Prostate, breast and colorectal cancer are the most common tumours in Spain. The aim of the present study was to evaluate the association between adherence to nutrition‐based guidelines for cancer ...prevention and prostate, breast and colorectal cancer, in the MCC‐Spain case–control study. A total of 1,718 colorectal, 1,343 breast and 864 prostate cancer cases and 3,431 population‐based controls recruited between 2007 and 2012, were included in the present study. The World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) score based on six recommendations for cancer prevention (on body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods and alcoholic drinks; score range 0–6) was constructed. We used unconditional logistic regression analysis adjusting for potential confounders. One‐point increment in the WCRF/AICR score was associated with 25% (95% CI 19–30%) lower risk of colorectal, and 15% (95% CI 7–22%) lower risk of breast cancer; no association with prostate cancer was detected, except for cases with a Gleason score ≥7 (poorly differentiated/undifferentiated tumours) (OR 0.87, 95% CI 0.76–0.99). These results add to the wealth of evidence indicating that a great proportion of common cancer cases could be avoided by adopting healthy lifestyle habits.
What's new?
Prostate, breast and colon cancer share common environmental risk factors, but preventable causes remain largely unknown. Here the authors evaluated adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines on diet, physical activity and body fat for cancer prevention and risk of these cancers in Spain. They found an inverse association between adherence to the recommendations and colon cancer, postmenopausal breast cancer and poorly differentiated prostate cancer, underscoring the important role of preventable causes in the development of these cancers.
Purpose
To assess if the associations found between three previously identified dietary patterns with breast, prostate and gastric cancer are also observed for colorectal cancer (CRC).
Methods
...MCC-Spain is a multicase-control study that collected information of 1629 incident cases of CRC and 3509 population-based controls from 11 Spanish provinces. Western, Prudent and Mediterranean data-driven dietary patterns—derived in another Spanish case-control study—were reconstructed in MCC-Spain. Their association with CRC was assessed using mixed multivariable logistic regression models considering a possible interaction with sex. Risk by tumor site (proximal colon, distal colon, and rectum) was evaluated using multinomial regression models.
Results
While no effect of the Prudent pattern on CRC risk was observed, a high adherence to the Western dietary pattern was associated with increased CRC risk for both males OR
fourth(Q4) vs. first(Q1)quartile
(95% CI): 1.45 (1.11;1.91) and females OR
Q4 vs. Q1
(95% CI): 1.50 (1.07;2.09) but seem to be confined to distal colon OR
fourth(Q4) vs. first(Q1)quartile
(95% CI): 2.02 (1.44;2.84) and rectal OR
Q4 vs. Q1
(95% CI): 1.46 (1.05;2.01) tumors. The protective effect of the Mediterranean dietary pattern against CRC was observed for both sexes males: OR
Q4 vs. Q1
(95% CI): 0.71 (0.55;0.92); females: OR
Q4 vs. Q1
(95% CI): 0.56 (0.40;0.77) and for all cancer sites: proximal colon OR
Q4 vs. Q1
(95% CI): 0.70 (0.51;0.97), distal colon OR
Q4 vs. Q1
(95% CI): 0.65 (0.48;0.89), and rectum (OR
Q4 vs. Q1
(95% CI): 0.60 (0.45;0.81).
Conclusion
Our results are consistent with most of the associations previously found between these patterns and breast, prostate and gastric cancer risk and indicate that consuming whole fruits, vegetables, legumes, olive oil, nuts, and fish and avoiding red and processed meat, refined grains, sweets, caloric drinks, juices, convenience food, and sauces might reduce CRC risk.
•Feature selection techniques may be unstable dealing with colorectal cancer data.•Robustness and Performance of Feature selection for CRC should be studied together.•Feature selection algorithms ...improve the colorectal risk prediction model performance measured in terms of AUC.•Potential Risk (or protective) factors can be identified with machine learning techniques.•Graphical approaches allow to analyze at a glance both stability and similarities.
Risk prediction models aim at identifying people at higher risk of developing a target disease. Feature selection is particularly important to improve the prediction model performance avoiding overfitting and to identify the leading cancer risk (and protective) factors. Assessing the stability of feature selection/ranking algorithms becomes an important issue when the aim is to analyze the features with more prediction power.
This work is focused on colorectal cancer, assessing several feature ranking algorithms in terms of performance for a set of risk prediction models (Neural Networks, Support Vector Machines (SVM), Logistic Regression, k-Nearest Neighbors and Boosted Trees). Additionally, their robustness is evaluated following a conventional approach with scalar stability metrics and a visual approach proposed in this work to study both similarity among feature ranking techniques as well as their individual stability. A comparative analysis is carried out between the most relevant features found out in this study and features provided by the experts according to the state-of-the-art knowledge.
The two best performance results in terms of Area Under the ROC Curve (AUC) are achieved with a SVM classifier using the top-41 features selected by the SVM wrapper approach (AUC=0.693) and Logistic Regression with the top-40 features selected by the Pearson (AUC=0.689). Experiments showed that performing feature selection contributes to classification performance with a 3.9% and 1.9% improvement in AUC for the SVM and Logistic Regression classifier, respectively, with respect to the results using the full feature set. The visual approach proposed in this work allows to see that the Neural Network-based wrapper ranking is the most unstable while the Random Forest is the most stable.
This study demonstrates that stability and model performance should be studied jointly as Random Forest turned out to be the most stable algorithm but outperformed by others in terms of model performance while SVM wrapper and the Pearson correlation coefficient are moderately stable while achieving good model performance.
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used despite their risk of gastrointestinal bleeding or cardiovascular events. We report the profile of people taking NSAIDs in Spain, and we ...include demographic factors, health-related behaviours and cardiovascular disease history.
Four thousand sixtyparticipants were selected using a pseudorandom number list from Family Practice lists in 12 Spanish provinces. They completed a face-to-face computerized interview on their NSAID consumption, demographic characteristics, body mass index, alcohol and tobacco consumption and medical history. In addition, participants completed a self-administered food-frequency and alcohol consumption questionnaire. Factors associated with ever and current NSAID consumption were identified by logistic regression.
Women consumed more non-aspirin NSAIDs (38.8% 36.7-41.0) than men (22.3 20.5-24.2), but men consumed more aspirin (11.7% 10.3-13.2) than women (5.2% 4.3-6.3). Consumption of non-aspirin NSAIDs decrease with age from 44.2% (39.4-49.1) in younger than 45 to 21.1% (18.3-24.2) in older than 75, but the age-pattern for aspirin usage was the opposite. Aspirin was reported by about 11% patients, as being twice as used in men (11.7%) than in women (5.2%); its consumption increased with age from 1.7% (< 45 years old) to 12.4% (≥75 years old). Aspirin was strongly associated with the presence of cardiovascular risk factors or established cardiovascular disease, reaching odds ratios of 15.2 (7.4-31.2) in women with acute coronary syndrome, 13.3 (6.2-28.3) in women with strokes and 11.1 (7.8-15.9) in men with acute coronary syndrome. Participants with cardiovascular risk factors or diseases consumed as much non-aspirin NSAID as participants without such conditions.
Non-aspirin NSAIDs were more consumed by women and aspirin by men. The age patterns of aspirin and non-aspirin NSAIDs were opposite: the higher the age, the lower the non-aspirin NSAIDs usage and the higher the aspirin consumption. People with cardiovascular risk factors or diseases consumed more aspirin, but they did not decrease their non-aspirin NSAIDs usage.
There are many different methods used to measure the degree of adherence to a Mediterranean diet (MD), limiting comparison and interpretation of their results. The concordance between different ...methodologies has been questioned and their evaluation recommended. The aim of this study was to evaluate the agreement among five indexes that measure adherence to a Mediterranean dietary pattern. The study population included healthy adults selected in the Multi-Case Control Spain (MCC-Spain) study recruited in 12 provinces. A total of 3640 controls were matched to cases by age and sex. To reach the aim, the following scores of adherence to a Mediterranean dietary pattern were calculated: Mediterranean diet score (MDS), alternative Mediterranean diet (aMED), relative Mediterranean diet (rMED), dietary score (DS) and literature-based adherence score (LBAS). The relative frequency of subjects with a high level of adherence to a MD varied from 22% (aMED index) to 37.2% (DS index). Similarly, a high variability was observed for the prevalence of a low level of MD: from 24% (rMED) to 38.4% (aMED). The correlation among MDS, aMED and rMED indexes was moderate, except for MDS and aMED with a high coefficient of correlation 0.75 (95% CI 0.74⁻0.77). The Cohen's Kappa coefficient among indexes showed a moderate⁻fair concordance, except for MDS and aMED with a 0.56 (95% CI 0.55⁻0.59) and 0.67 (95% CI 0.66⁻0.68) using linear and quadratic weighting, respectively. The existing MD adherence indexes measured the same, although they were based on different constructing algorithms and varied in the food groups included, leading to a different classification of subjects. Therefore, concordance between these indexes was moderate or low.
Volver a lo básico: líneas estratégicas 2018 Baladia, Eduard; Martínez-Rodríguez, Rodrigo; Navarrete-Muñoz, Eva María ...
Revista española de nutrición humana y dietética,
12/2017, Volume:
21, Issue:
4
Journal Article
Background
The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified ...dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology.
Methods
MCC-Spain is a multicase–control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns—derived in another Spanish case–control study—with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models.
Results
A high adherence to the Western pattern increased gastric adenocarcinoma risk odds ratio
fourth_vs._first_quartile
(95% confidence interval), 2.09 (1.31; 3.33) even at low levels odds ratio
second_vs._first_quartile
(95% confidence interval), 1.63 (1.05; 2.52). High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma odds ratio
fourth_vs._first_quartile
(95% confidence interval), 0.53 (0.34; 0.82). Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors.
Conclusion
Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma.
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