High-fat dairy food and conjugated linoleic acid intakes in relation to colorectal cancer incidence in the Swedish Mammography Cohort

BACKGROUND: High-fat dairy foods contain many potentially anticarcinogenic factors, including conjugated linoleic acid (CLA). However, few epidemiologic studies have specifically evaluated high-fat dairy food consumption, and none have evaluated CLA intake, in relation to colorectal cancer risk. OBJECTIVE: The aim of this study was to prospectively examine the associations of long-term high-fat dairy food consumption and CLA intake and the incidence of colorectal cancer. DESIGN: Our study population consisted of 60 708 women aged 40-76 y who participated in the Swedish Mammography Cohort. The women's consumption of high-fat dairy foods was assessed at baseline, which was from 1987 to 1990, and again in 1997. RESULTS: We ascertained 798 incident cases of colorectal cancer during an average 14.8 y of follow-up. After adjustment for age and other potential confounders, the women who consumed > or =4 servings of high-fat dairy foods/d (including whole milk, full-fat cultured milk, cheese, cream, sour cream, and butter) had a multivariate rate ratio of colorectal cancer of 0.59 (95% CI: 0.44, 0.79; P for trend = 0.002) when compared with the women who consumed <1 serving/d. Each increment of 2 servings of high-fat dairy foods/d corresponded to a 13% reduction in the risk of colorectal cancer (multivariate rate ratio: 0.87; 95% CI: 0.78, 0.96). For CLA, the multivariate rate ratio of colorectal cancer in a comparison of the 2 extreme quartiles of intake was 0.71 (95% CI: 0.55, 0.91; P for trend = 0.004). CONCLUSION: These prospective data suggest that high intakes of high-fat dairy foods and CLA may reduce the risk of colorectal cancer.     

Calcium and dairy food intakes are inversely associated with colorectal cancer risk in the Cohort of Swedish Men

BACKGROUND: Recent epidemiologic studies have generally reported a modest inverse association between calcium intake and the risk of colorectal cancer. However, findings pertaining to specific subsites in the colorectum have been conflicting. OBJECTIVE: Our objective was to prospectively examine the relations between intakes of calcium and dairy foods and the risk of colorectal cancer, overall and by anatomic subsite, in men from the Cohort of Swedish Men. DESIGN: In 1997, 45 306 men aged 45-79 y and without a history of cancer completed a food-frequency questionnaire. The men were followed through 31 December 2004. RESULTS: During a mean follow-up of 6.7 y, we ascertained 449 incident cases of colorectal cancer. After adjustment for age and other known or potential risk factors, the multivariate rate ratio (RR) of colorectal cancer for men in the highest quartile of total calcium intake compared with those in the lowest quartile was 0.68 (95% CI: 0.51, 0.91; P for trend = 0.01). A high consumption of dairy foods was also associated with a lower risk of colorectal cancer. The multivariate RR of colorectal cancer for > or = 7 servings/d of total dairy foods compared with <2 servings/d was 0.46 (0.30, 0.71; P for trend = 0.01). For cancer subsites, the corresponding RRs were 0.37 (0.16, 0.88) for proximal colon, 0.43 (0.20, 0.93) for distal colon, and 0.48 (0.23, 0.99) for rectum. CONCLUSION: Our findings provide support for inverse associations between intakes of calcium and dairy foods and the risk of colorectal cancer.     

Plant sterol intakes and colorectal cancer risk in the Netherlands Cohort Study on Diet and Cancer.

BACKGROUND: Plant sterols in vegetable foods might prevent colorectal cancer. OBJECTIVE: The objective was to study plant sterol intakes in relation to colorectal cancer risk in an epidemiologic study. DESIGN: The study was performed within the framework of the Netherlands Cohort Study on Diet and Cancer in 120852 subjects who completed a baseline questionnaire in 1986. After 6.3 y of follow-up, 620 colon and 344 rectal cancer cases were detected. A case-cohort approach was used to calculate confounder-adjusted rate ratios (RRs) and their 95% CIs for quintiles of plant sterol intake. RESULTS: The total mean (+/-SD) intake of campesterol, stigmasterol, beta-sitosterol, campestanol, and beta-sitostanol was 285 +/- 97 mg/d. Major contributors to plant sterol intake were bread (38%), vegetable fats (26%), and fruit and vegetables (21%). For men, there was no clear association between intake of any of the plant sterols and colon cancer risk when age, smoking, alcohol use, family history of colorectal cancer, education level, and cholecystectomy were controlled for. Adjustment for energy did not alter the result. For rectal cancer, adjustment for energy resulted in positive associations between risk and campesterol and stigmasterol intakes. For women, there was no clear association between intake of any of the plant sterols and colorectal cancer risk. CONCLUSION: A high dietary intake of plant sterols was not associated with a lower risk of colon and rectal cancers in the Netherlands Cohort Study on Diet and Cancer.     

Some life-style factors and the risk of invasive epithelial ovarian cancer in Swedish women

The objective of this nationwide case-control study was to examine body mass index (BMI), alcohol use, coffee consumption, cigarette smoking, and leisure-time physical activity in relation to epithelial ovarian cancer (EOC) risk. Subjects were 655 newly diagnosed EOC cases and 3899 population controls, all 50-74 years of age at recruitment between 1993 and 1995. Data were collected through mailed questionnaires. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Women with a BMI 30 kg/m² compared with those with a BMI < 22 kg/m² appeared to have an elevated EOC risk (OR = 1.37, 95% CI: 1.01-1.85), particularly of mucinous (OR = 2.76, 95% CI: 1.15-6.61) and clear-cell histologies (OR = 2.68, 95% CI: 0.96-7.48). The OR for EOC among coffee users reporting 6 daily cups compared with non-users was 0.68 (95% CI: 0.42-1.10). Alcohol consumption was unrelated to EOC risk. Compared to non-smokers the ORs of EOC among current smokers were 0.70 (95% CI: 0.52-0.94) for those who smoked 1-10 cigarettes/day and 0.74 (95% CI: 0.53-1.02) for heavier smokers, while former smokers were at an unaltered risk (OR = 0.83, 95% CI: 0.66-1.04). Reduced EOC risks were observed among women in the highest compared with the lowest physical activity levels both at age 18-30 years (OR = 0.67, 95% CI: 0.52-0.87) and during the last years preceding study enrollment (OR = 0.68, 95% CI: 0.53-0.87). We conclude that women may avoid an excess risk of EOC through maintaining a normal BMI and reduce their risk by participation in leisure-time physical activity. The use of coffee, alcohol, or cigarette smoking does not appearto increase the risk of EOC.     

Association of dairy products,lactose, and calcium with the risk of ovarian cancer

Epidemiologic findings have been inconsistent regarding the association of dietary fat, dairy products, and lactose with risk of ovarian cancer. The authors conducted a case-control study in Hawaii and Los Angeles, California, to examine several dietary hypotheses regarding the etiology of ovarian cancer in a population with a broad range of dietary intakes. A total of 558 patients with ovarian cancer diagnosed in 1993-1999 and 607 controls were interviewed regarding their diet. Consumption of all dairy products, all types of milk, and low-fat milk, but not consumption of whole milk, was significantly inversely related to the odds of ovarian cancer. Similar inverse gradients in the odds ratios were obtained for intakes of lactose and calcium, although these nutrients were highly correlated (r = 0.77). The odds ratio for ovarian cancer was 0.46 (95% confidence interval: 0.27, 0.76) among women in the highest quartile of dietary calcium intake versus the lowest (p for trend = 0.0006). The significant dietary association was limited to dairy sources of calcium (p for trend = 0.003), although a nonsignificant inverse gradient in risk was also found in relation to calcium supplement intake. These results suggest that intake of low-fat milk, calcium, or lactose may reduce the risk of ovarian cancer.     

The influence of lactose consumption on the association of oral contraceptive use and ovarian cancer risk

The authors investigated the joint effects of diet and oral contraceptive use on ovarian cancer risk in 194 white women aged 65 years or less with epithelial ovarian cancer and 193 age- and residence-matched controls in Boston between 1984 and 1987 by using in-person interviews and self-administered food frequency questionnaires. Use of oral contraceptives for 3 months or more was associated with a modest protective effect for ovarian cancer (odds ratio (OR) = 0.7, 95 percent confidence interval (CI) 0.5-1.1). In women who consumed 11 g or less per day of lactose, use of oral contraceptives for 3 months or more was associated with a nonsignificant increased risk (OR = 1.6, 95 percent CI 0.8-3.2). In women who consumed more than 11 g per day of lactose, use of oral contraceptives for 3 months or more was associated with a substantially decreased risk of ovarian cancer (OR = 0.3, 95 percent CI 0.1-0.7). Within this group, the strongest association occurred with more than 4 years of total oral contraceptive use (OR = 0.2, 95 percent CI 0.1-0.6) and in those who had more than 2 years of oral contraceptive use after age 30 years (OR = 0.1, 95 percent CI 0.03-0.4). These results suggest that, with respect to ovarian cancer, lactose users may be the most likely to benefit from oral contraceptive use and that the benefit may be strongest when oral contraceptive use occurs after age 30 years.     

Food and nutrient intakes in Swedish diabetic children

Food and energy intakes in diabetic children, 7-9 and 12-14 years of age, were studied by the 7-d record method. The mean duration of diabetes in the younger group was 3.0 years and in the older group 4.2. The children had 3 main meals and 3.4 light meals daily. The median daily number of sandwiches was 7, often offered as snacks. All children used a low-fat margarine, low-fat cheese and low-fat milk. Sweets and diabetic food were seldom used. Of the energy intake protein contributed 18 per cent, fat 32 per cent and carbohydrates 50 per cent, including sucrose 2 per cent. Mean daily intake of fibre was 20 g. Compared to healthy children of the same age and from the same areas of Sweden the diabetics had a more regular meal pattern, their energy intakes did not differ, but the diet of diabetics was lower in fat and sucrose and higher in protein. The mean height, weight and BMI did not differ from healthy children.     

Alcohol consumption and ovarian cancer risk

To study the influence of alcohol consumption on the risk of ovarian cancer in women under age 55, the authors examined data collected in a multicenter, population-based case-control study--the Centers for Disease Control's Cancer and Steroid Hormone Study. Between August 1981 and December 1982, 433 women 20-54 years of age with newly diagnosed ovarian cancer and 2,915 women 20-54 years of age selected at random from the same geographic areas were asked about their consumption of alcoholic beverages during the previous five years. Women who drank any alcohol during the five-year period had a risk of ovarian cancer of 0.9 (95% confidence interval (CI) = 0.7-1.2) compared with nondrinkers. Risk was not associated with the type of alcoholic beverage consumed, nor were the results affected by controlling for demographic characteristics and oral contraceptive use. Although there was no association between moderate alcohol consumption and ovarian cancer, women who drank more than about 20 drinks per week had a relative risk of ovarian cancer of 0.5 (95% CI = 0.2-0.9) compared with women who did not drink.     

Nutritional risk factors and ovarian cancer

In a hospital-based case-control study, consumption of lactose-containing (dairy) foods and foods containing beta-carotene by 71 women with epithelial cancer of the ovary and 141 matched controls was investigated. No significant differences were found between cases and controls in the frequency of consumption of dairy foods or in the amount of lactose consumed. Consumption of carrots was found to decrease risk. Logistic regression analyses indicated a protective effect of high beta-carotene intake (odds ratio = 0.3, 95% confidence interval = 0.1-0.8), after adjusting for body mass, smoking, and lactose consumption.     

卵巢癌风险模型在卵巢癌诊断中的应用价值研究

目的分析基于血清中人附睾上皮分泌蛋白4(HE4)及CA125抗原表达水平所构建的卵巢癌风险模型(ROMA)在卵巢癌诊断中的价值。方法选取2015年1—12月收治的30名卵巢癌患者作为癌症组,选择同期收治的30例卵巢良性肿瘤患者作为良性组,同期在本院接受健康体检的30名健康者为对照组。对比三组受检者血清中HE4与CA125的表达水平,并根据检测结果计算ROMA值,分析HE4、CA125及ROMA对于卵巢癌诊断的价值。计量资料三组比较采取单因素方差分析,两两比较采用LSD-t检验,P0.05为差异有统计学意义。结果三组受检者血清HE4、CA125及ROMA比较差异有统计学意义(均P0.05);癌症组HE4、CA125水平及ROMA高于对照组与良性组(均P0.05),良性组HE4、ROMA与对照组比较差异无统计学意义(均P0.05),良性组CA125高于对照组(P0.05)。在卵巢癌的诊断方面,ROMA灵敏度与阴性预测值最高,HE4特异度与阳性预测值及诊断符合率最高。ROC曲线图分析HE4曲线下面积最大(0.867)。结论血清HE4与CA125抗原表达水平构建的ROMA有利于卵巢癌的早期诊断。     

Dietary fat intake and risk of Parkinson disease: results from the Swedish National March Cohort

European Journal of Epidemiology - Following progressive aging of the population worldwide, the prevalence of Parkinson disease is expected to increase in the next decades. Primary prevention of...     

Association of vegetable, fruit, and grain intakes with colorectal cancer: the Multiethnic Cohort Study

BACKGROUND: It is uncertain whether or not vegetables, fruit, or grains protect against colorectal cancer. OBJECTIVE: In a large prospective study, we investigated the association of vegetable, fruit, and grain intakes with colorectal cancer risk. DESIGN: Between 1993 and 1996, 85 903 men and 105 108 women completed a quantitative food-frequency questionnaire that included approximately 180 foods and beverages in the Multiethnic Cohort Study. A diagnosis of colorectal cancer was made in 1138 men and 972 women after an average follow-up of 7.3 y. Cox proportional hazards models were used to calculate multivariate-adjusted relative risks and 95% CIs for colorectal cancer. RESULTS: In men, multivariate adjustment for energy intake, dietary, and nondietary variables resulted in relative risks in the highest quintile group of 0.74 (95% CI: 0.59, 0.93; P for trend = 0.02) for vegetables and fruit combined, 0.80 (95% CI: 0.64, 0.99; P for trend = 0.09) for fruit alone, and 0.85 (95% CI: 0.69, 1.05; P for trend = 0.05) for vegetables alone. When colon and rectal cases were separated among men, the inverse associations were stronger for colon than for rectal cancer. In women, none of the associations with vegetables, fruit, or vegetables and fruit combined were significant. Grain intake was not associated with colorectal cancer for either men or women. CONCLUSION: The intake of vegetables and fruit was inversely related to colorectal cancer risk among men but not among women. The association appears stronger for colon than for rectal cancer.     

Occupational exposures and the risk of ovarian cancer in Sweden

BACKGROUND: Studies of occupational exposures and ovarian cancer, often limited by few subjects or proportionate mortality data, have yielded inconsistent results. METHODS: Swedish women employed in 1960, 1970, or during both years were followed from 1971 to 1989 using census data linked to nationwide cancer and death registries. A total of 9,591 ovarian cancer cases were identified among 1,670,517 women. Poisson regression was used to estimate the relative risk of ovarian cancer in specific occupational groups and in women exposed to particular occupational exposures defined by job exposure matrices. We lacked data on reproductive factors. RESULTS: Jobs associated with elevated ovarian cancer rates in this and previous studies include dry cleaning, telegraph and telephone work, paper packaging, and graphic and printing work. In contrast to results of some previous studies, we found that hairdressers and beauticians were not at increased risk of ovarian cancer. Organic dusts, aromatic amines, aliphatic and aromatic hydrocarbons are suggested as specific etiologic agents. CONCLUSIONS: In this large study, we have confirmed some results from smaller studies and identified some new relationships that need to be confirmed elsewhere.     

Occupations with increased risk of pancreatic cancer in the Swedish population

Aims: To identify occupations with increased risk of pancreatic cancer in the Swedish population gainfully employed in 1970 over the period 1971–89.

Methods: The base population was made up of Swedish men (1 779 646) and Swedish women (1 101 669) gainfully employed at the time of the 1970 census and were still alive and over age 24 on 1 January 1971. Information was drawn from two data sets: the Swedish cancer environment register and a background population register. After 19 years of follow up, 4420 men and 2143 women were diagnosed with histologically confirmed incident pancreatic adenocarcinoma. Log linear Poisson models were fitted, allowing for geographical area and town size. Risk estimators were also calculated for workers reporting the same occupation in 1960 and 1970.

Results: Among women, a statistically significant risk excess of pancreatic cancer was observed for "educational methods advisors", "librarian, archivist, curator", "motor vehicle driver", "typographer, lithographer", "purser, steward, stewardess", "other housekeeping and related workers", and the groups of occupations of "electrical, electronic, and related" and "glass, pottery, and tile workers". Men showed a higher incidence of pancreatic cancer among "technical assistants", "travelling agents", "other metal processing workers", "baker and pastry cook", "docker and freight handler", and "waiters".

Conclusions: This study does not indicate that occupational factors play an important role in the aetiology of pancreatic cancer in Sweden. Few occupations were at increased risk of pancreatic cancer in both men and women, and the associations observed are in accordance with some previous studies from Western countries.

     

Familial breast and ovarian cancer: a Swedish population-based register study

A cohort of offspring of mothers with breast or ovarian cancer diagnosed in 1958-1993 was established using Swedish population-based registers. The children (n = 158,041) were born between 1941 and 1993, and their cancer incidence was followed between 1961 and 1993. A total of 3,257 tumors in 3,102 children were found. Observed numbers of cases were compared with expected numbers based on national calendar year-, age-, and sex-specific incidences. For daughters of women with breast cancer, the standardized morbidity ratios for being diagnosed with breast cancer and ovarian cancer before age 50 years were 1.99 (95% confidence interval (CI): 1.86, 2.14) and 1.28 (95% CI: 1.05, 1.54), respectively. The corresponding figures for daughters of women with ovarian cancer were 1.79 (95% CI: 1.55, 2.07) and 2.38 (95% CI: 1.77, 3.12). The risks were raised if the mother's cancer was diagnosed at a young age, the mother had multiple breast/ovarian diagnoses, or there was a sister with breast/ovarian cancer. Among all offspring, increased risks were found for thyroid cancer, testicular cancer, and malignant melanoma, while lung cancer risk was decreased if the mother had had breast cancer. The authors developed a variance estimator for the standardized morbidity ratio to cope with overdispersion due to dependency within families.