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Title: Methodological issues in a prospective study on plasma concentrations of persistent organic pollutants and pancreatic cancer risk within the EPIC cohort
Author: Gasull, Magda
Pumarega, José
Kiviranta, Hannu
Rantakokko, Panu
Raaschou-Nielsen, Ole
Bergdahl, Ingvar A.
Sandanger, Torkjel Manning
Goñi, Fernándo
Cirera, Lluís
Donat Vargas, Carolina
Alguacil, Juan
Iglesias, Mar
Tjønneland, Anne
Overvad, Kim
Mancini, Francesca Romana
Boutron-Ruault, Marie-Christine
Severi, Gianluca
Johnson, Theron
Kuhn, Tilman
Trichopoulou, Antonia
Karakatsani, Anna
Peppa, Eleni
Palli, Domenico
Pala, Valeria
Tumino, Rosario
Naccarati, Alessio
Panico, Salvatore
Verschuren, Monique
Vermeulen, Roel
Rylander, Charlotta
Nost, Therese
Rodríguez Barranco, Miguel
Molinuevo, Amaia
Chirlaque, María Dolores
Ardanaz, Eva
Sund, Malin
Key, Tim
Ye, Weimin
Jenab, Mazda
Michaud, Dominique
Matullo, Giuseppe
Canzian, Federico
Kaaks, Rudolf
Nieters, Alexandra
Nothlings, Ute
Jeurnink, Suzanne
Chajès, Véronique
Matejcic, Marco
Gunter, Marc
Aune, Dagfinn
Riboli, Elio
Agudo, Antonio
González, Carlos Alberto
Weiderpass, Elisabete
Bueno de Mesquita, H. Bas
Duell, Eric J.
Vineis, Paolo
Porta, Miquel, 1957-
Keywords: Càncer de pancrees
Marcadors bioquímics
Contaminants persistents
Pancreas cancer
Biochemical markers
Persistent pollutants
Issue Date: 1-Feb-2019
Publisher: Academic Press Inc Elsevier Science
Abstract: Background: The use of biomarkers of environmental exposure to explore new risk factors for pancreatic cancer presents clinical, logistic, and methodological challenges that are also relevant in research on other complex diseases. Objectives: First, to summarize the main design features of a prospective case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort on plasma concentrations of persistent organic pollutants (POPs) and pancreatic cancer risk. And second, to assess the main methodological challenges posed by associations among characteristics and habits of study participants, fasting status, time from blood draw to cancer diagnosis, disease progression bias, basis of cancer diagnosis, and plasma concentrations of lipids and POPs. Results from etiologic analyses on POPs and pancreatic cancer risk, and other analyses, will be reported in future articles. Methods: Study subjects were 1533 participants (513 cases and 1020 controls matched by study centre, sex, age at blood collection, date and time of blood collection, and fasting status) enrolled between 1992 and 2000. Plasma concentrations of 22 POPs were measured by gas chromatography - triple quadrupole mass spectrometry (GC-MS/MS). To estimate the magnitude of the associations we calculated multivariate-adjusted odds ratios by unconditional logistic regression, and adjusted geometric means by General Linear Regression Models. Results: There were differences among countries in subjects' characteristics (as age, gender, smoking, lipid and POP concentrations), and in study characteristics (as time from blood collection to index date, year of last followup, length of follow-up, basis of cancer diagnosis, and fasting status). Adjusting for centre and time of blood collection, no factors were significantly associated with fasting status. Plasma concentrations of lipids were related to age, body mass index, fasting, country, and smoking. We detected and quantified 16 of the 22 POPs in more than 90% of individuals. All 22 POPs were detected in some participants, and the smallest number of POPs detected in one person was 15 (median, 19) with few differences by country. The highest concentrations were found for p,p'-DDE, PCBs 153 and 180 (median concentration: 3371, 1023, and 810 pg/mL, respectively). We assessed the possible occurrence of disease progression bias (DPB) in eight situations defined by lipid and POP measurements, on one hand, and by four factors: interval from blood draw to index date, tumour subsite, tumour stage, and grade of differentiation, on the other. In seven of the eight situations results supported the absence of DPB. Conclusions: The coexistence of differences across study centres in some design features and participant characteristics is of relevance to other multicentre studies. Relationships among subjects' characteristics and among such characteristics and design features may play important roles in the forthcoming analyses on the association between plasma concentrations of POPs and pancreatic cancer risk.
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It is part of: Environmental Research, 2019-02-01, Vol. 169, P. 417-433
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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