Endogenous versus exogenous exposure to N-nitroso compounds and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study.
The risk of gastric cancer (GC) associated with dietary intake of nitrosodimethylamine (NDMA) and endogenous formation of nitroso compounds (NOCs) was investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC). The study included 521,457 individuals and 314 incident cases of GC that had occurred after 6.6 average years of follow-up. An index of endogenous NOC (ENOC) formation was estimated using data of the iron content from meat intake and faecal apparent total NOC formation according to previous published studies. Antibodies to Helicobacter pylori and vitamin C levels were measured in a sub-sample of cases and matched controls included in a nested case-control within the cohort. Exposure to NDMA was < 1 microg on average compared with 93 mug on average from ENOC. There was no association between NDMA intake and GC risk (HR, 1.00; 95% CI, 0.7-1.43). ENOC was significantly associated with non-cardia cancer risk (HR, 1.42; 95% CI, 1.14-1.78 for an increase of 40 microg/day) but not with cardia cancer (HR, 0.96; 95% CI, 0.69-1.33). Although the number of not infected cases is low, our data suggest a possible interaction between ENOC and H.pylori infection (P for interaction = 0.09). Moreover, we observed an interaction between plasma vitamin C and ENOC (P < 0.02). ENOC formation may account for our previously reported association between red and processed meat consumption and gastric cancer risk.
Department of Epidemiology, Catalan Institute of Oncology, (ICO-IDIBELL) Barcelona, Spain. paujak@ico.scs.es
Paula
P
Jakszyn
Sheila
S
Bingham
Guillem
G
Pera
Antonio
A
Agudo
Robert
R
Luben
Ailsa
A
Welch
Heiner
H
Boeing
Giuseppe
G
Del Giudice
Domenico
D
Palli
Calogero
C
Saieva
Vittorio
V
Krogh
Carlotta
C
Sacerdote
Rosario
R
Tumino
Salvatore
S
Panico
Göran
G
Berglund
Henrik
H
Simán
Göran
G
Hallmans
María José
MJ
Sanchez
Nerea
N
Larrañaga
Aurelio
A
Barricarte
María Dolores
MD
Chirlaque
José R
JR
Quirós
Timothy J
TJ
Key
Naomi
N
Allen
Eiliv
E
Lund
Fátima
F
Carneiro
Jakob
J
Linseisen
Gabriele
G
Nagel
Kim
K
Overvad
Anne
A
Tjonneland
Anja
A
Olsen
H Bas
HB
Bueno-de-Mesquita
Marga O
MO
Ocké
Petra Hm
PH
Peeters
Mattijs E
ME
Numans
Françoise
F
Clavel-Chapelon
Antonia
A
Trichopoulou
Claus
C
Fenger
Roger
R
Stenling
Pietro
P
Ferrari
Mazda
M
Jenab
Teresa
T
Norat
Elio
E
Riboli
Carlos A
CA
Gonzalez
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology; D000818:Animals; D001205:Ascorbic Acid / Q000097:blood; D016022:Case-Control Studies; D002417:Cattle; D004032:Diet; D004128:Dimethylnitrosamine / Q000378:metabolism; D005060:Europe; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D007501:Iron; D008297:Male; D008460:Meat / Q000009:adverse effects; D008875:Middle Aged; D009602:Nitrosamines / Q000378:metabolism* / Q000494:pharmacology*; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000209:etiology
D009602:Nitrosamines; D007501:Iron; D004128:Dimethylnitrosamine; D001205:Ascorbic Acid