Περίληψη:
Published associations between dietary folate and bladder cancer risk
are inconsistent. Biomarkers may provide more accurate measures of
nutrient status. This nested case-control analysis within the European
Prospective Investigation into Cancer and Nutrition (EPIC) investigated
associations between pre-diagnostic serum folate, homocysteine, vitamins
B6 and B12 and the risk of urothelial cell carcinomas of the bladder
(UCC). A total of 824 patients with newly diagnosed UCC were matched
with 824 cohort members. Serum folate, homocysteine, and vitamins B6 and
B12 were measured. Odds ratios (OR) and 95% confidence intervals (CI)
for total, aggressive, and non-aggressive UCC were estimated using
conditional logistic regression with adjustment for smoking status,
smoking duration and intensity, and other potential confounders.
Additionally, statistical interaction with smoking status was assessed.
A halving in serum folate concentrations was moderately associated with
risk of UCC (OR: 1.18; 95% CI: 0.98-1.43), in particular aggressive UCC
(OR: 1.34; 95% CI: 1.02-1.75; p-heterogeneity = 0.19). Compared to
never smokers in the highest quartile of folate concentrations, this
association seemed only apparent among current smokers in the lowest
quartile of folate concentrations (OR: 6.26; 95% CI: 3.62-10.81,
p-interaction = 0.07). Dietary folate was not associated with aggressive
UCC (OR: 1.26; 95% CI: 0.81-1.95; p-heterogeneity = 0.14). No
association was observed between serum homocysteine, vitamins B6 and B12
and risk of UCC. This study suggests that lower serum folate
concentrations are associated with increased UCC risk, in particular
aggressive UCC. Residual confounding by smoking cannot be ruled out and
these findings require confirmation in future studies with multiple
measurements.
Συγγραφείς:
Vrieling, Alina
Bueno-De-Mesquita, H. Bas
Ros, Martine M. and
Kampman, Ellen
Aben, Katja K.
Buchner, Frederike L.
Jansen,
Eugene H.
Roswall, Nina
Tjonneland, Anne
Boutron-Ruault,
Marie-Christine
Cadeau, Claire
Chang-Claude, Jenny
Kaaks,
Rudolf
Weikert, Steffen
Boeing, Heiner
Trichopoulou, Antonia
and Lagiou, Pagona
Trichopoulos, Dimitrios
Sieri, Sabina and
Palli, Domenico
Panico, Salvatore
Peeters, Petra H. and
Weiderpass, Elisabete
Skeie, Guri
Jakszyn, Paula
Chirlaque,
Maria-Dolores
Ardanaz, Eva
Sanchez, Maria-Jose
Ehrnstrom,
Roy
Malm, Johan
Ljungberg, Borje
Khaw, Kay-Tee
Wareham,
Nick J.
Brennan, Paul
Johansson, Mattias
Riboli, Elio and
Kiemeney, Lambertus A.
