ArticleEuropean journal of epidemiology2015
Molecular pathological epidemiology gives clues to paradoxical findings.
Article in European journal of epidemiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- The Role of the Gut Microbiome in Clinical Outcomes of Colorectal Cancer: A Systematic Review (2020-2025).Oncology research · 2026Pooled it
- Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial.Journal of the American Heart Association · 2017Trial
- The early-onset cancer epidemics: evidence synthesis using the prospective cohort incident-tumor biobank method.European journal of epidemiology · 2025Review
- Analysis of Factors Contributing to Adverse Events and Evaluation of Their Impact on Prognosis in Metastatic Renal Cell Carcinoma Patients-Real-World Experience in a Single-Center Retrospective Study and Narrative Review.Medicina (Kaunas, Lithuania) · 2024Review
- Spatially resolved multimarker evaluation of CD274 (PD-L1)/PDCD1 (PD-1) immune checkpoint expression and macrophage polarisation in colorectal cancer.British journal of cancer · 2023Article
- Prognostic value of pan-immune-inflammation value and body mass index in geriatric patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors as first line treatment. A single-center retrospective study.Contemporary oncology (Poznan, Poland) · 2023Article
- Cancer Risk Studies and Priority Areas for Cancer Risk Appraisal in Uganda.Annals of global health · 2020Review
- Microsatellite Instability and Life Style Factors in Sporadic Colorectal Cancer.Asian Pacific journal of cancer prevention : APJCP · 2020Article
- Obesity paradox in cancer: Is bigger really better?Evolutionary applications · 2019Article
- Integration of microbiology, molecular pathology, and epidemiology: a new paradigm to explore the pathogenesis of microbiome-driven neoplasms.The Journal of pathology · 2019Review
- Insights into Pathogenic Interactions Among Environment, Host, and Tumor at the Crossroads of Molecular Pathology and Epidemiology.Annual review of pathology · 2019Review
- Adiposity and gastrointestinal cancers: epidemiology, mechanisms and future directions.Nature reviews. Gastroenterology & hepatology · 2018Review
- Integrative analysis of exogenous, endogenous, tumour and immune factors for precision medicine.Gut · 2018Review
- Utility of inverse probability weighting in molecular pathological epidemiology.European journal of epidemiology · 2018Article
- Four Principles Regarding an Effective Treatment of Aging.Current aging science · 2018Review
- Physical Activity Decreases Kidney Cancer Mortality.Current urology · 2017Article
- Aspirin exerts high anti-cancer activity inOncotarget · 2017Article
- The Rotterdam Study: 2018 update on objectives, design and main results.European journal of epidemiology · 2017Article
- Aspirin Use and Colorectal Cancer Survival According to Tumor CD274 (Programmed Cell Death 1 Ligand 1) Expression Status.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2017Article
- Body mass index and risk of colorectal carcinoma subtypes classified by tumor differentiation status.European journal of epidemiology · 2017Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
A number of epidemiologic studies have described what appear to be paradoxical associations, where an incongruous relationship is observed between a certain well-established risk factor for disease incidence and favorable clinical outcome among patients with that disease. For example, the "obesity paradox" represents the association between obesity and better survival among patients with a certain disease such as coronary heart disease. Paradoxical observations cause vexing clinical and public health problems as they raise questions on causal relationships and hinder the development of effective interventions. Compelling evidence indicates that pathogenic processes encompass molecular alterations within cells and the microenvironment, influenced by various exogenous and endogenous exposures, and that interpersonal heterogeneity in molecular pathology and pathophysiology exists among patients with any given disease. In this article, we introduce methods of the emerging integrative interdisciplinary field of molecular pathological epidemiology (MPE), which is founded on the unique disease principle and disease continuum theory. We analyze and decipher apparent paradoxical findings, utilizing the MPE approach and available literature data on tumor somatic genetic and epigenetic characteristics. Through our analyses in colorectal cancer, renal cell carcinoma, and glioblastoma (malignant brain tumor), we can readily explain paradoxical associations between disease risk factors and better prognosis among disease patients. The MPE paradigm and approach can be applied to not only neoplasms but also various non-neoplastic diseases where there exists indisputable ubiquitous heterogeneity of pathogenesis and molecular pathology. The MPE paradigm including consideration of disease heterogeneity plays an essential role in advancements of precision medicine and public health.
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