Background We sought to develop a proteomics-based risk model for lung cancer and evaluate its ri... more Background We sought to develop a proteomics-based risk model for lung cancer and evaluate its risk-discriminatory performance in comparison with a smoking-based risk model (PLCOm2012) and a commercially available autoantibody biomarker test. Methods We designed a case-control study nested in 6 prospective cohorts, including 624 lung cancer participants who donated blood samples at most 3 years prior to lung cancer diagnosis and 624 smoking-matched cancer free participants who were assayed for 302 proteins. We used 470 case-control pairs from 4 cohorts to select proteins and train a protein-based risk model. We subsequently used 154 case-control pairs from 2 cohorts to compare the risk-discriminatory performance of the protein-based model with that of the Early Cancer Detection Test (EarlyCDT)-Lung and the PLCOm2012 model using receiver operating characteristics analysis and by estimating models’ sensitivity. All tests were 2-sided. Results The area under the curve for the protein-b...
Identification of novel risk biomarkers may enhance early detection of smoking-related lung cance... more Identification of novel risk biomarkers may enhance early detection of smoking-related lung cancer. We measured 1,162 proteins in blood samples drawn at most three years before diagnosis in 731 smoking-matched case-control sets nested within six prospective cohorts from the US, Europe, Singapore, and Australia.We identified 36 proteins with replicable associations with risk of imminent lung cancer diagnosis (all p<4×10-5). These included several documented tumor markers (e.g. CA-125/MUC-16 and CEACAM5/CEA) but most had not been previously reported. The 36 proteins included several growth factors (e.g. HGF, IGFBP-1, IGFP-2), tumor necrosis factor-receptors (e.g. TNFRSF6B, TNFRSF13B), and chemokines and cytokines (e.g. CXL17, GDF-15, SCF). The odds ratio per standard deviation ranged from 1.31 for IGFBP-1 (95% CI: 1.17-1.47) to 2.43 for CEACAM5 (95% CI: 2.04-2.89). We mapped the 36 proteins to the hallmarks of cancer and found that proliferative signaling, tumor-promoting inflammat...
Background: Findings from an analysis published in 2013, using combined retrospective and prospec... more Background: Findings from an analysis published in 2013, using combined retrospective and prospective data pooled from 3 cohort studies, were consistent with tamoxifen use after 1st breast cancer (BC) being associated with reduced CBC risk for both BRCA1 and BRCA2 mutation carriers, although the analysis of prospective data alone (based on 100 incident CBCs) gave inconclusive results. The association did not differ by estrogen receptor (ER) status of the 1st BC, suggesting that tamoxifen may be a useful secondary BC prevention agent for mutation carriers regardless of the ER status of their 1st BC. The aim of this updated analysis was to assess these associations after incorporating data from an additional 1,279 mutation carriers and with further follow-up providing 153 additional prospective CBC events. Methods: Eligible women were BRCA1 and BRCA2 mutation carriers diagnosed with unilateral BC since 1970 and with no other invasive cancer or tamoxifen use before their 1st BC. They w...
Background: Biomarker levels of very long-chain saturated fatty acids (VLCSFAs) have been found t... more Background: Biomarker levels of very long-chain saturated fatty acids (VLCSFAs) have been found to be favorably associated with cardiovascular risk factors including lower risk of diabetes and reduced triglycerides. Few studies have examined the association between VLCSFAs and coronary heart disease (CHD). Aims: To assess the association of circulating arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) with incident total, fatal, and nonfatal CHD. Methods: We used data from the Fatty Acids and Outcomes Research Consortium consisting of 15 prospective cohorts worldwide which included adults (age≥18 years) who were free of cardiovascular disease and had blood measurements of 20:0, 22:0, and 24:0 at baseline. A study protocol with standardized definitions of exposures, disease outcomes, and covariates was developed, for which each cohort conducted individual participant-level analysis. Cohort-specific associations were pooled using inverse variance-weighted meta-ana...
Background: Emerging evidence suggests that dietary omega-6 polyunsaturated fatty acids (n-6 PUFA... more Background: Emerging evidence suggests that dietary omega-6 polyunsaturated fatty acids (n-6 PUFA) plays a role in the primary prevention of type 2 diabetes (T2D). Aims: To evaluate the relation between blood and adipose tissue levels of n-6 PUFA and incident T2D, including n-6 linoleic acid (LA), the major dietary PUFA abundant in vegetable oils, and n-6 arachidonic acid (AA), a key precursor of endogenous metabolites that modulate glucose metabolism and inflammation. Methods: A global consortium of 20 prospective cohort studies identified by February 2016. Each study measured LA and AA at study baseline among adults>18y without prevalent T2D, and assessed the association of n-6 PUFA biomarkers and T2D risk prospectively using individual-level data, using a pre-specified analytic plan and harmonized exposures, covariates, and effect modifiers. Findings were centrally pooled using fixed-effects meta-analysis. Results: 39,740 men and women from 10 countries were included (range of...
We examined associations between sex‐specific alcohol intake trajectories and alcohol‐related can... more We examined associations between sex‐specific alcohol intake trajectories and alcohol‐related cancer risk using data from 22 756 women and 15 701 men aged 40 to 69 years at baseline in the Melbourne Collaborative Cohort Study. Alcohol intake for 10‐year periods from age 20 until the decade encompassing recruitment, calculated using recalled beverage‐specific frequency and quantity, was used to estimate group‐based sex‐specific intake trajectories. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for primary invasive alcohol‐related cancer (upper aerodigestive tract, breast, liver and colorectum). Three distinct alcohol intake trajectories for women (lifetime abstention, stable light, increasing moderate) and six for men (lifetime abstention, stable light, stable moderate, increasing heavy, early decreasing heavy, late decreasing heavy) were identified. 2303 incident alcohol‐related cancers were diagnosed during 485 525 person‐years in women and 789 during 303 218 ...
Objectives: To estimate the extent of measurement error in the Active Australia questionnaire, an... more Objectives: To estimate the extent of measurement error in the Active Australia questionnaire, and to examine the impact of measurement error on the association of moderate-vigorous physical activity (MVPA) with obesity. Design: Accelerometer Validation Study, cross-sectional; data from the third wave of a prospective cohort (Australian Diabetes, Obesity, and Lifestyle (AusDiab) Study)). Methods: Self-reported physical activity data were obtained from 4005 participants of the third wave of the AusDiab study via the Active Australia questionnaire. Accelerometer-derived physical activity data were obtained from a subsample of 670 participants. Validity coefficients and attenuation factors were estimated from a measurement error model. A regression calibration method was applied to a logistic regression model examining the association between self-reported MVPA and obesity to adjust observed odds ratios (OR) for measurement error. Results: The validity coefficient was 0.35 (0.28, 0.43) and the attenuation factor was 0.16 (0.13, 0.20) in models adjusted for age and sex. The uncorrected OR for obesity for 210 min/week of MVPA (50th percentile) relative to 80 min/week (25th percentile) was 0.87 (0.85, 0.90). The attenuation factor was used to adjust this OR for measurement error, giving a corrected OR of 0.43 (0.32, 0.55). Conclusions: Substantial measurement error (relative to accelerometry) was evident in the Active Australia questionnaire, leading to attenuation of the association of MVPA with obesity. A regressioncalibration method can be used to adjust risk estimates for associations between self-reported MVPA and health-related outcomes for measurement error specific to self-report. These corrected risk estimates reflect associations that would be expected if MVPA were measured by accelerometry.
Multiple myeloma (MM) is the second most common hematological cancer and causes significant morta... more Multiple myeloma (MM) is the second most common hematological cancer and causes significant mortality and morbidity. Knowledge regarding modifiable risk factors for MM remains limited. This analysis of an Australian population‐based case–control family study investigates whether smoking or alcohol consumption is associated with risk of MM and related diseases. Incident cases (n = 789) of MM were recruited via cancer registries in Victoria and New South Wales. Controls (n = 1,113) were either family members of cases (n = 696) or controls recruited for a similarly designed study of renal cancers (n = 417). Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional multivariable logistic regression. Heavy intake (>20 g ethanol/day) of alcohol had a lower risk of MM compared with nondrinkers (OR = 0.68, 95% CI: 0.50–0.93), and there was an inverse dose–response relationship for average daily alcohol intake (OR per 10 g ethanol per day = 0.92, 95% C...
Cancer Epidemiology, Biomarkers & Prevention, 2020
Background: Obesity increases the risk of 13 cancer types. Given the long process of carcinogenes... more Background: Obesity increases the risk of 13 cancer types. Given the long process of carcinogenesis, it is important to determine the impact of patterns of body mass over time. Methods: Using data from 30,377 participants in the Melbourne Collaborative Cohort Study, we identified body mass index (BMI) trajectories across adulthood and examined their association with the risk of obesity-related cancer. Participants completed interviews and questionnaires at baseline (1990–1994, age 40–69 years), follow-up 1 (1995–1998), and follow-up 2 (2003–2005). Body mass was recalled for age 18 to 21 years, measured at baseline, self-reported at follow-up 1, and measured at follow-up 2. Height was measured at baseline. Cancer diagnoses were ascertained from the Victorian Cancer Registry and the Australian Cancer Database. A latent class trajectory model was used to identify BMI trajectories that were not defined a priori. Cox regression was used to estimate HRs and 95% confidence intervals (CI) o...
PURPOSE The incidence of renal cell carcinoma (RCC) is rising. Use of analgesics such as non-ster... more PURPOSE The incidence of renal cell carcinoma (RCC) is rising. Use of analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol may affect renal function. The aim of this study was to assess associations between analgesic use and risk of RCC. METHODS A population-based case-control family design was used. Cases were recruited via two Australian state cancer registries. Controls were siblings or partners of cases. Analgesic use was captured by self-completed questionnaire. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for RCC risk associated with regular analgesic use (at least 5 times per month for 6 months or more) and duration and frequency of use. RESULTS The analysis included 1064 cases and 724 controls. Regular use of paracetamol was associated with an increased risk of RCC (OR 1.41, 95%CI 1.13-1.77). Regular use of NSAIDs was associated with increased risk of RCC for women (OR 1.71, 95% CI 1.23-2.39) but not men (OR 0.83, 95% CI 0.58-1.18; p-interaction=0.003). There was no evidence of a dose-response for duration of use of paracetamol (linear trend p = 0.77) and weak evidence for non- aspirin NSAID use by women (linear trend p = 0.054). CONCLUSION This study found that regular use of paracetamol was associated with increased risk of RCC. NSAID use was associated with increased risk only for women.
Purpose: Using the Melbourne Collaborative Cohort Study, we examined the associations of occupati... more Purpose: Using the Melbourne Collaborative Cohort Study, we examined the associations of occupation, household, transport, and leisure physical activity with pain interference with normal work and muscle pain after activity. Methods: This cross-sectional analysis included 7655 working and 11,766 nonworking participants. Physical activity was assessed using the long-form International Physical Activity Questionnaire. Pain interference was assessed with the Short-Form 12-Item Health Survey version 2.0, and muscle pain after activity was assessed using the 12-item Somatic and Psychological Health Report. Ordered logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI), and restricted cubic splines were used to graphically represent the shape of associations. Results: All physical activity domain-pain outcome associations were nonlinear. Compared with participants who reported the lowest level of activity, participants who reported the median level of transport physical activity (10 MET•h•wk -1 ) reported less pain interference (workers: OR, 0.86 [95% CI, 0.77-0.97]; nonworkers: OR, 0.88 [95% CI, 0.79-0.97]) and muscle pain after activity (workers: OR, 0.81 [95% CI, 0.70-0.95]; nonworkers: OR, 0.86 [95% CI, 0.77-0.95]). Higher levels of leisure time activity (20 MET•h•wk -1 ) were associated with less pain interference in nonworkers (OR, 0.87; 95% CI, 0.77-0.98) and muscle pain after activity in workers (OR, 0.67; 95% CI, 0.56-0.80). Workers who reported the median level of household activity (16 MET•h•wk -1 ) had increased pain interference (OR, 1.19; 95% CI, 1.07-1.32) and muscle pain after activity (OR, 1.23; 95% CI, 1.06-1.42) than did those who reported the least household activity. Conclusions: Associations between domain-specific physical activity and pain outcomes were not uniform. Within the transport and leisure domains, physical activity was inversely associated with pain-related outcomes, whereas household physical activity was positively associated with pain scores within the working sample.
Social support and interactions are associated with better health outcomes, but scarce evidence e... more Social support and interactions are associated with better health outcomes, but scarce evidence exists regarding their potential benefit to prostate cancer survivors. Our study included 1,421 men with prostate cancer, among whom 338 deaths from any cause were observed. Those living alone had substantially higher mortality than those living with someone. No associations were observed for other measures of social connectedness, such as visits to friends/relatives, visits from friends/relatives, and time involved in social activities.
Purpose Diet and body size may affect the risk of aggressive prostate cancer (APC), but current e... more Purpose Diet and body size may affect the risk of aggressive prostate cancer (APC), but current evidence is inconclusive. Methods A case-control study was conducted in men under 75 years of age recruited from urology practices in Victoria, Australia; 1,254 with APC and 818 controls for whom the presence of prostate cancer had been excluded by biopsy. Dietary intakes were assessed using a validated food frequency questionnaire. Multivariable unconditional logistic regression estimated odds ratios and confidence intervals for hypothesized risk factors, adjusting for age, family history of prostate cancer, country of birth, socioeconomic status, smoking, and other dietary factors. Results Positive associations with APC (odds ratio, 95% confidence intervals, highest vs. lowest category or quintile) were observed for body mass index (1.34, 1.02-1.78, P trend = 0.04), and trouser size (1.54, 1.17-2.04, P trend = 0.001). Intakes of milk and all dairy products were inversely associated with APC risk (0.71, 9.53-0.96, P trend = 0.05, and 0.64, 0.48-0.87, P trend = 0.012, respectively), but there was little evidence of an association with other dietary variables (P trend > 0.05). Conclusions We confirmed previous evidence for a positive association between body size and risk of APC, and suggest that consumption of dairy products, and milk more specifically, is inversely associated with risk.
5007 Background: This randomized, prospective phase III trial investigated if immediate intervent... more 5007 Background: This randomized, prospective phase III trial investigated if immediate intervention with androgen deprivation therapy (ADT) (Arm B) improved overall survival compared to delayed AD...
Background: Effects of omega-3 fatty acids on the prevention of type 2 diabetes (T2D) are unclear... more Background: Effects of omega-3 fatty acids on the prevention of type 2 diabetes (T2D) are unclear. Relatively few prospective studies have utilized objective omega-3 biomarkers to assess risk. Aims: To assess the prospective relationship between circulating and tissue levels of alpha linoleic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), with respect to risk of T2D. Methods: A global consortium of 20 prospective cohort studies from 14 nations with assessments of ALA, EPA, DPA, or DHA in adults (age > 18 years) were identified through July 2017 and included in this investigation. A pre-specified analytic protocol, including definitions for exposures, covariate list, disease outcome definitions, and subgroup analyses was developed and followed in new participant-level cohort analysis. Associations were pooled using inverse variance-weighted meta-analysis. Results: Among 65,147 participants, 16,693 incident cases of T2D occurre...
Background We sought to develop a proteomics-based risk model for lung cancer and evaluate its ri... more Background We sought to develop a proteomics-based risk model for lung cancer and evaluate its risk-discriminatory performance in comparison with a smoking-based risk model (PLCOm2012) and a commercially available autoantibody biomarker test. Methods We designed a case-control study nested in 6 prospective cohorts, including 624 lung cancer participants who donated blood samples at most 3 years prior to lung cancer diagnosis and 624 smoking-matched cancer free participants who were assayed for 302 proteins. We used 470 case-control pairs from 4 cohorts to select proteins and train a protein-based risk model. We subsequently used 154 case-control pairs from 2 cohorts to compare the risk-discriminatory performance of the protein-based model with that of the Early Cancer Detection Test (EarlyCDT)-Lung and the PLCOm2012 model using receiver operating characteristics analysis and by estimating models’ sensitivity. All tests were 2-sided. Results The area under the curve for the protein-b...
Identification of novel risk biomarkers may enhance early detection of smoking-related lung cance... more Identification of novel risk biomarkers may enhance early detection of smoking-related lung cancer. We measured 1,162 proteins in blood samples drawn at most three years before diagnosis in 731 smoking-matched case-control sets nested within six prospective cohorts from the US, Europe, Singapore, and Australia.We identified 36 proteins with replicable associations with risk of imminent lung cancer diagnosis (all p<4×10-5). These included several documented tumor markers (e.g. CA-125/MUC-16 and CEACAM5/CEA) but most had not been previously reported. The 36 proteins included several growth factors (e.g. HGF, IGFBP-1, IGFP-2), tumor necrosis factor-receptors (e.g. TNFRSF6B, TNFRSF13B), and chemokines and cytokines (e.g. CXL17, GDF-15, SCF). The odds ratio per standard deviation ranged from 1.31 for IGFBP-1 (95% CI: 1.17-1.47) to 2.43 for CEACAM5 (95% CI: 2.04-2.89). We mapped the 36 proteins to the hallmarks of cancer and found that proliferative signaling, tumor-promoting inflammat...
Background: Findings from an analysis published in 2013, using combined retrospective and prospec... more Background: Findings from an analysis published in 2013, using combined retrospective and prospective data pooled from 3 cohort studies, were consistent with tamoxifen use after 1st breast cancer (BC) being associated with reduced CBC risk for both BRCA1 and BRCA2 mutation carriers, although the analysis of prospective data alone (based on 100 incident CBCs) gave inconclusive results. The association did not differ by estrogen receptor (ER) status of the 1st BC, suggesting that tamoxifen may be a useful secondary BC prevention agent for mutation carriers regardless of the ER status of their 1st BC. The aim of this updated analysis was to assess these associations after incorporating data from an additional 1,279 mutation carriers and with further follow-up providing 153 additional prospective CBC events. Methods: Eligible women were BRCA1 and BRCA2 mutation carriers diagnosed with unilateral BC since 1970 and with no other invasive cancer or tamoxifen use before their 1st BC. They w...
Background: Biomarker levels of very long-chain saturated fatty acids (VLCSFAs) have been found t... more Background: Biomarker levels of very long-chain saturated fatty acids (VLCSFAs) have been found to be favorably associated with cardiovascular risk factors including lower risk of diabetes and reduced triglycerides. Few studies have examined the association between VLCSFAs and coronary heart disease (CHD). Aims: To assess the association of circulating arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) with incident total, fatal, and nonfatal CHD. Methods: We used data from the Fatty Acids and Outcomes Research Consortium consisting of 15 prospective cohorts worldwide which included adults (age≥18 years) who were free of cardiovascular disease and had blood measurements of 20:0, 22:0, and 24:0 at baseline. A study protocol with standardized definitions of exposures, disease outcomes, and covariates was developed, for which each cohort conducted individual participant-level analysis. Cohort-specific associations were pooled using inverse variance-weighted meta-ana...
Background: Emerging evidence suggests that dietary omega-6 polyunsaturated fatty acids (n-6 PUFA... more Background: Emerging evidence suggests that dietary omega-6 polyunsaturated fatty acids (n-6 PUFA) plays a role in the primary prevention of type 2 diabetes (T2D). Aims: To evaluate the relation between blood and adipose tissue levels of n-6 PUFA and incident T2D, including n-6 linoleic acid (LA), the major dietary PUFA abundant in vegetable oils, and n-6 arachidonic acid (AA), a key precursor of endogenous metabolites that modulate glucose metabolism and inflammation. Methods: A global consortium of 20 prospective cohort studies identified by February 2016. Each study measured LA and AA at study baseline among adults>18y without prevalent T2D, and assessed the association of n-6 PUFA biomarkers and T2D risk prospectively using individual-level data, using a pre-specified analytic plan and harmonized exposures, covariates, and effect modifiers. Findings were centrally pooled using fixed-effects meta-analysis. Results: 39,740 men and women from 10 countries were included (range of...
We examined associations between sex‐specific alcohol intake trajectories and alcohol‐related can... more We examined associations between sex‐specific alcohol intake trajectories and alcohol‐related cancer risk using data from 22 756 women and 15 701 men aged 40 to 69 years at baseline in the Melbourne Collaborative Cohort Study. Alcohol intake for 10‐year periods from age 20 until the decade encompassing recruitment, calculated using recalled beverage‐specific frequency and quantity, was used to estimate group‐based sex‐specific intake trajectories. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for primary invasive alcohol‐related cancer (upper aerodigestive tract, breast, liver and colorectum). Three distinct alcohol intake trajectories for women (lifetime abstention, stable light, increasing moderate) and six for men (lifetime abstention, stable light, stable moderate, increasing heavy, early decreasing heavy, late decreasing heavy) were identified. 2303 incident alcohol‐related cancers were diagnosed during 485 525 person‐years in women and 789 during 303 218 ...
Objectives: To estimate the extent of measurement error in the Active Australia questionnaire, an... more Objectives: To estimate the extent of measurement error in the Active Australia questionnaire, and to examine the impact of measurement error on the association of moderate-vigorous physical activity (MVPA) with obesity. Design: Accelerometer Validation Study, cross-sectional; data from the third wave of a prospective cohort (Australian Diabetes, Obesity, and Lifestyle (AusDiab) Study)). Methods: Self-reported physical activity data were obtained from 4005 participants of the third wave of the AusDiab study via the Active Australia questionnaire. Accelerometer-derived physical activity data were obtained from a subsample of 670 participants. Validity coefficients and attenuation factors were estimated from a measurement error model. A regression calibration method was applied to a logistic regression model examining the association between self-reported MVPA and obesity to adjust observed odds ratios (OR) for measurement error. Results: The validity coefficient was 0.35 (0.28, 0.43) and the attenuation factor was 0.16 (0.13, 0.20) in models adjusted for age and sex. The uncorrected OR for obesity for 210 min/week of MVPA (50th percentile) relative to 80 min/week (25th percentile) was 0.87 (0.85, 0.90). The attenuation factor was used to adjust this OR for measurement error, giving a corrected OR of 0.43 (0.32, 0.55). Conclusions: Substantial measurement error (relative to accelerometry) was evident in the Active Australia questionnaire, leading to attenuation of the association of MVPA with obesity. A regressioncalibration method can be used to adjust risk estimates for associations between self-reported MVPA and health-related outcomes for measurement error specific to self-report. These corrected risk estimates reflect associations that would be expected if MVPA were measured by accelerometry.
Multiple myeloma (MM) is the second most common hematological cancer and causes significant morta... more Multiple myeloma (MM) is the second most common hematological cancer and causes significant mortality and morbidity. Knowledge regarding modifiable risk factors for MM remains limited. This analysis of an Australian population‐based case–control family study investigates whether smoking or alcohol consumption is associated with risk of MM and related diseases. Incident cases (n = 789) of MM were recruited via cancer registries in Victoria and New South Wales. Controls (n = 1,113) were either family members of cases (n = 696) or controls recruited for a similarly designed study of renal cancers (n = 417). Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional multivariable logistic regression. Heavy intake (>20 g ethanol/day) of alcohol had a lower risk of MM compared with nondrinkers (OR = 0.68, 95% CI: 0.50–0.93), and there was an inverse dose–response relationship for average daily alcohol intake (OR per 10 g ethanol per day = 0.92, 95% C...
Cancer Epidemiology, Biomarkers & Prevention, 2020
Background: Obesity increases the risk of 13 cancer types. Given the long process of carcinogenes... more Background: Obesity increases the risk of 13 cancer types. Given the long process of carcinogenesis, it is important to determine the impact of patterns of body mass over time. Methods: Using data from 30,377 participants in the Melbourne Collaborative Cohort Study, we identified body mass index (BMI) trajectories across adulthood and examined their association with the risk of obesity-related cancer. Participants completed interviews and questionnaires at baseline (1990–1994, age 40–69 years), follow-up 1 (1995–1998), and follow-up 2 (2003–2005). Body mass was recalled for age 18 to 21 years, measured at baseline, self-reported at follow-up 1, and measured at follow-up 2. Height was measured at baseline. Cancer diagnoses were ascertained from the Victorian Cancer Registry and the Australian Cancer Database. A latent class trajectory model was used to identify BMI trajectories that were not defined a priori. Cox regression was used to estimate HRs and 95% confidence intervals (CI) o...
PURPOSE The incidence of renal cell carcinoma (RCC) is rising. Use of analgesics such as non-ster... more PURPOSE The incidence of renal cell carcinoma (RCC) is rising. Use of analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol may affect renal function. The aim of this study was to assess associations between analgesic use and risk of RCC. METHODS A population-based case-control family design was used. Cases were recruited via two Australian state cancer registries. Controls were siblings or partners of cases. Analgesic use was captured by self-completed questionnaire. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for RCC risk associated with regular analgesic use (at least 5 times per month for 6 months or more) and duration and frequency of use. RESULTS The analysis included 1064 cases and 724 controls. Regular use of paracetamol was associated with an increased risk of RCC (OR 1.41, 95%CI 1.13-1.77). Regular use of NSAIDs was associated with increased risk of RCC for women (OR 1.71, 95% CI 1.23-2.39) but not men (OR 0.83, 95% CI 0.58-1.18; p-interaction=0.003). There was no evidence of a dose-response for duration of use of paracetamol (linear trend p = 0.77) and weak evidence for non- aspirin NSAID use by women (linear trend p = 0.054). CONCLUSION This study found that regular use of paracetamol was associated with increased risk of RCC. NSAID use was associated with increased risk only for women.
Purpose: Using the Melbourne Collaborative Cohort Study, we examined the associations of occupati... more Purpose: Using the Melbourne Collaborative Cohort Study, we examined the associations of occupation, household, transport, and leisure physical activity with pain interference with normal work and muscle pain after activity. Methods: This cross-sectional analysis included 7655 working and 11,766 nonworking participants. Physical activity was assessed using the long-form International Physical Activity Questionnaire. Pain interference was assessed with the Short-Form 12-Item Health Survey version 2.0, and muscle pain after activity was assessed using the 12-item Somatic and Psychological Health Report. Ordered logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI), and restricted cubic splines were used to graphically represent the shape of associations. Results: All physical activity domain-pain outcome associations were nonlinear. Compared with participants who reported the lowest level of activity, participants who reported the median level of transport physical activity (10 MET•h•wk -1 ) reported less pain interference (workers: OR, 0.86 [95% CI, 0.77-0.97]; nonworkers: OR, 0.88 [95% CI, 0.79-0.97]) and muscle pain after activity (workers: OR, 0.81 [95% CI, 0.70-0.95]; nonworkers: OR, 0.86 [95% CI, 0.77-0.95]). Higher levels of leisure time activity (20 MET•h•wk -1 ) were associated with less pain interference in nonworkers (OR, 0.87; 95% CI, 0.77-0.98) and muscle pain after activity in workers (OR, 0.67; 95% CI, 0.56-0.80). Workers who reported the median level of household activity (16 MET•h•wk -1 ) had increased pain interference (OR, 1.19; 95% CI, 1.07-1.32) and muscle pain after activity (OR, 1.23; 95% CI, 1.06-1.42) than did those who reported the least household activity. Conclusions: Associations between domain-specific physical activity and pain outcomes were not uniform. Within the transport and leisure domains, physical activity was inversely associated with pain-related outcomes, whereas household physical activity was positively associated with pain scores within the working sample.
Social support and interactions are associated with better health outcomes, but scarce evidence e... more Social support and interactions are associated with better health outcomes, but scarce evidence exists regarding their potential benefit to prostate cancer survivors. Our study included 1,421 men with prostate cancer, among whom 338 deaths from any cause were observed. Those living alone had substantially higher mortality than those living with someone. No associations were observed for other measures of social connectedness, such as visits to friends/relatives, visits from friends/relatives, and time involved in social activities.
Purpose Diet and body size may affect the risk of aggressive prostate cancer (APC), but current e... more Purpose Diet and body size may affect the risk of aggressive prostate cancer (APC), but current evidence is inconclusive. Methods A case-control study was conducted in men under 75 years of age recruited from urology practices in Victoria, Australia; 1,254 with APC and 818 controls for whom the presence of prostate cancer had been excluded by biopsy. Dietary intakes were assessed using a validated food frequency questionnaire. Multivariable unconditional logistic regression estimated odds ratios and confidence intervals for hypothesized risk factors, adjusting for age, family history of prostate cancer, country of birth, socioeconomic status, smoking, and other dietary factors. Results Positive associations with APC (odds ratio, 95% confidence intervals, highest vs. lowest category or quintile) were observed for body mass index (1.34, 1.02-1.78, P trend = 0.04), and trouser size (1.54, 1.17-2.04, P trend = 0.001). Intakes of milk and all dairy products were inversely associated with APC risk (0.71, 9.53-0.96, P trend = 0.05, and 0.64, 0.48-0.87, P trend = 0.012, respectively), but there was little evidence of an association with other dietary variables (P trend > 0.05). Conclusions We confirmed previous evidence for a positive association between body size and risk of APC, and suggest that consumption of dairy products, and milk more specifically, is inversely associated with risk.
5007 Background: This randomized, prospective phase III trial investigated if immediate intervent... more 5007 Background: This randomized, prospective phase III trial investigated if immediate intervention with androgen deprivation therapy (ADT) (Arm B) improved overall survival compared to delayed AD...
Background: Effects of omega-3 fatty acids on the prevention of type 2 diabetes (T2D) are unclear... more Background: Effects of omega-3 fatty acids on the prevention of type 2 diabetes (T2D) are unclear. Relatively few prospective studies have utilized objective omega-3 biomarkers to assess risk. Aims: To assess the prospective relationship between circulating and tissue levels of alpha linoleic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), with respect to risk of T2D. Methods: A global consortium of 20 prospective cohort studies from 14 nations with assessments of ALA, EPA, DPA, or DHA in adults (age > 18 years) were identified through July 2017 and included in this investigation. A pre-specified analytic protocol, including definitions for exposures, covariate list, disease outcome definitions, and subgroup analyses was developed and followed in new participant-level cohort analysis. Associations were pooled using inverse variance-weighted meta-analysis. Results: Among 65,147 participants, 16,693 incident cases of T2D occurre...
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