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Pastorino R, Pezzullo AM, Osti T, Adany R, Borry P, Barnhoorn F, Fadil E, Kroese M, Metspalu A, Perez-Gomez B, Perola M, Quaggia D, Scollen S, Shabani M, Swartling Peterson S, van El C, Vicente A, Boccia S. The PROPHET project paves the way for personalized prevention in the future healthcare. Eur J Cancer Prev 2024:00008469-990000000-00127. [PMID: 38598497 DOI: 10.1097/cej.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Affiliation(s)
- Roberta Pastorino
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Maria Pezzullo
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Tommaso Osti
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roza Adany
- ELKH DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Pascal Borry
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Floris Barnhoorn
- European Public Health Association (EUPHA), Utrecht, Netherlands
| | - Eva Fadil
- G.A.C., Innovation Department., G.A.C. Group, Issy-les-Moulineaux, France
| | - Mark Kroese
- PHG Foundation, University of Cambridge, Cambridge, UK
| | | | - Beatriz Perez-Gomez
- Consortium for Biomedical Research in Epidemiology and Public Health
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Markus Perola
- Genomics and Biomarkers Unit, Department of Health, National Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | - Mahsa Shabani
- Department of Criminology, Criminal Law and Social Law, University of Gent, Gent, Belgium
| | | | - Carla van El
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Clinical Genetics, Section Community Genetics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Astrid Vicente
- Departamento de Promoção da Saúde e Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health-Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Plans-Beriso E, Gullon P, Fontan-Vela M, Franco M, Perez-Gomez B, Pollan M, Cura-Gonzalez I, Bilal U. Modifying effect of urban parks on socioeconomic inequalities in diabetes prevalence: a cross-sectional population study of Madrid City, Spain. J Epidemiol Community Health 2024:jech-2023-221198. [PMID: 38453450 DOI: 10.1136/jech-2023-221198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Evidence has shown contradicting results on how the density of urban green spaces may reduce socioeconomic inequalities in type 2 diabetes (equigenic hypothesis). The aim of this study is to test whether socioeconomic inequalities in diabetes prevalence are modified by park density. METHODS We designed a population-wide cross-sectional study of all adults registered in the primary healthcare centres in the city of Madrid, Spain (n=1 305 050). We obtained georeferenced individual-level data from the Primary Care Electronic Health Records, and census-tract level data on socioeconomic status (SES) and park density. We modelled diabetes prevalence using robust Poisson regression models adjusted by age, country of origin, population density and including an interaction term with park density, stratified by gender. We used this model to estimate the Relative Index of Inequality (RII) at different park density levels. FINDINGS We found an overall RII of 2.90 (95% CI 2.78 to 3.02) and 4.50 (95% CI 4.28 to 4.74) in men and women, respectively, meaning that the prevalence of diabetes was three to four and a half times higher in low SES compared with high SES areas. These inequalities were wider in areas with higher park density for both men and women, with a significant interaction only for women (p=0.008). INTERPRETATION We found an inverse association between SES and diabetes prevalence in both men and women, with wider inequalities in areas with more parks. Future works should study the mechanisms of these findings, to facilitate the understanding of contextual factors that may mitigate diabetes inequalities.
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Affiliation(s)
- Elena Plans-Beriso
- Department of Epidemiology of Chronic Diseases, National Center For Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Public Health and Epidemiology Research Group, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala de Henares, Alcala de Henares, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pedro Gullon
- Public Health and Epidemiology Research Group, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala de Henares, Alcala de Henares, Spain
| | - Mario Fontan-Vela
- Public Health and Epidemiology Research Group, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala de Henares, Alcala de Henares, Spain
| | - Manuel Franco
- Social and Cardiovascular Research Group, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala de Henares, Alcala de Henares, Spain
| | - Beatriz Perez-Gomez
- Department of Epidemiology of Chronic Diseases, National Center For Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Marina Pollan
- Department of Epidemiology of Chronic Diseases, National Center For Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Isabel Cura-Gonzalez
- Primary Care Research Unit, Madrid Health Service, Madrid, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Usama Bilal
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
- Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
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3
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Ward SV, Burton A, Tamimi RM, Pereira A, Garmendia ML, Pollan M, Boyd N, Dos-Santos-Silva I, Maskarinec G, Perez-Gomez B, Vachon C, Miao H, Lajous M, López-Ridaura R, Bertrand K, Kwong A, Ursin G, Lee E, Ma H, Vinnicombe S, Moss S, Allen S, Ndumia R, Vinayak S, Teo SH, Mariapun S, Peplonska B, Bukowska-Damska A, Nagata C, Hopper J, Giles G, Ozmen V, Aribal ME, Schüz J, Van Gils CH, Wanders JOP, Sirous R, Sirous M, Hipwell J, Kim J, Lee JW, Dickens C, Hartman M, Chia KS, Scott C, Chiarelli AM, Linton L, Flugelman AA, Salem D, Kamal R, McCormack V, Stone J. The association of age at menarche and adult height with mammographic density in the International Consortium of Mammographic Density. Breast Cancer Res 2022; 24:49. [PMID: 35836268 PMCID: PMC9284807 DOI: 10.1186/s13058-022-01545-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/29/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Early age at menarche and tall stature are associated with increased breast cancer risk. We examined whether these associations were also positively associated with mammographic density, a strong marker of breast cancer risk. METHODS Participants were 10,681 breast-cancer-free women from 22 countries in the International Consortium of Mammographic Density, each with centrally assessed mammographic density and a common set of epidemiologic data. Study periods for the 27 studies ranged from 1987 to 2014. Multi-level linear regression models estimated changes in square-root per cent density (√PD) and dense area (√DA) associated with age at menarche and adult height in pooled analyses and population-specific meta-analyses. Models were adjusted for age at mammogram, body mass index, menopausal status, hormone therapy use, mammography view and type, mammographic density assessor, parity and height/age at menarche. RESULTS In pooled analyses, later age at menarche was associated with higher per cent density (β√PD = 0.023 SE = 0.008, P = 0.003) and larger dense area (β√DA = 0.032 SE = 0.010, P = 0.002). Taller women had larger dense area (β√DA = 0.069 SE = 0.028, P = 0.012) and higher per cent density (β√PD = 0.044, SE = 0.023, P = 0.054), although the observed effect on per cent density depended upon the adjustment used for body size. Similar overall effect estimates were observed in meta-analyses across population groups. CONCLUSIONS In one of the largest international studies to date, later age at menarche was positively associated with mammographic density. This is in contrast to its association with breast cancer risk, providing little evidence of mediation. Increased height was also positively associated with mammographic density, particularly dense area. These results suggest a complex relationship between growth and development, mammographic density and breast cancer risk. Future studies should evaluate the potential mediation of the breast cancer effects of taller stature through absolute breast density.
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Affiliation(s)
- Sarah V Ward
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Anya Burton
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
- Translation Health Sciences, University of Bristol, Bristol, UK
| | - Rulla M Tamimi
- Population Health Sciences, Weill Cornell Medical College, Cornell University, New York, USA
| | - Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | | | - Marina Pollan
- Cancer and Environmental Epidemiology Unit, Instituto de Salud Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Norman Boyd
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Beatriz Perez-Gomez
- Cancer and Environmental Epidemiology Unit, Instituto de Salud Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Celine Vachon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Hui Miao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore
| | - Martín Lajous
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | | | - Ava Kwong
- Division of Breast Surgery, Faculty of Medicine, University of Hong Kong, Pok Fu Lam, Hong Kong, China
- Department of Surgery and Cancer Genetics Center, Hong Kong Sanatorium and Hospital, Pok Fu Lam, Hong Kong, China
- Hong Kong Hereditary Breast Cancer Family Registry, Pok Fu Lam, Hong Kong, China
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Eunjung Lee
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Huiyan Ma
- Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, USA
| | - Sarah Vinnicombe
- Division of Cancer Research, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland, UK
| | - Sue Moss
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Steve Allen
- Department of Imaging, Royal Marsden NHS Foundation Trust, London, UK
| | - Rose Ndumia
- Aga Khan University Hospital, Nairobi, Kenya
| | | | - Soo-Hwang Teo
- Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | | | - Beata Peplonska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Łódź, Poland
| | - Agnieszka Bukowska-Damska
- Department of Physiology, Pathophysiology and Clinical Immunology,, Medical University of Lodz., Łódź, Poland
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - John Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Graham Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Vahit Ozmen
- Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Erkin Aribal
- Department of Radiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Joachim Schüz
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Carla H Van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johanna O P Wanders
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Reza Sirous
- Radiology Department, George Washington University Hospital, Washington, DC, USA
| | - Mehri Sirous
- Radiology Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - John Hipwell
- Centre for Medical Image Computing, University College London, London, UK
| | - Jisun Kim
- Asan Medical Center, Seoul, Republic of Korea
| | | | - Caroline Dickens
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Kee-Seng Chia
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore
| | - Christopher Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Anna M Chiarelli
- Ontario Breast Screening Program, Cancer Care Ontario, Toronto, ON, Canada
| | - Linda Linton
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Anath Arzee Flugelman
- National Cancer Control Center, Lady Davis Carmel Medical Center, Faculty of Medicine, Technion-Israel Institute Technology, Haifa, Israel
| | - Dorria Salem
- Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals, Cairo, Egypt
| | - Rasha Kamal
- Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals, Cairo, Egypt
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France.
| | - Jennifer Stone
- School of Population and Global Health, The University of Western Australia, Perth, Australia
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4
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Lopez-Almazan H, Javier Pérez-Benito F, Larroza A, Perez-Cortes JC, Pollan M, Perez-Gomez B, Salas Trejo D, Casals M, Llobet R. A deep learning framework to classify breast density with noisy labels regularization. Comput Methods Programs Biomed 2022; 221:106885. [PMID: 35594581 DOI: 10.1016/j.cmpb.2022.106885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/12/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Breast density assessed from digital mammograms is a biomarker for higher risk of developing breast cancer. Experienced radiologists assess breast density using the Breast Image and Data System (BI-RADS) categories. Supervised learning algorithms have been developed with this objective in mind, however, the performance of these algorithms depends on the quality of the ground-truth information which is usually labeled by expert readers. These labels are noisy approximations of the ground truth, as there is often intra- and inter-reader variability among labels. Thus, it is crucial to provide a reliable method to obtain digital mammograms matching BI-RADS categories. This paper presents RegL (Labels Regularizer), a methodology that includes different image pre-processes to allow both a correct breast segmentation and the enhancement of image quality through an intensity adjustment, thus allowing the use of deep learning to classify the mammograms into BI-RADS categories. The Confusion Matrix (CM) - CNN network used implements an architecture that models each radiologist's noisy label. The final methodology pipeline was determined after comparing the performance of image pre-processes combined with different DL architectures. METHODS A multi-center study composed of 1395 women whose mammograms were classified into the four BI-RADS categories by three experienced radiologists is presented. A total of 892 mammograms were used as the training corpus, 224 formed the validation corpus, and 279 the test corpus. RESULTS The combination of five networks implementing the RegL methodology achieved the best results among all the models in the test set. The ensemble model obtained an accuracy of (0.85) and a kappa index of 0.71. CONCLUSIONS The proposed methodology has a similar performance to the experienced radiologists in the classification of digital mammograms into BI-RADS categories. This suggests that the pre-processing steps and modelling of each radiologist's label allows for a better estimation of the unknown ground truth labels.
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Affiliation(s)
- Hector Lopez-Almazan
- Instituto Tecnológico de la Informática, Universitat Politècnica de València,Camino de Vera, s/n, 46022 València, Spain.
| | - Francisco Javier Pérez-Benito
- Instituto Tecnológico de la Informática, Universitat Politècnica de València,Camino de Vera, s/n, 46022 València, Spain.
| | - Andrés Larroza
- Instituto Tecnológico de la Informática, Universitat Politècnica de València,Camino de Vera, s/n, 46022 València, Spain.
| | - Juan-Carlos Perez-Cortes
- Instituto Tecnológico de la Informática, Universitat Politècnica de València,Camino de Vera, s/n, 46022 València, Spain.
| | - Marina Pollan
- National Center for Epidemiology, Carlos III Institute of Health, Monforte de lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain.
| | - Beatriz Perez-Gomez
- National Center for Epidemiology, Carlos III Institute of Health, Monforte de lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain.
| | - Dolores Salas Trejo
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, València, Spain; Centro Superior de Investigación en Salud Pública CSISP, FISABIO, València, Spain.
| | - María Casals
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, València, Spain; Centro Superior de Investigación en Salud Pública CSISP, FISABIO, València, Spain.
| | - Rafael Llobet
- Instituto Tecnológico de la Informática, Universitat Politècnica de València,Camino de Vera, s/n, 46022 València, Spain.
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5
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Papantoniou K, Castaño-Vinyals G, Espinosa A, Turner MC, Martín-Sánchez V, Casabonne D, Aragonés N, Gómez-Acebo I, Ardanaz E, Jimenez-Moleon JJ, Amiano P, Molina-Barceló A, Alguacil J, Fernández-Tardón G, Huerta JM, Hernández-Segura N, Perez-Gomez B, Llorca J, Vidán-Alli J, Olmedo-Requena R, Gil L, Castañon-López C, Pollan M, Kogevinas M, Moreno V. Sleep duration and napping in relation to colorectal and gastric cancer in the MCC-Spain study. Sci Rep 2021; 11:11822. [PMID: 34083698 PMCID: PMC8175745 DOI: 10.1038/s41598-021-91275-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022] Open
Abstract
Sleep duration is a novel and potentially modifiable risk factor for cancer. We evaluated the association of self-reported sleep duration and daytime napping with odds of colorectal and gastric cancer. We included 2008 incident colorectal cancer cases, 542 gastric cancer cases and 3622 frequency-matched population controls, recruited in the MCC-Spain case-control study (2008-2013). Sleep information, socio-demographic and lifestyle characteristics were obtained through personal interviews. Multivariable adjusted logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (CI) for cancer, across categories of sleep duration (≤ 5, 6, 7, 8, ≥ 9 hours/day), daytime napping frequency (naps/week) and duration (minutes/nap). Compared to 7 hours of sleep, long sleep was associated with increased odds of colorectal (OR≥9 hours: 1.59; 95%CI 1.30-1.94) and gastric cancer (OR≥9 hours: 1.95; 1.37-2.76); short sleep was associated with increased odds of gastric cancer (OR≤5 hours: 1.32; 0.93-1.88). Frequent and long daytime naps increased the odds of colorectal (OR6-7 naps/week, ≥30 min: 1.32; 1.14-1.54) and gastric cancer (OR6-7 naps/week, ≥30 min: 1.56; 1.21-2.02). Effects of short sleep and frequent long naps were stronger among participants with night shift-work history. Sleep and circadian disruption may jointly play a role in the etiology of colorectal and gastric cancer.
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Affiliation(s)
- Kyriaki Papantoniou
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
- ISGlobal, Barcelona, Spain.
| | - Gemma Castaño-Vinyals
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Ana Espinosa
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Michelle C Turner
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada
| | - Vicente Martín-Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Biomedicine Institute (IBIOMED), University of León, Leon, Spain
| | - Delphine Casabonne
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- University of Cantabria, Santander, Spain
- IDIVAL, Santander, Spain
| | - Eva Ardanaz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Jose-Juan Jimenez-Moleon
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Instituto de Investigacion Biosanitaria de Granada (Ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, San Sebastian, Spain
- Biodonostia Research Institute, San Sebastian, Spain
| | | | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Campus Universitario de El Carmen, Huelva, Spain
| | - Guillermo Fernández-Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Health Research Institute of the Principality of Asturias, University of Oviedo, Oviedo, Spain
| | - José María Huerta
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | | | - Beatriz Perez-Gomez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Epidemiology Unit of the National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Majadahonda, Madrid, Spain
| | - Javier Llorca
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- University of Cantabria, Santander, Spain
| | - Juana Vidán-Alli
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Rocıo Olmedo-Requena
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Instituto de Investigacion Biosanitaria de Granada (Ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Leire Gil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, San Sebastian, Spain
- Biodonostia Research Institute, San Sebastian, Spain
| | | | - Marina Pollan
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Epidemiology Unit of the National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Victor Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Hospitalet de Llobregat, Barcelona, Spain
- Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
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6
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Galvez-Fernandez M, Grau-Perez M, Garcia-Barrera T, Ramirez-Acosta S, Gomez-Ariza JL, Perez-Gomez B, Galan-Labaca I, Navas-Acien A, Redon J, Briongos-Figuero LS, Dueñas-Laita A, Perez-Castrillon JL, Tellez-Plaza M, Martin-Escudero JC. Arsenic, cadmium, and selenium exposures and bone mineral density-related endpoints: The HORTEGA study. Free Radic Biol Med 2021; 162:392-400. [PMID: 33137469 PMCID: PMC9019194 DOI: 10.1016/j.freeradbiomed.2020.10.318] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Experimental data suggest that trace elements, such as arsenic (As), cadmium (Cd), and selenium (Se) can influence the bone remodeling process. We evaluated the cross-sectional association between As, Cd, and Se biomarkers with bone mineral density (BMD) measured at the calcaneus, in a representative sample of a general population from Spain. As secondary analyses we evaluated the associations of interest in subgroups defined by well-established BMD determinants, and also conducted prospective analysis of osteoporosis-related incident bone fractures restricted to participants older than 50 years-old. METHODS In N = 1365 Hortega Study participants >20 years-old, urine As and Cd were measured by inductively coupled-plasma mass spectrometry (ICPMS); plasma Se was measured by atomic absorption spectrometry (AAS) with graphite furnace; and BMD at the calcaneus was measured using the Peripheral Instaneuous X-ray Imaging system (PIXI). As levels were corrected for arsenobetaine (Asb) to account for inorganic As exposure. RESULTS The median of total urine As, Asb-corrected urine As, urine Cd, and plasma Se was 61.3, 6.53 and 0.39 μg/g creatinine, and 84.9 μg/L, respectively. In cross-sectional analysis, urine As and Cd were not associated with reduced BMD (T-score < -1 SD). We observed a non-linear dose-response of Se and reduced BMD, showing an inverse association below ~105 μg/L, which became increasingly positive above ~105 μg/L. The evaluated subgroups did not show differential associations. In prospective analysis, while we also observed a U-shape dose-response of Se with the incidence of osteoporosis-related bone fractures, the positive association above ~105 μg/L was markedly stronger, compared to the cross-sectional analysis. CONCLUSIONS Our results support that Se, but not As and Cd, was associated to BMD-related disease. The association of Se and BMD-related disease was non-linear, including a strong positive association with osteoporosis-related bone fractures risk at the higher Se exposure range. Considering the substantial burden of bone loss in elderly populations, additional large prospective studies are needed to confirm the relevance of our findings to bone loss prevention in the population depending on Se exposure levels.
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Affiliation(s)
- Marta Galvez-Fernandez
- Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Calle Arzobispo Morcillo, 4, 28029, Madrid, Spain; Department of Preventive Medicine, Hospital Severo Ochoa, Avenida de Orellana, 28914, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Calle de Melchor Fernández Almagro, 5, 28029, Madrid, Spain
| | - Maria Grau-Perez
- Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Calle Arzobispo Morcillo, 4, 28029, Madrid, Spain; Area of Renal Risk and Cardiometabolic Disease, Instituto de Investigación Sanitaria Hospital Clinic de Valencia (INCLIVA), Avinguda de Menéndez y Pelayo, 4, 46010, Valencia, Spain; Department of Statistics and Operational Research, University of Valencia, Calle Dr. Moliner, 50, 46100, Valencia, Spain
| | - Tamara Garcia-Barrera
- Department of Chemistry, University of Huelva, Avenida de las Fuerzas Armadas, 21007, Huelva, Spain
| | - Sara Ramirez-Acosta
- Department of Chemistry, University of Huelva, Avenida de las Fuerzas Armadas, 21007, Huelva, Spain
| | - Jose L Gomez-Ariza
- Department of Chemistry, University of Huelva, Avenida de las Fuerzas Armadas, 21007, Huelva, Spain
| | - Beatriz Perez-Gomez
- Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Calle de Melchor Fernández Almagro, 5, 28029, Madrid, Spain
| | - Iñaki Galan-Labaca
- Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Calle Arzobispo Morcillo, 4, 28029, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Calle de Melchor Fernández Almagro, 5, 28029, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722W, 168th Street, NY, 10032, USA
| | - Josep Redon
- Area of Renal Risk and Cardiometabolic Disease, Instituto de Investigación Sanitaria Hospital Clinic de Valencia (INCLIVA), Avinguda de Menéndez y Pelayo, 4, 46010, Valencia, Spain
| | - Laisa S Briongos-Figuero
- Departments of Internal Medicine and Toxicology, University Hospital Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid. University of Valladolid, Spain
| | - Antonio Dueñas-Laita
- Departments of Internal Medicine and Toxicology, University Hospital Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid. University of Valladolid, Spain
| | - Jose Luis Perez-Castrillon
- Departments of Internal Medicine and Toxicology, University Hospital Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid. University of Valladolid, Spain
| | - Maria Tellez-Plaza
- Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Calle Arzobispo Morcillo, 4, 28029, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Calle de Melchor Fernández Almagro, 5, 28029, Madrid, Spain; Area of Renal Risk and Cardiometabolic Disease, Instituto de Investigación Sanitaria Hospital Clinic de Valencia (INCLIVA), Avinguda de Menéndez y Pelayo, 4, 46010, Valencia, Spain.
| | - Juan Carlos Martin-Escudero
- Departments of Internal Medicine and Toxicology, University Hospital Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid. University of Valladolid, Spain
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7
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Pollan M, Lope V, Guerrero-Zotano A, Casas A, Baena-Cañada JM, Bermejo B, Perez-Gomez B, Sanchez-Rovira P, Ramos Vazquez M, Anton A, Garcia-Saenz JA, Munoz M, de Juan A, Andres R, Llombart Cussac A, Hernando B, Franquesa RM, Caballero R, Martin M, Priego F. Serum phospholipids fatty acids and breast cancer risk by pathological subtype: EpiGEICAM study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e13604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13604 Background: The role of fatty acids (FA) in breast cancer (BC) etiology is unclear. Most studies are based on self-reported dietary intake, without considering their internal transformation. This analysis tries to assess whether serum levels of 26 phospholipid FA (PL-FAs) and markers of their endogenous metabolism are associated with BC risk, both globally and by pathological BC subtype. Methods: EpiGEICAM-01 is a Spanish multicenter matched case-control study. BC cases and healthy women completed a lifestyle and a food frequency questionnaire, and serum samples were collected. Serum PL-FAs percentages were measured by gas chromatography-mass spectrometry (GC–MS). Conditional and multinomial logistic regression models were used to quantify the association of PL-FAs tertiles with BC risk, overall and by pathologic BC subtypes [luminal, HER2+ and triple negative]. Models were adjusted for age and region (multinomial models), education level, body mass index (BMI), menopausal status, age at menarche and at first birth, hormone replacement therapy, alcohol consumption, last year physical activity, history of benign breast disease, family history of BC and caloric intake, and were corrected for multiple testing. Stratified analyses by BMI and menopausal status were also performed. Results: Questionnaires and serum samples were collected from 795 case-control pairs. Women with high serum levels of stearic acid [odds ratio (OR)T3vsT1= 0.44; 95% confidence interval (CI) = 0.30-0.66], linoleic acid (ORT3vsT1= 0.66; 95% CI = 0.49-0.90) and arachidonic to dihomo-γ-linolenic acids ratio (OR T3vsT1= 0.64 95%; CI = 0.48-0.84; differences were remarkable in overweight/obese women) presented lower BC risk. Participants with high concentrations of palmitoleic acid (ORT3vsT1= 1.65; 95% CI = 1.20-2.26), trans-ruminant palmitelaidic acid (ORT3vsT1= 1.51; 95% CI = 1.12-2.02; differences observed were noticeable both in postmenopausal and in overweight/obese women), trans-industrial elaidic acid (ORT3vsT1= 1.52; 95% CI = 1.14-2.03; markedly both in premenopausal and in non-obese women), and high oleic to stearic acids ratio (ORT3vsT1= 2.04; 95% CI = 1.45-2.87) showed higher risk. These associations were similar in all BC pathological subtypes. Conclusions: Our results, which should be confirmed in future studies, emphasize the importance of analyzing fatty acids individually, as well as the desaturase activity indices. A decrease in the dietary intake of trans-monounsaturated fatty acids could be a good strategy for BC prevention.
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Affiliation(s)
- Marina Pollan
- National Center of Epidemiology, Instituto Salud Carlos III. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Angel Guerrero-Zotano
- Instituto Valenciano de Oncología, GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Ana Casas
- Hospital Universitario Virgen Del Rocio, GEICAM Spanish Breast Cancer Group, Seville, Spain
| | - José Manuel Baena-Cañada
- Hospital Puerta del Mar; Instituto de Investigación en Biomedicina de Cádiz (INiBICA); GEICAM Spanish Breast Cancer Group, Cádiz, Spain
| | - Begoña Bermejo
- Hospital Clinico Universitario Valencia. Biomedical Research Institute INCLIVA. CIBERONC ISCIII. GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Beatriz Perez-Gomez
- Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Manuel Ramos Vazquez
- Centro Oncologico de Galicia. GEICAM Spanish Breast Cancer Group, A Coruña, Spain
| | - Antonio Anton
- Hospital Universitario Miguel Servet, Geicam Spanish Breast Cancer Group, Zaragoza, Spain
| | | | - Montserrat Munoz
- Medical Oncology, Hospital Clínic Barcelona, GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Ana de Juan
- Hospital Marqués de Valdecilla; GEICAM Spanish Breast Cancer Group, Santander, Spain
| | - Raquel Andres
- Hospital Clínico Universitario Lozano Blesa, GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | | | - Blanca Hernando
- Hospital General Yagüe, GEICAM Spanish Breast Cancer Group, Burgos, Spain
| | | | | | - Miguel Martin
- Hospital General Universitario Gregorio Marañón, Instituto Investigación Sanitaria Gregorio Marañón. Universidad Complutense, CIBERONC ISCIII, GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Feliciano Priego
- Analytical Chemistry Department. Universidad de Córdoba., Córdoba, Spain
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8
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Rodriguez-Sanchez L, Fernández-Navarro P, López-Abente G, Nuñez O, Fernández de Larrea-Baz N, Jimenez-Moleón JJ, Páez Borda Á, Pollán M, Perez-Gomez B. Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. PLoS One 2019; 14:e0210980. [PMID: 30682085 PMCID: PMC6347247 DOI: 10.1371/journal.pone.0210980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/04/2019] [Indexed: 11/25/2022] Open
Abstract
Background Prostate cancer (PC) primarily affects elderly men. However, the specific features of cases diagnosed at younger ages (<65 years) suggest that they may represent a different clinical subtype. Our aim was to assess this suggestion by contrasting the geographical PC mortality and hospital admissions patterns in Spain for all ages to those in younger men. Methods The Spanish National Institute of Statistics supplied data on PC mortality, hospital admission, and population data. We estimated the expected town-specific number of deaths and calculated the standardized mortality ratios. Spatial autoregressive models of Besag-York-Mollié provided smoother municipal estimators of PC mortality risk (all ages; <65 years). We computed the provincial age-standardized rate ratios of PC hospital admissions (all men; <60 years) using Spanish rates as the reference. Results A total of 29,566 PC deaths (6% among those <65 years) were registered between 2010–2014, with three high-mortality risk zones: Northwest Spain; Southwest Andalusia & Granada; and a broad band extending from the Pyrenees Mountains to the north of Valencia. In younger men, the spatial patterns shared the high risk of mortality in the Northwest but not the central band. The PC hospital discharge rates confirmed a North-South gradient but also low mortality/high admission rates in Madrid and Barcelona and the opposite in Southwest Andalusia. Conclusion The consistent high PC mortality/morbidity risk in the Northwest of Spain indicates an area with a real excess of risk. The different spatial pattern in younger men suggests that some factors associated with geographical risk might have differential effects by age. Finally, the regional divergences in mortality and morbidity hint at clinical variability as a source of inequity within Spain.
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Affiliation(s)
- Lara Rodriguez-Sanchez
- Urology Department, Fuenlabrada General Hospital, Fuenlabrada, Spain
- Rey Juan Carlos University, Móstoles, Spain
| | - Pablo Fernández-Navarro
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Gonzalo López-Abente
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Olivier Nuñez
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Jose Juan Jimenez-Moleón
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Complejo Hospitales Universitarios, Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Álvaro Páez Borda
- Urology Department, Fuenlabrada General Hospital, Fuenlabrada, Spain
- Rey Juan Carlos University, Móstoles, Spain
| | - Marina Pollán
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Beatriz Perez-Gomez
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
- Cardiovascular & Metabolic Diseases Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- * E-mail:
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9
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O'Callaghan-Gordo C, Kogevinas M, Cirach M, Castaño-Vinyals G, Aragonés N, Delfrade J, Fernández-Villa T, Amiano P, Dierssen-Sotos T, Tardon A, Capelo R, Peiró-Perez R, Moreno V, Roca-Barceló A, Perez-Gomez B, Vidan J, Molina AJ, Oribe M, Gràcia-Lavedan E, Espinosa A, Valentin A, Pollán M, Nieuwenhuijsen MJ. Residential proximity to green spaces and breast cancer risk: The multicase-control study in Spain (MCC-Spain). Int J Hyg Environ Health 2018; 221:1097-1106. [DOI: 10.1016/j.ijheh.2018.07.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 07/24/2018] [Accepted: 07/26/2018] [Indexed: 11/26/2022]
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10
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García-Esquinas E, Jiménez A, Pastor-Barriuso R, Jones MR, Perez-Gomez B, Navas-Acien A, Tellez-Plaza M. Impact of declining exposure to secondhand tobacco smoke in public places to decreasing smoking-related cancer mortality in the US population. Environ Int 2018; 117:260-267. [PMID: 29775915 PMCID: PMC6136453 DOI: 10.1016/j.envint.2018.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/03/2018] [Accepted: 05/03/2018] [Indexed: 05/29/2023]
Abstract
BACKGROUND The major decrease in exposure to secondhand smoke (SHS) in public places in recent decades could have contributed to the decline in smoking-related cancer mortality observed in the US population. METHODS Prospective study among 11,856 non-smoking adults aged ≥40 years who participated in NHANES 1988-1994 or 1999-2004 and were followed for mortality through 2006. We estimated the amount of change in cancer mortality over time attributed to the intermediate pathway of changes in SHS exposure in public places, after adjustment for risk factors and SHS exposure at home. RESULTS The adjusted smoking-related cancer mortality rate ratios (95% CI) for a two-fold increase in serum cotinine and a 1-hour increase in occupational SHS exposure time were 1.10 (1.03, 1.17) and 1.14 (1.06, 1.24) for all-cancer, and 1.13 (1.03, 1.24) and 1.14 (1.02, 1.26) for smoking-related cancer, respectively. The absolute reduction in mortality comparing 1999-2004 to 1988-1994 was 75.8 (-25.5, 177.0) and 77.0 (2.6, 151.4) deaths/100,000 person-years, for all-cancer and smoking-related cancer, respectively. Among these avoided all-cancer deaths, 45.8 (2.8, 89.5) and 18.1 (-1.2, 39.6)/100,000 person-year were attributable to changes in serum cotinine concentrations and occupational SHS exposure time, respectively. The corresponding numbers of smoking-related cancer avoided deaths were 36.4 (0.7, 72.8) and 9.9 (-3.8, 24.9)/100,000 person-year. CONCLUSIONS Declines in SHS exposure were associated with reductions in all-cancer and smoking-related cancer mortality, supporting that smoking bans in public places may have reduced cancer mortality among non-smoking adults.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Angélica Jiménez
- Institute for Biomedical Research Hospital Clinic of Valencia (INCLIVA), Valencia, Spain
| | - Roberto Pastor-Barriuso
- National Center of Epidemiology, Carlos III Institutes of Health and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Beatriz Perez-Gomez
- National Center of Epidemiology, Carlos III Institutes of Health and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA.
| | - Maria Tellez-Plaza
- Institute for Biomedical Research Hospital Clinic of Valencia (INCLIVA), Valencia, Spain; Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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11
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Kogevinas M, Espinosa A, Castelló A, Gómez-Acebo I, Guevara M, Martin V, Amiano P, Alguacil J, Peiro R, Moreno V, Costas L, Fernández-Tardón G, Jimenez JJ, Marcos-Gragera R, Perez-Gomez B, Llorca J, Moreno-Iribas C, Fernández-Villa T, Oribe M, Aragones N, Papantoniou K, Pollán M, Castano-Vinyals G, Romaguera D. Effect of mistimed eating patterns on breast and prostate cancer risk (MCC-Spain Study). Int J Cancer 2018; 143:2380-2389. [PMID: 30016830 PMCID: PMC6220994 DOI: 10.1002/ijc.31649] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 05/23/2018] [Accepted: 06/01/2018] [Indexed: 12/21/2022]
Abstract
Modern life involves mistimed sleeping and eating patterns that in experimental studies are associated with adverse health effects. We assessed whether timing of meals is associated with breast and prostate cancer risk taking into account lifestyle and chronotype, a characteristic correlating with preference for morning or evening activity. We conducted a population‐based case‐control study in Spain, 2008–2013. In this analysis we included 621 cases of prostate and 1,205 of breast cancer and 872 male and 1,321 female population controls who had never worked night shift. Subjects were interviewed on timing of meals, sleep and chronotype and completed a Food Frequency Questionaire. Adherence to the World Cancer Research Fund/American Institute of Cancer Research recommendations for cancer prevention was examined. Compared with subjects sleeping immediately after supper, those sleeping two or more hours after supper had a 20% reduction in cancer risk for breast and prostate cancer combined (adjusted Odds Ratio [OR] = 0.80, 95%CI 0.67–0.96) and in each cancer individually (prostate cancer OR = 0.74, 0.55–0.99; breast cancer OR = 0.84, 0.67–1.06). A similar protection was observed in subjects having supper before 9 pm compared with supper after 10 pm. The effect of longer supper‐sleep interval was more pronounced among subjects adhering to cancer prevention recommendations (OR both cancers= 0.65, 0.44–0.97) and in morning types (OR both cancers = 0.66, 0.49–0.90). Adherence to diurnal eating patterns and specifically a long interval between last meal and sleep are associated with a lower cancer risk, stressing the importance of evaluating timing in studies on diet and cancer. What's new? Evidence shows that long‐term disruption of endogenous circadian rhythms may be associated with cancer. The effects of mistimed sleeping and eating patterns that come with modern life are however less clear. This large Spanish population‐based study examined whether meal timing and sleep patterns are associated with the two most common nightshift‐related cancers. Adherence to a more diurnal eating pattern, and specifically an early supper and a long interval between last meal and sleep were associated with a lower breast and prostate cancer risk, stressing the importance of evaluating circadian rhythms in diet and cancer studies and revisiting recommendations for prevention.
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Affiliation(s)
- Manolis Kogevinas
- ISGlobal, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ana Espinosa
- ISGlobal, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Adela Castelló
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.,Faculty of Medicine, University of Alcalá, Madrid, Spain
| | - Inés Gómez-Acebo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad de Cantabria - IDIVAL, Santander, Spain
| | - Marcela Guevara
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Institute of Navarra, IdiSNA, Pamplona, Spain
| | - Vicente Martin
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Juan Alguacil
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Centro de Investigación en Recursos Naturales, Salud, y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Rosana Peiro
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO - Salud Pública, Valencia, Spain
| | - Victor Moreno
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IDIBELL-Catalan Institute of Oncology, L'Hospitalet de Llobregat, Catalonia, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Laura Costas
- Unit of Molecular Epidemiology and Genetics in Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Guillermo Fernández-Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Jose Juan Jimenez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), Girona, Spain
| | - Beatriz Perez-Gomez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.,Cardiovascular & Metabolic Diseases Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad de Cantabria - IDIVAL, Santander, Spain
| | | | - Tania Fernández-Villa
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Madalen Oribe
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Nuria Aragones
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Division, Department of Health, Epidemiology Section, Madrid, Spain
| | - Kyriaki Papantoniou
- ISGlobal, Barcelona, Spain.,Department of Epidemiology, Center of Public Health, Medical University of Vienna, Vienna, Austria
| | - Marina Pollán
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Castano-Vinyals
- ISGlobal, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Dora Romaguera
- ISGlobal, Barcelona, Spain.,Instituto de Investigación Sanitaria Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma de Mallorca, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
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12
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Castello A, Shivappa N, Ruiz A, Casas A, Lluch Hernandez A, Baena-Cañada JM, Antolin S, Sánchez Rovira P, Ramos Vazquez M, Garcia-Saenz JA, Anton A, Munoz M, de Juan A, Jara-Sanchez C, Vioque J, Perez-Gomez B, Hébert JR, Lope V, Martin M, Pollan M. Dietary inflammatory index and breast cancer risk by menopausal status and histological subtype. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.1521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Adela Castello
- National Center for Epidemiology, Instituto de Salud Carlos III, Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III.Faculty of Medicine, University of Alcalá, Madrid, Spain
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia.Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia. Connecting Health Innovations LLC, Columbia., Columbia, SC
| | - Amparo Ruiz
- Instituto Valenciano de Oncología, GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - Ana Casas
- Hospital Universitario Virgen Del Rocio, Sevilla, Spain
| | - Ana Lluch Hernandez
- Fundación Instituto Valenciano de Oncología. Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Valencia, Spain
| | - José Manuel Baena-Cañada
- Hospital Puerta del Mar; Instituto de Investigación en Biomedicina de Cádiz (INiBICA); GEICAM Spanish Breast Cancer Group, Cádiz, Spain
| | - Silvia Antolin
- Complejo Hospitalario Universitario A Coruña. GEICAM Spanish Breast Cancer Group, A Coruña, Spain
| | | | - Manuel Ramos Vazquez
- Centro Oncologico de Galicia. GEICAM Spanish Breast Cancer Group, A Coruña, Spain
| | | | - Antonio Anton
- Hospital Universitario Miguel Servet; GEICAM Spanish Breast Cancer Group, Zaragoza, Spain
| | - Montserrat Munoz
- Hospital Clínic de Barcelona; Translational Genomics and Targeted Therapeutics; Institut d’Investigacions Biomèdiques Pi i Sunyer-IDIBAPS; GEICAM Spanish Breast Cancer Group, Barcelona, Spain
| | - Ana de Juan
- Hospital Marqués de Valdecilla; GEICAM Spanish Breast Cancer Group, Santander, Spain
| | | | - Jesus Vioque
- Department of Public Health, Universidad Miguel Hernandez. onsortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III., Sant Joan D'alacant, Spain
| | - Beatriz Perez-Gomez
- Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III., Madrid, Spain
| | - James R. Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia. Connecting Health Innovations LLC., Columbia, SC
| | - Virginia Lope
- Cancer Epidemiology Unit. National Center for Epidemiology. Instituto de Salud Carlos III. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Martin
- Instituto de Investigación Sanitaria Gregorio Marañón, Ciberonc, Geicam, Universidad Complutense, Madrid, Spain
| | - Marina Pollan
- National Center of Epidemiology, Instituto Salud Carlos III. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Instituto de Salud Carlos III, Madrid, Spain
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13
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Alonso-Molero J, González-Donquiles C, Palazuelos C, Fernández-Villa T, Ramos E, Pollán M, Aragonés N, Llorca J, Henar Alonso M, Tardón A, Amiano P, Moleon JJJ, Pérez RP, Capelo R, Molina AJ, Acebo IG, Guevara M, Perez-Gomez B, Lope V, Huerta JM, Castaño-Vinyals G, Kogevinas M, Moreno V, Martín V. The RS4939827 polymorphism in the SMAD7 GENE and its association with Mediterranean diet in colorectal carcinogenesis. BMC Med Genet 2017; 18:122. [PMID: 29084532 PMCID: PMC5661920 DOI: 10.1186/s12881-017-0485-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 10/18/2017] [Indexed: 02/06/2023]
Abstract
Background The objective of our investigation is to study the relationship between the rs4939827 SNP in the SMAD7 gene, Mediterranean diet pattern and the risk of colorectal cancer. Methods We examined 1087 cases of colorectal cancer and 2409 population controls with available DNA samples from the MCC-Spain study, 2008–2012. Descriptive statistical analyses, and multivariate logistic mixed models were performed. The potential synergistic effect of rs4939827 and the Mediterranean diet pattern was evaluated with logistic regression in different strata of of adherence to the Mediterranean diet and the genotype. Results High adherence to Mediterrenean diet was statistically significantly associated with colorectal cancer risk. A decreased risk for CRC cancer was observed for the CC compared to the TT genotype (OR = 0.65 and 95% CI = 0.51–0.81) of the rs4939827 SNP Also, we could show an association between the Mediterranean diet pattern (protective factor) and rs4939827. Although the decreased risk for the CC genotype was slightly more pronounced in subjects with high adherence to Mediterrenean diet, there was no statistically significant synergistic effect between genotype CC and adherence to the Mediterranean dietary pattern factors. Conclusion The SMAD7 gene and specifically the allele C could be protective for colorectal cancer. An independent protective association was also observed between high adherence Mediterranean diet pattern and CRC risk. Findings form this study indicate that high adherence to Mediterranean diet pattern has a protective role for CRC cancer probably involving the Tumor Growth Factor- β pathway in this cancer. Electronic supplementary material The online version of this article (10.1186/s12881-017-0485-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jéssica Alonso-Molero
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud. Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Carmen González-Donquiles
- Centro de Investigación Biomédica en Red (CIBERESP) and Oviedo University; Departamento de Ciencias Biomédicas. Universidad de León. Campus de Vegazana, León, Spain.
| | | | - Tania Fernández-Villa
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud. Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Elena Ramos
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud. Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Marina Pollán
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Javier Llorca
- Universidad de Cantabria, Santander, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M Henar Alonso
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer Prevention and Control Program, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain.,Colorectal Cancer Group, Bellvitge Biomedical Research Institute (IDIBELL). Hospitalet de Llobregat, Barcelona, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Oncology Institute IUOPA, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Navarra, Spain
| | - José Juan Jiménez Moleon
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Rosana Peiró Pérez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Dirección General de Salud Pública, Fundación para el fomento de la investigación sanitaria y biomédica de la Comunidad Valenciana, FISABIO-Salud Pública, Barcelona, Spain
| | - Rocío Capelo
- Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain
| | - Antonio J Molina
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud. Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Inés Gómez Acebo
- Universidad de Cantabria, Santander, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marcela Guevara
- Instituto de Salud Pública de Navarra, Pamplona, Navarra, Spain
| | - Beatriz Perez-Gomez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta De Hierro, Madrid, Spain
| | - Virginia Lope
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - José María Huerta
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Gemma Castaño-Vinyals
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,School of Public Health, Athens, Greece
| | - Victor Moreno
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer Prevention and Control Program, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain.,Colorectal Cancer Group, Bellvitge Biomedical Research Institute (IDIBELL). Hospitalet de Llobregat, Barcelona, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Grupo de Investigación en Interacciones Gen-Ambiente y Salud de la Universidad de León, León, Spain
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14
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Burton A, Maskarinec G, Perez-Gomez B, Vachon C, Miao H, Lajous M, López-Ridaura R, Rice M, Pereira A, Garmendia ML, Tamimi RM, Bertrand K, Kwong A, Ursin G, Lee E, Qureshi SA, Ma H, Vinnicombe S, Moss S, Allen S, Ndumia R, Vinayak S, Teo SH, Mariapun S, Fadzli F, Peplonska B, Bukowska A, Nagata C, Stone J, Hopper J, Giles G, Ozmen V, Aribal ME, Schüz J, Van Gils CH, Wanders JOP, Sirous R, Sirous M, Hipwell J, Kim J, Lee JW, Dickens C, Hartman M, Chia KS, Scott C, Chiarelli AM, Linton L, Pollan M, Flugelman AA, Salem D, Kamal R, Boyd N, dos-Santos-Silva I, McCormack V. Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide. PLoS Med 2017; 14:e1002335. [PMID: 28666001 PMCID: PMC5493289 DOI: 10.1371/journal.pmed.1002335] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/24/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Mammographic density (MD) is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known. METHODS AND FINDINGS We examined cross-sectional differences in MD by age and menopausal status in over 11,000 breast-cancer-free women aged 35-85 years, from 40 ethnicity- and location-specific population groups across 22 countries in the International Consortium on Mammographic Density (ICMD). MD was read centrally using a quantitative method (Cumulus) and its square-root metrics were analysed using meta-analysis of group-level estimates and linear regression models of pooled data, adjusted for body mass index, reproductive factors, mammogram view, image type, and reader. In all, 4,534 women were premenopausal, and 6,481 postmenopausal, at the time of mammography. A large age-adjusted difference in percent MD (PD) between post- and premenopausal women was apparent (-0.46 cm [95% CI: -0.53, -0.39]) and appeared greater in women with lower breast cancer risk profiles; variation across population groups due to heterogeneity (I2) was 16.5%. Among premenopausal women, the √PD difference per 10-year increase in age was -0.24 cm (95% CI: -0.34, -0.14; I2 = 30%), reflecting a compositional change (lower dense area and higher non-dense area, with no difference in breast area). In postmenopausal women, the corresponding difference in √PD (-0.38 cm [95% CI: -0.44, -0.33]; I2 = 30%) was additionally driven by increasing breast area. The study is limited by different mammography systems and its cross-sectional rather than longitudinal nature. CONCLUSIONS Declines in MD with increasing age are present premenopausally, continue postmenopausally, and are most pronounced over the menopausal transition. These effects were highly consistent across diverse groups of women worldwide, suggesting that they result from an intrinsic biological, likely hormonal, mechanism common to women. If cumulative breast density is a key determinant of breast cancer risk, younger ages may be the more critical periods for lifestyle modifications aimed at breast density and breast cancer risk reduction.
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Affiliation(s)
- Anya Burton
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Gertraud Maskarinec
- University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
| | | | - Celine Vachon
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Hui Miao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Martín Lajous
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Megan Rice
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ana Pereira
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Maria Luisa Garmendia
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Rulla M. Tamimi
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Kimberly Bertrand
- Slone Epidemiology Center, Boston University, Boston, Massachusetts, United States of America
| | - Ava Kwong
- Division of Breast Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
- Department of Surgery and Cancer Genetics Center, Hong Kong Sanatorium and Hospital, Hong Kong, China
- Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong, China
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, United States of America
| | - Eunjung Lee
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, United States of America
| | - Samera A. Qureshi
- Norwegian Centre for Migrant and Minority Health (NAKMI), Oslo, Norway
| | - Huiyan Ma
- Department of Population Sciences, City of Hope National Medical Center, Duarte, California, United States of America
| | - Sarah Vinnicombe
- Division of Cancer Research, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Sue Moss
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Steve Allen
- Department of Diagnostic Radiology, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Rose Ndumia
- Aga Khan University Hospital, Nairobi, Kenya
| | | | - Soo-Hwang Teo
- Breast Cancer Research Group, University of Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | | | - Farhana Fadzli
- Breast Cancer Research Unit, Faculty of Medicine, University of Malaya Cancer Research Institute, University of Malaya, Kuala Lumpur, Malaysia
- Biomedical Imaging Department, University of Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Chisato Nagata
- Department of Epidemiology & Preventive Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Jennifer Stone
- Centre for Genetic Origins of Health and Disease, University of Western Australia, Crawley, Western Australia, Australia
| | - John Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Graham Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Vahit Ozmen
- Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Erkin Aribal
- Department of Radiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Carla H. Van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johanna O. P. Wanders
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Reza Sirous
- Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehri Sirous
- Radiology Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - John Hipwell
- Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Jisun Kim
- Asan Medical Center, Seoul, Republic of Korea
| | | | - Caroline Dickens
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mikael Hartman
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Surgery, Yong Loo Lin School of Medicine, Singapore
| | - Kee-Seng Chia
- Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore
| | - Christopher Scott
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Anna M. Chiarelli
- Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Linda Linton
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Marina Pollan
- Instituto de Salud Carlos III, Madrid, Spain
- CIBERESP, Madrid, Spain
| | - Anath Arzee Flugelman
- National Cancer Control Center, Lady Davis Carmel Medical Center, Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
| | - Dorria Salem
- Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals, Cairo, Egypt
| | - Rasha Kamal
- Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals, Cairo, Egypt
| | - Norman Boyd
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Isabel dos-Santos-Silva
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Valerie McCormack
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
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15
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Villanueva CM, Gracia-Lavedan E, Bosetti C, Righi E, Molina AJ, Martín V, Boldo E, Aragonés N, Perez-Gomez B, Pollan M, Acebo IG, Altzibar JM, Zabala AJ, Ardanaz E, Peiró R, Tardón A, Chirlaque MD, Tavani A, Polesel J, Serraino D, Pisa F, Castaño-Vinyals G, Espinosa A, Espejo-Herrera N, Palau M, Moreno V, La Vecchia C, Aggazzotti G, Nieuwenhuijsen MJ, Kogevinas M. Colorectal Cancer and Long-Term Exposure to Trihalomethanes in Drinking Water: A Multicenter Case-Control Study in Spain and Italy. Environ Health Perspect 2017; 125:56-65. [PMID: 27383820 PMCID: PMC5226692 DOI: 10.1289/ehp155] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 03/21/2016] [Accepted: 06/10/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Evidence on the association between colorectal cancer and exposure to disinfection by-products in drinking water is inconsistent. OBJECTIVES We assessed long-term exposure to trihalomethanes (THMs), the most prevalent group of chlorination by-products, to evaluate the association with colorectal cancer. METHODS A multicenter case-control study was conducted in Spain and Italy in 2008-2013. Hospital-based incident cases and population-based (Spain) and hospital-based (Italy) controls were interviewed to ascertain residential histories, type of water consumed in each residence, frequency and duration of showering/bathing, and major recognized risk factors for colorectal cancer. We estimated adjusted odds ratios (OR) for colorectal cancer in association with quartiles of estimated average lifetime THM concentrations in each participant's residential tap water (micrograms/liter; from age 18 to 2 years before the interview) and estimated average lifetime THM ingestion from drinking residential tap water (micrograms/day). RESULTS We analyzed 2,047 cases and 3,718 controls. Median values (ranges) for average lifetime residential tap water concentrations of total THMs, chloroform, and brominated THMs were 30 (0-174), 17 (0-63), and 9 (0-145) μg/L, respectively. Total THM concentration in residential tap water was not associated with colorectal cancer (OR = 0.92, 95% CI: 0.66, 1.28 for highest vs. lowest quartile), but chloroform concentrations were inversely associated (OR = 0.31, 95% CI: 0.24, 0.41 for highest vs. lowest quartile). Brominated THM concentrations showed a positive association among men in the highest versus the lowest quartile (OR = 1.43, 95% CI: 0.83, 2.46). Patterns of association were similar for estimated average THM ingestion through residential water consumption. CONCLUSIONS We did not find clear evidence of an association between detailed estimates of lifetime total THM exposure and colorectal cancer in our large case-control study population. Negative associations with chloroform concentrations and ingestion suggest differences among specific THMs, but these findings should be confirmed in other study populations. Citation: Villanueva CM, Gracia-Lavedan E, Bosetti C, Righi E, Molina AJ, Martín V, Boldo E, Aragonés N, Perez-Gomez B, Pollan M, Gomez Acebo I, Altzibar JM, Jiménez Zabala A, Ardanaz E, Peiró R, Tardón A, Chirlaque MD, Tavani A, Polesel J, Serraino D, Pisa F, Castaño-Vinyals G, Espinosa A, Espejo-Herrera N, Palau M, Moreno V, La Vecchia C, Aggazzotti G, Nieuwenhuijsen MJ, Kogevinas M. 2017. Colorectal cancer and long-term exposure to trihalomethanes in drinking water: a multicenter case---control study in Spain and Italy. Environ Health Perspect 125:56-65; http://dx.doi.org/10.1289/EHP155.
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Affiliation(s)
- Cristina M. Villanueva
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Address correspondence to C.M. Villanueva, Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader, 88, 08003 Barcelona, Spain. Telephone: 34 93 214 73 44. E-mail:
| | - Esther Gracia-Lavedan
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cristina Bosetti
- Department of Epidemiology, IRCCS (Istituto di Ricerche Farmacologiche Mario Negri), Milan, Italy
| | - Elena Righi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonio José Molina
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of León, León, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of León, León, Spain
| | - Elena Boldo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS (Instituto de Investigación Sanitaria) Puerta De Hierro, Madrid, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS (Instituto de Investigación Sanitaria) Puerta De Hierro, Madrid, Spain
| | - Beatriz Perez-Gomez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS (Instituto de Investigación Sanitaria) Puerta De Hierro, Madrid, Spain
| | - Marina Pollan
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS (Instituto de Investigación Sanitaria) Puerta De Hierro, Madrid, Spain
| | - Ines Gomez Acebo
- Department of Preventive Medicine and Public Health, University of Cantabria, Santander, Spain
- IDIVAL (Instituto de Investigación Sanitaria Valdecilla), Santander, Spain
- Centre for Research in Public Health, Valencia, Spain
| | - Jone M. Altzibar
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Ana Jiménez Zabala
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
| | - Rosana Peiró
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Research in Public Health, Valencia, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Oncology Institute IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Universidad de Oviedo, Asturias, Spain
| | - Maria Dolores Chirlaque
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca (Biomedical Research Institute of Murcia), Murcia, Spain
| | - Alessandra Tavani
- Department of Epidemiology, IRCCS (Istituto di Ricerche Farmacologiche Mario Negri), Milan, Italy
| | - Jerry Polesel
- Unit of Epidemiology and Biostatistics, CRO (Centro di Riferimento Oncologico) Aviano National Cancer Institute, IRCCS, Aviano, Italy
| | - Diego Serraino
- Unit of Epidemiology and Biostatistics, CRO (Centro di Riferimento Oncologico) Aviano National Cancer Institute, IRCCS, Aviano, Italy
| | - Federica Pisa
- Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy
- Department of Biological and Medical Sciences, University of Udine, Udine, Italy
| | - Gemma Castaño-Vinyals
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ana Espinosa
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Nadia Espejo-Herrera
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Margarita Palau
- General Division of Public Health, Quality and Innovation, Ministry of Health, Social Services and Equity, Madrid, Spain
| | - Victor Moreno
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Gabriella Aggazzotti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Mark J Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Manolis Kogevinas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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16
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Espejo-Herrera N, Gracia-Lavedan E, Pollan M, Aragonés N, Boldo E, Perez-Gomez B, Altzibar JM, Amiano P, Zabala AJ, Ardanaz E, Guevara M, Molina AJ, Barrio JP, Gómez-Acebo I, Tardón A, Peiró R, Chirlaque MD, Palau M, Muñoz M, Font-Ribera L, Castaño-Vinyals G, Kogevinas M, Villanueva CM. Ingested Nitrate and Breast Cancer in the Spanish Multicase-Control Study on Cancer (MCC-Spain). Environ Health Perspect 2016; 124:1042-9. [PMID: 26942716 PMCID: PMC4937871 DOI: 10.1289/ehp.1510334] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 10/19/2015] [Accepted: 02/22/2016] [Indexed: 05/15/2023]
Abstract
BACKGROUND Ingested nitrate leads to endogenous formation of N-nitroso compounds that are breast carcinogens in animals, but human evidence is limited. OBJECTIVE We evaluated ingested nitrate as a risk factor for breast cancer (BC) in a multicase-control study. METHODS Hospital-based incident BC cases and population-based controls were recruited in eight Spanish regions in 2008-2013; participants provided residential and water consumption from 18 years of age and information on known BC risk factors. Long-term nitrate levels (1940-2010) were estimated and linked with residential histories and water consumption to calculate waterborne ingested nitrate (milligrams/day). Dietary ingested nitrate (milligrams/day) was calculated using food frequency questionnaires and published dietary nitrate contents. Interactions with endogenous nitrosation factors and other variables were evaluated. A total of 1,245 cases and 1,520 controls were included in the statistical analysis. RESULTS Among the study regions, average ± SD waterborne ingested nitrate ranged from 2.9 ± 1.9 to 13.5 ± 7.5 mg/day, and dietary ingested nitrate ranged from 88.5 ± 48.7 to 154 ± 87.8 mg/day. Waterborne ingested nitrate was not associated with BC overall, but among postmenopausal women, those with both high nitrate (> 6 vs. < 2.6 mg/day) and high red meat intake (≥ 20 vs. < 20 g/day) were more likely to be cases than women with low nitrate and low red meat intake (adjusted odds ratio = 1.64; 95% confidence interval: 1.08, 2.49; overall interaction p-value = 0.17). No association was found with dietary nitrate. CONCLUSIONS Waterborne ingested nitrate was associated with BC only among postmenopausal women with high red meat consumption. Dietary nitrate was not associated with BC regardless of the animal or vegetable source or of menopausal status. CITATION Espejo-Herrera N, Gracia-Lavedan E, Pollan M, Aragonés N, Boldo E, Perez-Gomez B, Altzibar JM, Amiano P, Zabala AJ, Ardanaz E, Guevara M, Molina AJ, Barrio JP, Gómez-Acebo I, Tardón A, Peiró R, Chirlaque MD, Palau M, Muñoz M, Font-Ribera L, Castaño-Vinyals G, Kogevinas M, Villanueva CM. 2016. Ingested nitrate and breast cancer in the Spanish Multicase-Control Study on Cancer (MCC-Spain). Environ Health Perspect 124:1042-1049; http://dx.doi.org/10.1289/ehp.1510334.
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Affiliation(s)
- Nadia Espejo-Herrera
- ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Esther Gracia-Lavedan
- ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marina Pollan
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, Instituto de Investigación Sanitaria (IIS) Puerta De Hierro, Madrid, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, Instituto de Investigación Sanitaria (IIS) Puerta De Hierro, Madrid, Spain
| | - Elena Boldo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, Instituto de Investigación Sanitaria (IIS) Puerta De Hierro, Madrid, Spain
| | - Beatriz Perez-Gomez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, Instituto de Investigación Sanitaria (IIS) Puerta De Hierro, Madrid, Spain
| | - Jone M. Altzibar
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Ana Jiménez Zabala
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Marcela Guevara
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Antonio J. Molina
- Research Group in Gene–Environment–Health Interactions (GIIGAS), University of Leon, León, Spain
| | - Juan Pablo Barrio
- Research Group in Gene–Environment–Health Interactions (GIIGAS), University of Leon, León, Spain
| | - Ines Gómez-Acebo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IDIVAL (Valdecilla Institute of Research), University of Cantabria, Santander, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Oncology Institute IUOPA (Institute of Oncology of Asturias), Universidad de Oviedo, Asturias, Spain
| | - Rosana Peiró
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centre for Research in Public Health, Valencia, Spain
| | - Maria Dolores Chirlaque
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Health Council, IMIB-Arrixaca, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Margarita Palau
- Division of Public Health Quality and Innovation, Health Ministry of Spain, Madrid, Spain
| | - Montse Muñoz
- Translational Genomics and Targeted Therapeutics in Solid Tumors (IDIBAPS), Hospital Clinic, Barcelona, Spain
| | - Laia Font-Ribera
- ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Manolis Kogevinas
- ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Cristina M. Villanueva
- ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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17
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Cimas M, Gullon P, Aguilera E, Meyer S, Freire JM, Perez-Gomez B. Healthcare coverage for undocumented migrants in Spain: Regional differences after Royal Decree Law 16/2012. Health Policy 2016; 120:384-95. [PMID: 26948703 DOI: 10.1016/j.healthpol.2016.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 02/03/2016] [Accepted: 02/07/2016] [Indexed: 12/25/2022]
Abstract
The economic crisis has prompted the debate on how to regulate health coverage of undocumented migrants in publicly funded healthcare systems. Spain, as one of the most heavily affected countries in Europe, can be considered a case of particular interest. In 2012 the Spanish Government issued a Royal Decree Law (RDL 16/2012) which revoked their previous full right to public healthcare coverage, now limited for some exceptions. However, the Spanish National Health System is highly decentralized, and this Central Government decree had to be implemented by the Regional Health Authorities. Our aim is to compare regional policies regarding entitlement to healthcare for undocumented migrants after RDL 16/2012 in the 17 Autonomous Regions by performing an exhaustive review of the regional health policy regulations published after the enactment of RDL 16/2012. Our analysis shows that many Regions adopted legal, legislative and administrative actions to void or limit its effects, while others applied it as intended, resulting in huge differences in healthcare coverage for irregular migrants among Spanish Regions. The unequal implementation of this Law constitutes a paradigmatic example of the complexity of nation-wide regulation of controversial key issues in decentralized health systems. In addition, our results highlight that within-country differences in access and/or entitlement can be as relevant as those reported among-country when there is healthcare decentralization.
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Affiliation(s)
- Marta Cimas
- Preventive & Public Health Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Pedro Gullon
- Preventive & Public Health Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain; Social and Cardiovascular Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Spain.
| | | | | | - José Manuel Freire
- Preventive & Public Health Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Beatriz Perez-Gomez
- Preventive & Public Health Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain; Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; CIBERESP, Madrid, Spain; Puerta de Hierro Hospital Research Institute, Madrid, Spain
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18
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McCormack VA, Burton A, dos-Santos-Silva I, Hipwell JH, Dickens C, Salem D, Kamal R, Hartman M, Lee CPL, Chia KS, Ozmen V, Aribal ME, Flugelman AA, Lajous M, Lopez-Riduara R, Rice M, Romieu I, Ursin G, Qureshi S, Ma H, Lee E, van Gils CH, Wanders JOP, Vinayak S, Ndumia R, Allen S, Vinnicombe S, Moss S, Won Lee J, Kim J, Pereira A, Garmendia ML, Sirous R, Sirous M, Peplonska B, Bukowska A, Tamimi RM, Bertrand K, Nagata C, Kwong A, Vachon C, Scott C, Perez-Gomez B, Pollan M, Maskarinec G, Giles G, Hopper J, Stone J, Rajaram N, Teo SH, Mariapun S, Yaffe MJ, Schüz J, Chiarelli AM, Linton L, Boyd NF. International Consortium on Mammographic Density: Methodology and population diversity captured across 22 countries. Cancer Epidemiol 2016; 40:141-51. [PMID: 26724463 PMCID: PMC4738079 DOI: 10.1016/j.canep.2015.11.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/12/2015] [Accepted: 11/30/2015] [Indexed: 12/31/2022]
Abstract
Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk. The population-based epidemiology of MD has revealed genetic, lifestyle and societal/environmental determinants, but studies have largely been conducted in women with similar westernized lifestyles living in countries with high breast cancer incidence rates. To benefit from the heterogeneity in risk factors and their combinations worldwide, we created an International Consortium on Mammographic Density (ICMD) to pool individual-level epidemiological and MD data from general population studies worldwide. ICMD aims to characterize determinants of MD more precisely, and to evaluate whether they are consistent across populations worldwide. We included 11755 women, from 27 studies in 22 countries, on whom individual-level risk factor data were pooled and original mammographic images were re-read for ICMD to obtain standardized comparable MD data. In the present article, we present (i) the rationale for this consortium; (ii) characteristics of the studies and women included; and (iii) study methodology to obtain comparable MD data from original re-read films. We also highlight the risk factor heterogeneity captured by such an effort and, thus, the unique insight the pooled study promises to offer through wider exposure ranges, different confounding structures and enhanced power for sub-group analyses.
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Affiliation(s)
- Valerie A McCormack
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France.
| | - Anya Burton
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Isabel dos-Santos-Silva
- Dept of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - John H Hipwell
- Centre for Medical Image Computing, University College London, UK
| | | | | | - Rasha Kamal
- Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals, Cairo, Egypt
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine and Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Charmaine Pei Ling Lee
- Department of Surgery, Yong Loo Lin School of Medicine and Saw Swee Hock School of Public Health, National University of Singapore, Singapore; NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore
| | - Kee-Seng Chia
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore
| | | | | | | | - Martín Lajous
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA; Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico, Mexico City, Mexico
| | - Ruy Lopez-Riduara
- Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico, Mexico City, Mexico
| | - Megan Rice
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Isabelle Romieu
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway; Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Samera Qureshi
- Norwegian Center for Minority Health Research (NAKMI), Oslo, Norway
| | - Huiyan Ma
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, USA
| | - Eunjung Lee
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Carla H van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Johanna O P Wanders
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | | | - Rose Ndumia
- Aga Khan University Hospital, Nairobi, Kenya
| | - Steve Allen
- Department of Imaging, Royal Marsden NHS Foundation Trust, London, UK
| | - Sarah Vinnicombe
- Division of Cancer Research, Ninewells Hospital & Medical School, Dundee, UK
| | - Sue Moss
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
| | | | - Jisun Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - Ana Pereira
- Institute of Nutrition and Food Technology, University of Chile, Chile
| | | | - Reza Sirous
- Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehri Sirous
- Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | | | | | - Ava Kwong
- Division of Breast Surgery, The University of Hong Kong Faculty of Medicine, and Department of Surgery, Hong Kong Sanatorium and Hospital, Hong Kong, People's Republic of China
| | - Celine Vachon
- Dept Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Christopher Scott
- Dept Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Beatriz Perez-Gomez
- Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid, Spain
| | - Marina Pollan
- Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid, Spain
| | | | - Graham Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia; School of Population and Global Health, The University of Melbourne, Australia
| | - John Hopper
- School of Population and Global Health, The University of Melbourne, Australia
| | - Jennifer Stone
- Centre for Genetic Origins of Health and Disease, University of Western Australia, Australia
| | - Nadia Rajaram
- Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
| | - Soo-Hwang Teo
- Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia; Cancer Research Malaysia, Subang Jaya, Malaysia
| | - Shivaani Mariapun
- Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia
| | | | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Anna M Chiarelli
- Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Canada
| | - Linda Linton
- Princess Margaret Cancer Centre, Toronto, Canada
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19
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Fernández-Rodríguez M, Arrebola JP, Artacho-Cordón F, Amaya E, Aragones N, Llorca J, Perez-Gomez B, Ardanaz E, Kogevinas M, Castano-Vinyals G, Pollan M, Olea N. Levels and predictors of persistent organic pollutants in an adult population from four Spanish regions. Sci Total Environ 2015; 538:152-61. [PMID: 26298258 DOI: 10.1016/j.scitotenv.2015.07.162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 07/31/2015] [Accepted: 07/31/2015] [Indexed: 05/26/2023]
Abstract
This research aimed to assess serum concentrations of a group of persistent organic pollutants (POPs) in a sample of adults recruited in four different regions from Spain and to assess socio-demographic, dietary, and lifestyle predictors of the exposure. The study population comprised 312 healthy adults selected from among controls recruited in the MCC-Spain multicase-control study. Study variables were collected using standardized questionnaires, and pollutants were analyzed by means of gas chromatography with electron capture detection. Multivariable analyses were performed to identify predictors of log-transformed pollutant concentrations, using combined backward and forward stepwise multiple linear regression models. Detection rates ranged from 89.1% (hexachlorobenzene, HCB) to 93.6% (Polychlorinated biphenyl-153 [PCB-153]); p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) showed the highest median concentrations (1.04ng/ml), while HCB showed the lowest (0.24ng/ml). In the multivariable models, age was positively associated with HCB, p,p'-DDE, and PCB-180. BMI was associated positively with p,p'-DDE but negatively with PCB-138. Total accumulated time residing in an urban area was positively associated with PCB-153 concentrations. The women showed higher HCB and lower p,p'-DDE concentrations versus the men. Notably, POP exposure in our study population was inversely associated with the breastfeeding received by participants and with the number of pregnancies of their mothers but was not related to the participants' history of breastfeeding their children or parity. Smoking was negatively associated with HCB and PCB-153 concentrations. Consumption of fatty foods, including blue fish, was in general positively associated with POP levels. Although POP environmental levels are declining worldwide, there is a need for the continuous monitoring of human exposure in the general population. The results of the present study confirm previous findings and point to novel predictors of long-term exposure to persistent organic pollutants.
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Affiliation(s)
- M Fernández-Rodríguez
- Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, San Cecilio University Hospital, Granada, Spain.
| | - J P Arrebola
- Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, San Cecilio University Hospital, Granada, Spain; Oncology Unit, Virgen de las Nieves University Hospital, Granada, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - F Artacho-Cordón
- Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, San Cecilio University Hospital, Granada, Spain
| | - E Amaya
- Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, San Cecilio University Hospital, Granada, Spain
| | - N Aragones
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Majadahonda, Madrid, Spain
| | - J Llorca
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universidad de Cantabria-IDIVAL, Santander, Spain
| | - B Perez-Gomez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Majadahonda, Madrid, Spain
| | - E Ardanaz
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA) Pamplona, Spain
| | - M Kogevinas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - G Castano-Vinyals
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - M Pollan
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Majadahonda, Madrid, Spain
| | - N Olea
- Instituto de Investigación Biosanitaria ibs.Granada, University of Granada, San Cecilio University Hospital, Granada, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Burton A, Silva IDS, Hipwell J, Flugelman A, Kwong A, Peplonska B, Tamimi RM, Bertrand K, Vachon C, Hartman M, Lee CPL, Chia KS, Nagata C, Salem D, Sirous R, Maskarinec G, Ursin G, Dickens C, Lee JW, Kim J, Giles G, Krishnan K, Pereira A, Garmendia ML, Perez-Gomez B, Pollan M, Lajous M, Rice M, Van Gils C, Wanders H, Teo S, Mariapun S, Vinayak S, Ndumia R, Ozmen V, Stone J, Hopper J, Boyd N, McCormack V. PP01 International pooling project of mammographic density - insights of a marker of breast cancer risk from 22 diverse countries. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pollán M, Castello A, Ruiz A, Casas A, Baena-Cañada JM, Lope V, Antolín S, Ramos Vazquez M, Munoz-Mateu M, Lluch A, De Juan A, Jara-Sanchez C, Jimeno MA, Rosado P, Diaz Pena E, Guillem V, Carrasco EM, Perez-Gomez B, Vioque J, Martin M. Breast cancer risk among women following lifestyle recommendations: A case-control study in Spain. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Marina Pollán
- National Center of Epidemiology, Instituto Salud Carlos III, Madrid, Spain
| | - Adela Castello
- Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo Ruiz
- Instituto Valenciano de Oncología, Valencia, Spain
| | - Ana Casas
- Hospital Universitario Virgen Del Rocio, Sevilla, Spain
| | | | | | - Silvia Antolín
- Medical Oncology, Complejo Hospitalario Universitario a Coruña, A Coruña, Spain
| | | | | | - Ana Lluch
- Hospital Clínico de Valencia - INCLIVA Health Research Institute, University of Valencia., Valencia, Spain
| | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | | | | | | | | | | | - Beatriz Perez-Gomez
- Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Jesus Vioque
- Department of Public Health, Universidad Miguel Hernandez, Sant Joan D'Alacant, Spain
| | - Miguel Martin
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Costas L, Papadopoulou E, Perez-Gomez B, Basagaña X, Alarcon F, Casabonne D, Benavente Y, Castaño-Vinyals G, Kogevinas M, de Sanjosé S. Reliability of 2D:4D measurements using a direct method suitable for clinical settings. Personality and Individual Differences 2013. [DOI: 10.1016/j.paid.2013.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Esteban-Vasallo MD, Aragonés N, Pollan M, López-Abente G, Perez-Gomez B. Human placenta and markers of heavy metals exposure: Esteban-Vasallo et al. Respond. Environ Health Perspect 2013; 121:A10-A11. [PMID: 23287489 PMCID: PMC3553445 DOI: 10.1289/ehp.1206061r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- María D. Esteban-Vasallo
- Subdirectorate for Health Promotion and Prevention, Madrid Regional Health Authority, Madrid, Spain
| | - Nuria Aragonés
- National Center for Epidemiology/CIBERESP, Carlos III Institute of Health, Madrid, Spain, E-mail:
| | - Marina Pollan
- National Center for Epidemiology/CIBERESP, Carlos III Institute of Health, Madrid, Spain, E-mail:
| | - Gonzalo López-Abente
- National Center for Epidemiology/CIBERESP, Carlos III Institute of Health, Madrid, Spain, E-mail:
| | - Beatriz Perez-Gomez
- National Center for Epidemiology/CIBERESP, Carlos III Institute of Health, Madrid, Spain, E-mail:
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Esteban-Vasallo MD, Aragonés N, Pollan M, López-Abente G, Perez-Gomez B. Mercury, cadmium, and lead levels in human placenta: a systematic review. Environ Health Perspect 2012; 120:1369-77. [PMID: 22591711 PMCID: PMC3491942 DOI: 10.1289/ehp.1204952] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 05/16/2012] [Indexed: 05/18/2023]
Abstract
BACKGROUND Placental tissue may furnish information on the exposure of both mother and fetus. Mercury (Hg), cadmium (Cd), and lead (Pb) are toxicants of interest in pregnancy because they are associated with alterations in child development. OBJECTIVES The aim of this study was to summarize the available information regarding total Hg, Cd, and Pb levels in human placenta and possible related factors. METHODS We performed a systematic search of PubMed/MEDLINE, EMBASE, Lilacs, OSH, and Web of Science for original papers on total Hg, Cd, or Pb levels in human placenta that were published in English or Spanish (1976-2011). Data on study design, population characteristics, collection and analysis of placenta specimens, and main results were extracted using a standardized form. RESULTS We found a total of 79 papers (73 different studies). Hg, Cd, and Pb levels were reported in 24, 46, and 46 studies, respectively. Most studies included small convenience samples of healthy pregnant women. Studies were heterogeneous regarding populations selected, processing of specimens, and presentation of results. Hg concentrations > 50 ng/g were found in China (Shanghai), Japan, and the Faroe Islands. Cd levels ranged from 1.2 ng/g to 53 ng/g and were highest in the United States, Japan, and Eastern Europe. Pb showed the greatest variability, with levels ranging from 1.18 ng/g in China (Shanghai) to 500 ng/g in a polluted area of Poland. CONCLUSION The use of the placenta as a biomarker to assess heavy metals exposure is not properly developed because of heterogeneity among the studies. International standardized protocols are needed to enhance comparability and increase the usefulness of this promising tissue in biomonitoring studies.
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Affiliation(s)
- María D Esteban-Vasallo
- Subdirectorate for Health Promotion and Prevention, Madrid Regional Health Authority, Madrid, Spain
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Lopez-Abente G, Aragones N, Ramis R, Hernandez-Barrera V, Perez-Gomez B, Escolar-Pujolar A, Pollan M. Municipal distribution of bladder cancer mortality in Spain: possible role of mining and industry. BMC Public Health 2006; 6:17. [PMID: 16438735 PMCID: PMC1409784 DOI: 10.1186/1471-2458-6-17] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2005] [Accepted: 01/27/2006] [Indexed: 12/04/2022] Open
Abstract
Background Spain shows the highest bladder cancer incidence rates in men among European countries. The most important risk factors are tobacco smoking and occupational exposure to a range of different chemical substances, such as aromatic amines. Methods This paper describes the municipal distribution of bladder cancer mortality and attempts to "adjust" this spatial pattern for the prevalence of smokers, using the autoregressive spatial model proposed by Besag, York and Molliè, with relative risk of lung cancer mortality as a surrogate. Results It has been possible to compile and ascertain the posterior distribution of relative risk for bladder cancer adjusted for lung cancer mortality, on the basis of a single Bayesian spatial model covering all of Spain's 8077 towns. Maps were plotted depicting smoothed relative risk (RR) estimates, and the distribution of the posterior probability of RR>1 by sex. Towns that registered the highest relative risks for both sexes were mostly located in the Provinces of Cadiz, Seville, Huelva, Barcelona and Almería. The highest-risk area in Barcelona Province corresponded to very specific municipal areas in the Bages district, e.g., Suría, Sallent, Balsareny, Manresa and Cardona. Conclusion Mining/industrial pollution and the risk entailed in certain occupational exposures could in part be dictating the pattern of municipal bladder cancer mortality in Spain. Population exposure to arsenic is a matter that calls for attention. It would be of great interest if the relationship between the chemical quality of drinking water and the frequency of bladder cancer could be studied.
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Affiliation(s)
- Gonzalo Lopez-Abente
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Nuria Aragones
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Rebeca Ramis
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Valentin Hernandez-Barrera
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Beatriz Perez-Gomez
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | | | - Marina Pollan
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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Perez-Gomez B, Pollán M, Gustavsson P, Plato N, Aragonés N, López-Abente G. Cutaneous melanoma: hints from occupational risks by anatomic site in Swedish men. Occup Environ Med 2004; 61:117-26. [PMID: 14739377 PMCID: PMC1740709 DOI: 10.1136/oem.2002.006320] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To improve knowledge of the epidemiology of melanoma by comparing occupational risks of cutaneous melanoma (CM) by anatomic site in Swedish workers. METHODS Male workers employed in 1970 and living in the country in 1960 were followed up from 1971 to 1989 using the Swedish Registers of Death and Cancer. A more specifically exposed subcohort included men reporting the same occupation in 1960 and 1970. For each location, occupational risk ratios (RRs) were extracted from Poisson regression models adjusted by age, period, town size, and geographical area. To diminish the influence of socioeconomic factors, intrasector analyses, comparing only jobs belonging to the same occupational sector, were performed. Risk patterns for different locations were compared. RESULTS High RRs for different sites were found among workers exposed to UV sources (dentists, physiotherapists, and lithographers), and sun exposed workers (harbour masters, and lighthouse/related work). Risk excesses were seen in fur tailors, tanners/fur dressers, patternmakers/cutters, electrical fitters/wiremen, telephone/telegraph installers/repairmen, and some glass/pottery/tile workers. Results for lower and upper limbs were significantly correlated but somewhat independent of those found in thorax, the most frequent location. Correlation between head/neck and thorax was moderate. Specific risk excesses were found for rolling mill workers in head/neck, for chimney sweeps in upper limbs, and for aircraft pilots/navigators/flight engineers in lower limbs. CONCLUSIONS High RRs in the trunk among occupations with UV exposure from artificial sources suggest an effect not restricted to exposed sites. An unusual distribution of cases and RRs in chimney sweeps, rolling-mill, or glass/pottery/tile workers suggests local effects of exposures. The not previously reported risk excess in this job and in fur related processes, and the RR in electrical fitters and telephone/telegraph installers deserve further investigation. Disparities between locations, as RRs in thorax and limbs, may reflect differences in aetiological mechanisms.
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Affiliation(s)
- B Perez-Gomez
- Cancer and Environmental Epidemiology Area, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
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