Dr Carla van Gils
Dept of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care
University Medical Centre Utrecht
Utrecht, The Netherlands
http://www.juliuscenter.nl
http://www.epicnl.eu
Project title (1)
Feasibility of large-scale mammographic density assessments in EPIC (2008/SD10)
Scientific abstract
Women with high breast density have more vulnerable target tissue in the breast and may therefore be more susceptible to other risk factors. It is hoped that mammographic density and breast cancer risk can be studied in a large-scale cohort. Firstly, this pilot study will be used to investigate the feasibility of large-scale analysis of mammograms within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Including Northern and Southern European countries, this study enables investigation of large variations in diet, physical activity and body composition in relation to mammographic density. Its large size enables studying interactions between mammographic density and other risk factors, such as diet, in relation to breast cancer risk.
Feasibility depends on local existence of breast cancer screening programmes, storage locations, privacy regulations, and adaptations needed in the analysing software to accommodate differences in mammography equipment and settings.
In each centre (n=23) 10 cases and 10 controls will be retrieved, mammograms made within 2 years of recruitment into the cohort, and all feasibility aspects described. Data quality will be investigated by replicating well-established relationships between age, parity, hormone replacement therapy and mammographic density, and between mammographic density and breast cancer risk. Furthermore, geographic variation in mean mammographic density will be studied and this will be related to differences in breast cancer incidence rates.
For each center, the following will be reported: the proportion of cases and controls who have routine mammograms made in the required time span, the locations in which they are stored, the proportion in which they can be actually retrieved, the efforts and costs and also the legal/ethical issues involved in retrieval.
Project title (2)
Plasma carotenoids, vitamin C and risk of breast cancer (2006/13)
Scientific abstract
Although vegetables and fruits are high in putatively cancer protective substances, large cohort studies do not show protective effects on breast cancer risk. Due to measurement errors inherent to dietary questionnaires, small effects could have been missed. Even small effects though, can have large impact when considering preventive dietary recommendations on a population scale. Plasma levels of carotenoids and vitamin C are biomarkers of fruit and vegetable consumption and provide a better estimate of the concentration actually available to cells. In addition, they have strong antioxidative capacity.
The study will investigate plasma levels of vitamin C and carotenoids in relation to subsequent breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. At enrolment, plasma samples, demographic, lifestyle and dietary date have been collected for participants from 10 European countries. Samples were collected, processed and stored in a standardised manner. Using a nested case-control design this study will assess carotenoid and vitamin C levels in 1500 breast cancer case and 1500 controls.
The unique feature of the proposed study is its large sample size together with the fact that it includes participants from the north to the south of Europe, spanning a wide range of vegetables and fruit consumption and related plasma antioxidants.
Project 1 plain language abstract
Vegetables and fruits contain many putatively cancer protective substances. Several studies have used dietary questionnaires to measure vegetable and fruit consumption in large healthy populations and then followed participants for the occurrence of cancer. They do not show that vegetable and fruit consumption protects against breast cancer. It is, however, difficult to capture dietary habits by questionnaire and small protective effects may have been missed.
Carotenoids and vitamin C have cancer protective capacities and are abundantly present in vegetables and fruits. Blood levels of these micronutrients are good measures of vegetable and fruit consumption and they better estimate the concentration actually available to cells than dietary questionnaires.
We propose to study blood levels of carotenoids and vitamin C in relation to subsequent breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. At enrolment, blood samples, demographic, lifestyle and dietary data have been collected for participants from 10 European countries. Carotenoid and vitamin C levels will be compared between 1500 women who subsequently developed breast cancer and 1500 healthy women. Unique features of this study are its large size and that it includes participants from northern to southern Europe, spanning a wide range of vegetable and fruit consumption and related carotenoid and vitamin C levels.
Project 2 plain language abstract
Mammographic density is a strong breast cancer risk factor. It is not fully clear what determines mammographic density. From the viewpoint of prevention modifiable determinants are of particular interest. It is also unclear whether women with high mammographic density, and thus a larger amount of vulnerable target tissue, are more susceptible to other breast cancer risk factors (diet, hormones) than women with low density. To answer these questions we prepare a large-scale case-control study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Unique features of EPIC are its large size and that it includes participants form northern to southern Europe, spanning a wide range of dietary intake and lifestyle characteristics.
Here we propose a pilot study to investigate the feasibility of large-scale analysis of mammograms in EPIC. Feasibility depends on local existence of breast cancer screening programmes, storage locations, privacy regulations and mammography equipment. In each centre (n=23) we will retrieve mammograms for 10 cases and 10 controls and describe all feasibility aspects. We will investigate data quality by replicating well-established relationships between age, parity, hormone replacement therapy and mammographic density, and between mammographic density and breast cancer risk. We will study geographic variation in mammographic density and relate this to geographic variation in breast cancer incidence.
| Institution and location | Degree | Year | Scientific Field |
|---|---|---|---|
University of Nijmegen, |
MSc | 1994 | Biomedical Health |
University of Nijmegen, |
PhD | 1998 | Cancer Epidemiology |
National Institute of |
Fellowship Dutch Cancer Society |
1999-2000 | Molecular Epidemiology of Cancer |
Netherlands Institute for Health Sciences |
MSc | 2004 | Genetic Epidemiology |
2002 – present |
Assistant professor of epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands |
2001 - 2002 |
Postdoctoral researcher molecular cancer epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands |
1999 – 2001 |
Postdoctoral research fellow in molecular cancer epidemiology - Dutch Cancer Society, positioned at: |
| 1998 – 1999 | Postdoctoral research fellow, Dept of Epidemiology, University of Nijmegen, The Netherlands |
| 1994 – 1998 | PhD student, funded by Dutch Research Council, Dept of Epidemiology, University of Nijmegen, the Netherlands. Thesis: Mammographic density and breast cancer risk |
Research interests
Etiologic and diagnostic research questions related to breast cancer, and clinical epidemiological projects.
