scholarly journals Pre-diagnostic Circulating Concentrations of Fat-soluble Vitamins and Risk of Glioma in Three Cohort Studies

2020 ◽  
Author(s):  
Yiyang Yue ◽  
Jordan Creed ◽  
David Cote ◽  
Meir Stampfer ◽  
Molin Wang ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Conditional Logistic Regression ◽  
Plasma Concentrations ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Hydroxyvitamin D ◽  
Potential Association ◽  
25 Hydroxyvitamin D ◽  
Glioma Risk ◽  
Fat Soluble Vitamins

Abstract Few prospective studies have evaluated the relation between fat-soluble vitamins and glioma risk. Using three cohorts—UK Biobank (UKB), Nurses’ Health Study (NHS), and Health Professionals Follow-Up Study (HPFS), we investigated associations of pre-diagnostic concentrations of fat-soluble vitamins D, A, and E with incident glioma. In 346,785 participants (444 cases) in UKB, associations with vitamin D (25-hydroxyvitamin D [25(OH)D]) were evaluated by Cox proportional hazards regression. In NHS (52 cases, 104 controls) and HPFS (32 cases, 64 controls), associations with 25(OH)D, vitamin A (retinol), and vitamin E (α- and γ-tocopherol) were assessed using conditional logistic regression. Our results suggested plasma concentrations of 25(OH)D and retinol were not associated with glioma risk. Comparing the highest to lowest tertile, the multivariable hazard ratio (MVHR) for 25(OH)D was 0.87 (95% confidence interval [CI]: 0.68-1.11) in UKB and the multivariable risk ratio (MVRR) was 1.08 (95%CI: 0.55-2.09) in NHS and HPFS. In NHS and HPFS, the MVRR for the same comparison for retinol was 1.16 (95%CI: 0.56-2.38). Nonsignificant associations were observed for α-tocopherol (MVRRtertile3vs1=0.61, 95%CI: 0.29-1.32) and γ-tocopherol (MVRR tertile3vs1=1.30, 95%CI: 0.63-2.69) that became stronger in 4-year lagged analyses. Further investigation is warranted on a potential association between α- and γ-tocopherol and glioma risk.

scholarly journals Pre-diagnostic circulating concentrations of fat-soluble vitamins and risk of glioma in three cohort studies

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yiyang Yue ◽  
Jordan H. Creed ◽  
David J. Cote ◽  
Meir J. Stampfer ◽  
Molin Wang ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Conditional Logistic Regression ◽  
Plasma Concentrations ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Hydroxyvitamin D ◽  
Potential Association ◽  
25 Hydroxyvitamin D ◽  
Glioma Risk ◽  
Fat Soluble Vitamins

AbstractFew prospective studies have evaluated the relation between fat-soluble vitamins and glioma risk. Using three cohorts—UK Biobank (UKB), Nurses’ Health Study (NHS), and Health Professionals Follow-Up Study (HPFS), we investigated associations of pre-diagnostic concentrations of fat-soluble vitamins D, A, and E with incident glioma. In 346,785 participants (444 cases) in UKB, associations with vitamin D (25-hydroxyvitamin D [25(OH)D]) were evaluated by Cox proportional hazards regression. In NHS (52 cases, 104 controls) and HPFS (32 cases, 64 controls), associations with 25(OH)D, vitamin A (retinol), and vitamin E (α- and γ-tocopherol) were assessed using conditional logistic regression. Our results suggested plasma concentrations of 25(OH)D and retinol were not associated with glioma risk. Comparing the highest to lowest tertile, the multivariable hazard ratio (MVHR) for 25(OH)D was 0.87 (95% confidence interval [CI] 0.68–1.11) in UKB and the multivariable risk ratio (MVRR) was 0.97 (95% CI 0.51–1.85) in NHS and HPFS. In NHS and HPFS, the MVRR for the same comparison for retinol was 1.16 (95% CI 0.56–2.38). Nonsignificant associations were observed for α-tocopherol (MVRRtertile3vs1 = 0.61, 95% CI 0.29–1.32) and γ-tocopherol (MVRR tertile3vs1 = 1.30, 95% CI 0.63–2.69) that became stronger in 4-year lagged analyses. Further investigation is warranted on a potential association between α- and γ-tocopherol and glioma risk.

Circulating 25-Hydroxyvitamin D Levels and Survival in Patients With Colorectal Cancer

2008 ◽  
Vol 26 (18) ◽  
pp. 2984-2991 ◽  
Author(s):  
Kimmie Ng ◽  
Jeffrey A. Meyerhardt ◽  
Kana Wu ◽  
Diane Feskanich ◽  
Bruce W. Hollis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Progression ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Colorectal Carcinogenesis ◽  
Health Study ◽  
Blood Collection ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Overall Mortality

Purpose Higher plasma 25-hydroxyvitamin D3 (25(OH)D) levels are associated with a decreased incidence of colorectal cancer, but the influence of plasma 25(OH)D on the outcome of patients with established colorectal cancer is unknown. Patients and Methods We prospectively examined the association between prediagnosis 25(OH)D levels and mortality among 304 participants in the Nurses' Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) who were diagnosed with colorectal cancer from 1991 to 2002. Participants diagnosed within 2 years of blood collection were excluded. Patients were observed until death, June 2005 (NHS), or January 2005 (HPFS), whichever came first. The primary end point was overall mortality. Cox proportional hazards models were used to calculate hazard ratios (HR) adjusted for other risk factors for cancer survival. Results Higher plasma 25(OH)D levels were associated with a significant reduction in overall mortality (P for trend = .02). Compared with the lowest quartile, participants in the highest quartile had an adjusted HR of 0.52 (95% CI, 0.29 to 0.94) for overall mortality. A trend toward improved colorectal cancer–specific mortality was also seen (HR = 0.61; 95% CI, 0.31 to 1.19). The results remained unchanged after excluding patients diagnosed within 5 years of blood collection (P for trend = .04); the multivariate HR for overall mortality comparing extreme quartiles was 0.45 (95% CI, 0.19 to 1.09). Conclusion Among patients with colorectal cancer, higher prediagnosis plasma 25(OH)D levels were associated with a significant improvement in overall survival. Further study of the vitamin D pathway and its influence on colorectal carcinogenesis and cancer progression is warranted.

scholarly journals Association of serum 25-hydroxyvitamin D with prevalence, incidence, and clearance of vaginal HPV infection in young women

2020 ◽  
Author(s):  
Mariam El-Zein ◽  
Farzin Khosrow-Khavar ◽  
Ann N Burchell ◽  
Pierre-Paul Tellier ◽  
Shaun Eintracht ◽  
...  
Keyword(s):  
Vitamin D ◽  
Proportional Hazards ◽  
Hpv Infection ◽  
Cox Proportional Hazards ◽  
Baseline Serum ◽  
Hpv Dna ◽  
Hydroxyvitamin D ◽  
Hpv Prevalence ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D

Abstract Background We assessed the association between serum 25-hydroxyvitamin D levels and genital human papillomavirus (HPV) prevalence, incidence, and clearance among female participants of the HITCH cohort study. Methods We genotyped HPV DNA in vaginal samples and quantified baseline serum 25-hydroxyvitamin D levels using Roche’s Linear Array and Total vitamin D assay, respectively. We used logistic and Cox proportional hazards models to respectively estimate adjusted odds ratios (OR) and hazards ratios (HR) with 95% confidence intervals (CI). Results There was no association between vitamin D levels (every 10ng/mL increase) at baseline and HPV prevalence (OR=0.88, CI:0.73-1.03) or incidence (HR=0.88, CI:0.73-1.06), but we observed a modest negative association with HPV clearance (HR=0.76, CI:0.60-0.96). Vitamin D levels <30ng/mL, compared to ≥30ng/mL, were not associated with HPV prevalence (OR=0.98, CI:0.57-1.69) or incidence (HR=0.87, CI:0.50-1.43), but were associated with a marginally significant increased clearance (OR=2.14, CI:0.99-4.64). We observed consistent results with restricted cubic spline modelling of vitamin D levels and clinically defined categories. HPV type-specific analyses accounting for multiple HPV infections per participant showed no association between vitamin D levels and all study outcomes. Conclusion This study provided no evidence of an association between low vitamin D levels and increased HPV prevalence, acquisition, or clearance.

scholarly journals Short Communication: Vitamin D and COVID-19 infection and mortality in UK Biobank

2020 ◽  
Author(s):  
Claire E Hastie ◽  
Jill P Pell ◽  
Naveed Sattar
Keyword(s):  
Vitamin D ◽  
Proportional Hazards ◽  
Vitamin D Supplementation ◽  
Cox Proportional Hazards ◽  
Regression Analyses ◽  
Uk Biobank ◽  
Hydroxyvitamin D ◽  
Proportional Hazards Regression ◽  
Potential Link ◽  
25 Hydroxyvitamin D

AbstractPurposeVitamin D has been proposed as a potential causal factor in COVID-19 risk. We aimed to establish whether blood 25-hydroxyvitamin D (25(OH)D) concentration was associated with COVID-19 mortality, and inpatient confirmed COVID-19 infection, in UK Biobank participants.MethodsUK Biobank recruited 502,624 participants aged 37-73 years between 2006 and 2010. Baseline exposure data, including 25(OH)D concentration, were linked to COVID-19 mortality. Univariable and multivariable Cox proportional hazards regression analyses were performed for the association between 25(OH)D and COVID-19 death, and poisson regression analyses for the association between 25(OH)D and severe COVID-19 infection.ResultsComplete data were available for 341,484 UK Biobank participants, of which 656 had inpatient confirmed COVID-19 infection and 203 died of COVID-19 infection. Vitamin D was associated with severe COVID-19 infection and mortality univariably (mortality HR=0.99; 95% CI 0.98-0.998; p=0.016), but not after adjustment for confounders (mortality HR=0.998; 95% CI=0.99-1.01; p=0.696).ConclusionsOur findings do not support a potential link between vitamin D concentrations and risk of severe COVID-19 infection and mortality. Recommendations for vitamin D supplementation to lessen COVID-19 risks may provide false reassurance.

Association between fat-soluble vitamins and self-reported health status: a cross-sectional analysis of the MARK-AGE cohort

2021 ◽  
pp. 1-28
Author(s):  
Caroline S. Stokes ◽  
Daniela Weber ◽  
Stefan Wagenpfeil ◽  
Wolfgang Stuetz ◽  
María Moreno-Villanueva ◽  
...  
Keyword(s):  
Vitamin D ◽  
Health Status ◽  
Plasma Concentrations ◽  
Vitamin D Insufficiency ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Risk Of Death ◽  
25 Hydroxyvitamin D ◽  
Fair Poor ◽  
Fat Soluble Vitamins

Abstract Self-rated health (SRH) is associated with higher risk of death. Since low plasma levels of fat-soluble vitamins are related to mortality, we aimed to assess whether plasma concentrations of vitamins A, D and E were associated with SRH in the MARK-AGE study. We included 3158 participants (52% female) aged between 35–75 years. Cross-sectional data were collected via questionnaires. An enzyme immunoassay quantified 25-hydroxyvitamin D and HPLC determined α-tocopherol and retinol plasma concentrations. The median 25-hydroxyvitamin D and retinol concentrations differed significantly (P<0.001) between SRH categories, and were lower in the combined fair/poor category versus the excellent, very good, good categories (25-hydroxvitamin D: 40.8 vs. 51.9, 49.3, 46.7 nmol/l, respectively; retinol: 1.67 vs. 1.75, 1.74, 1.70 µmol/l, respectively). Both vitamin D and retinol status were independently associated with fair/poor SRH in multiple regression analyses: adjusted ORs (95% CI) for the vitamin D insufficiency, deficiency, severe deficiency categories were 1.33 (1.06–1.68), 1.50 (1.17–1.93), and 1.83 (1.34–2.50) respectively; P=0.015, P=0.001, P<0.001, and for the second/third/fourth retinol quartiles: 1.44 (1.18–1.75), 1.57 (1.28–1.93), 1.49 (1.20–1.84); all P<0.001. No significant associations were reported for α-tocopherol quartiles. Lower vitamin A and D status emerged as independent markers for fair/poor SRH. Further insights into the long-term implications of these modifiable nutrients on health status are warranted.

Abstract MP19: Serum 25-hydroxyvitamin D is associated with incident heart failure in whites but not blacks: The Atherosclerosis Risk in Communities Study (ARIC)

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Pamela L Lutsey ◽  
Erin D Michos ◽  
James S Pankow ◽  
Elizabeth Selvin ◽  
Laura R Loehr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Total Serum ◽  
Blood Draw ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Incident Heart Failure

Background: Suboptimal 25-hydroxyvitamin D [25(OH)D] is a potential cardiovascular risk factor, likely influencing cardiovascular events via established risk factors, namely hypertension, diabetes, and inflammation. Emerging evidence also suggests that the association between 25(OH)D and cardiovascular risk is stronger in whites than blacks, but these preliminary findings need further confirmation. Hypotheses: Serum 25(OH)D is inversely associated with incident heart failure, and (a) partly mediated by traditional cardiovascular risk factors and (b) stronger among whites than blacks. Methods: A total of 12,215 ARIC Study participants free of heart failure at baseline in 1990-92 (median age 56, 24% black) were followed through 2010. Total serum 25(OH)D was measured in stored samples at baseline using LCMS. Month of blood draw was accounted for. Incident heart failure events were identified via active surveillance and defined by a hospital discharge code of ICD9-428 and parallel ICD codes for deaths. Multivariable Cox proportional hazards regression models were employed. Results: During a median of 17 years of follow-up, there were 1,799 incident heart failure events. Median 25(OH)D was 26.2 and 19.0 ng/mL in whites and blacks, respectively. The association between 25(OH)D and heart failure varied by race (p-interaction = 0.01). Among whites, those in the lowest quintile of 25(OH)D were at 2-fold greater risk of heart failure relative to those in the highest quintile ( Table ). The HR was attenuated, but remained statistically significant after multivariable adjustment. In blacks there was no association between 25(OH)D and heart failure. Results were similar when race-specific quintiles were used. Conclusions: Low serum 25(OH)D was independently associated with risk of incident heart failure among whites, but not among blacks in this community-based population. Further work is needed to determine what mechanisms underlie racial variation in the association between vitamin D status and risk of heart failure.

Abstract 151: Vascular Events Occur More Frequently In Stroke Patients With Lower Concentrations of Vitamin D: A Prospective Cohort Analysis

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Sebastian K Khoo ◽  
Jayne Y Tan ◽  
Leonard Y Yeo ◽  
Prakash Paliwal ◽  
Hock L Teoh ◽  
...  
Keyword(s):  
Vitamin D ◽  
Ischemic Stroke ◽  
Proportional Hazards ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards ◽  
Vascular Events ◽  
Hydroxyvitamin D ◽  
Cox Proportional Hazards Models ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D

Introduction: Vitamin D deficiency has been implicated in vascular dysfunction and the risk of recurrent vascular events. Previous studies, limited by a small sample size and lack of comparisons with long-term events, have yielded discordant results. To assess the hypothesis that low vitamin D levels predict long-term vascular events in patients with ischemic stroke, we conducted a large hospital-based study to compare the association between baseline vitamin D levels and the subsequent risk of vascular events. Methods: Between January 2010 and July 2011, 590 participants (mean age, 60.7 years; 69% men) diagnosed with ischemic stroke and transient ischemic attack at the National University Hospital, Singapore, were prospectively followed for vascular events (recurrent stroke, myocardial infarction and vascular death). Serum 25-hydroxyvitamin D levels were determined using the Roche Cobas e411 analyzer. Cox proportional hazards models were used to assess the associations between quartiles of serum 25-hydroxyvitamin D and the risk of vascular events, which were adjusted for demographic, stroke severity and subtype, and vascular risk factor covariates. Results: During a mean follow-up of 3.2 years (1,190 person-year), 116 participants developed a recurrent vascular event (recurrent stroke, n=63; myocardial infarction, n=30; vascular death, n=23). Using Cox proportional hazards models, the multivariate adjusted hazard ratios (95% confidence interval) for recurrent vascular events in participants with lower levels of serum 25-hydroxyvitamin D (<14.9 mmol/l, 14.9-21.4 mmol/l and 21.5-28.9 mmol/l) were 1.43 (0.81-2.55), 1.70 (0.97-2.91) and 2.09 (1.22-3.58) compared to participants with higher concentrations (>28.9 mmol/l). Kaplan-Meier plots for unadjusted rates of vascular events show clear differences in risk by quartiles of serum 25-hydroxyvitamin D after a year of follow-up. Conclusions: Our results support the association between vitamin D deficiency and increased risk of recurrent vascular events in patients with ischemic stroke. Clinical trials are needed to ascertain whether correcting for this deficiency could indeed reduce the burden of vascular events in these individuals.

scholarly journals Association of oral contraceptives and tubal ligation with risk of early natural menopause

2021 ◽  
Author(s):  
C R Langton ◽  
B W Whitcomb ◽  
A C Purdue-Smithe ◽  
L L Sievert ◽  
S E Hankinson ◽  
...  
Keyword(s):  
Oral Contraceptives ◽  
Proportional Hazards ◽  
Reproductive Factors ◽  
Cox Proportional Hazards ◽  
Tubal Ligation ◽  
Health Study ◽  
Early Menopause ◽  
Natural Menopause ◽  
Increased Risk

Abstract STUDY QUESTION What is the association of oral contraceptives (OCs) and tubal ligation (TL) with early natural menopause? SUMMARY ANSWER We did not observe an association of OC use with risk of early natural menopause; however, TL was associated with a modestly higher risk. WHAT IS KNOWN ALREADY OCs manipulate hormone levels, prevent ovulation, and may modify the rate of follicular atresia, while TL may disrupt the blood supply to the ovaries. These mechanisms may be associated with risk of early menopause, a condition associated with increased risk of cardiovascular disease and other adverse health outcomes. STUDY DESIGN, SIZE, DURATION We examined the association of OC use and TL with natural menopause before the age of 45 years in a population-based study within the prospective Nurses’ Health Study II (NHSII) cohort. Participants were followed from 1989 to 2017 and response rates were 85-90% for each cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants included 106 633 NHSII members who were premenopausal and aged 25-42 years at baseline. Use, duration and type of OC, and TL were measured at baseline and every 2 years. Menopause status and age were assessed every 2 years. Follow-up continued until early menopause, age 45 years, hysterectomy, oophorectomy, death, cancer diagnosis, or loss to follow-up. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs adjusted for lifestyle, dietary, and reproductive factors. MAIN RESULTS AND THE ROLE OF CHANCE Over 1.6 million person-years, 2579 members of the analytic cohort experienced early natural menopause. In multivariable models, the duration, timing, and type of OC use were not associated with risk of early menopause. For example, compared with women who never used OCs, those reporting 120+ months of OC use had an HR for early menopause of 1.01 (95% CI, 0.87-1.17; P for trend=0.71). TL was associated with increased risk of early menopause (HR = 1.17, 95% CI, 1.06-1.28). LIMITATIONS, REASONS FOR CAUTION Our study population is homogenous with respect to race and ethnicity. Additional evaluation of these relations in more diverse populations is important. WIDER IMPLICATIONS OF THE FINDINGS To our knowledge, this is the largest study examining the association of OC use and TL with early natural menopause to date. While TL was associated with a modest higher risk of early menopause, our findings do not support any material hazard or benefit for the use of OCs. STUDY FUNDING/COMPETING INTEREST(S) The study was sponsored by UO1CA176726 and R01HD078517 from the National Institutes of Health and Department of Health and Human Services. The work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The authors have no competing interests to report. TRIAL REGISTRATION NUMBER N/A

Abstract MP49: Sugar Sweetened and Artificially Sweetened Beverages and risk of Mortality in US adults

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Vasanti S Malik ◽  
An Pan ◽  
Lawrence de Koning ◽  
Eva Schernhammer ◽  
Walter C Willett ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Sweetened Beverages ◽  
Risk Of Mortality ◽  
Regular Consumption ◽  
Increased Risk ◽  
Artificially Sweetened Beverages ◽  
Cvd Mortality

Background: Sugar sweetened beverages (SSBs) are the single largest source of calories and added sugars in the US diet and regular consumption has been associated with weight gain and risk of chronic diseases. Artificially sweetened beverages (ASBs) are often suggested as alternatives to SSB but little is known about their long-term health effects. Whether consumption of SSBs or ASBs is associated with risk of mortality is unknown. Methods: We prospectively followed 38,602 men from the Health Professional’s Follow-up study (1986-2010) and 82,592 women from the Nurses’ Health study (1980-2010) who were free from cardiovascular disease (CVD) and cancer at baseline. Diet was assessed using validated food frequency questionnaires every 4 years and Cox Proportional Hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Results: We documented 27,691 deaths (6,631 CVD and 10,447 cancer deaths) during 3.14 million person-years. After adjusting for major dietary and lifestyle risk factors, and BMI, baseline diabetes, hypertension and hypercholesterolemia, consumption of SSBs was associated with an increased risk of total mortality, which was mainly driven by CVD mortality among individuals consuming at least 2 servings per day; pooled HRs (95% CIs) across categories (<1/month, 1-4/month, 2-6/week, 1-<2/day and ≥2/day) were 1.00, 0.95 (0.91, 0.98), 0.96 (0.93, 0.99), 1.02 (0.96, 1.08), and 1.18 (1.04, 1.33), respectively (P-trend= 0.0001) for total mortality, and 1.00, 0.97 (0.90, 1.02), 0.96 (0.90, 1.02), 1.04 (0.93, 1.16) and 1.28 (1.09, 1.51), respectively (P-trend=0.007) for CVD mortality. In contrast, ASBs were not associated with mortality; pooled HR’s (95% CIs) across categories (<1/month, 1-4/month, 2-6/week, 1-<2/day and ≥2/day) were 1.00, 0.92 (0.89, 0.95), 0.91 (0.86, 0.97), 0.91 (0.86, 0.95) and 0.99 (0.85, 1.15), respectively (P-trend=0.50) for total mortality and 1.00, 0.86 (0.80, 0.92), 0.87 (0.81, 0.94), 0.96 (0.88, 1.06) and 0.96 (0.74, 1.25), respectively (P-trend=0.99) for CVD mortality. No associations were observed with cancer mortality for either SSBs or ASBs in multi-variable adjusted models. Conclusion: Regular consumption of SSBs is associated with an increased risk of total and CVD mortality, providing additional support for recommendations and policies to limit intake of these beverages.

scholarly journals Sedentary Behaviors, TV Viewing Time, and Risk of Young-Onset Colorectal Cancer

2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Long H Nguyen ◽  
Po-Hong Liu ◽  
Xiaobin Zheng ◽  
NaNa Keum ◽  
Xiaoyu Zong ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Proportional Hazards ◽  
Statistical Tests ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Viewing Time ◽  
Sedentary Behaviors ◽  
Tv Viewing ◽  
Young Onset ◽  
Increased Risk

Abstract Background Colorectal cancer (CRC) diagnosed before age 50 years, or young-onset CRC, is increasing globally with undefined etiology. A sedentary lifestyle is an emerging risk factor for CRC after age 50 years, but its role in young-onset CRC is unknown. Methods We prospectively evaluated sedentary behaviors, primarily time watching television (TV), and risk of young-onset CRC among 89 278 women in the Nurses’ Health Study II ages 25–42 years at recruitment (1991–2011). We used Cox proportional hazards modelling to estimate relative risks (RR) and 95% confidence intervals (CIs). Statistical tests were two-sided. Results We documented 118 young-onset CRCs over 1 262 540 person-years. Sedentary TV viewing time was statistically significantly associated with increased risk of young-onset CRC, after adjusting for putative risk factors, including obesity and physical activity. Compared to no more than 7 hours per week, women with 7.1–14 hours per week of TV time had a multivariable relative risk (RR) of 1.12 (95% confidence interval [CI] = 0.72 to 1.75), further increased for greater than 14 hours per week (RR = 1.69, 95% CI = 1.07 to 2.67, Ptrend = .03). This association was observed among participants without a CRC family history and was more pronounced for rectal cancer (RR for >14 vs ≤7 hours per week 2.44, 95% CI = 1.03 to 5.78, Ptrend = .04). Overweight or obese participants may be more susceptible. Conclusion Independent of exercise and obesity, prolonged sedentary TV viewing time, a surrogate for a more inactive lifestyle, was associated with increased risk of young-onset CRC, particularly of the rectum. These findings provide further evidence on the importance of maintaining an active lifestyle.

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