Endogenous versus exogenous exposure to N-nitroso compounds and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study.
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Del Giudice, Giuseppe
Sanchez, María José
Chirlaque, María Dolores
Quirós, José R.
Key, Timothy J.
Bueno-de-Mesquita, H. Bas
Ocké, Marga O.
Peeters, Petra Hm
Numans, Mattijs E.
Gonzalez, Carlos A.
MetadataShow full item record
AbstractThe risk of gastric cancer (GC) associated with dietary intake of nitrosodimethylamine (NDMA) and endogenous formation of nitroso compounds (NOCs) was investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC). The study included 521,457 individuals and 314 incident cases of GC that had occurred after 6.6 average years of follow-up. An index of endogenous NOC (ENOC) formation was estimated using data of the iron content from meat intake and faecal apparent total NOC formation according to previous published studies. Antibodies to Helicobacter pylori and vitamin C levels were measured in a sub-sample of cases and matched controls included in a nested case-control within the cohort. Exposure to NDMA was < 1 microg on average compared with 93 mug on average from ENOC. There was no association between NDMA intake and GC risk (HR, 1.00; 95% CI, 0.7-1.43). ENOC was significantly associated with non-cardia cancer risk (HR, 1.42; 95% CI, 1.14-1.78 for an increase of 40 microg/day) but not with cardia cancer (HR, 0.96; 95% CI, 0.69-1.33). Although the number of not infected cases is low, our data suggest a possible interaction between ENOC and H.pylori infection (P for interaction = 0.09). Moreover, we observed an interaction between plasma vitamin C and ENOC (P < 0.02). ENOC formation may account for our previously reported association between red and processed meat consumption and gastric cancer risk.
CitationCarcinogenesis 2006, 27 (7):1497-1501
DescriptionCancer epidemiologyCancer type:Gastric cancerStudy design:EPIC cohort study and nested case-control studyStudy size:521 457 subjects (368 010 women and 153 447 men) for the cohort and 314 adenocarcinoma cases for the case-control studyDescription of cohort(s) studied:subjets collected from 10 European countries, aged 35-70 years, and recruited mostly between 1992 and 1998Exposure(s) evaluated:dietary intake of nitrosodimethylamine (NDMA) and meat and faecal ATNC formationConfounders controlled for:plasma vitamin C and H.pylori infectionImpact on risk: NDMA dietary intake HR, 1.00; 95% CI, 0.70-1.43 for an increment of 1 mg of NDMA. ENOC (HR, 1.18; 95% CI, 0.99-1.39 for an increment of 40 mg of EN). ENOC and vit. C intake (OR, 3.24; 95% CI, 1.77-5.93 for those with less than 40 micromol/l of plasma vitamin C)Notes:non-cardia GC was positively associated with ENOC exposure but not with dietary NDMADietary modulation of cancer & cancer biomarkers Dietary item or component studied:NDMAOutcome studied (cancer or cancer biomarker):gastric cancerStudy type (in vitro, animals, humans): humansStudy design (if human):prospective, nested case-controlStudy size (if human):521 457 subjects (368 010 women and 153 447 men) for the cohort and 314 adenocarcinoma cases for the case-control studyTissue/biological material/sample size:plasma for the nested study, faeces for the cohortMode of exposure (if in vivo):red meat consumption. Keywords classification: adverse effects;Adenocarcinoma;Animals;Antibodies;Ascorbic Acid;blood;cancer epidemiology;Case-Control Studies;Cattle;Diet;dietary modulation of cancer & cancer biomarkers;Dimethylnitrosamine;epidemiology;etiology;Europe;Female;Helicobacter Infections;Helicobacter pylori;Humans;Iron;lifestyle modulation of cancer & cancer biomarkers;metabolism;Male;Meat;Middle Aged;Nitrosamines;pharmacology;Prospective Studies;Research;Risk Factors;Spain;Stomach Neoplasms;analysis;
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