Fluid intake and the risk of urothelial cell carcinomas in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Results from previous studies investigating the association between fluid intake and urothelial cell carcinomas (UCC) are inconsistent. We evaluated this association among 233,236 subjects in the European Prospective Investigation into Cancer and Nutrition (EPIC), who had adequate baseline information on water and total fluid intake. During a mean follow-up of 9.3 years, 513 first primary UCC occurred. At recruitment, habitual fluid intake was assessed by a food frequency questionnaire. Multivariable hazard ratios were estimated using Cox regression stratified by age, sex and center and adjusted for energy intake, smoking status, duration of smoking and lifetime intensity of smoking. When using the lowest tertile of intake as reference, total fluid intake was not associated with risk of all UCC (HR 1.12; 95%CI 0.86-1.45, p-trend = 0.42) or with risk of prognostically high-risk UCC (HR 1.28; 95%CI 0.85-1.93, p-trend = 0.27) or prognostically low-risk UCC (HR 0.93; 95%CI 0.65-1.33, p-trend = 0.74). No associations were observed between risk of UCC and intake of water, coffee, tea and herbal tea and milk and other dairy beverages. For prognostically low-risk UCC suggestions of an inverse association with alcoholic beverages and of a positive association with soft drinks were seen. Increased risks were found for all UCC and prognostically low-risk UCC with higher intake of fruit and vegetable juices. In conclusion, total usual fluid intake is not associated with UCC risk in EPIC. The relationships observed for some fluids may be due to chance, but further investigation of the role of all types of fluid is warranted.
Ros
Martine M
MM
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Bas Bueno-de-Mesquita
H B
HB
Büchner
Frederike L
FL
Aben
Katja K H
KK
Kampman
Ellen
E
Egevad
Lars
L
Overvad
Kim
K
Tjønneland
Anne
A
Roswall
Nina
N
Clavel-Chapelon
Francoise
F
Kaaks
Rudolf
R
Chang-Claude
Jenny
J
Boeing
Heiner
H
Weikert
Steffen
S
Trichopoulou
Antonia
A
Orfanos
Philippos
P
Stasinopulou
Georgia
G
Saieva
Calogero
C
Krogh
Vittorio
V
Vineis
Paolo
P
Tumino
Rosario
R
Mattiello
Amalia
A
Peeters
Petra H M
PH
van Duijnhoven
Fränzel J B
FJ
Lund
Eiliv
E
Gram
Inger T
IT
Chirlaque
Maria D
MD
Barricarte
Aurelio
A
Rodríguez
Laudina
L
Molina
Esther
E
Gonzalez
Carlos
C
Dorronsoro
Miren
M
Manjer
Jonas
J
Ehrnström
Roy
R
Ljungberg
Börje
B
Allen
Naomi E
NE
Roddam
Andrew W
AW
Khaw
Kay-Tee
KT
Wareham
Nick
N
Boffetta
Paolo
P
Slimani
Nadia
N
Michaud
Dominique S
DS
Kiemeney
Lambertus A L M
LA
Riboli
Elio
E
D000328:Adult; D000368:Aged; D001628:Beverages; D015331:Cohort Studies; D004326:Drinking; D005060:Europe / Q000453:epidemiology; D005247:Feeding Behavior; D005260:Female; D005440:Fluid Therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control