLUSIONS Early-life circumstances, indexed by adult height, may influence later dementia risk.
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Attained height, sex, and risk of cancer at different anatomic sites in the NIH-AARP diet and health study. Cancer Causes Control 2014; 25:1697-706. [PMID: 25307804 DOI: 10.1007/s10552-014-0476-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 10/07/2014] [Indexed: 01/19/2023]
Abstract
PURPOSE To examine the association of adult height with risk of cancer at different anatomic sites in a cohort of men and women. METHODS The association of self-reported height with subsequent cancer risk was assessed in 288,683 men and 192,514 women enrolled in the National Institutes of Health-AARP Diet and Health Study. After a median follow-up of 10.5 years, incident cancer was diagnosed in 51,139 men and 23,407 women. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) for the association of height with cancer risk. RESULTS After adjustment for covariates, height was positively associated with increased risk of all cancers combined in both men [HR10 cm increase = 1.05 (95 % CI 1.04-1.06)] and women [HR10 cm increase = 1.08 (95 % CI 1.06-1.10)]. Several sites common to men and women showed significant positive associations with height: colon, rectum, kidney, melanoma, and non-Hodgkin's lymphoma. For other shared sites, the association differed by sex. For still other sites, there was no clear association with height. Positive associations were also observed with cancers of the breast, endometrium, and prostate. CONCLUSIONS Different patterns were observed in the height-cancer association by sex. Studies investigating the biological mechanisms underlying the association of height with cancer risk should focus on those sites that show a reproducible association with attained height.
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Batty GD, Shipley M, Smith GD, Kivimaki M. Long term risk factors for coronary heart disease and stroke: influence of duration of follow-up over four decades of mortality surveillance. Eur J Prev Cardiol 2014; 22:1139-45. [PMID: 25183695 DOI: 10.1177/2047487314547659] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 07/27/2014] [Indexed: 11/16/2022]
Abstract
AIM While cohort studies have revealed a range of risk factors for coronary heart disease and stroke, the extent to which the strength of these associations varies according to duration of follow-up in studies with extended disease surveillance is unclear. This was the aim of the present study. METHODS AND RESULTS Initiated in 1967/70, the original Whitehall study is an on-going cohort study of 15,402 male UK government workers free of coronary heart disease when they took part in a baseline medical examination during which a range of standard risk factors was measured. In analyses in which we stratified by duration of follow-up, there was evidence of time-dependency for most risk factor-disease relationships. Thus, the associations of systolic and diastolic blood pressure, total cholesterol and cigarette smoking with coronary heart disease and stroke diminished in strength with increasing duration of follow-up, whereas the magnitude of the body mass index-coronary heart disease relation was unchanged. For example, the age-adjusted hazard ratios (95% confidence interval) for cigarette smoking (versus never smoked) in relation to coronary heart disease were: 2.49 (1.80, 3.44), 1.65 (1.34, 2.03), 1.36 (1.15, 1.61) and 1.32 (1.10, 1.58) for follow-up periods 0-10, 10-20, 20-30 and 30+ years, respectively. CONCLUSION Despite a general diminution in the strength of effect over time, even in the fourth decade of follow-up, classic risk factors retained some predictive capacity for coronary heart disease and, to a lesser degree, stroke.
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Affiliation(s)
- G David Batty
- Department of Epidemiology and Public Health, University College London, UK
| | - Martin Shipley
- Department of Epidemiology and Public Health, University College London, UK
| | | | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, UK
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Leoncini E, Ricciardi W, Cadoni G, Arzani D, Petrelli L, Paludetti G, Brennan P, Luce D, Stucker I, Matsuo K, Talamini R, La Vecchia C, Olshan AF, Winn DM, Herrero R, Franceschi S, Castellsague X, Muscat J, Morgenstern H, Zhang ZF, Levi F, Maso LD, Kelsey K, McClean M, Vaughan TL, Lazarus P, Purdue MP, Hayes RB, Chen C, Schwartz SM, Shangina O, Koifman S, Ahrens W, Matos E, Lagiou P, Lissowska J, Szeszenia-Dabrowska N, Fernandez L, Menezes A, Agudo A, Daudt AW, Richiardi L, Kjaerheim K, Mates D, Betka J, Yu GP, Schantz S, Simonato L, Brenner H, Conway DI, Macfarlane TV, Thomson P, Fabianova E, Znaor A, Rudnai P, Healy C, Boffetta P, Chuang SC, Lee YCA, Hashibe M, Boccia S. Adult height and head and neck cancer: a pooled analysis within the INHANCE Consortium. Eur J Epidemiol 2014; 29:35-48. [PMID: 24271556 PMCID: PMC4122122 DOI: 10.1007/s10654-013-9863-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 11/04/2013] [Indexed: 01/17/2023]
Abstract
Several epidemiological studies have shown a positive association between adult height and cancer incidence. The only study conducted among women on mouth and pharynx cancer risk, however, reported an inverse association. This study aims to investigate the association between height and the risk of head and neck cancer (HNC) within a large international consortium of HNC. We analyzed pooled individual-level data from 24 case-control studies participating in the International Head and Neck Cancer Epidemiology Consortium. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated separately for men and women for associations between height and HNC risk. Educational level, tobacco smoking, and alcohol consumption were included in all regression models. Stratified analyses by HNC subsites were performed. This project included 17,666 cases and 28,198 controls. We found an inverse association between height and HNC (adjusted OR per 10 cm height = 0.91, 95% CI 0.86-0.95 for men; adjusted OR = 0.86, 95% CI 0.79-0.93 for women). In men, the estimated OR did vary by educational level, smoking status, geographic area, and control source. No differences by subsites were detected. Adult height is inversely associated with HNC risk. As height can be considered a marker of childhood illness and low energy intake, the inverse association is consistent with prior studies showing that HNC occur more frequently among deprived individuals. Further studies designed to elucidate the mechanism of such association would be warranted.
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Affiliation(s)
- Emanuele Leoncini
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriella Cadoni
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Dario Arzani
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Livia Petrelli
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gaetano Paludetti
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Daniele Luce
- INSERM UMRS 1018, Centre for research in Epidemiology and Population Health, Villejuif, France
| | - Isabelle Stucker
- INSERM UMRS 1018, Centre for research in Epidemiology and Population Health, Villejuif, France
| | | | | | - Carlo La Vecchia
- Istituto di Ricerche Farmacologiche Mario Negri and University of Milan, Milan, Italy
| | - Andrew F. Olshan
- University of North Carolina School of Public Health, Chapel Hill, NC, USA
| | | | | | | | - Xavier Castellsague
- Institut Catala d’Oncologia (ICO), IDIBELL, CIBER-ESP, L’Hospitalet de Llobregat, Spain
| | | | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Fabio Levi
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | | | - Karl Kelsey
- Brown University, Providence, Rhode Island, USA
| | | | | | | | | | - Richard B. Hayes
- Division of Epidemiology, New York University School Of Medicine, NY, New York, USA
| | - Chu Chen
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Sergio Koifman
- Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Wolfgang Ahrens
- Bremen Institute for Prevention Research and Social Medicine (BIPS), Bremen, Germany
| | - Elena Matos
- Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina
| | - Pagona Lagiou
- University of Athens School of Medicine, Athens, Greece
| | - Jolanta Lissowska
- M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Dept. of Cancer Epidemiology and Prevention, Warsaw, Poland
| | | | | | - Ana Menezes
- Universidade Federal de Pelotas, Pelotas, Brazil
| | - Antonio Agudo
- Catalan Institute of Oncology (ICO), IDIBELL, L’Hospitalet de Llobregat, Spain
| | | | | | | | - Dana Mates
- Institute of Public Health, Bucharest, Romania
| | - Jaroslav Betka
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, Czech Republic
| | - Guo-Pei Yu
- New York Eye and Ear Infirmary, New York, NY, USA
| | | | | | - Hermann Brenner
- German Cancer Research Center, Division of Clinical Epidemiology and Aging Research
| | - David I Conway
- Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | | | | | - Ariana Znaor
- Croatian National Cancer Registry, Zagreb, Croatia
| | - Peter Rudnai
- National Institute of Environmental Health, Budapest, Hungary
| | - Claire Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | - Paolo Boffetta
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA
- International Prevention Research Institute, Lyon, France
| | | | - Yuan-Chin Amy Lee
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Mia Hashibe
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Stefania Boccia
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- IRCCS San Raffaele Pisana, Rome, Italy
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Wirén S, Häggström C, Ulmer H, Manjer J, Bjørge T, Nagel G, Johansen D, Hallmans G, Engeland A, Concin H, Jonsson H, Selmer R, Tretli S, Stocks T, Stattin P. Pooled cohort study on height and risk of cancer and cancer death. Cancer Causes Control 2013; 25:151-9. [PMID: 24173535 PMCID: PMC3929024 DOI: 10.1007/s10552-013-0317-7] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 10/21/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To assess the association between height and risk of cancer and cancer death. METHODS The metabolic syndrome and cancer project is a prospective pooled cohort study of 585,928 participants from seven cohorts in Austria, Norway, and Sweden. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for cancer incidence and death were estimated in height categories and per 5-cm increment for each cancer site using Cox proportional hazards model. RESULTS During a mean follow-up of 12.7 years (SD = 7.2), 38,862 participants were diagnosed with cancer and 13,547 participants died of cancer. Increased height (per 5-cm increment) was associated with an increased overall cancer risk in women, HR 1.07 (95 % CI 1.06-1.09), and in men, HR 1.04 (95 % CI 1.03-1.06). The highest HR was seen for malignant melanoma in women, HR 1.17 (95 % CI 1.11-1.24), and in men HR 1.12 (95 % CI 1.08-1.19). Height was also associated with increased risk of cancer death in women, HR 1.03 (95 % CI 1.01-1.16), and in men, HR 1.03 (95 % CI 1.01-1.05). The highest HR was observed for breast cancer death in postmenopausal women (>60 years), HR 1.10 (95 % CI 1.00-1.21), and death from renal cell carcinoma in men, HR 1.18 (95 % CI 1.07-1.30). All these associations were independent of body mass index. CONCLUSION Height was associated with risk of cancer and cancer death indicating that factors related to height such as hormonal and genetic factors stimulate both cancer development and progression.
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Affiliation(s)
- Sara Wirén
- Department of Surgery and Perioperative Sciences, Urology and Andrology, Umeå University, 901 87, Umeå, Sweden,
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Hwang AE, Mack TM, Hamilton AS, Gauderman WJ, Bernstein L, Cockburn MG, Zadnick J, Rand KA, Hopper JL, Cozen W. Childhood infections and adult height in monozygotic twin pairs. Am J Epidemiol 2013; 178:551-8. [PMID: 23585330 DOI: 10.1093/aje/kwt012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Adult height is determined by genetics and childhood nutrition, but childhood infections may also play a role. Monozygotic twins are genetically matched and offer an advantage when identifying environmental determinants. In 2005-2007, we examined the association of childhood infections with adult height in 140 height-discordant monozygotic twin pairs from the California Twin Program. To obtain information on childhood infections and growth, we interviewed the mothers of monozygotic twins who differed in self-reported adult height by at least 1-inch (2.5 cm). Within-pair differences in the relative frequency of childhood infections were highly correlated, especially within age groups. A conditional logistic regression analysis demonstrated that more reported episodes of febrile illness occurred in the twin with shorter stature (odds ratio = 2.00, 95% confidence interval: 1.18, 3.40). The association was strongest for differences in the relative frequency of infection during the toddler years (ages 1-5: odds ratio = 3.34, 95% confidence interval: 1.47, 7.59) and was similar when restricted to twin pairs of equal birth length. The association was not explained by differential nutritional status. Measures of childhood infection were associated with height difference in monozygotic twin pairs, independent of genome, birth length, and available measures of diet.
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Affiliation(s)
- Amie E Hwang
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
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Kabat GC, Anderson ML, Heo M, Hosgood HD, Kamensky V, Bea JW, Hou L, Lane DS, Wactawski-Wende J, Manson JE, Rohan TE. Adult stature and risk of cancer at different anatomic sites in a cohort of postmenopausal women. Cancer Epidemiol Biomarkers Prev 2013; 22:1353-63. [PMID: 23887996 DOI: 10.1158/1055-9965.epi-13-0305] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Prospective studies in Western and Asian populations suggest that height is a risk factor for various cancers. However, few studies have explored potential confounding or effect modification of the association by other factors. METHODS We examined the association between height measured at enrollment in 144,701 women participating in the Women's Health Initiative and risk of all cancers combined and cancer at 19 specific sites. Over a median follow-up of 12.0 years, 20,928 incident cancers were identified. We used Cox proportional hazards models to estimate HR and 95% confidence intervals (CI) per 10 cm increase in height, with adjustment for established risk factors. We also examined potential effect modification of the association with all cancer and specific cancers. RESULTS Height was significantly positively associated with risk of all cancers (HR = 1.13; 95% CI, 1.11-1.16), as well as with cancers of the thyroid, rectum, kidney, endometrium, colorectum, colon, ovary, and breast, and with multiple myeloma and melanoma (range of HRs: 1.13 for breast cancer to 1.29 for multiple myeloma and thyroid cancer). These associations were generally insensitive to adjustment for confounders, and there was little evidence of effect modification. CONCLUSIONS This study confirms the positive association of height with risk of all cancers and a substantial number of cancer sites. IMPACT Identification of single-nucleotide polymorphisms associated both with height and with increased cancer risk may help elucidate the association.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
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Fagherazzi G, Vilier A, Balkau B, Clavel-Chapelon F, Magliano DJ. Anthropometrics, body shape over 12 years and risk of cancer events in pre- and post-menopausal women. Int J Cancer 2013; 133:740-8. [PMID: 23364907 DOI: 10.1002/ijc.28069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 01/14/2013] [Indexed: 01/04/2023]
Abstract
Studies of anthropometry and cancer have focused on body mass index (BMI). Relations between weight, waist (WC) and hip circumferences (HC), birth length and adult height with cancer are less well studied. Women from the French E3N study, born between 1925 and 1950, were followed biennially from 1995 until 2008. Body shape was classed into four groups based on median WC and HC at baseline. Hazard ratios (HRs) were estimated by Cox proportional hazards regression models. Over the 12 years of follow-up, 7,247 of 63,798 women developed cancer. As WC increased, we found a trend for decreasing cancer risk in pre-menopausal women, which reversed to an increasing risk in post-menopausal women. This remained unchanged after further adjustment for HC /or height [HR: 0.72 (0.52-1.00) before menopause and 1.17 (1.04-1.31) in the 5th vs. 1st quintile of HC], and were similar after exclusion of breast cancer. We showed that large body shape decreased cancer risk before menopause and increased it after [HR: 0.87 (0.73-1.02) and 1.11 (1.04-1.17), respectively, in women with large waist and hips compared to small waist and hips]. Adult height was associated with an non-significant increase in cancer in pre-menopause and a significant cancer risk in menopause, independent of other anthropometric characteristics [5th vs. 1st quintile [HR: 1.24 (0.98-1.56) and 1.20 (1.10-1.30)], respectively as was long birth length in post-menopausal women [HR: 1.18 (1.07-1.30) compared to medium birth length]. These results suggest independent roles of height and WC on cancer risk, through different pathways.
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Affiliation(s)
- Guy Fagherazzi
- Inserm, Centre for research in Epidemiology and Population Health (CESP), CESP U1018, Nutrition, Hormones and Women's Health team, F-94805, Villejuif, France
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Beebe-Dimmer JL, Colt JS, Ruterbusch JJ, Keele GR, Purdue MP, Wacholder S, Graubard BI, Davis F, Chow WH, Schwartz KL. Body mass index and renal cell cancer: the influence of race and sex. Epidemiology 2012; 23:821-8. [PMID: 23007040 PMCID: PMC3466395 DOI: 10.1097/ede.0b013e31826b7fe9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Obesity is a risk factor for renal cell (or renal) cancer. The increasing prevalence of obesity may be contributing to the rising incidence of this cancer over the past several decades. The effects of early-age obesity and change in body mass index (BMI) on renal cancer have been studied less thoroughly, and the influence of race has never been formally investigated. METHODS Using data gathered as part of a large case-control study of renal cancer (1214 cases and 1234 controls), we investigated associations with BMI at several time points, as well as with height. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed using logistic regression modeling. Race- and sex-stratified analyses were conducted to evaluate subgroup differences. RESULTS Obesity (BMI ≥ 30 kg/m) early in adulthood (OR = 1.6 [95% CI = 1.1 to 2.4]) and 5 years before diagnosis (1.6 [1.1 to 2.2]) was associated with renal cancer. The association with early-adult obesity was stronger among whites than blacks (test for interaction, P = 0.006), whereas the association with obesity near diagnosis was marginally stronger in women than men (test for interaction, P = 0.08). The strongest association with renal cancer was observed for obese whites both in early adulthood and before interview (2.6 [1.5 to 4.4]); this association was not present among blacks. Estimates of the annual excess rate of renal cancer (per 100,000 persons) attributed to both overweight and obesity (BMI > 25 kg/m) ranged from 9.9 among black men to 5.6 among white women. CONCLUSION Obesity, both early and later in life, is associated with an increased risk of renal cancer. The association with early obesity seems to be stronger among whites than blacks.
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Adult height and the risk of cause-specific death and vascular morbidity in 1 million people: individual participant meta-analysis. Int J Epidemiol 2012; 41:1419-33. [PMID: 22825588 PMCID: PMC3465767 DOI: 10.1093/ije/dys086] [Citation(s) in RCA: 193] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2012] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The extent to which adult height, a biomarker of the interplay of genetic endowment and early-life experiences, is related to risk of chronic diseases in adulthood is uncertain. METHODS We calculated hazard ratios (HRs) for height, assessed in increments of 6.5 cm, using individual-participant data on 174374 deaths or major non-fatal vascular outcomes recorded among 1085949 people in 121 prospective studies. RESULTS For people born between 1900 and 1960, mean adult height increased 0.5-1 cm with each successive decade of birth. After adjustment for age, sex, smoking and year of birth, HRs per 6.5 cm greater height were 0.97 (95% confidence interval: 0.96-0.99) for death from any cause, 0.94 (0.93-0.96) for death from vascular causes, 1.04 (1.03-1.06) for death from cancer and 0.92 (0.90-0.94) for death from other causes. Height was negatively associated with death from coronary disease, stroke subtypes, heart failure, stomach and oral cancers, chronic obstructive pulmonary disease, mental disorders, liver disease and external causes. In contrast, height was positively associated with death from ruptured aortic aneurysm, pulmonary embolism, melanoma and cancers of the pancreas, endocrine and nervous systems, ovary, breast, prostate, colorectum, blood and lung. HRs per 6.5 cm greater height ranged from 1.26 (1.12-1.42) for risk of melanoma death to 0.84 (0.80-0.89) for risk of death from chronic obstructive pulmonary disease. HRs were not appreciably altered after further adjustment for adiposity, blood pressure, lipids, inflammation biomarkers, diabetes mellitus, alcohol consumption or socio-economic indicators. CONCLUSION Adult height has directionally opposing relationships with risk of death from several different major causes of chronic diseases.
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Kabat GC, Heo M, Kamensky V, Miller AB, Rohan TE. Adult height in relation to risk of cancer in a cohort of Canadian women. Int J Cancer 2012; 132:1125-32. [PMID: 22753236 DOI: 10.1002/ijc.27704] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 06/11/2012] [Indexed: 11/09/2022]
Abstract
Although the influence of body mass index on cancer risk has been intensively investigated, few epidemiologic studies have examined the association of adult height with risk of cancer. We assessed the association of height with risk of all cancer and of 19 site-specific cancers in the Canadian National Breast Screening Study, a prospective cohort of nearly 90,000 women. Weight and height were measured at enrollment, and information on reproductive and medical history as well as lifestyle exposures was obtained by means of questionnaire. After exclusions, 5,679 incident invasive cancers were identified among 88,256 women. We used Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI) per 10 cm increase in height. All tests of statistical significance were two sided. All cancers combined and ten specific sites (colorectum, colon, premenopausal breast, postmenopausal breast, endometrium, ovary, kidney, thyroid, melanoma and leukemia) showed statistically significant positive associations with height. The HR for all cancers combined was 1.13 (95% CI: 1.08-1.18), and the magnitude of the associations for specific sites ranged from HR 1.11 (95% CI: 1.03-1.20) for postmenopausal breast cancer to HR 1.51 (95% CI: 1.27-1.80) for melanoma. Our study provides strong support for a positive association of adult height with risk of certain cancers. The underlying biological mechanisms are not clear but may differ by anatomic site.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
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Height and pancreatic cancer risk: a systematic review and meta-analysis of cohort studies. Cancer Causes Control 2012; 23:1213-22. [DOI: 10.1007/s10552-012-9983-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 04/25/2012] [Indexed: 01/14/2023]
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Wang N, Zhang X, Xiang YB, Yang G, Li HL, Gao J, Cai H, Gao YT, Zheng W, Shu XO. Associations of adult height and its components with mortality: a report from cohort studies of 135,000 Chinese women and men. Int J Epidemiol 2012; 40:1715-26. [PMID: 22268239 DOI: 10.1093/ije/dyr173] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Although several studies have evaluated the relationship between adult height and mortality, their results have not been entirely consistent. Little is known about components of adult height in relation to mortality, particularly in developing countries. METHODS We examined the association of adult height and its components (leg and trunk length) with mortality using data from 74 869 Chinese women and 61,333 men in the Shanghai Women's (1996-2008) and Men's (2002-2008) Health Studies. Anthropometric measurements, including standing and sitting height and weight, were taken at baseline by trained interviewers according to a standard protocol. Deaths were ascertained by biennial home visits and linkage with the vital statistics registry. Cox regression models were used to evaluate the associations. RESULTS Neither height nor its components were associated with all-cause mortality. Height and, less consistently, its components were positively associated with cancer mortality, but inversely associated with cardiovascular disease (CVD) mortality. Hazard ratios (HRs) [95% confidence intervals (CIs)] for cancer mortality per 1-SD increment in height, trunk and leg length were 1.06 (1.01-1.12), 1.07 (1.01-1.12) and 1.03 (0.98-1.08), respectively, in women, and 1.13 (1.05-1.22), 1.09 (1.00-1.19) and 1.10 (1.03-1.16), respectively, in men. The corresponding HRs for CVD mortality were 0.89 (0.84-0.95), 0.93 (0.87-0.99) and 0.91 (0.86-0.98) in women, and 0.93 (0.86-1.02), 0.89 (0.81-0.98) and 0.99 (0.92-1.06) in men. CONCLUSIONS Our results suggest that different mechanisms may be involved in linking height and its components with cancer and CVD mortality.
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Affiliation(s)
- Na Wang
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN 37203-1738, USA
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Gray L, Lee IM, Sesso HD, Batty GD. Association of body mass index in early adulthood and middle age with future site-specific cancer mortality: the Harvard Alumni Health Study. Ann Oncol 2012; 23:754-759. [PMID: 21677311 PMCID: PMC3331729 DOI: 10.1093/annonc/mdr270] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 04/05/2011] [Accepted: 04/06/2011] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The association between adiposity in early adulthood and subsequent development of specific malignancies is unclear. Further, the potential for mediation by adiposity in middle age has not been well examined. In a rare study, we investigated the association of body mass index (BMI) in early adulthood with mortality from several site-specific cancers. DESIGN In the Harvard Alumni Health Study cohort, 19 593 males had a physical examination at the university between 1914 and 1952 (mean age: 18.4 years) and returned a questionnaire in 1962 or 1966 (mean age = 45.1 years). BMI was computed using weight (kg)/height(2) (m(2)) at both time points. Vital status follow up continued for a maximum of 82 years. RESULTS Positive early adulthood cancer mortality gradients by BMI were found for all malignancies combined (adjusted hazard ratio [HR] = 1.11; 95% confidence interval [CI]: 1.05-1.17 for a one standard deviation increase in early adulthood BMI), and for lung (HR = 1.24; 95% CI = 1.10-1.40) and skin (HR = 1.29; 95% CI = 0.96-1.75) cancers. There were also apparent associations for cancers of the oesophagus and urogenital sites. Mediation by BMI in middle age was found to be minimal. CONCLUSION Higher BMI in early adulthood appears to be a direct risk factor for selected malignancies several decades later.
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Affiliation(s)
- L Gray
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Glasgow, UK.
| | - I-M Lee
- Department of Epidemiology, Harvard School of Public Health, Boston; Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - H D Sesso
- Department of Epidemiology, Harvard School of Public Health, Boston; Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - G D Batty
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Glasgow, UK; Department of Epidemiology and Public Health, University College London (UCL), London, UK
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Schulte PA, Pandalai S, Wulsin V, Chun H. Interaction of occupational and personal risk factors in workforce health and safety. Am J Public Health 2011; 102:434-48. [PMID: 22021293 DOI: 10.2105/ajph.2011.300249] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Most diseases, injuries, and other health conditions experienced by working people are multifactorial, especially as the workforce ages. Evidence supporting the role of work and personal risk factors in the health of working people is frequently underused in developing interventions. Achieving a longer, healthy working life requires a comprehensive preventive approach. To help develop such an approach, we evaluated the influence of both occupational and personal risk factors on workforce health. We present 32 examples illustrating 4 combinatorial models of occupational hazards and personal risk factors (genetics, age, gender, chronic disease, obesity, smoking, alcohol use, prescription drug use). Models that address occupational and personal risk factors and their interactions can improve our understanding of health hazards and guide research and interventions.
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Affiliation(s)
- Paul A Schulte
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA.
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Height and cancer incidence in the Million Women Study: prospective cohort, and meta-analysis of prospective studies of height and total cancer risk. Lancet Oncol 2011; 12:785-94. [PMID: 21782509 PMCID: PMC3148429 DOI: 10.1016/s1470-2045(11)70154-1] [Citation(s) in RCA: 251] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Epidemiological studies have shown that taller people are at increased risk of cancer, but it is unclear if height-associated risks vary by cancer site, or by other factors such as smoking and socioeconomic status. Our aim was to investigate these associations in a large UK prospective cohort with sufficient information on incident cancer to allow direct comparison of height-associated risk across cancer sites and in relation to major potential confounding and modifying factors. Methods Information on height and other factors relevant for cancer was obtained in 1996–2001 for middle-aged women without previous cancer who were followed up for cancer incidence. We used Cox regression models to calculate adjusted relative risks (RRs) per 10 cm increase in measured height for total incident cancer and for 17 specific cancer sites, taking attained age as the underlying time variable. We also did a meta-analysis of published results from prospective studies of total cancer risk in relation to height. Findings 1 297 124 women included in our analysis were followed up for a total of 11·7 million person-years (median 9·4 years per woman, IQR 8·4–10·2), during which time 97 376 incident cancers occurred. The RR for total cancer was of 1·16 (95% CI 1·14–1·17; p<0·0001) for every 10 cm increase in height. Risk increased for 15 of the 17 cancer sites we assessed, and was statistically significant for ten sites: colon (RR per 10 cm increase in height 1·25, 95% CI 1·19–1·30), rectum (1·14, 1·07–1·22), malignant melanoma (1·32, 1·24–1·40), breast (1·17, 1·15–1·19), endometrium (1·19, 1·13–1·24), ovary (1·17, 1·11–1·23), kidney (1·29, 1·19–1·41), CNS (1·20, 1·12–1·29), non-Hodgkin lymphoma (1·21, 1·14–1·29), and leukaemia (1·26, 1·15–1·38). The increase in total cancer RR per 10 cm increase in height did not vary significantly by socioeconomic status or by ten other personal characteristics we assessed, but was significantly lower in current than in never smokers (p<0·0001). In current smokers, smoking-related cancers were not as strongly related to height as were other cancers (RR per 10 cm increase in height 1·05, 95% CI 1·01–1·09, and 1·17, 1·13–1·22, respectively; p=0·0004). In a meta-analysis of our study and ten other prospective studies, height-associated RRs for total cancer showed little variation across Europe, North America, Australasia, and Asia. Interpretation Cancer incidence increases with increasing adult height for most cancer sites. The relation between height and total cancer RR is similar in different populations. Funding Cancer Research UK and the UK Medical Research Council.
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Batty GD, Kivimäki M, Clarke R, Davey Smith G, Shipley MJ. Modifiable risk factors for prostate cancer mortality in London: forty years of follow-up in the Whitehall study. Cancer Causes Control 2011; 22:311-8. [PMID: 21116843 PMCID: PMC3226949 DOI: 10.1007/s10552-010-9691-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 11/08/2010] [Indexed: 12/29/2022]
Abstract
BACKGROUND The determinants of prostate cancer--aside from established but non-modifiable risk factors of increased age, black ethnicity, and a positive family history--are poorly understood. METHODS We examined the association of a series of baseline socioeconomic, behavioral, and metabolic characteristics with the risk of prostate cancer mortality in a 40-year follow-up of study members from the original Whitehall cohort study. During this period there were 578 prostate cancer deaths in 17,934 men. RESULTS After adjustment for a series of baseline covariates, results from proportional hazards regression analyses indicated that marital status (hazard ratio; 95% confidence interval: widowed/divorced vs. married: 1.44; 0.95, 2.18), raised blood cholesterol (tertile 3 vs. 1: 1.35; 1.11, 1.65), and increased physical stature (tertile 3 vs. 1: 1.37; 1.09, 1.74) were associated with death from prostate cancer, although statistical significance at conventional levels was not apparent in all analyses. There was no evidence that physical activity, smoking habit, socio-economic status, component of either blood pressure or diabetes predicted the risk of death from this malignancy herein. CONCLUSIONS In the present study, there was a suggestion that marital status, blood cholesterol, and height were risk indices for death from prostate cancer.
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Affiliation(s)
- G David Batty
- Department of Epidemiology and Public Health, University College London, UK.
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Batty GD, Shipley MJ, Kivimaki M, Marmot M, Davey Smith G. Walking pace, leisure time physical activity, and resting heart rate in relation to disease-specific mortality in London: 40 years follow-up of the original Whitehall study. An update of our work with professor Jerry N. Morris (1910-2009). Ann Epidemiol 2010; 20:661-9. [PMID: 20579904 DOI: 10.1016/j.annepidem.2010.03.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Accepted: 03/08/2010] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine the association of leisure time physical activity, walking pace and resting heart rate with disease-specific mortality in a prospective cohort study by reporting updated analyses of an earlier report we produced with the British epidemiologist, Jerry N. Morris (1910-2009). METHODS In the original Whitehall study, 19,019 male, nonindustrial, London-based government employees, aged from 40 to 69 years in 1967 and 1970, participated in a medical examination during which data on leisure time physical activity (N = 6715), self-rated walking pace (N = 6729), and resting heart rate (N = 1183) were collected. Cox proportional hazards analyses were used to estimate hazard ratios for the relation between these exposures and disease-specific mortality. RESULTS In models adjusted for a range of covariates including socioeconomic status, smoking, and obesity, high resting heart rate was associated with a modestly elevated rate of mortality from all causes (hazard ratio; 95% confidence interval: tertile 3 vs. tertile 1: 1.17; 0.99, 1.37 p[trend]: 0.07) and respiratory disease (1.69; 1.04, 2.76 p[trend]: 0.03). Of the two markers of physical activity, walking pace was inversely related to mortality ascribed to all causes (slow vs. high walking pace 1.71; 1.53, 1.91 p[trend]: <0.001]), coronary heart disease (2.03; 1.68, 2.47 p[trend]: <0.001), and total cancers (1.25; 0.98, 1.59 p[trend]: 0.04). The corresponding associations for leisure time activity were typically weaker. For other mortality endpoints-respiratory disease (walking pace: 1.96; 1.48, 2.60 p[trend]: <0.001]), hematopoietic cancer (walking pace: 1.36; 0.52, 3.51 p[trend]: 0.03), stomach cancer (inactive versus active leisure time: 1.53; 0.88, 2.64 p[trend]: 0.04), and rectal cancer (walking pace: 4.85; 1.70, 13.8 p[trend]: 0.007)-individual activity indices revealed effects, but not both. CONCLUSIONS Higher levels of physical activity indexed by the various markers herein appeared to confer protection against a range of mortality outcomes.
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Affiliation(s)
- G David Batty
- Medical Research Council Social and Public Health Sciences Unit, Glasgow, UK.
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Batty GD, Mortensen LH, Gale CR, Shipley MJ, Roberts BA, Deary IJ. IQ in late adolescence/early adulthood, risk factors in middle age, and later cancer mortality in men: the Vietnam Experience Study. Psychooncology 2010; 18:1122-6. [PMID: 19189278 DOI: 10.1002/pon.1521] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES (i) examine the relation, if any, of pre-morbid IQ scores at 20 years of age with the risk of later cancer mortality; and (ii) explore the role, if any, of potential mediating factors (e.g. smoking, obesity), assessed in middle age, in explaining the IQ-cancer relation. METHODS Cohort study of 14, 491 male, Vietnam-era, former US army personnel with IQ test scores at around 20 years of age (1965-71), who participated in a risk factor survey at around age 38 years of age (1985-6), who were then followed up for mortality experience for 15 years. RESULTS There were 176 cancer deaths during mortality surveillance. We found an inverse association of IQ with later mortality from all cancers combined (age-adjusted HR(per one SD decrease in IQ); 95% confidence interval: 1.27; 1.10, 1.46) and smoking-related malignancies (1.37; 1.14, 1.64). There was some attenuation following control for mediating variables, particularly smoking and income, but the gradients generally held at conventional levels of statistical significance. CONCLUSIONS Higher scores on pre-morbid IQ tests are associated with lower risk of later cancer morality. The strength of the relation was partially mediated by established risk factors.
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Affiliation(s)
- G David Batty
- MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK, G12 8RZ.
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Kim MY, Lee JW, Im JA, Lee DC. The Association between Height and Cognitive Function in Community Dwelling Old Women. Korean J Fam Med 2010. [DOI: 10.4082/kjfm.2010.31.2.108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Moo-Young Kim
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jee-Aee Im
- Sports and Medicine Research Center, INTOTO Inc., Seoul, Korea
| | - Duk-Chul Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Batty GD, Barzi F, Woodward M, Jamrozik K, Woo J, Kim HC, Ueshima H, Huxley RR. Adult height and cancer mortality in Asia: the Asia Pacific Cohort Studies Collaboration. Ann Oncol 2009; 21:646-654. [PMID: 19889610 DOI: 10.1093/annonc/mdp363] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The observation that taller people experience an increased risk of selected cancers is largely restricted to Caucasian cohorts. These associations may plausibly differ in Asian populations. For the first time, we make direct comparison in the same analyses of the associations between height and a series of malignancies in Australasian (Caucasian) and Asian populations. METHODS Analyses were based on the Asia Pacific Cohort Studies Collaboration of 506 648 study participants (408 381 Asia, 98 267 Australasia) drawn from 38 population-based cohort studies. Cox proportional hazards regression was used to estimate the relationship between height and cancer rates. RESULTS A total of 3 272 600 person-years of follow-up gave rise to 7497 cancer deaths (4415 in Asia; 3082 in Australasia). After multiple adjustments and left censoring, taller individuals experienced increased rates of carcinoma of the intestine (men and women); all cancers, liver, lung, breast, 'other' malignancies (all women); and cancers of the prostate and bladder (men). No consistent regional (Asia versus Australasia) or sex differences were observed. CONCLUSIONS In the present study, taller men and women had an elevated risk of selected malignancies. These associations did not differ appreciably between Asian and Caucasian populations.
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Affiliation(s)
- G D Batty
- Medical Research Council Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK; The George Institute for International Health, University of Sydney, Sydney, Australia.
| | - F Barzi
- The George Institute for International Health, University of Sydney, Sydney, Australia
| | - M Woodward
- The George Institute for International Health, University of Sydney, Sydney, Australia; Mount Sinai Medical Center, New York, NY, USA
| | - K Jamrozik
- School of Population Health and Clinical Practice, University of Adelaide, Adelaide, Australia
| | - J Woo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, The People's Republic of China
| | - H C Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - H Ueshima
- Department of Health Science, Shiga University of Medical Science, Shiga, Japan
| | - R R Huxley
- The George Institute for International Health, University of Sydney, Sydney, Australia
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