Disability-adjusted life-years (DALYs) are an indicator of mortality, morbidity, and disability. We calculated DALYs for cancer in middle-aged and older adults participating in the Consortium on Health and Ageing Network of Cohorts in Europe and the United States (CHANCES) consortium.
A total of 90 199 participants from five European cohorts with 10 455 incident cancers and 4399 deaths were included in this study. DALYs were calculated as the sum of the years of life lost because of premature mortality (YLLs) and the years lost because of disability (YLDs). Population-attributable fractions (PAFs) were also estimated for five cancer risk factors, ie, smoking, adiposity, physical inactivity, alcohol intake, and type II diabetes.
After a median follow-up of 12 years, the total number of DALYs lost from cancer was 34 474 (382 per 1000 individuals) with a similar distribution by sex. Lung cancer was responsible for the largest number of lost DALYs (22.9%), followed by colorectal (15.3%), prostate (10.2%), and breast cancer (8.7%). Mortality (81.6% of DALYs) predominated over disability. Ever cigarette smoking was the risk factor responsible for the greatest total cancer burden (24.0%, 95% confidence interval [CI] = 22.2% to 26.0%), followed by physical inactivity (4.9%, 95% CI = 0.8% to 8.1%) and adiposity (1.8%, 95% CI = 0.2% to 2.8%).
DALYs lost from cancer were substantial in this large European sample of middle-aged and older adults. Even if the burden of disease because of cancer is predominantly caused by mortality, some cancers have sizeable consequences for disability. Smoking remained the predominant risk factor for total cancer burden.
Journal of the National Cancer Institute. 2016 May 06*** epublish ***
Konstantinos K Tsilidis, Nikos Papadimitriou, Despoina Capothanassi, Christina Bamia, Vassiliki Benetou, Mazda Jenab, Heinz Freisling, Frank Kee, Annemarie Nelen, Mark G O'Doherty, Angela Scott, Isabelle Soerjomataram, Anne Tjønneland, Anne M May, J Ramón Quirós, Ulrika Pettersson-Kymmer, Hermann Brenner, Ben Schöttker, José M Ordóñez-Mena, Aida Karina Dieffenbach, Sture Eriksson, Ellisiv Bøgeberg Mathiesen, Inger Njølstad, Galatios Siganos, Tom Wilsgaard, Paolo Boffetta, Dimitrios Trichopoulos, Antonia Trichopoulou
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT) ., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT)., Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (KKT, NP); Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK (KKT); Hellenic Health Foundation, Athens, Greece (KKT, DC, CB, PB, DT, AT); World Health Organization Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece (CB, VB, AT); International Agency for Research on Cancer (IARC-WHO), Lyon, France (MJ, HF, IS); UKCRC Centre of Excellence for Public Health, Queens University Belfast, Northern Ireland, UK (FK, MGO, AS); Department of Health Economics and Management, University of Wuppertal, Wuppertal, Germany (AN); Research Centre for Education and the Labour Market, Maastricht University, Maastricht, the Netherlands (AN); Danish Cancer Society Research Center, Copenhagen, Denmark (AT); Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands (AMM); Public Health Directorate, Asturias, Spain (JRQ); Department of Pharmacology and Clinical Neurosciences (UPK) and Department of Biobank Research (SE), Umeå University, Umeå, Sweden (UPK); Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (HB), Heidelberg, Germany (HB, BS, JMOM, AKD); Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany (HB); Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany (JMOM); Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway (EBM, IN, GS, TW); Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (PB); Department of Epidemiology, Harvard School of Public Health, Boston, MA (DT); Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece (DT).