Body mass, tobacco smoking, alcohol drinking and risk of cancer of the small intestine-a pooled analysis of over 500 000 subjects in the Asia Cohort Consortium

Boffetta, P.,Hazelton, W.D.,Chen, Y.,Sinha, R.,Inoue, M.,Gao, Y.T.,Koh, W.P.,Shu, X.O.,Grant, E.J.,Tsuji, I.,Nishino, Y.,You, S.L.,Yoo, K.Y.,Yuan, J.M.,Kim, J.,Tsugane, S.,Yang, G.,Wang, R.,Xiang, Y.B Elsevier 2012 Annals of oncology Vol.23 No.7

Processed Meat Consumption and Squamous Cell Carcinoma of the Oesophagus in a Large Case-Control Study in Uruguay

Stefani, Eduardo De,Boffetta, Paolo,Ronco, Alvaro Luis,Deneo-Pellegrini, Hugo,Correa, Pelayo,Acosta, Gisele,Mendilaharsu, Maria Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.14

Background: The role of processed meat in the aetiology of squamous cell oesophageal cancer has been explored in detail. Methods: In the time period 1990-2005, a case-control study was conducted in Montevideo, Uruguay including 2,368 participants (876 cases of oesophageal cancer and 1,492 controls). Relative risks, approximated by the odds ratios, were estimated by multiple unconditional logistic regression. Results: Processed meat was positively associated with oesophageal cancer (upper quartile vs lower quartile OR 2.30, 95%CI 1.72-3.07), whereas salted meat intake was positively associated with squamous cell oesophageal cancer (OR 3.82, 95%CI 2.74-5.33). Finally other cured meats were positively associated with oesophageal cancer (OR 1.65, 95%CI 1.22-2.22). Conclusions: It could be concluded that processed meat consumption could be an important risk factor for the aetiology of squamous cell oesophageal cancer in Uruguay.

Meat Consumption, Related Nutrients, Obesity and Risk of Prostate Cancer: a Case-Control Study in Uruguay

Stefani, Eduardo De,Boffetta, Paolo,Ronco, Alvaro L,Deneo-Pellegrini, Hugo Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.4

Background: In order to determine the role of meat consumption and related nutrients in the etiology of prostate cancer we conducted a case-control study among Uruguayan men in the time period 1998-2007. Results: The study included 464 cases and 472 controls, frequency matched for age and residence. Both series were drawn from the four major public hospitals in Montevideo. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (95 % CI) of prostate cancer by quartiles of meat intake and related nutrients. The highest vs. the lowest quartile of intake of total meat (OR = 5.19, 95 % CI 3.46-7.81), red meat (OR = 4.64, 95 % CI 3.10-6.95), and processed meat (OR = 1.78, 95% CI 1.22-2.59) were associated with increased risk of prostate cancer. Meat nutrients were directly associated with the risk of prostate cancer (OR for cholesterol 5.61, 95 % CI 3.75-8.50). Moreover, both total meat and red meat displayed higher risks among obese patients. Conclusions: This study suggests that total and red meat and meat nutrients may play a role in the etiology of prostate cancer in Uruguay.

The Role of Common Pharmaceutical Agents on the Prevention and Treatment of Pancreatic Cancer

( Sunil Amin ),( Paolo Boffetta ),( Aimee L. Lucas ) 대한간학회 2016 Gut and Liver Vol.10 No.5

Survival from pancreatic cancer remains poor. Conventional treatment has resulted in only marginal improvements in survival compared with survival in the previous several decades. Thus, considerable interest has emerged regarding the potential use of common pharmaceutical agents as chemopreventative and chemotherapeutic options. Aspirin, metformin, statins, β-blockers, and bisphosphonates have biologically plausible mechanisms to inhibit pancreatic neoplasia, whereas dipeptidyl-peptidase 4 inhibitors may promote it. Regardless, real-world epidemiological data remain inconclusive. This review examines the hypotheses, evidence, and current state of the literature for each of these medications and their potential roles in the prevention and treatment of pancreatic cancer. (Gut Liver 2016;10:665-671)

Nutrient-derived Dietary Patterns and Risk of Colorectal Cancer: a Factor Analysis in Uruguay

Stefani, Eduardo De,Ronco, Alvaro L.,Boffetta, Paolo,Deneo-Pellegrini, Hugo,Correa, Pelayo,Acosta, Gisele,Mendilaharsu, Maria Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.1

In order to explore the role of nutrients and bioactive related substances in colorectal cancer, we conducted a case-control in Uruguay, which is the country with the highest production of beef in the world. Six hundred and eleven (611) cases afflicted with colorectal cancer and 1,362 controls drawn from the same hospitals in the same time period were analyzed through unconditional multiple logistic regression. This base population was submitted to a principal components factor analysis and three factors were retained. They were labeled as the meat-based, plant-based, and carbohydrates patterns. They were rotated using orthogonal varimax method. The highest risk was positively associated with the meat-based pattern (OR for the highest quartile versus the lowest one 1.63, 95 % CI 1.22-2.18, P value for trend = 0.001), whereas the plant-based pattern was strongly protective (OR 0.60, 95 % CI 0.45-0.81, P value for trend <0.0001. The carbohydrates pattern was only positively associated with colon cancer risk (OR 1.46, 95 % CI 1.02-2.09). The meat-based pattern was rich in saturated fat, animal protein, cholesterol, and phosphorus, nutrients originated in red meat. Since herocyclic amines are formed in the well-done red meat through the action of amino acids and creatine, it is suggestive that this pattern could be an important etiologic agent for colorectal cancer.

Meat Consumption, Animal Products, and the Risk of Bladder Cancer: A Case-Control Study in Uruguayan Men

Ronco, Alvaro Luis,Mendilaharsu, Maria,Boffetta, Paolo,Deneo-Pellegrini, Hugo,Stefani, Eduardo De Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.14

In the time period 1996-2004, all incident cases of bladder cancer were included in a case-control study in order to study the role of meat consumption and product animals in the etiology of urothelial cancer. The study included 225 cases and 1,510 hospitalized controls with non-neoplastic conditions, not related to smoking and alcohol drinking. Relative risks, approximated by the odds ratios, were calculated in order to clarify the effect of meat consumption in the etiology of urothelial cancer. Total meat consumption (OR 1.47, 95% CI 1.02-2.11), total processed meat (OR 1.57, 95% CI 1.08-2.27), frankfurters (hot dogs) (OR 2.03, 95% CI 1.28-3.21), ham (OR 1.79, 95% CI 1.21-2.67) and salted meat (OR 2.73, 95% CI 1.78-4.18) were positively associated with risk of bladder cancer. Animal products, like cheese, whole milk, and total eggs were also associated with bladder cancer risk (OR for eggs 4.05, 95% CI 2.68-6.12). In conclusion, total meat, processed meat, and eggs could play an important role in the etiology of bladder cancer in Uruguay.

Diet Patterns and Risk of Squamous Cell Oesophageal Carcinoma: A Case-control Study in Uruguay

De Stefani, Eduardo,Deneo-Pellegrini, Hugo,Ronco, Alvaro L.,Boffetta, Paolo,Correa, Pelayo,Mendilaharsu, Maria,Acosta, Gisele,Quarneti, Aldo,Silva, Cecilia Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.6

Background: Oesophageal cancer presents high incidence rates in the so-called Brazilian-Uruguayan belt. Materials and Methods: The present study included 1,170 participants (234 cases and 936 controls) which were analyzed by unconditional multiple logistic regression in order to examine risk of oesophageal squamous cell carcinoma (OESCC) associated with several food groups. Results: Boiled red meat (OR 2.59, 95%CI 1.69-3.97), lamb meat (OR 1.64, 95%CI 1.07-2.51), processed meat (OR 1.49, 95%CI 1.01-2.21), whole milk (OR 1.78, 1.19-1.68), fresh vegetables and fruits (OR 0.42, 95%CI 0.27-0.63), mate consumption (OR 2.04, 95%CI 1.32-3.16), and black tea (OR 0.10, 95%CI 0.04-0.28) were significantly associated with risk of OESCC. Conclusions: Hot beverages (mate) and hot foods (boiled meat) appear to be important determinants in the risk of OESCC, allowing the penetration of carcinogens in tobacco and alcohol into the oesophageal mucosa.

Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts

Zheng, Wei,McLerran, Dale F.,Rolland, Betsy A.,Fu, Zhenming,Boffetta, Paolo,He, Jiang,Gupta, Prakash Chandra,Ramadas, Kunnambath,Tsugane, Shoichiro,Irie, Fujiko,Tamakoshi, Akiko,Gao, Yu-Tang,Koh, Woon Public Library of Science 2014 PLoS medicine Vol.11 No.4

<▼1><P>Wei Zheng and colleagues quantify the burden of tobacco-smoking-related deaths for adults in Asia.</P><P><I>Please see later in the article for the Editors' Summary</I></P></▼1><▼2><P><B>Background</B></P><P>Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.</P><P><B>Methods and Findings</B></P><P>We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan—accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37–1.51) and 1.48-fold (1.38–1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%–17.2%) and 3.3% (2.6%–4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000–1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.</P><P><B>Conclusions</B></P><P>Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.</P><P><I>Please see later in the article for the Editors' Summary</I></P></▼2><▼3><P><B>Editors' Summary</B></P><P><B>Background</B></P><P>Every year, more than 5 million smokers die from tobacco-related diseases. Tobacco smoking is a major risk factor for cardiovascular disease (conditions that affect the heart and the circulation), respiratory disease (conditions that affect breathing), lung cancer, and several other types of cancer. All told, tobacco smoking kills up to half its users. The ongoing global “epidemic” of tobacco smoking and tobacco-related diseases initially affected people living in the US and other Western countries, where the prevalence of smoking (the proportion of the population that smokes) in men began to rise in the early 1900s, peaking in the 1960s. A similar epidemic occurred in women about 40 years later. Smoking-related deaths began to increase in the second half of the 20th century, and by the 1990s, tobacco smoking accounted for a third of all deaths and about half of cancer deaths among men in the US and other Western countries. More recently, increased awareness of the risks of smoking and the introduction of various tobacco control measures has led to a steady decline in tobacco use and in smoking-related diseases in many developed countries.</P><P><B>Why Was This Study Done?</B></P><P>Unfortunately, less well-developed tobacco control programs, inadequate public awareness of smoking risks, and tobacco company marketing have recently led to sharp increases in the prevalence of smoking in many low- and middle-income countries, particularly in Asia. More than 50% of men in many Asian countries are now smokers, about tw

Attributable Causes of Liver Cancer Mortality and Incidence in China

Fan, Jin-Hu,Wang, Jian-Bing,Jiang, Yong,Xiang, Wang,Liang, Hao,Wei, Wen-Qiang,Qiao, You-Lin,Boffetta, Paolo Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12

Objectives: To estimate the proportion of liver cancer cases and deaths due to infection with hepatitis B virus (HBV), hepatitis C virus (HCV), aflatoxin exposure, alcohol drinking and smoking in China in 2005. Study design: Systemic assessment of the burden of five modifiable risk factors on the occurrence of liver cancer in China using the population attributable fraction. Methods: We estimated the population attributable fraction of liver cancer caused by five modifiable risk factors using the prevalence data around 1990 and data on relative risks from meta-analyses, and large-scale observational studies. Liver cancer mortality data were from the 3rd National Death Causes Survey, and data on liver cancer incidence were estimated from the mortality data from cancer registries in China and a mortality/incidence ratio calculated. Results: We estimated that HBV infection was responsible for 65.9% of liver cancer deaths in men and 58.4% in women, while HCV was responsible for 27.3% and 28.6% respectively. The fraction of liver cancer deaths attributable to aflatoxin was estimated to be 25.0% for both men and women. Alcohol drinking was responsible for 23.4% of liver cancer deaths in men and 2.2% in women. Smoking was responsible for 18.7% and 1.0%. Overall, 86% of liver cancer mortality and incidence (88% in men and 78% in women) was attributable to these five modifiable risk factors. Conclusions: HBV, HCV, aflatoxin, alcohol drinking and tobacco smoking were responsible for 86% of liver cancer mortality and incidence in China in 2005. Our findings provide useful data for developing guidelines for liver cancer prevention and control in China and other developing countries.

Semi-Quantitative Exposure Assessment of Occupational Exposure to Wood Dust and Nasopharyngeal Cancer Risk

Ekpanyaskul, Chatchai,Sangrajrang, Suleeporn,Ekburanawat, Wiwat,Brennan, Paul,Mannetje, Andrea,Thetkathuek, Anamai,Saejiw, Nutjaree,Ruangsuwan, Tassanu,Boffetta, Paolo Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.10

Occupational exposure to wood dust is one cause of nasopharyngeal cancer (NPC); however, assessing this exposure remains problematic. Therefore, the objective of this study was to develop a semi-quantitative exposure assessment method and then utilize it to evaluate the association between occupational exposure to wood dust and the development of NPC. In addition, variations in risk by histology were examined. A case-control study was conducted with 327 newly diagnosed cases of NPC at the National Cancer Institute and regional cancer centers in Thailand with 1:1 controls matched for age, gender and geographical residence. Occupational information was obtained through personal interviews. The potential probability, frequency and intensity of exposure to wood dust were assessed on a job-by-job basis by experienced experts. Analysis was performed by conditional logistic regression and presented in odds ratio (ORs) estimates and 95% confidence intervals (CI). Overall, a non significant relationship between occupational wood dust exposure and NPC risk for all subjects was observed (ORs=1.61, 95%CI 0.99-2.59); however, the risk became significant when analyses focused on types 2 and 3 of NPC (ORs=1.62, 95%CI 1.03-2.74). The significant association was stronger for those exposed to wood dust for > 10 year (ORs=2.26, 95%CI 1.10-4.63), for those with first-time exposure at age > 25 year (ORs=2.07, 95%CI 1.08-3.94), and for those who had a high cumulative exposure (ORs=2.17, 95%CI 1.03-4.58) when compared with those considered unexposed. In conclusion, wood dust is likely to be associated with an increased risk of type 2 or 3 NPC in the Thai population. The results of this study show that semi-quantitative exposure assessment is suitable for occupational exposure assessment in a case control study and complements the information from self-reporting.