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000276913 1001_ $$00000-0003-0516-8681$$aErsoy Guller, Zeynep$$b0
000276913 245__ $$aDiet and lifestyle in relation to small intestinal cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC).
000276913 260__ $$aDordrecht [u.a.]$$bSpringer Science + Business Media B.V.$$c2023
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000276913 500__ $$a2023 Oct;34(10):927-937
000276913 520__ $$aThe incidence of small intestinal cancer (SIC) is increasing, however, its aetiology remains unclear due to a lack of data from large-scale prospective cohorts. We examined modifiable risk factors in relation to SIC overall and by histological subtype.We analysed 450,107 participants enrolled in the European Prospective Investigation into Cancer and Nutrition cohort. Cox proportional hazards models were used to estimate univariable and multivariable hazard ratios (HRs) and 95% confidence intervals (CIs).During an average of 14.1 years of follow-up, 160 incident SICs (62 carcinoids, 51 adenocarcinomas) were identified. Whilst univariable models revealed a positive association for current versus never smokers and SIC (HR, 95% CI: 1.77, 1.21-2.60), this association attenuated in multivariable models. In energy-adjusted models, there was an inverse association across vegetable intake tertiles for SIC overall (HRT3vsT1, 95% CI: 0.48, 0.32-0.71, p-trend: < 0.001) and for carcinoids (HRT3vsT1, 95% CI: 0.44, 0.24-0.82, p-trend: 0.01); however, these attenuated in multivariable models. Total fat was also inversely associated with total SIC and both subtypes but only in the second tertile (SIC univariable HRT2vsT1, 95% CI: 0.57, 0.38-0.84; SIC multivariable HRT2vsT1, 95% CI: 0.55, 0.37-0.81). Physical activity, intake of alcohol, red or processed meat, dairy products, or fibre were not associated with SIC.These exploratory analyses found limited evidence for a role of modifiable risk factors in SIC aetiology. However, sample size was limited, particularly for histologic subtypes; therefore, larger studies are needed to delineate these associations and robustly identify risk factors for SIC.
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000276913 650_7 $$2Other$$aAdenocarcinoma
000276913 650_7 $$2Other$$aAlcohol
000276913 650_7 $$2Other$$aCancer
000276913 650_7 $$2Other$$aCarcinoid
000276913 650_7 $$2Other$$aDiet
000276913 650_7 $$2Other$$aLifestyle
000276913 650_7 $$2Other$$aSmall intestine
000276913 650_7 $$2Other$$aSmoking
000276913 7001_ $$aHarewood, Rhea N$$b1
000276913 7001_ $$aWeiderpass, Elisabete$$b2
000276913 7001_ $$aHuybrechts, Inge$$b3
000276913 7001_ $$aJenab, Mazda$$b4
000276913 7001_ $$aHuerta, José María$$b5
000276913 7001_ $$aSánchez, Maria-Jose$$b6
000276913 7001_ $$aJakszyn, Paula$$b7
000276913 7001_ $$aAmiano, Pilar$$b8
000276913 7001_ $$aArdanaz, Eva$$b9
000276913 7001_ $$aAgnoli, Claudia$$b10
000276913 7001_ $$aTumino, Rosario$$b11
000276913 7001_ $$aPalli, Domenico$$b12
000276913 7001_ $$aSkeie, Guri$$b13
000276913 7001_ $$aManjer, Jonas$$b14
000276913 7001_ $$aPapier, Keren$$b15
000276913 7001_ $$aTjønneland, Anne$$b16
000276913 7001_ $$aEriksen, Anne Kirstine$$b17
000276913 7001_ $$aSchulze, Matthias B$$b18
000276913 7001_ $$0P:(DE-He78)4b2dc91c9d1ac33a1c0e0777d0c1697a$$aKaaks, Rudolf$$b19$$udkfz
000276913 7001_ $$0P:(DE-He78)fb68a9386399d72d84f7f34cfc6048b4$$aKatzke, Verena$$b20$$udkfz
000276913 7001_ $$aBergmann, Manuela M$$b21
000276913 7001_ $$aRiboli, Elio$$b22
000276913 7001_ $$aGunter, Marc J$$b23
000276913 7001_ $$aCross, Amanda J$$b24
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