Evidence Update on the Relationship between Diet and the Most Common Cancers from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: A Systematic Review

The European Prospective Investigation into Cancer and Nutrition (EPIC) is a multicentre prospective study conducted in 23 centres in 10 European countries. Here we review the findings from EPIC on the relationship between diet-related exposures and incidence or mortality from the four most frequent cancers in the European population: colorectal, breast, lung, and prostate cancer. We conducted a systematic review following PRISMA guidelines and identified 110 high-quality studies based on the EPIC cohort. Fruit and vegetable consumption had a protective effect against colorectal, breast, and lung cancer, whereas only fruit had a protective effect against prostate cancer. A higher consumption of fish and lower consumption of red and processed meat were related with a lower risk of colorectal cancer; and higher consumption of fatty fish with lower risk of breast cancer. Calcium and yogurt intake were found to protect against colorectal and prostate cancer. Alcohol consumption increased the risk for colorectal and breast cancer. Finally, adherence to the Mediterranean diet emerged as a protective factor for colorectal and breast cancer. The EPIC study results are in agreement with the latest evidence from leading authorities on cancer prevention and help to inform public prevention policies and strategies.

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Effect of Statins on the Risk of Different Stages of Prostate Cancer: A Meta-Analysis

Urologia Internationalis ◽

10.1159/000518164 ◽

2021 ◽

pp. 1-9

Author(s):

Yun Li ◽

Xuan Cheng ◽

Jia-lian Zhu ◽

Wen-wen Luo ◽

Huai-rong Xiang ◽

...

Keyword(s):

Prostate Cancer ◽

Lower Risk ◽

Advanced Prostate Cancer ◽

Meta Analysis ◽

Cochrane Library ◽

Low Grade ◽

High Grade ◽

The Cochrane Library ◽

The Relationship ◽

Comprehensive Literature Search

Introduction: The aim of this article was to investigate the relationship between statins and the risk of different stages or grades of prostate cancer. Methods: A comprehensive literature search was performed for articles published until December 18, 2020, on the PubMed, Embase, and the Cochrane Library databases. The pooled relative risk (RR) and 95% confidence interval (CI) were then analyzed using the STATA.16.0 software. Results: A total of 588,055 patients from 14 studies were included in the analysis. We found that the use of statins expressed a significant correlation with a lower risk of advanced prostate cancer (RR = 0.81, 95% CI: 0.73–0.91; RR = 0.86, 95% CI: 0.75–0.99, respectively). However, no evidence suggested that the use of statins was beneficial for the prevention of localized prostate cancer incidence. Similarly, the pooled results also revealed no association between the use of statins and the risk of high-grade and low-grade prostate cancer. Conclusion: It has been found that the use of statins is associated with a lower risk of advanced prostate cancer but was not related to the risk of localized, low-grade, or high-grade prostate cancer.

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Prostate cancer topography and tumour conspicuity on multiparametric magnetic resonance imaging: A systematic review and meta-analysis

10.7244/cmj.2021.04.001.2 ◽

2021 ◽

Author(s):

Pranav Satish ◽

Alex Freeman ◽

Daniel Kelly ◽

Alex Kirkham ◽

Clement Orczyk ◽

...

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Meta Analysis ◽

Peripheral Zone ◽

Transitional Zone ◽

Dynamic Contrast Enhancement ◽

Significant Difference ◽

Prisma Statement ◽

Tumour Location ◽

The Relationship

Introduction The implications of tumour location on mpMRI conspicuity are not fully understood. Identifying topographical correlates that influence conspicuity may improve outcomes. Here, we present the first systematic review and meta-analysis describing the effect of tumour location on prostate cancer conspicuity on mpMRI. Methods Medline, PubMed, EMBASE and Cochrane databases were systematically searched and results were assessed as per the PRISMA statement. Differential tumour conspicuity on mpMRI was compared between cancers in the peripheral zone (PZ), transitional zone (TZ), base, apex, anterior and posterior. Meta-analysis was conducted to compare diagnostic odds ratios (DOR) of mpMRI detection for tumours in the PZ and TZ. PROSPERO registration: CRD42021228087. Results Thematic synthesis showed apical and basal tumours had reduced conspicuity compared to mid-gland tumours. Cancer in the TZ demonstrated increased conspicuity on T2-weighted imaging, whilst PZ cancers had higher conspicuity on diffusion-weighted and dynamic contrast enhancement imaging. mpMRI had better diagnostic accuracy for PZ lesions, albeit higher specificity for TZ lesions. Meta-analysis showed an increased DOR for PZ tumours (OR: 7.206 [95% CI: 4.991;10.403], compared to TZ (OR: 5.310 [95% CI: 3.082; 9.151]). However, the test for subgroup differences was not significant (p = 0.2743). Conclusions Cancer in the apex or base of the prostate may be less conspicuous than mid-gland tumours. Similarly, TZ cancer appears to have reduced conspicuity compared to PZ cancer, however, meta-analysis did not show a significant difference between DOR. Future larger studies with prospective datasets are required to clarify the relationship between tumour position and conspicuity.

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The relationship between dairy products intake and breast cancer incidence: a meta-analysis of observational studies

BMC Cancer ◽

10.1186/s12885-021-08854-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yujing He ◽

Qinghua Tao ◽

Feifei Zhou ◽

Yuexiu Si ◽

Rongrong Fu ◽

...

Keyword(s):

Breast Cancer ◽

Protective Effect ◽

Dairy Products ◽

Meta Analysis ◽

Breast Cancer Incidence ◽

Cochrane Library ◽

Female Population ◽

Fermented Dairy Products ◽

Fermented Dairy ◽

The Relationship

Abstract Background The effect of dairy products intake on breast cancer (BC) is highly controversial. This study aims to investigate the relationship between dairy intake and BC incidence. Methods A search was carried out in PubMed, EBSCO, Web of Science, and Cochrane Library databases before January 2021. The primary objective was the risk of BC and intake of dairy products were exposure variables. Results The meta-analysis comprised 36 articles with 1,019,232 participants. Total dairy products have a protective effect on female population (hazard ratio (HR) =0.95, 95% confidence interval (CI) =0.91–0.99, p = 0.019), especially for estrogen receptor-positive (ER+) (HR = 0.79, p = 0.002) and progesterone receptor-positive (PR+) BC (HR = 0.75, p = 0.027). For ER+/PR+ BC, there is a trend of protection, but it has not reached statistical significance (HR = 0.92, p = 0.075). Fermented dairy products can reduce BC risk in postmenopausal population (HR = 0.96, 95%CI = 0.93–0.99, p = 0.021), but have no protective effect on premenopausal population (HR = 0.98, 95%CI = 0.94–1.03, p = 0.52). Non-fermented dairy products have no significant effect on BC occurrence (p > 0.05). High-fat dairy products are harmful to women, without statistical difference (HR = 1.06, 95%CI = 1.00–1.13, p = 0.066). On the contrary, low-fat dairy products can protect the premenopausal population (HR = 0.94, 95%CI = 0.89–1.00, p = 0.048). Conclusion The intake of dairy products can overall reduce BC risk in the female population, but different dairy products have varying effects on different BC subtypes and menopausal status.

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A treelet transform analysis to relate nutrient patterns to the risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Public Health Nutrition ◽

10.1017/s1368980015000294 ◽

2015 ◽

Vol 19 (2) ◽

pp. 242-254 ◽

Cited By ~ 13

Author(s):

Nada Assi ◽

Aurelie Moskal ◽

Nadia Slimani ◽

Vivian Viallon ◽

Veronique Chajes ◽

...

Keyword(s):

Breast Cancer ◽

Principal Component Analysis ◽

Lower Risk ◽

Menopausal Status ◽

Principal Component ◽

Component Analysis ◽

Cox Proportional Hazards ◽

Hormonal Receptor ◽

Nutrient Patterns ◽

Prospective Investigation

AbstractObjectivePattern analysis has emerged as a tool to depict the role of multiple nutrients/foods in relation to health outcomes. The present study aimed at extracting nutrient patterns with respect to breast cancer (BC) aetiology.DesignNutrient patterns were derived with treelet transform (TT) and related to BC risk. TT was applied to twenty-three log-transformed nutrient densities from dietary questionnaires. Hazard ratios (HR) and 95 % confidence intervals computed using Cox proportional hazards models quantified the association between quintiles of nutrient pattern scores and risk of overall BC, and by hormonal receptor and menopausal status. Principal component analysis was applied for comparison.SettingThe European Prospective Investigation into Cancer and Nutrition (EPIC).SubjectsWomen (n 334 850) from the EPIC study.ResultsThe first TT component (TC1) highlighted a pattern rich in nutrients found in animal foods loading on cholesterol, protein, retinol, vitamins B12 and D, while the second TT component (TC2) reflected a diet rich in β-carotene, riboflavin, thiamin, vitamins C and B6, fibre, Fe, Ca, K, Mg, P and folate. While TC1 was not associated with BC risk, TC2 was inversely associated with BC risk overall (HRQ5 v. Q1=0·89, 95 % CI 0·83, 0·95, Ptrend<0·01) and showed a significantly lower risk in oestrogen receptor-positive (HRQ5 v. Q1=0·89, 95 % CI 0·81, 0·98, Ptrend=0·02) and progesterone receptor-positive tumours (HRQ5 v. Q1=0·87, 95 % CI 0·77, 0·98, Ptrend<0·01).ConclusionsTT produces readily interpretable sparse components explaining similar amounts of variation as principal component analysis. Our results suggest that participants with a nutrient pattern high in micronutrients found in vegetables, fruits and cereals had a lower risk of BC.

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Consumption of red and processed meat and breast cancer incidence: A systematic review and meta-analysis of prospective studies

International Journal of Cancer ◽

10.1002/ijc.31848 ◽

2018 ◽

Vol 143 (11) ◽

pp. 2787-2799 ◽

Cited By ~ 25

Author(s):

Maryam S. Farvid ◽

Mariana C. Stern ◽

Teresa Norat ◽

Shizuka Sasazuki ◽

Paolo Vineis ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cancer Incidence ◽

Prospective Studies ◽

Meta Analysis ◽

Breast Cancer Incidence ◽

Processed Meat ◽

Red And Processed Meat

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First-degree family history of breast cancer is associated with prostate cancer risk: a systematic review and meta-analysis

BMC Cancer ◽

10.1186/s12885-019-6055-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Zheng-Ju Ren ◽

De-Hong Cao ◽

Qin Zhang ◽

Peng-Wei Ren ◽

Liang-Ren Liu ◽

...

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Systematic Review ◽

Family History ◽

Cancer Risk ◽

Meta Analysis ◽

Prostate Cancer Risk ◽

History Of

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The relationship between time to initiation of adjuvant chemotherapy and survival in breast cancer: a systematic review and meta-analysis

Breast Cancer Research and Treatment ◽

10.1007/s10549-016-3960-3 ◽

2016 ◽

Vol 160 (1) ◽

pp. 17-28 ◽

Cited By ~ 39

Author(s):

Michael J. Raphael ◽

James J. Biagi ◽

Weidong Kong ◽

Mihaela Mates ◽

Christopher M. Booth ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Adjuvant Chemotherapy ◽

Meta Analysis ◽

Time To Initiation ◽

The Relationship

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The relationship between serum vitamin D levels and breast cancer prognosis: A meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.1521 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 1521-1521

Author(s):

April Ann Nicole Rose ◽

Christine Elser ◽

Pamela Jean Goodwin

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Vitamin D ◽

Clinical Outcomes ◽

Survival Data ◽

Fixed Effects ◽

Meta Analysis ◽

Serum Vitamin ◽

Vitamin D Levels ◽

The Relationship

1521 Background: Vitamin D (VitD) is a circulating hormone known to regulate gene transcription in breast cancer (BC) cells. The association between VitD and BC risk has been extensively studied. Until recently, however, the role of VitD in BC progression and its association with clinical outcomes among BC patients was poorly understood. To assess these new developments, a systematic review and meta-analysis was performed. Methods: A systematic review and meta-analysis by searching MEDLINE (1982 – 2012), ASCO, and SABCS for abstracts (2009 – 2012), with the following keywords: “breast cancer” and “prognosis” or “survival”, and “vitamin D” or ”calcitriol.” Abstracts were scrutinized for reports correlating serum VitD levels with breast cancer clinical outcomes, including: disease-free survival (DFS) and overall survival (OS). Studies were included if serum VitD samples were taken shortly after diagnosis and survival data were reported. Meta-analyses were performed using an inverse-variance weighted fixed-effects model. Results: We identified 7 studies reporting correlative data between serum VitD levels and BC survival. These data included 4,885 patients evaluated for DFS and 3858 patients evaluated for OS. VitD-deficiency was defined as <30ng/mL, <20ng/mL, and <14ng/mL in 3, 3, and 1 studies, respectively, and was identified in an average of 48.1% of patients (range: 17.9-87.8%). VitD deficiency was associated with a pooled hazard ratio (HR) of 2.13 (CI: 1.64 - 2.78) and 1.76 (CI: 1.35 - 2.30) for DFS and OS, respectively. Conclusions: To our knowledge, this is the first report of a meta-analysis of the relationship between serum VitD and BC prognosis. The prevalence of VitD-deficiency varied widely across studies and may reflect differences in geographic location, race, and rates of supplementation across patient populations. These findings support the hypothesis that VitD-deficient breast cancer patients have poorer clinical outcomes than VitD sufficient patients; but do not establish whether this relationship is causative. Further studies are warranted to investigate the possible protective effects of VitD supplementation on survival among VitD-deficient BC patients.

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The relationship between statins and breast cancer prognosis varies by statin type and exposure time: A meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e21606 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e21606-e21606

Author(s):

Binliang Liu ◽

Zongbi Yi ◽

Xiuwen Guan ◽

Fei Ma ◽

Yi-Xin Zeng

Keyword(s):

Breast Cancer ◽

Protective Effect ◽

Breast Cancer Prognosis ◽

Cancer Prognosis ◽

All Cause Mortality ◽

Specific Mortality ◽

Cancer Specific Mortality ◽

The Relationship ◽

Statin Use

e21606 Background:Breast cancer is the most common cancer in females. The effects of statins on breast cancer prognosis have long been controversial, so it is important to investigate the relationship between statin type, exposure time, and breast cancer prognosis. This study sought to explore the effect of statins on breast cancer prognosis. Methods:We searched the MEDLINE, EMBASE, Cochrane Library between October 15, 2016 and January 20, 2017. Searches combined the terms “breast neoplasms[MeSH]”, “statins”, “prognosis” or “survival” or “mortality” with no limit on publication date. Data were analyzed using Stata/SE 11.0. Results: 7 studies finally met the selection criteria and 197,048 included women. Overall statin use was associated with lower cancer-specific mortality and all-cause mortality (HR 0.73, 95% CI 0.59-0.92, P = 0.000 and HR 0.72, 95% CI 0.58-0.89, P = 0.000). Lipophilic statins were associated with decreased breast cancer-specific and all-cause mortality (HR 0.57, 95% CI 0.46-0.70, P = 0.000 and HR 0.57, 95% CI 0.48-0.69, P = 0.000); however, hydrophilic statins were weakly protective against only all-cause mortality (HR 0.79, 95% CI 0.65-0.97, P = 0.132) and not breast cancer-specific mortality (HR 0.94, 95% CI 0.76-1.17, P = 0.174). Of note, more than four years of follow-up did not show a significant correlation between statin use and cancer-specific mortality or all-cause mortality (HR 0.84, 95% CI 0.71-1.00, P = 0.616 and HR 0.95, 95% CI 0.75-1.19, P = 0.181), while groups with less than four years of follow-up still showed the protective effect of statins against cancer-specific mortality and all-cause mortality (HR 0.62, 95% CI 0.44-0.87, P = 0.000 and HR 0.61, 95% CI 0.45-0.80, P = 0.000). Conclusions:Although statins can reduce breast cancer patient mortality, the benefit appears to be constrained by statin type and follow-up time. Lipophilic statins showed a strong protective function in breast cancer patients, while hydrophilic statins only slightly improved all-cause mortality. Finally, the protective effect of statins could only be observed in groups with less than four years of follow-up.

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