Lung cancer mortality in the European cohort of titanium dioxide workers: a reanalysis of the exposure–response relationship

Canu, Irina Guseva; Gaillen-Guedy, Alan; Antilla, Ahti; Charles, Sandrine; Fraize-Frontier, Sandrine; Luce, Danièle; McElvenny, Damien; Merletti, Franco; Michel, Cécile; Pukkala, Eero; Schubauer‐Berigan, Mary K.; Straif, Kurt; Wild, Pascal; Richardson, David B.

doi:10.1136/oemed-2021-108030

Cited by 9 publications

(3 citation statements)

References 8 publications

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“…A recent reanalysis of

workers in Europe noted the presence of a healthy worker survivor effect, and in analysis using the parametric g-formula to address this bias, a positive relation between

exposure and lung cancer mortality was observed. 172 …”

Section: Discussionmentioning

confidence: 99%

“…For some agents (e.g.,

, styrene), recent attempts to account for methodological sources of bias, such as the healthy worker survivor effect, have led to new positive findings of associations, potentially of relevance to resolve classification uncertainties. 84 , 172 In follow-up to recommendations of the Preamble Advisory Group, a recent IARC workshop was held on new methods of epidemiological bias assessment in cancer hazard identification for use in Monographs evaluations. 177 …”

Section: Discussionmentioning

confidence: 99%

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Research Recommendations for Selected IARC-Classified Agents: Impact and Lessons Learned

Turner,

Cogliano,

Guyton

et al. 2023

Environ Health Perspect

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Background: The International Agency for Research on Cancer (IARC) Monographs program assembles expert working groups who publish a critical review and evaluation of data on agents of interest. These comprehensive reviews provide a unique opportunity to identify research needs to address classification uncertainties. A multidisciplinary expert review and workshop held in 2009 identified research gaps and needs for 20 priority occupational chemicals, metals, dusts, and physical agents, with the goal of stimulating advances in epidemiological studies of cancer and carcinogen mechanisms. Overarching issues were also described. Objectives: In this commentary we review the current status of the evidence for the 20 priority agents identified in 2009. We examine whether identified Research Recommendations for each agent were addressed and their potential impact on resolving classification uncertainties. Methods: We reviewed the IARC classifications of each of the 20 priority agents and identified major new epidemiological and human mechanistic studies published since the last evaluation. Information sources were either the published Monograph for agents that have been reevaluated or, for agents not yet reevaluated, Advisory Group reports and literature searches. Findings are described in view of recent methodological developments in Monographs evidence evaluation processes. Discussion: The majority of the 20 priority agents were reevaluated by IARC since 2009. The overall carcinogen classifications of 9 agents advanced, and new cancer sites with either “sufficient” or “limited” evidence of carcinogenicity were also identified for 9 agents. Examination of published findings revealed whether evidence gaps and Research Recommendations have been addressed and highlighted remaining uncertainties. During the past decade, new research addressed a range of the 2009 recommendations and supported updated classifications for priority agents. This supports future efforts to systematically apply findings of Monograph reviews to identify research gaps and priorities relevant to evaluation criteria established in the updated IARC Monograph Preamble. https://doi.org/10.1289/EHP12547

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“…A recent reanalysis of

workers in Europe noted the presence of a healthy worker survivor effect, and in analysis using the parametric g-formula to address this bias, a positive relation between

exposure and lung cancer mortality was observed. 172 …”

Section: Discussionmentioning

confidence: 99%

“…For some agents (e.g.,

Section: Discussionmentioning

confidence: 99%

Research Recommendations for Selected IARC-Classified Agents: Impact and Lessons Learned

Turner,

Cogliano,

Guyton

et al. 2023

Environ Health Perspect

Self Cite

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“…However, mounting evidence has shown their adverse effects on cancer survival. For instance, a recent pooled analysis revealed a positive association of the exposure to titanium dioxide, a whitening and brightening food additive, with the risk of lung cancerspecific mortality (34). Finally, UPFs have been suggested to have higher glycemic index than other NOVA-defined food groups (i.e., observed association between UPF consumption and all-cause mortality in patients with lung or prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

Prediagnosis ultra-processed food consumption and prognosis of patients with colorectal, lung, prostate, or breast cancer: a large prospective multicenter study

Pu,

Xu,

Zhu

et al. 2023

Front. Nutr.

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Background and aimsWhether ultra-processed food consumption is associated with cancer prognosis remains unknown. We aimed to test whether prediagnosis ultra-processed food consumption is positively associated with all-cause and cancer-specific mortality in patients with colorectal, lung, prostate, or breast cancer.MethodsThis study included 1,100 colorectal cancer patients, 1750 lung cancer patients, 4,336 prostate cancer patients, and 2,443 breast cancer patients. Ultra-processed foods were assessed using the NOVA classification before the diagnosis of the first cancer. Multivariable Cox regression was used to calculate hazard ratio (HR) and 95% confidence interval (CI) for all-cause and cancer-specific mortality.ResultsHigh ultra-processed food consumption before cancer diagnosis was significantly associated with an increased risk of all-cause mortality in lung (HRquartile 4 vs. 1: 1.18; 95% CI: 0.98, 1.40; Ptrend = 0.021) and prostate (HRquartile 4 vs. 1: 1.18; 95% CI: 1.00, 1.39; Ptrend = 0.017) cancer patients in a nonlinear dose–response manner (all Pnonlinearity < 0.05), whereas no significant results were found for other associations of interest. Subgroup analyses additionally revealed a significantly positive association with colorectal cancer-specific mortality among colorectal cancer patients in stages I and II but not among those in stages III and IV (Pinteraction = 0.006), and with prostate cancer-specific mortality among prostate cancer patients with body mass index <25 but not among those with body mass index ≥25 (Pinteraction = 0.001).ConclusionOur study suggests that reducing ultra-processed food consumption before cancer diagnosis may improve the overall survival of patients with lung or prostate cancer, and the cancer-specific survival of certain subgroups of patients with colorectal or prostate cancer.

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Occupational Epidemiology

Consonni,

D’Errico,

Merletti

2024

Handbook of Epidemiology

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Lung cancer mortality in the European cohort of titanium dioxide workers: a reanalysis of the exposure–response relationship

Cited by 9 publications

References 8 publications

Research Recommendations for Selected IARC-Classified Agents: Impact and Lessons Learned

Research Recommendations for Selected IARC-Classified Agents: Impact and Lessons Learned

Prediagnosis ultra-processed food consumption and prognosis of patients with colorectal, lung, prostate, or breast cancer: a large prospective multicenter study

Occupational Epidemiology

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