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000157248 1001_ $$aMahamat-Saleh, Yahya$$b0
000157248 245__ $$aCitrus intake and risk of skin cancer in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC).
000157248 260__ $$aDordrecht [u.a.]$$bSpringer Science + Business Media B.V.$$c2020
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000157248 500__ $$a2020 Nov;35(11):1057-1067
000157248 520__ $$aCitrus intake has been suggested to increase the risk of skin cancer. Although this relation is highly plausible biologically, epidemiologic evidence is lacking. We aimed to examine the potential association between citrus intake and skin cancer risk. EPIC is an ongoing multi-center prospective cohort initiated in 1992 and involving ~ 520,000 participants who have been followed-up in 23 centers from 10 European countries. Dietary data were collected at baseline using validated country-specific dietary questionnaires. We used Cox proportional hazards regression models to compute hazard ratios (HR) and 95% confidence intervals (CI). During a mean follow-up of 13.7 years, 8448 skin cancer cases were identified among 270,112 participants. We observed a positive linear dose-response relationship between total citrus intake and skin cancer risk (HR = 1.10, 95% CI 1.03-1.18 in the highest vs. lowest quartile; Ptrend = 0.001), particularly with basal cell carcinoma (BCC) (HR = 1.11, 95% CI 1.02-1.20, Ptrend = 0.007) and squamous cell carcinoma (SCC) (HR = 1.23, 95% CI 1.04-1.47, Ptrend = 0.01). Citrus fruit intake was positively associated with skin cancer risk (HR = 1.08, 95% CI 1.01-1.16, Ptrend = 0.01), particularly with melanoma (HR = 1.23, 95% CI 1.02-1.48; Ptrend = 0.01), although with no heterogeneity across skin cancer types (Phomogeneity = 0.21). Citrus juice was positively associated with skin cancer risk (Ptrend = 0.004), particularly with BCC (Ptrend = 0.008) and SCC (Ptrend = 0.004), but not with melanoma (Phomogeneity = 0.02). Our study suggests moderate positive linear dose-response relationships between citrus intake and skin cancer risk. Studies with available biomarker data and the ability to examine sun exposure behaviors are warranted to clarify these associations and examine the phototoxicity mechanisms of furocoumarin-rich foods.
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000157248 7001_ $$aCervenka, Iris$$b1
000157248 7001_ $$aAl-Rahmoun, Marie$$b2
000157248 7001_ $$aMancini, Francesca R$$b3
000157248 7001_ $$aSeveri, Gianluca$$b4
000157248 7001_ $$aGhiasvand, Reza$$b5
000157248 7001_ $$aVeierod, Marit B$$b6
000157248 7001_ $$aCaini, Saverio$$b7
000157248 7001_ $$aPalli, Domenico$$b8
000157248 7001_ $$aBotteri, Edoardo$$b9
000157248 7001_ $$aSacerdote, Carlotta$$b10
000157248 7001_ $$aRicceri, Fulvio$$b11
000157248 7001_ $$aTrichopoulou, Antonia$$b12
000157248 7001_ $$aPeppa, Eleni$$b13
000157248 7001_ $$aLa Vecchia, Carlo$$b14
000157248 7001_ $$aOvervad, Kim$$b15
000157248 7001_ $$aDahm, Christina C$$b16
000157248 7001_ $$aOlsen, Anja$$b17
000157248 7001_ $$aTjønneland, Anne$$b18
000157248 7001_ $$aPerez-Cornago, Aurora$$b19
000157248 7001_ $$aJakszyn, Paula$$b20
000157248 7001_ $$aGrioni, Sara$$b21
000157248 7001_ $$aSchulze, Matthias B$$b22
000157248 7001_ $$aSkeie, Guri$$b23
000157248 7001_ $$aLasheras, Cristina$$b24
000157248 7001_ $$aColorado-Yohar, Sandra$$b25
000157248 7001_ $$aRodríguez-Barranco, Miguel$$b26
000157248 7001_ $$0P:(DE-He78)0907a10ba1dc8f53f04907f54f6fdcfe$$aKühn, Tilman$$b27$$udkfz
000157248 7001_ $$0P:(DE-He78)fb68a9386399d72d84f7f34cfc6048b4$$aKatzke, Verena A$$b28$$udkfz
000157248 7001_ $$aAmiano, Pilar$$b29
000157248 7001_ $$aTumino, Rosario$$b30
000157248 7001_ $$aPanico, Salvatore$$b31
000157248 7001_ $$aEzponda, Ana$$b32
000157248 7001_ $$aSonestedt, Emily$$b33
000157248 7001_ $$aScalbert, Augustin$$b34
000157248 7001_ $$aWeiderpass, Elisabete$$b35
000157248 7001_ $$aBoutron-Ruault, Marie-Christine$$b36
000157248 7001_ $$aKvaskoff, Marina$$b37
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