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Autier P.,International Prevention Research Institute IPRI | Dore J.-F.,French Institute of Health and Medical Research | Eggermont A.M.M.,Cancer Institute Gustave Roussy | Coebergh J.W.,Erasmus University Rotterdam | Coebergh J.W.,Comprehensive Cancer Center South
Current Opinion in Oncology | Year: 2011

Purpose of review: Epidemiological data have contributed to the classification in 2009 of the full ultraviolet (UV) radiation spectrum as carcinogenic to humans. We reviewed the epidemiological evidence that UVA could be involved in the genesis of cutaneous melanoma. Recent findings: Use of artificial UV tanning devices (sunbeds) consists mainly of repeated exposure to high UVA doses. Epidemiological studies published over the last years confirmed the association between sunbed use and melanoma. Sunbed use is the most probable cause of an epidemic of melanoma that took place in Iceland from 1990 to 2006. The four-fold increase in melanoma incidence was not followed by an increase in melanoma mortality. Sunscreens were primarily devised for the prevention of sunburn, and UVB is the wavelength causing most sunburns. All observational studies and randomized trials show that sunscreen use may extend sun exposure intended for getting a tan, while it does not necessarily decrease sunburn occurrence. Sunscreen use for tan acquisition would thus lead to similar exposure to UVB and greater exposure to UVA, which could explain the slightly higher melanoma risk often found among sunscreen users. Summary: UVA could be involved in the occurrence of nonlife-threatening melanoma. The increasing use of sunbeds and of sunscreens may partly explain why melanoma incidence increases in most light-skinned populations without concomitant increase in mortality. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Autier P.,International Prevention Research Institute IPRI
Revue du Praticien | Year: 2013

Breast cancer screening in France is done though two parallel systems: individualized screening and a national programme of organized screening. The latter is free of charge and manages a double-reading of mammography films. Since 2004, a steadily greater proportion of French women 50 to 74 years of age participate to the national programme. Justification of screening in France is based on Swedish randomised trials that documented the ability of mammography screening to reduce the risk to die from breast cancer. However, since 3 years, a growing number of studies indicate that screening seems not to have much influence on the incidence of advanced breast cancer and on mortality from breast cancer. Moreover, numerous breast cancers are detected that would have never clinically surfaced and would have never been life threatening (overdiagnosis). In view of current doubts, it is better to inform women on health benefits, limitations and possible side effects of mammography screening. For women willing to be screened, it is recommended to invite them to participate to the national programme.

Autier P.,International Prevention Research Institute IPRI | Esserman L.J.,University of California at San Francisco | Flowers C.I.,H. Lee Moffitt Cancer Center and Research Institute | Houssami N.,University of Sydney
Nature Reviews Clinical Oncology | Year: 2012

Early detection of cancer has long been thought to be the first step towards eradicating the mortality associated with the disease. National screening programmes for breast cancer have been implemented in many countries. However, there is controversy regarding the efficacy and optimal methods of screening, which is regularly discussed in articles, at conferences and is apparent in conflicting guidelines. In this article, Nature Reviews Clinical Oncology asks four experts their opinions on some of the pressing questions associated with breast cancer screening. © 2012 Macmillan Publishers Limited. All rights reserved.

Mullie P.,International Prevention Research Institute IPRI | Godderis L.,Catholic University of Leuven | Clarys P.,Vrije Universiteit Brussel
Appetite | Year: 2012

Objectives: the objective was to study determinants and nutritional implications associated with low-fat food consumption. Methods: a cross-sectional design was used, 5,000 military men were contacted and 1,852 participated. Using mailed questionnaires, the low-fat food consumption frequency was recorded and stratified in number of portions a day. The following low-fat food items were included: mayonnaise, yoghurt, milk, cheese, cottage cheese and meat. Results: the two most daily consumed low-fat foods were meat and yoghurt by, respectively, 21.7% and 17.3% of the participants. Only 3.5% consumed a daily portion of low-fat cheese, and 7.4% consumed one or more daily portions of low-fat milk. After adjustment, Body Mass Index (BMI), physical activity and non-smoking were associated with an increasing consumption of low-fat foods. Consumption of low-fat foods was associated with a decreased daily total and saturated fat intake, from respectively, 37.9 and 14.7 energy-percent for low consumption to 30.5 and 11.6 energy-percent for high consumption. This decrease was compensated by an increased intake in carbohydrates and sugar, respectively, 42.5 and 16.7 energy-percent to 46.5 and 22.6 energy-percent. Conclusions: age, BMI, physical activity and non-smoking were associated with an increasing consumption of low-fat foods. The fact that low-fat foods consumers had a higher intake of carbohydrates and proteins question the efficacy of these items in energy reducing programs. © 2011 Elsevier Ltd.

Autier P.,International Prevention Research Institute IPRI | Gandini S.,Italian National Cancer Institute | Mullie P.,International Prevention Research Institute IPRI
Journal of Clinical Endocrinology and Metabolism | Year: 2012

Context: Few studies in subjects over 50 yr of age have evaluated the influence of variable doses of vitamin D supplementation on serum 25-hydroxyvitamin D levels. Objective: We performed a meta-analysis of changes in circulating 25-hydroxyvitamin D level associated with vitamin D supplementation in Caucasian subjects over 50 yr old. Data Sources: We conducted a systematic search in literature databases and in references of past reviews. Study Selection: Randomized placebo or open-label trials that evaluated the influence of vitamin D supplementation on clinical outcomes were included in the study. Data Extraction: We reviewed trial characteristics and serum 25-hydroxyvitamin D concentrations at baseline and during the trial. Data Synthesis: Seventy-six trials published from 1984 to March 2011 included 6207 subjects allocated to 101 intervention groups that tested supplement doses ranging from 5 to 250 μg/d (median, 20 μg/d). For similar doses, trials could obtain increases in 25-hydroxyvitamin D three to four times lower than other trials. A meta-regression showed that in the absence of concomitant use of calcium supplements, the average increase in serum 25-hydroxyvitamin D concentrations was 0.78 ng/ml (1.95 nmol/liter) per microgram of vitamin D3 supplement per day. Compared to the vitamin D3, the vitamin D2 was associated with significantly lower increases (P = 0.03). Concomitant use of calcium supplementation and high 25-hydroxyvitamin D concentration at baseline was nonsignificantly associated with lower increases in 25-hydroxyvitamin D concentrations. Conclusions: Dietary recommendations and randomized trials on vitamin D supplementation should evaluate whether increases in circulating 25-hydroxyvitamin D levels match expectations-for instance, the average increases obtained by trials on vitamin D3 without concomitant calcium supplements. Copyright © 2012 by The Endocrine Society.

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