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

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  • Yahya Mahamat-Saleh, 1] Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France [2] Paris-Sud University, UMRS 1018, F-94805 Villejuif, France [3] Institut Gustave Roussy, F-94805 Villejuif, France., Frankrig
  • Iris Cervenka, 1] Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France [2] Paris-Sud University, UMRS 1018, F-94805 Villejuif, France [3] Institut Gustave Roussy, F-94805 Villejuif, France., Frankrig
  • Marie Al-Rahmoun, 1] Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France [2] Paris-Sud University, UMRS 1018, F-94805 Villejuif, France [3] Institut Gustave Roussy, F-94805 Villejuif, France., Frankrig
  • Francesca R Mancini, 1] Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France [2] Paris-Sud University, UMRS 1018, F-94805 Villejuif, France [3] Institut Gustave Roussy, F-94805 Villejuif, France., Frankrig
  • Gianluca Severi, 1] Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France [2] Paris-Sud University, UMRS 1018, F-94805 Villejuif, France [3] Institut Gustave Roussy, F-94805 Villejuif, France., Frankrig
  • Reza Ghiasvand, University of Oslo, Norge
  • Marit B Veierod, University of Oslo, Norge
  • Saverio Caini, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO., Italien
  • Domenico Palli, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO., Italien
  • Edoardo Botteri, University of Oslo, Norge
  • Carlotta Sacerdote, Piedmont Reference Centre for Epidemiology and Cancer Prevention (CPO Piemonte), Turin, Italien
  • Fulvio Ricceri, Epidemiology Unit, ASL TO3, Piedmont Region, Grugliasco, Italien
  • Antonia Trichopoulou, Hellenic Health Foundation, Athens, Greece., Grækenland
  • Eleni Peppa, Hellenic Health Foundation, Athens, Greece., Grækenland
  • Carlo La Vecchia, Hellenic Health Foundation, Athens, Greece., Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy., Grækenland
  • Kim Overvad
  • Christina C Dahm
  • Anja Olsen
  • Anne Tjønneland, Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen, Danmark
  • Aurora Perez-Cornago, Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, United Kingdom., Storbritannien
  • Paula Jakszyn, Medical Oncology, Catalan Institute of Oncology, IDIBELL., Facultat de Ciències de la Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain., Spanien
  • Sara Grioni, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Italien
  • Matthias B Schulze, German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany., Tyskland
  • Guri Skeie, University of Tromsø, Tromsø, Norge
  • Cristina Lasheras, Univ Oviedo, University of Oviedo, Spanien
  • Sandra Colorado-Yohar, University of Antioquia, Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain., CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Spanien
  • Miguel Rodríguez-Barranco, CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Andalusian School of Public Health (EASP), Granada, Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, 18014 Granada, Spain., Spanien
  • Tilman Kühn, German Cancer Research Center (DKFZ), Tyskland
  • Verena A Katzke, German Cancer Research Center (DKFZ), Tyskland
  • Pilar Amiano, Donostia Hospital, San Sebastián, Spain., CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Spanien
  • Rosario Tumino, Civic-M.P. Arezzo Hospital, Italien
  • Salvatore Panico, Dipartimento di Medicina Clinica e Sperimentale, Federico II University, Naples, Italy., Italien
  • Ana Ezponda, Clinica Universidad de Navarra, Pamplona, Spain., Spanien
  • Emily Sonestedt, Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, CRC, hus 60 plan 13 205 02 Malmö, Sweden., Sverige
  • Augustin Scalbert, Biomarkers Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008 Lyon, France., Frankrig
  • Elisabete Weiderpass, International Agency for Research on Cancer, World Health Organization, Lyon, Frankrig
  • Marie-Christine Boutron-Ruault, 1] Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France [2] Paris-Sud University, UMRS 1018, F-94805 Villejuif, France [3] Institut Gustave Roussy, F-94805 Villejuif, France., Frankrig
  • Marina Kvaskoff, 1] Inserm, Centre for research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health team, F-94805 Villejuif, France [2] Paris-Sud University, UMRS 1018, F-94805 Villejuif, France [3] Institut Gustave Roussy, F-94805 Villejuif, France., Frankrig

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.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Epidemiology
Vol/bind35
Nummer11
Sider (fra-til)1057-1067
Antal sider11
ISSN0393-2990
DOI
StatusUdgivet - nov. 2020

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