Carcinogenesis Advance Access originally published online on March 29, 2006
Carcinogenesis 2006 27(7):1497-1501; doi:10.1093/carcin/bgl019
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Endogenous versus exogenous exposure to N-nitroso compounds and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study
Department of Epidemiology, Catalan Institute of Oncology, (ICO-IDIBELL) Barcelona, Spain, 1 Medical Research Council, Dunn Human Nutrition Unit, Wellcome Trust/MRC Building, Cambridge, UK, 2 Strangeways Research Laboratory, Cambridge, UK, 3 German Institute of Human Nutrition, Potsdam-Rehbücke, Germany, 4 IRIS Research Center, Chiron-Vaccines, Siena, Italy, 5 Molecular and Nutritional Epidemiology Unit, CSPO – Scientific Institute of Tuscany, Florence, Italy, 6 Epidemiology Unit, Istituto Tumori, Milan, Italy, 7 University of Torino, Italy, 8 Cancer Registry, Azienda Ospedaliera ‘Civile M.P. Arezzo’, Ragusa, Italy, 9 Dipartamento di Medicina Clinica e Sperimentale, Federico II University, Compagnia di San Paolo, Naples, Italy, 10 Department of Medicine, University Hospital Malmo, Lund University Malmo, Sweden, 11 Department of Nutritional Research, University of Umeå, Sweden, 12 Andalusian School of Public Health, Granada, Spain, 13 Department of Public Health of Guipuzkoa, San Sebastian, Spain, 14 Public Health Institute of Navarra, Pamplona, Spain, 15 Epidemiology Department, Health Council of Murcia, Spain, 16 Public Health and Health Planning Directorate, Asturias, Spain, 17 Cancer Epidemiology Unit, University of Oxford, UK, 18 Institute of Community Medicine, University of Tromso, Norway, 19 Institute of Molecular Pathology and Immunology of the University of Porto and Medical Faculty, Porto, Portugal, 20 Division of Clinical Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany, 21 Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark, 22 Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark, 23 Center for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands, 24 Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands, 25 INSERM, Institut Gustave Roussy, Villejuif, France, 26 Department of Hygiene and Epidemiology, Medical School, University of Athens, Greece, 27 Det Sundhedsvidenskabelige Fakultet, Syddansk Universitet, Denmark, 28 Department of Medical Biosciences, University of Umea, Sweden, 29 Nutrition and Hormones Group, International Agency for Research on Cancer, Lyon, France and 30 Department of Epidemiology and Public Health, Imperial College, London, UK
* To whom correspondence and requests for reprints should be addressed at: Department of Epidemiology, Catalan Institute of Oncology (ICO-IDIBELL), Avenue Gran vía s/n km. 2.7 (08907) L'Hospitalet de Llobregat, Barcelona, Spain. Email: paujak{at}ico.scs.es
The risk of gastric cancer (GC) associated with dietary intake of nitrosodimethylamine (NDMA) and endogenous formation of nitroso compounds (NOCs) was investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC). The study included 521 457 individuals and 314 incident cases of GC that had occurred after 6.6 average years of follow-up. An index of endogenous NOC (ENOC) formation was estimated using data of the iron content from meat intake and faecal apparent total NOC formation according to previous published studies. Antibodies to Helicobacter pylori and vitamin C levels were measured in a sub-sample of cases and matched controls included in a nested case–control within the cohort. Exposure to NDMA was <1 µg on average compared with 93 µg on average from ENOC. There was no association between NDMA intake and GC risk (HR, 1.00; 95% CI, 0.7–1.43). ENOC was significantly associated with non-cardia cancer risk (HR, 1.42; 95% CI, 1.14–1.78 for an increase of 40 µg/day) but not with cardia cancer (HR, 0.96; 95% CI, 0.69–1.33). Although the number of not infected cases is low, our data suggest a possible interaction between ENOC and H.pylori infection (P for interaction = 0.09). Moreover, we observed an interaction between plasma vitamin C and ENOC (P < 0.02). ENOC formation may account for our previously reported association between red and processed meat consumption and gastric cancer risk.
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