Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and risk of in situ breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort
Abstract Background Even though in situ breast cancer (BCIS) accounts for a large proportion of the breast cancers diagnosed, few studies have investigated potential risk factors for BCIS. Their results suggest that some established risk factors for invasive breast cancer have a similar impact on BC...
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2019-12-01
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Series: | BMC Medicine |
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Online Access: | https://doi.org/10.1186/s12916-019-1444-0 |
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English |
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DOAJ |
author |
Nena Karavasiloglou Anika Hüsing Giovanna Masala Carla H. van Gils Renée Turzanski Fortner Jenny Chang-Claude Inge Huybrechts Elisabete Weiderpass Marc Gunter Patrick Arveux Agnès Fournier Marina Kvaskoff Anne Tjønneland Cecilie Kyrø Christina C. Dahm Helene Tilma Vistisen Marije F. Bakker Maria-Jose Sánchez María Dolores Chirlaque López Carmen Santiuste Eva Ardanaz Virginia Menéndez Antonio Agudo Antonia Trichopoulou Anna Karakatsani Carlo La Vecchia Eleni Peppa Domenico Palli Claudia Agnoli Salvatore Panico Rosario Tumino Carlotta Sacerdote Salma Tunå Butt Signe Borgquist Guri Skeie Matthias Schulze Timothy Key Kay-Tee Khaw Kostantinos K. Tsilidis Merete Ellingjord-Dale Elio Riboli Rudolf Kaaks Laure Dossus Sabine Rohrmann Tilman Kühn |
spellingShingle |
Nena Karavasiloglou Anika Hüsing Giovanna Masala Carla H. van Gils Renée Turzanski Fortner Jenny Chang-Claude Inge Huybrechts Elisabete Weiderpass Marc Gunter Patrick Arveux Agnès Fournier Marina Kvaskoff Anne Tjønneland Cecilie Kyrø Christina C. Dahm Helene Tilma Vistisen Marije F. Bakker Maria-Jose Sánchez María Dolores Chirlaque López Carmen Santiuste Eva Ardanaz Virginia Menéndez Antonio Agudo Antonia Trichopoulou Anna Karakatsani Carlo La Vecchia Eleni Peppa Domenico Palli Claudia Agnoli Salvatore Panico Rosario Tumino Carlotta Sacerdote Salma Tunå Butt Signe Borgquist Guri Skeie Matthias Schulze Timothy Key Kay-Tee Khaw Kostantinos K. Tsilidis Merete Ellingjord-Dale Elio Riboli Rudolf Kaaks Laure Dossus Sabine Rohrmann Tilman Kühn Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and risk of in situ breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort BMC Medicine In situ breast cancer Cohort Lifestyle Prevention Lifestyle Score |
author_facet |
Nena Karavasiloglou Anika Hüsing Giovanna Masala Carla H. van Gils Renée Turzanski Fortner Jenny Chang-Claude Inge Huybrechts Elisabete Weiderpass Marc Gunter Patrick Arveux Agnès Fournier Marina Kvaskoff Anne Tjønneland Cecilie Kyrø Christina C. Dahm Helene Tilma Vistisen Marije F. Bakker Maria-Jose Sánchez María Dolores Chirlaque López Carmen Santiuste Eva Ardanaz Virginia Menéndez Antonio Agudo Antonia Trichopoulou Anna Karakatsani Carlo La Vecchia Eleni Peppa Domenico Palli Claudia Agnoli Salvatore Panico Rosario Tumino Carlotta Sacerdote Salma Tunå Butt Signe Borgquist Guri Skeie Matthias Schulze Timothy Key Kay-Tee Khaw Kostantinos K. Tsilidis Merete Ellingjord-Dale Elio Riboli Rudolf Kaaks Laure Dossus Sabine Rohrmann Tilman Kühn |
author_sort |
Nena Karavasiloglou |
title |
Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and risk of in situ breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort |
title_short |
Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and risk of in situ breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort |
title_full |
Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and risk of in situ breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort |
title_fullStr |
Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and risk of in situ breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort |
title_full_unstemmed |
Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and risk of in situ breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort |
title_sort |
adherence to the world cancer research fund/american institute for cancer research cancer prevention recommendations and risk of in situ breast cancer in the european prospective investigation into cancer and nutrition (epic) cohort |
publisher |
BMC |
series |
BMC Medicine |
issn |
1741-7015 |
publishDate |
2019-12-01 |
description |
Abstract Background Even though in situ breast cancer (BCIS) accounts for a large proportion of the breast cancers diagnosed, few studies have investigated potential risk factors for BCIS. Their results suggest that some established risk factors for invasive breast cancer have a similar impact on BCIS risk, but large population-based studies on lifestyle factors and BCIS risk are lacking. Thus, we investigated the association between lifestyle and BCIS risk within the European Prospective Investigation into Cancer and Nutrition cohort. Methods Lifestyle was operationalized by a score reflecting the adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations. The recommendations utilized in these analyses were the ones pertinent to healthy body weight, physical activity, consumption of plant-based foods, energy-dense foods, red and processed meat, and sugary drinks and alcohol, as well as the recommendation on breastfeeding. Cox proportional hazards regression was used to assess the association between lifestyle score and BCIS risk. The results were presented as hazard ratios (HR) and corresponding 95% confidence intervals (CI). Results After an overall median follow-up time of 14.9 years, 1277 BCIS cases were diagnosed. Greater adherence to the WCRF/AICR cancer prevention recommendations was not associated with BCIS risk (HR = 0.98, 95% CI 0.93–1.03; per one unit of increase; multivariable model). An inverse association between the lifestyle score and BCIS risk was observed in study centers, where participants were recruited mainly via mammographic screening and attended additional screening throughout follow-up (HR = 0.85, 95% CI 0.73–0.99), but not in the remaining ones (HR = 0.99, 95% CI 0.94–1.05). Conclusions While we did not observe an overall association between lifestyle and BCIS risk, our results indicate that lifestyle is associated with BCIS risk among women recruited via screening programs and with regular screening participation. This suggests that a true inverse association between lifestyle habits and BCIS risk in the overall cohort may have been masked by a lack of information on screening attendance. The potential inverse association between lifestyle and BCIS risk in our analyses is consistent with the inverse associations between lifestyle scores and breast cancer risk reported from previous studies. |
topic |
In situ breast cancer Cohort Lifestyle Prevention Lifestyle Score |
url |
https://doi.org/10.1186/s12916-019-1444-0 |
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doaj-b68399fb6b9d40c3b16fa6cbbba89f612020-12-06T12:31:47ZengBMCBMC Medicine1741-70152019-12-0117111110.1186/s12916-019-1444-0Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and risk of in situ breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohortNena Karavasiloglou0Anika Hüsing1Giovanna Masala2Carla H. van Gils3Renée Turzanski Fortner4Jenny Chang-Claude5Inge Huybrechts6Elisabete Weiderpass7Marc Gunter8Patrick Arveux9Agnès Fournier10Marina Kvaskoff11Anne Tjønneland12Cecilie Kyrø13Christina C. Dahm14Helene Tilma Vistisen15Marije F. Bakker16Maria-Jose Sánchez17María Dolores Chirlaque López18Carmen Santiuste19Eva Ardanaz20Virginia Menéndez21Antonio Agudo22Antonia Trichopoulou23Anna Karakatsani24Carlo La Vecchia25Eleni Peppa26Domenico Palli27Claudia Agnoli28Salvatore Panico29Rosario Tumino30Carlotta Sacerdote31Salma Tunå Butt32Signe Borgquist33Guri Skeie34Matthias Schulze35Timothy Key36Kay-Tee Khaw37Kostantinos K. Tsilidis38Merete Ellingjord-Dale39Elio Riboli40Rudolf Kaaks41Laure Dossus42Sabine Rohrmann43Tilman Kühn44Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of ZurichDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ)Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPROJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ)Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)International Agency for Research on CancerInternational Agency for Research on CancerInternational Agency for Research on CancerCESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-SaclayCESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-SaclayCESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-SaclayDepartment of Public Health, Faculty of Health and Medical Sciences, University of CopenhagenDanish Cancer Society Research CenterDepartment of Public Health, Aarhus UniversityDepartment of Public Health, Aarhus UniversityJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityAndalusian School of Public Health (EASP)CIBER of Epidemiology and Public Health (CIBERESP)CIBER of Epidemiology and Public Health (CIBERESP)CIBER of Epidemiology and Public Health (CIBERESP)Public Health DirectorateUnit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute - IDIBELLHellenic Health FoundationHellenic Health FoundationHellenic Health FoundationHellenic Health FoundationCancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPROEpidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei TumoriDepartment of Clinical Medicine and Surgery, Federico II UniversityCancer Registry and Histopathology Department, Azienda Sanitaria Provinciale (ASP)Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO)Department of Clinical Sciences, Lund UniversityDepartment of Oncology, Aarhus University Hospital, Aarhus UniversityDepartment of Community Medicine, University of Tromsø, The Arctic University of NorwayDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE)Nuffield Department of Population Health, University of OxfordDepartment of Public Health and Primary Care, University of CambridgeDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College LondonDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College LondonDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College LondonDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ)International Agency for Research on CancerDivision of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of ZurichDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ)Abstract Background Even though in situ breast cancer (BCIS) accounts for a large proportion of the breast cancers diagnosed, few studies have investigated potential risk factors for BCIS. Their results suggest that some established risk factors for invasive breast cancer have a similar impact on BCIS risk, but large population-based studies on lifestyle factors and BCIS risk are lacking. Thus, we investigated the association between lifestyle and BCIS risk within the European Prospective Investigation into Cancer and Nutrition cohort. Methods Lifestyle was operationalized by a score reflecting the adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations. The recommendations utilized in these analyses were the ones pertinent to healthy body weight, physical activity, consumption of plant-based foods, energy-dense foods, red and processed meat, and sugary drinks and alcohol, as well as the recommendation on breastfeeding. Cox proportional hazards regression was used to assess the association between lifestyle score and BCIS risk. The results were presented as hazard ratios (HR) and corresponding 95% confidence intervals (CI). Results After an overall median follow-up time of 14.9 years, 1277 BCIS cases were diagnosed. Greater adherence to the WCRF/AICR cancer prevention recommendations was not associated with BCIS risk (HR = 0.98, 95% CI 0.93–1.03; per one unit of increase; multivariable model). An inverse association between the lifestyle score and BCIS risk was observed in study centers, where participants were recruited mainly via mammographic screening and attended additional screening throughout follow-up (HR = 0.85, 95% CI 0.73–0.99), but not in the remaining ones (HR = 0.99, 95% CI 0.94–1.05). Conclusions While we did not observe an overall association between lifestyle and BCIS risk, our results indicate that lifestyle is associated with BCIS risk among women recruited via screening programs and with regular screening participation. This suggests that a true inverse association between lifestyle habits and BCIS risk in the overall cohort may have been masked by a lack of information on screening attendance. The potential inverse association between lifestyle and BCIS risk in our analyses is consistent with the inverse associations between lifestyle scores and breast cancer risk reported from previous studies.https://doi.org/10.1186/s12916-019-1444-0In situ breast cancerCohortLifestylePreventionLifestyle Score |