RT Journal Article
T1 Citrus intake and risk of skin cancer in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC).
A1 Mahamat-Saleh, Yahya
A1 Cervenka, Iris
A1 Al-Rahmoun, Marie
A1 Mancini, Francesca R
A1 Severi, Gianluca
A1 Ghiasvand, Reza
A1 Veierod, Marit B
A1 Caini, Saverio
A1 Palli, Domenico
A1 Botteri, Edoardo
A1 Sacerdote, Carlotta
A1 Ricceri, Fulvio
A1 Trichopoulou, Antonia
A1 Peppa, Eleni
A1 La Vecchia, Carlo
A1 Overvad, Kim
A1 Dahm, Christina C
A1 Olsen, Anja
A1 Tjønneland, Anne
A1 Perez-Cornago, Aurora
A1 Jakszyn, Paula
A1 Grioni, Sara
A1 Schulze, Matthias B
A1 Skeie, Guri
A1 Lasheras, Cristina
A1 Colorado-Yohar, Sandra
A1 Rodríguez-Barranco, Miguel
A1 Kühn, Tilman
A1 Katzke, Verena A
A1 Amiano, Pilar
A1 Tumino, Rosario
A1 Panico, Salvatore
A1 Ezponda, Ana
A1 Sonestedt, Emily
A1 Scalbert, Augustin
A1 Weiderpass, Elisabete
A1 Boutron-Ruault, Marie-Christine
A1 Kvaskoff, Marina
K1 Citrus
K1 Cohort studies
K1 Cutaneous melanoma
K1 Epidemiology
K1 Keratinocyte cancers
AB Citrus intake has been suggested to increase the risk of skin cancer. Although this relation is highly plausible biologically, epidemiologic evidence is lacking. We aimed to examine the potential association between citrus intake and skin cancer risk. EPIC is an ongoing multi-center prospective cohort initiated in 1992 and involving ~ 520,000 participants who have been followed-up in 23 centers from 10 European countries. Dietary data were collected at baseline using validated country-specific dietary questionnaires. We used Cox proportional hazards regression models to compute hazard ratios (HR) and 95% confidence intervals (CI). During a mean follow-up of 13.7 years, 8448 skin cancer cases were identified among 270,112 participants. We observed a positive linear dose-response relationship between total citrus intake and skin cancer risk (HR = 1.10, 95% CI 1.03-1.18 in the highest vs. lowest quartile; Ptrend = 0.001), particularly with basal cell carcinoma (BCC) (HR = 1.11, 95% CI 1.02-1.20, Ptrend = 0.007) and squamous cell carcinoma (SCC) (HR = 1.23, 95% CI 1.04-1.47, Ptrend = 0.01). Citrus fruit intake was positively associated with skin cancer risk (HR = 1.08, 95% CI 1.01-1.16, Ptrend = 0.01), particularly with melanoma (HR = 1.23, 95% CI 1.02-1.48; Ptrend = 0.01), although with no heterogeneity across skin cancer types (Phomogeneity = 0.21). Citrus juice was positively associated with skin cancer risk (Ptrend = 0.004), particularly with BCC (Ptrend = 0.008) and SCC (Ptrend = 0.004), but not with melanoma (Phomogeneity = 0.02). Our study suggests moderate positive linear dose-response relationships between citrus intake and skin cancer risk. Studies with available biomarker data and the ability to examine sun exposure behaviors are warranted to clarify these associations and examine the phototoxicity mechanisms of furocoumarin-rich foods.
PB Springer Dordrecht
YR 2020
FD 2020-07-16
LK http://hdl.handle.net/10668/15999
UL http://hdl.handle.net/10668/15999
LA en
NO Mahamat-Saleh Y, Cervenka I, Al-Rahmoun M, Mancini FR, Severi G, Ghiasvand R, et al. Citrus intake and risk of skin cancer in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Eur J Epidemiol. 2020 Nov;35(11):1057-1067.
DS RISalud
RD Apr 17, 2025