umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Publications (10 of 133) Show all publications
Ge, W., Clendenen, T. V., Afanasyeva, Y., Koenig, K. L., Agnoli, C., Brinton, L. A., . . . Zeleniuch-Jacquotte, A. (2018). Circulating anti-Müllerian hormone and breast cancer risk: a study in ten prospective cohorts. International Journal of Cancer, 142(11), 2215-2226
Open this publication in new window or tab >>Circulating anti-Müllerian hormone and breast cancer risk: a study in ten prospective cohorts
Show others...
2018 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 142, no 11, p. 2215-2226Article in journal (Refereed) Published
Abstract [en]

A strong positive association has been observed between circulating anti‐Müllerian hormone (AMH), a biomarker of ovarian reserve, and breast cancer risk in three prospective studies. Confirming this association is important because of the paucity of biomarkers of breast cancer risk in premenopausal women. We conducted a consortium study including ten prospective cohorts that had collected blood from premenopausal women. A nested case–control design was implemented within each cohort. A total of 2,835 invasive (80%) and in situ (20%) breast cancer cases were individually matched to controls (n = 3,122) on age at blood donation. AMH was measured using a high sensitivity enzyme‐linked immunoabsorbent assay. Conditional logistic regression was applied to the aggregated dataset. There was a statistically significant trend of increasing breast cancer risk with increasing AMH concentration (ptrend across quartiles <0.0001) after adjusting for breast cancer risk factors. The odds ratio (OR) for breast cancer in the top vs. bottom quartile of AMH was 1.60 (95% CI = 1.31–1.94). Though the test for interaction was not statistically significant (pinteraction = 0.15), the trend was statistically significant only for tumors positive for both estrogen receptor (ER) and progesterone receptor (PR): ER+/PR+: ORQ4–Q1 = 1.96, 95% CI = 1.46–2.64, ptrend <0.0001; ER+/PR−: ORQ4–Q1 = 0.82, 95% CI = 0.40–1.68, ptrend = 0.51; ER−/PR+: ORQ4–Q1 = 3.23, 95% CI = 0.48–21.9, ptrend = 0.26; ER−/PR−: ORQ4–Q1 = 1.15, 95% CI = 0.63–2.09, ptrend = 0.60. The association was observed for both pre‐ (ORQ4–Q1= 1.35, 95% CI = 1.05–1.73) and post‐menopausal (ORQ4–Q1 = 1.61, 95% CI = 1.03–2.53) breast cancer (pinteraction = 0.34). In this large consortium study, we confirmed that AMH is associated with breast cancer risk, with a 60% increase in risk for women in the top vs. bottom quartile of AMH.

What's new? To make informed decisions about screening and prevention, women need tools to accurately assess their breast cancer risk. Young women have few predictive biomarkers to look to; estrogen and progesterone are only weakly predictive before menopause. Anti-Müllerian hormone (AMH), which strongly correlates with age at menopause, may also correlate with breast cancer risk, according to some previous data. Here, the authors test this correlation by conducting nested case-control studies within ten different cohorts. They found that breast cancer risk increased along with increasing AMH concentration, confirming this hormone as a possible biomarker for breast cancer.

Place, publisher, year, edition, pages
Hoboken: John Wiley & Sons, 2018
Keywords
AMH, anti-Müllerian hormone, breast cancer, nested case-control study
National Category
Surgery Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-146526 (URN)10.1002/ijc.31249 (DOI)000429545800003 ()29315564 (PubMedID)
Available from: 2018-04-11 Created: 2018-04-11 Last updated: 2018-08-31Bibliographically approved
Del Chiaro, M., Besselink, M. G., Scholten, L., Bruno, M. J., Cahen, D. L., Gress, T. M., . . . Wusten, L. (2018). European evidence-based guidelines on pancreatic cystic neoplasms. Gut, 67(5), 789-804
Open this publication in new window or tab >>European evidence-based guidelines on pancreatic cystic neoplasms
Show others...
2018 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 67, no 5, p. 789-804Article in journal (Refereed) Published
Abstract [en]

Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring < 40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter >= 40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule > 5 mm, and MPD diameter > 10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-147291 (URN)10.1136/gutjnl-2018-316027 (DOI)000429733600004 ()29574408 (PubMedID)
Available from: 2018-05-28 Created: 2018-05-28 Last updated: 2018-06-09Bibliographically approved
Klein, A. P., Wolpin, B. M., Risch, H. A., Stolzenberg-Solomon, R. Z., Mocci, E., Zhang, M., . . . Amundadottir, L. T. (2018). Genome-wide meta-analysis identifies five new susceptibility loci for pancreatic cancer. Nature Communications, 9, Article ID 556.
Open this publication in new window or tab >>Genome-wide meta-analysis identifies five new susceptibility loci for pancreatic cancer
Show others...
2018 (English)In: Nature Communications, ISSN 2041-1723, E-ISSN 2041-1723, Vol. 9, article id 556Article in journal (Refereed) Published
Abstract [en]

In 2020, 146,063 deaths due to pancreatic cancer are estimated to occur in Europe and the United States combined. To identify common susceptibility alleles, we performed the largest pancreatic cancer GWAS to date, including 9040 patients and 12,496 controls of European ancestry from the Pancreatic Cancer Cohort Consortium (PanScan) and the Pancreatic Cancer Case-Control Consortium (PanC4). Here, we find significant evidence of a novel association at rs78417682 (7p12/TNS3, P = 4.35 x 10(-8)). Replication of 10 promising signals in up to 2737 patients and 4752 controls from the PANcreatic Disease ReseArch (PAN-DoRA) consortium yields new genome-wide significant loci: rs13303010 at 1p36.33 (NOC2L, P = 8.36 x 10(-14)), rs2941471 at 8q21.11 (HNF4G, P = 6.60 x 10(-10)), rs4795218 at 17q12 (HNF1B, P = 1.32 x 10(-8)), and rs1517037 at 18q21.32 (GRP, P = 3.28 x 10(-8)). rs78417682 is not statistically significantly associated with pancreatic cancer in PANDoRA. Expression quantitative trait locus analysis in three independent pancreatic data sets provides molecular support of NOC2L as a pancreatic cancer susceptibility gene.

Place, publisher, year, edition, pages
Nature Publishing Group, 2018
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-145138 (URN)10.1038/s41467-018-02942-5 (DOI)000424451300001 ()29422604 (PubMedID)
Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2018-06-09Bibliographically approved
Naudin, S., Li, K., Jaouen, T., Assi, N., Kyrø, C., Tjønneland, A., . . . Ferrari, P. (2018). Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study. International Journal of Cancer, 143(4), 801-812
Open this publication in new window or tab >>Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study
Show others...
2018 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 143, no 4, p. 801-812Article in journal (Refereed) Published
Abstract [en]

Recent evidence suggested a weak relationship between alcohol consumption and pancreatic cancer (PC) risk. In our study, the association between lifetime and baseline alcohol intakes and the risk of PC was evaluated, including the type of alcoholic beverages and potential interaction with smoking. Within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, 1,283 incident PC (57% women) were diagnosed from 476,106 cancer-free participants, followed up for 14 years. Amounts of lifetime and baseline alcohol were estimated through lifestyle and dietary questionnaires, respectively. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and their 95% confidence interval (CI). Alcohol intake was positively associated with PC risk in men. Associations were mainly driven by extreme alcohol levels, with HRs comparing heavy drinkers (>60 g/day) to the reference category (0.1-4.9 g/day) equal to 1.77 (95% CI: 1.06, 2.95) and 1.63 (95% CI: 1.16, 2.29) for lifetime and baseline alcohol, respectively. Baseline alcohol intakes from beer (>40 g/day) and spirits/liquors (>10 g/day) showed HRs equal to 1.58 (95% CI: 1.07, 2.34) and 1.41 (95% CI: 1.03, 1.94), respectively, compared to the reference category (0.1-2.9 g/day). In women, HR estimates did not reach statistically significance. The alcohol and PC risk association was not modified by smoking status. Findings from a large prospective study suggest that baseline and lifetime alcohol intakes were positively associated with PC risk, with more apparent risk estimates for beer and spirits/liquors than wine intake.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-146524 (URN)10.1002/ijc.31367 (DOI)000438203500009 ()29524225 (PubMedID)
Available from: 2018-04-11 Created: 2018-04-11 Last updated: 2018-09-19Bibliographically approved
Wadsten, C., Wennstig, A.-K., Garmo, H., Nilsson, G., Blomqvist, C., Holmberg, L., . . . Sund, M. (2018). Risk of ischemic heart disease after radiotherapy for ductal carcinoma in situ. Breast Cancer Research and Treatment, 171(1), 95-101
Open this publication in new window or tab >>Risk of ischemic heart disease after radiotherapy for ductal carcinoma in situ
Show others...
2018 (English)In: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 171, no 1, p. 95-101Article in journal (Refereed) Published
Abstract [en]

Purpose: The use of adjuvant radiotherapy (RT) in the management of ductal carcinoma in situ (DCIS) is increasing. Left-sided breast irradiation may involve exposure of the heart to ionising radiation, increasing the risk of ischemic heart disease (IHD). We examined the incidence of IHD in a population-based cohort of women with DCIS.

Methods: The Breast Cancer DataBase Sweden (BCBase) cohort includes women registered with invasive and in situ breast cancers 1992-2012 and age-matched women without a history of breast cancer. In this analysis, 6270 women with DCIS and a comparison cohort of 31,257 women were included. Through linkage with population-based registers, data on comorbidity, socioeconomic status and incidence of IHD was obtained. Hazard ratios (HR) for IHD with 95% confidence intervals (CI) were analysed.

Results: Median follow-up time was 8.8 years. The risk of IHD was not increased for women with DCIS versus women in the comparison cohort (HR 0.93; 95% CI 0.82-1.06), after treatment with radiotherapy versus surgery alone (HR 0.77; 95% CI 0.60-0.98) or when analysing RT by laterality (HR 0.85; 95% CI 0.53-1.37 for left-sided versus right-sided RT).

Conclusions: The risk of IHD was lower for women with DCIS allocated to RT compared to non-irradiated women and to the comparison cohort, probably due to patient selection. Comparison of RT by laterality did not show any over-risk for irradiation of the left breast.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
ductal carcinoma in situ, radiotherapy, ischemic heart disease
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-150356 (URN)10.1007/s10549-018-4803-1 (DOI)000438656200010 ()29730730 (PubMedID)2-s2.0-85046479273 (Scopus ID)
Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2018-09-08Bibliographically approved
Wennstig, A. K., Garmo, H., Isacsson, U., Gagliardi, G., Rintelä, N., Lagerqvist, B., . . . Nilsson, G. (2018). The relationship between radiation doses to coronary arteries and later intervention requiring coronary stenosis in breast cancer. Paper presented at 11th European Breast Cancer Conference (EBCC), MAR 21-23, 2018, Barcelona, SPAIN. European Journal of Cancer, 92, S61-S62
Open this publication in new window or tab >>The relationship between radiation doses to coronary arteries and later intervention requiring coronary stenosis in breast cancer
Show others...
2018 (English)In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 92, p. S61-S62Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-147319 (URN)10.1016/S0959-8049(18)30408-8 (DOI)000429103100150 ()
Conference
11th European Breast Cancer Conference (EBCC), MAR 21-23, 2018, Barcelona, SPAIN
Note

Supplement: 3

Meeting Abstract: 233 (PB-028)

Available from: 2018-05-25 Created: 2018-05-25 Last updated: 2018-06-09Bibliographically approved
Wadsten, C., Garmo, H., Fredriksson, I., Sund, M. & Warnberg, F. (2017). DCIS and the risk of breast cancer death: a case control study. Paper presented at San Antonio Breast Cancer Symposium, DEC 06-10, 2016, San Antonio, TX.. Cancer Research, 77
Open this publication in new window or tab >>DCIS and the risk of breast cancer death: a case control study
Show others...
2017 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 77Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: The risk of breast cancer death after a primary ductal carcinoma in situ (DCIS) is less than 2 % after 10 years. Whereas in situ recurrences do not influence survival, a 17-fold elevated risk of breast cancer specific mortality has been shown for invasive recurrences. Adjuvant radiotherapy (RT) effectively reduces recurrences after breast conserving surgery (BCS) for DCIS, but no studies have been able to demonstrate a survival benefit from adjuvant RT treatment or from choosing mastectomy instead of BCS. Here patient and tumour related risk factors for breast cancer death in women with a pure primary DCIS were studied.

Patients and methods: Women registered with a primary DCIS, between 1992-2012 in three of Sweden´s health care regions with a population of approximately 5.2 million, were enrolled in a nested case-control study. Out of 6,964 women with DCIS, 96 patients who later died from breast cancer were identified. Four controls per case (n=318) were randomly selected by incidence density sampling. We retrieved medical records and pathology reports and calculated OR with 95% CIs for various variables using conditional logistic regression.

Results: Of the 96 cases, 10 patients developed distant metastasis without a known local recurrence. In 56 patients death was preceded by an invasive ipsilateral recurrence and in 3 patients by a recurrent ipsilateral DCIS. Seven patients had invasive breast events in both the ipsilateral and the contralateral breast. Seventeen patients had contralateral invasive breast cancer and 3 patients contralateral DCIS.

Multifocality and tumour size over 25mm (OR 2.6 (1.6 to 4.2)), positive or uncertain margin status (OR 2.8 (1.6 to 4.9)) and detection outside screening (OR 2.1 (1.2 to 3.9)) increased the risk of breast cancer death in univariate analysis, when adjusted for age and year of diagnosis. Suspicion of micro-invasion and nuclear grade 3 was associated with a nonsignificant increased risk, OR 1.8 (0.6 to 5.0) and 2.6 (0.9-6.5), respectively. The risk was not affected by age or treatment. Tumour size and margin status remained significant in the multivariable analysis, when adjusted for treatment and for contralateral breast cancer (OR 2.0 (1.2 to 3.7)).

Conclusion: In the present study, large tumours and positive or uncertain margin status were significant risk factors for later breast cancer death after a primary DCIS. More extensive treatment was not related to a lower risk. The significance of tumour biology and nuclear grade will be further examined and evaluated.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-133667 (URN)10.1158/1538-7445.SABCS16-P3-17-03 (DOI)000397999001245 ()
Conference
San Antonio Breast Cancer Symposium, DEC 06-10, 2016, San Antonio, TX.
Note

Supplement: 4

Meeting Abstract: P3-17-03

Available from: 2017-04-25 Created: 2017-04-25 Last updated: 2018-06-09Bibliographically approved
Wennstig, A.-K., Garmo, H., Hållström, P., Witt Nyström, P., Edlund, P., Blomqvist, C., . . . Nilsson, G. (2017). Inter-observer variation in delineating the coronary arteries as organs at risk. Radiotherapy and Oncology, 122(1), 72-78
Open this publication in new window or tab >>Inter-observer variation in delineating the coronary arteries as organs at risk
Show others...
2017 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 122, no 1, p. 72-78Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To determine the inter-observer variation in delineating the coronary arteries as organs at risk (OAR) in breast cancer (BC) radiotherapy (RT) and how this variation affects the estimated coronary artery radiation dose.

METHOD: Delineation of the left main and the left anterior descending coronary artery (LMCA and LAD), and the right coronary artery (RCA), by using the heart atlas by Feng et al., was performed by three radiation oncologists in 32 women who had received adjuvant RT for BC. Centres of the arteries were calculated and distances between artery centres were measured and the artery radiation doses were estimated. The intraclass correlation coefficient (ICC) was used to quantify the variability in doses.

RESULTS: Along the extent of RCA, the median distance between centres of arteries varied from 2 to 9mm with similar patterns over pairs of oncologists. For the LMCA-LAD the median distance varied from 1 to 4mm. The estimated maximum radiation doses showed an ICC variation from 0.82 to 0.97.

CONCLUSION: The coronary arteries can be reliably identified and delineated as OARs in BC RT. The spatial variance is limited and the total variation in radiation dose is almost completely determined by the between patient variation.

National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-130163 (URN)10.1016/j.radonc.2016.11.007 (DOI)000395217900013 ()27866849 (PubMedID)
Available from: 2017-01-13 Created: 2017-01-13 Last updated: 2018-06-09Bibliographically approved
Molina-Montes, E., Sanchez, M.-J., Buckland, G., Bueno-de-Mesquita, H. B., Weiderpass, E., Amiano, P., . . . Duell, E. J. (2017). Mediterranean diet and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition cohort. British Journal of Cancer, 116(6), 811-820
Open this publication in new window or tab >>Mediterranean diet and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition cohort
Show others...
2017 (English)In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 116, no 6, p. 811-820Article in journal (Refereed) Published
Abstract [en]

Background: The Mediterranean diet (MD) has been proposed as a means for cancer prevention, but little evidence has been accrued regarding its potential to prevent pancreatic cancer. We investigated the association between the adherence to the MD and pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Methods: Over half a million participants from 10 European countries were followed up for over 11 years, after which 865 newly diagnosed exocrine pancreatic cancer cases were identified. Adherence to the MD was estimated through an adapted score without the alcohol component (arMED) to discount alcohol-related harmful effects. Cox proportional hazards regression models, stratified by age, sex and centre, and adjusted for energy intake, body mass index, smoking status, alcohol intake and diabetes status at recruitment, were used to estimate hazard ratios (HRs) associated with pancreatic cancer and their corresponding 95% confidence intervals (CIs).

Results: Adherence to the arMED score was not associated with risk of pancreatic cancer (HR highvs low adherence=0.99; 95% CI: 0.77–1.26, and HR per increments of two units in adherence to arMED=1.00; 95% CI: 0.94–1.06). There was no convincing evidence for heterogeneity by smoking status, body mass index, diabetes or European region. There was also no evidence of significant associations in analyses involving microscopically confirmed cases, plausible reporters of energy intake or other definitions of the MD pattern.

Conclusions: A high adherence to the MD is not associated with pancreatic cancer risk in the EPIC study.

Keywords
Mediterranean diet, pancreatic cancer, cohort study
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-133758 (URN)10.1038/bjc.2017.14 (DOI)000397436100017 ()28170373 (PubMedID)
Available from: 2017-05-03 Created: 2017-05-03 Last updated: 2018-06-09Bibliographically approved
Franklin, O., Jonsson, P., Billing, O., Lundberg, E., Öhlund, D., Nyström, H., . . . Sund, M. (2017). Plasma micro-RNA alterations appear late in pancreatic cancer. Annals of Surgery
Open this publication in new window or tab >>Plasma micro-RNA alterations appear late in pancreatic cancer
Show others...
2017 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: The aim of this research was to study whether plasma microRNAs (miRNA) can be used for early detection of pancreatic cancer (PC) by analyzing prediagnostic plasma samples collected before a PC diagnosis. Background: PC has a poor prognosis due to late presenting symptoms and early metastasis. Circulating miRNAs are altered in PC at diagnosis but have not been evaluated in a prediagnostic setting. Methods: We first performed an initial screen using a panel of 372 miRNAs in a retrospective case-control cohort that included early-stage PC patients and healthy controls. Significantly altered miRNAs at diagnosis were then measured in an early detection case-control cohort wherein plasma samples in the cases are collected before a PC diagnosis. Carbohydrate antigen 19–9 (Ca 19–9) levels were measured in all samples for comparison. Results: Our initial screen, including 23 stage I-II PC cases and 22 controls, revealed 15 candidate miRNAs that were differentially expressed in plasma samples at PC diagnosis. We combined all 15 miRNAs into a multivariate statistical model, which outperformed Ca 19–9 in receiver-operating characteristics analysis. However, none of the candidate miRNAs, individually or in combination, were significantly altered in prediagnostic plasma samples from 67 future PC patients compared with 132 matched controls. In comparison, Ca 19–9 levels were significantly higher in the cases at <5 years before diagnosis. Conclusion: Plasma miRNAs are altered in PC patients at diagnosis, but the candidate miRNAs found in this study appear late in the course of the disease and cannot be used for early detection of the disease.

Keywords
blood samples, early detection, micro-RNA, miRNA, pancreatic cancer
National Category
Clinical Laboratory Medicine Chemical Sciences
Identifiers
urn:nbn:se:umu:diva-127998 (URN)10.1097/SLA.0000000000002124 (DOI)28425921 (PubMedID)
Note

Originally included in thesis in manuscript form.

Available from: 2016-11-21 Created: 2016-11-21 Last updated: 2018-06-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-7516-9543

Search in DiVA

Show all publications