Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition

Christakoudi, Sofia and Kakourou, Artemisia and Markozannes, Georgios and Tzoulaki, Ioanna and Weiderpass, Elisabete and Brennan, Paul and Gunter, Marc and Dahm, Christina C. and Overvad, Kim and Olsen, Anja and Tjonneland, Anne and Boutron-Ruault, Marie-Christine and Madika, Anne-Laure and Severi, Gianluca and Katzke, Verena and Kuehn, Tilman and Bergmann, Manuela M. and Boeing, Heiner and Karakatsani, Anna and Martimianaki, Georgia and Thriskos, Paschalis and Masala, Giovanna and Sieri, Sabina and Panico, Salvatore and Tumino, Rosario and Ricceri, Fulvio and Agudo, Antonio and Redondo-Sanchez, Daniel and Colorado-Yohar, Sandra M. and Mokoroa, Olatz and Melander, Ole and Stocks, Tanja and Haggstrom, Christel and Harlid, Sophia and Bueno-de-Mesquita, Bas and van Gils, Carla H. and Vermeulen, Roel Ch and Khaw, Kay-Tee and Wareham, Nicholas J. and Tong, Tammy Y. N. and Freisling, Heinz and Johansson, Mattias and Lennon, Hannah and AUne, Dagfinn and Ribolil, Elio and Trichopoulos, Dimitrios and Trichopoulou, Antonia and Tsilidis, Konstantinos K. (2020) Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition. International Journal of Cancer, 146 (10). pp. 2680-2693. ISSN 0020-7136, DOI

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Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08-1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14-1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07-1.26) (SBP), HR = 1.31 (1.13-1.51) (DBP), weaker for head and neck cancers: HR = 1.08 (1.04-1.12) (SBP), HR = 1.09 (1.01-1.17) (DBP) and, similarly, for skin SCC, colon cancer, postmenopausal breast cancer and uterine adenocarcinoma (AC), but not for esophageal AC, lung SCC, lung AC or uterine endometroid cancer. We observed weak inverse associations of SBP with cervical SCC: HR = 0.91 (0.82-1.00) and lymphomas: HR = 0.97 (0.93-1.00). There were no consistent associations with cancers in other locations. Our results are largely compatible with published studies and support weak associations of blood pressure with cancers in specific locations and morphologies.

Item Type: Article
Funders: Fondazione AIRC per la ricerca sul cancro, Cancer Research UK 14136, Cancer Research UK (C570/A16491), Cancer Research UK (C8221/A19170), Catalan Institute of Oncology (Barcelona, Spain), County Council of Skane (Sweden), County Council of Vasterbotten (Sweden), Danish Cancer Society, Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, Dutch Ministry of Public Health, Welfare and Sports (VWS), Dutch Prevention Funds, Netherlands Organization for Scientific Research (NWO), European Research Council (ERC) European Commission (ERC-2009-AdG 232997), European Commission European Commission Joint Research Centre, Federal Ministry of Education & Research (BMBF), Deutsche Krebshilfe, Helmholtz Association, Instituto de Salud Carlos III (PI13/00061), Instituto de Salud Carlos III (PI13/01162), Hellenic Health Foundation, Hellenic Republic, General Secretary of Research and Technology, Institut Gustave Roussy (France), Institut National de la Sante et de la Recherche Medicale (Inserm), International Agency for Research on Cancer, Ligue Contre le Cancer (France), Netherlands Government, UK Research & Innovation (UKRI) Medical Research Council UK (MRC) (1000143), UK Research & Innovation (UKRI) Medical Research Council UK (MRC) (MR/M012190/1), Mutuelle Generale de l'Education Nationale (France), Consiglio Nazionale delle Ricerche (CNR), Netherlands Cancer Registry (NKR), Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway)
Uncontrolled Keywords: Cancer; Hypertension; Morphology; Cohort; Europe; epidemiology; Association; Risk factors
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine > Social & Preventive Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 06 Mar 2023 01:41
Last Modified: 06 Mar 2023 01:41

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