Effect of employment and domestic load on fetal development and length of gestation in a birth cohort study

Fundamentos: Los estudios publicados no son concluyentes sobre el impacto de determinadas exposiciones ocupacionales en el embarazo, evidenciando la necesidad de considerar el doble rol, profesional y familiar, de las mujeres. El objetivo del presente trabajo fue evaluar el efecto de la situación laboral y de la carga doméstica de trabajo en la duración de la gestación y en el desarrollo fetal. Métodos: Mediante modelos de regresión univariante y multivariante, se estudió la asociación entre partos pretérmino (PPT) (<37 semanas), recién nacidos con bajo peso a término (BPT) (<2500g) y pequeños para su edad gestacional (PEG) (<percentil 10) en peso, talla y perímetro cefálico en función de la situación laboral materna (empleo/no empleo) y la carga doméstica (baja/media/alta) en 2506 mujeres. Los análisis se hicieron utilizando SPSS y R. Resultados: Las mujeres con carga doméstica media tenían menos riesgo que el resto de mujeres de PPT (OR=0,41; IC95%:0,21-0,81), PEG en peso (OR=0,47; IC95%:0,32-0,69), talla (OR=0,57; IC95%:0,39-0,83) y perímetro cefálico (OR=0,58; IC95%:0,40-0,83); las mujeres con carga doméstica elevada también reducían su riesgo de PEG en peso: (OR=0,72; IC95%:0,54-0,98) y perímetro cefálico (OR=0,73; IC95%:0,54-0,99). Al analizar conjuntamente la situación laboral y la carga doméstica, las mujeres con carga doméstica media tenían menos riesgo de PPT (OR=0,29; IC95%:0,14-0,58) que las mujeres sin carga doméstica o con carga elevada. Conclusiones: Los resultados muestran un efecto protector de la carga de trabajo doméstico de grado medio y elevado, reduciendo la probabilidad de parto pretérmino y de nacidos pequeños para su edad gestacional.Background: Published studies are not conclusive on the impact of certain occupational exposures in pregnancy, stressing the need to consider the double role, professional and family, of women. The objective of this study is to evaluate the effect of employment and domestic load on the duration of pregnancy and fetal development. Methods: Using Univariate and Multivariate regression models, we studied the association of preterm deliveries (PPT) (<37 weeks), full term newborns with low weight (BPT) (<2500g) and small for their gestational age (PEG) (<10th percentile) in weight, length and head circumference according to work situation (employment/non-employment) and domestic load (low/ medium/ high) in 2506 women. The analyses were carried out using SPSS and R. Results: Women with medium domestic load have lower risk of PPT (OR=0.41, 95%CI:0.21-0.81), PEG in weight (OR=0.47, 95%CI:0.32-0.69), length (OR=0.57, 95%CI:0.39-0.83) and head circumference (OR=0.58, 95% CI:0.40-0.83) and with high load PEG in weight (OR=0.72, 95%CI:0.54-0.98) and head circumference (OR = 0.73, 95% CI:0.54-0.99). When analyzing employment situation and domestic load, women with medium domestic load have less risk of PPT (OR=0.29, 95%CI:0.14-0.58) than the absence of load or high domestic load. Conclusions: The results show a protective effect of the medium and high domestic load, reducing the probability of preterm birth and small for gestational age babies.Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0041), (FIS-PI13/2429, PI041436, PI042018, PI06/0867, PI07/0252, PI08/1151, PI09/02311, y FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314, 09/02647, y MS13/00054), Generalitat de Catalunya-CIRIT 1999SGR 00241, Conselleria de Sanitat, Generalitat Valenciana, Departamento de Salud del Gobierno Vasco (2005111093 y 2009111069), Gobierno Provincial de Guipúzcoa (DFG06/004 and DFG08/001), Obra Social Cajastur, Universidad de Oviedo, European Union Commission (QLK4-1999-01422, QLK4-2002-00603 and CONTAMED FP7-ENV-212502), Consejería de Salud de la Junta de Andalucía (183/07), y Fundació Roger Torné

Prostate cancer genetic propensity risk score may modify the association between this tumour and type 2 diabetes mellitus (MCC-Spain study)

Background: Some studies have reported an inverse association between type 2 diabetes mellitus (T2DM) and prostate cancer (PCa), but results on this issue are still inconsistent. In this study, we evaluate whether this heterogeneity might be related to differences in this relationship by tumour or by individual genetic susceptibility to PCa. Methods: We studied 1047 incident PCa cases and 1379 randomly selected controls, recruited in 7 Spanish provinces for the population-based MCC-Spain case-control. Tumour were classified by aggressiveness according to the International Society of Urological Pathology (ISUP), and we constructed a PCa polygenic risk score (PRS) as proxy for genetic susceptibility. The epidemiological questionnaire collected detailed self-reported data on T2DM diagnosis and treatment. The association between T2DM status and PCa was studied by fitting mixed logistic regression models, and, for its association by aggressiveness of PCa, with multinomial logistic regression models. To evaluate the possible modulator role of PRS in this relationship, we included the corresponding interaction term in the model, and repeated the analysis stratified by PRS tertiles. Results: Globally, our results showed an inverse association between T2DM and overall PCa limited to grade 1 tumours (ORISUP = 1: 0.72; 95% CI: 0.53-0.98), which could be compatible with a detection bias. However, PCa risk also varied with duration of diabetes treatment -inversely to metformin and positively with insulin-, without differences by aggressiveness. When we considered genetic susceptibility, T2DM was more strongly associated with lower PCa risk in those with lower PRS (ORtertile 1: 0.31; 95% CI: 0.11-0.87), independently of ISUP grade. Conclusions: Our findings reinforce the need to include aggressiveness and susceptibility of PCa, and T2DM treatments in the study of the relationship between both diseases

The Association of Nighttime Fasting Duration and Prostate Cancer Risk: Results from the Multicase-Control (MCC) Study in Spain

Nighttime fasting has been inconclusively associated with a reduced risk of cancer. The purpose of this study was to investigate this association in relation to prostate cancer risk. We examined data from 607 prostate cancer cases and 848 population controls who had never worked in night shift work from the Spanish multicase-control (MCC) study, 2008-2013. Through an interview, we collected circadian information on meal timing at mid-age. We estimated odds ratios (OR) and 95% confidence intervals (CI) with unconditional logistic regression. After controlling for time of breakfast, fasting for more than 11 h overnight (the median duration among controls) was associated with a reduced risk of prostate cancer compared to those fasting for 11 h or less (OR = 0.77, 95% 0.54-1.07). Combining a long nighttime fasting and an early breakfast was associated with a lower risk of prostate cancer compared to a short nighttime fasting and a late breakfast (OR = 0.54, 95% CI 0.27-1.04). This study suggests that a prolonged nighttime fasting duration and an early breakfast may be associated with a lower risk of prostate cancer. Findings should be interpreted cautiously and add to growing evidence on the importance of chrononutrition in relation to cancer risk.Funding: Instituto de Salud Carlos III FIS PI11/01889. Anna Palomar-Cros is supported by a MINECO (Ministry of Economy in Spain) fellowship. We acknowledge support from the Spanish State Research Agency and Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program

High adherence to the Western, Prudent, and Mediterranean dietary patterns and risk of gastric adenocarcinoma: MCC-Spain study

BACKGROUND: The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology. METHODS: MCC-Spain is a multicase-control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns-derived in another Spanish case-control study-with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models. RESULTS: A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratiofourth_vs._first_quartile (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratiosecond_vs._first_quartile (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratiofourth_vs._first_quartile (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors. CONCLUSION: Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma.The study was supported by the “Acción Transversal del Cáncer,” approved by the Spanish Ministry Council on 11 October 2007, by the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), by the Instituto de Salud Carlos III grants, co-funded by FEDER funds: a way to build Europe-PI08/1770 (to M. Kogevinas), PI09/0773 (to J. Llorca), PI09/1286 (to V. Martín), PI09/1903 (to R. Peiró), PI09/2078 (to F.J. Caballero), PI09/1662 (to J.J. Jiménez-Moleón), PI11/01403 (to N. Aragonés), and PI12/00150 (to B. Pérez-Gómez), by the Fundación Marqués de Valdecilla grant API 10/09 (to J. Llorca), by Catalan Government DURSI grant 2014SGR647 (to V. Moreno) and 2014SGR756 (to S. de Sanjose), by the Junta de Castilla y León Grant LE22A10-2 (to V. Martín), by the Consejería de Salud of the Junta de Andalucía Grant 2009-S0143 (to J. Alguacil), by the Conselleria de Sanitat of the Generalitat Valenciana grant AP061/10 (to R. Peiró), by the Regional Government of the Basque Country, by the Consejería de Sanidad de la Región de Murcia, by the Fundación Caja de Ahorros de Asturias, by the University of Oviedo, by the Spanish Association Against Cancer (AECC) Scientific Foundation, and by the Spanish Ministry of Economy and Competitiveness Juan de la Cierva de Incorporación Grant IJCI-2014-20900 (to A. Castelló). None of the sponsors intervened in any stage of the research.S

Serum 25-hydroxyvitamin D and breast cancer risk by pathological subtype (MCC-Spain)

Epidemiologic evidence on the association between vitamin D and breast cancer is still inconclusive. This study analyzes the association between serum 25-hydroxyvitamin D (25(OH)D) and breast cancer risk by pathologic subtype, stage at diagnosis and specific breast cancer risk factors. We conducted a population-based multicase-control study where 546 histologically-confirmed breast cancer cases and 558 population controls, frequently matched by geographic area, age and body mass index, were recruited in 12 Spanish provinces (MCC-Spain). Information was collected by a questionnaire and plasma 25(OH)D was measured by solid-phase extraction on-line coupled to liquid chromatography-tandem mass spectrometry (SPE-LC-MS/MS). Odds ratios and 95% confidence intervals were calculated using logistic and multinomial mixed regression models. We found a clear protective effect between 25(OH)D levels and breast cancer risk, with a significant dose-response trend (OR per 10?nmol/L?=?0.88; 95%CI?=?0.82-0.94). While no differences were observed between pre and postmenopausal women, stage at diagnosis, or across strata of the main breast cancer risk factors, the protection was more pronounced for triple negative tumors (OR per 10?nmol/L?=?0.64; p-heterogeneity?=?0.038). Similar results were observed when only cases sampled in the first month after diagnosis were considered. The protective effect of vitamin D on breast cancer risk may be subtype specific, being stronger for more aggressive tumors, which provides a new approach to prevent this disease.The study was funded by Carlos III Institute of Health grants (PI12/00488, PI12/00265, PI12/00715, PI12/01270, PI09/00773 and PI08/1770), by the Spanish Ministry of Health (EC11-273), by the Spanish Ministry of Economy and Competitiveness (IJCI-2014-20900) and by Consejería de Salud de la Junta de Andalucía (PI-0571-2009) competitive calls including peer review for scientific quality. Additional funding was provided by the Spanish Federation of Breast Cancer Patients (FECMA: EPY 1169-10), the Association of Women with Breast Cancer from Elche (AMACMEC: EPY 1394/15), the Marqués de Valdecilla foundation (grant API 10/09), and by Acción Transversal del Cancer, approved by the Spanish Ministry Council on October 11, 2007. None of the funders played any role in conducting research or writing the paper. This article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health

Smoking history and breast cancer risk by pathological subtype: MCC-Spain study

INTRODUCTION The role of cigarette smoking on breast cancer risk remains controversial, due to its dual carcinogenic-antiestrogenic action.METHODS In the population-based multi-case-control study (MCC-Spain), we collected epidemiological and clinical information for 1733 breast cancer cases and 1903 controls, including smoking exposure. The association with breast cancer, overall, by pathological subtype and menopausal status, was assessed using logistic and multinomial regression models.RESULTS Smokers had higher risk of premenopausal breast cancer, particularly if they had smoked >= 30 years (AOR=1.75; 95% CI: 1.04-2.94), although most estimates did not achieve statistical significance. In contrast, among postmenopausal women, smoking was associated with lower risk of breast cancer, mainly in overweight and obese women. The strongest risk reductions were observed among postmenopausal women who had stopped smoking >= 10 years before cancer diagnosis, particularly for HER2+ tumors (AOR=0.28; 95% CI: 0.11-0.68); p for heterogeneity = 0.040). Also, those who had smoked <10 pack-years (AOR=0.68; 95% CI: 0.47-0.98) or 10-25 pack-years (AOR=0.62; 95% CI: 0.42-0.92) during their lifetime were at a reduced risk of all breast cancer subtypes (p for heterogeneity: 0.405 and 0.475, respectively); however, women who had smoked more than 25 pack-years showed no reduced risk.CONCLUSIONS Menopausal status plays a key role in the relationship between tobacco and breast cancer for all cancer subtypes. While smoking seems to increase the risk in premenopausal woman, it might be associated to lower risk of breast cancer among postmenopausal women with excess weight

Association of time of breakfast and nighttime fasting duration with breast cancer risk in the multicase-control study in Spain

Circadian nutritional behaviors, defined by the daily eating/fasting cycle, have been linked with breast cancer. This study aimed to further disentangle the association of nighttime fasting duration and time of breakfast with breast cancer risk. We analyzed data from 1,181 breast cancer cases and 1,326 population controls from the Spanish multicase-control study (MCC-Spain), 2008-2013. We collected circadian nutritional behaviors at mid-age via a telephonic interview. We applied logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CIs) for the association of nighttime fasting duration and time of breakfast with breast cancer risk in all women and stratified by menopausal status. Models were adjusted for age, center, education, family history of breast cancer, age at menarche, number of children, breastfeeding, age at first child, body mass index (BMI), contraceptive use, and hormonal replacement therapy (HRT). A later time of breakfast was associated with a non-significant increased risk of breast cancer (OR = 1.05, 95% CI: 0.95-1.16, per hour increase). This association was stronger among premenopausal women, among whom each hour later, the time of breakfast was associated with an 18% increase in breast cancer risk (OR = 1.18, 95% CI: 1.01-1.40). The association was not observed in postmenopausal women. We did not observe an association between nighttime fasting duration and breast cancer risk after adjusting for the time of breakfast. In this study, late breakfast was associated with increased breast cancer risk, especially among premenopausal women, compared with early breakfast. Aside from nutritional quality, circadian nutritional behaviors should be further studied in relation to cancer

Meat Intake, Cooking Methods, Doneness Preferences and Risk of Gastric Adenocarcinoma in the MCC-Spain Study

Background: The association of meat intake with gastric adenocarcinoma is controversial. We examined the relation between white, red, and processed meat intake and gastric adenocarcinoma, considering doneness preference and cooking methods, by histological subtype and anatomical subsite. Methods: MCC-Spain is a multicase-control study that included 286 incident gastric adenocarcinoma cases and 2993 controls who answered a food-frequency questionnaire. The association of gastric adenocarcinoma with meat intake, doneness preference and cooking methods was assessed using binary multivariate logistic regression mixed models and a possible interaction with sex was considered. Multinomial logistic regression models were used to estimate risk by tumor subsite (cardia vs. non-cardia) and subtype (intestinal vs. diffuse). Sensitivity analyses were conducted comparing models with and without data on Helicobacter pylori infection. Results: The intake of red and processed meat increased gastric adenocarcinoma risk (OR for one serving/week increase (95% CI) = 1.11 (1.02;1.20) and 1.04 (1.00;1.08), respectively), specifically among men and for non-cardia and intestinal gastric adenocarcinoma. Those who consume well done white or red meat showed higher risk of non-cardia (white: RRR = 1.57 (1.14;2.16); red: RRR = 1.42 (1.00;2.02)) and intestinal tumors (white: RRR = 1.69 (1.10;2.59); red: RRR = 1.61 (1.02;2.53)) than those with a preference for rare/medium doneness. Stewing and griddling/barbequing red and white meat, and oven baking white meat, seemed to be the cooking methods with the greatest effect over gastric adenocarcinoma. The reported associations remained similar after considering Helicobacter pylori seropositivity. Conclusions: Reducing red and processed meat intake could decrease gastric adenocarcinoma risk, especially for intestinal and non-cardia tumors. Meat cooking practices could modify the risk of some gastric cancer subtypes

Association of time of breakfast and nighttime fasting duration with breast cancer risk in the multicase-control study in Spain

Circadian nutritional behaviors, defined by the daily eating/fasting cycle, have been linked with breast cancer. This study aimed to further disentangle the association of nighttime fasting duration and time of breakfast with breast cancer risk. We analyzed data from 1,181 breast cancer cases and 1,326 population controls from the Spanish multicase-control study (MCC-Spain), 2008-2013. We collected circadian nutritional behaviors at mid-age via a telephonic interview. We applied logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CIs) for the association of nighttime fasting duration and time of breakfast with breast cancer risk in all women and stratified by menopausal status. Models were adjusted for age, center, education, family history of breast cancer, age at menarche, number of children, breastfeeding, age at first child, body mass index (BMI), contraceptive use, and hormonal replacement therapy (HRT). A later time of breakfast was associated with a non-significant increased risk of breast cancer (OR = 1.05, 95% CI: 0.95-1.16, per hour increase). This association was stronger among premenopausal women, among whom each hour later, the time of breakfast was associated with an 18% increase in breast cancer risk (OR = 1.18, 95% CI: 1.01-1.40). The association was not observed in postmenopausal women. We did not observe an association between nighttime fasting duration and breast cancer risk after adjusting for the time of breakfast. In this study, late breakfast was associated with increased breast cancer risk, especially among premenopausal women, compared with early breakfast. Aside from nutritional quality, circadian nutritional behaviors should be further studied in relation to cancer