Are retinol,vitamin C,vitamin E,folate and carotenoids intake associated with bladder cancer risk? Results from the Netherlands Cohort Study

In the Netherlands Cohort Study among 120 852 subjects aged 55-69 years at baseline (1986), the association between vitamins and carotenoids intake, vitamin supplement use, and bladder cancer incidence was examined. Exposure status was measured with a food-frequency questionnaire. After 6.3 years of follow-up, data from 569 cases and 3123 subcohort members were available for case-cohort analyses. The age-, sex-, and smoking-adjusted relative risks (RRs) for retinol, vitamin E, folate, a-carotene, b-carotene, lutein and zeaxanthin, and lycopene were 1.04, 0.98, 1.03, 0.99, 1.16, 1.11, and 1.08, respectively, comparing highest to lowest quintile of intake. Only vitamin C (RR: 0.81, 95% CI: 0.61-1.07, P-trend = 0.08), and b-cryptoxanthin intake (RR: 0.74, 95% CI: 0.53-1.03, P-trend < 0.01) were inversely associated with bladder cancer risk. The association with vitamin C disappeared after adjustment for b-cryptoxanthin but not vice versa. The RRs for supplemental use of vitamin A, C or E compared to no use were around unity. We conclude that dietary or supplemental intake of vitamin A, vitamin C, vitamin E, and intake of folate, and most carotenoids are not associated with bladder cancer. In this study, only b-cryptoxanthin intake appeared to be inversely associated.     

Is voluntary vitamin and mineral supplementation associated with better outcome in non-small cell lung cancer patients? Results from the Mayo Clinic lung cancer cohort

BACKGROUND: Some previous studies report that 80% of cancer patients take multivitamin and/or mineral supplements. To our knowledge, the consequences of such self-directed supplementation have not been examined previously in non-small cell lung cancer (NSCLC) patients. The goal of this study was to determine whether vitamin/mineral supplementation is associated with improved survival and quality of life in a cohort of NSCLC patients. METHODS: NSCLC patients or their proxies who responded to a questionnaire on vitamin/mineral use were assessed for survival and quality of life. RESULTS: A total of 1129 patients or their proxies responded to a vitamin/mineral questionnaire. Seven hundred and fourteen were vitamin/mineral users of either multivitamins or other specific vitamin/mineral supplements, and the rest non-users. Median survival was 4.3 years versus 2.0 years for vitamin/mineral users and non-users, respectively. A Cox proportional hazards model showed a relative risk of death of 0.74 (95% confidence interval (CI): 0.44, 0.65) (p < 0.01) in favor of vitamin/mineral use after adjustment for multiple prognostic factors, including tumor stage. The Lung Cancer Symptom Scale (LCSS) showed better quality of life among vitamin/mineral users (mean difference in score of 3 (95% CI: 0.8, 5.1) (p < 0.01); and after adjusting for related variables, there remained a trend in favor of vitamin/mineral use mean difference 1.8 (95% CI: 0.2, 3.9) (p = 0.08). CONCLUSIONS: Vitamin/mineral supplementation is associated with better survival and quality of life in this cohort of NSCLC patients. Future prospective clinical trials should focus on the role of such supplements in patients with NSCLC.     

Are patients with cancer receiving adequate thromboprophylaxis? Results from FRONTLINE

The FRONTLINE survey was designed in part to evaluate thromboprophylaxis regimens currently practised by clinicians worldwide for both surgical and medical patients with cancer. The survey showed that cancer patients undergoing surgery for their malignancy commonly receive thromboprophylaxis, but medical patients with cancer do not, with the exception of patients with a central venous catheter in place. Low-molecular-weight heparin is, overall, the most commonly used thromboprophylactic agent in cancer patients. Oral anticoagulants, however, are often used to prevent thrombosis in medical patients, and are the preferred agent in the USA. The duration of prophylaxis, when administered, is generally longer in medical patients compared with surgical patients. The perception of thrombosis risk for patients with central venous catheters is particularly high in North America where oral anticoagulants are used most commonly, in contrast to other geographical regions where low-molecular-weight heparin is favoured.     

Are low ultraviolet B and high animal protein intake associated with risk of renal cancer?

Incidence rates of kidney cancer are thought to be highest in places situated at high latitudes and in populations with high intake of energy from animal sources. This suggests that low 25-hydroxyvitamin D status, due to lower levels of UVB irradiance, and energy from animal sources might be involved in etiology. The association of latitude with age-adjusted incidence rates was determined for all 175 countries in a UN cancer database, GLOBOCAN. The independent association of UVB irradiance, cloud cover and intake of calories from animal sources with age-adjusted incidence rates was assessed using multiple regression in 139 countries that provided dietary data. Renal cancer incidence rates were highest in countries situated at the highest latitudes, in men (R(2) = 0.64, p < 0.01) and women (R(2) = 0.63, p < 0.01). According to multivariate analysis in men, UVB irradiance was inversely associated with renal cancer incidence rates (p = 0.0003), while cloud cover (p = 0.003) and intake of calories from animal sources (p < 0.0001) were independently positively associated (R(2) for model = 0.73, p < 0.0001). In women, UVB irradiance was inversely associated with incidence rates (p = 0.04), while total cloud cover (p = 0.0008) and calories from animal sources (p < 0.0001) were positively associated (R(2) = 0.68, p < 0.0001). Lower levels of UVB irradiance and higher intakes of calories from animal sources were independently associated with higher incidence rates of kidney cancer.     

Fruit and vegetable intake and risk of cancer in the Swedish women’s lifestyle and health cohort

Objective  

To investigate whether intake of fruits and vegetables is associated with overall cancer incidence in a large prospective cohort of women in Sweden characterised by young age at enrolment (30–49 years) and relatively low intake of fruits and vegetables.     

Are patients with cancer receiving adequate treatment for thrombosis? Results from FRONTLINE

The current practice of clinicians worldwide in the treatment of venous thromboembolism was assessed via responses to the FRONTLINE survey. Significant regional differences in practice were noted. Use of low-molecular-weight heparin was reported as the most common initial treatment for venous thromboembolism, although, in North America, unfractionated heparin was widely used to treat surgical cancer patients after a thrombotic episode. Oral anticoagulants were favoured for long-term treatment of venous thromboembolism, particularly in Western Europe and North America. Case study reports from the survey revealed that a substantial proportion of patients with cancer had been perceived to be at low risk of thrombosis, had consequently not received thromboprophylaxis and developed VTE.     

Are Coffee, Tea, and Total Fluid Consumption associated with Bladder Cancer Risk? Results from the Netherlands Cohort Study

Objectives: Coffee, tea, and fluid consumption have been thought to influence bladder cancer incidence. In a large prospective study, these associations were investigated. Methods: In 1986, cohort members (55–69 years) completed a questionnaire on cancer risk factors. Follow-up was established by linkage to cancer registries until 1992. The multivariable case–cohort analysis was based on 569 bladder cancer cases and 3123 subcohort members. Results: The incidence rate ratios (RR) for men consuming <2 cups of coffee/day was 0.89 (95% CI 0.51–1.5) using the median consumption category (4–<5 cups/day) as reference. This RR increased to 1.3 (95% CI 0.94–1.9) for men consuming 7 cups/day, although no clear dose–response association was found. The RRs decreased from 1.2 (95% CI 0.56–2.7) for women consuming <2 cups of coffee/day to 0.36 (95% CI 0.18–0.72) for women consuming 5 cups/day compared to the median consumption category (3–<4 cups/day). Men and women who abstained from drinking tea had a RR of 1.3 (95% CI 0.97–1.8) compared to those consuming 2–<3 cups of tea per day (median consumption category). The RR for men and women comparing highest to lowest quintile of total fluid consumption was 0.87 (95% CI 0.63–1.2). Conclusion: The data suggest a possible positive association between coffee consumption and bladder cancer risk in men and a probable inverse association in women. Tea consumption was inversely associated with bladder cancer. Total fluid consumption did not appear to be associated with bladder cancer.     

Do patients with pancreatic body or tail cancer benefit from adjuvant therapy?A cohort study

Introduction

Evidence supporting adjuvant therapy for resected pancreatic cancer is limited primarily to head tumors. We analyzed data from the National Cancer Database (NCDB) to evaluate the relationship of tumor site with benefit from adjunctive (adjuvant, neoadjuvant, perioperative) therapy (Rx).

Do both heterocyclic amines and omega‐6 polyunsaturated fatty acids contribute to the incidence of breast cancer in postmenopausal women of the Malmö diet and cancer cohort?

Heterocyclic amines (HAs), formed when meat and fish are cooked at high temperatures, have been linked to mammary gland cancer in rats, and some epidemiological studies indicate increased breast cancer risk by consumption of well-done meat. The epidemiological evidence linking HAs per se to breast cancer is however sparse, especially from prospective studies. Moreover, high-fat diets rich in omega-6 polyunsaturated fatty acids (PUFAs) have produced higher frequencies of HA-induced mammary gland tumors in rats compared to those fed low-fat diets. The aim was to evaluate prospectively if intake of HAs is associated with breast cancer incidence, and if the association is independent of omega-6 PUFA intakes. Among women 50 years or older at baseline from the population-based prospective Malm? Diet and Cancer cohort (n = 11,699), 430 women were diagnosed with incident invasive breast cancer during a mean follow-up of 10.4 years. Information on dietary habits was collected by a modified diet history method. Cox proportional hazards regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with energy-adjusted intakes of HAs and omega-6 PUFA. Intakes of HAs were not associated with breast cancer incidence (HR, 0.94; 95% CI, 0.69-1.28, for highest compared to lowest quintile). In individuals with low HA intakes, a significant increased risk was observed among those with high intakes of omega-6 PUFAs. In conclusion, intakes of HAs are not associated with breast cancer incidence in this Swedish cohort, but dietary patterns very high in omega-6 PUFA may promote breast cancer development.     

Are alcohol intake and smoking associated with mycosis fungoides? A European multicentre case-control study

The incidence of mycosis fungoides (MF) is low, and the aetiology of the disease is unknown. The aim of this study was to investigate whether wine consumption protects against the disease and whether smoking constitutes a risk factor. This paper is part of the European Rare Cancers Study that tries to determine the risk factors for seven selective rare cancers, including mycosis fungoides, involved in the development of cancer. A multicentre case-control study was conducted in six European countries. Only incident cases with confirmed histology were included in the analysis which include a total of 76 cases of MF and 2899 controls. Wine intake had no protective effect; on the contrary the consumption of more than 24 g of alcohol per day was associated with a high risk of MF (odds ratio (OR)=3.02, 95% confidence interval (CI), 1.34-6.79), after adjusting for centre, country, age, sex and education. There was a dose-dependent increase in the risk of MF with increased smoking habits, albeit the observed trend was not statistically significant. A combined exposure to high tobacco and alcohol use yielded a significantly increased risk factor for MF (P=0.0073). Alcohol intake was associated with MF.     

In‐house information about and contact with self‐help groups in breast cancer patients: associated with patient and hospital characteristics?

The number of breast cancer patients who are informed about and have contact with patient self-help groups (SHGs) during their hospital stay varies across hospitals. The aim of this study is to investigate which patient and hospital characteristics contribute to these differences. Multilevel regression analysis was applied, using data on hospital characteristics and data from a patient survey, which catalogued the disease and socio-demographic characteristics of newly diagnosed breast cancer patients, and recorded if they were informed about and had contact with SHGs during their hospital stay. Data from 2639 patients from 82 hospitals were analysed. The odds of being informed about SHGs were significantly lower if patients were treated at a teaching hospital. Patients aged 40 to 59 years significantly more often reported that they were informed about SHGs than patients aged 60 to 69 years. Patients with the highest education certificates significantly more often reported that they both were informed about and have had contact with SHGs. These results suggest that in teaching hospitals, information provided to patients about SHGs is reduced. Furthermore, patients are differentially given information about SHGs and have different levels of contact with SHGs, based on their age and education.     

Prostatitis,other genitourinary infections and prostate cancer risk: Influence of non‐steroidal anti‐inflammatory drugs? Results from the EPICAP study

Epidemiological studies have suggested that prostatitis may increase the risk of prostate cancer due to chronic inflammation. We studied the association between several genitourinary infections and the risk of prostate cancer based on data from the EPICAP study. EPICAP is a population‐based case‐control study conducted in the département of Hérault, France, between 2012 and 2014. A total of 819 incident cases and 879 controls have been face to face interviewed using a standardized questionnaire gathering information on known or suspected risk factors of prostate cancer, and personal history of genitourinary infections: prostatitis, urethritis, orchi‐epididymitis, and acute pyelonephritis. Odds Ratios (OR) and their 95% confidence interval were estimated using multivariate unconditional logistic regression. Overall, 139 (18%) cases and 98 (12%) controls reported having at least one personal history of genitourinary infections (OR = 1.64 [1.23–2.20]). The risk increased with the number of infections (p‐trend < 0.05). The association was specifically observed with personal history of chronic prostatitis and acute pyelonephritis (OR = 2.95 [1.26–6.92] and OR = 2.66 [1.29–5.51], respectively) and in men who did not use any non‐steroidal anti‐inflammatory drugs (OR = 2.00 [1.37–2.91]). Our results reinforce the hypothesis that chronic inflammation, generated by a personal history of genitourinary infections, may play a role in prostate carcinogenesis.     

High fat and alcohol intakes are risk factors of postmenopausal breast cancer: a prospective study from the Malmö diet and cancer cohort

Associations between intakes of relative fat, total alcohol and alcoholic beverages and risk of breast cancer were examined in a subsample of 11726 postmenopausal women from the MDC cohort. The MDC conducted baseline examinations from 1991 to 1996; the end of follow-up was 31 December 2001. Data were obtained by an interview-based diet history method, a structured questionnaire, anthropometric measurements and national and regional cancer registries. During 89602 person-years of follow-up, 342 incident cases were documented. Cox regression analysis examined breast cancer risks adjusted for potential confounders. Two energy-adjustment approaches (i.e., adjusting for total energy vs. adjusting for nonalcohol energy) were used. High total alcohol intake was associated with a nonsignificantly elevated risk. High wine intake was associated with a significantly elevated breast cancer risk (relative risk = 2.12, 95% CI 1.24-3.60). There were significant trends of increased breast cancer risk across quintiles of relative fat intake. Mutual adjustment did not affect risk estimates for total alcohol or relative fat intakes. The specific energy-adjustment approach did not influence associations differentially.