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1.
Gynecol Oncol ; 189: 111-118, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39096588

RESUMEN

OBJECTIVE: This study assessed the health-related quality of life (HRQo) of women surviving a borderline ovarian tumor (BOT) in comparison with early-stage ovarian cancer survivors treated surgically alone and with a matched cancer-free population. METHODS: Survivors of BOT and ovarian cancer were invited in two Dutch cross-sectional, population-based studies. Ovarian cancer survivors with tumor stage I who were treated surgically only were included. A random sample from the cancer-free population was matched on sex, age and education to the sample of BOT survivors. The EORTC QLQ-C30 (version 3.0) and the EORTC QLQ-OV28 were completed by the cancer-free population and the BOT and ovarian cancer survivors in study 1 and 2. The Hospital Anxiety and Depression Scale (HADS) was only completed by the cancer-free population and the survivors of BOT and ovarian cancer in study 1. BOT survivors were compared to early-stage ovarian cancer survivors and the general population using linear regression analyses and effect sizes regarding clinical importance. RESULTS: 83 BOT (42%), 88 early-stage ovarian cancer survivors (52%), and 82 women from the general population were included. In most HRQoL domains, BOT survivors were not significantly different from early-stage ovarian cancer survivors and the cancer-free population, except that BOT survivors reported significantly less insomnia than early-stage ovarian cancer survivors and more dyspnea than the cancer-free population (small clinical difference). CONCLUSION: In general, BOT survivors' HRQoL lies between the HRQoL of early-stage ovarian cancer survivors and of the cancer-free population, but clinical effect sizes between the groups were mostly only trivial.


Asunto(s)
Supervivientes de Cáncer , Estadificación de Neoplasias , Neoplasias Ováricas , Calidad de Vida , Humanos , Femenino , Neoplasias Ováricas/psicología , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Estudios Transversales , Persona de Mediana Edad , Supervivientes de Cáncer/psicología , Adulto , Anciano , Países Bajos/epidemiología
2.
BMC Cancer ; 23(1): 156, 2023 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-36797692

RESUMEN

BACKGROUND: Diet, alcohol, cigarette smoking, physical inactivity, and body mass index have been studied as risk factors for renal cell cancer (RCC). The joint effects of these lifestyle factors, captured as Healthy Lifestyle Index (HLI), were examined in one previous study. This study aims to investigate the association between HLI score and RCC risk in the prospective Netherlands Cohort Study (NLCS). METHODS: A case-cohort analysis (3,767 subcohort members, 485 cases) was conducted using NLCS data (n = 120,852). Data on aforementioned risk factors was used to calculate HLI score, ranging 0-20, with higher scores reflecting healthier lifestyles. RCC occurrence was obtained by record linkage to cancer registries. Multivariable-adjusted proportional hazard models were used to calculate Hazard Ratios (HR) and 95% Confidence Intervals (95%CI). RESULTS: Compared to participants in the unhealthiest HLI category, participants within the healthiest category had a lower RCC risk (HR = 0.79, 95%CI = 0.56-1.10, p for trend 0.045). A standard deviation (± 3-unit) increase in HLI score was not statistically significantly associated with a lower RCC risk (HR = 0.92, 95%CI = 0.83-1.01). This association was stronger after excluding diet or alcohol from the score, although confidence intervals overlap. CONCLUSIONS: Adherence to a healthy lifestyle was weakly, though not statistically significantly, associated with a lower RCC risk.


Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Humanos , Estudios de Cohortes , Carcinoma de Células Renales/epidemiología , Estudios Prospectivos , Países Bajos/epidemiología , Factores de Riesgo , Estilo de Vida Saludable , Neoplasias Renales/epidemiología , Neoplasias Renales/etiología
3.
BMC Cancer ; 23(1): 314, 2023 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-37020279

RESUMEN

Cancer of Unknown Primary (CUP) is metastatic cancer with an unidentifiable primary tumour origin during life. It remains difficult to study the occurrence and aetiology of CUP. Hitherto, it is unclear whether risk factors are associated with CUP, yet identifying these factors could reveal whether CUP is a specific entity or a cluster of metastasised cancers from various primary tumour origins. Epidemiological studies on possible CUP risk factors were systematically searched in PubMed and Web of Science on February 1st, 2022. Studies, published before 2022, were included if they were observational human-based, provided relative risk estimates, and investigated possible CUP risk factors. A total of 5 case-control and 14 cohort studies were included. There appears to be an increased risk for smoking in relation to CUP. However, limited suggestive evidence was found to link alcohol consumption, diabetes mellitus, and family history of cancer as increased risks for CUP. No conclusive associations could be made for anthropometry, food intake (animal or plant-based), immunity disorders, lifestyle (overall), physical activity, or socioeconomic status and CUP risk. No other CUP risk factors have been studied. This review highlights smoking, alcohol consumption, diabetes mellitus and family history of cancer as CUP risk factors. Yet, there remains insufficient epidemiological evidence to conclude that CUP has its own specific risk factor profile.


Asunto(s)
Diabetes Mellitus , Neoplasias Primarias Desconocidas , Humanos , Neoplasias Primarias Desconocidas/patología , Factores de Riesgo , Fumar , Consumo de Bebidas Alcohólicas
4.
Gynecol Oncol ; 169: 137-146, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36934308

RESUMEN

BACKGROUND: Limited data from prospective studies suggest that higher dietary intake of long-chain omega-3 polyunsaturated fatty acids (LCn3PUFA), which hold anti-inflammatory properties, may reduce endometrial cancer risk; particularly among certain subgroups characterized by body mass and tumor pathology. MATERIALS AND METHODS: Data from 12 prospective cohort studies participating in the Epidemiology of Endometrial Cancer Consortium were harmonized as nested case-control studies, including 7268 endometrial cancer cases and 26,133 controls. Habitual diet was assessed by food frequency questionnaire, from which fatty acid intakes were estimated. Two-stage individual-participant data mixed effects meta-analysis estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) through logistic regression for associations between study-specific energy-adjusted quartiles of LCn3PUFA and endometrial cancer risk. RESULTS: Women with the highest versus lowest estimated dietary intakes of docosahexaenoic acid, the most abundant LCn3PUFA in diet, had a 9% increased endometrial cancer risk (Quartile 4 vs. Quartile 1: OR 1.09, 95% CI: 1.01-1.19; P trend = 0.04). Similar elevated risks were observed for the summary measure of total LCn3PUFA (OR 1.07, 95% CI: 0.99-1.16; P trend = 0.06). Stratified by body mass index, higher intakes of LCn3PUFA were associated with 12-19% increased endometrial cancer risk among overweight/obese women and no increased risk among normal-weight women. Higher associations appeared restricted to White women. The results did not differ by cancer grade. CONCLUSION: Higher dietary intakes of LCn3PUFA are unlikely to reduce endometrial cancer incidence; rather, they may be associated with small to moderate increases in risk in some subgroups of women, particularly overweight/obese women.


Asunto(s)
Neoplasias Endometriales , Ácidos Grasos Omega-3 , Humanos , Femenino , Estudios Prospectivos , Sobrepeso , Dieta , Obesidad/epidemiología , Obesidad/complicaciones , Neoplasias Endometriales/epidemiología , Neoplasias Endometriales/prevención & control , Neoplasias Endometriales/etiología , Modelos Logísticos , Factores de Riesgo
5.
Int J Cancer ; 150(11): 1812-1824, 2022 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-35064924

RESUMEN

Early-life (childhood to adolescence) energy balance-related factors (height, energy restriction, BMI) have been associated with adult colorectal cancer (CRC) risk. Warburg-effect activation via PI3K/Akt-signaling might explain this link. We investigated whether early-life energy balance-related factors were associated with risk of Warburg-subtypes in CRC. We used immunohistochemistry for six proteins involved in the Warburg-effect (LDHA, GLUT1, MCT4, PKM2, P53, and PTEN) on tissue microarrays of 2399 incident CRC cases from the prospective Netherlands Cohort Study (NLCS). Expression levels of all proteins were combined into a pathway-based sum score and categorized into three Warburg-subtypes (Warburg-low/-moderate/-high). Multivariable Cox-regression analyses were used to estimate associations of height, energy restriction proxies (exposure to Dutch Hunger Winter; Second World War [WWII]; Economic Depression) and adolescent BMI with Warburg-subtypes in CRC. Height was positively associated with colon cancer in men, regardless of Warburg-subtypes, and with Warburg-low colon and Warburg-moderate rectal cancer in women. Energy restriction during the Dutch Hunger Winter was inversely associated with colon cancer in men, regardless of Warburg-subtypes. In women, energy restriction during the Hunger Winter and WWII was inversely associated with Warburg-low colon cancer, whereas energy restriction during the Economic Depression was positively associated with Warburg-high colon cancer. Adolescent BMI was positively associated with Warburg-high colon cancer in men, and Warburg-moderate rectal cancer in women. In conclusion, the Warburg-effect seems to be involved in associations of adolescent BMI with colon cancer in men, and of energy restriction during the Economic Depression with colon cancer in women. Further research is needed to validate these results.


Asunto(s)
Neoplasias Colorrectales , Fosfatidilinositol 3-Quinasas , Adolescente , Adulto , Estudios de Cohortes , Neoplasias Colorrectales/epidemiología , Femenino , Humanos , Masculino , Estudios Prospectivos , Factores de Riesgo
6.
Mol Carcinog ; 61(12): 1099-1115, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36177801

RESUMEN

KRAS mutations (KRASmut ), PIK3CAmut , BRAFmut , and deficient DNA mismatch repair (dMMR) have been associated with the Warburg effect. We previously reported differential associations between early-life energy balance-related factors (height, energy restriction, body mass index [BMI]) and colorectal cancer (CRC) subtypes based on the Warburg effect. We now investigated associations of early-life energy balance-related factors and the risk of CRC subgroups based on mutation and MMR status. Data from the Netherlands Cohort Study was used. KRASmut , PIK3CAmut, BRAFmut, and MMR status were available for 2349 CRC cases, and complete covariate data for 1934 cases and 3911 subcohort members. Multivariable-adjusted Cox regression was used to estimate associations of height, energy restriction proxies (exposure to Dutch Hunger Winter, Second World War, Economic Depression), and early adult BMI (age 20 years) with risk of CRC based on individual molecular features and combinations thereof (all-wild-type+MMR-proficient [pMMR]; any-mutation/dMMR). Height was positively associated with any-mutation/dMMR CRC but not all-wild-type+pMMR CRC, with the exception of rectal cancer in men, and with heterogeneity in associations observed for colon cancer in men (p-heterogeneity = 0.049) and rectal cancer in women (p-heterogeneity = 0.014). Results on early-life energy restriction proxies in relation to the risk of CRC subgroups did not show clear patterns. Early adult BMI was positively, but not significantly, associated with KRASmut colon cancer in men and with BRAFmut and dMMR colon cancer in women. Our results suggest a role of KRASmut , PIK3CAmut , BRAFmut , and dMMR in the etiological pathway between height and CRC risk. KRASmut might potentially play a role in associations of early adult BMI with colon cancer risk in men, and BRAFmut and dMMR in women.


Asunto(s)
Neoplasias del Colon , Neoplasias Colorrectales , Reparación de la Incompatibilidad de ADN , Neoplasias del Recto , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Fosfatidilinositol 3-Quinasa Clase I/genética , Estudios de Cohortes , Neoplasias del Colon/epidemiología , Neoplasias del Colon/genética , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/genética , Mutación , Proteínas Proto-Oncogénicas B-raf/genética , Proteínas Proto-Oncogénicas p21(ras)/genética , Neoplasias del Recto/epidemiología , Neoplasias del Recto/genética , Niño
7.
BMC Cancer ; 22(1): 399, 2022 Apr 13.
Artículo en Inglés | MEDLINE | ID: mdl-35418049

RESUMEN

BACKGROUND: Cancer of Unknown Primary (CUP) is a metastatic cancer for which the primary lesion remains unidentifiable during life and little is also known about the modifiable risk factors that contribute to its development. This study investigates whether vegetables and fruits are associated with CUP risk. METHODS: We used data from the prospective Netherlands Cohort Study on Diet and Cancer which includes 120,852 participants aged between 55 and 69 years in 1986. All participants completed a self-administered questionnaire on cancer risk factors at baseline. Cancer follow-up was established through record linkage to the Netherlands Cancer Registry and the Dutch Pathology Registry. As a result, 867 incident CUP cases and 4005 subcohort members were available for case-cohort analyses after 20.3 years of follow-up. Multivariable adjusted hazard ratios were calculated using proportional hazards models. RESULTS: We observed no associations between total vegetable and fruit consumption (combined or as separate groups) and CUP risk. However, there appeared to be an inverse association between the consumption of raw leafy vegetables and CUP. With respect to individual vegetable and fruit items, we found neither vegetable nor fruit items to be associated with CUP risk. CONCLUSIONS: Overall, vegetable and fruit intake were not associated with CUP incidence within this cohort.


Asunto(s)
Neoplasias Primarias Desconocidas , Verduras , Anciano , Estudios de Cohortes , Dieta , Frutas , Humanos , Incidencia , Persona de Mediana Edad , Países Bajos/epidemiología , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios
8.
Int J Cancer ; 148(7): 1586-1597, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33022785

RESUMEN

Cancer of unknown primary (CUP) is a metastasised malignancy with no identifiable primary tumour origin. Despite the frequent occurrence and bleak prognosis of CUP, research into its aetiology is scarce. Our study investigates alcohol consumption, tobacco smoking and CUP risk. We used data from the Netherlands Cohort Study, a cohort that includes 120 852 participants aged 55 to 69 years, who completed a self-administered questionnaire on cancer risk factors at baseline. Cancer follow-up was established through record linkage to the Netherlands Cancer Registry and Dutch Pathology Registry. After 20.3 years of follow-up, 963 CUP cases and 4288 subcohort members were available for case-cohort analyses. Multivariable-adjusted hazard ratios (HRs) were calculated using proportional hazard models. In general, CUP risk increased with higher levels of alcohol intake (Ptrend = .02). The association was more pronounced in participants who drank ≥30 g of ethanol per day (HR: 1.57, 95% confidence interval [CI]: 1.20-2.05) compared to abstainers. Current smokers were at an increased CUP risk (HR: 1.59, 95% CI: 1.29-1.97) compared to never smokers. We observed that the more the cigarettes or the longer a participant smoked, the higher the CUP risk was (Ptrend = .003 and Ptrend = .02, respectively). Interaction on additive scale was found for participants with the highest exposure categories of alcohol consumption and cigarette smoking frequency and CUP risk. Our findings demonstrate that alcohol consumption and cigarette smoking are associated with increased CUP risk. Lifestyle recommendations for cancer prevention regarding not drinking alcohol and avoiding exposure to smoking are therefore also valid for CUP.


Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Fumar Cigarrillos/efectos adversos , Neoplasias Glandulares y Epiteliales/etiología , Neoplasias Primarias Desconocidas/etiología , Anciano , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Neoplasias Glandulares y Epiteliales/diagnóstico , Neoplasias Glandulares y Epiteliales/mortalidad , Neoplasias Glandulares y Epiteliales/patología , Neoplasias Primarias Desconocidas/diagnóstico , Neoplasias Primarias Desconocidas/mortalidad , Neoplasias Primarias Desconocidas/patología , Países Bajos/epidemiología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Sistema de Registros , Factores de Riesgo , Encuestas y Cuestionarios
9.
Int J Cancer ; 148(1): 67-76, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-32638386

RESUMEN

At present, mostly case-control and retrospective studies have investigated the association between etiologic risk factors and the development of histologic subtypes of renal cell carcinoma (RCC). Therefore, we assessed the heterogeneity between body mass index (BMI), cigarette smoking, alcohol consumption and hypertension across clear-cell RCC (ccRCC) and papillary RCC (pRCC) risk in the prospective Netherlands Cohort Study on diet and cancer. In 1986, 120 852 participants aged 55 to 69 completed a self-administered questionnaire on diet and other risk factors for cancer. Participants were followed up for cancer through record linkage. Tumor histology was assessed through centralized revision by two experienced uropathologists. After 20.3 years of follow-up, 384 histologically verified RCC cases, including 315 ccRCC and 46 pRCC cases and 4144 subcohort members were eligible for case-cohort analysis. Hazard ratios and 95% confidence intervals were estimated by multivariable-adjusted proportional hazards models. Overall, BMI was associated positively with ccRCC risk, but inversely with pRCC risk. Cigarette smoking was associated with an increased ccRCC, but a decreased pRCC risk. Alcohol consumption was inversely associated with both ccRCC and pRCC risk. Hypertension was associated with an increased risk of both ccRCC and pRCC. Statistically significant etiologic heterogeneity was observed for BMI, BMI change since age 20, and smoking duration in current smokers across ccRCC and pRCC risk. In conclusion, we observed potential heterogeneity for BMI, BMI change and smoking duration across ccRCC and pRCC risk.


Asunto(s)
Carcinoma Papilar/epidemiología , Carcinoma de Células Renales/epidemiología , Neoplasias Renales/epidemiología , Anciano , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Índice de Masa Corporal , Carcinoma Papilar/etiología , Carcinoma de Células Renales/etiología , Estudios de Casos y Controles , Causalidad , Fumar Cigarrillos/efectos adversos , Fumar Cigarrillos/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Neoplasias Renales/etiología , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Medición de Riesgo/estadística & datos numéricos , Factores de Riesgo
10.
Int J Cancer ; 148(9): 2068-2078, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33105052

RESUMEN

A full-term pregnancy is associated with reduced endometrial cancer risk; however, whether the effect of additional pregnancies is independent of age at last pregnancy is unknown. The associations between other pregnancy-related factors and endometrial cancer risk are less clear. We pooled individual participant data from 11 cohort and 19 case-control studies participating in the Epidemiology of Endometrial Cancer Consortium (E2C2) including 16 986 women with endometrial cancer and 39 538 control women. We used one- and two-stage meta-analytic approaches to estimate pooled odds ratios (ORs) for the association between exposures and endometrial cancer risk. Ever having a full-term pregnancy was associated with a 41% reduction in risk of endometrial cancer compared to never having a full-term pregnancy (OR = 0.59, 95% confidence interval [CI] 0.56-0.63). The risk reduction appeared the greatest for the first full-term pregnancy (OR = 0.78, 95% CI 0.72-0.84), with a further ~15% reduction per pregnancy up to eight pregnancies (OR = 0.20, 95% CI 0.14-0.28) that was independent of age at last full-term pregnancy. Incomplete pregnancy was also associated with decreased endometrial cancer risk (7%-9% reduction per pregnancy). Twin births appeared to have the same effect as singleton pregnancies. Our pooled analysis shows that, while the magnitude of the risk reduction is greater for a full-term pregnancy than an incomplete pregnancy, each additional pregnancy is associated with further reduction in endometrial cancer risk, independent of age at last full-term pregnancy. These results suggest that the very high progesterone level in the last trimester of pregnancy is not the sole explanation for the protective effect of pregnancy.


Asunto(s)
Neoplasias Endometriales/epidemiología , Estudios de Casos y Controles , Femenino , Humanos , Embarazo , Resultado del Embarazo , Factores de Riesgo
11.
Eur J Epidemiol ; 36(1): 37-55, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33128203

RESUMEN

Associations between anthropometric factors and breast cancer (BC) risk have varied inconsistently by estrogen and/or progesterone receptor (ER/PR) status. Associations between prediagnostic anthropometric factors and risk of premenopausal and postmenopausal BC overall and ER/PR status subtypes were investigated in a pooled analysis of 20 prospective cohorts, including 36,297 BC cases among 1,061,915 women, using multivariable Cox regression analyses, controlling for reproductive factors, diet and other risk factors. We estimated dose-response relationships and tested for nonlinear associations using restricted cubic splines. Height showed positive, linear associations for premenopausal and postmenopausal BC risk (6-7% RR increase per 5 cm increment), with stronger associations for receptor-positive subtypes. Body mass index (BMI) at cohort baseline was strongly inversely associated with premenopausal BC risk, and strongly positively-and nonlinearly-associated with postmenopausal BC (especially among women who never used hormone replacement therapy). This was primarily observed for receptor-positive subtypes. Early adult BMI (at 18-20 years) showed inverse, linear associations for premenopausal and postmenopausal BC risk (21% and 11% RR decrease per 5 kg/m2, respectively) with stronger associations for receptor-negative subtypes. Adult weight gain since 18-20 years was positively associated with postmenopausal BC risk, stronger for receptor-positive subtypes, and among women who were leaner in early adulthood. Women heavier in early adulthood generally had reduced premenopausal BC risk, independent of later weight gain. Positive associations between height, baseline (adult) BMI, adult weight gain and postmenopausal BC risk were substantially stronger for hormone receptor-positive versus negative subtypes. Premenopausal BC risk was positively associated with height, but inversely with baseline BMI and weight gain (mostly in receptor-positive subtypes). Inverse associations with early adult BMI seemed stronger in receptor-negative subtypes of premenopausal and postmenopausal BC.


Asunto(s)
Peso Corporal/fisiología , Neoplasias de la Mama/epidemiología , Menopausia/fisiología , Receptores de Estrógenos/análisis , Aumento de Peso , Adulto , Anciano , Índice de Masa Corporal , Estudios de Cohortes , Femenino , Humanos , Persona de Mediana Edad , Premenopausia , Estudios Prospectivos , Factores de Riesgo
12.
Eur J Nutr ; 60(8): 4579-4593, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34155531

RESUMEN

PURPOSE: Cancer of unknown primary (CUP) is a metastasised cancer for which no primary lesion could be identified during life. Research into CUP aetiology with respect to dietary factors is particularly scarce. This study investigates whether meat consumption is associated with CUP risk. METHODS: Data was utilised from the prospective Netherlands cohort study that includes 1,20,852 participants aged 55-69 years. All participants completed a self-administered questionnaire on diet and other cancer risk factors at baseline. Cancer follow-up was established through record linkage to the Netherlands Cancer Registry and the Dutch Pathology Registry. A total of 899 CUP cases and 4111 subcohort members with complete and consistent dietary data were available for case-cohort analyses after 20.3 years of follow-up. Multivariable adjusted hazard ratios (HRs) were calculated using proportional hazards models. RESULTS: We found a statistically significant positive association with beef and processed meat consumption and CUP risk in women (multivariable adjusted HR Q4 vs. Q1 1.47, 95% CI 1.04-2.07, Ptrend = 0.004 and Q4 vs. Q1 1.53, 95% CI 1.08-2.16, Ptrend = 0.001, respectively), and a non-significant positive association with processed meat consumption and CUP risk in men (multivariable adjusted HR Q4 vs. Q1 1.33, 95% CI 0.99-1.79, Ptrend = 0.15). No associations were observed between red meat (overall), poultry or fish consumption and CUP risk. CONCLUSION: In this cohort, beef and processed meat consumption were positively associated with increased CUP risk in women, whereas a non-significant positive association was observed between processed meat consumption and CUP risk in men.


Asunto(s)
Neoplasias Primarias Desconocidas , Carne Roja , Animales , Bovinos , Estudios de Cohortes , Dieta , Femenino , Humanos , Masculino , Carne , Países Bajos/epidemiología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo
13.
Eur J Cancer Care (Engl) ; 30(6): e13485, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34224169

RESUMEN

OBJECTIVE: Cancer of Unknown Primary (CUP) refers to the presence of metastatic lesions, with no identifiable primary site during the patient's lifetime. Poor survival and lack of available treatment highlight the need to identify potential CUP risk factors. We investigated whether a family history of cancer is associated with increased CUP risk. METHODS: We performed a case cohort analysis using data from the Netherlands Cohort Study, which included a total of 963 CUP cases and 4,288 subcohort members. A Cox Proportional Hazards Regression was used to compare CUP risk in participants who reported to have a family member with cancer to those who did not, whilst adjusting for confounders. RESULTS: In general, we observed no increased CUP risk in those who reported a family history of cancer. CUP risk appeared slightly increased in those who reported cancer in a sibling (HR: 1.16, 95% CI: 0.97-1.38), especially in those with a sister with cancer compared with those without (HR: 1.23, 95% CI: 0.99-1.53), although these findings are not statistically significant. CONCLUSION: Having a family history of cancer is not an independent risk factor of CUP.


Asunto(s)
Neoplasias Primarias Desconocidas , Estudios de Cohortes , Familia , Humanos , Neoplasias Primarias Desconocidas/epidemiología , Neoplasias Primarias Desconocidas/genética , Países Bajos/epidemiología , Factores de Riesgo
14.
Eur J Public Health ; 31(5): 1021-1025, 2021 10 26.
Artículo en Inglés | MEDLINE | ID: mdl-34233355

RESUMEN

BACKGROUND: Early diagnosis of human papillomavirus (HPV) associated oropharyngeal cancer (OPC) is associated with improved survival. To achieve early diagnosis, it might be beneficial to increase awareness of the link between HPV and OPC. This increase of awareness could also be an important way to increase vaccination rates. The aim of our study was to explore the current public knowledge in the Netherlands regarding the association of HPV with OPC. METHODS: An online cross-sectional survey was used and sent by the company Flycatcher Internet Research to 1539 of their panel members. Data were analyzed statistically by gender, age, educational level and the participants' use of alcohol and tobacco. RESULTS: The response rate was 68% (1044 participants). Our data revealed that 30.6% of the participants had heard of HPV. There was a knowledge gap regarding HPV in males (P < 0.001), people older than 65 years (P < 0.001), people with low education level (P < 0.001) and current smokers (P < 0.001). Of the respondents who had heard of HPV, only 29.2% knew of the association between HPV and OPC. We also found that only 49.7% of the population knew of the existence of an HPV vaccine. CONCLUSIONS: The results of this survey indicate that the public awareness of HPV and the association of HPV with OPC is lacking. Interventions to increase awareness of HPV and its association with non-cervical cancer should be considered. This might help to increase the HPV vaccine uptake both for girls and boys and earlier diagnosis of this disease leading to improved survival.


Asunto(s)
Alphapapillomavirus , Neoplasias Orofaríngeas , Estudios Transversales , Humanos , Países Bajos/epidemiología , Neoplasias Orofaríngeas/epidemiología , Papillomaviridae
15.
Neurourol Urodyn ; 39(4): 1124-1128, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32125734

RESUMEN

OBJECTIVE: The prevalence of nocturia in patients with obstructive sleep apnea syndrome (OSAS) who received continuous positive airways pressure (CPAP) treatment was studied as well as the effect of CPAP treatment on nocturia. METHODS: All patients that were referred to the pulmonology department of a large teaching hospital in the Netherlands and received a CPAP mask for OSAS were interviewed and invited to take part in the study (N = 274). After informed consent, all patients were asked about the number of nocturia episodes before and after CPAP. RESULTS: In this prospective analysis, 274 patients (190 male and 84 female) were included. The mean age was 60.3 years (SE = 0.7). Sixty-four patients (23.4%) reported no nocturia episodes before CPAP and 210 patients (76.4%) reported ≥1 nocturia episode(s). Treatment of OSAS with CPAP reduced nocturia with one or more episodes per night in 42.3% of the patients. Clinically relevant nocturia (≥2 voids per night) was reduced from 73.0% to 51.5%. There were no statistically significant gender differences. CONCLUSION: The prevalence of nocturia in patients diagnosed with OSAS is 75.8% in both sexes. After treatment with CPAP, almost half of patients experienced a decrease in the nocturia frequency of one or more voids. Clinically relevant nocturia was reduced with one-third after CPAP. CPAP not only reduced the number of voids during the night but also improved the associated quality of life.


Asunto(s)
Presión de las Vías Aéreas Positiva Contínua , Nocturia/terapia , Calidad de Vida , Apnea Obstructiva del Sueño/terapia , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Nocturia/epidemiología , Nocturia/fisiopatología , Prevalencia , Estudios Prospectivos , Apnea Obstructiva del Sueño/epidemiología , Apnea Obstructiva del Sueño/fisiopatología
16.
Int J Cancer ; 144(8): 1844-1857, 2019 04 15.
Artículo en Inglés | MEDLINE | ID: mdl-30252931

RESUMEN

Adult-attained height is a marker for underlying mechanisms, such as cell growth, that may also influence postmenopausal breast cancer (BC) risk, perhaps specifically hormone-sensitive BC subtypes. Early life energy restriction may inhibit these mechanisms, resulting in shorter height and a reduced postmenopausal BC risk. Women (62,573) from the Netherlands Cohort Study completed a self-administered questionnaire in 1986 when 55-69 years old, and were followed-up for 20.3 years (case-cohort: Nsubcohort = 2,438; Ncases = 3,354). Cox multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated for BC risk overall and by estrogen and progesterone receptor subtypes in relation to height and early life energy restriction during the Hunger Winter, War Years, and Economic Depression. Although energy restriction can only influence longitudinal growth in women exposed before and/or during the growth spurt, it may also influence BC risk when occurring after the growth spurt, possibly through different growth processes. Therefore, Cox analyses were additionally conducted according to timing of energy restriction in relation to the growth spurt. Height was associated with an increased BC risk (HRper 5cm = 1.07, 95%CI:1.01-1.13), particularly hormone receptor-positive BC. Energy restriction before and/or during the growth spurt was associated with a decreased hormone receptor-positive BC risk. Energy restriction during the Hunger Winter increased the estrogen receptor-negative BC risk regardless of the timing of energy restriction. In conclusion, height and energy restriction before and/or during the growth spurt were both associated with hormone receptor-positive BC risk, in the direction as expected, indicating critical exposure windows for hormonal growth-related mechanisms.


Asunto(s)
Estatura/fisiología , Neoplasias de la Mama/epidemiología , Ingestión de Energía/fisiología , Privación de Alimentos/fisiología , Anciano , Neoplasias de la Mama/patología , Conducta Alimentaria/fisiología , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Países Bajos/epidemiología , Posmenopausia/fisiología , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Factores de Riesgo , Encuestas y Cuestionarios/estadística & datos numéricos
17.
Int J Cancer ; 145(1): 58-69, 2019 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-30561796

RESUMEN

Ovarian cancer risk factors differ by histotype; however, within subtype, there is substantial variability in outcomes. We hypothesized that risk factor profiles may influence tumor aggressiveness, defined by time between diagnosis and death, independent of histology. Among 1.3 million women from 21 prospective cohorts, 4,584 invasive epithelial ovarian cancers were identified and classified as highly aggressive (death in <1 year, n = 864), very aggressive (death in 1 to < 3 years, n = 1,390), moderately aggressive (death in 3 to < 5 years, n = 639), and less aggressive (lived 5+ years, n = 1,691). Using competing risks Cox proportional hazards regression, we assessed heterogeneity of associations by tumor aggressiveness for all cases and among serous and endometrioid/clear cell tumors. Associations between parity (phet = 0.01), family history of ovarian cancer (phet = 0.02), body mass index (BMI; phet ≤ 0.04) and smoking (phet < 0.01) and ovarian cancer risk differed by aggressiveness. A first/single pregnancy, relative to nulliparity, was inversely associated with highly aggressive disease (HR: 0.72; 95% CI [0.58-0.88]), no association was observed for subsequent pregnancies (per pregnancy, 0.97 [0.92-1.02]). In contrast, first and subsequent pregnancies were similarly associated with less aggressive disease (0.87 for both). Family history of ovarian cancer was only associated with risk of less aggressive disease (1.94 [1.47-2.55]). High BMI (≥35 vs. 20 to < 25 kg/m2 , 1.93 [1.46-2.56] and current smoking (vs. never, 1.30 [1.07-1.57]) were associated with increased risk of highly aggressive disease. Results were similar within histotypes. Ovarian cancer risk factors may be directly associated with subtypes defined by tumor aggressiveness, rather than through differential effects on histology. Studies to assess biological pathways are warranted.


Asunto(s)
Carcinoma Epitelial de Ovario/epidemiología , Carcinoma Epitelial de Ovario/patología , Neoplasias Ováricas/epidemiología , Neoplasias Ováricas/patología , Anciano , Índice de Masa Corporal , Estudios de Cohortes , Femenino , Humanos , Persona de Mediana Edad , Invasividad Neoplásica , Paridad , Embarazo , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Fumar/epidemiología
18.
Br J Cancer ; 120(3): 368-374, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30563989

RESUMEN

BACKGROUND: We examined the association between kidney stones and renal cell carcinoma (RCC) and upper tract urothelial carcinoma (UTUC) risk in the Netherlands Cohort Study on diet and cancer. METHODS: In total, 120,852 participants aged 55-69 completed a self-administered questionnaire on diet, medical conditions and other risk factors for cancer at baseline (1986). After 20.3 years of cancer follow-up 4352 subcohort members, 544 RCC cases and 140 UTUC cases were eligible for case-cohort analysis. Hazard ratios (HR) and 95% confidence intervals (CIs) were estimated by multivariable-adjusted proportional hazards models. RESULTS: Kidney stones were associated with an increased RCC risk (HR: 1.39, 95% CI 1.05-1.84), vs. no kidney stones. Kidney stones were associated with an increased risk of papillary RCC (HR: 3.08, 95% CI 1.55-6.11), but not clear-cell RCC (HR: 1.14, 95% CI 0.79-1.65). UTUC risk was increased for participants with kidney stones (HR: 1.66, 95% CI 1.03-2.68). No heterogeneity of associations was found for UTUC in the ureter and renal pelvis. An early kidney stone diagnosis (≤40 years) was associated with an increased RCC and UTUC risk, compared to later diagnosis. CONCLUSION: Kidney stones were associated with increased papillary RCC risk, but not clear-cell RCC risk. No heterogeneity was found for UTUC subtypes.


Asunto(s)
Carcinoma de Células Renales/epidemiología , Carcinoma de Células Transicionales/epidemiología , Cálculos Renales/epidemiología , Neoplasias Urológicas/epidemiología , Anciano , Carcinoma de Células Renales/complicaciones , Carcinoma de Células Renales/patología , Carcinoma de Células Transicionales/complicaciones , Carcinoma de Células Transicionales/patología , Estudios de Cohortes , Femenino , Tasa de Filtración Glomerular , Humanos , Cálculos Renales/complicaciones , Cálculos Renales/patología , Masculino , Persona de Mediana Edad , Nefrectomía , Países Bajos/epidemiología , Factores de Riesgo , Neoplasias Urológicas/complicaciones , Neoplasias Urológicas/patología
19.
Eur J Epidemiol ; 34(12): 1171-1174, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31728879

RESUMEN

OBJECTIVE: Autopsy rates have been declining worldwide. The present study reports the outcome of a retrospective analysis of all non-forensic autopsies in the Netherlands over a course of 25 years, and compares these with the most recent Dutch study. METHOD: Retrospectively, 25 years of data on clinical autopsies from the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA) was paired with the mortality registry (Statistics Netherlands). RESULTS: The crude prevalence of autopsies declined from 7.07% in 1991 to 2.73% in 2015. After adjusting for age at death, there was no difference in autopsy rate between males and females. An increasing age significantly decreased the autopsy rate. CONCLUSION: In the Netherlands, clinical autopsies have been declining over the last quarter century. Age at death, but not sex, was associated with the autopsy rate. These different results stress the importance of correct collection and analysis methods of data.


Asunto(s)
Autopsia/tendencias , Medicina Legal/estadística & datos numéricos , Adolescente , Adulto , Anciano , Autopsia/estadística & datos numéricos , Causas de Muerte , Preescolar , Femenino , Medicina Legal/tendencias , Mortalidad Hospitalaria , Humanos , Lactante , Masculino , Persona de Mediana Edad , Países Bajos , Prevalencia , Estudios Retrospectivos , Adulto Joven
20.
Eur J Nutr ; 58(3): 1033-1045, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29445914

RESUMEN

PURPOSE: The association between dietary acrylamide intake and estrogen receptor-positive (ER+) breast cancer risk in epidemiological studies is inconsistent. By analyzing gene-acrylamide interactions for ER+ breast cancer risk, we aimed to clarify the role of acrylamide intake in ER+ breast cancer etiology. METHODS: The prospective Netherlands Cohort Study on diet and cancer includes 62,573 women, aged 55-69 years. At baseline, a random subcohort of 2589 women was sampled from the total cohort for a case-cohort analysis approach. Dietary acrylamide intake of subcohort members (n = 1449) and ER+ breast cancer cases (n = 844) was assessed with a food frequency questionnaire. We genotyped single nucleotide polymorphisms (SNPs) in genes in acrylamide metabolism, sex steroid systems, oxidative stress and DNA repair. Multiplicative interaction between acrylamide intake and SNPs was assessed with Cox proportional hazards analysis, based on 20.3 years of follow-up. RESULTS: Unexpectedly, there was a statistically non-significant inverse association between acrylamide and ER+ breast cancer risk among all women but with no clear dose-response relationship, and no association among never smokers. Among the results for 57 SNPs and 2 gene deletions, rs1056827 in CYP1B1, rs2959008 and rs7173655 in CYP11A1, the GSTT1 gene deletion, and rs1052133 in hOGG1 showed a statistically significant interaction with acrylamide intake for ER+ breast cancer risk. CONCLUSIONS: This study did not provide evidence for a positive association between acrylamide intake and ER+ breast cancer risk. If anything, acrylamide was associated with a decreased ER+ breast cancer risk. The interaction with SNPs in CYP1B1 and CYP11A1 suggests that acrylamide may influence ER+ breast cancer risk through sex hormone pathways.


Asunto(s)
Acrilamida/administración & dosificación , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/metabolismo , Dieta/métodos , Polimorfismo de Nucleótido Simple/efectos de los fármacos , Acrilamida/efectos adversos , Anciano , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Variación Genética/efectos de los fármacos , Humanos , Persona de Mediana Edad , Países Bajos/epidemiología , Estudios Prospectivos , Receptores de Estrógenos , Factores de Riesgo , Encuestas y Cuestionarios
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