umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Werner, Mårten
Publications (10 of 20) Show all publications
Stepien, M., Duarte-Salles, T., Fedirko, V., Floegel, A., Barupal, D. K., Rinaldi, S., . . . Jenab, M. (2016). Alteration of amino acid and biogenic amine metabolism in hepatobiliary cancers: findings from a prospective cohort study. International Journal of Cancer, 138(2), 348-360.
Open this publication in new window or tab >>Alteration of amino acid and biogenic amine metabolism in hepatobiliary cancers: findings from a prospective cohort study
Show others...
2016 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 138, no 2, 348-360 p.Article in journal (Refereed) Published
Abstract [en]

Perturbations in levels of amino acids (AA) and their derivatives are observed in hepatocellular carcinoma (HCC). Yet, it is unclear whether these alterations precede or are a consequence of the disease, nor whether they pertain to anatomically related cancers of the intrahepatic bile duct (IHBC), and gallbladder and extrahepatic biliary tract (GBTC). Circulating standard AA, biogenic amines and hexoses were measured (Biocrates AbsoluteIDQ-p180Kit) in a case-control study nested within a large prospective cohort (147 HCC, 43 IHBC and 134 GBTC cases). Liver function and hepatitis status biomarkers were determined separately. Multivariable conditional logistic regression was used to calculate odds ratios and 95% confidence intervals (OR; 95%CI) for log-transformed standardised (mean = 0, SD = 1) serum metabolite levels and relevant ratios in relation to HCC, IHBC or GBTC risk. Fourteen metabolites were significantly associated with HCC risk, of which seven metabolites and four ratios were the strongest predictors in continuous models. Leucine, lysine, glutamine and the ratio of branched chain to aromatic AA (Fischer's ratio) were inversely, while phenylalanine, tyrosine and their ratio, glutamate, glutamate/glutamine ratio, kynurenine and its ratio to tryptophan were positively associated with HCC risk. Confounding by hepatitis status and liver enzyme levels was observed. For the other cancers no significant associations were observed. In conclusion, imbalances of specific AA and biogenic amines may be involved in HCC development.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keyword
hepatocellular carcinoma, biliary tract cancers, prospective cohort, targeted metabolomics, amino acids
National Category
Cancer and Oncology Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-107518 (URN)10.1002/ijc.29718 (DOI)000369161200010 ()26238458 (PubMedID)
Available from: 2015-08-24 Created: 2015-08-24 Last updated: 2017-12-04Bibliographically approved
Danielsson Borssén, Å., Wallerstedt, S., Nyhlin, N., Bergquist, A., Lindgren, S., Almer, S. & Werner, M. (2016). Pregnancy and childbirth in women with autoimmune hepatitis is safe, even in compensated cirrhosis. Scandinavian Journal of Gastroenterology, 51(4), 479-485.
Open this publication in new window or tab >>Pregnancy and childbirth in women with autoimmune hepatitis is safe, even in compensated cirrhosis
Show others...
2016 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 51, no 4, 479-485 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Autoimmune hepatitis (AIH) is a liver disease that primarily affects women. Many become ill during childbearing age, and medication can be lifelong. Few studies exist on pregnancy outcome in women with AIH. 

Objectives: The aim was to assess the outcome of women with AIH and their children during pregnancy and postpartum.

Materials and methods: Sixty-four women from a well-characterised cohort with AIH filled out a questionnaire with information about their disease, miscarriage/abortion, pregnancies and potential birth defects in 2012. In 2004, 106 women answered the same questionnaire and their results were analysed along with the new questionnaires. 

Results: One hundred and thirty-eight women have completed the questionnaire and 100 children have been born by 58 women. Fifty-seven women (41%) had cirrhosis. In 84% of the pregnancies, the AIH was stable or milder, 32% had an increase in activity postpartum. The proportion of preterm births (before week 38) was 22%, caesarean sections 17%, malformations 3%, and two children died. Twenty-three women with cirrhosis had children after diagnosis of cirrhosis but without more complications than for non-cirrhotic mothers. However, they did have a higher prevalence of caesarean sections. 

Conclusion: Pregnancy and childbirth in AIH appear to be safe for both child and mother, even in women with compensated liver cirrhosis.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keyword
Abortion, autoimmune, hepatitis, liver cirrhosis, pregnancy, pregnancy outcome, spontaneous
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-116729 (URN)10.3109/00365521.2015.1115893 (DOI)000368696900013 ()
Available from: 2016-02-19 Created: 2016-02-11 Last updated: 2017-11-30Bibliographically approved
Stepien, M., Fedirko, V., Duarte-Salles, T., Ferrari, P., Freisling, H., Trepo, E., . . . Jenab, M. (2016). Prospective association of liver function biomarkers with development of hepatobiliary cancers. Cancer Epidemiology, 40, 179-187.
Open this publication in new window or tab >>Prospective association of liver function biomarkers with development of hepatobiliary cancers
Show others...
2016 (English)In: Cancer Epidemiology, ISSN 1877-7821, E-ISSN 1877-783X, Vol. 40, 179-187 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Serum liver biomarkers (gamma-glutamyl transferase, GGT; alanine aminotransferase, ALT; aspartate aminotransferase, AST; alkaline phosphatase, ALP; total bilirubin) are used as indicators of liver disease, but there is currently little data on their prospective association with risk of hepatobiliary cancers. Methods: A nested-case control study was conducted within the prospective EPIC cohort (>520,000 participants, 10 European countries). After a mean 7.5 mean years of follow-up, 121 hepatocellular carcinoma (HCC), 34 intrahepatic bile duct (IHBC) and 131 gallbladder and biliary tract (GBTC) cases were identified and matched to 2 controls each. Circulating biomarkers were measured in serum taken at recruitment into the cohort, prior to cancer diagnosis. Multivariable adjusted conditional logistic regression was used to calculate odds ratios and 95% confidence intervals (OR; 95% CI). Results: In multivariable models, 1SD increase of each log-transformed biomarker was positively associated with HCC risk (OR(GGT) = 4.23, 95% CI: 2.72-6.59; OR(ALP) = 3.43, 95% CI: 2.31-5.10; OR(AST) = 3.00, 95% CI: 2.04-4.42; OR(ALT) = 2.69, 95% CI: 1.89-3.84; OR(Bilirubin) = 2.25, 95% CI: 1.58-3.20). Each liver enzyme (OR(GGT) = 4.98; 95% CI: 1.75-14.17; OR(AST) = 3.10, 95% CI: 1.04-9.30; OR(ALT) = 2.86, 95% CI: 1.26-6.48, OR(ALP) = 2.31, 95% CI: 1.10-4.86) but not bilirubin (OR(Bilirubin) = 1.46,95% CI: 0.85-2.51) showed a significant association with IHBC. Only ALP was significantly associated with GBTC risk (OR (ALP) = 1.59, 95% CI: 1.20-2.09). Conclusion: This study shows positive associations between circulating liver biomarkers in sera collected prior to cancer diagnoses and the risks of developing HCC or IHBC, but not GBTC.

Place, publisher, year, edition, pages
Elsevier, 2016
Keyword
Hepatobiliary cancer, Liver function test, Biological markers, Prospective cohort, Nested case-control udy
National Category
Cancer and Oncology Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-118263 (URN)10.1016/j.canep.2016.01.002 (DOI)000370167000025 ()26773278 (PubMedID)
Available from: 2016-03-17 Created: 2016-03-14 Last updated: 2017-11-30Bibliographically approved
Kong, S. Y., Tran, H. Q., Gewirtz, A. T., McKeown-Eyssen, G., Fedirko, V., Romieu, I., . . . Jenab, M. (2016). Serum Endotoxins and Flagellin and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) Cohort. Cancer Epidemiology, Biomarkers and Prevention, 25(2), 291-301.
Open this publication in new window or tab >>Serum Endotoxins and Flagellin and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) Cohort
Show others...
2016 (English)In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 25, no 2, 291-301 p.Article in journal (Refereed) Published
Abstract [en]

Background: Chronic inflammation and oxidative stress are thought to be involved in colorectal cancer development. These processes may contribute to leakage of bacterial products, such as lipopolysaccharide (LPS) and flagellin, across the gut barrier. The objective of this study, nested within a prospective cohort, was to examine associations between circulating LPS and flagellin serum antibody levels and colorectal cancer risk. Methods: A total of 1,065 incident colorectal cancer cases (colon, n = 667; rectal, n = 398) were matched (1:1) to control subjects. Serum flagellin-and LPS-specific IgA and IgG levels were quantitated by ELISA. Multivariable conditional logistic regression models were used to calculate ORs and 95% confidence intervals (CI), adjusting for multiple relevant confouding factors. Results: Overall, elevated anti-LPS and anti-flagellin biomarker levels were not associated with colorectal cancer risk. After testing potential interactions by various factors relevant for colorectal cancer risk and anti-LPS and anti-flagellin, sex was identified as a statistically significant interaction factor (P-interaction < 0.05 for all the biomarkers). Analyses stratified by sex showed a statistically significant positive colorectal cancer risk association for men (fully-adjusted OR for highest vs. lowest quartile for total anti-LPS + flagellin, 1.66; 95% CI, 1.10-2.51; P-trend, 0.049), whereas a borderline statistically significant inverse association was observed for women (fully-adjusted OR, 0.70; 95% CI, 0.47-1.02; P-trend, 0.18). Conclusion: In this prospective study on European populations, we found bacterial exposure levels to be positively associated to colorectal cancer risk among men, whereas in women, a possible inverse association may exist. Impact: Further studies are warranted to better clarify these preliminary observations. (C) 2016 AACR.

National Category
General Practice Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-119079 (URN)10.1158/1055-9965.EPI-15-0798 (DOI)000372173000009 ()26823475 (PubMedID)
Available from: 2016-04-20 Created: 2016-04-11 Last updated: 2018-01-10Bibliographically approved
Lorenz, F., Marklund, S., Werner, M., Palmqvist, R., Wahlin, B. E. & Wahlin, A. (2015). Fecal calprotectin as a biomarker of intestinal graft versus host disease after allogeneic hematopoietic stem cell transplantation. Scientific Reports, 5, 7920.
Open this publication in new window or tab >>Fecal calprotectin as a biomarker of intestinal graft versus host disease after allogeneic hematopoietic stem cell transplantation
Show others...
2015 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 5, 7920- p.Article in journal (Refereed) Published
Abstract [en]

The diagnosis of gastrointestinal graft versus host disease (GI-GVHD) is based on clinical symptoms and histological findings. In clinical practice, it is often difficult to decide whether abdominal symptoms in an allogeneic transplant recipient are caused by GVHD or other disorders. Endoscopic biopsies are helpful in establishing the diagnosis, but endoscopy is not always possible to perform due to poor general condition of the patients. No biomarkers are routinely used to predict GVHD. The aim of fecal calprotectin and alpha-1 antitrypsin testing in our study was to find out whether determination of the concentrations of these proteins may be used as a screening method for enteric GVHD. We studied prospectively 51 patients, 8 of whom developed GI-GVHD. Our data demonstrate that elevated fecal calprotectin levels were significantly associated with presence of GI-GVHD. We found a positive association between high F-calprotectin and severe gastrointestinal GVHD. In bivariate analysis, only calprotectin but not alpha-1 antitrypsin was independently associated with GI-GVHD. Testing for fecal calprotectin after allogeneic stem cell transplantation may be a useful screening tool.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-99770 (URN)10.1038/srep07920 (DOI)000348104300002 ()25605402 (PubMedID)
Available from: 2015-02-18 Created: 2015-02-12 Last updated: 2017-12-04Bibliographically approved
Danielsson Borssén, Å., Almer, S., Prytz, H., Wallerstedt, S., Friis-Liby, I.-L., Bergquist, A., . . . Werner, M. (2015). Hepatocellular and extrahepatic cancer in patients with autoimmune hepatitis: a long-term follow-up study in 634 Swedish patients. Scandinavian Journal of Gastroenterology, 50(2), 217-223.
Open this publication in new window or tab >>Hepatocellular and extrahepatic cancer in patients with autoimmune hepatitis: a long-term follow-up study in 634 Swedish patients
Show others...
2015 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 50, no 2, 217-223 p.Article in journal (Refereed) Published
Abstract [en]

Objectives. Cirrhosis is a well-known risk factor for hepatocellular cancer, but the true risk in autoimmune hepatitis (AIH) is scarcely studied. Other cancers may arise after prolonged use of immune-modulating drugs. The aim of this study was to investigate the cancer risk in a large cohort of AIH patients.

Material and methods. Six hundred and thirty-four Swedish patients in a well-defined cohort were matched to the Cause of Death Registry and the Cancer Registry. Standard incidence ratios were calculated by relating the incidences in the cohort to an age-matched material from the Swedish background population.

Results. A higher overall incidence of malignancies than the background population was found, counting from the date of diagnosis (standard incidence ratio (SIR) 2.08, 95% CI 1.68-2.55). The highest risk was found for hepatocellular carcinoma (HCC). We found 10 cases (4.0%) in 248 patients with cirrhosis, which gives an incidence rate of 0.3%. Standard incidence ratio for developing hepatobiliary cancer was 54.55 (95% CI 19.92-99.99). HCC only occurred in cirrhotic patients. There was also an increased risk for non-melanoma skin cancer (SIR 9.87, 95% CI 6.26-14.81).

Conclusion. A slightly enhanced risk for malignancies in general compared to the background population was found. The risk of hepatobiliary cancer was increased, but the annual risk over the observational period was well under the postulated 1.5% when surveillance in cirrhotic patients is considered to be cost-effective.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
Keyword
autoimmune hepatitis, autoimmune liver disease, cancer, extrahepatic cancer, hepatocellular rcinoma
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-100123 (URN)10.3109/00365521.2014.983154 (DOI)000347692700013 ()
Available from: 2015-03-04 Created: 2015-02-24 Last updated: 2017-05-11Bibliographically approved
Fedirko, V., Duarte-Salles, T., Bamia, C., Trichopoulou, A., Aleksandrova, K., Trichopoulos, D., . . . Jenab, M. (2014). Pre-diagnostic circulating vitamin D levels and risk of hepatocellular carcinoma in European populations: a nested case-control study. Hepatology, 60(4), 1222-1230.
Open this publication in new window or tab >>Pre-diagnostic circulating vitamin D levels and risk of hepatocellular carcinoma in European populations: a nested case-control study
Show others...
2014 (English)In: Hepatology, ISSN 0270-9139, E-ISSN 1527-3350, Vol. 60, no 4, 1222-1230 p.Article in journal (Refereed) Published
Abstract [en]

The association between vitamin D status and hepatocellular carcinoma has not been well investigated, despite experimental evidence supporting an important role of vitamin D in liver pathophysiology. Our objective was to investigate the association between pre-diagnostic circulating 25-hydroxyvitamin D [25(OH)D] serum levels and risk of hepatocellular carcinoma in a prospective, nested case-control study among 520,000 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Each case (n = 138) diagnosed between 1992 and 2010 was matched to one control by age, sex, study center, date and time of blood collection, and fasting status. Serum baseline levels of 25(OH)D were measured by liquid chromatography/tandem mass spectrometry. Multivariable incident rate ratios (IRR) of hepatocellular carcinoma associated with continuous (per 10 nmol/L) or categorical levels (tertiles or a priori-defined categories) of pre-diagnostic 25(OH)D. Higher 25(OH)D levels were associated with a 49% reduction in the risk of hepatocellular carcinoma (highest vs. lowest tertile: multivariable IRR = 0.51, 95% confidence interval, 0.26 to 0.99; Ptrend = 0.04; per 10 nmol/L increase: IRR = 0.80, 95% confidence interval, 0.68-0.94). The finding did not vary substantially by time from enrolment to diagnosis, and did not change after adjustment for biomarkers of pre-existing liver damage, nor chronic infection with hepatitis B or C viruses. The findings were not modified by body size or smoking status. Conclusion: In this prospective study on Western European populations, serum levels of 25(OH)D were inversely associated with risk of hepatocellular carcinoma. Given the rising incidence of this cancer in low-risk developed countries and the strong public health interest surrounding the potentially cancer-protective roles of vitamin D, additional studies in different populations are required. (Hepatology 2014;).

National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-88173 (URN)10.1002/hep.27079 (DOI)000342662100015 ()24644045 (PubMedID)
Available from: 2014-04-24 Created: 2014-04-24 Last updated: 2017-12-05Bibliographically approved
Lukanova, A., Becker, S., Hüsing, A., Schock, H., Fedirko, V., Trepo, E., . . . Kaaks, R. (2014). Pre-diagnostic plasma testosterone, sex hormone binding globulin, IGF-I and hepatocellular carcinoma: etiological factors or risk markers?. International Journal of Cancer, 134(1), 164-173.
Open this publication in new window or tab >>Pre-diagnostic plasma testosterone, sex hormone binding globulin, IGF-I and hepatocellular carcinoma: etiological factors or risk markers?
Show others...
2014 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 134, no 1, 164-173 p.Article in journal (Refereed) Published
Abstract [en]

Elevated pre-diagnostic testosterone and insulin-like growth factor-I (IGF-I) concentrations have been proposed to increase risk of hepatocellular carcinoma (HCC). However, the metabolism of these hormones is altered as a consequence of liver damage and they may have clinical utility as HCC risk markers. A case-control study was nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort and included 125 incident HCC cases and 247 individually matched controls. Testosterone, sex hormone binding globulin (SHBG) and IGF-I were analyzed by immunoassays. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by conditional logistic regression. The area under the receiver operating curves (AUC) was calculated to assess HCC predictive ability of the tested models. After adjustments for epidemiological variables (body mass index, smoking, ethanol intake, hepatitis and diabetes) and liver damage (a score based on albumin, bilirubin, aspartate aminotransaminase, alanine aminotransaminase, gamma-glutamyltransferase and alkaline phosphatase concentrations), only SHBG remained significantly associated with risk (OR for top versus bottom tertile of 3.86 (1.32-11.3), ptrend =0.009). As a single factor SHBG had an AUC of 0.81 (0.75-0.86). A small, but significant increase in AUC was observed when SHBG was added to a model including the liver damage score and epidemiological variables (from 0.89 to 0.91, p=0.02) and a net reclassification of 0.47% (0.45-0.48). The observed associations of HCC with pre-diagnostic SHBG, free testosterone and IGF-I concentrations are in directions opposite to that expected under the etiological hypotheses. SHBG has a potential to be tested as pre-diagnostic risk marker for HCC.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keyword
hepatocellular carcinoma, testosterone, sex hormone-binding globulin, insulin-like growth factor I, prospective study, EPIC
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:umu:diva-76677 (URN)10.1002/ijc.28342 (DOI)000325982000017 ()23801371 (PubMedID)
Available from: 2013-07-09 Created: 2013-07-09 Last updated: 2017-12-06Bibliographically approved
Schlesinger, S., Aleksandrova, K., Pischon, T., Fedirko, V., Jenab, M., Trepo, E., . . . Nöthlings, U. (2013). Abdominal obesity, weight gain during adulthood and risk of liver and biliary tract cancer in a European cohort. International Journal of Cancer, 132(3), 645-657.
Open this publication in new window or tab >>Abdominal obesity, weight gain during adulthood and risk of liver and biliary tract cancer in a European cohort
Show others...
2013 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 132, no 3, 645-657 p.Article in journal (Refereed) Published
Abstract [en]

General obesity has been positively associated with risk of liver and probably with biliary tract cancer, but little is known about abdominal obesity or weight gain during adulthood. We used multivariable Cox proportional hazard models to investigate associations between weight, body mass index, waist and hip circumference, waist-to-hip and waist-to-height ratio (WHtR), weight change during adulthood and risk of hepatocellular carcinoma (HCC), intrahepatic (IBDC) and extrahepatic bile duct system cancer [EBDSC including gallbladder cancer (GBC)] among 359,525 men and women in the European Prospective Investigation into Cancer and Nutrition study. Hepatitis B and C virus status was measured in a nested case-control subset. During a mean follow-up of 8.6 years, 177 cases of HCC, 58 cases of IBDC and 210 cases of EBDSC, including 76 cases of GBC, occurred. All anthropometric measures were positively associated with risk of HCC and GBC. WHtR showed the strongest association with HCC [relative risk (RR) comparing extreme tertiles 3.51, 95% confidence interval (95% CI): 2.09-5.87; p(trend) < 0.0001] and with GBC (RR: 1.56, 95% CI: 1.12-2.16 for an increment of one unit in WHtR). Weight gain during adulthood was also positively associated with HCC when comparing extreme tertiles (RR: 2.48, 95% CI: 1.49-4.13; <0.001). No statistically significant association was observed between obesity and risk of IBDC and EBDSC. Our results provide evidence of an association between obesity, particularly abdominal obesity, and risk of HCC and GBC. Our findings support public health recommendations to reduce the prevalence of obesity and weight gain in adulthood for HCC and GBC prevention in Western populations.

National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:umu:diva-57251 (URN)10.1002/ijc.27645 (DOI)000311620100022 ()22618881 (PubMedID)
Available from: 2012-07-10 Created: 2012-07-10 Last updated: 2018-01-12Bibliographically approved
Fedirko, V., Trichopolou, A., Bamia, C., Duarte-Salles, T., Trepo, E., Aleksandrova, K., . . . Jenab, M. (2013). Consumption of fish and meats and risk of hepatocellular carcinoma: the European Prospective Investigation into Cancer and Nutrition (EPIC). Annals of Oncology, 24(8), 2166-2173.
Open this publication in new window or tab >>Consumption of fish and meats and risk of hepatocellular carcinoma: the European Prospective Investigation into Cancer and Nutrition (EPIC)
Show others...
2013 (English)In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 24, no 8, 2166-2173 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: While higher intake of fish and lower consumption of red/processed meats have been suggested to play a protective role in the etiology of several cancers, prospective evidence for hepatocellular carcinoma (HCC) is limited, particularly in Western European populations.

METHODS: The associations of fish and meats with HCC risk were analyzed in the EPIC cohort. Between 1992 and 2010, 191 incident HCC were identified among 477 206 participants. Baseline diet was assessed using validated dietary questionnaires. A single 24-h diet recall from a cohort subsample was used for calibration. Multivariable proportional hazard regression was utilized to estimate hazard ratios (HR) and 95% confidence intervals (CI). In a nested case-control subset (HCC = 122), HBV/HCV status and liver function biomarkers were measured.

RESULTS: HCC risk was inversely associated with intake of total fish (per 20 g/day increase, HR = 0.83, 95% CI 0.74-0.95 and HR = 0.80, 95% CI 0.69-0.97 before and after calibration, respectively). This inverse association was also suggested after adjusting for HBV/HCV status and liver function score (per 20-g/day increase, RR = 0.86, 95% CI 0.66-1.11 and RR = 0.74, 95% CI 0.50-1.09, respectively) in a nested case-control subset. Intakes of total meats or subgroups of red/processed meats, and poultry were not associated with HCC risk.

CONCLUSIONS: In this large European cohort, total fish intake is associated with lower HCC risk.

National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:umu:diva-76719 (URN)10.1093/annonc/mdt168 (DOI)23670094 (PubMedID)
Available from: 2013-07-12 Created: 2013-07-12 Last updated: 2017-12-06Bibliographically approved
Organisations

Search in DiVA

Show all publications