Sanam Shah,Nasser Laouali,Yahya Mahamat-Saleh,Carine Biessy,Geneviève Nicolas,Sabina Rinaldi,Raul Zamora-Ros,Nikos Papadimitriou,Fernanda Morales-Berstein,Christina C Dahm,Anne Kristine Lundgård Christensen,Lene Mellemkjaer,Anne Marie Overgaard Nielsen,Francesca Romana Mancini,Xuan Ren,Chloé Marques,Verena Katzke,Charlotte Le Cornet,Christine El-Khoury,Matthias B Schulze,Claudia Agnoli,Vittorio Simeon,Rosario Tumino,Lorenzo Milani,Carlota Castro-Espin,Maria-Jose Sánchez,Amaia Aizpurua,Sandra M Colorado-Yohar,Marcela Guevara,Alicia Heath,Dagfinn Aune,Heinz Freisling,Inge Huybrechts,Laure Dossus
{"title":"Plant-based dietary patterns and breast cancer risk in the European prospective investigation into cancer and nutrition (EPIC) study.","authors":"Sanam Shah,Nasser Laouali,Yahya Mahamat-Saleh,Carine Biessy,Geneviève Nicolas,Sabina Rinaldi,Raul Zamora-Ros,Nikos Papadimitriou,Fernanda Morales-Berstein,Christina C Dahm,Anne Kristine Lundgård Christensen,Lene Mellemkjaer,Anne Marie Overgaard Nielsen,Francesca Romana Mancini,Xuan Ren,Chloé Marques,Verena Katzke,Charlotte Le Cornet,Christine El-Khoury,Matthias B Schulze,Claudia Agnoli,Vittorio Simeon,Rosario Tumino,Lorenzo Milani,Carlota Castro-Espin,Maria-Jose Sánchez,Amaia Aizpurua,Sandra M Colorado-Yohar,Marcela Guevara,Alicia Heath,Dagfinn Aune,Heinz Freisling,Inge Huybrechts,Laure Dossus","doi":"10.1007/s10654-025-01277-y","DOIUrl":"https://doi.org/10.1007/s10654-025-01277-y","url":null,"abstract":"While previous literature suggests that plant-based diets may be associated with a lower risk of breast cancer, evidence remains inconsistent. In this study, we investigated the association between adherence to plant-based diets and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Overall plant-based diet index (PDI), healthful (hPDI), and unhealthful PDI (uPDI) were calculated, and multivariable Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of breast cancer for the three indices. Mediation analysis was performed to assess the role of body mass index (BMI) and waist circumference (WC) in the association between hPDI and postmenopausal breast cancer risk. Over a median follow-up of 14.9 years, 10,805 incident invasive breast cancer cases were identified among 258,343 women. In the multivariable model, not adjusted for BMI, higher adherence to hPDI was inversely associated with breast cancer risk, with HR per 1-SD increase [95% (CI)] of 0.97 (0.94, 0.99). The corresponding HRs (95% CI) per 1-SD increase for overall PDI and uPDI were 0.98 (0.96, 1.00) and 1.01 (0.99, 1.03), respectively. The associations between hPDI and postmenopausal breast cancer were partly explained by BMI and WC, which mediated 30% and 52% of this association, respectively. Higher adherence to hPDI was associated with a slightly lower total breast cancer risk. For postmenopausal breast cancer, this association was partly explained by lower BMI or WC. These findings suggest that promoting healthful plant-based diets could support breast cancer risk reduction.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"45 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144622009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anne K Örtqvist,Jonas Söderling,Maria C Magnus,Stine Kjaer Urhoj,Siri E Håberg,Olof Stephansson
{"title":"COVID-19 infection increases the risk of venous thromboembolism during pregnancy and the postpartum period.","authors":"Anne K Örtqvist,Jonas Söderling,Maria C Magnus,Stine Kjaer Urhoj,Siri E Håberg,Olof Stephansson","doi":"10.1007/s10654-025-01268-z","DOIUrl":"https://doi.org/10.1007/s10654-025-01268-z","url":null,"abstract":"Pregnant and puerperal women are at increased risk of venous thromboembolism (VTE) owing to hemostatic changes in preparation for childbirth. The objective of this study was to investigate if COVID-19 infection was associated with VTE in pregnancy or 12 weeks postpartum when considering (prophylactic or therapeutic) anticoagulant use. This population-based register study included all women in Sweden and Norway giving birth after 22 gestational weeks, with conception dates from March 2020 to 2022. A PCR-verified COVID-19 test was used as the exposure, and a VTE diagnosis during pregnancy or 12 weeks postpartum was the outcome. Non-infected women consisted of those testing negative and untested individuals. Cox regression analyses, with COVID-19 infection as a time-varying exposure, and adjusted for maternal characteristics and anticoagulant use, provided overall hazard ratios. To evaluate whether there was a particular increased risk of VTE shortly after testing positive for COVID-19, we estimated time-specific risk of VTE in the first 2, 4, 8, 12, and 16 weeks following COVID-19 infection. Data from each country were first analyzed separately and then meta-analyzed. Among 323,868 participants, 46,048 (14.2%) had COVID-19 during pregnancy, and 80 (0.2%) were diagnosed with VTE. Pregnant women with COVID-19 had a higher VTE incidence rate compared to non-infected (4.9 vs. 2.9 per 1000 person-years; adjusted overall hazard ratio [aHR] 1.26, 95% Confidence Interval [CI] 0.80-2.00). The highest risk was within two weeks of infection (aHR 4.63, 95% CI 2.71-7.90) but remained elevated up to 12 weeks post-infection (aHR 1.86, 95% CI 1.17-2.94). In the postpartum period, 8,515 (2.6%) had COVID-19, and 6 (0.07%) were diagnosed with VTE (aHR 5.17, 95% CI 2.50-10.69). Although VTE post-COVID-19 infection was rare, the infection was associated with increased VTE risk during pregnancy and postpartum, even after adjusting for anticoagulant use. These findings should contribute to the individual risk assessment when evaluating the need for prophylactic anticoagulants in pregnancy and postpartum.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"4 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hormonal contraceptive use and anaemia: a nation-wide pharmacoepidemiological study from Northern Europe.","authors":"Sofie Ekroos,Elena Toffol,Oskari Heikinheimo,Jari Haukka,Mikko Arvas","doi":"10.1007/s10654-025-01272-3","DOIUrl":"https://doi.org/10.1007/s10654-025-01272-3","url":null,"abstract":"The WHO aims to reduce iron deficiency anaemia globally. Use of modern hormonal contraception (HC) could offer protection against anaemia in premenopausal women, but population-level effectiveness is unclear. We aim to quantify the effect of HC on anaemia. This nested case-control study includes over half the fertile-aged female population of Finland in 2017. Data on HC use from the national Prescription Center were combined with data on anaemia diagnosis from national care registries. Cases (anaemia diagnosis during follow-up, 2019-2020) were matched with up to five controls by age and municipality. After calculating the minimally sufficient adjustment set, adjusted odds ratios were derived in a conditional multivariable regression model accounting for matching. 3 100 cases of anaemia were matched with 13 143 controls. The minimally sufficient adjustment set included age, education level, obesity, abnormal uterine bleeding, and cancer. Compared to non-users of HC, risk of anaemia was lower in users of combined oral contraceptives containing ethinylestradiol (0·74 [0·66-0·83]) or oestradiol (0·49 [0·35-0·68]), progestin-only oral contraceptives (0·42 [0·35-0·51]), LNG-IUDs (0·64 [0·43-0·94]), and contraceptive vaginal rings (0·68 [0·49-0·94]). Individual product effects ranged from 0·77 [0·66-0·90] for drospirenone and ethinylestradiol to 0·40 [0·32-0·48] for desogestrel-only. Benefits of HC use extend to anaemia protection on population level. Anaemia protection should be included in guidelines on HC to support clinical decision making.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"72 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma L Ivansson,Therese Johansson,Torgny Karlsson,Åsa Johansson
{"title":"Oral contraceptive use increases bone density and reduces the risk of osteoporosis.","authors":"Emma L Ivansson,Therese Johansson,Torgny Karlsson,Åsa Johansson","doi":"10.1007/s10654-025-01273-2","DOIUrl":"https://doi.org/10.1007/s10654-025-01273-2","url":null,"abstract":"Osteoporotic fractures, largely resulting from reduced estrogen levels after menopause and subsequent bone loss, are a leading cause of disability among older women. Although oral contraceptive pills (OCPs) contain estrogen, their long-term impact on bone health and osteoporosis risk remain uncertain. Here, we assessed the effect of OCP use on bone mineral density (BMD) and osteoporosis using data from 257,185 women from the UK Biobank, born 1936-1970. Time-dependent Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for osteoporosis, while multivariable linear regression was used to assess the effect of OCP use on BMD, measured as T-scores in standard deviation units based on quantitative ultrasound of the calcaneus. By the end of follow-up in 2020, 7.6% of the participants had received an osteoporosis diagnosis. The rate of osteoporosis was lower among ever OCP users (HR = 0.86; 95% CI 0.83-0.89; P = 2.8 × 10-17). OCP use was also associated with a higher BMD T-score (0.052; 0.038-0.067; P = 2.1 × 10-12) with an increasing effect with longer use. Use of OCPs for 0-1 years had no significant effect on BMD (P = 0.081). However, longer durations were associated with increased BMD T-scores compared to never users: 2-5 years (0.046; 0.027-0.065, P = 2.2 × 10-6), 6-10 years (0.062; 0.043-0.080; P = 3.5 × 10-12), 11-15 years (0.062; 0.042-0.081; P = 3.2 × 10-12) and 16 + years (0.064; 0.044-0.083; P = 1.2 × 10-10). We found prior OCP use to be associated with higher BMD and a reduced risk of osteoporosis, potentially offering long-term benefits and suggesting that OCP use could reduce osteoporotic complications in older women.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"72 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Danbee Kang,Juwon Park,Hyunsoo Kim,Jeong Eon Lee,Seok Jin Nam,Seok Won Kim,Jonghan Yu,Byung Joo Chae,Jai Min Ryu,Juhee Cho,Se Kyung Lee
{"title":"Breast Cancer Information Grand Round for Survivorship (BIG-S) prospective cohort.","authors":"Danbee Kang,Juwon Park,Hyunsoo Kim,Jeong Eon Lee,Seok Jin Nam,Seok Won Kim,Jonghan Yu,Byung Joo Chae,Jai Min Ryu,Juhee Cho,Se Kyung Lee","doi":"10.1007/s10654-025-01262-5","DOIUrl":"https://doi.org/10.1007/s10654-025-01262-5","url":null,"abstract":"Existing evidence indicates that long-term effects of breast cancer treatment can significantly impact survivors' ability to fulfill their personal, familial, and social roles. However, few studies comprehensively integrate patient-reported outcomes (PROs) and real-world healthcare utilization data, particularly in Asian populations. Thus, we established a prospective cohort, the Breast Cancer Information Grand Round for Survivorship (BIG-S), to address these gaps and introduce this resource. The prospective BIG-S cohort recruited patients newly diagnosed with breast cancer at Samsung Medical Center starting in November 2018. Clinical data, recurrence, and healthcare utilization were systematically collected from electronic medical records by trained researchers, and body composition was measured using multifrequency bioelectrical impedance analysis. PROs were assessed following recommendations from the International Consortium for Health Outcomes Measurement (ICHOM). These included health-related quality of life, physical, psychological, social, and cognitive functions, symptoms, healthy behaviors, financial difficulty, spiritual well-being, and cancer adaptation, using validated questionnaires. A total of 2,749 patients participated, with an average age of 49.7 years. The mean quality-of-life score at diagnosis was 55.6, indicating moderate general well-being, and improved gradually to 68.2 at four years post-diagnosis. At baseline, participants showed high physical, cognitive, and role functioning scores but had relatively lower emotional and social functioning scores. Over four years, emotional and social functioning improved, whereas cognitive and role functioning declined. Survivors initially reported low sexual functioning, sexual enjoyment, and future perspectives, all of which significantly decreased during follow-up. Fatigue and insomnia were persistent throughout the observation period. Healthcare utilization initially concentrated on plastic surgery and rehabilitation medicine and increasingly shifted towards gynecology, family medicine, and psychiatry after two years. The BIG-S cohort uniquely integrates clinical data, PROs, and healthcare utilization patterns, offering comprehensive insights into breast cancer survivorship trajectories. Findings from BIG-S are expected to guide targeted interventions and inform tailored survivorship care strategies, especially for Asian breast cancer survivors.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"106 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hermann Brenner,Thomas Heisser,Michael Hoffmeister
{"title":"Looking at randomized trials with the critical eyes of epidemiologists: the case of screening colonoscopy.","authors":"Hermann Brenner,Thomas Heisser,Michael Hoffmeister","doi":"10.1007/s10654-025-01269-y","DOIUrl":"https://doi.org/10.1007/s10654-025-01269-y","url":null,"abstract":"Based on compelling evidence from observational epidemiological studies, screening colonoscopy has since long been thought to strongly lower the burden of colorectal cancer (CRC), both by early detection of prevalent CRC and prevention of incident CRC through detection and removal of precancerous lesions. Widespread offer and use of screening colonoscopy went along with a dramatic decline in CRC incidence in screening age groups in the US, in contrast to an increase in incidence at younger ages and in countries not engaging in CRC screening. The recently published 10-year results from the NordICC trial, the first randomized clinical trial (RCT) reporting long-term effects of screening colonoscopy on CRC risk and mortality, has been widely interpreted as challenging the evidence for strong efficacy of screening colonoscopy. Such reasoning was based on the trust that randomization in this large-sized trial should have prevented any residual confounding that might have affected the observational epidemiological studies. However, randomization cannot prevent other potential biases which should be carefully addressed and minimized in both observational and interventional studies. We illustrate that such biases may have led to major underestimation of screening effects in the NordICC trial. The observed patterns underline the need for more rigorous efforts to prevent and correct for such biases, along with the need to derive more informative metrics of screening efficacy. Such metrics should include informative estimates of screening colonoscopy effects on both early detection of prevalent CRC cases and prevention of incident CRC cases. The momentum for CRC screening should by no means slowed by misinterpretation of the NordICC trial evidence.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"3 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michal Abrahamowicz,Marie-Eve Beauchamp,Emily K Roberts,Jeremy M G Taylor
{"title":"Revisiting the hazards of hazard ratios through simulations and case studies.","authors":"Michal Abrahamowicz,Marie-Eve Beauchamp,Emily K Roberts,Jeremy M G Taylor","doi":"10.1007/s10654-025-01245-6","DOIUrl":"https://doi.org/10.1007/s10654-025-01245-6","url":null,"abstract":"The hazard has been a central concept in the analysis and interpretation of time-to-event data for over 50 years. At any follow-up time, the hazard is the probability of the event happening in the next unit of time amongst those still at risk. Hazard ratios (HRs) between groups are frequently used to quantify the exposure/treatment's association with the failure time. In a highly cited paper, Hernán criticized HRs, asserting that their decreases over time may reflect simply a built-in selection bias, induced by an unmeasured susceptibility, and should not be interpreted as genuine changes in treatment effect. Hernán supports his arguments mainly by the results of a hormone therapy trial, where the HR for coronary heart events decreased largely during follow-up, with hazards crossing from harmful to protective treatment effect. However, he did not present simulations or algebraic derivations to demonstrate that these changes may reflect just an unmeasured susceptibility. We use simulations and real-world case studies to systematically explore this issue. The first simulation series reveals how the underestimation bias and changes over time in Cox proportional hazards model-based HRs depend on the joint impact of susceptibility on the hazard, its distribution, and the incidence of events; with important bias toward the null occurring only for a very strong susceptibility. Further simulations mimic the hormone therapy trial highlighted by Hernán, to demonstrate that the reported bias and crossing hazards are extremely unlikely to reflect just an unmeasured susceptibility, which suggests some biological reasons for decaying treatment HR, possibly including decreasing treatment adherence. Finally, we present real-world examples of interpretable and clinically plausible time-dependent HRs in cancer research. In conclusion, results of our simulations and real-world case studies suggest that concerns about HR limitations may be overstated, and we encourage researchers to model time-dependent HRs and consider potential biological and clinical causes thereof.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"51 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elena Toffol,Timo Partonen,Oskari Heikinheimo,Anna But,Antti Latvala,Jari Haukka
{"title":"Use of systemic hormonal contraception and risk of depression: a registry-based study from Finland.","authors":"Elena Toffol,Timo Partonen,Oskari Heikinheimo,Anna But,Antti Latvala,Jari Haukka","doi":"10.1007/s10654-025-01267-0","DOIUrl":"https://doi.org/10.1007/s10654-025-01267-0","url":null,"abstract":"Earlier findings on the relationship between use of hormonal contraception (HC) and depressive symptoms and disorders are contradictory. Thus, we assessed the associations of use of different types of systemic hormonal contraceptives in the six preceding months with the risk of depression in women aged 15-49 years. Data were obtained from national registers in Finland. All cases of depression in the years 2018-2019 were identified in a population-based cohort of women. We used a nested case-control design with 1:4 ratio (n = 117,360 cases) and applied multivariable conditional logistic regression models. During the follow-up a total of 23,480 new cases with the diagnosis of depression were observed (incidence rate: 21.7, 95% confidence interval = 21.5-22.0 per 1000 person-years). Use of HC in the six preceding months, specifically that of combined hormonal contraceptives (containing gestodene and ethinylestradiol, drospirenone and ethinylestradiol, and nomegestrol and estradiol), was significantly associated with a lower risk of depression compared to non-use when controlling for marital status, socioeconomic status, education, recent delivery, recent psychiatric hospitalization, chronic diseases, use of psychiatric medications (excluding antidepressants) and former use of HC (odds ratio: 0.90, 95% confidence interval = 0.85-0.95; 0.86, 95% confidence interval = 0.81-0.91, respectively). Current use of progestogen-only preparations (norethisterone, levonorgestrel, desogestrel) was not associated with depression. This pattern was evident in all age groups, including adolescent girls. HC use appeared not associated with an increased risk of depression in fertile-aged women and across all age groups, including adolescent girls.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"26 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ingestion of titanium dioxide as an excipient in medicines and the risk of cancer: a nationwide study within the French National health data system.","authors":"Manon Cairat,Gianluca Severi,Inge Huybrechts,Agnès Fournier","doi":"10.1007/s10654-025-01263-4","DOIUrl":"https://doi.org/10.1007/s10654-025-01263-4","url":null,"abstract":"Concerns about the safety of titanium dioxide (TiO2), including potential carcinogenicity, have prompted its ban in foods in the European Union, while remaining allowed as pharmaceutical excipient. We aimed to evaluate whether ingesting increasing quantities of TiO2 through medicines is associated with higher cancer risk. Data were derived from the French National Health Data System, a nationwide medico-administrative database. A case-control study was nested within two cohorts: users of metformin (all doses) and users of 200 mg acebutolol, both available in TiO2-containing and TiO2-free formulations. During 2013-2021, 293,101 cancer cases were identified and matched to 2,930,633 controls. TiO2 exposure through metformin and acebutolol consumption was calculated based on drug claims from 2006 up to five years before the index date. Conditional logistic regression models estimated linear associations between TiO2 exposure and cancer risk. RRs of overall cancer per 1000 TiO2-containing tablets and per 10,000 mg of TiO2 increments were both 1.00 (95% CI: 0.99-1.01). Analyses by cancer site also yielded RRs very close to 1.00 or slightly different but not statistically significant, except for breast (RR per 10,000 mg: 1.03, 95% CI:1.00-1.07) and lymphoid/hematopoietic (RR per 1000 tablets: 0.97, 95% CI: 0.95-1.00) cancers, which however lost significance after Bonferroni correction. There was a suggestion of non-linear positive association for central nervous system cancers. This first epidemiological study on TiO2 ingestion and cancer found no meaningful linear association between increasing TiO2 exposure through medicines and overall or site-specific cancer risk. Non-linear associations cannot be excluded.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"2 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna M Posthumus,Tim J Knobbe,Daan Kremer,Antonio W Gomes-Neto,Isabelle J C Dielwart,Jip Jonker,Caecilia S E Doorenbos,Michele F Eisenga,Marco van Londen,Rianne M Douwes,Lianne M Nieuwenhuis,Coby Annema,Marieke T de Boer,Martin H de Borst,Kevin Damman,Robert A Pol,C Tji Gan,Erik A M Verschuuren,Hans Blokzijl,Vincent E de Meijer,Stephan J L Bakker,
{"title":"TransplantLines, a biobank and cohort study of solid organ transplant recipients and donors.","authors":"Anna M Posthumus,Tim J Knobbe,Daan Kremer,Antonio W Gomes-Neto,Isabelle J C Dielwart,Jip Jonker,Caecilia S E Doorenbos,Michele F Eisenga,Marco van Londen,Rianne M Douwes,Lianne M Nieuwenhuis,Coby Annema,Marieke T de Boer,Martin H de Borst,Kevin Damman,Robert A Pol,C Tji Gan,Erik A M Verschuuren,Hans Blokzijl,Vincent E de Meijer,Stephan J L Bakker,","doi":"10.1007/s10654-025-01258-1","DOIUrl":"https://doi.org/10.1007/s10654-025-01258-1","url":null,"abstract":"The TransplantLines Biobank and Cohort Study (NCT03272841) is an ongoing prospective study conducted at the University Medical Centre Groningen, The Netherlands. TransplantLines aims to identify risk factors and biomarkers associated with health problems following solid organ transplantation and donation. Additionally, the study seeks to develop new interventions to reduce symptom burden and improve long-term outcomes, including health-related quality of life, cardiovascular complications, graft failure, and mortality. It includes recipients of (combined) heart, liver, lung, kidney, pancreas, and small bowel transplants, as well as living liver and kidney donors, and deceased (multi-)organ donors. The biobank contains a wide range of biomaterials including whole blood, serum, EDTA-plasma, buffy coat, 24-h urine samples, faeces, hair, nails, and tissues. Data collection includes physical and cognitive assessments, extensive laboratory analysis, metagenomic sequencing, and questionnaires. TransplantLines, initiated in 2015, consists of 5143 participants as of October 2024, among 2312 (45%) females. The mean age was 50 (± 16) years at transplantation, 55 (± 11) years at living donation and 56 (± 15) years at deceased donation. Both cross-sectional and longitudinal biomaterials and data are included. For recipients, longitudinal biomaterials and data were collected at: pre-transplantation, at transplantation, and at 3, 6, 12, 24, and 60 months post-transplantation. For living donors, data were collected at pre-donation, donation, 3 months post-donation, and/or 5 or 10 years post-donation.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"41 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}