title: Macronutrient intake and risk of urothelial cell carcinoma in the European prospective investigation into cancer and nutrition.
abstract: Previous studies have suggested that dietary factors may be important in the development of bladder cancer. We examined macronutrient intake in relation to risk of urothelial cell carcinoma among 469,339 men and women in the European Prospective Investigation into Cancer and Nutrition. Associations were examined using Cox regression, stratified by sex, age at recruitment and centre and further adjusted for smoking status and duration, body mass index and total energy intake. After an average of 11.3 years of follow-up, 1,416 new cases of urothelial cell carcinoma were identified. After allowing for measurement error, a 3% increase in the consumption of energy intake from animal protein was associated with a 15% higher risk (95% confidence interval [CI]: 3-30%; p(trend)  = 0.01) and a 2% increase in energy from plant protein intake was associated with a 23% lower risk (95% CI: 36-7%, p(trend)  = 0.006). Dietary intake of fat, carbohydrate, fibre or calcium was not associated with risk. These findings suggest that animal and/or plant protein may affect the risk of urothelial cell carcinoma, and examination of these associations in other studies is needed.
authors.affiliation: Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom. naomi.allen@ctsu.ox.ac.uk
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Allen
authors.forename: Paul N
authors.initials: PN
authors.lastname: Appleby
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
authors.forename: H B
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Martine M
authors.initials: MM
authors.lastname: Ros
authors.forename: Lambertus A L M
authors.initials: LA
authors.lastname: Kiemeney
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Nina
authors.initials: N
authors.lastname: Roswall
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Steffen
authors.initials: S
authors.lastname: Weikert
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Jenny
authors.initials: J
authors.lastname: Chang-Claude
authors.forename: Birgit
authors.initials: B
authors.lastname: Teucher
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Carlotta
authors.initials: C
authors.lastname: Sacerdote
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.forename: Petra
authors.initials: P
authors.lastname: Peeters
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Quirós
authors.forename: Paula
authors.initials: P
authors.lastname: Jakszyn
authors.forename: Esther
authors.initials: E
authors.lastname: Molina-Montes
authors.forename: María-Dolores
authors.initials: MD
authors.lastname: Chirlaque
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nick
authors.initials: N
authors.lastname: Wareham
authors.forename: Börje
authors.initials: B
authors.lastname: Ljungberg
authors.forename: Göran
authors.initials: G
authors.lastname: Hallmans
authors.forename: Roy
authors.initials: R
authors.lastname: Ehrnström
authors.forename: Ulrika
authors.initials: U
authors.lastname: Ericson
authors.forename: Inger Torhild
authors.initials: IT
authors.lastname: Gram
authors.forename: Christine L
authors.initials: CL
authors.lastname: Parr
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Tina
authors.initials: T
authors.lastname: Karapetyan
authors.forename: Vardis
authors.initials: V
authors.lastname: Dilis
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Guy
authors.initials: G
authors.lastname: Fagherrazzi
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gunter
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002136:Calcium, Dietary / Q000008:administration & dosage; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage*; D005060:Europe / Q000453:epidemiology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008460:Meat; D008875:Middle Aged; D009752:Nutritional Status; D014674:Plant Proteins, Dietary / Q000008:administration & dosage*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking; D011795:Surveys and Questionnaires; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D002136:Calcium, Dietary; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D014674:Plant Proteins, Dietary