Mirian Brink

Meat consumption and K-ras mutations in sporadic colon and rectal cancer in The Netherlands Cohort Study

Case–cohort analyses were performed on meat and fish consumption in relation to K-ras mutations in 448 colon and 160 rectal cancers that occurred during 7.3 years of follow-up, excluding the first 2.3 years, and 2948 subcohort members of The Netherlands Cohort Study on diet and cancer. Adjusted incidence rate ratios and 95% confidence intervals were computed for colon and rectal cancer and for K-ras mutation status subgroups. Total fresh meat, most types of fresh meat and fish were not associated with colon or rectal cancer, neither overall nor with K-ras mutation status. However, several weak associations were observed for tumours with a wild-type K-ras, including beef and colon tumours, and an inverse association for pork with colon and rectal tumours; for meat products, an increased association was observed with wild-type K-ras tumours in the colon and possibly with G>A transitions in rectal tumours.

Prevalence of multiple malignancies in the Netherlands in 2007.

As the number of cancer survivors increases in the Netherlands, there is a concomitant increase in patients with multiple malignancies (MMs), the prevalence of which needs to be assessed to estimate care needs. This study analyzed incidence data on all malignant cancers diagnosed between 1989 and 2006 retrieved from the population‐based Netherlands Cancer Registry. The point prevalence of MMs was determined on January 1, 2007. Of all cancer survivors in 2007, 30,064 (7% of the total) were patients with MMs. Their median age was 74 (interquartile range 71–76) years. Ninety two percent (i.e., 27,660) of these patients had two cancer diagnoses. The most common subsequent cancers being squamous cell skin cancer (5,468), colorectal cancer (4,634), and breast cancer (3,959). High frequency of combinations included: (i) female breast and genital cancers (any order), (ii) urinary tract and prostate cancers (any order), (iii) Hodgkins lymphoma and subsequent female breast cancer and (iv) non‐Hodgkins lymphoma and subsequent squamous cell skin cancer. As the number of cancer survivors continues to increase and their survival improves, MMs are becoming more important in the field of cancer surveillance.

Dietary folate intake and k-ras mutations in sporadic colon and rectal cancer in The Netherlands Cohort Study.

We studied the association between dietary folate and specific K‐ras mutations in colon and rectal cancer in The Netherlands Cohort Study on diet and cancer. After 7.3 years of follow‐up, 448 colon and 160 rectal cancer patients and 3,048 sub‐cohort members (55–69 years at baseline) were available for data analyses. Mutation analysis of the K‐ras gene was carried out on all archival adenocarcinoma specimens. Case–cohort analyses were used to compute adjusted incidence rate ratios (RR) and 95% confidence intervals (CI) for colon and rectal cancer overall and for K‐ras mutation status subgroups according to 100 μg/day increased intake in dietary folate. Dietary folate intake was not significantly associated with colon cancer risk for men or women, neither overall nor with K‐ras mutation status. For rectal cancer, folate intake was associated with a decreased disease risk in men and was most pronounced for K‐ras mutated tumors, whereas an increased association was observed for women. Regarding the K‐ras mutation status in women, an increased association was observed for both wild‐type and mutated K‐ras tumors. Specifically, folate intake was associated with an increased risk of G>T and G>C transversions in rectal tumors (RR = 2.69, 95% CI = 1.43–5.09), but inversely associated with G>A transitions (RR = 0.08, 95% CI = 0.01–0.53). Our data suggest that the effect of folate on rectal cancer risk is different for men and women and depends on the K‐ras mutation status of the tumor.

Markedly increased incidence and improved survival of testicular cancer in the Netherlands

Abstract Background. Worldwide marked changes have been observed in the incidence and survival of testicular cancer (TC) during the last decades. We conducted a study on trends in TC incidence, treatment, survival, and mortality in the Netherlands during the period 1970–2009 with specific focus on trends according to age, histology and stage of disease. Methods. Data from the Eindhoven cancer registry, the Netherlands cancer registry and Statistics Netherlands was used. Age-standardized incidence and mortality rates and five-year relative survival were calculated. Treatment was categorized into five major groups. Results. TC incidence showed a substantial annual increase of 3.9% in the period 1989–2009. The incidence increased for all stages of both seminoma and non-seminoma TC. Stage distribution for the non-seminoma patients shifted towards more localized disease. Most patients received primary treatment according to the guidelines. Five-year relative survival improved (non-significantly) for most groups of stage and histology. TC mortality dropped sharply in the 1970s and 1980s and remained relatively stable thereafter. Conclusion. This study shows that incidence of TC has increased sharply in the Netherlands. Relative survival is high and improved in most disease stages. There is a growing demand for medical care of newly diagnosed TC patients and for the rapidly increasing number of prevalent TC patients.