TY - JOUR
TI - Dairy products and risk of hepatocellular carcinoma: The European
Prospective Investigation into Cancer and Nutrition
AU - Duarte-Salles, Talita
AU - Fedirko, Veronika
AU - Stepien, Magdalena and
AU - Trichopoulou, Antonia
AU - Bamia, Christina
AU - Lagiou, Pagona and
AU - Lukanova, Annekatrin
AU - Trepo, Elisabeth
AU - Overvad, Kim and
AU - Tjonneland, Anne
AU - Halkjaer, Jytte
AU - Boutron-Ruault, Marie-Christine
AU - and Racine, Antoine
AU - Cadeau, Claire
AU - Kuehn, Tilman and
AU - Aleksandrova, Krasimira
AU - Trichopoulos, Dimitrios
AU - Tsiotas,
AU - Konstantinos
AU - Boffetta, Paolo
AU - Palli, Domenico
AU - Pala, Valeria
AU - and Tumino, Rosario
AU - Sacerdote, Carlotta
AU - Panico, Salvatore and
AU - Bueno-de-Mesquita, H. B(as)
AU - Dik, Vincent K.
AU - Peeters, Petra H.
AU - and Weiderpass, Elisabete
AU - Gram, Inger Torhild
AU - Hjartaker, Anette
AU - and Ramon Quiros, Jose
AU - Fonseca-Nunes, Ana
AU - Molina-Montes, Esther
AU - and Dorronsoro, Miren
AU - Navarro Sanchez, Carmen
AU - Barricarte,
AU - Aurelio
AU - Lindkvist, Bjorn
AU - Sonestedt, Emily
AU - Johansson,
AU - Ingegerd
AU - Wennberg, Maria
AU - Khaw, Kay-Tee
AU - Wareham, Nick and
AU - Travis, Ruth C.
AU - Romieu, Isabelle
AU - Riboli, Elio
AU - Jenab, Mazda
JO - International Journal  of Cancer
PY - 2014
VL - 135
TODO - 7
SP - 1662-1672
PB - Wiley
SN - 0020-7136
TODO - 10.1002/ijc.28812
TODO - hepatocellular carcinoma; dairy products; calcium; prospective cohort
TODO - Intake of dairy products has been associated with risk of some cancers,
but findings are often inconsistent and information on hepatocellular
carcinoma (HCC) risk is limited, particularly from prospective settings.
The aim of our study was to investigate the association between
consumption of total and specific dairy products (milk/cheese/ yogurt)
and their components (calcium/vitamin D/fats/protein), with first
incident HCC (N-cases=191) in the European Prospective Investigation
into Cancer and Nutrition cohort, including a nested case-control subset
(N-cases=122) with the assessment of hepatitis B virus/hepatitis C virus
infections status, liver damage and circulating insulin-like growth
factor (IGF)-I levels. For cohort analyses, multivariable-adjusted Cox
proportional hazard models were used to estimate hazard ratios (HRs) and
95% confidence intervals (95% CI). For nested case-control analyses,
conditional logistic regression was used to calculate odds ratios and
95% CI. A total of 477,206 participants were followed-up for an average
of 11 years (person-years follow-up=5,415,385). In the cohort study, a
significant positive HCC risk association was observed for total dairy
products (highest vs. lowest tertile, HR=1.66, 95% CI: 1.13-2.43;
p(trend)=0.012), milk (HR=1.51, 95% CI: 1.02-2.24; p(trend=)0.049), and
cheese (HR=1.56, 95% CI: 1.02-2.38; p(trend)=0.101), but not yogurt
(HR=0.94, 95% CI: 0.65-1.35). Dietary calcium, vitamin D, fat and
protein from dairy sources were associated with increased HCC risk,
whereas the same nutrients from nondairy sources showed inverse or null
associations. In the nested case-control study, similar results were
observed among hepatitis-free individuals. Results from this large
prospective cohort study suggest that higher consumption of dairy
products, particularly milk and cheese, may be associated with increased
HCC risk. Validation of these findings in other populations is
necessary. Potential biologic mechanisms require further exploration.
What’s new?
Currently, the role of dairy product intake in the development of
hepatocellular carcinoma (HCC) is unclear. Using detailed data from a
large multi-centric prospective cohort, this study investigated the
association between consumption of total and specific dairy products
with first incident HCC. The study found that higher dairy product
consumption, particularly milk and cheese, was associated with increased
HCC risk. Dietary calcium, vitamin D, fat and protein did not explain
the observed associations. However, higher circulating IGF-I levels may
play a role.
ER -