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Genome-Wide DNA Methylation Profiles in Community Members Exposed to the World Trade Center Disaster

Arslan, Alan A; Tuminello, Stephanie; Yang, Lei; Zhang, Yian; Durmus, Nedim; Snuderl, Matija; Heguy, Adriana; Zeleniuch-Jacquotte, Anne; Shao, Yongzhao; Reibman, Joan
The primary goal of this pilot study was to assess feasibility of studies among local community members to address the hypothesis that complex exposures to the World Trade Center (WTC) dust and fumes resulted in long-term epigenetic changes. We enrolled 18 WTC-exposed cancer-free women from the WTC Environmental Health Center (WTC EHC) who agreed to donate blood samples during their standard clinical visits. As a reference WTC unexposed group, we randomly selected 24 age-matched cancer-free women from an existing prospective cohort who donated blood samples before 11 September 2001. The global DNA methylation analyses were performed using Illumina Infinium MethylationEpic arrays. Statistical analyses were performed using R Bioconductor package. Functional genomic analyses were done by mapping the top 5000 differentially expressed CpG sites to the Kyoto Encyclopedia of Genes and Genomes (KEGG) Pathway database. Among cancer-free subjects, we observed substantial methylation differences between WTC-exposed and unexposed women. The top 15 differentially methylated gene probes included BCAS2, OSGIN1, BMI1, EEF1A2, SPTBN5, CHD8, CDCA7L, AIDA, DDN, SNORD45C, ZFAND6, ARHGEF7, UBXN8, USF1, and USP12. Several cancer-related pathways were enriched in the WTC-exposed subjects, including endocytosis, mitogen-activated protein kinase (MAPK), viral carcinogenesis, as well as Ras-associated protein-1 (Rap1) and mammalian target of rapamycin (mTOR) signaling. The study provides preliminary data on substantial differences in DNA methylation between WTC-exposed and unexposed populations that require validation in further studies.
PMID: 32751422
ISSN: 1660-4601
CID: 4553982

Exogenous hormone use, reproductive factors and risk of intrahepatic cholangiocarcinoma among women: results from cohort studies in the Liver Cancer Pooling Project and the UK Biobank

Petrick, Jessica L; McMenamin, Úna C; Zhang, Xuehong; Zeleniuch-Jacquotte, Anne; Wactawski-Wende, Jean; Simon, Tracey G; Sinha, Rashmi; Sesso, Howard D; Schairer, Catherine; Rosenberg, Lynn; Rohan, Thomas E; Robien, Kim; Purdue, Mark P; Poynter, Jenny N; Palmer, Julie R; Lu, Yunxia; Linet, Martha S; Liao, Linda M; Lee, I-Min; Koshiol, Jill; Kitahara, Cari M; Kirsh, Victoria A; Hofmann, Jonathan N; Graubard, Barry I; Giovannucci, Edward; Gaziano, J Michael; Gapstur, Susan M; Freedman, Neal D; Florio, Andrea A; Chong, Dawn Q; Chen, Yu; Chan, Andrew T; Buring, Julie E; Freeman, Laura E Beane; Bea, Jennifer W; Cardwell, Christopher R; Campbell, Peter T; McGlynn, Katherine A
BACKGROUND:Intrahepatic cholangiocarcinoma (ICC) arises from cholangiocytes in the intrahepatic bile duct and is the second most common type of liver cancer. Cholangiocytes express both oestrogen receptor-α and -β, and oestrogens positively modulate cholangiocyte proliferation. Studies in women and men have reported higher circulating oestradiol is associated with increased ICC risk, further supporting a hormonal aetiology. However, no observational studies have examined the associations between exogenous hormone use and reproductive factors, as proxies of endogenous hormone levels, and risk of ICC. METHODS:We harmonised data from 1,107,498 women who enroled in 12 North American-based cohort studies (in the Liver Cancer Pooling Project, LCPP) and the UK Biobank between 1980-1998 and 2006-2010, respectively. Cox proportional hazards regression models were used to generate hazard ratios (HR) and 95% confidence internals (CI). Then, meta-analytic techniques were used to combine the estimates from the LCPP (n = 180 cases) and the UK Biobank (n = 57 cases). RESULTS:Hysterectomy was associated with a doubling of ICC risk (HR = 1.98, 95% CI: 1.27-3.09), compared to women aged 50-54 at natural menopause. Long-term oral contraceptive use (9+ years) was associated with a 62% increased ICC risk (HR = 1.62, 95% CI: 1.03-2.55). There was no association between ICC risk and other exogenous hormone use or reproductive factors. CONCLUSIONS:This study suggests that hysterectomy and long-term oral contraceptive use may be associated with an increased ICC risk.
PMID: 32376888
ISSN: 1532-1827
CID: 4430382

Circulating markers of cellular immune activation in pre-diagnostic blood sample and lung cancer risk in the Lung Cancer Cohort Consortium (LC3)

Huang, Joyce Yongxu; Larose, Tricia L; Luu, Hung N; Wang, Renwei; Fanidi, Anouar; Alcala, Karine; Stevens, Victoria L; Weinstein, Stephanie J; Albanes, Demetrius; Caporaso, Neil E; Purdue, Mark P; Ziegler, Regina G; Freedman, Neal D; Lan, Qing; Prentice, Ross L; Pettinger, Mary; Thomson, Cynthia A; Cai, Qiuyin; Wu, Jie; Blot, William J; Shu, Xiao-Ou; Zheng, Wei; Arslan, Alan A; Zeleniuch-Jacquotte, Anne; Le Marchand, Loïc; Wilkens, Lynn R; Haiman, Christopher A; Zhang, Xuehong; Stampfer, Meir J; Han, Jiali; Giles, Graham G; Hodge, Allison M; Severi, Gianluca; Johansson, Mikael; Grankvist, Kjell; Langhammer, Arnulf; Hveem, Kristian; Xiang, Yong-Bing; Li, Hong-Lan; Gao, Yu-Tang; Visvanathan, Kala; Ueland, Per M; Midttun, Øivind; Ulvi, Arve; Buring, Julie E; Lee, I-Min; Sesso, Howard D; Gaziano, J Michael; Manjer, Jonas; Relton, Caroline; Koh, Woon-Puay; Brennan, Paul; Johansson, Mattias; Yuan, Jian-Min
Cell-mediated immune suppression may play an important role in lung carcinogenesis. We investigated the associations for circulating levels of tryptophan, kynurenine, kynurenine:tryptophan ratio (KTR), quinolinic acid (QA), and neopterin as markers of immune regulation and inflammation with lung cancer risk in 5,364 smoking-matched case-control pairs from 20 prospective cohorts included in the international Lung Cancer Cohort Consortium. All biomarkers were quantified by mass spectrometry-based methods in serum/plasma samples collected on average 6 years before lung cancer diagnosis. Odds ratios (ORs) and 95% confidence intervals (CIs) for lung cancer associated with individual biomarkers were calculated using conditional logistic regression with adjustment for circulating cotinine. Compared with the lowest quintile, the highest quintiles of kynurenine, KTR, QA and neopterin were associated with a 20-30% higher risk, and tryptophan with a 15% lower risk of lung cancer (all Ptrend <0.05). The strongest associations were seen for current smokers, where the adjusted ORs (95% CIs) of lung cancer for the highest quintile of KTR, QA and neopterin were 1.42 (1.15-1.75), 1.42 (1.14-1.76) and 1.45 (1.13-1.86), respectively. A stronger association was also seen for KTR and QA with risk of lung squamous cell carcinoma followed by adenocarcinoma, and for lung cancer diagnosed within the first 2 years after blood draw. This study demonstrated that components of the tryptophan-kynurenine pathway with immunomodulatory effects are associated with risk of lung cancer overall, especially for current smokers. Further research is needed to evaluate the role of these biomarkers in lung carcinogenesis and progression. This article is protected by copyright. All rights reserved.
PMID: 31276202
ISSN: 1097-0215
CID: 3967432

Lipid trait variants and the risk of non-Hodgkin lymphoma subtypes: A Mendelian Randomization Study

Kleinstern, Geffen; Camp, Nicola J; Berndt, Sonja I; Birmann, Brenda M; Nieters, Alexandra; Bracci, Paige M; McKay, James D; Ghesquières, Hervé; Lan, Qing; Hjalgrim, Henrik; Benavente, Yolanda; Monnereau, Alain; Wang, Sophia S; Zhang, Yawei; Purdue, Mark P; Zeleniuch-Jacquotte, Anne; Giles, Graham G; Vermeulen, Roel; Cocco, Pierluigi; Albanes, Demetrius; Teras, Lauren R; Brooks-Wilson, Angela R; Vajdic, Claire M; Kane, Eleanor; Caporaso, Neil E; Smedby, Karin E; Salles, Gilles; Vijai, Joseph; Chanock, Stephen J; Skibola, Christine F; Rothman, Nathaniel; Slager, Susan L; Cerhan, James R
BACKGROUND:Lipid traits have been inconsistently linked to risk of non-Hodgkin lymphoma (NHL). We examined the association of genetically predicted lipid traits with risk of diffuse large B-cell lymphoma (DLBCL), chronic lymphocytic leukemia (CLL), follicular (FL) and marginal zone (MZL) lymphoma using Mendelian randomization (MR) analysis. METHODS:GWAS data from the InterLymph Consortium were available for 2661 DLBCLs, 2179 CLLs, 2142 FLs, 824 MZLs, and 6221 controls. SNPs associated (P<5x10-8) with high-density lipoprotein (HDL, N=164), low-density lipoprotein (LDL, N=137), total cholesterol (TC, N=161), and triglycerides (TG, N=123) were used as instrumental variables (IV), explaining 14.6%, 27.7%, 16.8% and 12.8% of phenotypic variation, respectively. Associations between each lipid trait and NHL subtype were calculated using the MR inverse variance-weighted method, estimating odds ratios (OR) per standard deviation, and 95% confidence intervals (CI). RESULTS:HDL was positively associated with DLBCL (OR=1.14, CI:1.00-1.30) and MZL (OR=1.09, CI:1.01-1.18), while TG was inversely associated with MZL risk (OR=0.90, CI:0.83-0.99) all at nominal significance (P<0.05). A positive trend was observed for HDL with FL risk (OR=1.08, CI:0.99-1.19; P=0.087). No associations were noteworthy after adjusting for multiple testing. CONCLUSIONS:We did not find evidence of a clear or strong association of these lipid traits with the most common NHL subtypes. While these IVs have been previously linked to other cancers, our findings do not support any causal associations with these NHL subtypes. IMPACT/CONCLUSIONS:Our results suggest that prior reported inverse associations of lipid traits are not likely to be causal and could represent reverse causality or confounding.
PMID: 32108027
ISSN: 1538-7755
CID: 4323682

Cumulative Burden of Colorectal Cancer-Associated Genetic Variants is More Strongly Associated With Early-onset vs Late-onset Cancer

Archambault, Alexi N; Su, Yu-Ru; Jeon, Jihyoun; Thomas, Minta; Lin, Yi; Conti, David V; Win, Aung Ko; Sakoda, Lori C; Lansdorp-Vogelaar, Iris; Peterse, Elisabeth Fp; Zauber, Ann G; Duggan, David; Holowatyj, Andreana N; Huyghe, Jeroen R; Brenner, Hermann; Cotterchio, Michelle; Bézieau, Stéphane; Schmit, Stephanie L; Edlund, Christopher K; Southey, Melissa C; MacInnis, Robert J; Campbell, Peter T; Chang-Claude, Jenny; Slattery, Martha L; Chan, Andrew T; Joshi, Amit D; Song, Mingyang; Cao, Yin; Woods, Michael O; White, Emily; Weinstein, Stephanie J; Ulrich, Cornelia M; Hoffmeister, Michael; Bien, Stephanie A; Harrison, Tabitha A; Hampe, Jochen; Li, Christopher I; Schafmayer, Clemens; Offit, Kenneth; Pharoah, Paul D; Moreno, Victor; Lindblom, Annika; Wolk, Alicja; Wu, Anna H; Li, Li; Gunter, Marc J; Gsur, Andrea; Keku, Temitope O; Pearlman, Rachel; Bishop, D Timothy; Castellví-Bel, Sergi; Moreira, Leticia; Vodicka, Pavel; Kampman, Ellen; Giles, Graham G; Albanes, Demetrius; Baron, John A; Berndt, Sonja I; Brezina, Stefanie; Buch, Stephan; Buchanan, Daniel D; Trichopoulou, Antonia; Severi, Gianluca; Chirlaque, María-Dolores; Sánchez, Maria-José; Palli, Domenico; Kühn, Tilman; Murphy, Neil; Cross, Amanda J; Burnett-Hartman, Andrea N; Chanock, Stephen J; Chapelle, Albert de la; Easton, Douglas F; Elliott, Faye; English, Dallas R; Feskens, Edith Jm; FitzGerald, Liesel M; Goodman, Phyllis J; Hopper, John L; Hudson, Thomas J; Hunter, David J; Jacobs, Eric J; Joshu, Corinne E; Küry, Sébastien; Markowitz, Sanford D; Milne, Roger L; Platz, Elizabeth A; Rennert, Gad; Rennert, Hedy S; Schumacher, Fredrick R; Sandler, Robert S; Seminara, Daniela; Tangen, Catherine M; Thibodeau, Stephen N; Toland, Amanda E; van Duijnhoven, Franzel Jb; Visvanathan, Kala; Vodickova, Ludmila; Potter, John D; Männistö, Satu; Weigl, Korbinian; Figueiredo, Jane; Martín, Vicente; Larsson, Susanna C; Parfrey, Patrick S; Huang, Wen-Yi; Lenz, Heinz-Josef; Castelao, Jose E; Gago-Dominguez, Manuela; Muñoz-Garzón, Victor; Mancao, Christoph; Haiman, Christopher A; Wilkens, Lynne R; Siegel, Erin; Barry, Elizabeth; Younghusband, Ban; Van Guelpen, Bethany; Harlid, Sophia; Zeleniuch-Jacquotte, Anne; Liang, Peter S; Du, Mengmeng; Casey, Graham; Lindor, Noralane M; Le Marchand, Loic; Gallinger, Steven J; Jenkins, Mark A; Newcomb, Polly A; Gruber, Stephen B; Schoen, Robert E; Hampel, Heather; Corley, Douglas A; Hsu, Li; Peters, Ulrike; Hayes, Richard B
BACKGROUND & AIMS/OBJECTIVE:Early-onset colorectal cancer (CRC, in persons younger than 50 years old) is increasing in incidence; yet, in the absence of a family history of CRC, this population lacks harmonized recommendations for prevention. We aimed to determine whether a polygenic risk score (PRS) developed from 95 CRC-associated common genetic risk variants was associated with risk for early-onset CRC. METHODS:We studied risk for CRC associated with a weighted PRS in 12,197 participants younger than 50 years old vs 95,865 participants 50 years or older. PRS was calculated based on single-nucleotide polymorphisms associated with CRC in a large-scale genome-wide association study as of January 2019. Participants were pooled from 3 large consortia that provided clinical and genotyping data: the Colon Cancer Family Registry, the Colorectal Transdisciplinary study, and the Genetics and Epidemiology of Colorectal Cancer Consortium and were all of genetically defined European descent. Findings were replicated in an independent cohort of 72,573 participants. RESULTS:). When we compared the highest with the lowest quartiles in this group, risk increased 4.3-fold for early-onset CRC (95% CI, 3.61-5.01) vs 2.9-fold for late-onset CRC (95% CI, 2.70-3.00). Sensitivity analyses were consistent with these findings. CONCLUSIONS:In an analysis of associations with CRC per standard deviation of PRS, we found the cumulative burden of CRC-associated common genetic variants to associate with early-onset cancer, and to be more strongly associated with early-onset than late-onset cancer-particularly in the absence of CRC family history. Analyses of PRS, along with environmental and lifestyle risk factors, might identify younger individuals who would benefit from preventative measures.
PMID: 31866242
ISSN: 1528-0012
CID: 4243992

The risk of ovarian cancer increases with an increase in the lifetime number of ovulatory cycles: an analysis from the Ovarian Cancer Cohort Consortium (OC3)

Trabert, Britton; Tworoger, Shelley S; O'Brien, Katie M; Townsend, Mary K; Fortner, Renée T; Iversen, Edwin S; Hartge, Patricia; White, Emily; Amiano, Pilar; Arslan, Alan A; Bernstein, Leslie; Brinton, Louise A; Buring, Julie E; Dossus, Laure; Fraser, Gary E; Gaudet, Mia M; Giles, Graham G; Gram, Inger T; Harris, Holly R; Hoffman Bolton, Judith; Idahl, Annika; Jones, Michael E; Kaaks, Rudolf; Kirsh, Victoria A; Knutsen, Synnove F; Kvaskoff, Marina; Lacey, James V; Lee, I-Min; Milne, Roger L; Onland-Moret, N Charlotte; Overvad, Kim; Patel, Alpa V; Peters, Ulrike; Poynter, Jenny N; Riboli, Elio; Robien, Kim; Rohan, Thomas E; Sandler, Dale P; Schairer, Catherine; Schouten, Leo J; Setiawan, Veronica Wendy; Swerdlow, Anthony J; Travis, Ruth C; Trichopoulou, Antonia; van den Brandt, Piet A; Visvanathan, Kala; Wilkens, Lynne R; Wolk, Alicja; Zeleniuch-Jacquotte, Anne; Wentzensen, Nicolas
Repeated exposure to the acute pro-inflammatory environment that follows ovulation at the ovarian surface and distal fallopian tube over a woman's reproductive years may increase ovarian cancer risk. To address this, analyses included individual-level data from 558,709 naturally menopausal women across 20 prospective cohorts, among whom 3,246 developed invasive epithelial ovarian cancer (2045 serous, 319 endometrioid, 184 mucinous, 121 clear cell, 577 other/unknown). Cox models were used to estimate multivariable-adjusted hazard ratios (HR) between lifetime ovulatory cycles (LOC) and its components and ovarian cancer risk overall and by histotype. Women in the 90th percentile of LOC (>514 cycles) were almost twice as likely to be diagnosed with ovarian cancer than women in the 10th percentile (<294) [HR (95% confidence interval): 1.92 (1.60-2.30)]. Risk increased 14% per five-year increase in LOC (60 cycles) [(1.10-1.17)]; this association remained after adjustment for LOC components: number of pregnancies and oral contraceptive use [1.08 (1.04-1.12)]. The association varied by histotype, with increased risk of serous [1.13 (1.09-1.17)], endometrioid [1.20 (1.10-1.32)], and clear cell [1.37 (1.18-1.58)], but not mucinous [0.99 (0.88-1.10), P-heterogeneity=0.01] tumors. Heterogeneity across histotypes was reduced [P-heterogeneity=0.15] with adjustment for LOC components [1.08 serous, 1.11 endometrioid, 1.26 clear cell, 0.94 mucinous]. Although the 10-year absolute risk of ovarian cancer is small, it roughly doubles as the number of LOC rises from ~300 to 500. The consistency and linearity of effects strongly support the hypothesis that each ovulation leads to small increases in the risk of most ovarian cancers, a risk which cumulates through life, suggesting this as an important area for identifying intervention strategies.
PMID: 31932455
ISSN: 1538-7445
CID: 4263142

Inherited variants at 3q13.33 and 3p24.1 are associated with risk of diffuse large B-cell lymphoma and implicate immune pathways

Kleinstern, Geffen; Yan, Huihuang; Hildebrandt, Michelle A T; Vijai, Joseph; Berndt, Sonja I; Ghesquières, Hervé; McKay, James; Wang, Sophia S; Nieters, Alexandra; Ye, Yuanqing; Monnereau, Alain; Brooks-Wilson, Angela R; Lan, Qing; Melbye, Mads; Jackson, Rebecca D; Teras, Lauren R; Purdue, Mark P; Vajdic, Claire M; Vermeulen, Roel C H; Giles, Graham G; Cocco, Pier Luigi; Birmann, Brenda M; Kraft, Peter; Albanes, Demetrius; Zeleniuch-Jacquotte, Anne; Crouch, Simon; Zhang, Yawei; Sarangi, Vivekananda; Asmann, Yan; Offit, Kenneth; Salles, Gilles; Wu, Xifeng; Smedby, Karin E; Skibola, Christine F; Slager, Susan L; Rothman, Nathaniel; Chanock, Stephen J; Cerhan, James R
We previously identified five SNPs at four susceptibility loci for diffuse large B-cell lymphoma (DLBCL) in individuals of European ancestry through a large genome-wide association study (GWAS). To further elucidate genetic susceptibility to DLBCL, we sought to validate 2 loci at 3q13.33 and 3p24.1 that were suggestive in the original GWAS with additional genotyping. In the meta-analysis (5,662 cases and 9,237 controls) of the four original GWAS discovery scans and three replication studies, the 3q13.33 locus (rs9831894; minor allele frequency [MAF]=0.40) was associated with DLBCL risk (OR=0.83, P=3.62x10-13). rs9831894 is in linkage disequilibrium (LD) with additional variants that are part of a super-enhancer that physically interacts with promoters of CD86 and ILDR1. In the meta-analysis (5,510 cases and 12,817 controls) of the four GWAS discovery scans and four replication studies, the 3p24.1 locus (rs6773363; MAF=0.45) was also associated with DLBCL risk (OR=1.20, P=2.31x10-12). This SNP is 29,426 bp upstream of the nearest gene EOMES and in LD with additional SNPs that are part of a highly lineage-specific and tumor-acquired super-enhancer that shows long-range interaction with AZI2 promoter. These loci provide additional evidence for the role of immune function in the etiology of DLBCL, the most common lymphoma subtype.
PMID: 31600786
ISSN: 1460-2083
CID: 4130032

Reproductive and hormonal factors and risk of ovarian cancer by tumor dominance: results from the Ovarian Cancer Cohort Consortium (OC3)

Huang, Tianyi; Townsend, Mary K; Wentzensen, Nicolas; Trabert, Britton; White, Emily; Arslan, Alan A; Weiderpass, Elisabete; Buring, Julie E; Clendenen, Tess V; Giles, Graham G; Lee, I-Min; Milne, Roger L; Onland-Moret, N Charlotte; Peters, Ulrike; Sandler, Dale P; Schouten, Leo J; van den Brandt, Piet A; Wolk, Alicja; Zeleniuch-Jacquotte, Anne; Tworoger, Shelley S
BACKGROUND:Laterality of epithelial ovarian tumors may reflect the underlying carcinogenic pathways and origins of tumor cells. METHODS:We pooled data from 9 prospective studies participating in the Ovarian Cancer Cohort Consortium. Information on measures of tumor size or tumor dominance was extracted from surgical pathology reports or obtained through cancer registries. We defined dominant tumors as those restricted to one ovary or where the dimension of one ovary was at least twice as large as the other, and non-dominant tumors as those with similar dimensions across the two ovaries or peritoneal tumors. Competing risks Cox models were used to examine whether associations with reproductive and hormonal risk factors differed by ovarian tumor dominance. RESULTS:Of 1,058 ovarian cancer cases with tumor dominance information, 401 were left-dominant, 363 were right-dominant, and 294 were non-dominant. Parity was more strongly inversely associated with risk of dominant than non-dominant ovarian cancer (p-heterogeneity=0.004). Ever use of oral contraceptives (OCs) was associated with lower risk of dominant tumors, but was not associated with non-dominant tumors (p-heterogeneity=0.01). Higher body mass index was associated with higher risk of left-dominant tumors, but not significantly associated with risk of right-dominant or non-dominant tumors (p-heterogeneity=0.08). CONCLUSIONS:These data suggest that reproductive and hormonal risk factors appear to have a stronger impact on dominant tumors, which may have an ovarian or endometriosis origin. IMPACT/CONCLUSIONS:Examining the associations of ovarian cancer risk factors by tumor dominance may help elucidate the mechanisms through which these factors influence ovarian cancer risk.
PMID: 31719062
ISSN: 1538-7755
CID: 4185342

Smoking, Alcohol, and Biliary Tract Cancer Risk: A Pooling Project of 26 Prospective Studies

McGee, Emma E; Jackson, Sarah S; Petrick, Jessica L; Van Dyke, Alison L; Adami, Hans-Olov; Albanes, Demetrius; Andreotti, Gabriella; Beane-Freeman, Laura E; de Gonzalez, Amy Berrington; Buring, Julie E; Chan, Andrew T; Chen, Yu; Fraser, Gary E; Freedman, Neal D; Gao, Yu-Tang; Gapstur, Susan M; Gaziano, J Michael; Giles, Graham G; Grant, Eric J; Grodstein, Francine; Hartge, Patricia; Jenab, Mazda; Kitahara, Cari M; Knutsen, Synnove F; Koh, Woon-Puay; Larsson, Susanna C; Lee, I-Min; Liao, Linda M; Luo, Juhua; Milne, Roger L; Monroe, Kristine R; Neuhouser, Marian L; O'Brien, Katie M; Peters, Ulrike; Poynter, Jenny N; Purdue, Mark P; Robien, Kim; Sandler, Dale P; Sawada, Norie; Schairer, Catherine; Sesso, Howard D; Simon, Tracey G; Sinha, Rashmi; Stolzenberg-Solomon, Rachael; Tsugane, Shochiro; Wang, Renwei; Weiderpass, Elisabete; Weinstein, Stephanie J; White, Emily; Wolk, Alicja; Yuan, Jian-Min; Zeleniuch-Jacquotte, Anne; Zhang, Xuehong; Zhu, Bin; McGlynn, Katherine A; Campbell, Peter T; Koshiol, Jill
BACKGROUND:Tobacco and alcohol are well-established risk factors for numerous cancers, yet their relationship to biliary tract cancers remains unclear. METHODS:We pooled data from 26 prospective studies to evaluate associations of cigarette smoking and alcohol consumption with biliary tract cancer risk. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with smoking and alcohol consumption were calculated. Random effects meta-analysis produced summary estimates. All statistical tests were two-sided. RESULTS:Over a period of 38,369,156 person-years of follow-up, 1,391 gallbladder, 758 intrahepatic bile duct, 1,208 extrahepatic bile duct, and 623 ampulla of Vater cancer cases were identified. Ever, former, and current smoking were associated with increased extrahepatic bile duct and ampulla of Vater cancers risk (e.g., current versus never smokers hazard ratio [HR] = 1.69, 95% confidence interval [CI] = 1.34 to 2.13 and 2.22, 95%CI = 1.69 to 2.92, respectively), with dose-response effects for smoking pack-years, duration, and intensity (all P-trend<0.01). Current smoking and smoking intensity were also associated with intrahepatic bile duct cancer (e.g., >40 cigarettes/day versus never smokers HR = 2.15, 95%CI: 1.15 to 4.00; P-trend=0.001). No convincing association was observed between smoking and gallbladder cancer. Alcohol consumption was only associated with intrahepatic bile duct cancer, with increased risk for individuals consuming ≥5 versus 0 drinks/day (HR = 2.35, 95%CI = 1.46 to 3.78; P-trend=0.04). There was evidence of statistical heterogeneity between several cancer sites, particularly between gallbladder cancer and the other biliary tract cancers. CONCLUSIONS:Smoking appears to increase the risk of developing all biliary tract cancers except gallbladder cancer. Alcohol may increase the risk of intrahepatic bile duct cancer. Findings highlight etiologic heterogeneity across the biliary tract.
PMID: 31127946
ISSN: 1460-2105
CID: 3921162

High levels of C-reactive protein are associated with an increased risk of ovarian cancer: Results from the Ovarian Cancer Cohort Consortium

Peres, Lauren C; Mallen, Adrianne R; Townsend, Mary K; Poole, Elizabeth M; Trabert, Britton; Allen, Naomi E; Arslan, Alan A; Dossus, Laure; Fortner, Renée T; Gram, Inger T; Hartge, Patricia; Idahl, Annika; Kaaks, Rudolf; Kvaskoff, Marina; Magiocco, Anthony; Merritt, Melissa A; Quirós, J Ramón; Tjonneland, Anne; Trichopoulou, Antonia; Tumino, Rosario; van Gils, Carla; Visvanathan, Kala; Wentzensen, Nicolas; Zeleniuch-Jacquotte, Anne; Tworoger, Shelley S
Growing epidemiologic evidence supports chronic inflammation as a mechanism of ovarian carcinogenesis. An association between a circulating marker of inflammation, C-reactive protein (CRP), and ovarian cancer risk has been consistently observed, yet, potential heterogeneity of this association by tumor and patient characteristics has not been adequately explored. In this study, we pooled data from case-control studies nested within six cohorts in the Ovarian Cancer Cohort Consortium (OC3) to examine the association between CRP and epithelial ovarian cancer risk overall, by histologic subtype and by participant characteristics. CRP concentrations were measured from pre-diagnosis serum or plasma in 1,091 cases and 1,951 controls. Multivariable conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). When CRP was evaluated using tertiles, no associations with ovarian cancer risk were observed. A 67% increased ovarian cancer risk was found for women with CRP concentrations >10mg/L compared to <1mg/L (OR=1.67, 95% CI=1.12, 2.48). A CRP concentration >10mg/L was positively associated with risk of mucinous (OR=9.67, 95% CI=1.10, 84.80) and endometrioid carcinoma (OR=3.41, 95% CI=1.07, 10.92), and suggestively positive, though not statistically significant, for serous (OR=1.43, 95% CI=0.82, 2.49) and clear cell carcinoma (OR=2.05, 95% CI=0.36, 11.57; p-heterogeneity=0.20). Heterogeneity was observed with oral contraceptive use (p-interaction=0.03), where the increased risk was present only among ever users (OR=3.24, 95% CI=1.62, 6.47). The present study adds to the existing evidence that CRP plays a role in ovarian carcinogenesis, and suggests that inflammation may be particularly implicated in the etiology of endometrioid and mucinous carcinoma.
PMID: 31462430
ISSN: 1538-7445
CID: 4054522