Processed meat consumption and squamous cell carcinoma of the oesophagus in a large case-control study in Uruguay.

BACKGROUND: The role of processed meat in the aetiology of squamous cell oesophageal cancer has been explored in detail. METHODS: In the time period 1990-2005, a case-control study was conducted in Montevideo, Uruguay including 2,368 participants (876 cases of oesophageal cancer and 1,492 controls). Relative risks, approximated by the odds ratios, were estimated by multiple unconditional logistic regression. RESULTS: Processed meat was positively associated with oesophageal cancer (upper quartile vs lower quartile OR 2.30, 95%CI 1.72-3.07), whereas salted meat intake was positively associated with squamous cell oesophageal cancer (OR 3.82, 95%CI 2.74-5.33). Finally other cured meats were positively associated with oesophageal cancer (OR 1.65, 95%CI 1.22- 2.22). CONCLUSIONS: It could be concluded that processed meat consumption could be an important risk factor for the aetiology of squamous cell oesophageal cancer in Uruguay.

Diet patterns and risk of squamous cell oesophageal carcinoma: a case-control study in Uruguay.

BACKGROUND: Oesophageal cancer presents high incidence rates in the so-called Brazilian-Uruguayan belt. MATERIALS AND METHODS: The present study included 1,170 participants (234 cases and 936 controls) which were analyzed by unconditional multiple logistic regression in order to examine risk of oesophageal squamous cell carcinoma (OESCC) associated with several food groups. RESULTS: Boiled red meat (OR 2.59, 95%CI 1.69-3.97), lamb meat (OR 1.64, 95%CI 1.07-2.51), processed meat (OR 1.49, 95%CI 1.01-2.21), whole milk (OR 1.78, 1.19-1.68), fresh vegetables and fruits (OR 0.42, 95%CI 0.27-0.63), mate consumption (OR 2.04, 95%CI 1.32- 3.16), and black tea (OR 0.10, 95%CI 0.04-0.28) were significantly associated with risk of OESCC. CONCLUSIONS: Hot beverages (mate) and hot foods (boiled meat) appear to be important determinants in the risk of OESCC, allowing the penetration of carcinogens in tobacco and alcohol into the oesophageal mucosa.

Maté drinking and esophageal squamous cell carcinoma in South America: pooled results from two large multicenter case-control studies.

BACKGROUND: Maté tea is a nonalcoholic infusion widely consumed in southern South America, and may increase risk of esophageal squamous cell carcinoma (ESCC) and other cancers due to polycyclic aromatic hydrocarbons (PAH) and/or thermal injury. METHODS: We pooled two case-control studies: a 1988 to 2005 Uruguay study and a 1986 to 1992 multinational study in Argentina, Brazil, Paraguay, and Uruguay, including 1,400 cases and 3,229 controls. We computed ORs and fitted a linear excess OR (EOR) model for cumulative maté consumption in liters/day-year (LPDY). RESULTS: The adjusted OR for ESCC with 95% confidence interval (CI) by ever compared with never use of maté was 1.60 (1.2-2.2). ORs increased linearly with LPDY (test of nonlinearity; P = 0.69). The estimate of slope (EOR/LPDY) was 0.009 (0.005-0.014) and did not vary with daily intake, indicating maté intensity did not influence the strength of association. EOR/LPDY estimates for consumption at warm, hot, and very hot beverage temperatures were 0.004 (-0.002-0.013), 0.007 (0.003-0.013), and 0.016 (0.009-0.027), respectively, and differed significantly (P < 0.01). EOR/LPDY estimates were increased in younger (<65) individuals and never alcohol drinkers, but these evaluations were post hoc, and were homogeneous by sex. CONCLUSIONS: ORs for ESCC increased linearly with cumulative maté consumption and were unrelated to intensity, so greater daily consumption for shorter duration or lesser daily consumption for longer duration resulted in comparable ORs. The strength of association increased with higher maté temperatures. IMPACT: Increased understanding of cancer risks with maté consumption enhances the understanding of the public health consequences given its purported health benefits.

Meat, milk and risk of lymphoid malignancies: a case-control study in Uruguay.

In the time period 1996-2004, 697 cases with lymphoid neoplasms and 3606 controls with nonneoplastic conditions were included in a case-control study conducted in the Cancer Institute of Uruguay. They were administered a routine questionnaire that included 8 sections and a food frequency questionnaire focused on intakes of total meat, red meat, salted meat, barbecued meat, processed meat, milk, total vegetables and total fruits, and alcoholic beverages. Lymphoid cancers were analyzed by multiple polytomous regression. Red meat, salted meat, and milk were positively associated with risk of lymphoid cancers [odds ratios (OR) for the highest tertile vs. the lowest one of red meat = 1.68, 95% confidence interval (CI) 1.37-2.08, OR for whole milk = 2.92, 95% CI 2.63-3.63). On the other hand, plant foods, particularly total fruits, and alcoholic beverages (mainly red wine) were protective. We could conclude that these foods could play a significant role in the etiology of lymphoid malignancies.

Dietary patterns and risk of cancers of the upper aerodigestive tract: a factor analysis in Uruguay.

In the time period 1996-2004, we conducted a case-control study in Montevideo, Uruguay with the objective of exploring the role of foods and alcoholic beverages in the etiology of cancers of the upper aerodigestive tract (UADT). In brief, 563 male cases and 1099 male controls were frequency matched on age and residence using random sampling. All the participants were drawn from the 4 major public hospitals in Montevideo. We used exploratory factor analysis among controls. Through Scree plot test, the model retained 4 factors, which were labeled as prudent, starchy plants, Western, and drinker. These dietary patterns explained 34.8% of the total variance. Whereas the prudent pattern was inversely associated with UADT cancer [odds ratios (OR) for the upper tertile vs. the lowest one 0.52, 95% confidence intervals 0.32-0.76, P value for trend = 0.0005), the remaining patterns were significantly and positively associated with UADT cancers. We conclude that these patterns were similar among the oral and laryngeal cancers, both in the direction of the ORs and in the magnitude of the associations, suggesting that these cancer sites share the effect of dietary patterns in the etiology of cancer of the upper aerodigestive tract.

Nutrient-based dietary patterns of head and neck squamous cell cancer: a factor analysis in Uruguay.

OBJECTIVE: The aim of this study was to investigate the association between nutrient-based dietary patterns and squamous cell cancers of the head and neck. METHODS: We used a case-control study which included 548 cases and 548 controls. From these participants, we derived 23 nutrients and they were then submitted to a factorability analysis in order to conduct a principal component factor analysis. RESULTS: We were able to identify four nutrient-derived patterns. The first pattern (meat-based pattern) was positively associated with squamous cell cancer of the head and neck (OR 2.85, 95 % CI 1.81-4.15), whereas the third pattern (fruit-based) was strongly protective (OR 0.43, 95 % CI 0.27-0.63). The other nutrient patterns were also significantly associated with head and neck squamous cell carcinoma with minor ORs. CONCLUSION: Both patterns suggest that red meat and fruits are major factors in the etiology of head and neck squamous cell cancer, replicating previous studies in the field.

Maté consumption and risk of oral cancer: Case-control study in Uruguay.

BACKGROUND: In the period 1990 to 2001, a case-control study on oral cancer and maté consumption was conducted at the Cancer Institute of Uruguay. METHODS: The study included 696 newly diagnosed cases with squamous cell carcinoma and 696 controls afflicted with nonneoplastic conditions not related to tobacco smoking and alcohol drinking. The participants were matched on age and residence and the study was restricted to men. RESULTS: In order to control confounding for tobacco and alcohol, we fitted 2 models. According to model 1, the odds ratio (OR) for maté consumption was 1.15 (95% confidence interval [CI], 0.76-1.73), whereas the results for model 2 showed an OR of 3.47 (95% CI, 1.60-7.52). CONCLUSIONS: The inclusion of a term for the interaction between maté and smoking (or drinking) was rewarding and the ORs were even higher than those observed with the crude estimates.

Food groups and risk of prostate cancer: a case-control study in Uruguay.

OBJECTIVE: The role of foods and beverages has been studied in detail in order to establish probable risk factors for prostate cancer. METHODS: Data were derived from 326 cases with incident and microscopically confirmed adenocarcinomas of the prostate and 652 controls. Odds ratios and 95 % confidence intervals of prostate cancer were estimated by unconditional multiple logistic regression. RESULTS: We identified the following food items as risk factors: lamb meat, salted meat, whole milk, total eggs, and maté consumption. The highest OR was associated with total eggs (OR, 2.43; 95 % CI, 1.70-3.48), followed by salted meat (OR, 2.65; 95 % CI, 1.36-3.76), maté consumption (OR, 1.96; 95 % CI, 1.17-3.31), and whole milk (OR, 2.01; 95 % CI, 1.26-2.51). CONCLUSIONS: The final model, fitted by stepwise forward method, included total eggs, salted meat, whole milk, and maté consumption, whereas fruits were protective.

Nutrient-derived dietary patterns and risk of colorectal cancer: a factor analysis in Uruguay.

In order to explore the role of nutrients and bioactive related substances in colorectal cancer, we conducted a case-control in Uruguay, which is the country with the highest production of beef in the world. Six hundred and eleven (611) cases afflicted with colorectal cancer and 1,362 controls drawn from the same hospitals in the same time period were analyzed through unconditional multiple logistic regression. This base population was submitted to a principal components factor analysis and three factors were retained. They were labeled as the meat-based, plant-based, and carbohydrates patterns. They were rotated using orthogonal varimax method. The highest risk was positively associated with the meat-based pattern (OR for the highest quartile versus the lowest one 1.63, 95 % CI 1.22-2.18, P value for trend = 0.001), whereas the plant-based pattern was strongly protective (OR 0.60, 95 % CI 0.45-0.81, P value for trend <0.0001. The carbohydrates pattern was only positively associated with colon cancer risk (OR 1.46, 95 % CI 1.02-2.09). The meat-based pattern was rich in saturated fat, animal protein, cholesterol, and phosphorus, nutrients originated in red meat. Since herocyclic amines are formed in the well-done red meat through the action of amino acids and creatine, it is suggestive that this pattern could be an important etiologic agent for colorectal cancer.

Meat consumption, cooking methods, mutagens, and risk of squamous cell carcinoma of the esophagus: a case-control study in Uruguay.

The role of meat in squamous cell carcinoma of the esophagus (ESCC) has been considered conflictive. For this reason, we decided to conduct a case-control study on meat consumption and ESCC. Data included 234 newly diagnosed and microscopically examined ESCC and 2,020 controls with conditions not related to tobacco smoking nor alcohol drinking and without changes in their diets. We studied total meat, red meat, beef, lamb, processed meat, poultry, fish, total white meat, liver, fried meat, barbecued meat, boiled meat, heterocyclic amines, nitrosodimethylamine, and benzo[a]pyrene in relation with the risk of ESCC. Red meat, lamb, and boiled meat were directly associated with the risk of ESCC, whereas total white meat, poultry, fish, and liver were mainly protective against this malignancy.

Dietary benzo[a]pyrene, alcohol drinking, and risk of breast cancer: a case-control study in Uruguay.

In order to determine to the effect of benzo[a]pyrene (BaP) on breast cancer risk we conducted a case-control study in the time period 1996-2004. The study included 1,098 participants (460 cases and 638 controls). All the patients were drawn from the four major hospitals in Montevideo, Uruguay. Statistical analysis was performed using unconditional multiple logistic regression and the models included age, residence, urban/rural status, education, monthly income, body mass index, menopausal status, age at menarche, parity, smoking index, alcohol drinking, mate consumption, total energy, total vegetables and fruits, and BaP intake. The highest vs. the lowest quartile of BaP intake (OR 2.0, 95% CI 1.2-3.3) was significantly associated with breast cancer risk. Alcohol drinking was also directly associated with breast cancer risk (OR 1.63, 95% CI 1.19-2.23) and the joint effect of BaP and alcohol drinking showed an elevated risk of the disease (OR 3.32, 95% CI 2.17-5.06). The present study suggests that elevated consumption of BaP could play an important role in the etiology of breast cancer. This effect is enhanced by the intake of alcohol.

Maté consumption and risk of cancer: a multi-site case-control study in Uruguay.

In the time period 1990-2004 we conducted a multisite case-control study in order to examine the relationship of mate consumption and risk of 13 cancer sites in Montevideo, Uruguay. The study included 13,201 participants (8,875 cases and 4,326 controls) drawn from the four major public hospitals in the city of Montevideo. Newly diagnosed and microscopically confirmed cases of cancers of the mouth, pharynx, esophagus, stomach, colon, rectum, larynx, lung, female breast, cervix uteri, prostate, bladder and kidney were included in the study. Controls were drawn from the same hospitals and in the same time period and were afflicted by non-neoplastic conditions not related with tobacco smoking or alcohol drinking and without recent changes in their diets. Odds ratios for mate consumption was directly associated with cancers of the upper aerodigestive tract (UADT), esophagus, stomach, larynx, lung, cervix uteri, prostate, bladder, and kidney. In conclusion these results suggest that chemicals, like benzo[a]pyrene, could be responsible of the carcinogenic effect of mate in the above mentioned cancer sites.

Dietary patterns and risk of colorectal cancer: a factor analysis in uruguay.

In the time period 1996-2004, a case-control study of colorectal cancer was conducted in Montevideo, Uruguay. The study included 610 cases and 1,220 controls, frequency matched for age, sex, and residence. All cases were newly diagnosed and microscopically confirmed and controls were drawn from the same hospitals. Controls were submitted to factor analysis (principal components method) and 4 dietary patterns for men (prudent, traditional, Western, drinker) and 3 for women (prudent, Western, drinker) were retained. These were rotated and normalized by the Kaiser method. Scores were applied to all participants (cases and controls) and odds ratios were estimated by logistic regression and polynomial regression. The Western pattern showed an OR of 2.62 (95 % CI 1.36-5.08) for colon cancer among men, and women displayed a similar increase in risk. However, rectal cancer was not associated with this diet, rather being inversely associated with the prudent and traditional patterns among men (OR 0.49, 95 % CI 0.28-0.57 for the traditional pattern). In conclusion, whereas the Western pattern was directly associated with colon cancer, the prudent pattern was strongly protective for rectal cancer.

Celiac disease and gyneco-obstetrics complications: can serum antibodies modulate tissue transglutaminase functions and contribute to clinical pattern?

PROBLEM: Untreated celiac disease (CD) is often associated with early miscarriages, infertility, and alterations in menstrual cycle. Tissue transglutaminase (tTG) antibodies could be involved by interfering with tTG transamidating activity and/or biological functions mediated by its interaction with fibronectin (FN). METHOD OF STUDY: The correlation between the presence of extra-digestive disorders and the reactivity of sera against tTG-FN and its effects on tTG transamidating activity was analyzed in a group or 50 women with recently diagnosed CD. RESULTS: Heterogeneous behavior was observed among serum samples derived from patients with different complaints, suggesting that differences in fine specificity patterns could condition clinical outcome. Sera from women with gynecological and/or obstetric problems induced significant inhibition of in vitro enzymatic activity in comparison with those without these kinds of disorders. CONCLUSIONS: The significant correlation observed between serum effects and clinical profile suggests a putative involvement of tTG-specific antibodies in gynecological and/or obstetric disorders during active CD.

Dietary patterns and risk of adenocarcinoma of the lung in males: a factor analysis in Uruguay.

In the period 1996-2004, a hospital-based case-control study on diet and adenocarcinoma of the lung in men was conducted in Montevideo, Uruguay. The study included 200 cases and 800 controls, frequency matched on age, residence, and interviewers. Factor analysis (principal components) was used to identify the major food patterns associated with adenocarcinoma. The analysis of food groups led to the identification of 4 patterns, arbitrarily labeled as Western, starchy vegetables, prudent, and milk/coffee. Whereas the Western pattern (OR 1.94, 95% CI 1.08-3.45) and the milk/coffee pattern (OR 2.30, 95% CI 1.35-3.90) were positively associated with risk of adenocarcinoma of the lung, the starchy vegetables (OR 0.49, 95% 0.28-0.86) and prudent patterns (OR 0.54, 95% CI 0.32-0.92) were significantly protective against this malignancy. The results suggests that adenocarcinoma of the lung could be considered a different nosologic entity, compared with the other histologies of lung cancer.

Nutrient patterns and risk of breast cancer in Uruguay.

OBJECTIVES: To explore the role of nutrient patterns in the etiology of breast cancer (BC) among Uruguayan women. METHODS: A principal component analysis was conducted. The study included 442 newly diagnosed cases of BC and 442 hospitalized controls. RESULTS: Two dietary patterns derived from factor analysis and were labeled as high-meat and antioxidants patterns. Whereas the high-meat pattern was directly associated with BC risk (OR for the highest versus the lowest quartile = 3.50, 95 % CI 1.94-6.30, p-value for trend <0.0001), the antioxidants pattern displayed a protective effect (OR=0.44, 95 % CI 0.27-0.74). Its negative association was stronger for postmenopausal than for premenopausal women (OR=0.63, 95% CI 0.51-0.79 vs. OR=0.89, 95% CI 0.50-1.56, respectively). Both strata were heterogeneous (p=0.004). The high-meat pattern was more associated with BC risk among patients with family history of BC compared with participants without it, but results did not differ by histology. In contrast, the antioxidants pattern was more associated with non-ductal cancers (OR=0.50 [95 % CI 0.35-0.69]) than with ductal cancers (OR=0.72, 95 % CI 0.58-0.88, heterogeneity p-value=0.03). CONCLUSIONS: Results support an association between the high-meat and antioxidant dietary patterns and BC risk. Furthermore, findings suggest that gene-environmental interactions may be important in BC etiology.

Dietary patterns and risk of advanced prostate cancer: a principal component analysis in Uruguay.

OBJECTIVE: In order to explore the role of broader eating patterns in the etiology of prostate cancer, we conducted a principal components analysis among Uruguayan men. METHODS: The study included 345 newly diagnosed cases of advanced prostate cancer and 690 hospitalized controls. The factor analysis was performed using the control population. RESULTS: Factor analysis allowed the extraction of five patterns, labeled as prudent, traditional, substituter, drinker, and Western. Whereas the traditional and Western patterns were directly associated with risk of prostate cancer (OR for high quartile versus the low quartile of the Western diet was 2.35, 95% CI 1.44-3.85, p-value for trend < 0.0001), the prudent, drinker, and substituter patterns were not associated with risk of the disease. After adjustment of each pattern for the foods with high loadings, these three patterns did not modify substantially their original ORs. CONCLUSION: The Western and traditional patterns could partially explain the high incidence of advanced prostate cancer in Uruguay, a main producer of beef in the World.

Meat consumption, meat cooking and risk of lung cancer among Uruguayan men.

A case-control study was conducted in Uruguay, including 876 male cases of lung cancer and 876 male hospitalized controls, frequency matched for age (ten-year intervals), residence and hospital. The following explanatory variables were included in the study: fried red meat, barbecued red meat, boiled red meat, and salted red meat. These items were log transformed and energy-adjusted by the residuals method. The following potential confounders were included into the models: age, residence, hospital, education, family history of lung cancer, body mass index, smoking index, alcohol drinking, mate consumption, total energy intake, non-meat fatty foods and total fruits. The main objective was to estimate the odds ratios associated with lung cancer risk. Whereas fried meat, barbecued meat, and salted meat were positively associated with risk (OR of the highest quartile of salted meat versus the lowest, 2.90, 95 % CI 1.99-4.25, p-value for trend<0.0001), boiled red meat was mainly protective. We conclude that salted meat was the main risk factor. The mechanisms could be related to the content of N-nitroso compounds in salted meat.

Dietary patterns and risk of ductal carcinoma of the breast: a factor analysis in Uruguay.

Breast cancer (BC) shows very high incidence rates in Uruguayan women. The present factor analysis of ductal carcinoma of the breast, the most frequent histological type of this malignancy both in Uruguay and in the World, was conducted at a prepaid hospital of Montevideo, Uruguay. We identified 111 cases with ductal BC and 222 controls with normal mammograms. A factor analysis was conducted using 39 food groups, allowing retention of six factors analyzed through logistic regression in order to obtain odds ratios (OR) associated with ductal BC. The low fat and non-alcoholic beverage patterns were inversely associated (OR=0.30 and OR=0.45, respectively) with risk. Conversely, the fatty cheese pattern was positively associated (OR=4.17) as well as the fried white meat (OR=2.28) and Western patterns (OR 2.13). Ductal BC shared similar dietary risk patterns as those identified by studies not discriminating between histologic type of breast cancer.

Meat intake, meat mutagens and risk of lung cancer in Uruguayan men.

OBJECTIVE: To determine the role of meat consumption and related mutagens in the etiology of lung cancer, we conducted a case-control study among Uruguayan males in the time period 1996-2004. METHODS: The study included 846 cases and 846 controls, frequency matched on age and residence. Both series were drawn from the four major public hospitals in Montevideo, Uruguay. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) of lung cancer by quartiles of meat intake and mutagens. RESULTS: The highest vs. the lowest quartile of intake of total meat (OR = 2.04, 95% CI 1.42-2.92), red meat (OR = 2.33, 95% CI 1.63-3.32), and processed meat (OR = 1.79, 95% CI 1.22-2.65) was associated with increased risk of lung cancer, while intake of total white meat, poultry and fish was not. Heterocyclic amines (IQ, MeIQx, PhIP), nitrosamines and benzo[a]pyrene were directly associated with the risk of lung cancer (OR for PhIP 2.16, 95% CI 1.48-3.15). Moreover, both red meat and meat mutagens displayed higher risks among former smokers compared with current smokers. CONCLUSIONS: This study suggests that red and processed meat and meat mutagens may play a role in the etiology of lung cancer.