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@ARTICLE{ErsoyGuller:276913,
      author       = {Z. Ersoy Guller and R. N. Harewood and E. Weiderpass and I.
                      Huybrechts and M. Jenab and J. M. Huerta and M.-J. Sánchez
                      and P. Jakszyn and P. Amiano and E. Ardanaz and C. Agnoli
                      and R. Tumino and D. Palli and G. Skeie and J. Manjer and K.
                      Papier and A. Tjønneland and A. K. Eriksen and M. B.
                      Schulze and R. Kaaks$^*$ and V. Katzke$^*$ and M. M.
                      Bergmann and E. Riboli and M. J. Gunter and A. J. Cross},
      title        = {{D}iet and lifestyle in relation to small intestinal cancer
                      risk: findings from the {E}uropean {P}rospective
                      {I}nvestigation into {C}ancer and {N}utrition ({EPIC}).},
      journal      = {Cancer causes $\&$ control},
      volume       = {34},
      number       = {10},
      issn         = {0957-5243},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V.},
      reportid     = {DKFZ-2023-01206},
      pages        = {927-937},
      year         = {2023},
      note         = {2023 Oct;34(10):927-937},
      abstract     = {The 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.},
      keywords     = {Adenocarcinoma (Other) / Alcohol (Other) / Cancer (Other) /
                      Carcinoid (Other) / Diet (Other) / Lifestyle (Other) / Small
                      intestine (Other) / Smoking (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37330982},
      doi          = {10.1007/s10552-023-01731-w},
      url          = {https://inrepo02.dkfz.de/record/276913},
}