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@ARTICLE{Karavasiloglou:148323,
      author       = {N. Karavasiloglou$^*$ and A. Hüsing$^*$ and G. Masala and
                      C. H. van Gils and R. Turzanski Fortner$^*$ and J.
                      Chang-Claude$^*$ and I. Huybrechts and E. Weiderpass and M.
                      Gunter and P. Arveux and A. Fournier and M. Kvaskoff and A.
                      Tjønneland and C. Kyrø and C. C. Dahm and H. T. Vistisen
                      and M. F. Bakker and M.-J. Sánchez and M. D. Chirlaque
                      López and C. Santiuste and E. Ardanaz and V. Menéndez and
                      A. Agudo and A. Trichopoulou and A. Karakatsani and C. La
                      Vecchia and E. Peppa and D. Palli and C. Agnoli and S.
                      Panico and R. Tumino and C. Sacerdote and S. T. Butt and S.
                      Borgquist and G. Skeie and M. Schulze and T. Key and K.-T.
                      Khaw and K. K. Tsilidis and M. Ellingjord-Dale and E. Riboli
                      and R. Kaaks$^*$ and L. Dossus and S. Rohrmann and T.
                      Kühn$^*$},
      title        = {{A}dherence to the {W}orld {C}ancer {R}esearch
                      {F}und/{A}merican {I}nstitute for {C}ancer {R}esearch cancer
                      prevention recommendations and risk of in situ breast cancer
                      in the {E}uropean {P}rospective {I}nvestigation into
                      {C}ancer and {N}utrition ({EPIC}) cohort.},
      journal      = {BMC medicine},
      volume       = {17},
      number       = {1},
      issn         = {1741-7015},
      address      = {Heidelberg [u.a.]},
      publisher    = {Springer},
      reportid     = {DKFZ-2019-02881},
      pages        = {221},
      year         = {2019},
      note         = {EA: C020LA: C020},
      abstract     = {Even though in situ breast cancer (BCIS) accounts for a
                      large proportion of the breast cancers diagnosed, few
                      studies have investigated potential risk factors for BCIS.
                      Their results suggest that some established risk factors for
                      invasive breast cancer have a similar impact on BCIS risk,
                      but large population-based studies on lifestyle factors and
                      BCIS risk are lacking. Thus, we investigated the association
                      between lifestyle and BCIS risk within the European
                      Prospective Investigation into Cancer and Nutrition
                      cohort.Lifestyle was operationalized by a score reflecting
                      the adherence to the World Cancer Research Fund/American
                      Institute for Cancer Research (WCRF/AICR) cancer prevention
                      recommendations. The recommendations utilized in these
                      analyses were the ones pertinent to healthy body weight,
                      physical activity, consumption of plant-based foods,
                      energy-dense foods, red and processed meat, and sugary
                      drinks and alcohol, as well as the recommendation on
                      breastfeeding. Cox proportional hazards regression was used
                      to assess the association between lifestyle score and BCIS
                      risk. The results were presented as hazard ratios (HR) and
                      corresponding $95\%$ confidence intervals (CI).After an
                      overall median follow-up time of 14.9 years, 1277 BCIS
                      cases were diagnosed. Greater adherence to the WCRF/AICR
                      cancer prevention recommendations was not associated with
                      BCIS risk (HR = 0.98, $95\%$ CI 0.93-1.03; per one unit
                      of increase; multivariable model). An inverse association
                      between the lifestyle score and BCIS risk was observed in
                      study centers, where participants were recruited mainly via
                      mammographic screening and attended additional screening
                      throughout follow-up (HR = 0.85, $95\%$ CI 0.73-0.99),
                      but not in the remaining ones (HR = 0.99, $95\%$ CI
                      0.94-1.05).While we did not observe an overall association
                      between lifestyle and BCIS risk, our results indicate that
                      lifestyle is associated with BCIS risk among women recruited
                      via screening programs and with regular screening
                      participation. This suggests that a true inverse association
                      between lifestyle habits and BCIS risk in the overall cohort
                      may have been masked by a lack of information on screening
                      attendance. The potential inverse association between
                      lifestyle and BCIS risk in our analyses is consistent with
                      the inverse associations between lifestyle scores and breast
                      cancer risk reported from previous studies.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31787099},
      doi          = {10.1186/s12916-019-1444-0},
      url          = {https://inrepo02.dkfz.de/record/148323},
}