PURPOSE: We sought to investigate the effect of serum uric acid (SUA) levels on risk of cancer incidence in men and to flexibly determine the shape of this association by using a novel analytical approach. METHODS: A population-based cohort of 78,850 Austrian men who received 264,347 serial SUA measurements was prospectively followed-up for a median of 12.4 years. Data were collected between 1985 and 2003. Penalized splines (P-splines) in extended Cox-type additive hazard regression were used to flexibly model the association between SUA, as a time-dependent covariate, and risk of overall and site-specific cancer incidence and to calculate adjusted hazard ratios with their 95% confidence intervals. RESULTS: During follow-up 5189 incident cancers were observed. Restricted maximum-likelihood optimizing P-spline models revealed a moderately J-shaped effect of SUA on risk of overall cancer incidence, with statistically significantly increased hazard ratios in the upper third of the SUA distribution. Increased SUA (>/=8.00 mg/dL) further significantly increased risk for several site-specific malignancies, with P-spline analyses providing detailed insight about the shape of the association with these outcomes. CONCLUSIONS: Our study is the first to demonstrate a dose-response association between SUA and cancer incidence in men, simultaneously reporting on the usefulness of a novel methodological framework in epidemiologic research.
PURPOSE: We sought to investigate the effect of serum uric acid (SUA) levels on risk of cancer incidence in men and to flexibly determine the shape of this association by using a novel analytical approach. METHODS: A population-based cohort of 78,850 Austrian men who received 264,347 serial SUA measurements was prospectively followed-up for a median of 12.4 years. Data were collected between 1985 and 2003. Penalized splines (P-splines) in extended Cox-type additive hazard regression were used to flexibly model the association between SUA, as a time-dependent covariate, and risk of overall and site-specific cancer incidence and to calculate adjusted hazard ratios with their 95% confidence intervals. RESULTS: During follow-up 5189 incident cancers were observed. Restricted maximum-likelihood optimizing P-spline models revealed a moderately J-shaped effect of SUA on risk of overall cancer incidence, with statistically significantly increased hazard ratios in the upper third of the SUA distribution. Increased SUA (>/=8.00 mg/dL) further significantly increased risk for several site-specific malignancies, with P-spline analyses providing detailed insight about the shape of the association with these outcomes. CONCLUSIONS: Our study is the first to demonstrate a dose-response association between SUA and cancer incidence in men, simultaneously reporting on the usefulness of a novel methodological framework in epidemiologic research.
Authors: Tae Woo Yoo; Ki Chul Sung; Hun Sub Shin; Byung Jin Kim; Bum Soo Kim; Jin Ho Kang; Man Ho Lee; Jung Ro Park; Hyang Kim; Eun Jung Rhee; Won Young Lee; Sun Woo Kim; Seung Ho Ryu; Dong Geuk Keum Journal: Circ J Date: 2005-08 Impact factor: 2.993
Authors: Jerry Polesel; Luigino Dal Maso; Vincenzo Bagnardi; Antonella Zucchetto; Antonella Zambon; Fabio Levi; Carlo La Vecchia; Silvia Franceschi Journal: Int J Cancer Date: 2005-05-01 Impact factor: 7.396
Authors: Matthew F Buas; Haiwei Gu; Danijel Djukovic; Jiangjiang Zhu; Lynn Onstad; Brian J Reid; Daniel Raftery; Thomas L Vaughan Journal: Metabolomics Date: 2017-01-20 Impact factor: 4.290
Authors: G Goebel; R Berger; A M Strasak; D Egle; E Müller-Holzner; S Schmidt; J Rainer; E Presul; W Parson; S Lang; A Jones; M Widschwendter; H Fiegl Journal: Br J Cancer Date: 2011-11-22 Impact factor: 7.640