Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition
Document Type
Article
Publication Date
5-1-2020
Abstract
Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08-1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14-1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07-1.26) (SBP), HR = 1.31 (1.13-1.51) (DBP), weaker for head and neck cancers: HR = 1.08 (1.04-1.12) (SBP), HR = 1.09 (1.01-1.17) (DBP) and, similarly, for skin SCC, colon cancer, postmenopausal breast cancer and uterine adenocarcinoma (AC), but not for esophageal AC, lung SCC, lung AC or uterine endometroid cancer. We observed weak inverse associations of SBP with cervical SCC: HR = 0.91 (0.82-1.00) and lymphomas: HR = 0.97 (0.93-1.00). There were no consistent associations with cancers in other locations. Our results are largely compatible with published studies and support weak associations of blood pressure with cancers in specific locations and morphologies.
Keywords
Cancer, Hypertension, Morphology, Cohort, Europe, epidemiology, Association, Risk factors
Divisions
Socialprevent
Funders
Fondazione AIRC per la ricerca sul cancro,Cancer Research UK 14136,Cancer Research UK (C570/A16491),Cancer Research UK (C8221/A19170),Catalan Institute of Oncology (Barcelona, Spain),County Council of Skane (Sweden),County Council of Vasterbotten (Sweden),Danish Cancer Society,Deutsche Krebshilfe,Deutsches Krebsforschungszentrum,Dutch Ministry of Public Health, Welfare and Sports (VWS),Dutch Prevention Funds,Netherlands Organization for Scientific Research (NWO),European Research Council (ERC) European Commission (ERC-2009-AdG 232997),European Commission European Commission Joint Research Centre,Federal Ministry of Education & Research (BMBF),Deutsche Krebshilfe,Helmholtz Association,Instituto de Salud Carlos III (PI13/00061),Instituto de Salud Carlos III (PI13/01162),Hellenic Health Foundation,Hellenic Republic, General Secretary of Research and Technology,Institut Gustave Roussy (France),Institut National de la Sante et de la Recherche Medicale (Inserm),International Agency for Research on Cancer,Ligue Contre le Cancer (France),Netherlands Government,UK Research & Innovation (UKRI) Medical Research Council UK (MRC) (1000143),UK Research & Innovation (UKRI) Medical Research Council UK (MRC) (MR/M012190/1),Mutuelle Generale de l'Education Nationale (France),Consiglio Nazionale delle Ricerche (CNR),Netherlands Cancer Registry (NKR),Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway)
Publication Title
International Journal of Cancer
Volume
146
Issue
10
Publisher
Wiley
Publisher Location
111 RIVER ST, HOBOKEN 07030-5774, NJ USA