Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition
Christakoudi, Sofia; Kakourou, Artemisia; Markozannes, Georgios; Tzoulaki, Ioanna; Weiderpass, Elisabete; Brennan, Paul; Gunter, Marc; Dahm, Christina C; Overvad, Kim; Olsen, Anja; Tjønneland, Anne; Boutron-Ruault, Marie-Christine; Madika, Anne-Laure; Severi, Gianluca; Katzke, Verena; Kühn, Tilman; Bergmann, Manuela M; Boeing, Heiner; Karakatsani, Anna; Martimianaki, Georgia; Thriskos, Paschalis; Masala, Giovanna; Sieri, Sabina; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Agudo, Antonio; Redondo-Sánchez, Daniel; Colorado-Yohar, Sandra M; Mokoroa, Olatz; Melander, Olle; Stocks, Tanja; Häggström, Christel; Harlid, Sophia; Bueno-de-Mesquita, Bas; van Gils, Carla H; Vermeulen, Roel C H; Khaw, Kay-Tee; Wareham, Nicholas J; Tong, Tammy Y N; Freisling, Heinz; Johansson, Mattias; Lennon, Hannah; Aune, Dagfinn; Riboli, Elio; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Tsilidis, Konstantinos K
(2020) International Journal of Cancer, volume 146, issue 10, pp. 2680 - 2693
(Article)
Abstract
Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs)
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(95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08–1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14–1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07–1.26) (SBP), HR = 1.31 (1.13–1.51) (DBP), weaker for head and neck cancers: HR = 1.08 (1.04–1.12) (SBP), HR = 1.09 (1.01–1.17) (DBP) and, similarly, for skin SCC, colon cancer, postmenopausal breast cancer and uterine adenocarcinoma (AC), but not for esophageal AC, lung SCC, lung AC or uterine endometroid cancer. We observed weak inverse associations of SBP with cervical SCC: HR = 0.91 (0.82–1.00) and lymphomas: HR = 0.97 (0.93–1.00). There were no consistent associations with cancers in other locations. Our results are largely compatible with published studies and support weak associations of blood pressure with cancers in specific locations and morphologies.
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Keywords: association, cancer, cohort, epidemiology, Europe, hypertension, morphology, risk factors, Oncology, Cancer Research, Journal Article
ISSN: 0020-7136
Publisher: Wiley-Liss Inc.
Note: Funding Information: The coordination of European Prospective Investigation into Cancer and Nutrition (EPIC) is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer (France), Institut Gustave Roussy (France), Mutuelle G?n?rale de l'Education Nationale (France), Institut National de la Sant? et de la Recherche M?dicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF, Germany), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds (The Netherlands), Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (to EPIC Netherlands), Statistics Netherlands; ERC-2009-AdG 232997 to EPIC-Norway and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS, Spain), PI13/00061 to EPIC-Granada, PI13/01162 to EPIC-Murcia, Regional Governments of Andaluc?a, Asturias, Basque Country, Murcia, Navarra (Spain), and the Catalan Institute of Oncology (Barcelona) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Sk?ne and V?sterbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (UK) (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (United Kingdom). For information on how to submit an application for gaining access to EPIC data and/or biospecimens, please follow the instructions at http://epic.iarc.fr/access/index.php. K.K.T. was supported by the Hellenic Republic, General Secretary of Research and Technology, Aristeia II funding program for his work in this paper. Publisher Copyright: © 2019 UICC
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