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Title: Diet and risk of central nervous system tumours
Author: Kuan, Ai Seon
ISNI:       0000 0004 7652 9015
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2018
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Existing evidence suggests diet may be associated with risk of central nervous system (CNS) tumours, but there is inconsistency between studies and limited knowledge of variation by tumour subtype. I present findings from the first systematic review and meta-analysis of the literature, and the first comprehensive analyses for the major subtypes of CNS tumours in large prospective studies with systematic coverage of dietary patterns, food groups, and nutrients. Systematic review identified 37 epidemiological (predominantly case-control) studies, investigating risk of CNS tumours (predominantly glioma) in relation to 36 dietary factors in total. Meta-analyses of case-control studies showed some evidence for associations between vegetable or carotene intake and grains/cereal intake with decreased and increased glioma risk, respectively, and fruit intake and decreased meningioma risk, but these associations were not supported by the limited prospective evidence. I investigated CNS tumour risk in relation to 29 food groups/nutrients and 3 dietary patterns, using data from the Million Women Study, NIH-AARP Study and PLCO Study for 2,313 cases of glioma, 750 of meningioma, 191 of pituitary tumours, and 174 of vestibular schwannoma, occurring during 15.4 million person-years follow-up. Using Cox regression, I found no significant association between any dietary factor and risk of any CNS tumour subtype, after applying a correction for multiple testing. For glioma, there were some borderline significant associations before correction, between increasing intakes of plant-based foods or increasing healthy diet scores and increasing risk, but these attenuated towards null in analyses accounting for reverse causation. For meningioma and vestibular schwannoma, the few significant associations found before correction for multiple testing may be chance findings. For pituitary tumours, there was no evidence of an association with diet. This largest prospective analysis provides little evidence for any association of public health importance between diet and risk of the four major CNS tumour subtypes.
Supervisor: Green, Jane ; Sweetland, Siân Sponsor: Cancer Research UK
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Nutritional epidemiology ; Cancer epidemiology