| 1. |
- Suzuki, Reiko, et al.
(författare)
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A prospective analysis of the association between dietary fiber intake and prostate cancer risk in EPIC
- 2009
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 124:1, s. 245-249
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have examined the association between dietary fiber intake and prostate cancer risk. We evaluated the association between dietary fiber intake and the risk of prostate cancer among 142,590 men in the European Prospective Investigation into Cancer and Nutrition (EPIC). Consumption of dietary fiber (total, cereal, fruit and vegetable fiber) seas estimated by validated dietary questionnaires and calibrated using 24-hr dietary recalls. Incidence rate ratios were estimated using Cox regression and adjusted for potential confounding factors. During all average of 8.7 years follow-up, prostate cancer was diagnosed in 2,747 men. Overall, there was no association between dietary fiber intake (total, cereal, fruit or vegetable fiber) and prostate cancer risk, although calibrated intakes of total fiber and fruit fiber were associated with nonstatistically significant reductions in risk. There was no association between fiber derived from cereals or vegetables and risk and no evidence for heterogeneity in any of the risk estimates by stage or grade of disease. Our results suggest that dietary fiber intake is not associated with prostate cancer risk. (C) 2008 Wiley-Liss, Inc.
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| 2. |
- Suzuki, Reiko, et al.
(författare)
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Alcohol intake and risk of breast cancer defined by estrogen and progesterone receptor status - A meta-analysis of epidemiological studies
- 2008
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Ingår i: International Journal of Cancer. - : WILEY. - 0020-7136 .- 1097-0215. ; 122:8, s. 1832-1841
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Tidskriftsartikel (refereegranskat)abstract
- The association between alcohol consumption and an increased risk of breast cancer has been established. It is still unclear however, whether this relationship differs across the estrogen receptor (ER) and progesterone receptor (PR) tumors subtypes. To provide a quantitative assessment of the association between alcohol intake and the risk of ER-/PR-defined breast cancer, we conducted a meta-analysis of cohort and case-control studies. Studies were identified by a literature search of PubMed through April 20, 2007 and by searching the reference lists of relevant articles. Summarized risk estimates (REs) with 95% confidence intervals (CIs) were calculated using random-effects models. The summarized results of the meta-analysis comparing the highest versus the lowest consumption categories showed statistically significant higher risks of developing all ER+ (27%), all ER- (14%), ER+PR+ (22%) and ER+PR- (28%), but not ER-PR- tumors. The dose-response meta-analysis showed that an increase in alcohol consumption of 10 g of ethanol per day was associated with statistically significant increased risks for all ER+ (12%), all ER(7%), ER+PR+ (11%) and ER+PR- (15%), but not ER-PR-. A statistically significant heterogeneity of the REs across all ER+ versus ER-PR- was observed (P-heterogeneity = 0.02). The summarized results from studies with adjustment for postmenopausal hormone use, body mass index and family history of breast cancer were higher and statistically significantly different from those without. The observed positive associations with alcohol for ER+PR+ and ER+PR- tumors cannot be explained by estrogen-dependent pathway only. Further studies need to clarify the biological mechanisms.
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| 3. |
- Suzuki, Reiko, et al.
(författare)
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Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status-A meta-analysis
- 2009
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Ingår i: International Journal of Cancer. - : WILEY. - 0020-7136 .- 1097-0215. ; 124:3, s. 698-712
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Tidskriftsartikel (refereegranskat)abstract
- Epidemiological evidence indicates that the association between body weight and breast cancer risk may differ across menopausal status as well as the estrogen receptor (ER) and progesterone receptor (PR) tumor status. To date, no meta-analysis has been conducted to assess the association between body weight and ER/PR defined breast cancer risk, taking into account menopausal status and study design. We searched MEDLINE for relevant studies published from January 1, 1970 through December 31, 2007. Summarized risk estimates with 95% confidence intervals (CIs) were calculated using a random-effects model. The summarized results of 9 cohorts and 22 case-control studies comparing the highest versus the reference categories of relative body weight showed that the risk for ER+PR+ tumors was 20% lower (95% CI = -30% to -8%) among premenopausal (2,643 cases) and 82% higher (95% CI = 55-114%) among postmenopausal (5,469 cases) women. The dose-response meta-analysis of ER+PR+ tumors showed that each 5-unit increase in body mass index (BMI, kg/m(2)) was associated with a 33% increased risk among postmenopausal women (95% CI = 20-48%) and 10% decreased risk among premenopausal women (95% Cl = -18% to -1%). No associations were observed for ER-PR- or ER+PR-tumors. For discordant tumors ER+PR- (pre) and ER-PR+ (pre/post) the number of cases were too small (<200) to interpret results. The relation between body weight and breast cancer risk is critically dependent on the tumor's ER/PR status and the woman's menopausal status. Body weight control is the effective strategy for preventing ER+PR+ tumors after menopause. (C) 2008 Wiley-Liss, Inc.
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| 4. |
- Suzuki, Reiko, et al.
(författare)
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Body weight and postmenopausal breast cancer risk defined by estrogen and progesterone receptor status among Swedish women : A prospective cohort study
- 2006
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Ingår i: International Journal of Cancer. - Karolinska Inst, Natl Inst Environm Med, Div Nutrit Epidemiol, S-17177 Stockholm, Sweden. Karolinska Inst, Dept Med Epidemiol & Biostat, S-17177 Stockholm, Sweden. Tokyo Metropolitan Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Div Clin Trials & Res, Tokyo, Japan. : WILEY-LISS. - 0020-7136 .- 1097-0215. ; 119:7, s. 1683-1689
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Tidskriftsartikel (refereegranskat)abstract
- Although obesity is one of the established risk factors for postmenopausal breast cancer, it is not clear whether this positive association differs across estrogen receptor (ER) and progesterone receptor (PR) status of breast tumors. We evaluated the association between body weight and ER/PR defined breast cancer risk stratified by postmenopausal hormone (PMH) use and a family history of breast cancer in the population-based Swedish Mammography Screening Cohort comprising 51,823 postmenopausal women. Relative body weight was measured by body mass index (kg/m(2)) based on self-reported weight and height collected in 1987 and 1997. Relative risks (RRs) were estimated by hazard ratios derived from Cox proportional hazards regression models. During an average of 8.3-year follow-up, 1,188 invasive breast cancer cases with known ER and PR status were diagnosed. When comparing to normal weight group, we observed a positive association between obesity and risk for the development of ER+ PR+ tumors (RR = 1.67, 95% CI = 1.34-2.07) and an inverse association for the development of all PR- tumors (RR = 0.68, 95 % CI = 0.47-0.98). Statistically significant heterogeneity was observed in the RRs between ER+ PR+ tumors and all PR- tumors (P-heterogeneity < 0.0001). The positive association of obesity with the development of ER+ PR+ tumors was confined to never-users of PMHs (RR = 1.90 (Cl 95%:1.38-2.61)) and to those without a family history of breast cancer (RR = 1.82 (Cl 95%:1.45-2.29)). Our results support the hypothesis that excess endogenous estrogen due to obesity contributes to an increased risk of ER+ PR+ postmenopausal breast cancer. (c) 2006 Wiley-Liss, Inc.
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| 5. |
- Suzuki, Reiko, et al.
(författare)
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Dietary fiber intake and risk of postmenopausal breast cancer defined by estrogen and progesterone receptor status - A prospective cohort study among Swedish women
- 2008
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Ingår i: International Journal of Cancer. - : WILEY. - 0020-7136 .- 1097-0215. ; 122:2, s. 403-412
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Tidskriftsartikel (refereegranskat)abstract
- There is few data on the association between dietary fiber intake and estrogen receptor (ER)/progesterone receptor (PR)-defined breast cancer risk. We evaluated the association between dietary fiber and ER/PR-defined breast cancer risk stratified by postmenopausal hormone use, alcohol intake, and family history of breast cancer in the population-based Swedish Mammography Screening Cohort comprising 51,823 postmenopausal women. Fiber intake was measured by food-frequency questionnaire collected in 1987 and 1997. Relative risks (RRs) were estimated by hazard ratio derived from Cox proportional hazard regression models. During an average of 8.3-year follow-up, 1,188 breast cancer cases with known ER/PR status were diagnosed. When comparing the highest to the lowest quintile, we observed non-significant inverse associations between total fiber intake and the risk of all tumor subtypes; the multivariate-adjusted RRs were 0.85 (95% CI: 0.69-1.05) for overall, 0.85 (0.64-1.13) for ER+PR+, 0.83 (0.52-1.31) for ER+PR- and 0.94 (0.49-1.80) for ER-PR-. For specific fiber, we observed statistically significant risk reductions for overall (34%) and for ER+PR+ (38%) for the highest versus lowest quintile of fruit fiber, and non-significant inverse associations for other subtypes of cancer and types of fiber. Among ever-users of postmenopausal hormone (PMH), total fiber intake and especially cereal fiber were statistically significantly associated with similar to 50% reduced risk for overall and ER+PR+ tumors when comparing the highest to the lowest quartile, but no association was observed among PMH never users. Our results suggest that dietary fiber intake from fruit and cereal may play a role in reducing breast cancer risk. (C) 2007 Wiley-Liss, Inc.
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| 6. |
- Suzuki, Reiko
(författare)
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Hormone-related dietary factors and estrogen/progesterone-receptor defined postmenopausal breast cancer
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Breast cancer is the most common invasive cancer among women in Western countries including Sweden. It has been hypothesized that ovarian hormones, such as estrogen and progesterone may, at least partly, play an important role in the etiology of breast cancer. Several nutritional related factors - alcohol, body weight, dietary fiber, and dietary lignans - are postulated to affect levels of estrogen, progesterone and/or insulin and to be associated with the development/prevention of breast cancer through hormonal modulation. Evidence from in vitro, in vivo and from observational studies suggested an association between these dietary factors and the risk of breast cancer. However, it is not fully defined whether the major underlying mechanisms of the association between these factors and breast cancer are hormone-dependent or not. The aim of this thesis was to investigate the relation between these hormone-related nutritional factors, such as alcohol, body weight, dietary fiber, and dietary lignans, and invasive breast cancer incidence with estrogen-progesterone-receptor (ER/PR) status in the population-based prospective Swedish Mammography Cohort (SMC). The SMC includes women born between 1914 and 1948 and living in Uppsala and Västmanland Counties who received a mailed questionnaire (1987-90) and a follow-up questionnaire (1997). Our analyses include 51 823 postmenopausal women in the SMC who were cancer free and completed the questionnaire at baseline. Cox proportional hazard models were used to estimate rate ratios (RRs) with 95% confidence intervals (CIs) with adjustment for potential confounders. All statistical tests were two-sided. From March 1987 through June 2004, 1,188 invasive breast cancer patients with known ER/PR status were identified. Among them, 716 were ER+PR+, 279 were ER+PR-, 50 were ER-PR+, and 143 were ER-PR-. Alcohol intake was positively associated with the risk of breast cancer, especially with ER+ tumors and the observed associations were more pronounced among PMH users. Body weight was positively associated with the development of ER+PR+ tumors, but not with other tumors subtypes. This positive association was confined to PMH never-users. We observed non-significant inverse association of total dietary fiber with all types of tumors. However, we observed statistically significant inverse associations confined to women without family history of breast cancer, to PMH ever-users, and to those with high alcohol consumption. Fruit fiber intake was inversely associated with the risk of all breast cancer, especially among PMH never-users. In contrast, among PMH ever-users, cereal fiber intake was inversely associated with the risk of ER+PR+ tumors. We observed non-significant inverse association of dietary lignans with all breast cancer risk. In a similar manner as cereal fiber intake, dietary lignans were inversely associated with the risk of ER+PR+ tumors among PMH ever-users. In conclusion, our findings from this large prospective cohort suggest that alcohol, body weight, dietary fiber and lignans intake could partly affect the risk of postmenopausal breast cancer through hormone dependent mechanisms. Our results indicate that the choice of diet rich in dietary fiber and low alcohol consumption - and body weight control are important factors for the prevention of postmenopausal breast cancer, especially among PMH ever-users. In evaluating the association between hormone-related nutritional factors and the risk of postmenopausal breast cancer, the tumors' ER/PR status should be considered.
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