201 research outputs found
Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies
Objective To investigate the association between intake of dietary fibre and whole grains and risk of colorectal cancer
Circulating lipoprotein (a) and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis.
AIMS
To investigate the association between circulating lipoprotein(a) (Lp(a)) and risk of all-cause and cause-specific mortality in the general population and in patients with chronic diseases, and to elucidate the dose-response relations.
METHODS AND RESULTS
We searched literature to find prospective studies reporting adjusted risk estimates on the association of Lp(a) and mortality outcomes. Forty-three publications, reporting on 75 studies (957,253 participants), were included. The hazard ratios (HRs) and 95% confidence intervals (95%CI ) for the top versus bottom tertile of Lp(a) levels and risk of all-cause mortality were 1.09 (95%CI: 1.01-1.18, I2: 75.34%, nâ=â19) in the general population and 1.18 (95%CI: 1.04-1.34, I2: 52.5%, nâ=â12) in patients with cardiovascular diseases (CVD). The HRs for CVD mortality were 1.33 (95%CI: 1.11-1.58, I2: 82.8%, nâ=â31) in the general population, 1.25 (95%CI: 1.10-1.43, I2: 54.3%, nâ=â17) in patients with CVD and 2.53 (95%CI: 1.13-5.64, I2: 66%, nâ=â4) in patients with diabetes mellitus. Linear dose-response analyses revealed that each 50Â mg/dL increase in Lp(a) levels was associated with 31% and 15% greater risk of CVD death in the general population and in patients with CVD. No non-linear dose-response association was observed between Lp(a) levels and risk of all-cause or CVD mortality in the general population or in patients with CVD (Pnonlinearity > 0.05).
CONCLUSION
This study provides further evidence that higher Lp(a) levels are associated with higher risk of all-cause mortality and CVD-death in the general population and in patients with CVD. These findings support the ESC/EAS Guidelines that recommend Lp(a) should be measured at least once in each adult person's lifetime, since our study suggests those with higher Lp(a) might also have higher risk of mortality
Circulating free insulin-like growth factor-I and prostate cancer: a case-control study nested in the European prospective investigation into cancer and nutrition
Background: Circulating total insulin-like growth factor-I (IGF-I) is an established risk factor for prostate cancer. However, only a small proportion of circulating IGF-I is free or readily dissociable from IGF-binding proteins (its bioavailable form), and few studies have investigated the association of circulating free IGF-I with prostate cancer risk. Methods: We analyzed data from 767 prostate cancer cases and 767 matched controls nested within the European Prospective Investigation into Cancer and Nutrition cohort, with an average of 14-years (interquartile range = 2.9) follow-up. Matching variables were study center, length of follow-up, age, and time of day and fasting duration at blood collection. Circulating free IGF-I concentration was measured in serum samples collected at recruitment visit (mean age 55 years old; standard deviation = 7.1) using an enzyme-linked immunosorbent assay (ELISA). Conditional logistic regressions were performed to examine the associations of free IGF-I with risk of prostate cancer overall and subdivided by time to diagnosis (⤠14 and > 14 years), and tumor characteristics. Results: Circulating free IGF-I concentrations (in fourths and as a continuous variable) were not associated with prostate cancer risk overall (odds ratio [OR] = 1.00 per 0.1 nmol/L increment, 95% CI: 0.99, 1.02) or by time to diagnosis, or with prostate cancer subtypes, including tumor stage and histological grade. Conclusions: Estimated circulating free IGF-I was not associated with prostate cancer risk. Further research may consider other assay methods that estimate bioavailable IGF-I to provide more insight into the well-substantiated association between circulating total IGF-I and subsequent prostate cancer risk
Postâdiagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme ( CUP Global) systematic literature review and metaâanalysis
The adiposity influence on colorectal cancer prognosis remains poorly characterised. We performed a systematic review and metaâanalysis on postâdiagnosis adiposity measures (body mass index [BMI], waist circumference, waistâtoâhip ratio, weight) or their changes and colorectal cancer outcomes. PubMed and Embase were searched through 28 February 2022. Randomâeffects metaâanalyses were conducted when at least three studies had sufficient information. The quality of evidence was interpreted and graded by the Global Cancer Update Programme (CUP Global) independent Expert Committee on Cancer Survivorship and Expert Panel. We reviewed 124 observational studies (85 publications). Metaâanalyses were possible for BMI and allâcause mortality, colorectal cancerâspecific mortality, and cancer recurrence/diseaseâfree survival. Nonâlinear metaâanalysis indicated a reverse Jâshaped association between BMI and colorectal cancer outcomes (nadir at BMI 28 kg/m2). The highest risk, relative to the nadir, was observed at both ends of the BMI distribution (18 and 38 kg/m2), namely 60% and 23% higher risk for allâcause mortality; 95% and 26% for colorectal cancerâspecific mortality; and 37% and 24% for cancer recurrence/diseaseâfree survival, respectively. The higher risk with low BMI was attenuated in secondary analyses of RCTs (compared to cohort studies), among studies with longer followâup, and in women suggesting potential methodological limitations and/or altered physiological state. Descriptively synthesised studies on other adiposityâoutcome associations of interest were limited in number and methodological quality. All the associations were graded as limited (likelihood of causality: no conclusion) due to potential methodological limitations (reverse causation, confounding, selection bias). Additional wellâdesigned observational studies and interventional trials are needed to provide further clarification
Postâdiagnosis adiposity, physical activity, sedentary behaviour, dietary factors, supplement use and colorectal cancer prognosis: Global Cancer Update Programme ( CUP Global) summary of evidence grading
Based on the World Cancer Research Fund Global Cancer Update Programme, we performed systematic reviews and metaâanalyses to investigate the association of postâdiagnosis adiposity, physical activity, sedentary behaviour, and dietary factors with colorectal cancer prognosis. We searched PubMed and Embase until 28th February, 2022. An independent expert committee and expert panel graded the quality of evidence. A total of 167 unique publications were reviewed, and all but five were observational studies. The quality of the evidence was graded conservatively due to the high risk of several biases. There was evidence of nonâlinearity in the associations between body mass index and colorectal cancer prognosis. The associations appeared reverse Jâshaped, and the quality of this evidence was graded as limited (likelihood of causality: limitedâno conclusion). The evidence on recreational physical activity and lower risk of allâcause mortality (relative risk [RR] highest vs. lowest: 0.69, 95% confidence interval [CI]: 0.62â0.77) and recurrence/diseaseâfree survival (RR: 0.80, 95% CI: 0.70â0.92) was graded as limitedâsuggestive. There was limitedâsuggestive evidence for the associations between healthy dietary and/or lifestyle patterns (including diets that comprised plantâbased foods), intake of whole grains and coffee with lower risk of allâcause mortality, and between unhealthy dietary patterns and intake of sugary drinks with higher risk of allâcause mortality. The evidence for other exposures on colorectal cancer outcomes was sparse and graded as limitedâno conclusion. Analyses were conducted excluding cancer patients with metastases without substantial changes in the findings. Wellâdesigned intervention and cohort studies are needed to support the development of lifestyle recommendations for colorectal cancer patients
Postâdiagnosis dietary factors, supplement use and colorectal cancer prognosis: A Global Cancer Update Programme ( CUP Global) systematic literature review and metaâanalysis
The role of diet in colorectal cancer prognosis is not well understood and specific lifestyle recommendations are lacking. We searched for randomised controlled trials (RCTs) and longitudinal observational studies on postâdiagnosis dietary factors, supplement use and colorectal cancer survival outcomes in PubMed and Embase from inception until 28th February 2022. Randomâeffects doseâresponse metaâanalyses were conducted when at least three studies had sufficient information. The evidence was interpreted and graded by the CUP Global independent Expert Committee on Cancer Survivorship and Expert Panel. Five RCTs and 35 observational studies were included (30,242 cases, over 8700 allâcause and 2100 colorectal cancer deaths, 3700 progression, recurrence, or diseaseâfree events). Metaâanalyses, including 3â10 observational studies each, were conducted for: whole grains, nuts/peanuts, red and processed meat, dairy products, sugary drinks, artificially sweetened beverages, coffee, alcohol, dietary glycaemic load/index, insulin load/index, marine omegaâ3 polyunsaturated fatty acids, supplemental calcium, circulating 25âhydroxyvitamin D (25[OH]D) and allâcause mortality; for alcohol, supplemental calcium, circulating 25(OH)D and colorectal cancerâspecific mortality; and for circulating 25(OH)D and recurrence/diseaseâfree survival. The overall evidence was graded as âlimitedâ. The inverse associations between healthy dietary and/or lifestyle patterns (including diets that comprised plantâbased foods), whole grains, total, caffeinated, or decaffeinated coffee and allâcause mortality and the positive associations between unhealthy dietary patterns, sugary drinks and allâcause mortality provided âlimitedâsuggestiveâ evidence. All other exposureâoutcome associations provided âlimitedâno conclusionâ evidence. Additional, wellâconducted cohort studies and carefully designed RCTs are needed to develop specific lifestyle recommendations for colorectal cancer survivors
Postâdiagnosis physical activity and sedentary behaviour and colorectal cancer prognosis: A Global Cancer Update Programme ( CUP Global) systematic literature review and metaâanalysis
Low physical activity and high sedentary behaviour have been clearly linked with colorectal cancer development, yet data on their potential role in colorectal cancer survival is limited. Better characterisation of these relationships is needed for the development of postâdiagnosis physical activity and sedentary behaviour guidance for colorectal cancer survivors. We searched PubMed and Embase through 28 February 2022 for studies assessing postâdiagnosis physical activity, and/or sedentary behaviour in relation to allâcause and causeâspecific mortality and recurrence after colorectal cancer diagnosis. Total and recreational physical activity were assessed overall and by frequency, duration, intensity, and volume using categorical, linear, and nonâlinear doseâresponse randomâeffects metaâanalyses. The Global Cancer Update Programme (CUP Global) independent Expert Committee on Cancer Survivorship and Expert Panel interpreted and graded the likelihood of causality. We identified 16 observational studies on 82,220 nonâoverlapping patients from six countries. Physical activity was consistently inversely associated with colorectal cancer morbidity and mortality outcomes, with 13%â60% estimated reductions in risk. Sedentary behaviour was positively associated with allâcause mortality. The evidence had methodological limitations including potential confounding, selection bias and reverse causation, coupled with a limited number of studies for most associations. The CUP Global Expert panel concluded limitedâsuggestive evidence for recreational physical activity with allâcause mortality and cancer recurrence. Total physical activity and its specific domains and dimensions, and sedentary behaviour were all graded as limitedâno conclusion for all outcomes. Future research should focus on randomised trials, while observational studies should obtain objective and repeated physical activity measures and better adjustment for confounders
Dietary intake of advanced glycation endproducts and risk of hepatobiliary cancers: A multinational cohort study
Advanced glycation endproducts (AGEs) may contribute to liver carcinogenesis because of their proinflammatory and prooxidative properties. Diet is a major source of AGEs, but there is sparse human evidence on the role of AGEs intake in liver cancer etiology. We examined the association between dietary AGEs and the risk of hepatobiliary cancers in the European Prospective Investigation into Cancer and Nutrition prospective cohort (n = 450 111). Dietary intake of three AGEs, Nξ -[carboxymethyl]lysine (CML), Nξ -[1-carboxyethyl]lysine (CEL) and Nδ -[5-hydro-5-methyl-4-imidazolon-2-yl]-ornithine (MG-H1), was estimated using country-specific dietary questionnaires linked to an AGEs database. Cause-specific hazard ratios (HR) and their 95% confidence intervals (CI) for associations between dietary AGEs and risk of hepatocellular carcinoma (HCC), gallbladder and biliary tract cancers were estimated using multivariable Cox proportional hazard regression. After a median follow-up time of 14.9 years, 255 cases of HCC, 100 cases of gallbladder cancer and 173 biliary tract cancers were ascertained. Higher intakes of dietary AGEs were inversely associated with the risk of HCC (per 1 SD increment, HR-CML = 0.87, 95% CI: 0.76-0.99, HR-CEL = 0.84, 95% CI: 0.74-0.96 and HR-MH-G1 = 0.84, 95% CI: 0.74-0.97). In contrast, positive associations were observed with risk of gallbladder cancer (per 1 SD, HR-CML = 1.28, 95% CI: 1.05-1.56, HR-CEL = 1.17; 95% CI: 0.96-1.40, HR-MH-G1 = 1.27, 95% CI: 1.06-1.54). No associations were observed for cancers of the intra and extrahepatic bile ducts. Our findings suggest that higher intakes of dietary AGEs are inversely associated with the risk of HCC and positively associated with the risk of gallbladder cancer
Prediagnosis Leisure-Time Physical Activity and Lung Cancer Survival: A Pooled Analysis of 11 Cohorts
Background: Little is known about the association between physical activity before cancer diagnosis and survival among lung cancer patients. In this pooled analysis of 11 prospective cohorts, we investigated associations of prediagnosis leisuretime physical activity (LTPA) with all-cause and lung cancerâspecific mortality among incident lung cancer patients. Methods: Using self-reported data on regular engagement in exercise and sports activities collected at study enrollment, we assessed metabolic equivalent hours (MET-h) of prediagnosis LTPA per week. According to the Physical Activity Guidelines for Americans, prediagnosis LTPA was classified into inactivity, less than 8.3 and at least 8.3 MET-h per week (the minimum recommended range). Cox regression was used to estimate hazard ratios (HRs) and 95% confidence interval (CIs) for all-cause and lung cancerâspecific mortality after adjustment for major prognostic factors and lifetime smoking history. Results: Of 20 494 incident lung cancer patients, 16 864 died, including 13 596 deaths from lung cancer (overall 5-year relative survival rate Âź 20.9%, 95% CI Âź 20.3% to 21.5%). Compared with inactivity, prediagnosis LTPA of more than 8.3 MET-h per week was associated with a lower hazard of all-cause mortality (multivariable-adjusted HR Âź 0.93, 95% CI Âź 0.88 to 0.99), but not with lung cancerâspecific mortality (multivariable-adjusted HR Âź 0.99, 95% CI Âź 0.95 to 1.04), among the overall population. Additive interaction was found by tumor stage (Pinteraction Âź .008 for all-cause mortality and .003 for lung cancerâspecific mortality). When restricted to localized cancer, prediagnosis LTPA of at least 8.3 MET-h per week linked to 20% lower mortality: multivariableadjusted HRs were 0.80 (95% CIÂź 0.67 to 0.97) for all-cause mortality and 0.80 (95% CIÂź 0.65 to 0.99) for lung cancerâspecific mortality. Conclusions: Regular participation in LTPA that met or exceeded the minimum Physical Activity Guidelines was associated with reduced hazards of mortality among lung cancer patients, especially those with early stage cancer
The association between body fatness and mortality among breast cancer survivors: results from a prospective cohort study
Evidence linking body fatness to breast cancer (BC) prognosis is limited. While it seems that excess adiposity is associated with poorer BC survival, there is uncertainty over whether weight changes reduce mortality. This study aimed to assess the association between body fatness and weight changes pre- and postdiagnosis and overall mortality and BC-specific mortality among BC survivors. Our study included 13,624 BC survivors from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, with a mean follow-up of 8.6 years after diagnosis. Anthropometric data were obtained at recruitment for all cases and at a second assessment during follow-up for a subsample. We measured general obesity using the body mass index (BMI), whereas waist circumference and A Body Shape Index were used as measures of abdominal obesity. The annual weight change was calculated for cases with two weight assessments. The association with overall mortality and BC-specific mortality were based on a multivariable Cox and Fine and Gray models, respectively. We performed Mendelian randomization (MR) analysis to investigate the potential causal association. Five-unit higher BMI prediagnosis was associated with a 10% (95% confidence interval: 5â15%) increase in overall mortality and 7% (0â15%) increase in dying from BC. Women with abdominal obesity demonstrated a 23% (11â37%) increase in overall mortality, independent of the association of BMI. Results related to weight change postdiagnosis suggested a U-shaped relationship with BC-specific mortality, with higher risk associated with losing weight or gainingâ>â2% of the weight annually. MR analyses were consistent with the identified associations. Our results support the detrimental association of excess body fatness on the survival of women with BC. Substantial weight changes postdiagnosis may be associated with poorer survival
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