Association of occupational heat exposure and colorectal cancer in the MCC-Spain study

Objective Heat exposure and heat stress/strain is a concern for many workers. There is increasing interest in potential chronic health effects of occupational heat exposure, including cancer risk. We examined potential associations of occupational heat exposure and colorectal cancer (CRC) risk in a large Spanish multi-case–­control study. Methods We analyzed data on 1198 histologically confirmed CRC cases and 2690 frequency-matched controls. The Spanish job-exposure matrix, MatEmEsp, was used to assign heat exposure estimates to the lifetime occupations of participants. Three exposure indices were assessed: ever versus never exposed, cumulative exposure and duration (years). We estimated odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression adjusting for potential confounders. Results Overall, there was no association of ever, compared with never, occupational heat exposure and CRC (OR 1.09, 95% CI 0.92–1.29). There were also no associations observed according to categories of cumulative exposure or duration, and there was no evidence for a trend. There was no clear association of ever occupational heat exposure and CRC in analysis conducted among either men or women when analyzed separately. Positive associations were observed among women in the highest categories of cumulative exposure (OR 1.81, 95% CI 1.09–3.03) and duration (OR 2.89, 95% CI 1.50–5.59) as well as some evidence for a trend (P<0.05). Conclusion Overall, this study provides no clear evidence for an association between occupational heat exposure and CRC.Instituto de Salud Carlos IIIInstituto de Salud Carlos III European Union (EU) Spanish Government PI08/1770 PI08/1359 PI09/00773 PI09/01286 PI09/01903 PI09/02078 PI09/01662 PI11/01403 PI11/01889 PI12/00265Junta de Andalucia 2010ACUP 00310Conselleria de Sanitat of the Generalitat Valenciana FOOD-CT-2006-036224-HIWATELa Caixa Foundation 2014SGR647Regional government of the Basque CountryEuropean Union (EU) European Commission Joint Research Centre 2017SGR1085Spanish Association Against Cancer (AECC) Scientific FoundationCatalan Government DURSI RYC-2017-01892Instituto de Salud Carlos III CEX2018-000806-SSecretariat for Universities and Research of the Ministry of Business and Knowledge of the Government of CataloniaJunta de Castilla y LeonPrincipality of AsturiasConsejeria de Sanidad de la Region de MurciaSpanish GovernmentUniversity of OviedoSpanish Ministry of Science, Innovation and Universities - European Social FundSpanish Ministry of Science and Innovation through the "Centro de Excelencia Severo Ochoa LE22A10-2Generalitat de Catalunya through the CERCA Program 2009-S0143 AP_061/1

Yoghurt Intake and Gastric Cancer: A Pooled Analysis of 16 Studies of the StoP Consortium

Background: Yoghurt can modify gastrointestinal disease risk, possibly acting on gut microbiota. Our study aimed at exploring the under-investigated association between yoghurt and gastric cancer (GC). Methods: We pooled data from 16 studies from the Stomach Cancer Pooling (StoP) Project. Total yoghurt intake was derived from food frequency questionnaires. We calculated study-specific odds ratios (ORs) of GC and the corresponding 95% confidence intervals (CIs) for increasing categories of yoghurt consumption using univariate and multivariable unconditional logistic regression models. A two-stage analysis, with a meta-analysis of the pooled adjusted data, was conducted. Results: The analysis included 6278 GC cases and 14,181 controls, including 1179 cardia and 3463 non-cardia, 1191 diffuse and 1717 intestinal cases. The overall meta-analysis revealed no association between increasing portions of yoghurt intake (continuous) and GC (OR = 0.98, 95% CI = 0.94–1.02). When restricting to cohort studies, a borderline inverse relationship was found (OR = 0.93, 95% CI = 0.88–0.99). The adjusted and unadjusted OR were 0.92 (95% CI = 0.85–0.99) and 0.78 (95% CI = 0.73–0.84) for any vs. no yoghurt consumption and GC risk. The OR for 1 category of increase in yoghurt intake was 0.96 (95% CI = 0.91–1.02) for cardia, 1.03 (95% CI = 1.00–1.07) for non-cardia, 1.12 (95% CI = 1.07–1.19) for diffuse and 1.02 (95% CI = 0.97–1.06) for intestinal GC. No effect was seen within hospital-based and population-based studies, nor in men or women. Conclusions: We found no association between yoghurt and GC in the main adjusted models, despite sensitivity analyses suggesting a protective effect. Additional studies should further address this association.Fondazione AIRC per la ricerca sul cancro 21378Unidade de Investigacao em Epidemiologia-Instituto de Saude Publica da Universidade do Porto (EPIUnit) UIDB/04750/2020National funds from the Foundation for Science and Technology-FCT (Portuguese Ministry of Science, Technology and Higher Education)Project NEON-PC-Neuro-oncological complications of prostate cancer: longitudinal study of cognitive decline' - FEDER through the Operational Program Competitiveness and Internationalisation POCI-01-0145-FEDER-03235 PTDC/SAU-EPI/32358/2017Fundacao para a Ciencia e a Tecnologia (FCT)EPIunit-Junior Research-Prog Financing UIDP/04750/2020Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) 2014/26897-0European Cancer Prevention OrganizationUnited States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Cancer Institute (NCI

Different spatial pattern of municipal prostate cancer mortality in younger men in Spain

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. 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. 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.The study was supported by research grants from the Spanish Health Research Fund ISCIII cofunded by FEDER funds -a way to build Europe (http://www.isciii.es/): PFN: FIS PI11/ 00871, BPG: FIS PI12/00150, PI17CIII/00034, GLA: PI14CIII/00050, JJJM: PI15/00914; Joint Action InfAct (European Commission): BPG: HPJA- 06-2017, PFN: HP-JA-06-2017

Health-related quality of life and mortality in the ‘Seguimiento Universidad de Navarra’ prospective cohort study

This project was made possible by funding from the Spanish Government- Instituto de Salud Carlos III , and the European Regional Development Fund (FEDER) (RD 06/0045, CIBER-OBN, Grants PI10/02658 , PI10/02293 , PI13/00615 , PI14/01668 , PI14/01798 , PI14/01764 , PI17/01795 , PI18/00631 , PI20/00564 and G03/140 ), from the Government of Navarra ( 27/2011 , 45/2011 , 122/2014 ), from the National Plan on Drugs ( 2020/021 ) as well as from the University of Navarra .Objective: To study the association between health-related quality of life (HRQoL) and all-cause mortality in a healthy middle-aged Mediterranean cohort. Methods: We included 15,390 participants –mean age 42.8 years at first HRQoL ascertainment, all university graduates–. HRQoL was assessed with the self-administered Medical Outcomes Study Short Form-36 (SF-36) twice, with a 4-year gap. We used multivariable-adjusted Cox regression models to address the relation between self-reported health and Physical or Mental Component Summary (PCS-36 or MCS-36) and mortality, and their interaction with prior comorbidities or adherence to the Mediterranean diet (MedDiet). Results: Over 8.7 years of median follow-up time, 266 deaths were identified. Hazard ratio (HR) for the excellent vs. poor/fair category in self-reported health was 0.30 (95 % confidence interval (CI), 0.16–0.57) in the model with repeated measurements of HRQoL. Both the PCS-36 (HRquartile4(Q4)vs.Q1 0.57 [95%CI, 0.36–0.90], ptrend < 0.001; HRper+10points: 0.64 [95%CI, 0.54–0.75]) and the MCS-36 (HRQ4vs.Q1 0.67 [95%CI, 0.46–0.97], ptrend = 0.025; HRper+10points: 0.86 [95%CI, 0.74–0.99]) were inversely associated with mortality in the model with repeated measurements of HRQoL. Previous comorbidities or adherence to the MedDiet did not modify these associations. Conclusions: Self-reported HRQoL –assessed as self-reported health, PCS-36 and MCS-36– obtained with the Spanish version of the SF-36 were inversely associated with mortality risk, regardless of the presence of previous comorbidities or adherence to the MedDiet.CIBER-OBN G03/140, PI10/02293, PI10/02658, PI13/00615, PI14/01668, PI14/01764, PI14/01798, PI17/01795, PI18/00631, PI20/00564Government-Instituto de Salud Carlos IIIHershey'sHarvard UniversityPlan Nacional sobre Drogas 2020/021 PNSDFederación Española de Enfermedades Raras RD 06/0045 FEDERUniversidad de Navarra 010830European Regional Development Fund ERDFGobierno de Navarra 122/2014, 27/2011, 45/201

Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Recommendations and Breast Cancer in the SUN Project

A proportion of breast cancer cases are attributable to combined modifiable risk factors. The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) has recently updated the recommendations for cancer prevention and a standard scoring system has been published. The aim of this study was to evaluate the association between compliance with the 2018 WCRF/AICR cancer prevention recommendations (Third Expert Report) and the risk of breast cancer in the SUN (“Seguimiento Universidad de Navarra”) prospective cohort. Spanish female university graduates, initially free of breast cancer, were included (n = 10,930). An 8-item score to measure compliance to the recommendations was built: body fat, physical activity, consumption of wholegrains/vegetables/fruit/beans, “fast foods”, red/processed meat consumption, sugar-sweetened drinks consumption, alcohol intake, and breastfeeding. A stratified analysis was conducted according to menopausal status. A non-significant inverse association was observed for overall breast cancer. The inverse association became statistically significant for post-menopausal breast cancer after multivariable adjustment (hazard ratio for > 5 vs. ≤ 3 points = 0.27; 95% CI: 0.08-0.93). The results suggested that the possible inverse association with breast cancer was attributable to the combined effects of the different nutritional and lifestyle components.Instituto de Salud Carlos III PI10/02658 PI10/02293 PI13/00615 PI14/01668 PI14/01798 PI14/01764 PI17/01795 G03/140European Union (EU) RD 06/0045European Union (EU) PI10/02658 PI10/02293 PI13/00615 PI14/01668 PI14/01798 PI14/01764 PI17/01795 G03/140Navarra Regional Government 45/2011 122/2014 41/2016University of Navarr

Long-Term Nightshift Work and Breast Cancer Risk: An Updated Systematic Review and Meta-Analysis with Special Attention to Menopausal Status and to Recent Nightshift Work

Conceptualization, B.P.-G., C.S. and A.M.P.-F.; methodology, B.P.-G., A.M.P.-F. and C.S. validation, B.P.-G., N.F.d.L., R.P.-B. and V.L; formal analysis, A.M.P.-F., R.P.-B. and C.S.; investigation, A.M.P.-F., R.P.-B. and C.S. resources, B.P.-G. and M.P., data curation, A.M.P.-F. and C.S.; writing—original draft preparation, C.S. and B.P.-G.; writing—review and editing R.P.-B., V.L., N.F.d.L., J.J.J.-M. and M.P.; visualization, A.M.P.-F., B.P.-G., R.P.-B. and C.S.; supervision, B.P.-G., M.P. and J.J.J.-M.; project administration, B.P.-G. All authors have read and agreed to the published version of the manuscript.This systematic review discusses long-term NSW and female BC risk, with special attention to differences between pre-and postmenopausal BC, to test the association with recent NSW. The review follows PRISMA guidelines (Prospero registry: CRD42018102515). We searched PubMed, Embase, and WOS for case–control, nested case–control, and cohort studies addressing long-term NSW (≥15 years) as risk exposure and female BC as outcome until 31 December 2020. Risk of bias was evaluated with the Newcastle–Ottawa scale. Eighteen studies were finally in-cluded (eight cohorts; five nested case–control; five case–control). We performed meta-analyses on long-term NSW and BC risk; overall and by menopausal status; a subanalysis on recent long-term NSW, based on studies involving predominantly women below retirement age; and a dose– response meta-analysis on NSW duration. The pooled estimate for long-term NSW and BC was 1.13 (95%CI = 1.01–1.27; 18 studies, I2 = 56.8%, p = 0.002). BC risk increased 4.7% per 10 years of NSW (95%CI = 0.94–1.09; 16 studies, I2 = 33.4%, p = 0.008). The pooled estimate for premenopausal BC was 1.27 (95%CI = 0.96–1.68; six studies, I2 = 32.0%, p = 0.196) and for postmenopausal BC 1.05 (95%CI = 0.90–1.24, I2 = 52.4%; seven studies, p = 0.050). For recent long-term exposure, the pooled estimate was 1.23 (95%CI = 1.06–1.42; 15 studies; I2 = 48.4%, p = 0.018). Our results indicate that long-term NSW increases the risk for BC and that menopausal status and time since exposure might be relevant

Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation

High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociacion Espanola Contra el Cancer (AECC) (PROYE20023SANC). Subprograma de Vigilancia Epidemiologica del Cancer (VICA), del CIBER de Epidemiologia y Salud Publica (CIBERESP), Instituto de Salud Carlos III (ISCIII). Instituto de Salud Carlos III (ISCIII): PI18/01593 EU/FEDER. Acciones de Movilidad CIBERESP, 2022. Dafina Petrova is supported by a Juan de la Cierva Fellowship from the Ministry of Science and the National Research Agency of Spain (MCIN/AEI, JC2019-039691-I, https://doi.org/10.13039/501100011033,Accessed 4 October 2021).The funders had no role in the study design, data collection, analysis, interpretation of data, writing or decision to publish.Background Lung cancer is the main cause of cancer mortality worldwide and in Spain. Several previous studies have documented socio-economic inequalities in lung cancer mortality but these have focused on specific provinces or cities. The goal of this study was to describe lung cancer mortality in Spain by sex as a function of socio-economic deprivation. Methods We analysed all registered deaths from lung cancer during the period 2011–2017 in Spain. Mortality data was obtained from the National Institute of Statistics, and socio-economic level was measured with the small-area deprivation index developed by the Spanish Society of Epidemiology, with the census tract of residence at the time of death as the unit of analysis. We computed crude and age-standardized rates per 100,000 inhabitants by sex, deprivation quintile, and type of municipality (rural, semi-rural, urban) considering the 2013 European standard population (ASR-E). We further calculated ASR-E ratios between the most deprived (Q5) and the least deprived (Q1) areas and mapped census tract smoothed standardized lung cancer mortality ratios by sex. Results We observed 148,425 lung cancer deaths (80.7% in men), with 73.5 deaths per 100,000 men and 17.1 deaths per 100,000 women. Deaths from lung cancer in men were five times more frequent than in women (ASR-E ratio = 5.3). Women residing in the least deprived areas had higher mortality from lung cancer (ASR-E = 22.2), compared to women residing in the most deprived areas (ASR-E = 13.2), with a clear gradient among the quintiles of deprivation. For men, this pattern was reversed, with the highest mortality occurring in areas of lower socio-economic level (ASR-E = 99.0 in Q5 vs. ASR-E = 86.6 in Q1). These socio-economic inequalities remained fairly stable over time and across urban and rural areas. Conclusions Socio-economic status is strongly related to lung cancer mortality, showing opposite patterns in men and women, such that mortality is highest in women residing in the least deprived areas and men residing in the most deprived areas. Systematic surveillance of lung cancer mortality by socio-economic status may facilitate the assessment of public health interventions aimed at mitigating cancer inequalities in Spain.High Resolution Study of Social Inequalities in Cancer (HiReSIC)Asociacion Espanola Contra el Cancer (AECC) PROYE20023SANCSubprograma de Vigilancia Epidemiologica del Cancer (VICA)CIBER de Epidemiologia y Salud Publica (CIBERESP)Instituto de Salud Carlos III Spanish Government PI18/01593Juan de la Cierva Fellowship from the Ministry of ScienceNational Research Agency of Spain (MCIN/AEI) JC2019-039691-INational Statistics Institute (INE) BE099-202

Obesity as a risk factor in COVID-19: Possible mechanisms and implications

Varios artículos recientes sugieren que la obesidad es un factor de riesgo para una enfermedad más grave por coronavirus. En este artículo se resume la evidencia científica disponible sobre el papel de la obesidad en COVID-19, con especial atención en las personas más jóvenes y los mecanismos biológicos propuestos para explicar tanto el mayor riesgo observado como la posible mayor contagiosidad de esta población. Se consideran varias implicaciones de la pandemia sobre las personas con obesidad, en relación con las posibles dificultades en el manejo de los pacientes ingresados, las implicaciones del confinamiento sobre el control y tratamiento de la obesidad, y el estigma que sufren estas personas por su condición, y que puede verse aumentado si se confirma la relación de la obesidad con COVID-19. Comprender el papel de la obesidad en COVID-19 debería ser una prioridad de salud pública, dada la alta prevalencia de esta condición en nuestro país.Recent reports suggest that obesity is a risk factor for more severe coronavirus disease. This article summarizes the available scientific evidence on the role of obesity in COVID-19. We focus on implications for younger patients and the proposed biological mechanisms that could explain both the higher risk observed and the possible higher contagiousness of people with obesity. We consider implications of the pandemic for people with obesity in relation to: difficulties in managing hospitalized patients, implications of confinement for the control and treatment of obesity, and the stigma people with obesity suffer, that could increase should the relationship between obesity and COVID-19 be confirmed. Understanding the role of obesity in COVID-19 should be a public health priority, given the high prevalence of this condition in our country

Una evaluación de las tasas de mortalidad infantil en Colombia, 1980-2009

Purpose. The infant mortality rate (IMR) is a key indicator of human welfare and development. However, in Colombia, the Departamento Administrativo Nacional de Estadística (DANE) has set the registered rate for 2009 as 13.69 per 1,000 live births, while the estimated rate is 20.13, suggesting the presence of inconsistencies in the data, as in many other transitional economies. This paper aims to set the record straight on Colombia’s IMR reporting since 1980 by using all available data that have recently become public. Methodology. The study analyzes 8,636,510 records of live births (1998–2009) and 443,338 records of deaths (1979–2009), and considers information from various other sources such as the statistical yearbooks and survey results. An exponential function is used to estimate the IMRs in Colombia for 1980–2009 while resolving internal inconsistencies in the data from all sources. Findings. The analysis demonstrates that the registered and the estimated rates for 2009 are incompatible since they follow inconsistent long-term rates of decline in IMR. While the registered rate underestimates the real situation, the estimated rate appears to grossly overestimate it. Analyses, based on other sources, put the IMR between 15.81 and 17.58 in 2009, with rates of decline between 3.0 and 5.0 percent for the period 1980–2009. Value. The study concludes that during the period 1980–2009, the IMR for Colombia on average fell from about 54 to about 17, suggesting a long-term annual rate of decline of about 4.0 percent.Research Resources Icesi Universit

Consumption of aspartame and other artificial sweeteners and risk of cancer in the Spanish multicase-control study (MCC-Spain)

The study was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773-Cantabria, PS09/01286-León, PS09/01903-Valencia, PS09/02078-Huelva, PS09/01662-Granada, PI11/01403, PI11/01889-FEDER, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150, PI14/01219, PI14/0613, PI15/00069, PI15/00914, PI15/01032, PI17CIII/00034), by the Fundaci on Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consor- tium CLL (The ICGC CLL-Genome Project is funded by Spanish Ministerio de Economía y Competitividad [MINECO] through the Instituto de Salud Carlos III [ISCIII] and Red Temática de Investigaci on del Cáncer [RTICC] del ISCIII [RD12/0036/0036]), by the Junta de Castilla y Le on (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571-2009, PI-0306-2011, salud201200057018tra), by the Conselleria de Sanitat of the Generalitat Valenciana (AP_061/10), by the Recercaixa (2010ACUP 00310), by the Regional Government of the Basque Country, by the Consejería de Sanidad de la Regi on de Murcia, by the European Commission grants FOOD-CT-2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the Catalan Government-Agency for Management of University and Research Grants (AGAUR) grants 2017SGR723, 2014SGR850, 2017SGR1085, 2021SGR01354 by the Fundaci on Caja de Ahorros de Asturias and by the University of Oviedo. ISGlobal acknowledges support from the Spanish 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. Anna Palomar-Cros is supported by a MINECO (Spanish Ministry of Econ- omy) fellowship (PRE2019-089038). Camille Lassale is supported by a Ramon y Cajal Fellowship RYC2020-029599 funded by MCIN (Spanish Ministry of Science and Innovation) and EI FSE “Invest in your future”.Use of artificial sweeteners (AS) such as aspartame, cyclamate, saccharin and sucralose is widespread. We evaluated the association of use of aspartame and other AS with cancer. In total 1881 colorectal, 1510 breast, 972 prostate and 351 stomach cancer and 109 chronic lymphocytic leukaemia (CLL) cases and 3629 population controls from the Spanish Multicase-Control (MCC-Spain) study were recruited (2008-2013). The consumption of AS, from table-top sweeteners and artificially sweetened beverages, was assessed through a self-administered and validated food frequency questionnaire (FFQ). Sex-specific quartiles among controls were determined to compare moderate consumers (<third quartile) and high consumers (≥ third quartile) vs non consumers (reference category), distinguishing aspartame-containing products and other AS. Unconditional logistic regression models were used to estimate adjusted OR and 95%CI, and results were stratified by diabetes status. Overall, we found no associations between the consumption of aspartame or other AS and cancer. Among participants with diabetes, high consumption of other AS was associated with colorectal cancer (OR = 1.58, 95% CI 1.05-2.41, P trend = .03) and stomach cancer (OR = 2.27 [0.99-5.44], P trend = .06). High consumption of aspartame, was associated with stomach cancer (OR = 2.04 [0.7-5.4], P trend = .05), while a lower risk was observed for breast cancer (OR = 0.28 [0.08-0.83], P trend = .03). In some cancers, the number of cases in participants with diabetes were small and results should be interpreted cautiously. We did not find associations between use of AS and cancer, but found associations between high consumption of aspartame and other AS and different cancer types among participants with diabetes.AGAUR 2014SGR850, 2017SGR1085, 2017SGR723, 2021SGR01354Catalan Government‐Agency for Management of University and Research GrantsCentro de Excelencia Severo Ochoa 2019‐2023Consejería de Salud of the Junta de Andalucía PI‐0306‐2011Consejería de Sanidad de la Región de MurciaRegional Government of the Basque CountryConselleria de Sanitat of the Generalitat Valenciana 2010ACUP 00310, AP_061/10EI FSEEuropean Commission grants FOOD-CT- 2006-036224-HIWATEFundación Caja de Ahorros de AsturiasFundación Marqués de Valdecilla API 10/09Generalitat de CatalunyaICGC International Cancer Genome Consortium CLLInstituto de Salud Carlos III‐FEDER PI08/0533, PI08/1359, PI08/1770, PI11/00226, PI11/01403, PI11/01810, PI11/01889, PI11/02213, PI12/00150, PI12/00265, PI12/00488, PI12/00715, PI12/01270, PI14/01219, PI14/0613, PI15/00069, PI15/00914, PI15/01032, PI17CIII/00034, PS09/00773, PS09/01286, PS09/01662, PS09/02078Junta de Castilla y León LE22A10‐2MCINMINECORTICC RD12/0036/0036Red Temática de Investigación del CáncerSpanish Association Against Cancer (AECC) Scientific FoundationSpanish Ministry of Economy PRE2019‐089038Spanish Ministry of Science and InnovationUniversity of Ovied