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  • 1. Ferro, Ana
    et al.
    Morais, Samantha
    Rota, Matteo
    Pelucchi, Claudio
    Bertuccio, Paola
    Bonzi, Rossella
    Galeone, Carlotta
    Zhang, Zuo-Feng
    Matsuo, Keitaro
    Ito, Hidemi
    Hu, Jinfu
    Johnson, Kenneth C
    Yu, Guo-Pei
    Palli, Domenico
    Ferraroni, Monica
    Muscat, Joshua
    Malekzadeh, Reza
    Ye, Weimin
    Song, Huan
    Zaridze, David
    Maximovitch, Dmitry
    Aragonés, Nuria
    Castaño-Vinyals, Gemma
    Vioque, Jesus
    Navarrete-Muñoz, Eva M
    Pakseresht, Mohammadreza
    Pourfarzi, Farhad
    Wolk, Alicja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Orsini, Nicola
    Bellavia, Andrea
    Håkansson, Niclas
    Mu, Lina
    Pastorino, Roberta
    Kurtz, Robert C
    Derakhshan, Mohammad H
    Lagiou, Areti
    Lagiou, Pagona
    Boffetta, Paolo
    Boccia, Stefania
    Negri, Eva
    La Vecchia, Carlo
    Peleteiro, Bárbara
    Lunet, Nuno
    Tobacco smoking and gastric cancer:: meta-analyses of published data versus pooled analyses of individual participant data (StoP Project).2018In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 27, no 3, p. 197-204Article in journal (Refereed)
    Abstract [en]

    Tobacco smoking is one of the main risk factors for gastric cancer, but the magnitude of the association estimated by conventional systematic reviews and meta-analyses might be inaccurate, due to heterogeneous reporting of data and publication bias. We aimed to quantify the combined impact of publication-related biases, and heterogeneity in data analysis or presentation, in the summary estimates obtained from conventional meta-analyses. We compared results from individual participant data pooled-analyses, including the studies in the Stomach Cancer Pooling (StoP) Project, with conventional meta-analyses carried out using only data available in previously published reports from the same studies. From the 23 studies in the StoP Project, 20 had published reports with information on smoking and gastric cancer, but only six had specific data for gastric cardia cancer and seven had data on the daily number of cigarettes smoked. Compared to the results obtained with the StoP database, conventional meta-analyses overvalued the relation between ever smoking (summary odds ratios ranging from 7% higher for all studies to 22% higher for the risk of gastric cardia cancer) and yielded less precise summary estimates (SE ≤2.4 times higher). Additionally, funnel plot asymmetry and corresponding hypotheses tests were suggestive of publication bias. Conventional meta-analyses and individual participant data pooled-analyses reached similar conclusions on the direction of the association between smoking and gastric cancer. However, published data tended to overestimate the magnitude of the effects, possibly due to publication biases and limited the analyses by different levels of exposure or cancer subtypes.

  • 2.
    Hernes, Eivor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Johansson, Lars Age
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Fosså, SD
    Pedersen, Anne Gro
    Glattre, E
    High prostate cancer mortality in Norway evaluated by automated classification of medical entities2008In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. Aug, no 4, p. 331-335Article in journal (Refereed)
  • 3. Hernes, Eivor
    et al.
    Johansson, Lars Age
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Fosså, Sophie D.
    Pedersen, Anne G.
    Glattre, Eystein
    High prostate cancer mortality in Norway evaluated by automated classification of medical entities.2008In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 17, no 4, p. 331-335Article in journal (Refereed)
    Abstract [en]

    The new standard of cause of death classification is an automated selection of the underlying cause of death using the international software Automated Classification of Medical Entities (ACME). Norwegian mortality rates are, however, based on manual classification of deaths. The aim of this study was to investigate how the use of ACME would influence Norwegian prostate cancer mortality rates. A previously described cohort of Norwegian prostate cancer patients deceased during 1996 was applied. Multiple causes of death data based on information from death certificates, autopsies and queries was coded according to ACME specifications, thereby ACME selected the underlying cause of death. In addition, the underlying cause of death that originally was manually classified for the official mortality statistics was retrieved from Statistics Norway in all cases. Age-standardized prostate cancer mortality rates (world population) per 100,000 person-years were calculated. A total of 2012 cases were included. On the basis of ACME classification, the age-standardized prostate cancer mortality rate in Norway for 1996 would have been 24.4 (95% confidence interval: 22.9-26.0) as compared with the rate based on manual classification for the official mortality statistics of 24.9 (95% confidence interval: 23.4-26.5). Thus, automated classification by ACME does not significantly influence the age-adjusted Norwegian prostate cancer mortality rate for the year 1996. There is reason to assume that the use of manual classification of deaths is not a major explanation of the high prostate cancer mortality rates in Norway.

  • 4.
    Papadopoulos, Fotios C.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Pantziaras, Ioannis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Lagiou, P
    Brandt, L
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Ekbom, Anders
    Age at onset of anorexia nervosa and breast cancer risk2009In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 18, no 3, p. 207-211Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate breast cancer occurrence among women treated for anorexia nervosa (AN), with emphasis on age at the onset of this disorder. We conducted a register-based retrospective cohort with a total of 6009 women with at least one admission with an AN diagnosis (luring the period 1973-2003 in Sweden. During a mean follow-up of 13.4 years, information on 80057 women-years was generated. The standardized incidence ratio (SIR) - the ratio of observed-to-expected number of cases - was used as the measure of relative risk. Overall, 16 women developed breast cancer versus 25.5  expected cases [SIR: 0.6, 95% confidence interval (CI): 0.4-0.9]. Among women who were first admitted for AN between the age of 10 and 24 years, four developed breast cancer versus 11.3 expected (SIR: 0.4, 95%  CI: 0.1-0.9). In this group of women with early onset AN, only one parous woman developed breast cancer versus 6.3 expected (SIR: 0.2,95%   CI: 0-0.9). Among women first hospitalized for AN between the age of 25 and 40 years, 12 developed breast cancer, whereas the expected number was 14.2, a nonsignificant deficit Our results suggest that early onset AN may play an important role in the development of breast cancer, possibly because of the extreme restriction of energy intake at a crucial period for mammary gland development. Late onset AN is likely to play a relatively less important role.

  • 5.
    Pelucchi, Claudio
    et al.
    IRCCS Ist Ric Farmacol Mario Negri, Dept Epidemiol, I-20156 Milan, Italy..
    Lunet, Nuno
    Univ Porto ISPUP, Inst Publ Hlth, Oporto, Portugal.;Univ Porto, Sch Med, Dept Clin Epidemiol Predict Med & Publ Hlth, P-4100 Oporto, Portugal..
    Boccia, Stefania
    Univ Cattolica Sacro Cuore, Inst Publ Hlth, Sect Hyg, Rome, Italy.;IRCCS San Raffaele Pisana, Rome, Italy..
    Zhang, Zuo-Feng
    Univ Calif Los Angeles, Dept Epidemiol, Fielding Sch Publ Hlth, Los Angeles, CA USA.;Jonsson Comprehens Canc Ctr, Los Angeles, CA 90034 USA..
    Praud, Delphine
    IRCCS Ist Ric Farmacol Mario Negri, Dept Epidemiol, I-20156 Milan, Italy.;Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy..
    Boffetta, Paolo
    Mt Sinai Sch Med, Tisch Canc Inst, New York, NY USA.;Mt Sinai Sch Med, Inst Translat Epidemiol, New York, NY USA..
    Levi, Fabio
    Univ Lausanne Hosp, Inst Social & Prevent Med IUMSP, Canc Epidemiol Unit, Lausanne, Switzerland..
    Matsuo, Keitaro
    Kyushu Univ, Fac Med Sci, Dept Prevent Med, Fukuoka 812, Japan..
    Ito, Hidemi
    Aichi Canc Ctr Res Inst, Div Epidemiol & Prevent, Nagoya, Aichi, Japan..
    Hu, Jinfu
    Publ Hlth Agcy Canada, Social Determinants & Sci Integrat Directorate, Sci Integrat Div, Calgary, AB, Canada..
    Johnson, Kenneth C.
    Univ Ottawa, Dept Epidemiol & Community Hlth, Ottawa, ON, Canada..
    Ferraroni, Monica
    Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy..
    Yu, Guo-Pei
    Peking Univ, Med Informat Ctr, Beijing, Peoples R China..
    Peleteiro, Barbara
    Univ Porto ISPUP, Inst Publ Hlth, Oporto, Portugal.;Univ Porto, Sch Med, Dept Clin Epidemiol Predict Med & Publ Hlth, P-4100 Oporto, Portugal..
    Malekzadeh, Reza
    Univ Tehran Med Sci, Digest Dis Res Inst, Digest Oncol Res Ctr, Tehran, Iran..
    Derakhshan, Mohammad H.
    Univ Tehran Med Sci, Digest Dis Res Inst, Digest Oncol Res Ctr, Tehran, Iran.;Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland..
    Ye, Weimin
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Zaridze, David
    Russian NN Blokhin Canc Res Ctr, Dept Epidemiol & Prevent, Moscow, Russia..
    Maximovitch, Dmitry
    Russian NN Blokhin Canc Res Ctr, Dept Epidemiol & Prevent, Moscow, Russia..
    Aragones, Nuria
    Inst Salud Carlos III, Natl Ctr Epidemiol, Environm & Canc Epidemiol Unit, Madrid, Spain.;CIBERESP, Madrid, Spain.;IIS Puerta Hierro, Majadahonda, Spain..
    Martin, Vicente
    CIBERESP, Madrid, Spain.;Univ Leon, E-24071 Leon, Spain..
    Pakseresht, Mohammadreza
    Univ Alberta, Dept Med, Aboriginal & Global Hlth Res Grp, Edmonton, AB, Canada.;Univ Tehran Med Sci, Digest Dis Res Inst, Digest Oncol Res Ctr, Tehran, Iran..
    Pourfarzi, Farhad
    Univ Tehran Med Sci, Digest Dis Res Inst, Digest Oncol Res Ctr, Tehran, Iran.;Ardabil Univ Med Sci, Dept Community Med, Ardebil, Iran..
    Bellavia, Andrea
    Karolinska Inst, Inst Environm Med, Unit Nutr Epidemiol, S-10401 Stockholm, Sweden..
    Orsini, Nicola
    Karolinska Inst, Inst Environm Med, Unit Nutr Epidemiol, S-10401 Stockholm, Sweden..
    Wolk, Alicja
    Karolinska Inst, Inst Environm Med, Unit Nutr Epidemiol, S-10401 Stockholm, Sweden..
    Mu, Lina
    SUNY Buffalo, Sch Publ Hlth & Hlth Profess, Dept Social & Prevent Med, Buffalo, NY 14260 USA..
    Arzani, Dario
    Univ Cattolica Sacro Cuore, Inst Publ Hlth, Sect Hyg, Rome, Italy..
    Kurtz, Robert C.
    Mem Sloan Kettering Canc Ctr, Rockville Ctr, New York, NY 10065 USA..
    Lagiou, Pagona
    Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, GR-11527 Athens, Greece.;Acad Athens, Bur Epidemiol Res, Athens, Greece..
    Trichopoulos, Dimitrios
    Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA.;Acad Athens, Bur Epidemiol Res, Athens, Greece..
    Muscat, Joshua
    Penn State Coll Med, Hershey, PA USA..
    La Vecchia, Carlo
    IRCCS Ist Ric Farmacol Mario Negri, Dept Epidemiol, I-20156 Milan, Italy.;Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy..
    Negri, Eva
    IRCCS Ist Ric Farmacol Mario Negri, Dept Epidemiol, I-20156 Milan, Italy..
    The stomach cancer pooling (StoP) project: study design and presentation2015In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 24, no 1, p. 16-23Article in journal (Refereed)
    Abstract [en]

    Gastric cancer affects about one million people per year worldwide, being the second leading cause of cancer mortality. The study of its etiology remains therefore a global issue as it may allow the identification of major targets, besides eradication of Helicobacter pylori infection, for primary prevention. It has however received little attention, given its comparatively low incidence in most high-income countries. We introduce a consortium of epidemiological investigations named the Stomach cancer Pooling (StoP) Project'. Twenty-two studies agreed to participate, for a total of over 9000 cases and 23 000 controls. Twenty studies have already shared the original data set. Of the patients, 40% are from Asia, 43% from Europe, and 17% from North America; 34% are women and 66% men; the median age is 61 years; 56% are from population-based case-control studies, 41% from hospital-based ones, and 3% from nested case-control studies derived from cohort investigations. Biological samples are available from 12 studies. The aim of the StoP Project is to analyze the role of lifestyle and genetic determinants in the etiology of gastric cancer through pooled analyses of individual-level data. The uniquely large data set will allow us to define and quantify the main effects of each risk factor of interest, including a number of infrequent habits, and to adequately address associations in subgroups of the population, as well as interaction within and between environmental and genetic factors. Further, we will carry out separate analyses according to different histotypes and subsites of gastric cancer, to identify potential different risk patterns and etiological characteristics. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

  • 6.
    Petridou, Eleni Th
    et al.
    Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
    Sergentanis, Theodoros N
    Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
    Skalkidou, Alkistis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Antonopoulos, Constantine N
    Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
    Dessypris, Nick
    Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
    Svensson, Tobias
    Unit of Clinical Epidemiology, Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet, Solna, Sweden.
    Stephansson, Olof
    Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Solna, Sweden.
    Kieler, Helle
    Unit of Clinical Epidemiology, Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet, Solna, Sweden.
    Smedby, Karin E
    Unit of Clinical Epidemiology, Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institutet, Solna, Sweden.
    Maternal and birth anthropometric characteristics in relation to the risk of childhood lymphomas: a Swedish nationwide cohort study2015In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 24, no 6, p. 535-541Article in journal (Refereed)
    Abstract [en]

    This Swedish nationwide cohort study aims to examine the role of maternal characteristics (maternal age, education, smoking, BMI, diabetes, and preeclampsia) and multiple intrauterine growth measures on the risk of childhood lymphomas. A total of 3 444 136 singleton live births registered in the Swedish Medical Birth Register were analyzed, among whom there were 515 incident non-Hodgkin lymphoma (NHL) cases and 169 Hodgkin lymphoma (HL) cases aged 0-14 years at diagnosis (1973-2007) identified through linkage with the Swedish Cancer Register. Proportional hazards models were used to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) of NHL and HL. Male sex (HR=2.00, 95% CI: 1.66-2.41), older maternal age (HR=1.03, 95% CI: 1.00-1.06, per 1-year increase), and large for gestational age compared with appropriate for gestational age (AGA) birth weight (HR=1.83, 95% CI: 1.20-2.79) were correlated with the risk of NHL; of note, in subanalysis by sex, the latter association was confined to girls (HR=3.37, 95% CI: 1.90-5.97, Pinteraction by sex=0.008). The risk of childhood HL overall was more evident among boys (HR=2.03, 95% CI: 1.46-2.81), whereas indices of accelerated fetal growth were not convincingly associated with the risk of HL. Apart from the established association with sex, the findings point to accelerated intrauterine growth as a risk factor for childhood NHL that may differ by sex. Given the rarity of this condition at birth, however, further studies with more elaborate indices are needed to conclude on its association with rare diseases such as HL.

  • 7. Praud, Delphine
    et al.
    Rota, Matteo
    Pelucchi, Claudio
    Bertuccio, Paola
    Rosso, Tiziana
    Galeone, Carlotta
    Zhang, Zuo-Feng
    Matsuo, Keitaro
    Ito, Hidemi
    Hu, Jinfu
    Johnson, Kenneth C
    Yu, Guo-Pei
    Palli, Domenico
    Ferraroni, Monica
    Muscat, Joshua
    Lunet, Nuno
    Peleteiro, Bárbara
    Malekzadeh, Reza
    Ye, Weimin
    Song, Huan
    Zaridze, David
    Maximovitch, Dmitry
    Aragonés, Nuria
    Castaño-Vinyals, Gemma
    Vioque, Jesus
    Navarrete-Muñoz, Eva M
    Pakseresht, Mohammadreza
    Pourfarzi, Farhad
    Wolk, Alicja
    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Orsini, Nicola
    Bellavia, Andrea
    Håkansson, Niclas
    Mu, Lina
    Pastorino, Roberta
    Kurtz, Robert C
    Derakhshan, Mohammad H
    Lagiou, Areti
    Lagiou, Pagona
    Boffetta, Paolo
    Boccia, Stefania
    Negri, Eva
    La Vecchia, Carlo
    Cigarette smoking and gastric cancer in the Stomach Cancer Pooling (StoP) Project.2018In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 27, no 2, p. 124-133Article in journal (Refereed)
    Abstract [en]

    Tobacco smoking is a known cause of gastric cancer, but several aspects of the association remain imprecisely quantified. We examined the relation between cigarette smoking and the risk of gastric cancer using a uniquely large dataset of 23 epidemiological studies within the 'Stomach cancer Pooling (StoP) Project', including 10 290 cases and 26 145 controls. We estimated summary odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) by pooling study-specific ORs using random-effects models. Compared with never smokers, the ORs were 1.20 (95% CI: 1.09-1.32) for ever, 1.12 (95% CI: 0.99-1.27) for former, and 1.25 (95% CI: 1.11-1.40) for current cigarette smokers. Among current smokers, the risk increased with number of cigarettes per day to reach an OR of 1.32 (95% CI: 1.10-1.58) for smokers of more than 20 cigarettes per day. The risk increased with duration of smoking, to reach an OR of 1.33 (95% CI: 1.14-1.54) for more than 40 years of smoking and decreased with increasing time since stopping cigarette smoking (P for trend<0.01) and became similar to that of never smokers 10 years after stopping. Risks were somewhat higher for cardia than noncardia gastric cancer. Risks were similar when considering only studies with information on Helicobacter pylori infection and comparing all cases to H. pylori+ controls only. This study provides the most precise estimate of the detrimental effect of cigarette smoking on the risk of gastric cancer on the basis of individual data, including the relationship with dose and duration, and the decrease in risk following stopping smoking.

  • 8.
    Thomopoulos, Thomas P
    et al.
    Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine.
    Skalkidou, Alkistis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Dessypris, Nick
    Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine.
    Chrousos, George
    First Department of Pediatrics, ‘Aghia Sophia’ Children’s Hospital, School of Medicine, University of Athens.
    Karalexi, Maria A
    Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine.
    Karavasilis, Theodoros G
    Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine.
    Baka, Margarita
    Department of Pediatric HematologyOncology, ‘Pan. & Agl. Kyriakou’ Children’s Hospital.
    Hatzipantelis, Emmanuel
    Second Department of Pediatrics, AHEPA General Hospital, Aristotelion University of Thessalonik.
    Kourti, Maria
    Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessalonik.
    Polychronopoulou, Sophia
    Department of Pediatric Haematology-Oncology, ‘Aghia Sophia’ Children’s Hospital.
    Sidi, Vasiliki
    Department of Pediatric Hematology and Oncology, Hippokration Hospital, Thessaloniki.
    Stiakaki, Eftichia
    Department of Pediatric HematologyOncology, University Hospital of Heraklion, Greece.
    Moschovi, Maria
    HaematologyOncology Unit, First Department of Pediatrics, Athens University Medical School, ‘Aghia Sophia’ Children’s Hospital.
    Loutradis, Dimitrios
    First Department of Obstetrics and Gynecology, ‘Alexandra’ Hospital, School of Medicine, University of Athens.
    Petridou, Eleni Th
    Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine.
    Prelabor cesarean delivery and early-onset acute childhood leukemia risk.2016In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 25, no 2, p. 155-161Article in journal (Refereed)
    Abstract [en]

    The long-term impact of cesarean delivery (CD) on the health of the offspring is being explored methodically. We sought to investigate the effect of birth by (a) prelabor and (b) during-labor CD on the risk of early-onset (≤3 years) acute lymphoblastic leukemia (ALL), specifically of its prevailing precursor B (B-ALL) subtype. A total of 1099 incident cases of ALL (957 B-ALL), 131 of acute myeloid leukemia (AML), and their 1 : 1 age-matched and sex-matched controls, derived from the Nationwide Registry for Childhood Hematological Malignancies (1996-2013), were analyzed using multivariate regression models. A null association was found between prelabor and/or during labor CD and either ALL (B-ALL) or AML in the 0-14 age range. By contrast, birth by CD increased significantly the risk of early-onset ALL [odds ratioCD (ORCD)=1.57, 95% confidence interval (CI): 1.10-2.24] mainly on account of prelabor CD (ORprelaborCD=1.66, 95% CI: 1.13-2.43). The respective figures were even higher for the early-onset precursor B-ALL (ORCD=1.66, 95% CI: 1.15-2.40 and ORprelaborCD=1.79, 95% CI: 1.21-2.66), whereas no association emerged for early-onset AML. Prelabor CD, which deprives exposure of the fetus/infant to the presumably beneficial effect of stress hormones released in both vaginal labor and during labor CD, was associated exclusively with an increased risk of early-onset ALL, particularly the precursor B-ALL subtype. If confirmed, these adverse long-term outcomes of CD may point to re-evaluation of prelabor CD practices and prompt scientific discussion on the best ways to simulate the effects of vaginal delivery, such as a precesarean induction of labor.

  • 9.
    Thurfjell, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Hsieh, C.C.
    Lipworth, L.
    Ekbom, A.
    Adami, Hans-Olov
    Trichopoulos, D.
    Breast size and mammographic pattern in relation to breast cancer risk1996In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 5, no 1, p. 37-41Article in journal (Refereed)
    Abstract [en]

    The relation of Wolfe's parenchymal patterns and radiographically-assessed breast size with breast cancer risk was evaluated in a population-based nested case-control study in Uppsala, Sweden. All women who attended a mammographic screening programme in Uppsala county starting in 1988 have been followed for the occurrence of breast cancer through 1993. The analysis was based on 295 cases and 589 age-matched controls, whose mammograms were blindly evaluated for parenchymal pattern and breast size. Women with P2 or DY pattern had a significantly elevated risk of breast cancer compared with women with N1 or P1 (OR = 2.09; 95% CI = 1.52-2.86). There was an inverse association of breast size with breast cancer risk, which disappeared after adjusting for parenchymal pattern, because breasts of smaller size tended to have high-risk parenchymal patterns. It is concluded that in Swedish women, and perhaps in Caucasian women in general, small breast size is associated with increasing breast risk through its association with high-risk parenchymal pattern. This is in contrast to the fact that Asian women, who in general have breasts of smaller size, have low prevalence of high-risk parenchymal pattern as well as low rates of breast cancer.

  • 10. Wuu, J.
    et al.
    Hellerstein, S.
    Lipworth, L.
    Wide, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Xu, B.
    Yu, G-P.
    Kuper, H.
    Lagiou, P.
    Hankinson, S.E.
    Ekbom, A.
    Carlström, K.
    Trichopoulos, D.
    Adami, Hans-Olov
    Hsieh, C-C.
    Correlates of pregnancy oestrogen, progesterone and sex hormone-binding globulin in the USA and China2002In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 11, no 3, p. 283-293Article in journal (Refereed)
    Abstract [en]

    The objective of this study is to examine perinatal correlates of oestradiol (E2), oestriol (E3), progesterone and sex hormone-binding globulin (SHBG) among pregnant women in the USA and China. Three hundred and four Caucasian women in Boston and 335 Chinese women in Shanghai were studied. Levels of E2, E3, progesterone and SHBG were measured in maternal blood at weeks 16 and 27 of gestation, and correlated with maternal, gestational and perinatal characteristics. Height, weight and body mass index (BMI) before pregnancy is inversely associated with E2 and SHBG, whereas E3 is inversely associated with height and progesterone is inversely associated with weight and BMI. A previous live birth is associated with lower E2 and SHBG in the index pregnancy. Total gestation duration is inversely associated with E2, E3 and progesterone, whereas weight gain during pregnancy is inversely associated with progesterone and SHBG. In the US, pregnancies with female fetuses are characterized by significantly reduced progesterone. Pregnancy hormones are associated with several maternal, gestational and neonatal characteristics.

  • 11. Xu, B.
    et al.
    Lipworth, L.
    Wide, Leif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Wuu, J.
    Yu, S.Z.
    Lagiou, P.
    Kuper, H.
    Hankinson, S.E.
    Carlström, K.
    Adami, Hans-Olov
    Trichopoulos, D.
    Hsieh, C.C.
    Maternal and gestational correlates of pregnancy prolactin and growth hormone in USA and China2003In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 12, no 1, p. 35-42Article in journal (Refereed)
    Abstract [en]

    The objective of this study is to determine correlates of prolactin and growth hormone levels among pregnant women in the USA and China. We studied 304 pregnant Caucasian and 335 pregnant Chinese women. Levels of prolactin and growth hormone were measured at weeks 16 and 27 of gestation, and correlated with maternal, gestational and perinatal characteristics. Both growth hormone and, to a lesser extent, prolactin were inversely associated with pregnancy weight and body mass index, history of a previous live birth and newborn size, whereas educated women had higher levels of both hormones. Growth hormone levels were lower in women who gained more weight, smoked and had nausea and vomiting during pregnancy, whereas prolactin increased with longer total gestation. We found robust associations between maternal and newborn characteristics on the one hand and prolactin and growth hormone during pregnancy on the other.

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