In utero and childhood exposure to the Great Chinese Famine and risk of cancer in adulthood: the Kailuan Study
The risk of cancer in adulthood can be influenced by exposure to environmental factors (e.g., food shortage and stress) in early life. This study compared the risk of cancer morbidity and mortality between Chinese adults who were or were not exposed to the Great Chinese Famine (1959–1961) in utero o...
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| Veröffentlicht in: | The American journal of clinical nutrition 2021-12, Vol.114 (6), p.2017-2024 |
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| creator | Zhang, Xinyuan Wang, Gang Forman, Michele R Fu, Qingjiang Rogers, Connie J Wu, Shouling Gao, Xiang |
| description | The risk of cancer in adulthood can be influenced by exposure to environmental factors (e.g., food shortage and stress) in early life.
This study compared the risk of cancer morbidity and mortality between Chinese adults who were or were not exposed to the Great Chinese Famine (1959–1961) in utero or during early childhood.
The Kailuan Study participants (n = 101,095) were classified into 5 famine exposure groups by birth year collected at study baseline (2006–2007): after 1961 (unexposed), 1959–1961 (in utero exposed), 1956–1958 (infancy and early childhood exposed, aged 0.1–2.9 y), 1953–1955 (childhood exposed, aged 3.0–5.9 y), and before 1953 (exposed, aged 6+ y). They were further classified by the severity of famine exposure. Cancer and cancer mortality cases from 2006 to 2016 were confirmed by reviewing medical records. Cox proportional hazard models were computed, adjusting for sex, socioeconomic status, and other time-varying cancer-related covariates.
During a median follow-up of 10.0 y, we identified 3560 incident cancer cases and 1749 cancer deaths. Famine exposure at all ages was positively associated with the risk of cancer morbidity and mortality (P < 0.001 for all, compared with unexposed). Severe exposure to famine in early childhood, but not other ages, had a higher risk of composite cancer events [adjusted HR = 2.04 (95% CI: 1.47, 2.84) for 0.1–2.9 y; and 1.61 (95% CI: 1.15, 2.25) for 3.0–5.9 y], relative to the less severely exposed groups of the same age range. When cancer morbidity and mortality were studied separately, similar patterns were observed.
In utero and early childhood exposures to famine, especially severe famine, were associated with a higher risk of cancer morbidity and mortality in adulthood. Awareness should be raised regarding the long-term effect of early life nutritional status. Trial registration number: ChiCTR-TNRC-11001489 (http://www.chictr.org.cn/showprojen.aspx?proj=8050). |
| doi_str_mv | 10.1093/ajcn/nqab282 |
| format | Article |
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This study compared the risk of cancer morbidity and mortality between Chinese adults who were or were not exposed to the Great Chinese Famine (1959–1961) in utero or during early childhood.
The Kailuan Study participants (n = 101,095) were classified into 5 famine exposure groups by birth year collected at study baseline (2006–2007): after 1961 (unexposed), 1959–1961 (in utero exposed), 1956–1958 (infancy and early childhood exposed, aged 0.1–2.9 y), 1953–1955 (childhood exposed, aged 3.0–5.9 y), and before 1953 (exposed, aged 6+ y). They were further classified by the severity of famine exposure. Cancer and cancer mortality cases from 2006 to 2016 were confirmed by reviewing medical records. Cox proportional hazard models were computed, adjusting for sex, socioeconomic status, and other time-varying cancer-related covariates.
During a median follow-up of 10.0 y, we identified 3560 incident cancer cases and 1749 cancer deaths. Famine exposure at all ages was positively associated with the risk of cancer morbidity and mortality (P < 0.001 for all, compared with unexposed). Severe exposure to famine in early childhood, but not other ages, had a higher risk of composite cancer events [adjusted HR = 2.04 (95% CI: 1.47, 2.84) for 0.1–2.9 y; and 1.61 (95% CI: 1.15, 2.25) for 3.0–5.9 y], relative to the less severely exposed groups of the same age range. When cancer morbidity and mortality were studied separately, similar patterns were observed.
In utero and early childhood exposures to famine, especially severe famine, were associated with a higher risk of cancer morbidity and mortality in adulthood. Awareness should be raised regarding the long-term effect of early life nutritional status. Trial registration number: ChiCTR-TNRC-11001489 (http://www.chictr.org.cn/showprojen.aspx?proj=8050).</description><identifier>ISSN: 0002-9165</identifier><identifier>EISSN: 1938-3207</identifier><identifier>DOI: 10.1093/ajcn/nqab282</identifier><identifier>PMID: 34582544</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Cancer ; cancer mortality ; Child, Preschool ; Childhood ; Children ; China - epidemiology ; cohort study ; early-life nutritional programming ; Environmental factors ; Exposure ; Famine ; Female ; Health risks ; Humans ; Intrauterine exposure ; Medical records ; Morbidity ; Mortality ; Neoplasms - epidemiology ; Neoplasms - etiology ; Nutritional status ; Prenatal Exposure Delayed Effects ; Risk ; Risk Factors ; Socioeconomics ; Starvation - complications ; Statistical models</subject><ispartof>The American journal of clinical nutrition, 2021-12, Vol.114 (6), p.2017-2024</ispartof><rights>2021 American Society for Nutrition.</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.</rights><rights>Copyright American Society for Clinical Nutrition, Inc. Dec 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-510b816081eba20e8472c360efa67b491e0d4790a86727d05beb18c30e4a0fc83</citedby><cites>FETCH-LOGICAL-c436t-510b816081eba20e8472c360efa67b491e0d4790a86727d05beb18c30e4a0fc83</cites><orcidid>0000-0002-2974-8392 ; 0000-0003-2617-6509</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34582544$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Xinyuan</creatorcontrib><creatorcontrib>Wang, Gang</creatorcontrib><creatorcontrib>Forman, Michele R</creatorcontrib><creatorcontrib>Fu, Qingjiang</creatorcontrib><creatorcontrib>Rogers, Connie J</creatorcontrib><creatorcontrib>Wu, Shouling</creatorcontrib><creatorcontrib>Gao, Xiang</creatorcontrib><title>In utero and childhood exposure to the Great Chinese Famine and risk of cancer in adulthood: the Kailuan Study</title><title>The American journal of clinical nutrition</title><addtitle>Am J Clin Nutr</addtitle><description>The risk of cancer in adulthood can be influenced by exposure to environmental factors (e.g., food shortage and stress) in early life.
This study compared the risk of cancer morbidity and mortality between Chinese adults who were or were not exposed to the Great Chinese Famine (1959–1961) in utero or during early childhood.
The Kailuan Study participants (n = 101,095) were classified into 5 famine exposure groups by birth year collected at study baseline (2006–2007): after 1961 (unexposed), 1959–1961 (in utero exposed), 1956–1958 (infancy and early childhood exposed, aged 0.1–2.9 y), 1953–1955 (childhood exposed, aged 3.0–5.9 y), and before 1953 (exposed, aged 6+ y). They were further classified by the severity of famine exposure. Cancer and cancer mortality cases from 2006 to 2016 were confirmed by reviewing medical records. Cox proportional hazard models were computed, adjusting for sex, socioeconomic status, and other time-varying cancer-related covariates.
During a median follow-up of 10.0 y, we identified 3560 incident cancer cases and 1749 cancer deaths. Famine exposure at all ages was positively associated with the risk of cancer morbidity and mortality (P < 0.001 for all, compared with unexposed). Severe exposure to famine in early childhood, but not other ages, had a higher risk of composite cancer events [adjusted HR = 2.04 (95% CI: 1.47, 2.84) for 0.1–2.9 y; and 1.61 (95% CI: 1.15, 2.25) for 3.0–5.9 y], relative to the less severely exposed groups of the same age range. When cancer morbidity and mortality were studied separately, similar patterns were observed.
In utero and early childhood exposures to famine, especially severe famine, were associated with a higher risk of cancer morbidity and mortality in adulthood. Awareness should be raised regarding the long-term effect of early life nutritional status. Trial registration number: ChiCTR-TNRC-11001489 (http://www.chictr.org.cn/showprojen.aspx?proj=8050).</description><subject>Adult</subject><subject>Cancer</subject><subject>cancer mortality</subject><subject>Child, Preschool</subject><subject>Childhood</subject><subject>Children</subject><subject>China - epidemiology</subject><subject>cohort study</subject><subject>early-life nutritional programming</subject><subject>Environmental factors</subject><subject>Exposure</subject><subject>Famine</subject><subject>Female</subject><subject>Health risks</subject><subject>Humans</subject><subject>Intrauterine exposure</subject><subject>Medical records</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Neoplasms - epidemiology</subject><subject>Neoplasms - etiology</subject><subject>Nutritional status</subject><subject>Prenatal Exposure Delayed Effects</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Socioeconomics</subject><subject>Starvation - complications</subject><subject>Statistical models</subject><issn>0002-9165</issn><issn>1938-3207</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkTtvFDEUhS0EIkugo0aWKKBgyPVjZjx0aEVCRCQKoLY89h2tl1l74wci_57Z7EKBkKh8i-98ss4h5DmDtwwGcWG2NlyEWzNyxR-QFRuEagSH_iFZAQBvBta1Z-RJzlsAxqXqHpMzIVvFWylXJFwHWgumSE1w1G787DYxOoo_9zHXhLREWjZIrxKaQtcbHzAjvTS75biPJJ-_0zhRa4LFRH2gxtW5HCTv7pOfjJ-rCfRLqe7uKXk0mTnjs9N7Tr5dfvi6_tjcfL66Xr-_aawUXWlaBqNiHSiGo-GASvbcig5wMl0_yoEhONkPYFTX895BO-LIlBWA0sBklTgnr4_efYq3FXPRO58tzrMJGGvWvO37XnABfEFf_oVuY01h-Z3mHSyQVAIW6s2RsinmnHDS--R3Jt1pBvqwgz7soE87LPiLk7SOO3R_4N_FL8CrIxDr_n-q7kji0tcPj0ln63Ep2_mEtmgX_b-DvwC2_aRD</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Zhang, Xinyuan</creator><creator>Wang, Gang</creator><creator>Forman, Michele R</creator><creator>Fu, Qingjiang</creator><creator>Rogers, Connie J</creator><creator>Wu, Shouling</creator><creator>Gao, Xiang</creator><general>Elsevier Inc</general><general>Oxford University Press</general><general>American Society for Clinical Nutrition, Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T7</scope><scope>7TS</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2974-8392</orcidid><orcidid>https://orcid.org/0000-0003-2617-6509</orcidid></search><sort><creationdate>202112</creationdate><title>In utero and childhood exposure to the Great Chinese Famine and risk of cancer in adulthood: the Kailuan Study</title><author>Zhang, Xinyuan ; Wang, Gang ; Forman, Michele R ; Fu, Qingjiang ; Rogers, Connie J ; Wu, Shouling ; Gao, Xiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-510b816081eba20e8472c360efa67b491e0d4790a86727d05beb18c30e4a0fc83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Cancer</topic><topic>cancer mortality</topic><topic>Child, Preschool</topic><topic>Childhood</topic><topic>Children</topic><topic>China - epidemiology</topic><topic>cohort study</topic><topic>early-life nutritional programming</topic><topic>Environmental factors</topic><topic>Exposure</topic><topic>Famine</topic><topic>Female</topic><topic>Health risks</topic><topic>Humans</topic><topic>Intrauterine exposure</topic><topic>Medical records</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Neoplasms - epidemiology</topic><topic>Neoplasms - etiology</topic><topic>Nutritional status</topic><topic>Prenatal Exposure Delayed Effects</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Socioeconomics</topic><topic>Starvation - complications</topic><topic>Statistical models</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Xinyuan</creatorcontrib><creatorcontrib>Wang, Gang</creatorcontrib><creatorcontrib>Forman, Michele R</creatorcontrib><creatorcontrib>Fu, Qingjiang</creatorcontrib><creatorcontrib>Rogers, Connie J</creatorcontrib><creatorcontrib>Wu, Shouling</creatorcontrib><creatorcontrib>Gao, Xiang</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of clinical nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Xinyuan</au><au>Wang, Gang</au><au>Forman, Michele R</au><au>Fu, Qingjiang</au><au>Rogers, Connie J</au><au>Wu, Shouling</au><au>Gao, Xiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>In utero and childhood exposure to the Great Chinese Famine and risk of cancer in adulthood: the Kailuan Study</atitle><jtitle>The American journal of clinical nutrition</jtitle><addtitle>Am J Clin Nutr</addtitle><date>2021-12</date><risdate>2021</risdate><volume>114</volume><issue>6</issue><spage>2017</spage><epage>2024</epage><pages>2017-2024</pages><issn>0002-9165</issn><eissn>1938-3207</eissn><abstract>The risk of cancer in adulthood can be influenced by exposure to environmental factors (e.g., food shortage and stress) in early life.
This study compared the risk of cancer morbidity and mortality between Chinese adults who were or were not exposed to the Great Chinese Famine (1959–1961) in utero or during early childhood.
The Kailuan Study participants (n = 101,095) were classified into 5 famine exposure groups by birth year collected at study baseline (2006–2007): after 1961 (unexposed), 1959–1961 (in utero exposed), 1956–1958 (infancy and early childhood exposed, aged 0.1–2.9 y), 1953–1955 (childhood exposed, aged 3.0–5.9 y), and before 1953 (exposed, aged 6+ y). They were further classified by the severity of famine exposure. Cancer and cancer mortality cases from 2006 to 2016 were confirmed by reviewing medical records. Cox proportional hazard models were computed, adjusting for sex, socioeconomic status, and other time-varying cancer-related covariates.
During a median follow-up of 10.0 y, we identified 3560 incident cancer cases and 1749 cancer deaths. Famine exposure at all ages was positively associated with the risk of cancer morbidity and mortality (P < 0.001 for all, compared with unexposed). Severe exposure to famine in early childhood, but not other ages, had a higher risk of composite cancer events [adjusted HR = 2.04 (95% CI: 1.47, 2.84) for 0.1–2.9 y; and 1.61 (95% CI: 1.15, 2.25) for 3.0–5.9 y], relative to the less severely exposed groups of the same age range. When cancer morbidity and mortality were studied separately, similar patterns were observed.
In utero and early childhood exposures to famine, especially severe famine, were associated with a higher risk of cancer morbidity and mortality in adulthood. Awareness should be raised regarding the long-term effect of early life nutritional status. Trial registration number: ChiCTR-TNRC-11001489 (http://www.chictr.org.cn/showprojen.aspx?proj=8050).</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34582544</pmid><doi>10.1093/ajcn/nqab282</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2974-8392</orcidid><orcidid>https://orcid.org/0000-0003-2617-6509</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Cancer cancer mortality Child, Preschool Childhood Children China - epidemiology cohort study early-life nutritional programming Environmental factors Exposure Famine Female Health risks Humans Intrauterine exposure Medical records Morbidity Mortality Neoplasms - epidemiology Neoplasms - etiology Nutritional status Prenatal Exposure Delayed Effects Risk Risk Factors Socioeconomics Starvation - complications Statistical models |
| title | In utero and childhood exposure to the Great Chinese Famine and risk of cancer in adulthood: the Kailuan Study |
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