RT Journal Article
T1 Degree of food processing and breast cancer risk: a prospective study in 9 European countries
A1 Cairat, Manon
A1 Yammine, Sahar
A1 Fiolet, Thibault
A1 Fournier, Agnès
A1 Boutron-Ruault, Marie-Christine
A1 Laouali, Nasser
A1 Mancini, Francesca Romana
A1 Severi, Gianluca
A1 Berstein, Fernanda Morales
A1 Rauber, Fernanda
A1 Levy, Renata Bertazzi
A1 Skeie, Guri
A1 Borch, Kristin Benjaminsen
A1 Tjønneland, Anne
A1 Mellemkjær, Lene
A1 Borné, Yan
A1 Rosendahl, Ann H
A1 Masala, Giovanna
A1 Giraudo, Maria Teresa
A1 de Magistris, Maria Santucci
A1 Katzke, Verena
A1 Bajracharya, Rashmita
A1 Santiuste, Carmen
A1 Amiano, Pilar
A1 Bodén, Stina
A1 Castro-Espin, Carlota
A1 Sanchez-Perez, Maria-Jose
A1 Touvier, Mathilde
A1 Deschasaux-Tanguy, Mélanie
A1 Srour, Bernard
A1 Schulze, Matthias B
A1 Guevara, Marcela
A1 Kliemann, Nathalie
A1 Lopez, Jessica Blanco
A1 Al Nahas, Aline
A1 Chang, Kiara
A1 Vamos, Eszter P
A1 Millett, Christopher
A1 Riboli, Elio
A1 Heath, Alicia K
A1 Biessy, Carine
A1 Viallon, Vivian
A1 Casagrande, Corinne
A1 Nicolas, Genevieve
A1 Gunter, Marc J
A1 Huybrechts, Inge
K1 Breast cancer
K1 Epidemiology
K1 Food processing
K1 NOVA classification
K1 Prospective study
AB Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk, although some studies also reported no association. Furthermore, the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited. Thus, we investigated the associations between dietary intake by degree of food processing and breast cancer risk, overall and by breast cancer subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake of EPIC participants was assessed via questionnaires at baseline. More than 11,000 food ingredients were classified into four groups of food processing levels using the NOVA classification system: unprocessed/minimally processed (NOVA 1), culinary ingredients (NOVA 2), processed (NOVA 3) and ultra-processed (NOVA 4). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer per standard deviation increase in daily consumption (grams) of foods from each NOVA group. The current analysis included 14,933 breast cancer cases, diagnosed among the 318,686 EPIC female participants, (median follow-up of 14.9 years). No associations were found between breast cancer risk and the level of dietary intake from NOVA 1 [HR =0.99 (95% CI 0.97 - 1.01)], NOVA 2 [HR  =1.01 (95% CI 0.98 - 1.03)] and NOVA 4 [HR  =1.01 (95% CI 0.99 - 1.03)] foods. However, a positive association was found between NOVA 3 and breast cancer risk [HR  =1.05 (95% CI 1.03 - 1.07)] which became non-significant after adjustment for alcohol intake [HR  =1.01 (95% CI 0.98 - 1.05)] or when beer and wine were excluded from this group [HR  =0.99 (95% CI 0.97 - 1.01)]. The associations did not differ by breast cancer subtype, menopausal status or body mass index. Findings from this large-scale prospective study suggest that the positive association between processed food intake and breast cancer risk was likely driven by alcoholic beverage consumption.
PB BioMed Central
YR 2024
FD 2024-10-09
LK https://hdl.handle.net/10668/24320
UL https://hdl.handle.net/10668/24320
LA en
NO Cairat M, Yammine S, Fiolet T, Fournier A, Boutron-Ruault MC, Laouali N, et al. Degree of food processing and breast cancer risk: a prospective study in 9 European countries. Food Prod Process Nutr. 2024;6(1):89.
NO FMB was supported by a Wellcome Trust PhD studentship in Molecular, Genetic and Lifecourse Epidemiology (224982/Z/22/Z). The coordination of EPIC is fnancially supported by IARC and by the Depart‑ ment of Epidemiology and Biostatistics, School of Public Health, Imperial College London which has additional infrastructure support provided by the NIHR Imperial Biomedical Research Centre (BRC). The national cohorts are sup‑ ported by: Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (Inserm) (France); German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutri‑ tion Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Väster‑ botten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk; MR/ M012190/1 to EPIC-Oxford). (United Kingdom). The work reported in this paper was performed during Agnès Fournier’s term as a Visiting Scientist at the IARC. This work was supported by Cancer Research UK C33493/A29678; l’Institut National du Cancer (« INCa ») APPEL À PROJET SHS 2021 Grant number: INCa N°2021-138 and APPEL À PROJET 2021 Grant number: INCa N°SHSESP 21-074 and the World Cancer Research Fund (WCRF) Grant reference number: IIG_FULL_2020_033. Researchers were independent from the funders. Funders had no role in the collection, analysis, and interpre‑ tation of data, the writing of the report, and the decision to submit the article for publication.
DS RISalud
RD Apr 7, 2025