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Helsinki, Finland

Lukic M.,University of Tromso | Licaj I.,University of Tromso | Lund E.,University of Tromso | Skeie G.,University of Tromso | And 5 more authors.
European Journal of Epidemiology | Year: 2016

An association between coffee consumption and cancer has long been investigated. Coffee consumption among Norwegian women is high, thus this is a favorable population in which to study the impact of coffee on cancer incidence. Information on coffee consumption was collected from 91,767 women at baseline in the Norwegian Women and Cancer Study. These information were applied until follow-up information on coffee consumption, collected 6–8 years after baseline, became available. Multiple imputation was performed as a method for dealing with missing data. Multivariable Cox regression models were used to calculate hazard ratios (HR) for breast, colorectal, lung, and ovarian cancer, as well as cancer at any site. We observed a 17 % reduced risk of colorectal cancer (HR = 0.83, 95 % CI 0.70–0.98, ptrend across categories of consumption = 0.10) and a 9 % reduced risk of cancer at any site (HR = 0.91, 95 % CI 0.86–0.97, ptrend = 0.03) in women who drank more than 3 and up to 7 cups/day, compared to women who drank ≤1 cup/day. A significantly increased risk of lung cancer was observed with a heavy coffee consumption (>7 vs. ≤1 cup/day HR = 2.01, 95 % CI 1.47–2.75, ptrend < 0.001). This was most likely caused by residual confounding due to smoking, as no statistically significant association was observed in never smokers (>5 vs. ≤1 cup/day HR = 1.42, 95 % CI 0.44–4.57, ptrend = 0.30). No significant association was found between coffee consumption and the risk of breast or ovarian cancer. In this study, coffee consumption was associated with a modest reduced risk of cancer at any site. Residual confounding due to smoking may have contributed to the positive association between high coffee consumption and the risk of lung cancer. © 2016 Springer Science+Business Media Dordrecht

Alfonso J.H.,National Institute of Occupational Health | Martinsen J.I.,Cancer Registry of Norway | Pukkala E.,Institute for Statistical and Epidemiological Cancer Research | Pukkala E.,University of Tampere | And 8 more authors.
Journal of the American Academy of Dermatology | Year: 2016

Background: The age-adjusted incidence of cutaneous squamous cell carcinoma (cSCC) in the Nordic countries has increased during the last 60 years, and the identification of occupational variation in the relative risk of cSCC may have preventive implications. Objective: We sought to describe variation in the relative risk of cSCC between occupational categories in Finland, Iceland, Norway, and Sweden. Methods: This is a historical prospective cohort study based on record linkages between census data for 12.9 million people and cancer registry data from 1961 to 2005. Standardized incidence ratios for cSCC were estimated for 53 occupational categories with the cSCC incidence rates for the national population of each country used as reference. Results: During follow-up, 87,619 incident cases of cSCC were reported to the national cancer registries. In all countries combined, significant increased standardized incidence ratios were observed among seamen, military personnel, public safety workers, technical workers, teachers, transport workers, physicians, dentists, nurses, other health workers, religious workers, clerical workers, administrators, and sale agents (standardized incidence ratios between 1.08 and 1.77). Limitations: Information on occupation was based on 1 point in time only. Conclusion: The occupational variation of the relative risk of cSCC might be associated with socioeconomic factors, and to some extent to occupational exposures. © 2016 American Academy of Dermatology, Inc.

Weiderpass E.,Karolinska Institutet | Weiderpass E.,University of Tromso | Weiderpass E.,Genetic Epidemiology Group | Tyczynski J.E.,Astrazeneca
Molecular Diagnosis and Therapy | Year: 2015

Ovarian cancer survival rates have improved only slightly in recent decades; however, treatment of this disease is expected to undergo rapid change as strategies incorporating molecular-targeted therapies enter clinical practice. Carriers of deleterious mutations (defined as a harmful mutation) in either the BRCA1 or BRCA2 gene (BRCAm) have a significantly increased risk of developing ovarian cancer. Epidemiology data in large (>500 patients) unselected ovarian cancer populations suggest that the expected incidence rate for BRCAm in this population is 12–14 %. Patients with a BRCAm are typically diagnosed at a younger age than those without a BRCAm. Associations with BRCAm vary according to ethnicity, with women of Ashkenazi Jewish descent being 10 times more likely to have a BRCAm than the general population. In terms of survival, patients with invasive epithelial ovarian cancer who have a BRCAm may have improved overall survival compared with patients who do not carry a BRCAm. Although genetic testing for BRCAm remains relatively uncommon in ovarian cancer patients, testing is becoming cheaper and increasingly accessible; however, this approach is not without numerous social, ethical and policy issues. Current guidelines recommend BRCAm testing in specific ovarian cancer patients only; however, with the emergence of treatments that are targeted at patients with a BRCAm, genetic testing of all patients with high-grade serous ovarian cancer may lead to improved patient outcomes in this patient population. Knowledge of BRCAm status could, therefore, help to inform treatment decisions and identify relatives at increased risk of developing cancer. © 2015, Springer International Publishing Switzerland.

Roswall N.,Danish Cancer Society | Roswall N.,Karolinska Institutet | Li Y.,Karolinska Institutet | Li Y.,Zhejiang University | And 7 more authors.
Cancer Epidemiology Biomarkers and Prevention | Year: 2015

Background: Recently, theNordic diet has gained interest, and a healthy Nordic food index has been developed, which has been found inversely related to colorectal canceramong Danishwomen. This single finding, however, requires replication in other cohorts. Methods: We conducted a prospective study in the Women's Lifestyle and Health cohort, including 45,222 women, recruited in 1991-92, and followed up ever since through Swedish registries. Participants were classified according to the Nordic food index (consisting of whole grain bread, oatmeal, apples/pears, cabbages, root vegetables, and fish/shellfish), and the association between adherence and colorectal cancer was assessed using the Cox proportional hazards models. Results: In the fully adjusted models, we found no association, neither with the continuous index score [incidence rate ratio (IRR), 1.04; 95% confidence interval (CI), 0.95-1.12, per 1-point increment] nor in the categorical analyses (IRR, 1.09; 95% CI, 0.78-1.52 for highest vs. lowest adherers). Conclusion: The present study does, thus, not support a previous finding of an inverse association between a healthy Nordic food index and colorectal cancer. Impact: This article adds new evidence to the field of the Nordic diet in disease prevention. Cancer Epidemiol Biomarkers Prev; 24(4); 755-7. © 2015 AACR.

Roswall N.,Danish Cancer Society | Roswall N.,Karolinska Institutet | Weiderpass E.,Karolinska Institutet | Weiderpass E.,Genetic Epidemiology Group | Weiderpass E.,University of Tromso
Journal of Preventive Medicine and Public Health | Year: 2015

The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study. © 2015 The Korean Society for Preventive Medicine.

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