Pooling of Finnish population-based health studies: lifestyle risk factors of colorectal and lung cancer

Pitkäniemi, Janne; Heikkinen, Sanna; Seppä, Karri; Ryynänen, Heidi; Ylöstalo, Tiina; Eriksson, Johan G.; Härkänen, Tommi; Jousilahti, Pekka; Knekt, Paul; Koskinen, Seppo; Männistö, Satu; Albanês, Demetrius; Rissanen, Harri; Malila, Nea; Laaksonen, Maarit A.

doi:10.1080/0284186x.2020.1789214

Cited by 8 publications

(35 citation statements)

References 15 publications

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“…Since 2016, the structure of cancer incidence among Polish men has been similar to that observed in other countries with a very high Human Development Index, namely with the domination of prostate and lung cancer 9 – 13 . In most voivodships (corresponding to a province in other countries; 14 out of 16), prostate cancer was the most common male cancer, followed by lung cancer.…”

Section: Discussionsupporting

confidence: 66%

Cancer incidence and mortality in Poland in 2019

Didkowska

Wojciechowska

Michałek

et al. 2022

Sci Rep

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The purpose of this paper is to offer the most important epidemiological indicators of malignant neoplasms in Poland for the year 2019. In 2019, the Polish National Cancer Registry received information on almost 171.2 thousand new cancer cases and 100.3 thousand cancer deaths. The most common male cancers were prostate (20.6%), lung (16.1%), colon (6.8%), bladder (6.4%), and rectal (4.2%) cancers. Age-standardized incidence rates were at 118 per 100,000 for prostate, 89 for lung, 40 for colon, 38 for bladder, and 23 for the rectum. The most prevalent female cancers encompassed breast (22.9%), lung (9.9%), corpus uteri (7.0%), colon (5.9%), and ovary (4.3%). Age-standardized incidence rate was at 95 per 100,000 for breast cancer, 40 for lung 40, 29 for corpus uteri, 24 for colon, and 18 for ovarian cancer. The five leading causes of male cancer deaths were cancer of the lung (27.4%), prostate (10.3%), colon (8.0%), bladder (5.8%), and stomach (5.7%). Age-standardized mortality rates were 100 per 100,000 for lung, 46 for prostate, 32 for colon, 24 for urinary bladder, and 22 for stomach cancer. Most female deaths due to cancer were caused by lung (17.9%), breast (15.1%), colon (7.7%), ovary (6.0%), pancreas (5.7%), and corpus uteri (4.0%) cancers. Age-standardized mortality rates were 39 per 100,000 for lung, 33 for breast, 17 for colon, 13 for ovarian, 13 for pancreatic, and 9 for corpus uteri cancer.

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Section: Discussionsupporting

confidence: 66%

Cancer incidence and mortality in Poland in 2019

Didkowska

Wojciechowska

Michałek

et al. 2022

Sci Rep

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“…We have previously performed sensitivity analyses for time dependence of exposure effects, where we excluded the first 2 years of follow‐up or follow‐up longer than 10 years. Neither detection nor information bias had a notable effect in the reported results 22 …”

Section: Discussionmentioning

confidence: 63%

“…The follow‐up started either from the date of baseline survey or the date when the person turns 50 years, which ever occurred latest. The follow‐up continued until the end of 2013 or 2015 (depending on the cohort), death or emigration 22 …”

Section: Methodsmentioning

confidence: 99%

“…We used data pooled for the METCA consortium (Prospective METa Cohort Study of Cancer Burden in Finland). 22 The study covers the following survey studies monitoring health behavior between 1972 and 2015: The National FINRISK Study conducted at 5‐year intervals since 1972 (FINRISK), 23 The Adult Health, Wellbeing, and Services Studies 1 from 2010 to 2011 (ATH1) and 2 from 2012 to 2015 (ATH2), 24 The Health 2000 Survey (H2000), 25 The Finnish Mobile Clinic Health Survey from 1972 to 1977 (FMCF), 26 The Mini‐Finland Health Survey from 1978 to 1980 (MFH), 26 the Helsinki Health Study from 2000 to 2002 (HHS) 27 and The Helsinki Birth Cohort Study (HBCS) 28 ( Appendix S1 in Data S1). Exposure assessment includes both survey data and health examinations.…”

Section: Methodsmentioning

confidence: 99%

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Pairwise association of key lifestyle factors and risk of colorectal cancer: a prospective pooled multicohort study

et al. 2022

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Background Several lifestyle factors are associated with an increased risk of colorectal cancer (CRC). Although lifestyle factors co‐occur, in most previous studies these factors have been studied focusing upon a single risk factor or assuming independent effects between risk factors. Aim To examine the pairwise effects and interactions of smoking, alcohol consumption, physical inactivity, and body mass index (BMI) with risk of subsequent colorectal cancer (CRC). Methods and results We used METCA cohort data (pooled data from seven population‐based Finnish health behavior survey studies during years 1972–2015) consisting of 171 063 women and men. Participants' smoking, alcohol consumption, physical inactivity and BMI measures were gathered, and participants were categorized into those exposed and those not exposed. The incidence of CRC was modeled by Poisson regression with main and interaction effects of key lifestyle factors. The cohort members were followed‐up through register linkage to the Finnish Cancer Registry for first primary CRC case until the end of 2015. Follow‐up time was 1715, 690 person years. The highest pairwise CRC risk was among male smokers who had overweight (BMI ≥ 25 kg/m2) (HR 1.75, 95% CI 1.36–2.26) and women who had overweight and consumed alcohol (HR 1.45, 95% CI 1.14–1.85). Overall, among men the association of lifestyle factors and CRC risk was stronger than among women. In men, both having overweight and being a smoker combined with any other adverse lifestyle factor increased CRC risk. Among women, elevated CRC risks were observed for those who were physically inactive and who consumed alcohol or had overweight. No statistically significant interactions were detected between pairs of lifestyle factors. Conclusions This study strengthens the evidence of overweight, smoking, and alcohol consumption as CRC risk factors. Substantial protective benefits in CRC risk can be achieved by preventing smoking, maintaining BMI to <25 kg/m2 and not consuming alcohol.

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“…We excluded lung cancer from some of the analyses because its causal association with smoking has been established 14 and recently reported in studies from NorTwinCan, 9 Nordic population data 31 and Finnish population‐based cohort data. 32 Therefore, we extended the causality analyses to the study of other cancer sites that are associated with smoking, but for which causality between smoking and cancer has not been deeply investigated with genetically informative twin data.…”

Section: Discussionmentioning

confidence: 99%

Cancer in twin pairs discordant for smoking: The Nordic Twin Study of Cancer

Korhonen

Hjelmborg

Harris

et al. 2022

Intl Journal of Cancer

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The discordant twin pair study design is powerful to control for familial confounding. We employed this approach to investigate the associations of smoking with several cancers. The NorTwinCan study combines data from the Danish, Finnish, Norwegian and Swedish twin and cancer registries. Follow‐up started when smoking status was determined and ended at cancer diagnosis confirmed by information in the cancer registry, death or end of follow‐up. We classified the participants as never (n = 59 093), former (n = 21 168) or current (n = 47 314) smokers. We pooled data from twin pairs where one co‐twin was diagnosed with any of the following tobacco‐related cancers: esophagus, kidney, larynx, liver, oral cavity, pancreas, pharynx or urinary bladder, while their co‐twin had none of those. Lung cancer was included in further analysis. We used Cox regression allowing for pair‐specific baseline functions to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). For tobacco‐related cancer sites, we recorded 7379 cases during median 27 years of follow‐up. The analyses based on individual twins showed that former (HR 1.31, 95% CI: 1.17‐1.48) and current (HR 2.14 [1.95‐2.34]) smokers are at increased risk to develop one of cancers listed above, compared to never smokers. Among 109 monozygotic twin pairs discordant for cancer and smoking, the HR was 1.85 (95% CI: 1.15‐2.98) among current smokers and 1.69 (1.00‐2.87) among former smokers when compared to their never smoking co‐twin. Thus, associations of smoking with several cancers were replicated for discordant identical twin pairs. Analyses based on genetically informative data provide evidence consistent with smoking causing multiple cancers.

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Pooling of Finnish population-based health studies: lifestyle risk factors of colorectal and lung cancer

Cited by 8 publications

References 15 publications

Cancer incidence and mortality in Poland in 2019

Cancer incidence and mortality in Poland in 2019

Pairwise association of key lifestyle factors and risk of colorectal cancer: a prospective pooled multicohort study

Cancer in twin pairs discordant for smoking: The Nordic Twin Study of Cancer

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