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2.
Artigo em Inglês | MEDLINE | ID: mdl-33268491

RESUMO

BACKGROUND: Mechanisms linking occupational heat exposure with chronic diseases have been proposed. However, evidence on occupational heat exposure and cancer risk is limited. METHODS: We evaluated occupational heat exposure and female breast cancer risk in a large Spanish case-control study. We enrolled 1,738 breast cancer cases and 1,910 frequency-matched population controls. A Spanish job exposure matrix, MatEmEsp, was used to assign estimates of the proportion of workers exposed (P greater than or equal to 25% for at least one year) and work time with heat stress (wet bulb globe temperature ISO 7243) for each occupation. We used three exposure indices: ever vs. never exposed, lifetime cumulative exposure and duration of exposure (years). We estimated odds ratios (ORs) and 95% confidence intervals (CIs), applying a lag-period of 5 years, adjusting for potential confounders. RESULTS: Ever occupational heat exposure was associated with a moderate but statistically significant higher risk of breast cancer (OR 1.22; 95% CI 1.01, 1.46), with significant trends across categories of lifetime cumulative exposure and duration (p-trend = 0.01 and 0.03 respectively). Stronger associations were found for hormone receptor positive disease (OR ever exposure = 1.38; 95% CI 1.12, 1.67). We found no confounding effects from multiple other common occupational exposures, however results attenuated with adjustment for occupational detergent exposure. CONCLUSIONS: This study provides some evidence of an association between occupational heat exposure and female breast cancer risk. IMPACT: Our results contribute substantially to the scientific literature. Further investigations are needed, considering multiple occupational exposures.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33103203

RESUMO

Objectives This study aimed to estimate the risk of lymphoma and its major subtypes in relation to occupational exposure to specific organic dusts. Methods We explored the association in 1853 cases and 1997 controls who participated in the EpiLymph case-control study, conducted in six European countries in 1998-2004. Based on expert assessment of lifetime occupational exposures, we calculated the risk of the major lymphoma subtypes associated with exposure to six specific organic dusts, namely, flour, hardwood, softwood, natural textile, synthetic textile, and leather, and two generic (any types) groups: wood and textile dusts. Risk was predicted with unconditional regression modeling, adjusted by age, gender, study center, and education. Results We observed a 2.1-fold increase in risk of follicular lymphoma associated with ever exposure to leather dust [95% confidence interval (CI) 1.01-4.20]. After excluding subjects who ever worked in a farm or had ever been exposed to solvents, risk of B-cell lymphoma was elevated in relation to ever exposure to leather dust [odd ratio (OR) 2.2, 95% CI 1.00-4.78], but it was not supported by increasing trends with the exposure metrics. Risk of Hodgkin lymphoma was elevated (OR 2.0, 95% CI 0.95-4.30) for exposure to textile dust, with consistent upward trends by cumulative exposure and three independent exposure metrics combined (P=0.023, and P=0.0068, respectively). Conclusions Future, larger studies might provide further insights into the nature of the association we observed between exposure to textile dust and risk of Hodgkin lymphoma.

4.
Rev Esp Salud Publica ; 942020 Oct 20.
Artigo em Espanhol | MEDLINE | ID: mdl-33079073

RESUMO

OBJECTIVE: Nowadays sedentarism has become a public health issue, as a matter of gender and age. Older women are more sedentary, which affects their Quality of life. The aim of this study was to evaluate the Activa-Murcia Program impact over the Quality of life in women participating in it. METHODS: Longitudinal retrospective descriptive study within a gender perspective was carried out, including women who had participated in the Activa-Murcia Program. A SF-36 Survey of Quality of Life has been evaluated, scoring age range in three different stages and the enviroment in which they live. An analysis of repeated measurements was carried aout using ANOVA, and the Bonferroni Test was used for the pairwise analysis. RESULTS: The sample included 1,140 women. "Overall health" dimension improved up to 3 points, except in women over 60. Score highed inversely proportional to their age in the following dimensions: "Vitality" in 9.9, 6.2 and 3.9; "Mental health" in 7.7, 5.6 and 3.7; "Declared health evolution" in 11.2, 8.6. and 7.6. Women between 30-44 years old living in rural areas and those over 60 living in urban areas did not improve in "Social functions". Dealing with "Emotional Role", women between 30-44 and women between 45-59 in urban areas improved (p<0.05). There was a statistical asociation between being highly aged and improving less in "Vitality", "Emotional Role" and "Mental health". CONCLUSIONS: As women were getting older improve less in the dimensions of quality of life; so that could show, among others, an empowerment deficit.

5.
Int J Cancer ; 2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33128820

RESUMO

To better understand the role of individual and lifestyle factors in human disease, an exposome-wide association study was performed to investigate within a single-study anthropometry measures and lifestyle factors previously associated with B-cell lymphoma (BCL). Within the European Prospective Investigation into Cancer and nutrition study, 2402 incident BCL cases were diagnosed from 475 426 participants that were followed-up on average 14 years. Standard and penalized Cox regression models as well as principal component analysis (PCA) were used to evaluate 84 exposures in relation to BCL risk. Standard and penalized Cox regression models showed a positive association between anthropometric measures and BCL and multiple myeloma/plasma cell neoplasm (MM). The penalized Cox models additionally showed the association between several exposures from categories of physical activity, smoking status, medical history, socioeconomic position, diet and BCL and/or the subtypes. PCAs confirmed the individual associations but also showed additional observations. The PC5 including anthropometry, was positively associated with BCL, diffuse large B-cell lymphoma (DLBCL) and MM. There was a significant positive association between consumption of sugar and confectionary (PC11) and follicular lymphoma risk, and an inverse association between fish and shellfish and Vitamin D (PC15) and DLBCL risk. The PC1 including features of the Mediterranean diet and diet with lower inflammatory score showed an inverse association with BCL risk, while the PC7, including dairy, was positively associated with BCL and DLBCL risk. Physical activity (PC10) was positively associated with DLBCL risk among women. This study provided informative insights on the etiology of BCL.

6.
PLoS One ; 15(7): e0235658, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649712

RESUMO

Medical diagnostic X-rays are an important source of ionizing radiation (IR) exposure in the general population; however, it is unclear if the resulting low patient doses increase lymphoma risk. We examined the association between lifetime medical diagnostic X-ray dose and lymphoma risk, taking into account potential confounding factors, including medical history. The international Epilymph study (conducted in the Czech-Republic, France, Germany, Ireland, Italy, and Spain) collected self-reported information on common diagnostic X-ray procedures from 2,362 lymphoma cases and 2,465 frequency-matched (age, sex, country) controls. Individual lifetime cumulative bone marrow (BM) dose was estimated using time period-based dose estimates for different procedures and body parts. The association between categories of BM dose and lymphoma risk was examined using unconditional logistic regression models adjusting for matching factors, socioeconomic variables, and the presence of underlying medical conditions (atopic, autoimmune, infectious diseases, osteoarthritis, having had a sick childhood, and family history of lymphoma) as potential confounders of the association. Cumulative BM dose was low (median 2.25 mGy) and was not positively associated with lymphoma risk. Odds ratios (ORs) were consistently less than 1.0 in all dose categories compared to the reference category (less than 1 mGy). Results were similar after adjustment for potential confounding factors, when using different exposure scenarios, and in analyses by lymphoma subtype and by type of control (hospital-, population-based). Overall no increased risk of lymphoma was observed. The reduced ORs may be related to unmeasured confounding or other sources of systematic bias.We found little evidence that chronic medical conditions confound lymphoma risk and medical radiation associations.


Assuntos
Linfoma/etiologia , Exposição à Radiação/efeitos adversos , Radiação Ionizante , Adulto , Idoso , Medula Óssea/patologia , Medula Óssea/efeitos da radiação , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Linfoma/diagnóstico , Masculino , Pessoa de Meia-Idade , Razão de Chances , Doses de Radiação , Fatores de Risco
7.
Artigo em Inglês | MEDLINE | ID: mdl-32709095

RESUMO

We aimed to study the association between occupational exposure to pesticides and chronic lymphocytic leukemia (CLL) in Spain. Occupational exposure to pesticides (four insecticides, four herbicides and two fungicides) was evaluated using a job-exposure matrix for the Spanish population (MatEmESp) among 302 CLL cases and 1567 population controls in five regions of Spain, 2010-2013. Cumulative exposure scores (CES) were obtained by summing across the exposed jobs the product of prevalence, intensity and duration of exposure to each active substance. Principal components analysis (PCA) and logistic regression models adjusted for age, sex, region, education and occupational exposure to solvents were used. Around 20% of controls and 29% of cases were exposed to one or more pesticides. Compared to non-exposed, subjects in the highest tertile (3rd tertile) of CES of insecticides, herbicides, fungicides were more likely to have CLL [OR (95% CI), P-trend; 2.10 (1.38; 3.19), 0.002; 1.77 (1.12; 2.80), 0.12; and 1.67 (1.06; 2.64), 0.10, respectively). Following PCA, the first component (PC1, explaining 70% of the variation) equally led by seven active substances (the insecticide pyrethrin, all herbicides, all fungicides) was associated with a 26% higher odds of having CLL for 1-standard deviation increase in PC1 (95% CI: 1.14 to 1.40). These results confirm previous associations between CLL and exposure to pesticides and provide additional evidence by application groups and active substance. However, more research is needed to disentangle independent effects of individual active substances.


Assuntos
Diabetes Mellitus Tipo 2 , Leucemia Linfocítica Crônica de Células B , Exposição Ocupacional , Praguicidas , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/induzido quimicamente , Leucemia Linfocítica Crônica de Células B/epidemiologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Praguicidas/toxicidade , Fatores de Risco , Espanha/epidemiologia
8.
Environ Health ; 19(1): 43, 2020 04 25.
Artigo em Inglês | MEDLINE | ID: mdl-32334593

RESUMO

BACKGROUND: Evidence linking risk of lymphoma and B-cell lymphoma subtypes to ionizing radiation is inconclusive, particularly at low exposure levels. METHODS: We investigated risk of lymphoma (all subtypes), B-cell lymphomas, and its major subtypes, associated with low-level occupational exposure to ionizing radiation, in 2346 lymphoma cases and 2463 controls, who participated in the multicenter EpiLymph case-control study. We developed a job-exposure matrix to estimate exposure to ionizing radiation, distinguishing between internal and external radiation, and we applied it to the lifetime occupational history of study subjects, We calculated the Odds Ratio (OR) and its 95% confidence interval (95% CI) for lymphoma (all subtypes combined), B-cell lymphoma, and its major subtypes using unconditional, polytomous logistic regression adjusting for age, gender, and education. RESULTS: We did not observe an association between exposure metrics of external and internal radiation and risk of lymphoma (all subtypes), nor with B-cell lymphoma, or its major subtypes, at the levels regularly experienced in occupational settings. An elevated risk of diffuse large B cell lymphoma was observed among the most likely exposed study subjects with relatively higher exposure intensity, which would be worth further investigation. CONCLUSIONS: Further investigation is warranted on risk of B cell lymphoma subtypes associated with low-level occupational exposure to external ionizing radiation, and to clarify whether lymphoma should be included among the cancer outcomes related to ionizing radiation.


Assuntos
Linfoma/epidemiologia , Exposição Ocupacional/efeitos adversos , Radiação Ionizante , Adulto , Idoso , Estudos de Casos e Controles , República Tcheca/epidemiologia , Feminino , França/epidemiologia , Alemanha/epidemiologia , Humanos , Irlanda/epidemiologia , Itália/epidemiologia , Linfoma/etiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Espanha/epidemiologia
9.
Cancer Cytopathol ; 128(11): 792-802, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32202704

RESUMO

Cervico-vaginal cytology is primarily a cervical cancer screening test. The anatomical continuity of the uterine cavity with the cervix makes the Papanicolaou (Pap) test accessible to evaluate signs of disease shed from the endometrium. Our aim was to determine the sensitivity of routine Pap test in endometrial carcinoma detection and its relationship with clinico-pathologic factors. We performed a systematic review of studies reporting Pap test results prior to diagnosis of or surgery for endometrial carcinoma between 1990 and 2018 in PubMed or Web of Science. Two independent reviewers extracted data and assessed study quality using an adapted Newcastle-Ottawa Quality Assessment Scale and Quality Assessment of Diagnostic Accuracy Studies tool. We identified 45 studies including a total of 6599 women with endometrial cancer. Abnormal Pap test results prior to diagnosis of or surgery for endometrial carcinoma were observed in 45% (95% CI, 40%-50%) of study participants. This percentage was significantly higher among those of non-endometrioid histology compared with endometrioid subtypes (77% [95% CI, 66%-87%] vs 44% [95% CI, 34%-53%], respectively; P heterogeneity <.001). Several clinico-pathologic factors were related to a higher percentage of abnormal Pap test results, including high-stage, myometrial invasion >50%, high histological grade, positive peritoneal cytology, presence of lymph node metastasis, cervical involvement, and lymphovascular invasion (P heterogeneity <.05 for all variables). Routine cervical cytology can detect endometrial cancer in almost half of patients, whereas sensitivity is higher among individuals with non-endometrioid histology or more advanced cancers. This review summarizes the current clinical and prognostic value of cervical cytology in endometrial carcinoma. Recent technological developments using molecular biomarkers may improve accuracy for early cancer detection.

10.
Int J Cancer ; 147(5): 1315-1324, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32012253

RESUMO

Chronic lymphocytic leukemia (CLL) is an incurable disease accounting for almost one-third of leukemias in the Western world. Aberrant expression of microRNAs (miRNAs) is a well-established characteristic of CLL, and the robust nature of miRNAs makes them eminently suitable liquid biopsy biomarkers. Using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC), the predictive values of five promising human miRNAs (hsa-miR-16-5p, hsa-miR-29a-3p, hsa-miR-150-5p, hsa-miR-155-5p and hsa-miR-223-3p), identified in a pilot study, were examined in serum of 224 CLL cases (diagnosed 3 months to 18 years after enrollment) and 224 matched controls using Taqman based assays. Conditional logistic regressions were applied to adjust for potential confounders. The median time from blood collection to CLL diagnosis was 10 years (p25-p75: 7-13 years). Overall, the upregulation of hsa-miR-150-5p, hsa-miR-155-5p and hsa-miR-29a-3p was associated with subsequent risk of CLL [OR1∆Ct-unit increase (95%CI) = 1.42 (1.18-1.72), 1.64 (1.31-2.04) and 1.75 (1.31-2.34) for hsa-miR-150-5p, hsa-miR-155-5p and hsa-miR-29a-3p, respectively] and the strongest associations were observed within 10 years of diagnosis. However, the predictive performance of these miRNAs was modest (area under the curve <0.62). hsa-miR-16-5p and hsa-miR-223-3p levels were unrelated to CLL risk. The findings of this first prospective study suggest that hsa-miR-29a, hsa-miR-150-5p and hsa-miR-155-5p were upregulated in early stages of CLL but were modest predictive biomarkers of CLL risk.

11.
Cancer Epidemiol Biomarkers Prev ; 29(5): 1074-1078, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32108027

RESUMO

BACKGROUND: Lipid traits have been inconsistently linked to risk of non-Hodgkin lymphoma (NHL). We examined the association of genetically predicted lipid traits with risk of diffuse large B-cell lymphoma (DLBCL), chronic lymphocytic leukemia (CLL), follicular lymphoma (FL), and marginal zone lymphoma (MZL) using Mendelian randomization (MR) analysis. METHODS: Genome-wide association study data from the InterLymph Consortium were available for 2,661 DLBCLs, 2,179 CLLs, 2,142 FLs, 824 MZLs, and 6,221 controls. SNPs associated (P < 5 × 10-8) with high-density lipoprotein (HDL, n = 164), low-density lipoprotein (LDL, n = 137), total cholesterol (TC, n = 161), and triglycerides (TG, n = 123) were used as instrumental variables (IV), explaining 14.6%, 27.7%, 16.8%, and 12.8% of phenotypic variation, respectively. Associations between each lipid trait and NHL subtype were calculated using the MR inverse variance-weighted method, estimating odds ratios (OR) per standard deviation and 95% confidence intervals (CI). RESULTS: HDL was positively associated with DLBCL (OR = 1.14; 95% CI, 1.00-1.30) and MZL (OR = 1.09; 95% CI, 1.01-1.18), while TG was inversely associated with MZL risk (OR = 0.90; 95% CI, 0.83-0.99), all at nominal significance (P < 0.05). A positive trend was observed for HDL with FL risk (OR = 1.08; 95% CI, 0.99-1.19; P = 0.087). No associations were noteworthy after adjusting for multiple testing. CONCLUSIONS: We did not find evidence of a clear or strong association of these lipid traits with the most common NHL subtypes. While these IVs have been previously linked to other cancers, our findings do not support any causal associations with these NHL subtypes. IMPACT: Our results suggest that prior reported inverse associations of lipid traits are not likely to be causal and could represent reverse causality or confounding.

12.
Cancer Epidemiol ; 64: 101629, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31756676

RESUMO

INTRODUCTION: Preventable risk factors for chronic lymphocytic leukemia (CLL) remain largely unknown. The aim of this study was to evaluate the association between adherence to nutrition-based guidelines for cancer prevention and CLL, in the MCC-Spain case-control study. METHODS: A total of 318 CLL cases and 1293 population-based controls were included in the present study. The World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) score based on the 2018 recommendations for cancer prevention (on body fatness, physical activity, and diet) was constructed. We used logistic regression analysis adjusting for potential confounders. RESULTS: Individuals in the highest tertile of the WCRF/AICR score had an odds ratio for CLL of 1.25 (95 % CI 0.91; 1.73) compared with individuals with low adherence (p-trend = 0.172). Each point increment in the score was associated with an OR for CLL of 1.06 (95 % CI 0.91; 1.23). Analyses by severity of disease did not show significant heterogeneity of effects. CONCLUSION: Overall, our results do not support an association between the WCRF/AICR score and CLL, yet we might have been limited by statistical power and study design to detect modest associations. Further research, ideally with a prospective design, long follow-up, and including additional lymphoma subtypes, is warranted to confirm the impact of composite healthy lifestyle behaviors on lymphoma risk.


Assuntos
Leucemia Linfocítica Crônica de Células B/epidemiologia , Leucemia Linfocítica Crônica de Células B/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Composição Corporal , Estudos de Casos e Controles , Dieta/estatística & dados numéricos , Exercício Físico , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Fatores de Risco , Espanha/epidemiologia , Adulto Jovem
13.
Eur J Nutr ; 59(2): 813-823, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30903361

RESUMO

INTRODUCTION: Chronic inflammation plays a critical role in lymphomagenesis and several dietary factors seem to be involved its regulation. The aim of the current study was to assess the association between the inflammatory potential of the diet and the risk of lymphoma and its subtypes in the European Investigation into Cancer and Nutrition (EPIC) study. METHODS: The analysis included 476,160 subjects with an average follow-up of 13.9 years, during which 3,136 lymphomas (135 Hodgkin lymphoma (HL), 2606 non-Hodgkin lymphoma (NHL) and 395 NOS) were identified. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated using 28 dietary components and their corresponding inflammatory weights. The association between the ISD and lymphoma risk was estimated by hazard ratios (HR) and 95% confidence intervals (CI) calculated by multivariable Cox regression models adjusted for potential confounders. RESULTS: The ISD was not associated with overall lymphoma risk. Among lymphoma subtypes, a positive association between the ISD and mature B-cell NHL (HR for a 1-SD increase: 1.07 (95% CI 1.01; 1.14), p trend = 0.03) was observed. No statistically significant association was found among other subtypes. However, albeit with smaller number of cases, a suggestive association was observed for HL (HR for a 1-SD increase = 1.22 (95% CI 0.94; 1.57), p trend 0.13). CONCLUSIONS: Our findings suggested that a high ISD score, reflecting a pro-inflammatory diet, was modestly positively associated with the risk of B-cell lymphoma subtypes. Further large prospective studies on low-grade inflammation induced by diet are warranted to confirm these findings.

14.
Rev. esp. salud pública ; 94: 0-0, 2020. tab
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET1-6758

RESUMO

OBJETIVO: El sedentarismo es un problema de Salud Pública, influenciado por brechas de género y edad. Las mujeres mayores son más sedentarias, lo que repercute en su calidad de vida. El objetivo general de este trabajo fue evaluar el impacto del Programa Activa-Murcia sobre la calidad de Vida de las participantes en dicho programa. MÉTODOS: Se realizó un análisis secundario con perspectiva de género de un estudio descriptivo longitudinal retrospectivo de una cohorte de mujeres que habían participado en el Programa Activa-Murcia, evaluándose las dimensiones del Cuestionario de Calidad de Vida SF-36 y las puntuaciones según tres franjas etarias y el ámbito en el que vivían. Se realizó un análisis de medidas repetidas mediante ANOVA, y para el análisis por pares se utilizó el Test de Bonferroni. RESULTADOS: La muestra la componían 1.140 mujeres. La dimensión "Salud General" mejoró alrededor de 3 puntos, excepto en las mayores de 60 años. Aumentaron las puntuaciones de forma inversamente proporcional a la edad en siguientes dimensiones: "Vitalidad", en 9,9, 6,2 y 3,9 puntos; "Salud Mental", en 7,7, 5,6 y 3,7 puntos; y "Evolución Declarada de Salud", en 11,2, 8,6 y 7,6 puntos. Las mujeres entre 30-44 años rurales y las mayores de 60 años urbanas no mejoraron en "Función Social". Sobre el "Rol Emocional", las mujeres entre 30-44 años y las mujeres entre 45-59 años de zona urbana mejoraban (p < 0,05). Existió asociación estadísticamente significativa entre tener mayor edad y mejorar menos en "Vitalidad", "Rol Emocional" y "Salud Mental". CONCLUSIONES: Las mujeres mayores mejoran menos en las dimensiones de la calidad de vida, lo que podría indicar, entre otros motivos, un déficit de empoderamiento


OBJECTIVE: Nowadays sedentarism has become a public health issue, as a matter of gender and age. Older women are more sedentary, which affects their Quality of life. The aim of this study was to evaluate the Activa-Murcia Program impact over the Quality of life in women participating in it. METHODS: Longitudinal retrospective descriptive study within a gender perspective was carried out, including women who had participated in the Activa-Murcia Program. A SF-36 Survey of Quality of Life has been evaluated, scoring age range in three different stages and the enviroment in which they live. An analysis of repeated measurements was carried aout using ANOVA, and the Bonferroni Test was used for the pairwise analysis. RESULTS: The sample included 1,140 women. "Overall health" dimension improved up to 3 points, except in women over 60. Score highed inversely proportional to their age in the following dimensions: "Vitality" in 9.9, 6.2 and 3.9; "Mental health" in 7.7, 5.6 and 3.7; "Declared health evolution" in 11.2, 8.6. and 7.6. Women between 30-44 years old living in rural areas and those over 60 living in urban areas did not improve in "Social functions". Dealing with "Emotional Role", women between 30-44 and women between 45-59 in urban areas improved (p < 0.05). There was a statistical asociation between being highly aged and improving less in "Vitality", "Emotional Role" and "Mental health". CONCLUSIONS: As women were getting older improve less in the dimensions of quality of life; so that could show, among others, an empowerment deficit

15.
Nutrients ; 12(1)2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31878004

RESUMO

Chronic inflammation plays a role in the development of chronic lymphocytic leukaemia (CLL), and diet might modulate chronic inflammation. This study aims to evaluate the association between the dietary inflammatory index (DII®) and CLL. A total of 366 CLL cases and 1643 controls of the Spanish multicase-control (MCC) Spain study were included. The inflammatory potential of the diet was assessed using the energy-adjusted dietary inflammatory index (E-DII) based on 30 items from a validated semi-quantitative food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models controlling for potential confounders. Overall, a modest, non-statistically significant, positive association was observed between CLL and E-DII scores (OR for a one-unit increase in E-DII: 1.05 (CI 95%: 0.99, 1.12), p-value = 0.09 and by tertiles: ORT2vsT1: 1.20 (CI 95%: 0.90, 1.59); OR T3vsT1: 1.21 (CI 95%: 0.90, 1.62), p trend = 0.21). These results were independent from disease severity (p-het: 0.70), time from diagnosis (p-het: 0.67) and CLL treatment received (p-het: 0.56). No interactions were detected. In conclusion, the consumption of a diet with high pro-inflammatory components was not significantly associated with CLL. Changes towards a more pro-inflammatory dietary pattern in younger generations not included here warrant future research.


Assuntos
Dieta/efeitos adversos , Inflamação/epidemiologia , Leucemia Linfocítica Crônica de Células B/epidemiologia , Idoso , Estudos de Casos e Controles , Registros de Dieta , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Índice de Gravidade de Doença , Espanha/epidemiologia
16.
Br J Cancer ; 121(11): 954-965, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31616037

RESUMO

BACKGROUND: To conduct a meta-analysis of performance of DNA methylation in women with high-grade cervical intraepithelial neoplasia (CIN2+). METHODS: Medline and Embase databases were searched for studies of methylation markers versus histological endpoints. Pooled sensitivity, specificity and positive predictive value (PPV) for CIN2+ were derived from bivariate models. Relative sensitivity and specificity for CIN2+ compared to cytology and HPV16/18 genotyping were pooled using random-effects models. RESULTS: Sixteen thousand three hundred thirty-six women in 43 studies provided data on human genes (CADM1, MAL, MIR-124-2, FAM19A4, POU4F3, EPB41L3, PAX1, SOX1) and HPV16 (L1/L2). Most (81%) studies evaluated methylation assays following a high-risk (HR)-HPV-positive or abnormal cytology result. Pooled CIN2+ and CIN3+ prevalence was 36.7% and 21.5%. For a set specificity of 70%, methylation sensitivity for CIN2+ and CIN3+ were 68.6% (95% CI: 62.9-73.8) and 71.1% (95% CI: 65.7-76.0) and PPV were 53.4% (95% CI: 44.4-62.1) and 35.0% (95% CI: 28.9-41.6). Among HR-HPV+ women, the relative sensitivity of methylation for CIN2+ was 0.81 (95% CI: 0.63-1.04) and 1.22 (95% CI: 1.05-1.42) compared to cytology of atypical squamous cells of undetermined significance, or greater (ASCUS+) and HPV16/18 genotyping, respectively, while relative specificity was 1.25 (95% CI: 0.99-1.59) and 1.03 (95% CI: 0.94-1.13), respectively. CONCLUSION: DNA methylation is significantly higher in CIN2+ and CIN3+ compared to ≤CIN1. As triage test, DNA methylation has higher specificity than cytology ASCUS+ and higher sensitivity than HPV16/18 genotyping.


Assuntos
Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/genética , Metilação de DNA/genética , Triagem/métodos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Genoma Humano/genética , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/genética , Sensibilidade e Especificidade , Adulto Jovem
17.
Int J Cancer ; 145(12): 3194-3206, 2019 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-31199503

RESUMO

Due to the anatomical continuity of the uterine cavity with the cervix, genomic exploitation of material from routine Pap smears and other noninvasive sampling methods represent a unique opportunity to detect signs of disease using biological material shed from the upper genital tract. Recent research findings offer a promising perspective in the detection of endometrial cancer, but certain questions need to be addressed in order to accelerate the implementation of novel technologies in a routine screening or clinical setting. We discuss here new perspectives on detection of endometrial cancer using genomic and other biomarkers in minimally invasive sampling methods with a special focus on public health classic screening criteria, highlighting current gaps in knowledge.


Assuntos
Neoplasias do Endométrio/diagnóstico , Biomarcadores Tumorais/genética , Detecção Precoce de Câncer/métodos , Neoplasias do Endométrio/genética , Feminino , Humanos , Programas de Rastreamento/métodos
18.
Cancer Epidemiol ; 61: 129-132, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31238232

RESUMO

INTRODUCTION: The current availability of genomic information represents an opportunity to develop new strategies for early detection of cancer. New molecular tests for endometrial cancer may improve performance and failure rates of histological aspirate-based diagnosis, and provide promising perspectives for a potential screening scenario. However, the selection of relevant biomarkers to develop efficient strategies can be a challenge. MATERIALS AND METHODS: We developed an algorithm to identify the largest number of patients with endometrial cancer using the minimum number of somatic mutations based on The Cancer Genome Atlas (TCGA) dataset. RESULTS: The algorithm provided the number of subjects with mutations (sensitivity) for a given number of biomarkers included in the signature. For instance, by evaluating the 50 most representative point mutations, up to 81.9% of endometrial cancers can be identified in the TCGA dataset. At gene level, a 92.9% sensitivity can be obtained by interrogating five genes. DISCUSSION: We developed a computational method to aid in the selection of relevant genomic biomarkers in endometrial cancer that can be adapted to other cancer types or diseases.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias do Endométrio/diagnóstico , Genômica/métodos , Algoritmos , Feminino , Humanos , Mutação
19.
Front Oncol ; 9: 1539, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32064237

RESUMO

Although the evidence is not consistent, epidemiologic studies have suggested that taller adult height may be associated with an increased risk of some non-Hodgkin lymphoma (NHL) subtypes. Height is largely determined by genetic factors, but how these genetic factors may contribute to NHL risk is unknown. We investigated the relationship between genetic determinants of height and NHL risk using data from eight genome-wide association studies (GWAS) comprising 10,629 NHL cases, including 3,857 diffuse large B-cell lymphoma (DLBCL), 2,847 follicular lymphoma (FL), 3,100 chronic lymphocytic leukemia (CLL), and 825 marginal zone lymphoma (MZL) cases, and 9,505 controls of European ancestry. We evaluated genetically predicted height by constructing polygenic risk scores using 833 height-associated SNPs. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for association between genetically determined height and the risk of four NHL subtypes in each GWAS and then used fixed-effect meta-analysis to combine subtype results across studies. We found suggestive evidence between taller genetically determined height and increased CLL risk (OR = 1.08, 95% CI = 1.00-1.17, p = 0.049), which was slightly stronger among women (OR = 1.15, 95% CI: 1.01-1.31, p = 0.036). No significant associations were observed with DLBCL, FL, or MZL. Our findings suggest that there may be some shared genetic factors between CLL and height, but other endogenous or environmental factors may underlie reported epidemiologic height associations with other subtypes.

20.
Am J Epidemiol ; 188(2): 274-281, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30481275

RESUMO

The role of hormonal factors in the etiology of lymphoid neoplasms remains unclear. Previous studies have yielded conflicting results, have lacked sufficient statistical power to assess many lymphoma subtypes, or have lacked detailed information on relevant exposures. Within the European Prospective Investigation Into Cancer and Nutrition cohort, we analyzed comprehensive data on reproductive factors and exogenous hormone use collected at baseline (1992-2000) among 343,458 women, including data on 1,427 incident cases of B-cell non-Hodgkin lymphoma (NHL) and its major subtypes identified after a mean follow-up period of 14 years (through 2015). We estimated hazard ratios and 95% confidence intervals using multivariable proportional hazards modeling. Overall, we observed no statistically significant associations between parity, age at first birth, breastfeeding, oral contraceptive use, or ever use of postmenopausal hormone therapy and risk of B-cell NHL or its subtypes. Women who had undergone surgical menopause had a 51% higher risk of B-cell NHL (based on 67 cases) than women with natural menopause (hazard ratio = 1.51, 95% confidence interval: 1.17, 1.94). Given that this result may have been due to chance, our results provide little support for the hypothesis that sex hormones play a role in lymphomagenesis.


Assuntos
Terapia de Reposição de Estrogênios/estatística & dados numéricos , Linfoma de Células B/epidemiologia , História Reprodutiva , Aleitamento Materno , Europa (Continente)/epidemiologia , Feminino , Humanos , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Saúde da Mulher
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