Netherlands Cohort Study on diet and cancer NLCS

Transcription

1 Netherlands Cohort Study on diet and cancer NLCS Leo Schouten Matty Weijenberg Maastricht University GROW-School for Oncology and Developmental Biology Department of Epidemiology

2 Design PI s: Piet van den Brandt & Sandra Bausch- Goldbohm September ,852 men and women (55-69 years old) birth years municipalities Self-administered food frequency questionnaire on dietary habits (150 items) and other risk factors for cancer famine 2

3 years of follow-up Design of NLCS 250 stomach m + f 450 colon m + f Cohort: 58,279 m + 62,573 f x 300 rectum m + f 800 breast f 1200 lung m + f subcohort 3500 m + f x x x x x Relative and attributable risks intraindividual dietary variation 250 x = random sample 250 3

4 Follow-up Annual record-linkage cancer registry and pathology registry Biennial follow-up of subcohort Linkages to Central Bureau of Genealogy (1995 and 2000) New: Linkage to the Automated Municipal population registries GBA Linkage to causes of death registry (Statistics Netherlands) famine 4

5 Number of cases NLCS Cancer follow-up 16.3 years ( ) Subcohort ~5000 Stomach 830 Colorectal 3500 Lung 3200 Breast 2750 Ovary 420 Prostate 3400 Kidney 480 Other endpoints Barrett s oesophagus 1200 Causes of death ( ) Cancer 7700 Cardiovascular 6700 Respiratory 1050 famine 5

6 Our biobank famine 6

7 Collection of biosamples Toenails (~90,000) for selenium contents and DNA Buccal swabs in subcohort (~2,000) Tumor blocks: Colorectal cancer (~800 cases) Renal cell cancer (~235 cases) famine 7

8 Molecular studies Colorectal cancer: e.g. mutations in APC, K-Ras gene p53 expression methylation of promoter region of genes (e.g. CIMP markers) Renal cell cancer: mutations and methylation in VHL-gene famine 8

9 Current NLCS projects Molecular-epidemiological studies colorectal cancer Risk factors of oesophagus, stomach cancer and Barrett s oesophagus Risk factors of pancreatic cancer Dietary acrylamide and cancer risk Drinking Water and Health Funded by Netherlands Cancer Society, Netherlands Food Agency, NUTRIM, KIWA Research Institute for drinking water, and many others famine 9

10 Exposure measurement famine Three questions: employment status father during crisis Residence during the 2nd World War Residence during the Hunger Winter famine 10

11 Descriptive data (subcohort) Father work during crisis Females Males Yes % % No % % Residence during war Rural % % City % % Residence during hunger winter Non-West % % Country-side West % % City West % % famine 11

12 Breast Cancer (Cancer Causes Control 1999; 10: ) Father work during crisis Multivariable HRs and 95% CI Yes 1 Ref No Residence during war Rural 1 Ref City Residence during hunger winter Non-West 1 Ref Country-side West City West famine 12

13 Prostate Cancer (Am J Epidemiol 2001; 154: ) Father work during crisis Multivariable HRs and 95% CI Yes 1 Ref No Residence during war Rural 1 Ref City Residence during hunger winter Non-West 1 Ref Country-side West City West famine 13

14 Colon cancer (Cancer 2003; 97: 46-55) Father work during crisis Females Males Yes 1 Ref 1 Ref No Residence during war Rural 1 Ref 1 Ref City Residence during hunger winter Non-West 1 Ref 1 Ref Country-side West City West famine 14

15 Ovarian Cancer (manuscript submitted) Father work during crisis Multivariable HRs and 95% CI Yes 1 Ref No Residence during war Rural 1 Ref City Residence during hunger winter Non-West 1 Ref Country-side West City West famine 15

16 New project on energy restriction and colorectal cancer Body weight and height, weight change, energy restriction in childhood and physical activity as determinants of colorectal cancer: the role of (epi)genetic instability (World Cancer Research Fund) MP Weijenberg, GROW Epidemiology UM M van Engeland, GROW Pathology UM RA Goldbohm, TNO Leiden AFPM de Goeij, GROW Pathology UM A de Bruine, GROW Pathology UM PA van den Brandt, GROW Epidemiology UM famine 16

17 New project on energy restriction and colorectal cancer Hypothesis Proxy of exposure to growth factors at young age Energy restriction Height Weight at age 20 Weight change since age 20 (Epi)genetic phenotypes of CRC Mutations in genes Chromosomal inst. Microsatellite inst. CpG island methylator phenotype famine 17

18 Collaborators Maastricht University GROW School for Oncology and Developmental Biology Department of Epidemiology Piet van den Brandt Leo Schouten, Matty Weijenberg Bas Verhage, Andras Keszei Postdocs: Lina Leurs, Kim Smits PhD students: Stefan de Vogel, Janneke Hogervorst, Jessie Steevens, Mirjam Heinen, Laura Hughes TNO Quality of Life Sandra Bausch-Goldbohm famine 18