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Pancreatic Neoplasms: HELP
Articles by Carlo La Vecchia
Based on 77 articles published since 2009
(Why 77 articles?)
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Between 2009 and 2019, C. La Vecchia wrote the following 77 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Review Genomics in Primary and Secondary Prevention of Pancreatic Cancer. 2017

Malats, Núria / Molina-Montes, Esther / La Vecchia, Carlo. ·Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), and CIBERONC, Madrid, Spain. ·Public Health Genomics · Pubmed #28689205.

ABSTRACT: BACKGROUND: Pancreatic cancer (PC) is one of the deadliest cancers worldwide for which little clinical progress has been made in the last decades. Furthermore, increased trends of PC mortality rates have been reported in Westernised countries. PC is usually diagnosed in advanced stages, precluding patients of an effective treatment. Identifying high-risk populations and early detection markers is the first and crucial step to impact on these figures and change the PC horizon. AIMS/OBJECTIVES: To discuss the published body of evidence on host and tumor genomics promising markers for primary and/or secondary personalised PC prevention, as well as the future perspectives in the field. METHODS: A review of the literature was performed to identify germline and tumor DNA and RNA markers that showed potential usefulness in defining the high-risk population, diagnosing the disease early, and identifying new carcinogens associated with PC. RESULTS: Only high-penetrance inherited mutations are used, at present, to define the high-risk PC population. Although there are some promising genomics markers to be used as early detection tests, none has been validated adequately to be integrated into the clinics routine. CONCLUSIONS: Despite of important efforts made in the recent time, little progress has been made to better characterise high-risk PC populations and to identify genomics-based markers for its early diagnosis. PC rates continue to rise, and this disease is becoming a real public health problem in the Westernised world. International and multidisciplinary strategies to identify new markers and properly validate the promising ones are urgently needed to implement cost-efficient primary and secondary prevention interventions in PC.

2 Review Pancreatic cancer. 2016

Kleeff, Jorg / Korc, Murray / Apte, Minoti / La Vecchia, Carlo / Johnson, Colin D / Biankin, Andrew V / Neale, Rachel E / Tempero, Margaret / Tuveson, David A / Hruban, Ralph H / Neoptolemos, John P. ·NIHR Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Duncan Building, Daulby Street, Liverpool L69 3GA, UK. · Department of General, Visceral and Pediatric Surgery, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany. · Departments of Medicine, and Biochemistry and Molecular Biology, Indiana University School of Medicine, the Melvin and Bren Simon Cancer Center, and the Pancreatic Cancer Signature Center, Indianapolis, Indiana, USA. · SWS Clinical School, University of New South Wales, and Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia. · Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. · University Surgical Unit, University Hospital Southampton, Southampton, UK. · Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Garscube Estate, Bearsden, Glasgow, Scotland, UK. · QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. · UCSF Pancreas Center, University of California San Francisco - Mission Bay Campus/Mission Hall, San Francisco, California, USA. · Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, New York, USA. · The Sol Goldman Pancreatic Cancer Research Center, Departments of Pathology and Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. ·Nat Rev Dis Primers · Pubmed #27158978.

ABSTRACT: Pancreatic cancer is a major cause of cancer-associated mortality, with a dismal overall prognosis that has remained virtually unchanged for many decades. Currently, prevention or early diagnosis at a curable stage is exceedingly difficult; patients rarely exhibit symptoms and tumours do not display sensitive and specific markers to aid detection. Pancreatic cancers also have few prevalent genetic mutations; the most commonly mutated genes are KRAS, CDKN2A (encoding p16), TP53 and SMAD4 - none of which are currently druggable. Indeed, therapeutic options are limited and progress in drug development is impeded because most pancreatic cancers are complex at the genomic, epigenetic and metabolic levels, with multiple activated pathways and crosstalk evident. Furthermore, the multilayered interplay between neoplastic and stromal cells in the tumour microenvironment challenges medical treatment. Fewer than 20% of patients have surgically resectable disease; however, neoadjuvant therapies might shift tumours towards resectability. Although newer drug combinations and multimodal regimens in this setting, as well as the adjuvant setting, appreciably extend survival, ∼80% of patients will relapse after surgery and ultimately die of their disease. Thus, consideration of quality of life and overall survival is important. In this Primer, we summarize the current understanding of the salient pathophysiological, molecular, translational and clinical aspects of this disease. In addition, we present an outline of potential future directions for pancreatic cancer research and patient management.

3 Review Effects of moderate beer consumption on health and disease: A consensus document. 2016

de Gaetano, G / Costanzo, S / Di Castelnuovo, A / Badimon, L / Bejko, D / Alkerwi, A / Chiva-Blanch, G / Estruch, R / La Vecchia, C / Panico, S / Pounis, G / Sofi, F / Stranges, S / Trevisan, M / Ursini, F / Cerletti, C / Donati, M B / Iacoviello, L. ·Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy. Electronic address: giovanni.degaetano@moli-sani.org. · Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, 86077 Pozzilli, Italy. · Cardiovascular Research Center (CSIC-ICCC), Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de Sant Pau, Barcelona, Spain. · Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg. · Department of Internal Medicine, Hospital Clinic, University of Barcelona, Spain. · Department of Clinical Sciences and Community Health, University of Milan, Italy. · Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy. · Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Don Carlo Gnocchi Foundation, ONLUS IRCCS, Florence, Italy. · City College, New York, NY, USA. · Dipartimento di Medicina Molecolare, Università di Padova, Italy. ·Nutr Metab Cardiovasc Dis · Pubmed #27118108.

ABSTRACT: A large evidence-based review on the effects of a moderate consumption of beer on human health has been conducted by an international panel of experts who reached a full consensus on the present document. Low-moderate (up to 1 drink per day in women, up to 2 in men), non-bingeing beer consumption, reduces the risk of cardiovascular disease. This effect is similar to that of wine, at comparable alcohol amounts. Epidemiological studies suggest that moderate consumption of either beer or wine may confer greater cardiovascular protection than spirits. Although specific data on beer are not conclusive, observational studies seem to indicate that low-moderate alcohol consumption is associated with a reduced risk of developing neurodegenerative disease. There is no evidence that beer drinking is different from other types of alcoholic beverages in respect to risk for some cancers. Evidence consistently suggests a J-shaped relationship between alcohol consumption (including beer) and all-cause mortality, with lower risk for moderate alcohol consumers than for abstainers or heavy drinkers. Unless they are at high risk for alcohol-related cancers or alcohol dependency, there is no reason to discourage healthy adults who are already regular light-moderate beer consumers from continuing. Consumption of beer, at any dosage, is not recommended for children, adolescents, pregnant women, individuals at risk to develop alcoholism, those with cardiomyopathy, cardiac arrhythmias, depression, liver and pancreatic diseases, or anyone engaged in actions that require concentration, skill or coordination. In conclusion, although heavy and excessive beer consumption exerts deleterious effects on the human body, with increased disease risks on many organs and is associated to significant social problems such as addiction, accidents, violence and crime, data reported in this document show evidence for no harm of moderate beer consumption for major chronic conditions and some benefit against cardiovascular disease.

4 Review Dietary acrylamide and cancer risk: an updated meta-analysis. 2015

Pelucchi, Claudio / Bosetti, Cristina / Galeone, Carlotta / La Vecchia, Carlo. ·Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. ·Int J Cancer · Pubmed #25403648.

ABSTRACT: The debate on the potential carcinogenic effect of dietary acrylamide is open. In consideration of the recent findings from large prospective investigations, we conducted an updated meta-analysis on acrylamide intake and the risk of cancer at several sites. Up to July 2014, we identified 32 publications. We performed meta-analyses to calculate the summary relative risk (RR) of each cancer site for the highest versus lowest level of intake and for an increment of 10 µg/day of dietary acrylamide, through fixed-effects or random-effects models, depending on the heterogeneity test. Fourteen cancer sites could be examined. No meaningful associations were found for most cancers considered. The summary RRs for high versus low acrylamide intake were 0.87 for oral and pharyngeal, 1.14 for esophageal, 1.03 for stomach, 0.94 for colorectal, 0.93 for pancreatic, 1.10 for laryngeal, 0.88 for lung, 0.96 for breast, 1.06 for endometrial, 1.12 for ovarian, 1.00 for prostate, 0.93 for bladder and 1.13 for lymphoid malignancies. The RR was of borderline significance only for kidney cancer (RR = 1.20; 95% confidence interval, CI, 1.00-1.45). All the corresponding continuous estimates ranged between 0.95 and 1.03, and none of them was significant. Among never-smokers, borderline associations with dietary acrylamide emerged for endometrial (RR = 1.23; 95% CI, 1.00-1.51) and ovarian (RR = 1.39; 95% CI, 0.97-2.00) cancers. This systematic review and meta-analysis of epidemiological studies indicates that dietary acrylamide is not related to the risk of most common cancers. A modest association for kidney cancer, and for endometrial and ovarian cancers in never smokers only, cannot be excluded.

5 Review Aspartame, low-calorie sweeteners and disease: regulatory safety and epidemiological issues. 2013

Marinovich, Marina / Galli, Corrado L / Bosetti, Cristina / Gallus, Silvano / La Vecchia, Carlo. ·Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy. Electronic address: marina.marinovich@unimi.it. ·Food Chem Toxicol · Pubmed #23891579.

ABSTRACT: Aspartame is a synthetic sweetener that has been used safely in food for more than 30 years. Its safety has been evaluated by various regulatory agencies in accordance with procedures internationally recognized, and decisions have been revised and updated regularly. The present review summarizes the most relevant conclusions of epidemiological studies concerning the use of low-calorie sweeteners (mainly aspartame), published between January 1990 and November 2012. In the Nurses' Health study and the Health Professionals Followup study some excess risk of Hodgkin lymphoma and multiple myeloma was found in men but not in women; no association was found with leukemia. In the NIH-AARP Diet and Health Study, there was no association between aspartame and haematopoietic neoplasms. US case-control studies of brain and haematopoietic neoplasms also showed no association. The NIH-AARP Diet and Health Study and case-control studies from California showed no association with pancreatic cancer, and a case-control study from Denmark found no relation with breast cancer risk. Italian case-control studies conducted in 1991-2008 reported no consistent association for cancers of the upper aerodigestive tract, digestive tract, breast, endometrium, ovary, prostate, and kidney. Low calorie sweeteners were not consistently related to vascular events and preterm deliveries.

6 Review Cancer risk for patients using thiazolidinediones for type 2 diabetes: a meta-analysis. 2013

Bosetti, Cristina / Rosato, Valentina / Buniato, Danilo / Zambon, Antonella / La Vecchia, Carlo / Corrao, Giovanni. ·Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Via La Masa, 19 20156 Milano, Italy. ·Oncologist · Pubmed #23345544.

ABSTRACT: OBJECTIVE: To clarify and quantify the effect of thiazolidinediones (TZDs; e.g., pioglitazone, rosiglitazone) on the risk of bladder cancer, other selected cancers, and overall cancer in patients with type 2 diabetes, we performed a systematic review and meta-analysis of observational studies. METHODS: A PubMed/MEDLINE search was conducted for studies published in English up to June 30, 2012. Random-effect models were fitted to estimate summary relative risks (RR). RESULTS: Seventeen studies satisfying inclusion criteria (3 case-control studies and 14 cohort studies) were considered. Use of TZDs was not associated to the risk of cancer overall (summary RR: 0.96; 95% confidence interval [CI]: 0.91-1.01). A modest excess risk of bladder cancer was reported in pioglitazone (RR: 1.20; 95% CI: 1.07-1.34 from six studies) but not in rosiglitazone (RR: 1.08; 95% CI: 0.95-1.23 from three studies) users. The RRs of bladder cancer were higher for longer duration (RR: 1.42 for >2 years) and higher cumulative dose of pioglitazone (RR: 1.64 for >28,000 mg). Inverse relations were observed with colorectal cancer (RR: 0.93; 95% CI: 0.90-0.97 from six cohort studies) and liver cancer (RR: 0.65; 95% CI: 0.48-0.89 from four studies), whereas there was no association with pancreatic, lung, breast, and prostate cancers. CONCLUSIONS: Adequate evidence excludes an overall excess cancer risk in TZD users within a few years after starting treatment. However, there is a modest excess risk of bladder cancer, particularly with reference to pioglitazone. Assuming that this association is real, the potential implications on the risk-benefit analysis of TZD use should be evaluated.

7 Review Cancer risk associated with use of metformin and sulfonylurea in type 2 diabetes: a meta-analysis. 2012

Soranna, Davide / Scotti, Lorenza / Zambon, Antonella / Bosetti, Cristina / Grassi, Guido / Catapano, Alberico / La Vecchia, Carlo / Mancia, Giuseppe / Corrao, Giovanni. ·Dipartimento di Epidemiologia, Istituto di Ricerche Farmacologiche Mario Negri, Via La Masa 19, Milan, Italy. ·Oncologist · Pubmed #22643536.

ABSTRACT: OBJECTIVE: Oral antidiabetic drugs (including metformin and sulfonylurea) may play a role in the relationship between type 2 diabetes and cancer. To quantify the association between metformin and sulfonylurea and the risk of cancer, we performed a meta-analysis of available studies on the issue. MATERIALS AND METHODS: We performed a MEDLINE search for observational studies that investigated the risk of all cancers and specific cancer sites in relation to use of metformin and/or sulfonylurea among patients with type 2 diabetes mellitus. Fixed- and random-effect models were fitted to estimate the summary relative risk (RR). Between-study heterogeneity was tested using χ(2) statistics and measured with the I(2) statistic. Publication bias was evaluated using funnel plot and Egger's regression asymmetry test. RESULTS: Seventeen studies satisfying inclusion criteria and including 37,632 cancers were evaluated after reviewing 401 citations. Use of metformin was associated with significantly decreased RR of all cancers (summary RR 0.61, 95% confidence interval [CI] 0.54-0.70), colorectal cancer (0.64, 95% CI 0.54-0.76), and pancreatic cancer (0.38, 95% CI 0.14-0.91). With the exception of colorectal cancer, significant between-study heterogeneity was observed. Evidence of publication bias for metformin-cancer association was also observed. There was no evidence that metformin affects the risk of breast and prostate cancers, nor that sulfonylurea affects the risk of cancer at any site. CONCLUSIONS: Metformin, but not sulfonylurea, appears to reduce subsequent cancer risk. This has relevant implications in light of the exploding global epidemic of diabetes.

8 Review Alcohol consumption and cancer risk. 2011

Pelucchi, Claudio / Tramacere, Irene / Boffetta, Paolo / Negri, Eva / La Vecchia, Carlo. ·Mario Negri Institute for Pharmacological Research, Milan, Italy. claudio.pelucchi@marionegri.it ·Nutr Cancer · Pubmed #21864055.

ABSTRACT: This review focuses on selected aspects of the relation between alcohol consumption and cancer risk. Heavy alcohol consumption (i.e., ≥4 drinks/day) is significantly associated with an increased risk of about 5-fold for oral and pharyngeal cancer and esophageal squamous cell carcinoma, 2.5-fold for laryngeal cancer, 50% for colorectal and breast cancers, and 30% for pancreatic cancer. These estimates are based on a large number of epidemiological studies and are generally consistent across strata of several covariates. The evidence suggests that at low doses of alcohol consumption (i.e., ≤1 drink/day) the risk is also increased by about 20% for oral and pharyngeal cancer and 30% for esophageal squamous cell carcinoma. Thus, for these sites there is little evidence of a threshold effect. While consumption of fewer than 3 alcoholic drinks/wk is not associated with an increased risk of breast cancer, an intake of 3 to 6 drinks/wk might already yield a (small) increase in risk. On the other hand, intakes up to 1 drink/day are not associated to the risk of laryngeal, colorectal, and pancreatic cancer. The positive association between alcohol consumption and the risk of head and neck cancers is independent from tobacco exposure.

9 Review Exposure to acrylamide and human cancer--a review and meta-analysis of epidemiologic studies. 2011

Pelucchi, C / La Vecchia, C / Bosetti, C / Boyle, P / Boffetta, P. ·Department of Epidemiology, Mario Negri Institute for Pharmacological Research, Milan, Italy. ·Ann Oncol · Pubmed #21239401.

ABSTRACT: BACKGROUND: Acrylamide has been associated to cancer risk in rodents, but data on humans are inconclusive. We thus carried out a critical review and meta-analysis of studies of exposure to acrylamide and cancer. METHODS: We identified 586 publications, 25 presented relevant results. We conducted meta-analyses of studies of dietary intake based on random-effects models by calculating pooled relative risks (RR) and the corresponding 95% confidence intervals (CI). We combined results of occupational studies according to a fixed-effect model. RESULTS: The summary RRs for an increase of 10 μg/day of acrylamide intake were close to unity for all the cancers considered, ranging from 0.98 for esophageal cancer to 1.01 for colon, endometrial, ovarian and kidney cancer. None of the estimates was significant. Exclusion of one case-control study from Sweden resulted in a summary RR of kidney cancer of 1.04 (95% CI 1.00-1.08). The combined standardized mortality ratios for high occupational exposure were 1.67 (95% CI 0.83-2.99) for pancreatic cancer and 2.22 (95% CI 0.81-4.84) for kidney cancer. CONCLUSIONS: Available studies consistently suggest a lack of an increased risk of most types of cancer from exposure to acrylamide. The main association that requires further monitoring involves kidney cancer.

10 Review Aspirin and cancer risk: a summary review to 2007. 2009

Bosetti, Cristina / Gallus, Silvano / La Vecchia, Carlo. ·Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. ·Recent Results Cancer Res · Pubmed #19213573.

ABSTRACT: Aspirin has been associated with a reduced risk of colorectal cancer and--based on limited evidence--to cancers of the oesophagus, stomach, breast, ovary and lung. The role of aspirin on other cancers, such as pancreatic, prostate and bladder cancer and non-Hodgkin's lymphomas and myeloma is less clear, and an increase of risk has been suggested for kidney cancer. For most cancer sites, however, significant heterogeneity between studies, and particularly between study design, was found, with a reduction in risk generally stronger in case-control studies than in cohort ones.

11 Article European cancer mortality predictions for the year 2019 with focus on breast cancer. 2019

Malvezzi, M / Carioli, G / Bertuccio, P / Boffetta, P / Levi, F / La Vecchia, C / Negri, E. ·Departments of Clinical Sciences and Community Health. · Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy. · Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA. · Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland. ·Ann Oncol · Pubmed #30887043.

ABSTRACT: BACKGROUND: To overcome the lag with which cancer statistics become available, we predicted numbers of deaths and rates from all cancers and selected cancer sites for 2019 in the European Union (EU). MATERIALS AND METHODS: We retrieved cancer death certifications and population data from the World Health Organization and Eurostat databases for 1970-2014. We obtained estimates for 2019 with a linear regression on number of deaths over the most recent trend period identified by a logarithmic Poisson joinpoint regression model. We calculated the number of avoided deaths over the period 1989-2019. RESULTS: We estimated about 1 410 000 cancer deaths in the EU for 2019, corresponding to age-standardized rates of 130.9/100 000 men (-5.9% since 2014) and 82.9 women (-3.6%). Lung cancer trends in women are predicted to increase 4.4% between 2014 and 2019, reaching a rate of 14.8. The projected rate for breast cancer was 13.4. Favourable trends for major neoplasms are predicted to continue, except for pancreatic cancer. Trends in breast cancer mortality were favourable in all six countries considered, except Poland. The falls were largest in women 50-69 (-16.4%), i.e. the age group covered by screening, but also seen at age 20-49 (-13.8%), while more modest at age 70-79 (-6.1%). As compared to the peak rate in 1988, over 5 million cancer deaths have been avoided in the EU over the 1989-2019 period. Of these, 440 000 were breast cancer deaths. CONCLUSION: Between 2014 and 2019, cancer mortality will continue to fall in both sexes. Breast cancer rates will fall steadily, with about 35% decline in rates over the last three decades. This is likely due to reduced hormone replacement therapy use, improvements in screening, early diagnosis and treatment. Due to population ageing, however, the number of breast cancer deaths is not declining.

12 Article Dietary folate intake and pancreatic cancer risk: Results from the European prospective investigation into cancer and nutrition. 2019

Park, Jin Young / Bueno-de-Mesquita, H Bas / Ferrari, Pietro / Weiderpass, Elisabete / de Batlle, Jordi / Tjønneland, Anne / Kyro, Cecilie / Rebours, Vinciane / Boutron-Ruault, Marie-Christine / Mancini, Francesca Romana / Katzke, Verena / Kühn, Tilman / Boeing, Heiner / Trichopoulou, Antonia / La Vecchia, Carlo / Kritikou, Maria / Masala, Giovanna / Pala, Valeria / Tumino, Rosario / Panico, Salvatore / Peeters, Petra H / Skeie, Guri / Merino, Susana / Duell, Eric J / Rodríguez-Barranco, Miguel / Dorronsoro, Miren / Chirlaque, Maria-Dolores / Ardanaz, Eva / Gylling, Björn / Schneede, Jörn / Ericson, Ulrika / Sternby, Hanna / Khaw, Kay-Tee / Bradbury, Kathryn E / Huybrechts, Inge / Aune, Dagfinn / Vineis, Paolo / Slimani, Nadia. ·International Agency for Research on Cancer, Lyon, France. · National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. · Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. · School of Public Health, Imperial College London, London, United Kingdom. · Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway. · Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. · Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland. · Group of Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain. · Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. · Danish Cancer Society Research Center, Copenhagen, Denmark. · Pancreatology Unit, Beaujon Hospital, Clichy, France. · INSERM-UMR 1149, University Paris 7, France. · CESP, INSERM U1018, University of Paris-Sud, UVSQ, Université Paris-Saclay, France. · Gustave Roussy, Villejuif, France. · German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany. · Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Germany. · Hellenic Health Foundation, Athens, Greece. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. · Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network-ISPRO, Florence, Italy. · Epidemiology and Prevention Unit, IRCCS Foundation National Cancer Institute, Milan, Italy. · Cancer Registry and Histopathology Department, 'Civic-M.P. Arezzo' Hospital, ASP Ragusa, Italy. · Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. · Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht. · Public Health Directorate, Asturias, Spain. · Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. · Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. · CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. · Dirección de Salud Pública y Adicciones, Gobierno Vasco, Vitoria, Spain. · Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain. · Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain. · Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain. · Navarra Public Health Institute, Pamplona, Spain. · IdiSNA, Navarra Institute for Health Research, Pamplona, Spain. · Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden. · Department of Clinical Pharmacology, Pharmacology and Clinical Neurosciences, Umeå University, Umeå, Sweden. · Diabetes and Cardiovascular disease, Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Sweden. · Department of Surgery, Institution of Clinical Sciences Malmö, Lund University, Sweden. · Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. · Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom. · Bjørknes University College, Oslo, Norway. · IIGM Foundation, Turin, Italy. ·Int J Cancer · Pubmed #30178496.

ABSTRACT: Pancreatic cancer (PC) has an exceptionally low survival rate and primary prevention strategies are limited. Folate plays an important role in one-carbon metabolism and has been associated with the risk of several cancers, but not consistently with PC risk. We aimed to investigate the association between dietary folate intake and PC risk, using the standardised folate database across 10 European countries. A total of 477,206 participants were followed up for 11 years, during which 865 incident primary PC cases were recorded. Folate intake was energy-adjusted using the residual method. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. In multivariable analyses stratified by age, sex, study centre and adjusted for energy intake, smoking status, BMI, educational level, diabetes status, supplement use and dietary fibre intake, we found no significant association between folate intake and PC risk: the HR of PC risk for those in the highest quartile of folate intake (≥353 μg/day) compared to the lowest (<241 μg/day) was 0.81 (95% CI: 0.51, 1.31; p

13 Article Processed meat and risk of selected digestive tract and laryngeal cancers. 2019

Rosato, Valentina / Kawakita, Daisuke / Negri, Eva / Serraino, Diego / Garavello, Werner / Montella, Maurizio / Decarli, Adriano / La Vecchia, Carlo / Ferraroni, Monica. ·Unit of Medical Statistics, Biometry and Bioinformatics, National Cancer Institute, IRCCS Foundation, Milan, Italy. · Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University, Nagoya, Japan. · Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy. · Cancer Epidemiology Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy. · Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. · Epidemiology Unit, National Cancer Institute G. Pascale Foundation, Naples, Italy. · Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. · Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. monica.ferraroni@unimi.it. ·Eur J Clin Nutr · Pubmed #29662231.

ABSTRACT: BACKGROUND/OBJECTIVES: To assess the association between processed meat and the risk of selected digestive tract and laryngeal cancers. SUBJECTS/METHODS: We conducted a series of case-control studies between 1985 and 2007 in Italy. The studies included a total of 1475 cases of cancer of the oral cavity and pharynx, 1077 of the larynx, 716 of the esophagus, 999 of the stomach, 684 of the liver, 159 of the biliary tract, 688 of the pancreas, and a total of 9720 controls. Odds ratios (ORs), and the corresponding 95% confidence intervals (CIs), were estimated by unconditional logistic regression models, including terms for socio-demographic factors, tobacco smoking, and alcohol intake. RESULTS: Compared to the lowest tertile of processed meat consumption, the ORs for subjects in the highest one were 1.18 (95% CI 0.98-1.43) for oral cavity and pharyngeal, 1.51 (95% CI 1.18-1.91) for esophageal, 1.19 (95% CI 0.96-1.47) for laryngeal, 0.98 (95% CI 0.81-1.18) for stomach, 0.85 (95% CI 0.51-1.40) for biliary tract, 1.20 (95% CI 0.94-1.54) for liver, and 1.46 (95% CI 1.15-1.85) for pancreatic cancers. CONCLUSIONS: Our findings support the hypothesis that high processed meat consumption increases esophageal and pancreatic cancers risk. Residual confounding by socio-demographic factors, tobacco smoking, and alcohol intake may, partly or largely, account for these associations. We found no overall association with other digestive tract and laryngeal cancers.

14 Article Relation between mortality trends of cardiovascular diseases and selected cancers in the European Union, in 1970-2017. Focus on cohort and period effects. 2018

Malvezzi, M / Carioli, G / Bertuccio, P / Negri, E / La Vecchia, C. ·Department of Clinical Sciences and Community Health, Universitá Degli Studi di Milano, Milan, Italy. · Department of Biomedical and Clinical Sciences, Universitá Degli Studi di Milano, Milan, Italy. · Department of Clinical Sciences and Community Health, Universitá Degli Studi di Milano, Milan, Italy. Electronic address: carlo.lavecchia@unimi.it. ·Eur J Cancer · Pubmed #30029971.

ABSTRACT: AIM: To characterise mortality trends from major non-communicable diseases in the European Union (EU) analysing data from the World Health Organization (WHO) Mortality Database. METHODS: We obtained EU population and death certification data for major non-communicable diseases, i.e. seven cancer sites (stomach, intestine, pancreas, lung, breast, prostate and haematopoietic), total cancers, coronary heart diseases (CHDs) and cerebrovascular diseases (CVDs) from the WHO Mortality Database over the 1970 and 2012 period. We computed age-standardised rates (world standard population) and applied joinpoint regression models to identify temporal trends and age period cohort (APC) models to disentangle the effects of age, period of death and cohort of birth on mortality. RESULTS: In 2012, 2.4 million deaths were recorded in the EU (1.3 million from cancers and 1.1 million from CHD and CVD combined). Over the last decade, mortality from cancer fell by 14% in men and 8% in women, resulting in age-standardised rates of 144 and 88/100,000 persons, respectively, in 2012. The only exceptions to the general downward trends were pancreatic cancer and female lung cancer. Both cardiovascular diseases mortality fell over 35% in both sexes with rates of 60 and 28/100,000 for CHD, and of 30 and 23/100,000 for CVD, in men and women, respectively, in 2012. CONCLUSIONS: Overall trends in mortality rates from non-communicable diseases in the EU were favourable, and the joinpoint and APC models indicated these trends are likely to continue in the near future. Lack of progress in tobacco-related mortality in women underlines the importance of female-specific anti-tobacco policies.

15 Article Pancreatic cancer risk is modulated by inflammatory potential of diet and ABO genotype: a consortia-based evaluation and replication study. 2018

Antwi, Samuel O / Bamlet, William R / Pedersen, Katrina S / Chaffee, Kari G / Risch, Harvey A / Shivappa, Nitin / Steck, Susan E / Anderson, Kristin E / Bracci, Paige M / Polesel, Jerry / Serraino, Diego / La Vecchia, Carlo / Bosetti, Cristina / Li, Donghui / Oberg, Ann L / Arslan, Alan A / Albanes, Demetrius / Duell, Eric J / Huybrechts, Inge / Amundadottir, Laufey T / Hoover, Robert / Mannisto, Satu / Chanock, Stephen J / Zheng, Wei / Shu, Xiao-Ou / Stepien, Magdalena / Canzian, Federico / Bueno-de-Mesquita, Bas / Quirós, José Ramon / Zeleniuch-Jacquotte, Anne / Bruinsma, Fiona / Milne, Roger L / Giles, Graham G / Hébert, James R / Stolzenberg-Solomon, Rachael Z / Petersen, Gloria M. ·Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. · Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. · Division of Oncology, Washington University, St. Louis, MO, USA. · Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA. · Cancer Prevention and Control Program, USA. · Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. · Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA. · Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA. · Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (PN), Italy. · Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. · Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. · Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. · Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA. · Department of Population Health, New York University School of Medicine, New York, NY, USA. · Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA. · Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA. · Unit of Nutrition and Cancer, Bellvitge Biomedical Research Institute-IDIBELL, Catalan Institute of Oncology-ICO. L'Hospitalet de Llobregat, Barcelona, Spain. · International Agency for Research on Cancer, World Health Organization, France. · Department of Public Health Solutions, National Institute for Health and Welfare Helsinki, Finland. · Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA. · Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany. · Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, UK. · Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, Kuala Lumpur, Malaysia. · Public Health Directorate, Asturias, Spain. · Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA. · Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, Melbourne, Australia. ·Carcinogenesis · Pubmed #29800239.

ABSTRACT: Diets with high inflammatory potential are suspected to increase risk for pancreatic cancer (PC). Using pooled analyses, we examined whether this association applies to populations from different geographic regions and population subgroups with varying risks for PC, including variation in ABO blood type. Data from six case-control studies (cases, n = 2414; controls, n = 4528) in the Pancreatic Cancer Case-Control Consortium (PanC4) were analyzed, followed by replication in five nested case-control studies (cases, n = 1268; controls, n = 4215) from the Pancreatic Cancer Cohort Consortium (PanScan). Two polymorphisms in the ABO locus (rs505922 and rs8176746) were used to infer participants' blood types. Dietary questionnaire-derived nutrient/food intake was used to compute energy-adjusted dietary inflammatory index (E-DII®) scores to assess inflammatory potential of diet. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable-adjusted logistic regression. Higher E-DII scores, reflecting greater inflammatory potential of diet, were associated with increased PC risk in PanC4 [ORQ5 versus Q1=2.20, 95% confidence interval (CI) = 1.85-2.61, Ptrend < 0.0001; ORcontinuous = 1.20, 95% CI = 1.17-1.24], and PanScan (ORQ5 versus Q1 = 1.23, 95% CI = 0.92-1.66, Ptrend = 0.008; ORcontinuous = 1.09, 95% CI = 1.02-1.15). As expected, genotype-derived non-O blood type was associated with increased PC risk in both the PanC4 and PanScan studies. Stratified analyses of associations between E-DII quintiles and PC by genotype-derived ABO blood type did not show interaction by blood type (Pinteraction = 0.10 in PanC4 and Pinteraction=0.13 in PanScan). The results show that consuming a pro-inflammatory diet and carrying non-O blood type are each individually, but not interactively, associated with increased PC risk.

16 Article European cancer mortality predictions for the year 2018 with focus on colorectal cancer. 2018

Malvezzi, M / Carioli, G / Bertuccio, P / Boffetta, P / Levi, F / La Vecchia, C / Negri, E. ·Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. · Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA. · Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland. · Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy. ·Ann Oncol · Pubmed #29562308.

ABSTRACT: Background: We projected cancer mortality statistics for 2018 for the European Union (EU) and its six more populous countries, using the most recent available data. We focused on colorectal cancer. Materials and methods: We obtained cancer death certification data from stomach, colorectum, pancreas, lung, breast, uterus, ovary, prostate, bladder, leukaemia, and total cancers from the World Health Organisation database and projected population data from Eurostat. We derived figures for France, Germany, Italy, Poland, Spain, the UK, and the EU in 1970-2012. We predicted death numbers by age group and age-standardized (world population) rates for 2018 through joinpoint regression models. Results: EU total cancer mortality rates are predicted to decline by 10.3% in men between 2012 and 2018, reaching a predicted rate of 128.9/100 000, and by 5.0% in women with a rate of 83.6. The predicted total number of cancer deaths is 1 382 000 when compared with 1 333 362 in 2012 (+3.6%). We confirmed a further fall in male lung cancer, but an unfavourable trend in females, with a rate of 14.7/100 000 for 2018 (13.9 in 2012, +5.8%) and 94 500 expected deaths, higher than the rate of 13.7 and 92 700 deaths from breast cancer. Colorectal cancer predicted rates are 15.8/100 000 men (-6.7%) and 9.2 in women (-7.5%); declines are expected in all age groups. Pancreatic cancer is stable in men, but in women it rose +2.8% since 2012. Ovarian, uterine and bladder cancer rates are predicted to decline further. In 2018 alone, about 392 300 cancer deaths were avoided compared with peak rates in the late 1980s. Conclusion: We predicted continuing falls in mortality rates from major cancer sites in the EU and its major countries to 2018. Exceptions are pancreatic cancer and lung cancer in women. Improved treatment and-above age 50 years-organized screening may account for recent favourable colorectal cancer trends.

17 Article The Association of Recently Diagnosed Diabetes and Long-term Diabetes With Survival in Pancreatic Cancer Patients: A Pooled Analysis. 2018

Jeon, Christie Y / Li, Donghui / Cleary, Sean / Stolzenberg-Solomon, Rachael / Bosetti, Cristina / La Vecchia, Carlo / Porta, Miquel / Toriola, Adetunji T / Hung, Rayjean J / Kurtz, Robert C / Olson, Sara H. · ·Pancreas · Pubmed #29401167.

ABSTRACT: OBJECTIVES: It is unclear whether long-standing diabetes or new-onset pancreatogenic diabetes contributes to poor prognosis in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: We investigated the influence of diabetes diagnosed shortly before PDAC and long-term diabetes on overall survival in 2792 PDAC patients who had participated in 3 PDAC case-control studies in the Pancreatic Cancer Case-Control Consortium. There were 300 patients with long-term diabetes of more than 3 years' duration (11%) and 418 patients with recently diagnosed diabetes of 3-year duration or less (15%). We performed Cox regression to determine the association of long-term diabetes and recently diagnosed diabetes with overall survival, adjusting for study site, age, sex, race, stage of disease, surgery, chemotherapy, smoking history, and body mass index at diagnosis. RESULTS: In the overall population, neither long-term diabetes (hazard ratio [HR], 1.10; 95% confidence interval [CI], 0.97-1.26) nor recently diagnosed diabetes (HR, 1.06; 95% CI, 0.94-1.18) was associated with shorter survival. When stratified by stage of disease, long-term diabetes was associated with 42% increase in rate of death in persons with resectable PDAC (HR, 1.42; 95% CI, 1.13-1.78), whereas it was not associated with survival in PDAC patients with more advanced disease. CONCLUSION: Long-term diabetes was associated with increased rate of death in patients with resectable PDAC.

18 Article Cancer mortality predictions for 2017 in Latin America. 2017

Carioli, G / La Vecchia, C / Bertuccio, P / Rodriguez, T / Levi, F / Boffetta, P / Negri, E / Malvezzi, M. ·Department of Clinical Sciences and Community Health, Universitá degli Studi di Milano, Milan, Italy. · Navarra Health Service, Pamplona, Navarra, Spain. · Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland. · Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA. · Department of Biomedical and Clinical Sciences, Universitá degli Studi di Milano, Milan, Italy. ·Ann Oncol · Pubmed #28911064.

ABSTRACT: Background: From most recent available data, we predicted cancer mortality statistics in selected Latin American countries for the year 2017, with focus on lung cancer. Materials and methods: We obtained death certification data from the World Health Organization and population data from the Pan American Health Organization database for all neoplasms and selected cancer sites. We derived figures for Argentina, Brazil, Chile, Colombia, Cuba, Mexico and Venezuela. Using a logarithmic Poisson count data joinpoint model, we estimated number of deaths and age-standardized (world population) mortality rates in 2017. Results: Total cancer mortality rates are predicted to decline in all countries. The highest mortality rates for 2017 are in Cuba, i.e. 132.3/100 000 men and 93.3/100 000 women. Mexico had the lowest predicted rates, 64.7/100 000 men and 60.6/100 000 women. In contrast, the total number of cancer deaths is expected to rise due to population ageing and growth. Men showed declines in lung cancer trends in all countries and age groups considered, while only Colombian and Mexican women had downward trends. Stomach and (cervix) uteri rates are predicted to continue their declines, though mortality from these neoplasms remains comparatively high. Colorectal, breast and prostate cancer rates were predicted to decline moderately, as well as leukaemias. There was no clear pattern for pancreatic cancer. Between 1990 and 2017 about 420 000 cancer deaths were avoided in 5 of the 7 countries, no progress was observed in Brazil and Cuba. Conclusion: Cancer mortality rates for 2017 in seven selected Latin American countries are predicted to decline, though there was appreciable variability across countries. Mortality from major cancers-including lung and prostate-and all cancers remains comparatively high in Cuba, indicating the need for improved prevention and management.

19 Article A systems approach identifies time-dependent associations of multimorbidities with pancreatic cancer risk. 2017

Gomez-Rubio, P / Rosato, V / Márquez, M / Bosetti, C / Molina-Montes, E / Rava, M / Piñero, J / Michalski, C W / Farré, A / Molero, X / Löhr, M / Ilzarbe, L / Perea, J / Greenhalf, W / O'Rorke, M / Tardón, A / Gress, T / Barberá, V M / Crnogorac-Jurcevic, T / Muñoz-Bellvís, L / Domínguez-Muñoz, E / Gutiérrez-Sacristán, A / Balsells, J / Costello, E / Guillén-Ponce, C / Huang, J / Iglesias, M / Kleeff, J / Kong, B / Mora, J / Murray, L / O'Driscoll, D / Peláez, P / Poves, I / Lawlor, R T / Carrato, A / Hidalgo, M / Scarpa, A / Sharp, L / Furlong, L I / Real, F X / La Vecchia, C / Malats, N / Anonymous4870902. ·Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid, and CIBERONC, Spain. · Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro," Department of Clinical Sciences and Community Health, University of Milan, Milan. · Unit of Medical Statistics, Biometry and Bioinformatics, National Cancer Institute, IRCCS Foundation, Milan. · Department of Epidemiology, Mario Negri Institute for Pharmacological Research-IRCCS, Milan, Italy. · Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute (IMIM), Pompeu Fabra Univeristy (UPF), Barcelona, Spain. · Department of Surgery, Technical University of Munich, Munich. · Department of Surgery, University of Heidelberg, Heidelberg, Germany. · Department of Gastroenterology, Santa Creu i Sant Pau Hospital, Barcelona. · Exocrine Pancreas Research Unit and Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Barcelona. · Department of Medicine, Universitat Autònoma de Barcelona, Barcelona. · Network of Biomedical Research Centres (CIBER), Hepatic and Digestive Diseases and Epidemiology and Public Health, Madrid, Spain. · Gastrocentrum, Karolinska Institutet and University Hospital, Stockholm, Sweden. · Department of Gastroenterology, Parc de Salut Mar University Hospital, Barcelona. · Department of Surgery, 12 de Octubre University Hospital, Madrid, Spain. · Department of Molecular and Clinical Cancer Medicine, The Royal Liverpool University Hospital, Liverpool. · Centre for Public Health, Queen's University Belfast, Belfast, UK. · Department of Medicine, University Institute of Oncology of Asturias, Oviedo, Spain. · Department of Gastroenterology, University Hospital of Giessen and Marburg, Marburg, Germany. · Molecular Genetics Laboratory, General University Hospital of Elche, Elche, Spain. · Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, London, UK. · General and Digestive Surgery Department, Salamanca University Hospital, Salamanca. · Department of Gastroenterology, Clinical University Hospital of Santiago de Compostela, Santiago de Compostela. · Department of Oncology, Ramón y Cajal Hospital, Madrid, and CIBERONC, Spain. · Research Programme, National Cancer Registry Ireland. · ARC-Net Centre for Applied Research on Cancer and Department of Pathology and Diagnostics, University and Hospital trust of Verona, Verona, Italy. · Clara Campal Integrated Oncological Centre, Sanchinarro Hospital, Madrid, Spain. · Institute of Health & Society, Newcastle University, UK. · Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre (CNIO), Madrid, and CIBERONC. · Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain. ·Ann Oncol · Pubmed #28383714.

ABSTRACT: Background: Pancreatic ductal adenocarcinoma (PDAC) is usually diagnosed in late adulthood; therefore, many patients suffer or have suffered from other diseases. Identifying disease patterns associated with PDAC risk may enable a better characterization of high-risk patients. Methods: Multimorbidity patterns (MPs) were assessed from 17 self-reported conditions using hierarchical clustering, principal component, and factor analyses in 1705 PDAC cases and 1084 controls from a European population. Their association with PDAC was evaluated using adjusted logistic regression models. Time since diagnosis of morbidities to PDAC diagnosis/recruitment was stratified into recent (<3 years) and long term (≥3 years). The MPs and PDAC genetic networks were explored with DisGeNET bioinformatics-tool which focuses on gene-diseases associations available in curated databases. Results: Three MPs were observed: gastric (heartburn, acid regurgitation, Helicobacter pylori infection, and ulcer), metabolic syndrome (obesity, type-2 diabetes, hypercholesterolemia, and hypertension), and atopic (nasal allergies, skin allergies, and asthma). Strong associations with PDAC were observed for ≥2 recently diagnosed gastric conditions [odds ratio (OR), 6.13; 95% confidence interval CI 3.01-12.5)] and for ≥3 recently diagnosed metabolic syndrome conditions (OR, 1.61; 95% CI 1.11-2.35). Atopic conditions were negatively associated with PDAC (high adherence score OR for tertile III, 0.45; 95% CI, 0.36-0.55). Combining type-2 diabetes with gastric MP resulted in higher PDAC risk for recent (OR, 7.89; 95% CI 3.9-16.1) and long-term diagnosed conditions (OR, 1.86; 95% CI 1.29-2.67). A common genetic basis between MPs and PDAC was observed in the bioinformatics analysis. Conclusions: Specific multimorbidities aggregate and associate with PDAC in a time-dependent manner. A better characterization of a high-risk population for PDAC may help in the early diagnosis of this cancer. The common genetic basis between MP and PDAC points to a mechanistic link between these conditions.

20 Article European cancer mortality predictions for the year 2017, with focus on lung cancer. 2017

Malvezzi, M / Carioli, G / Bertuccio, P / Boffetta, P / Levi, F / La Vecchia, C / Negri, E. ·Department of Clinical Sciences and Community Health, Universitá degli Studi di Milano, Milan. · Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy. · Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA. · Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland. ·Ann Oncol · Pubmed #28327906.

ABSTRACT: Background: We predicted cancer mortality figures in the European Union (EU) for the year 2017 using most recent available data, with a focus on lung cancer. Materials and methods: We retrieved cancer death certification data and population figures from the World Health Organisation and Eurostat databases. Age-standardized (world standard population) rates were computed for France, Germany, Italy, Poland, Spain, the UK and the EU overall in 1970-2012. We obtained estimates for 2017 by implementing a joinpoint regression model. Results: The predicted number of cancer deaths for 2017 in the EU is 1 373 500, compared with 1 333 400 in 2012 (+3%). Cancer mortality rates are predicted to decline in both sexes, reaching 131.8/100 000 men (-8.2% when compared with 2012) and 84.5/100 000 women (-3.6%). Mortality rates for all selected cancer sites are predicted to decline, except pancreatic cancer in both sexes and lung cancer in women. In men, pancreatic cancer rate is stable, in women it increases by 3.5%. Lung cancer mortality rate in women is predicted to rise to 14.6/100 000 in 2017 (+5.1% since 2012, corresponding to 92 300 predicted deaths), compared with 14.0/100 000 for breast cancer, corresponding to 92 600 predicted deaths. Only younger (25-44) women have favourable lung cancer trends, and rates at this age group are predicted to be similar in women (1.4/100 000) and men (1.2/100 000). In men lung cancer rates are predicted to decline by 10.7% since 2012, and falls are observed in all age groups. Conclusion: European cancer mortality projections for 2017 confirm the overall downward trend in rates, with a stronger pattern in men. This is mainly due to different smoking prevalence trends in different generations of men and women. Lung cancer rates in young European women are comparable to those in men, confirming that smoking has the same impact on lung cancer in the two sexes.

21 Article Dietary acrylamide and the risk of pancreatic cancer in the International Pancreatic Cancer Case-Control Consortium (PanC4). 2017

Pelucchi, C / Rosato, V / Bracci, P M / Li, D / Neale, R E / Lucenteforte, E / Serraino, D / Anderson, K E / Fontham, E / Holly, E A / Hassan, M M / Polesel, J / Bosetti, C / Strayer, L / Su, J / Boffetta, P / Duell, E J / La Vecchia, C. ·Department of Clinical Sciences and Community Health, University of Milan, Milan. · Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. · Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco. · Department of Gastrointestinal Medical Oncology, M.D. Anderson Cancer Center, University of Texas, Houston, USA. · Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia. · Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Florence. · Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano (PN), Italy. · School of Public Health, University of Minnesota, Minneapolis. · Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, USA. · Department of Epidemiology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. · Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock. · The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA. · Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain. ·Ann Oncol · Pubmed #27836886.

ABSTRACT: Background: Occupational exposure to acrylamide was associated with excess mortality from pancreatic cancer, though in the absence of dose-risk relationship. Few epidemiological studies have examined the association between acrylamide from diet and pancreatic cancer risk. Patients and methods: We considered this issue in a combined set of 1975 cases of pancreatic cancer and 4239 controls enrolled in six studies of the Pancreatic Cancer Case-Control Consortium (PanC4). We calculated pooled odds ratios (ORs) and their 95% confidence intervals (CI) by estimating study-specific ORs through multivariate unconditional logistic regression models and pooling the obtained estimates using random-effects models. Results: Compared with the lowest level of estimated dietary acrylamide intake, the pooled ORs were 0.97 (95% CI, 0.79-1.19) for the second, 0.91 (95% CI, 0.71-1.16) for the third, and 0.92 (95% CI, 0.66-1.28) for the fourth (highest) quartile of intake. For an increase of 10 µg/day of acrylamide intake, the pooled OR was 0.96 (95% CI, 0.87-1.06), with heterogeneity between estimates (I2 = 67%). Results were similar across various subgroups, and were confirmed when using a one-stage modelling approach. Conclusions: This PanC4 pooled-analysis found no association between dietary acrylamide and pancreatic cancer.

22 Article Global Trends in Pancreatic Cancer Mortality From 1980 Through 2013 and Predictions for 2017. 2016

Lucas, Aimee L / Malvezzi, Matteo / Carioli, Greta / Negri, Eva / La Vecchia, Carlo / Boffetta, Paolo / Bosetti, Cristina. ·Henry D. Janowitz Division of Gastroenterology, Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: aimee.lucas@mssm.edu. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. · Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. · Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York. ·Clin Gastroenterol Hepatol · Pubmed #27266982.

ABSTRACT: BACKGROUND & AIMS: Pancreatic cancer is a leading cause of cancer mortality, and its mortality has not decreased in recent years. We sought to determine global trends in pancreatic cancer mortality. METHODS: We derived data on deaths from pancreatic cancer from the World Health Organization database for 59 countries from 1980 through 2013. Age-standardized mortalities were computed for persons of all ages and for persons 35-64 years old; for selected countries, they were computed for persons 25-49 years old. Joinpoint regression models were used to identify significant changes in mortality. For selected larger countries, we predicted number of deaths and mortality for 2017. RESULTS: Between 1980 and 2013, overall pancreatic cancer mortality in men increased in the European Union (EU) as well as in Southern and Eastern Europe, Brazil, Japan, and Republic of Korea. Overall pancreatic cancer mortality decreased in most Northern European countries, Australia, Canada, Mexico, and the United States (US). In women, mortality increased in the EU, Brazil, US, Japan, and Republic of Korea but decreased in Canada and Mexico. In 2012, Eastern Europe and Japan had the highest pancreatic cancer mortality for both sexes. In men 25-49 years old, mortality decreased in the EU, US, Japan, and most large European countries. On the basis of our data, we predict overall pancreatic cancer mortality in 2017 to level off in men in the EU and US but increase in Japan. In women, mortality will continue to increase in most countries except the US; the greatest increase is predicted to occur in Japan. CONCLUSIONS: Mortality from pancreatic cancer has not decreased as it has for other cancers in recent years. A notable exception is a decrease in mortality in men 25-49 years old, which could indicate a reversal in the current increasing global trends.

23 Article Dietary total antioxidant capacity and pancreatic cancer risk: an Italian case-control study. 2016

Lucas, Aimee L / Bosetti, Cristina / Boffetta, Paolo / Negri, Eva / Tavani, Alessandra / Serafini, Mauro / Polesel, Jerry / Serraino, Diego / La Vecchia, Carlo / Rossi, Marta. ·Samuel Bronfman Department of Medicine, Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York 10029, USA. · Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan 20156, Italy. · Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York 10029, USA. · Functional Foods and Metabolic Stress Prevention Laboratory, Center for Food and Nutrition, Research Center on Agriculture and Economics, Rome 00178, Italy. · Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano (PN) 33081, Italy. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan 20133, Italy. ·Br J Cancer · Pubmed #27172251.

ABSTRACT: BACKGROUND: Pancreatic cancer is one of the leading causes of cancer mortality. Diet may be associated with pancreatic cancer, but it is unknown whether specific dietary components contribute to its risk. The potential differential role of dietary antioxidants warrants further investigation. METHODS: We analysed data from a case-control study of 326 pancreatic cancer cases and 652 controls conducted between 1991 and 2008 in Northern Italy. Subjects' usual diet was assessed through a validated and reproducible food frequency questionnaire. Using this information and an Italian food composition database, we calculated three indices of dietary total antioxidant capacity (TAC): Trolox equivalent antioxidant capacity (TEAC), total radical-trapping antioxidant parameter (TRAP) and ferric-reducing antioxidant power (FRAP). We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for pancreatic cancer using multiple logistic regression models conditioned on study centre, sex and age, and adjusted for major known pancreatic cancer risk factors. RESULTS: Significant inverse associations were found for the highest tertile of TAC compared with the lowest tertile for both TEAC and FRAP. The ORs were 0.61 (95% CI 0.39-0.94, P-value for trend 0.03) and 0.63 (95% CI 0.41-0.99, P-value for trend 0.05), respectively. Total radical-trapping antioxidant parameter was inversely, but not significantly, associated with pancreatic cancer risk, with an OR of 0.78 (95% CI 0.49-1.24, P-value for trend 0.27). CONCLUSIONS: Diet high in TAC, as measured by TEAC and FRAP, is inversely associated with pancreatic cancer risk.

24 Article Menstrual and Reproductive Factors, Hormone Use, and Risk of Pancreatic Cancer: Analysis From the International Pancreatic Cancer Case-Control Consortium (PanC4). 2016

Lujan-Barroso, Leila / Zhang, Wei / Olson, Sara H / Gao, Yu-Tang / Yu, Herbert / Baghurst, Peter A / Bracci, Paige M / Bueno-de-Mesquita, H Bas / Foretová, Lenka / Gallinger, Steven / Holcatova, Ivana / Janout, Vladimír / Ji, Bu-Tian / Kurtz, Robert C / La Vecchia, Carlo / Lagiou, Pagona / Li, Donghui / Miller, Anthony B / Serraino, Diego / Zatonski, Witold / Risch, Harvey A / Duell, Eric J. ·From the *Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; †Department of Epidemiology, Shanghai Cancer Institute and Jiao Tong University, Shanghai, China; ‡Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY; §Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI; ∥Public Health, Women's and Children's Hospital, Adelaide, SA, Australia; ¶University of California, San Francisco, San Francisco, CA; #National Institute for Public Health and the Environment (RIVM), Bilthoven; **Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands; ††Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; ‡‡Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; §§Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Institute and MF MU, Brno, Czech Republic; ∥∥University Health Network, Department of Surgery, University of Toronto, Toronto, Canada; ¶¶Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University in Prague, Prague; ##Department of Preventive Medicine, Faculty of Medicine, Palacky University, Olomouc, Czech Republic; ***National Cancer Institute, Bethesda, MD; †††Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; ‡‡‡Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; §§§Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece; ∥∥∥Department of Epidemiology, Harvard School of Public Health, Boston, MA; ¶¶¶M.D. Anderson Cancer Center, University of Texas, Houston, TX; ###Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; ****Unit of Epidemiology and Biostatistics, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy; ††††Cancer Center and Institute of Oncology, Warsaw, Poland; and ‡‡‡‡Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT. ·Pancreas · Pubmed #27088489.

ABSTRACT: OBJECTIVES: We aimed to evaluate the relation between menstrual and reproductive factors, exogenous hormones, and risk of pancreatic cancer (PC). METHODS: Eleven case-control studies within the International Pancreatic Cancer Case-control Consortium took part in the present study, including in total 2838 case and 4748 control women. Pooled estimates of odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using a 2-step logistic regression model and adjusting for relevant covariates. RESULTS: An inverse OR was observed in women who reported having had hysterectomy (ORyesvs.no, 0.78; 95% CI, 0.67-0.91), remaining significant in postmenopausal women and never-smoking women, adjusted for potential PC confounders. A mutually adjusted model with the joint effect for hormone replacement therapy (HRT) and hysterectomy showed significant inverse associations with PC in women who reported having had hysterectomy with HRT use (OR, 0.64; 95% CI, 0.48-0.84). CONCLUSIONS: Our large pooled analysis suggests that women who have had a hysterectomy may have reduced risk of PC. However, we cannot rule out that the reduced risk could be due to factors or indications for having had a hysterectomy. Further investigation of risk according to HRT use and reason for hysterectomy may be necessary.

25 Article Risk Factors for Early-Onset and Very-Early-Onset Pancreatic Adenocarcinoma: A Pancreatic Cancer Case-Control Consortium (PanC4) Analysis. 2016

McWilliams, Robert R / Maisonneuve, Patrick / Bamlet, William R / Petersen, Gloria M / Li, Donghui / Risch, Harvey A / Yu, Herbert / Fontham, Elizabeth T H / Luckett, Brian / Bosetti, Cristina / Negri, Eva / La Vecchia, Carlo / Talamini, Renato / Bueno de Mesquita, H Bas / Bracci, Paige / Gallinger, Steven / Neale, Rachel E / Lowenfels, Albert B. ·From the *Department of Oncology, Mayo Clinic, Rochester, MN; †Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy; ‡Division of Biostatistics, Mayo Clinic; §Department of Health Sciences Research, Mayo Clinic, Rochester, MN; ∥Department of Gastrointestinal Medical Oncology, UT MD Anderson Cancer Center, Houston, TX; ¶Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT; #Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI; **Louisiana State University School of Public Health, New Orleans, LA; ††Tulane School of Public Health, New Orleans, LA; ‡‡Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri," and §§Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; ∥∥S.O.C. Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy; ¶¶National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands; School of Public Health, Imperial College London, London, United Kingdom; ##Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; ***Division of General Surgery, University of Toronto, Toronto, Ontario, Canada; †††Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia; and ‡‡‡Department of Surgery, Department of Family Medicine, New York Medical College, Valhalla, NY. ·Pancreas · Pubmed #26646264.

ABSTRACT: OBJECTIVES: While pancreatic cancer (PC) most often affects older adults, to date, there has been no comprehensive assessment of risk factors among PC patients younger than 60 years. METHODS: We defined early-onset PC (EOPC) and very-early-onset PC (VEOPC) as diagnosis of PC in patients younger than 60 and 45 years, respectively. We pooled data from 8 case-control studies, including 1954 patients with EOPC and 3278 age- and sex-matched control subjects. Logistic regression analysis was performed to identify associations with EOPC and VEOPC. RESULTS: Family history of PC, diabetes mellitus, smoking, obesity, and pancreatitis were associated with EOPC. Alcohol use equal to or greater than 26 g daily also was associated with increased risk of EOPC (odds ratio, 1.49; 95% confidence interval, 1.21-1.84), and there appeared to be a dose- and age-dependent effect of alcohol on risk. The point estimate for risk of VEOPC was an odds ratio of 2.18 (95% confidence interval, 1.17-4.09). CONCLUSIONS: The established risk factors for PC, including smoking, diabetes, family history of PC, and obesity, also apply to EOPC. Alcohol intake appeared to have an age-dependent effect; the strongest association was with VEOPC.

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