Citrus intake and risk of skin cancer in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC) View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-07-24

AUTHORS

Yahya Mahamat-Saleh, Iris Cervenka, Marie Al-Rahmoun, Francesca R. Mancini, Gianluca Severi, Reza Ghiasvand, Marit B. Veierod, Saverio Caini, Domenico Palli, Edoardo Botteri, Carlotta Sacerdote, Fulvio Ricceri, Antonia Trichopoulou, Eleni Peppa, Carlo La Vecchia, Kim Overvad, Christina C. Dahm, Anja Olsen, Anne Tjønneland, Aurora Perez-Cornago, Paula Jakszyn, Sara Grioni, Matthias B. Schulze, Guri Skeie, Cristina Lasheras, Sandra Colorado-Yohar, Miguel Rodríguez-Barranco, Tilman Kühn, Verena A. Katzke, Pilar Amiano, Rosario Tumino, Salvatore Panico, Ana Ezponda, Emily Sonestedt, Augustin Scalbert, Elisabete Weiderpass, Marie-Christine Boutron-Ruault, Marina Kvaskoff

ABSTRACT

Citrus intake has been suggested to increase the risk of skin cancer. Although this relation is highly plausible biologically, epidemiologic evidence is lacking. We aimed to examine the potential association between citrus intake and skin cancer risk. EPIC is an ongoing multi-center prospective cohort initiated in 1992 and involving ~ 520,000 participants who have been followed-up in 23 centers from 10 European countries. Dietary data were collected at baseline using validated country-specific dietary questionnaires. We used Cox proportional hazards regression models to compute hazard ratios (HR) and 95% confidence intervals (CI). During a mean follow-up of 13.7 years, 8448 skin cancer cases were identified among 270,112 participants. We observed a positive linear dose–response relationship between total citrus intake and skin cancer risk (HR = 1.10, 95% CI 1.03–1.18 in the highest vs. lowest quartile; Ptrend = 0.001), particularly with basal cell carcinoma (BCC) (HR = 1.11, 95% CI 1.02–1.20, Ptrend = 0.007) and squamous cell carcinoma (SCC) (HR = 1.23, 95% CI 1.04–1.47, Ptrend = 0.01). Citrus fruit intake was positively associated with skin cancer risk (HR = 1.08, 95% CI 1.01–1.16, Ptrend = 0.01), particularly with melanoma (HR = 1.23, 95% CI 1.02–1.48; Ptrend = 0.01), although with no heterogeneity across skin cancer types (Phomogeneity = 0.21). Citrus juice was positively associated with skin cancer risk (Ptrend = 0.004), particularly with BCC (Ptrend = 0.008) and SCC (Ptrend = 0.004), but not with melanoma (Phomogeneity = 0.02). Our study suggests moderate positive linear dose–response relationships between citrus intake and skin cancer risk. Studies with available biomarker data and the ability to examine sun exposure behaviors are warranted to clarify these associations and examine the phototoxicity mechanisms of furocoumarin-rich foods. More... »

PAGES

1057-1067

References to SciGraph publications

Journal

TITLE

European Journal of Epidemiology

ISSUE

11

VOLUME

35

Author Affiliations

  • Inserm UMR1018, Gustave Roussy, 114 Rue Edouard Vaillant, F-94805, Villejuif, France
  • Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
  • Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research, Prevention and Clinical Network Institute (ISPRO), Florence, Italy
  • Norwegian National Advisory Unit for Women’s Health, Women’s Clinic, Oslo University Hospital, Oslo, Norway
  • Piedmont Reference Centre for Epidemiology and Cancer Prevention (CPO Piemonte), 10126, Turin, Italy
  • Epidemiology Unit, ASL TO3, Piedmont Region, 10095, Grugliasco, Italy
  • Hellenic Health Foundation, Athens, Greece
  • Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
  • Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
  • Department of Public Health, Aarhus University, Aarhus, Denmark
  • Danish Cancer Society Research Center, Copenhagen, Denmark
  • Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
  • Facultat de Ciències de la Salut Blanquerna, Universitat Ramón Llull, Barcelona, Spain
  • Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany
  • Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
  • Department of Functional Biology, University of Oviedo, Asturias, Spain
  • Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
  • Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Universidad de Granada, Granada, Spain
  • Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
  • Public Health Division of Gipuzkoa, BioDonostia Research Institue, Donostia-San Sebastian, Spain
  • Cancer Registry and Histopathology Department, Civic-M. P. Arezzo Hospital, ASP Ragusa, Ragusa, Italy
  • Dipartimento di Medicina Clinica e Sperimentale, Federico II University, Naples, Italy
  • Clínica Universidad de Navarra, Pamplona, Spain
  • Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
  • Biomarkers Group, International Agency for Research on Cancer, Lyon, France
  • International Agency for Research on Cancer, World Health Organization, Lyon, France
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s10654-020-00666-9

    DOI

    http://dx.doi.org/10.1007/s10654-020-00666-9

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1129639031

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32710289


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