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@ARTICLE{MahamatSaleh:157248,
      author       = {Y. Mahamat-Saleh and I. Cervenka and M. Al-Rahmoun and F.
                      R. Mancini and G. Severi and R. Ghiasvand and M. B. Veierod
                      and S. Caini and D. Palli and E. Botteri and C. Sacerdote
                      and F. Ricceri and A. Trichopoulou and E. Peppa and C. La
                      Vecchia and K. Overvad and C. C. Dahm and A. Olsen and A.
                      Tjønneland and A. Perez-Cornago and P. Jakszyn and S.
                      Grioni and M. B. Schulze and G. Skeie and C. Lasheras and S.
                      Colorado-Yohar and M. Rodríguez-Barranco and T. Kühn$^*$
                      and V. A. Katzke$^*$ and P. Amiano and R. Tumino and S.
                      Panico and A. Ezponda and E. Sonestedt and A. Scalbert and
                      E. Weiderpass and M.-C. Boutron-Ruault and M. Kvaskoff},
      title        = {{C}itrus intake and risk of skin cancer in the {E}uropean
                      {P}rospective {I}nvestigation into {C}ancer and {N}utrition
                      cohort ({EPIC}).},
      journal      = {European journal of epidemiology},
      volume       = {35},
      number       = {11},
      issn         = {1573-7284},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V.},
      reportid     = {DKFZ-2020-01505},
      pages        = {1057-1067},
      year         = {2020},
      note         = {2020 Nov;35(11):1057-1067},
      abstract     = {Citrus 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.},
      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:32710289},
      doi          = {10.1007/s10654-020-00666-9},
      url          = {https://inrepo02.dkfz.de/record/157248},
}