Case-control Study In Uruguay Research Articles

Dietary Acid Load and Breast Cancer Risk: A Case-Control Study in Uruguay

If the endogenous acid-base balance is not well regulated, dietary acid load contributes to metabolic acidosis, leading to inflammation and cell transformation, which can contribute to the development of cancer. Nevertheless, there is still limited epidemiologic evidence on the association between diet-dependent acid load and cancer risk, particularly for breast cancer (BC), although an increased risk of recurrence among BC survivors was reported for a high acid load. Therefore, we have explored in the present study its role in BC risk.

564 Poster - Dietary acid load and breast cancer risk: A case-control study in Uruguay

564 Poster - Dietary acid load and breast cancer risk: A case-control study in Uruguay

FRIED FOOD AND POSSIBLE HEALTH HAZARDS

FRIED FOOD AND POSSIBLE HEALTH HAZARDS

Processed meat consumption and squamous cell carcinoma of the oesophagus in a large case-control study in Uruguay.

The role of processed meat in the aetiology of squamous cell oesophageal cancer has been explored in detail. In the time period 1990-2005, a case-control study was conducted in Montevideo, Uruguay including 2,368 participants (876 cases of oesophageal cancer and 1,492 controls). Relative risks, approximated by the odds ratios, were estimated by multiple unconditional logistic regression. Processed meat was positively associated with oesophageal cancer (upper quartile vs lower quartile OR 2.30, 95%CI 1.72-3.07), whereas salted meat intake was positively associated with squamous cell oesophageal cancer (OR 3.82, 95%CI 2.74-5.33). Finally other cured meats were positively associated with oesophageal cancer (OR 1.65, 95%CI 1.22- 2.22). It could be concluded that processed meat consumption could be an important risk factor for the aetiology of squamous cell oesophageal cancer in Uruguay.

Diet Patterns and Risk of Squamous Cell Oesophageal Carcinoma: A Case-control Study in Uruguay

Oesophageal cancer presents high incidence rates in the so-called Brazilian-Uruguayan belt. The present study included 1,170 participants (234 cases and 936 controls) which were analyzed by unconditional multiple logistic regression in order to examine risk of oesophageal squamous cell carcinoma (OESCC) associated with several food groups. Boiled red meat (OR 2.59, 95%CI 1.69-3.97), lamb meat (OR 1.64, 95%CI 1.07-2.51), processed meat (OR 1.49, 95%CI 1.01-2.21), whole milk (OR 1.78, 1.19-1.68), fresh vegetables and fruits (OR 0.42, 95%CI 0.27-0.63), mate consumption (OR 2.04, 95%CI 1.32- 3.16), and black tea (OR 0.10, 95%CI 0.04-0.28) were significantly associated with risk of OESCC. Hot beverages (mate) and hot foods (boiled meat) appear to be important determinants in the risk of OESCC, allowing the penetration of carcinogens in tobacco and alcohol into the oesophageal mucosa.

Body composition, somatotype and risk of premenopausal breast cancer: a case-control study in Uruguay

Body composition, somatotype and risk of premenopausal breast cancer: a case-control study in Uruguay

Meat, Milk and Risk of Lymphoid Malignancies: A Case-Control Study in Uruguay

In the time period 1996–2004, 697 cases with lymphoid neoplasms and 3606 controls with nonneoplastic conditions were included in a case-control study conducted in the Cancer Institute of Uruguay. They were administered a routine questionnaire that included 8 sections and a food frequency questionnaire focused on intakes of total meat, red meat, salted meat, barbecued meat, processed meat, milk, total vegetables and total fruits, and alcoholic beverages. Lymphoid cancers were analyzed by multiple polytomous regression. Red meat, salted meat, and milk were positively associated with risk of lymphoid cancers [odds ratios (OR) for the highest tertile vs. the lowest one of red meat = 1.68, 95% confidence interval (CI) 1.37–2.08, OR for whole milk = 2.92, 95% CI 2.63–3.63). On the other hand, plant foods, particularly total fruits, and alcoholic beverages (mainly red wine) were protective. We could conclude that these foods could play a significant role in the etiology of lymphoid malignancies.

Body Composition, Somatotype and the Risk of Premenopausal Breast Cancer: A Case-Control Study in Uruguay

Body Composition, Somatotype and the Risk of Premenopausal Breast Cancer: A Case-Control Study in Uruguay

Risk Factors for Premenopausal Breast Cancer: A Case-control Study in Uruguay

In order to thoroughly analyze risk factors of breast cancer (BC) in premenopausal Uruguayan women, a case-control study was carried out at the Pereira Rossell Women's Hospital, Montevideo, where 253 incident BC cases and 497 frequency-matched healthy controls were interviewed on menstrual and reproductive story, were administered a short food frequency questionnaire and undertook a series of body measurements necessary to calculate body composition and somatotype. Odds ratio (OR) coefficients were taken as estimates of relative risk derived from unconditional logistic regression. Among the classical risk factors, only the family history of BC in first degree relatives was significantly associated with risk of premenopausal BC (OR=2.20, 95% CI 1.33-3.62). Interestingly, this risk factor was found to be stronger in women of ages >40 (OR=4.05, 95% CI 2.10-7.81), late menarche (OR= 2.39, 95% CI 1.18-4.85), early age for their first delivery (OR=3.02, 95% CI 1.26-7.22), short time between menarche and first delivery (OR=3.22, 95% CI 1.29-8.07), and with high parity (OR=4.10, 95% CI 1.79-9.36), although heterogeneity was detected only for age and parity. High consumption of red meat was positively associated with the disease risk (OR=2.20, 95% CI 1.35-3.60), in the same way as fried foods (OR=1.79, 95% CI 1.12-2.84). Conversely, a high intake of plant foods displayed a protective effect (OR=0.41, 95% CI 0.26-0.65). Except for hypertension (OR=1.55, 95% CI 1.03-2.35), none of the analyzed components of metabolic syndrome were associated to BC risk. Particular increases of risk for premenopausal BC were found for family history in first degree relatives in certain subsets derived from the menstrual-reproductive history. Preventive strategies could broaden their scope if new studies confirm the present results, in view of the limited prevention measures that premenopausal BC currently has.

Diabetes, Overweight and Risk of Postmenopausal Breast Cancer: A Case-Control Study in Uruguay

Obese postmenopausal women increase their risk of developing breast cancer (BC), in particular if they display an android-type pattern of adiposity, which is also associated to increased risks of diabetes mellitus, hypertension and cardiovascular disease. In order to explore the associations among anthropometry (body mass index, body composition, somatotype), some specific items of medical history (diabetes, hypertension, dislypidemias, hyperuricemia) and the risk of BC in Uruguayan women, a case-control study was carried out between 2004-2009 at our Oncology Unit. 912 women of ages between 23-69 years (367 new BC cases and 545 non hospitalized, age-matched controls with a normal mammography) were interviewed. Twenty body measurements were taken in order to calculate body composition and somatotype. Patients were queried on socio-demographics, reproductive history, family history of cancer, a brief food frequency questionnaire and on personal history of diabetes, dislypidemias, hyperuricemia, hypertension and gallbladder stones. Uni- and multivariate analyses were done, generating odds ratios (ORs) as an expression of relative risks. A personal history of diabetes was positively associated to BC risk (OR=1.64, 95% CI 1.00-2.69), being higher among postmenopausal women (OR=1.92, 95% CI 1.04-3.52). The risks of BC for diabetes in postmenopausal women with overweight combined with dislypidemia (OR=9.33, 95% CI 2.10-41.5) and high fat/muscle ratio (OR=7.81, 95% CI 2.01-30.3) were significantly high. As a conclusion, a personal history of diabetes and overweight was strongly associated to BC. The studied sample had a subset of high-risk of BC featured by postmenopausal overweight and diabetic women, who also had a personal history of hypertension and/or dyslipidemia. The present results could contribute to define new high risk groups and individuals for primary as well as for secondary prevention, since this pattern linked to the metabolic syndrome is usually not considered for BC prevention.

Meat Consumption, Cooking Methods, Mutagens, and Risk of Squamous Cell Carcinoma of the Esophagus: A Case-Control Study in Uruguay

The role of meat in squamous cell carcinoma of the esophagus (ESCC) has been considered conflictive. For this reason, we decided to conduct a case-control study on meat consumption and ESCC. Data included 234 newly diagnosed and microscopically examined ESCC and 2,020 controls with conditions not related to tobacco smoking nor alcohol drinking and without changes in their diets. We studied total meat, red meat, beef, lamb, processed meat, poultry, fish, total white meat, liver, fried meat, barbecued meat, boiled meat, heterocyclic amines, nitrosodimethylamine, and benzo[a]pyrene in relation with the risk of ESCC. Red meat, lamb, and boiled meat were directly associated with the risk of ESCC, whereas total white meat, poultry, fish, and liver were mainly protective against this malignancy.

Dietary patterns and risk of cervical cancer: a case-control study in Uruguay

In the time period 1996-2004, a case-control study on diet and cervical cancer was conducted at the National Cancer Institute in Uruguay. The study included 268 cases and 536 controls with non-neoplastic diseases. The foods and beverages in the food-frequency questionnaire were included in a factor analytic model. This method retained three factors which were labeled as the drinker, red meat, and prudent patterns. The model explained 60% of the variance. Whereas the red meat and drinker patterns were directly associated with the risk of cervical cancer (OR for red meat pattern 1.79, 95% CI 1.12-2.86), on the other hand, the prudent pattern was inversely associated with cervical cancer (OR 0.60, 95% CI 0.38-0.93). To our knowledge, this study was the first one using factor analysis in order to elucidate the role of the diet in relation with cervical cancer.

Somatotype and risk of breast cancer: a case-control study in Uruguay

According to the evidence, there is a need for more thorough assessment and quantification of body size and shape and the risk of breast cancer. Using the somatotype methodology, we carried out an original research in order to explore possible associations between body shape and the risk of breast cancer in Uruguayan women. With this objective, 254 recent breast cancer cases and 1,000 frequency-matched healthy controls were interviewed on menstrual and reproductive story, and a series of skinfolds, circumferences and diameters were measured specifically to calculate somatotype. A positive association with breast cancer was found for high endomorphy (Odds Ratio [OR] = 2.82, p < 0.001), mainly among pre-menopausal women (OR = 4.98, p <0.001) and normoweight women (OR = 5.12, p = 0.002), whereas almost no differences were observed for mesomorphic and ectomorphic women. Analysis showed a high meso-endomorphic pattern in the study population. Further studies are needed to confirm the present results obtained in a country with high incidence of the disease.

Nutrient Intake and Risk of Squamous Cell Carcinoma of the Esophagus: A Case-Control Study in Uruguay

: In 1996-2004 a case-control study on nutrient intake, dietary constituents and risk of squamous cell carcinoma of the esophagus was conducted in Montevideo, Uruguay. In fact, Uruguay, and especially its northern provinces, which border Brazil, are high-risk areas. The study included 234 cases and 936 controls. The controls were hospitalized patients with non-neoplastic disease, which was not related to tobacco smoking and alcohol drinking, and without recent changes in their diets. Controls were frequency matched to cases on age (10-yr intervals), sex, and residence (Montevideo and other provinces). Dietary constituents were energy adjusted using the residuals method and then categorized in quartiles according to the distribution of the controls. The final model included linoleic acid, lycopene, α-carotene, β-cryptoxanthin, vitamin A, monounsaturated fat, total carbohydrates, β-carotene, and folate. The odds ratio (OR) for high intake of linoleic acid was 1.4 (95% confidence interval, CI = 1.2–1.6), whereas lycopene displayed a strong protective effect (OR = 0.7; 95% CI = 0.6–0.9). The possible role of these and other dietary constituents in esophageal carcinogenesis is discussed.

The effect of smoking and drinking in oral and pharyngeal cancers: A case-control study in Uruguay

In the time period 1988–2000, a case-control study on oral and pharyngeal cancers was conducted among men in Montevideo, Uruguay. The study included 776 cases and 1501 controls. The cases were distributed by site in oral cancers (335 patients) and pharyngeal cancers (441 patients). Odds ratios for smoking were higher among participants with pharyngeal cancers compared with those with oral carcinomas, but there was no significant heterogeneity. On the contrary, alcohol drinking displayed statistically higher risks among those with pharyngeal carcinomas compared with patients with oral cancer ( P-value for heterogeneity=0.01). The effect of alcohol was particularly strong for cancers of the hypopharynx. Our results raise the possibility that oral and pharyngeal carcinomas are in fact different entities. Further studies are needed in order to clarify this important point.

Dietary patterns and risk of gastric cancer: a case-control study in Uruguay

Gastric cancer is a frequent malignancy in the Uruguayan population. In northern counties, incidence rates reach high figures (age-standardized rates [ASR], 37.3 per 100,000 men and 18.3 per 100,000 women). Diet is a major determinant in gastric carcinogenesis. Because foods or food groups have the advantage over nutrients in being most directly related to dietary recommendations, we decided to conduct a case-control study on the relationships between food groups and risk of gastric cancer. For this purpose, we included 240 cases and 960 controls. In the present study we employed three analytical approaches: (1) individual food group analysis, (2) factor analysis, and (3) analysis of empirical scores of risk. Individual analysis of food groups was performed by multiple unconditional logistic regression, with food groups being the explanatory variables. Nineteen food groups were created and categorized in tertiles according to the control distribution. Factor analysis aggregated intercorrelated foods in broader eating patterns. In this study we were able to identify three factors or patterns, arbitrarily labeled "starchy," "healthy," and "mixed." Finally, empirical scores of risk were created after examining the risk of each individual food and summing each significant item. This resulted in a risk enhancing score and a protective score. Both scores were categorized in tertiles according to the control distribution. The individual analysis of food groups showed increased risks of gastric cancer for rice, salted meat, stewed meat, white bread, potatoes, and tubers. On the other hand, raw vegetables, total fruits, legumes, and black tea were inversely associated with risk of gastric cancer. All three dietary patterns, generated by factor analysis, were significantly associated with gastric carcinoma risk. Whereas the starchy factor was directly associated with gastric cancer, the healthy and mixed patterns were strongly protective. Finally, the risk enhancing empirical score displayed an increased risk of gastric cancer (odds ratio [OR], 4.1, 95% confidence interval [CI], 2.6-6.6), whereas the protective score showed an important reduction in risk, of 0.38. This study displayed consistent results from three different approaches. Concerning different food groups, stewed and processed meat are rich in salt; rice, tubers, and winter squash are sources of starch; and vegetables and fruits are rich in ascorbic acid and carotenoids. All these substances have been strongly related to gastric carcinogenesis. Furthermore, this study suggests that diets rich in vegetables and fruits and with low amounts of salty and starchy foods are recommendable for the prevention of gastric cancer.

Risk factors for esophageal cancer in non-smokers and non-drinkers: a case-control study in Uruguay

In order to analyze possible associations of lifestyle factors with esophageal cancer among non-smokers and non-drinkers, the authors carried out the present study. Special emphasis was placed on the analysis of "mate" (infusion of the herb Ilex paraguariensis) drinking, which has been associated with most cancers of the upper aerodigestive tract. The study was conducted at the Instituto Nacional de Oncología in Montevideo, Uruguay. Data corresponded to 73 esophageal cancer cases and 219 controls. A detailed questionnaire included sections on sociodemographic variables, occupation, family history of cancer, "mate" drinking, and a restricted list of dietary items including: red meat, processed meat, salted meat, barbecue, milk, fresh vegetables and fruits. Odds ratios (ORs) were estimated by unconditional logistic regression, adjusting for major potential confounders, including age, sex, education, urban/rural status and region of birth. Moderate increases in risk were observed for: daily "mate" consumption (OR=2.2), age of quitting (OR=2.02), duration (OR=2.49) and intensity (OR=1.91), most of which were statistically significant. Consequently, our report demonstrates a particular role for "mate" consumption on esophageal cancer in Uruguay, regardless of other well-known risk factors.

Cigarette smoking and risk of large cell carcinoma of the lung: a case-control study in Uruguay

In the time period 1988–2000, a case-control study on large cell carcinoma of the lung was conducted in Montevideo, Uruguay. The study included 149 cases (139 men and 10 women) and 596 controls (556 men and 40 women) afflicted with diseases not related with tobacco smoking. Cases and controls were frequency matched on age, sex, residence and urban/rural status. According to our results, large cell carcinoma was strongly related with cigarette smoking (OR for heavy smokers 155.2, 95% CI: 30.6–786.1). Furthermore, all cases displayed higher risks for intensity compared with smoking duration. Smokers of black tobacco showed odds ratios (ORs) significantly higher than those presented by smokers of blond tobacco and smoking cessation displayed a reduction in risk of 95%, close to the risk of never smokers. Finally, filter use was not associated with any reduction in risk. It could be concluded that undifferentiated large cell carcinoma of the lung could be included among those lung tumors classified as Kreyberg I cancers.

Alcohol intake and risk of adenocarcinoma of the lung: A case-control study in Uruguay

In order to examine in detail the relationship between alcohol drinking and risk of adenocarcinoma of the lung, a case-control study involving 160 cases of this cell type and 520 hospitalized controls was conducted in Uruguay in the time period January 1998–July 2000. Total alcohol intake was not associated with risk of adenocarcinoma of the lung (OR 1.2, 95% CI 0.6–2.1). Also beer drinking was not associated with risk of carcinoma (OR 0.6, 95% CI 0.3–1.6). On the other hand, wine drinking displayed a marginally significant reduction in risk (OR 0.4, 95% CI 0.2–1.1). On the contrary, hard liquor intake was associated with a 40% increase in risk of adenocarcinoma of the lung. These findings suggest that wine drinking has a protective effect in adenocarcinoma of the lung, whereas hard liquor increases moderately the risk of this cell type of lung cancer.

Meat, fat and risk of laryngeal cancer: a case-control study in Uruguay.

The effect of meat and fat in laryngeal carcinogenesis was examined in a case-control study carried out in Uruguay in the time period 1998-1999. One-hundred and forty patients with squamous cell laryngeal carcinoma and 420 hospitalized patients, afflicted with conditions not related with tobacco smoking, alcohol drinking or recent dietary changes comprised the cases and controls in this study. All patients were interviewed face-to-face in the hospitals with a detailed questionnaire which included queries on 64 food items. Red and total meat intakes were associated with strong increases in risk of laryngeal cancer (odds ratio [OR] for high total meat intake 3.32, 95% confidence interval [C.I.] 1.23-8.95). This effect disappeared after controlling for total fat intake. On the other hand, total fat intake displayed a strong association with risk of laryngeal cancer when red meat was included in the same model (OR for high fat intake 7.05, 95% C.I. 2.51-19.8). Total fat intake combines its effect multiplicatively with tobacco smoking.