Cancer Epidemiology最新文献

{"title":"Radon exposure and cancer burden: A regional spatial analysis in Finland","authors":"Saqib Amin","doi":"10.1016/j.canep.2025.102783","DOIUrl":"10.1016/j.canep.2025.102783","url":null,"abstract":"<div><div>This study investigates the regional disparities in the association between radon exposure and cancer burdens in Finland using spatial panel data analysis. We analyze data from 19 Finnish regions spanning the years 1990–2023, focusing on variations in radon concentrations and their association with regional cancer incidence and mortality rates. Our approach integrates both temporal and spatial dimensions, allowing for a comprehensive assessment of the relationship between radon exposure levels and cancer outcomes while accounting for regional heterogeneity and spatial dependencies. The results suggest a significant positive association between elevated radon exposure and increased cancer incidence and mortality, with notable regional differences in the strength of this effect. The findings have important implications for public health interventions and policies aimed at reducing radon exposure and mitigating its cancer-related risks in Finland and other radon-prone regions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"96 ","pages":"Article 102783"},"PeriodicalIF":2.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive appraisal of the association between sexually transmitted infections and prostate cancer: A scoping review of empirical studies, reviews, and meta-analyses","authors":"Rodrigo Noorani,&nbsp;Sarah Botting-Provost,&nbsp;George Kas Barsoum,&nbsp;Cassandra Laurie,&nbsp;Mariam El-Zein,&nbsp;Eduardo L. Franco","doi":"10.1016/j.canep.2025.102781","DOIUrl":"10.1016/j.canep.2025.102781","url":null,"abstract":"<div><div>We performed a scoping review on the association of sexually transmitted infections (STIs) with prostate cancer and identified knowledge gaps. Searching four databases (Medline, Embase, Scopus, and Cochrane) identified 286 eligible records. Most empirical studies (n = 191) were cross-sectional (n = 66) and case-control (n = 52). The most studied STIs were human papillomavirus (HPV) (n = 82), human immunodeficiency virus (HIV) (n = 52), and herpes simplex virus (HSV) (n = 30). We included 68 narrative reviews, 10 systematic reviews, and 17 meta-analyses. Most effect estimates (odds ratios, hazard ratios, risk ratios and standardised incidence ratios) did not support an association between STIs and prostate cancer: 373 and 218 of 591 effect estimates were above and below the null, respectively, except for HIV where 74 of 108 estimates were below the null. Knowledge gaps included case-control studies, insights into HIV-related mechanisms for a lower risk for prostate cancer, studies on <em>Mycoplasma</em> and <em>Ureaplasma</em>, studies adjusting for co-infection with other STIs, and studies assessing whether STIs predispose men to a more aggressive form of prostate cancer. A key research priority identified is the need for more evidence on the biological mechanisms driving infection-mediated prostate carcinogenesis.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"96 ","pages":"Article 102781"},"PeriodicalIF":2.4,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of survival in women diagnosed with breast cancer between 2008 and 2017: An analysis of a cohort using data from four Population-Based Cancer Registries of Colombia","authors":"Karen Cárdenas-Garzón ,&nbsp;Daniel Jurado ,&nbsp;Karen Coronell ,&nbsp;Karen Florez-Lozano ,&nbsp;Nelson Arias-Ortiz ,&nbsp;Luisa M. Bravo ,&nbsp;Claudia Uribe-Perez ,&nbsp;Edgar Navarro-Lechuga ,&nbsp;Gloria I. Sanchez","doi":"10.1016/j.canep.2025.102765","DOIUrl":"10.1016/j.canep.2025.102765","url":null,"abstract":"<div><h3>Background</h3><div>Breast Cancer (BC) is the leading cause of cancer-related mortality in women, especially in low- and middle-income countries. Population-Based Cancer Registries (PBCRs) play a crucial role in monitoring cancer trends and guiding evaluation and planning of cancer control programs. In Colombia, there are no national analyses of BC survival. The aim was to estimate the overall survival up to 5-year of women diagnosed with BC, as well as its determinants, in Colombia using population-based data from four Colombian PBCRs.</div></div><div><h3>Methods</h3><div>We conducted a cohort study with women diagnosed with invasive BC between 2008 and 2017, identified by the corresponding PBCRs as residents of the Colombian cities of Barranquilla, Bucaramanga metropolitan area, Manizales, and Pasto. We performed follow-up up to 5 years after the BC diagnosis, or until death (all-cause). We estimated the overall survival (Kaplan Meier). We evaluated the simultaneous effect of multiple risk factors on death risk using Cox proportional hazards analysis, obtaining adjusted Hazard Ratios (aHR) and Confidence Intervals (CI).</div></div><div><h3>Results</h3><div>The analysis cohort included 8020 BC cases. The observed overall survival was 72.5 %. The likelihood of 5-year survival was lowest for women aged 70 or older (aHR 1.61; 95 % CI 1.42–1.83), those living in a middle Socioeconomic Stratum (SES) (aHR 1.32; 95 % CI 1.05–1.66), those affiliated to the subsidized Health Insurance Regime (HIR) (aHR 1.47; 95 % CI 1.32–1.63), and those diagnosed in stages III-IV (aHR 2.29; 95 % CI 2.03–2.57) compared to women with a diagnosis age between 50 and 70 years, residents in high SES, those affiliated to the contributory HIR, and those diagnosed at stages I-II, respectively.</div></div><div><h3>Conclusion</h3><div>Social disparities are linked to BC survival in Colombia, likely due to limited access to healthcare services. This suggests the importance of strengthening screening and diagnostic care, especially for vulnerable populations.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102765"},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticipation effect in Pakistani breast cancer families with or without BRCA1/2 pathogenic variants","authors":"Noor Muhammad ,&nbsp;Humaira Naeemi ,&nbsp;Shumaila Arif ,&nbsp;Ute Hamann ,&nbsp;Muhammad Usman Rashid","doi":"10.1016/j.canep.2025.102782","DOIUrl":"10.1016/j.canep.2025.102782","url":null,"abstract":"<div><h3>Background</h3><div>Genetic anticipation refers to the earlier onset of breast cancer (BC) in successive generations, is underreported in Asian populations. This study investigates the phenomenon in Pakistani familial BC patients.</div></div><div><h3>Methods</h3><div>The study analyzed 171 mother-daughter BC pairs, including <em>BRCA1</em> (n = 52), <em>BRCA2</em> (n = 11) pathogenic variant (PV) carriers, and non-carriers (n = 108). Additionally, 741 first-degree female relatives of the mothers and daughters, affected (n = 96) or unaffected (n = 645) with BC, were included. Ages at BC diagnosis in mother-daughter pairs were compared using a paired <em>t-</em>test, while differences in BC occurrence between daughters’ and mothers’ generations were assessed using odds ratios (ORs).</div></div><div><h3>Results</h3><div>Daughters were diagnosed with BC significantly earlier than their mothers, with intergenerational age differences of 14.3 years in <em>BRCA1</em> (33.7 <em>vs</em>. 48.0; <em>P</em> &lt; 0.0001), 11.5 years in <em>BRCA2</em> (37.4 <em>vs</em>. 48.9; <em>P</em> &lt; 0.0001) PV carriers, and 12.6 years in non-carriers (41.3 <em>vs</em>. 53.9; <em>P</em> &lt; 0.0001). This difference was independent of birth cohort effects and ascertainment bias. While BC incidence was 20 % higher in the mothers’ generation compared to the daughters’ generation (42.7 % <em>vs</em>. 38.3 %; OR 1.20, 95 % CI 0.94 – 1.53; <em>P</em> = 0.135), the difference was not statistically significant. Survival durations between generations were also comparable (4.49 years <em>vs.</em> 3.94 years; <em>P</em> = 0.465).</div></div><div><h3>Conclusion</h3><div>This first study on anticipation effect in Pakistani familial BC patients demonstrates significantly earlier BC onset in daughters than in mothers, irrespective of <em>BRCA1/2</em> PV carrier status. These findings highlight the need to refine BC screening guidelines for high-risk Pakistani populations.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"96 ","pages":"Article 102782"},"PeriodicalIF":2.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational benzene exposure and risk of nervous system cancers: A systematic review and meta-analysis","authors":"Silvia Mangiaterra ,&nbsp;Paolo Boffetta ,&nbsp;Monireh Sadat Seyyedsalehi","doi":"10.1016/j.canep.2025.102779","DOIUrl":"10.1016/j.canep.2025.102779","url":null,"abstract":"<div><h3>Background</h3><div>Benzene is a solvent that has played a significant role in various industries and applications over time, but its use declined due to its carcinogenic nature. Classified as a human carcinogen since 1979, benzene exposure is linked to leukemia and possibly other cancers. The global rise of nervous system cancers urges investigation into the possible role of benzene. Our aim is to investigate this association through a systematic review and meta-analysis of occupational cohort and case-control studies.</div></div><div><h3>Methods</h3><div>We registered our study protocol and followed established guidelines (Registration No. CRD42022379720). A systematic search across databases yielded 36 independent cohort and case-control studies. We conducted a random-effects meta-analysis of relative risks (RR) for nervous system cancers. Analyses were stratified based on various factors such as region, study design, and exposure level. Publication bias was evaluated using a funnel plot and Egger test.</div></div><div><h3>Results</h3><div>Our meta-analysis indicates an association between benzene exposure and risk of overall nervous system cancers (RR = 1.21, 95 % confidence interval [CI] = 1.05–1.38). Stratified analyses showed an association with glioma (RR = 3.88, 95 % CI = 1.33–11.31, N risk estimates=2). Publication bias was detected (p = 0.01).</div></div><div><h3>Conclusion</h3><div>Our study found an association between occupational benzene exposure and increased risks of nervous system cancers, which however cannot be interpreted as causal. While these findings highlight the need for stringent safety measures, they also reveal gaps in literature. Further research is essential to address these limitations and deepen our understanding of benzene's health implications.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102779"},"PeriodicalIF":2.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-specific lung cancer incidence trends in Canada from 1992 to 2022","authors":"Matthew T. Warkentin ,&nbsp;Johnathan A. Murray ,&nbsp;Yibing Ruan ,&nbsp;Kirk Graff ,&nbsp;Alain Tremblay ,&nbsp;Darren R. Brenner","doi":"10.1016/j.canep.2025.102774","DOIUrl":"10.1016/j.canep.2025.102774","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer incidence has historically been higher in males than females, but these rates have been converging. Here we detail the trends in age-specific lung cancer incidence in Canada from 1992 to 2022.</div></div><div><h3>Methods</h3><div>Lung cancer incidence data from 1992 to 2022 by sex and age were obtained from Statistics Canada. We report lung cancer incidence rates and annual percent changes (APC) based on Joinpoint Regression. Birth cohort effects are presented as incidence rate ratios (IRR) with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Lung cancer incidence has decreased among males aged 35 or above with the largest decreases occurring among those 65 or above. Females under 55 showed similar decreasing trends. However, females 55 or above show stable or increasing incidence rates until around 2017 when rates began decreasing significantly. Birth cohort analysis showed males born after 1957 have lower risk compared to those born at of before 1957. Females risk peaked in 1943–47 and the risk after 1957 slowly returned to early twentieth century levels.</div></div><div><h3>Conclusion</h3><div>The sex difference in lung cancer incidence continues to narrow. Lung cancer rates among males have declined for decades, while the decline among females is more recent and incidence is higher for females at younger ages for the first time.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102774"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Biased effects of pre-diagnostic physical activity on breast cancer survival: Systematic review and meta-analysis” [Cancer Epidemiol. 89 (2024) 102544]","authors":"Ziyu Wang ,&nbsp;Frances E.M. Albers ,&nbsp;Sabrina E. Wang ,&nbsp;Dallas R. English ,&nbsp;Brigid M. Lynch","doi":"10.1016/j.canep.2025.102773","DOIUrl":"10.1016/j.canep.2025.102773","url":null,"abstract":"","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102773"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of recurrence among adults diagnosed with screen-detected lung cancer","authors":"Nikki M. Carroll ,&nbsp;Jennifer Eisenstein ,&nbsp;Kris F. Wain ,&nbsp;Jared M. Freml ,&nbsp;Robert T. Greenlee ,&nbsp;Stacey A. Honda ,&nbsp;Christine Neslund-Dudas ,&nbsp;Katharine A. Rendle ,&nbsp;Anil Vachani ,&nbsp;Debra P. Ritzwoller","doi":"10.1016/j.canep.2025.102777","DOIUrl":"10.1016/j.canep.2025.102777","url":null,"abstract":"<div><h3>Background</h3><div>With the recent shift in lung cancer staging towards early-stage disease coinciding with the introduction of lung cancer screening (LCS), little is known if LCS has affected the rate of recurrence and survival in community settings. Our objective was to evaluate variation in the detection and outcomes of recurrent lung cancer stratified by receipt of LCS.</div></div><div><h3>Methods</h3><div>Patients aged 55–80 years old diagnosed with stage I-IIIA non-small cell lung cancer (NSCLC) between 1/1/2014 and 12/31/2020 who completed definitive therapy and were considered disease-free were identified. Rates of recurrence were calculated in discrete 12-month intervals and by cumulative incidence. Survival was evaluated by multivariable adjusted Restricted Mean Survival Time (aRMST). Factors associated with recurrence were evaluated by Poisson models.</div></div><div><h3>Results</h3><div>Among 916 patients meeting study criteria, 708 (77 %) were non-screen-detected and 208 (23 %) were considered screen-detected. The proportion of recurrence between non-screen-detected (22 %) and screen-detected (17 %) was similar (P = 0.11). Recurrence rates during the first and second years after definitive therapy were 10.1 and 4.1 per 100 person-years for the non-screen-detected and 6.0 and 4.5 per 100 person-years for screen-detected, respectively. Two-year cumulative incidence of recurrence was 16.5 % (95 % CI, 13.9 %-19.4 %) for non-screen-detected patients and 13.8 % (95 % CI, 9.3 %-19.0 %) in the screen-detected group. Recurrence-free survival and survival after recurrence were similar between the two groups. Screening status was not associated with the likelihood of recurrence (RR=0.94, 95 % CI, 0.59–1.50).</div></div><div><h3>Conclusion</h3><div>These findings provide evidence of recurrence being a part of the intrinsic nature of disease progression despite mode of detection. Our findings emphasize the need for all patients to receive surveillance and survivorship care after treatment for early-stage NSCLC regardless of mode of detection. Further study with longer follow-up is warranted.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102777"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of time trends of prevalence of high-risk HPV infections, high grade cervical precancer and cervical cancer disease in women from Eastern India over 20 years − Pooled analysis from three studies","authors":"Sreeya Bose ,&nbsp;Ranajit Mandal ,&nbsp;Dipanwita Banerjee ,&nbsp;Manisha Vernekar ,&nbsp;Maqsood Siddiqi ,&nbsp;Jayanta Chakrabarti ,&nbsp;Rengaswamy Sankaranarayanan ,&nbsp;Eric Lucas ,&nbsp;Richard Muwonge ,&nbsp;Partha Basu","doi":"10.1016/j.canep.2025.102776","DOIUrl":"10.1016/j.canep.2025.102776","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer remains a leading cause of cancer related morbidity and mortality among women worldwide, particularly in low-and middle- income countries (LMICs). The incidence of cervical cancer has declined in India over the last two decades despite the lack of any organised population-based screening programme or HPV vaccination. This study analyses the trends in high-risk human papilloma virus (hrHPV) prevalence and CIN 2 + detection and examines the influence of sociodemographic factors in West Bengal, India from over a span of two decades.</div></div><div><h3>Methods</h3><div>Data from three cervical cancer screening studies conducted in rural West Bengal were analysed between 2001 and 2021. A total of 80,988 women aged 30–60 years were screened using Hybrid Capture II© (HC II) test. Detection rates of CIN 2 + were stratified by age, education and marriage. Logistic regression models were used to identify factors influencing high risk HPV positivity and CIN 2 + prevalence.</div></div><div><h3>Results</h3><div>The overall high risk HPV positivity rate remained relatively stable (5 %) across the study periods with no significant difference between self-collected and provider collected samples. However, CIN 2 + detection rates declined significantly from 5.7/1000 in 2001-2003 to 2/1000 in 2018–2021 (adjusted odds ratio [OR]:0.27; 95 % confidence interval [CI]:0.12–0.46). Higher education (OR: 0.64; 95 % CI: 0.45–0.88) and delayed age at marriage (OR: 0.62; 95 %CI: 0.31–1 for age&gt;21) were associated with lower CIN 2 + risk.</div></div><div><h3>Conclusion</h3><div>The findings of the study indicate that the observed decline in CIN 2 + prevalence in West Bengal can be attributed to improved education, delayed age at marriage, reduced fertility rate and women’s empowerment, which can explain the gradual reduction in cervical cancer incidence in India. However, the cervical cancer incidence in India remains above WHO elimination targets. Expedited implementation of HPV vaccination and strengthening screening programmes are necessary to sustain and accelerate progress towards elimination of cervical cancer.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102776"},"PeriodicalIF":2.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthy Eating Index (HEI-2020) score and colorectal cancer risk","authors":"Arianna Natale ,&nbsp;Dariush Khaleghi Hashemian ,&nbsp;Jerry Polesel ,&nbsp;Attilio Giacosa ,&nbsp;Livia S.A. Augustin ,&nbsp;Eva Negri ,&nbsp;Federica Toffolutti ,&nbsp;Carlo La Vecchia ,&nbsp;Marta Rossi ,&nbsp;Francesca Bravi","doi":"10.1016/j.canep.2025.102771","DOIUrl":"10.1016/j.canep.2025.102771","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study is to evaluate if the alignment with the 2020–2025 Dietary Guidelines for Americans (DGA), measured by the Healthy Eating Index 2020 (HEI-2020), is associated with colorectal cancer (CRC) risk in an Italian population.</div></div><div><h3>Methods</h3><div>A multicentric case-control study was carried out in Italy between 1992 and 1996. Cases were 1953 patients (males 58 %, median age = 62 years) admitted to major hospitals with incident, histologically confirmed CRC. Controls were 4154 patients (males 50 %, median age = 58 years) admitted to the same hospitals for acute non-neoplastic conditions. Participants’ usual diet before study enrolment was collected using a validated food frequency questionnaire, and the alignment with DGA was assessed using the HEI-2020 score, ranging between 0 (no alignment) and 100 (complete alignment). Odds ratios (ORs) and the corresponding 95 % confidence intervals (CIs) were estimated using multiple logistic regression models including terms for selected socioeconomic, lifestyle factors, and potential confounders.</div></div><div><h3>Results</h3><div>The HEI-2020 score ranged from 29.4 and 97.0. Subjects in the highest tertile of scores had lower risk of CRC compared to those in the lowest tertile (OR: 0.69, 95 % CI = 0.60–0.80). Similar estimates were found for colon (OR: 0.70, 95 % CI = 0.59 – 0.83) and rectal cancer (OR: 0.69, 95 % CI = 0.56–0.85). The findings were also consistent across strata of different covariates.</div></div><div><h3>Conclusions</h3><div>Alignment with DGA was inversely associated with CRC risk in an Italian population.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"95 ","pages":"Article 102771"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}