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Ferro A, Costa AR, Morais S, Bertuccio P, Rota M, Pelucchi C, Hu J, Johnson KC, Zhang ZF, Palli D, Ferraroni M, Yu GP, Bonzi R, Peleteiro B, López-Carrillo L, Tsugane S, Hamada GS, Hidaka A, Malekzadeh R, Zaridze D, Maximovitch D, Vioque J, Navarrete-Munoz EM, Alguacil J, Castaño-Vinyals G, Wolk A, Håkansson N, Hernández-Ramírez RU, Pakseresht M, Ward MH, Pourfarzi F, Mu L, López-Cervantes M, Persiani R, Kurtz RC, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, Camargo MC, Curado MP, La Vecchia C, Lunet N. Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project. Int J Cancer 2020; 147:3090-3101. [PMID: 32525569 PMCID: PMC8545605 DOI: 10.1002/ijc.33134] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 10/19/2019] [Revised: 03/20/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022]
Abstract
A low intake of fruits and vegetables is a risk factor for gastric cancer, although there is uncertainty regarding the magnitude of the associations. In our study, the relationship between fruits and vegetables intake and gastric cancer was assessed, complementing a previous work on the association betweenconsumption of citrus fruits and gastric cancer. Data from 25 studies (8456 cases and 21 133 controls) with information on fruits and/or vegetables intake were used. A two-stage approach based on random-effects models was used to pool study-specific adjusted (sex, age and the main known risk factors for gastric cancer) odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Exposure-response relations, including linear and nonlinear associations, were modeled using one- and two-order fractional polynomials. Gastric cancer risk was lower for a higher intake of fruits (OR: 0.76, 95% CI: 0.64-0.90), noncitrus fruits (OR: 0.86, 95% CI: 0.73-1.02), vegetables (OR: 0.68, 95% CI: 0.56-0.84), and fruits and vegetables (OR: 0.61, 95% CI: 0.49-0.75); results were consistent across sociodemographic and lifestyles categories, as well as study characteristics. Exposure-response analyses showed an increasingly protective effect of portions/day of fruits (OR: 0.64, 95% CI: 0.57-0.73 for six portions), noncitrus fruits (OR: 0.71, 95% CI: 0.61-0.83 for six portions) and vegetables (OR: 0.51, 95% CI: 0.43-0.60 for 10 portions). A protective effect of all fruits, noncitrus fruits and vegetables was confirmed, supporting further dietary recommendations to decrease the burden of gastric cancer.
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Affiliation(s)
- Ana Ferro
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Ana Rute Costa
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Samantha Morais
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Matteo Rota
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Kenneth C. Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson, Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network – ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Bárbara Peleteiro
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Eva M. Navarrete-Munoz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (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
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
- Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
| | - Mary H. Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | | | - Roberto Persiani
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Roma, Italia
- Università Cattolica del Sacro Cuore, Dipartimento di Chirurgia, Roma, Italia
| | - Robert C. Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stefania Boccia
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - M. Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brasil
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Nuno Lunet
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Shah SC, Boffetta P, Johnson KC, Hu J, Palli D, Ferraroni M, Tsugane S, Hamada GS, Hidaka A, Zaridze D, Maximovich D, Vioque J, Navarrete-Munoz EM, Zhang ZF, Mu L, Boccia S, Pastorino R, Kurtz RC, Rota M, Bonzi R, Negri E, La Vecchia C, Pelucchi C, Hashim D. Occupational exposures and odds of gastric cancer: a StoP project consortium pooled analysis. Int J Epidemiol 2020; 49:422-434. [PMID: 31965145 PMCID: PMC10507679 DOI: 10.1093/ije/dyz263] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 12/02/2019] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Gastric cancer pathogenesis represents a complex interaction of host genetic determinants, microbial virulence factors and environmental exposures. Our primary aim was to determine the association between occupations/occupational exposures and odds of gastric cancer. METHODS We conducted a pooled-analysis of individual-level data harmonized from 11 studies in the Stomach cancer Pooling Project. Multivariable logistic regression was used to estimate the odds ratio (OR) of gastric cancer adjusted for relevant confounders. RESULTS A total of 5279 gastric cancer cases and 12 297 controls were analysed. There were higher odds of gastric cancer among labour-related occupations, including: agricultural and animal husbandry workers [odds ratio (OR) 1.33, 95% confidence interval (CI): 1.06-1.68]; miners, quarrymen, well-drillers and related workers (OR 1.70, 95% CI: 1.01-2.88); blacksmiths, toolmakers and machine-tool operators (OR 1.41, 95% CI: 1.05-1.89); bricklayers, carpenters and construction workers (OR 1.30, 95% CI: 1.06-1.60); and stationary engine and related equipment operators (OR 6.53, 95% CI: 1.41-30.19). The ORs for wood-dust exposure were 1.51 (95% CI: 1.01-2.26) for intestinal-type and 2.52 (95% CI: 1.46-4.33) for diffuse-type gastric cancer. Corresponding values for aromatic amine exposure were 1.83 (95% CI: 1.09-3.06) and 2.92 (95% CI: 1.36-6.26). Exposure to coal derivatives, pesticides/herbicides, chromium, radiation and magnetic fields were associated with higher odds of diffuse-type, but not intestinal-type gastric cancer. CONCLUSIONS Based on a large pooled analysis, we identified several occupations and related exposures that are associated with elevated odds of gastric cancer. These findings have potential implications for risk attenuation and could be used to direct investigations evaluating the impact of targeted gastric cancer prevention/early detection programmes based on occupation.
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Affiliation(s)
- Shailja C Shah
- Gastroenterology, Hepatology and Nutrition, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Paolo Boffetta
- Tisch Cancer Institute, Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth C Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovich
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Jesus Vioque
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Campus San Juan, Alicante, Spain
| | - Eva M Navarrete-Munoz
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Campus San Juan, Alicante, Spain
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Stefania Boccia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Roberta Pastorino
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Matteo Rota
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Dana Hashim
- Tisch Cancer Institute, Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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3
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Ferro A, Rosato V, Rota M, Costa AR, Morais S, Pelucchi C, Johnson KC, Hu J, Palli D, Ferraroni M, Zhang ZF, Bonzi R, Yu GP, Peleteiro B, López-Carrillo L, Tsugane S, Hamada GS, Hidaka A, Zaridze D, Maximovitch D, Vioque J, Navarrete-Munoz EM, Aragonés N, Martín V, Hernández-Ramírez RU, Bertuccio P, Ward MH, Malekzadeh R, Pourfarzi F, Mu L, López-Cervantes M, Persiani R, Kurtz RC, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, Camargo MC, Curado MP, La Vecchia C, Lunet N. Meat intake and risk of gastric cancer in the Stomach cancer Pooling (StoP) project. Int J Cancer 2019; 147:45-55. [PMID: 31584199 DOI: 10.1002/ijc.32707] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [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: 03/19/2019] [Revised: 07/17/2019] [Accepted: 07/23/2019] [Indexed: 12/12/2022]
Abstract
The consumption of processed meat has been associated with noncardia gastric cancer, but evidence regarding a possible role of red meat is more limited. Our study aims to quantify the association between meat consumption, namely white, red and processed meat, and the risk of gastric cancer, through individual participant data meta-analysis of studies participating in the "Stomach cancer Pooling (StoP) Project". Data from 22 studies, including 11,443 cases and 28,029 controls, were used. Study-specific odds ratios (ORs) were pooled through a two-stage approach based on random-effects models. An exposure-response relationship was modeled, using one and two-order fractional polynomials, to evaluate the possible nonlinear association between meat intake and gastric cancer. An increased risk of gastric cancer was observed for the consumption of all types of meat (highest vs. lowest tertile), which was statistically significant for red (OR: 1.24; 95% CI: 1.00-1.53), processed (OR: 1.23; 95% CI: 1.06-1.43) and total meat (OR: 1.30; 95% CI: 1.09-1.55). Exposure-response analyses showed an increasing risk of gastric cancer with increasing consumption of both processed and red meat, with the highest OR being observed for an intake of 150 g/day of red meat (OR: 1.85; 95% CI: 1.56-2.20). This work provides robust evidence on the relation between the consumption of different types of meat and gastric cancer. Adherence to dietary recommendations to reduce meat consumption may contribute to a reduction in the burden of gastric cancer.
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Affiliation(s)
- Ana Ferro
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Valentina Rosato
- Unit of Medical Statistics, Biometry and Bioinformatics, National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - Matteo Rota
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Ana Rute Costa
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Kenneth C Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Zuo-Feng Zhang
- Department of Epidemiology, Comprehensive Cancer Center, UCLA Fielding School of Public Health and Jonsson, Los Angeles, CA
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Bárbara Peleteiro
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Eva M Navarrete-Munoz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, 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
| | - Vicente Martín
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Research Group in Gene-Environment Interactions and Health, University of León, León, Spain
| | - Raúl Ulisses Hernández-Ramírez
- Mexico National Institute of Public Health, Morelos, Mexico.,Department of Biostatistics, Yale School of Medicine, Yale School of Public Health, New Haven, CT
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.,Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | | | - Roberto Persiani
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Rome, Italy.,Dipartimento di Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY
| | - Areti Lagiou
- Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Paolo Boffetta
- Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stefania Boccia
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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