ORCID Profile
0000-0002-7307-0291
Current Organisation
Washington University in Saint Louis
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Publisher: Elsevier BV
Date: 2014
Publisher: American Society of Clinical Oncology (ASCO)
Date: 04-2016
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1016/J.SOCSCIMED.2006.03.010
Abstract: Baseline data from the Black Women's Health Study (BWHS) were analyzed to assess the relation of smoking to in idual, neighborhood, and state socioeconomic characteristics. Data on smoking status and in idual socioeconomic characteristics were obtained via a self-administered postal questionnaire at entry. Neighborhood characteristics of 41,726 never and current smokers were obtained by linking participants' addresses with census tract data from the 1990 US Census. In a multilevel logistic regression model, higher neighborhood poverty was associated with increased smoking prevalence after adjusting for age, education, marital status, and occupation at the in idual level, and percent high school graduate, percent college graduate, and percentage Black at the neighborhood level. Relative to women residing in neighborhoods with less than 5% of the residents below the poverty line, the odds ratio was 1.1 (95% confidence interval: 1.0-1.2) for women in neighborhoods with 5-9.9% of the residents below the poverty line, 1.3 (1.2-1.4) for women in neighborhoods with 10-19.9% of the residents below the poverty line, and 1.6 (1.5-1.8) for women in neighborhoods with 20% or more of the residents below poverty. State of residence was also significantly associated with prevalence of current smoking. These results suggest that contextual factors (at both the neighborhood and state level) play a role in Black women's smoking behaviors over and above in idual characteristics.
Publisher: Springer Science and Business Media LLC
Date: 22-03-2015
Publisher: BMJ
Date: 05-2002
Publisher: Elsevier BV
Date: 04-2019
Publisher: American Academy of Pediatrics (AAP)
Date: 04-2003
Abstract: Objective. Cross-sectional studies have suggested that children who were less physically active and children who watched more television (TV) had more excess body weight, but no large nationwide longitudinal studies have addressed whether children who change their personal levels of activity or inactivity, from one year to the next, experience changes in adiposity. Our objective is to study the association between change in body mass index (BMI) over 1 year and same year change in recreational physical activity and change in recreational inactivity (TV/videos/video games). Design. Cohort study using data from 2 mailed questionnaires, 1 year apart. Participants. A total of 11 887 boys and girls, aged 10 to 15, who returned questionnaires in both 1997 and 1998 as part of the Growing Up Today Study. Outcome Measure. Change in BMI from 1997–1998, accounting for increases in BMI associated with growth and development. Results. An increase in physical activity from 1997–1998 was associated with decreasing relative BMI in girls (−0.06 kg/m2 per hour increase in daily activity 95% confidence interval [CI]: −0.11, −0.01) and in overweight boys (−0.22 kg/m2 CI: −0.33, −0.10). An increase in inactivity was associated with increasing BMI in girls (+0.05 kg/m2 per hour increase in daily TV/videos/video games CI: +0.02, +0.08). Effects were generally stronger among overweight children. Increasing time doing aerobics/dancing and walking were associated with BMI declines for some groups of children. Conclusions. Many children may benefit by increasing their physical activity and by reducing time watching TV or videos and playing video games. In particular, 2 activities accessible to most children, aerobics/dancing and walking, also appeared beneficial.
Publisher: Wiley
Date: 02-11-2011
Publisher: Swets & Zeitlinger Publishers
Date: 2002
DOI: 10.1076/OPEP.9.3.179.1513
Abstract: Women are at higher risk for age-related cataract than men, and it has been hypothesized that this difference is due in part to gender-related hormonal differences. We investigated the association between postmenopausal hormone use and lens opacities in a population of 480 postmenopausal women from the Nurses' Health Study for whom we had prospectively collected exposure data. Participants received standardized eye exams the Lens Opacity Classification System III (LOCS III) was used to measure the degree of opacification. A total of 342 women had some opacity in one or both eyes. Overall, we did not observe a significant association between current hormone use and presence of any type of opacity (compared to never users, multivariate relative risk: 0.85 95% confidence interval (CI): 0.54-1.34). In ordinal logistic regression compared to never users, current hormone users had multivariate relative risks of cortical opacities of 0.80 (95% CI: 0.54-1.19) and for past users the relative risk was 0.76 (95% CI: 0.48-1.22). For nuclear opacities, the comparable relative risk for current use of hormones was 0.77 (95% CI: 0.52-1.13), and for past use the relative risk was 1.48 (95% CI: 0.92-2.34). Current use of estrogen-only preparations was associated with a 49% decreased risk of nuclear opacities compared to never use (multivariate relative risk 0.51, 95% CI: 0.29-0.89). While the overall findings are null, they do not exclude the possibility of a protective effect, particularly among current estrogen users.
Publisher: American Medical Association (AMA)
Date: 02-04-1997
Publisher: Wiley
Date: 17-05-2016
DOI: 10.1002/IJC.30167
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-1994
Abstract: To examine prospectively the association between self-reported symptoms of phobic anxiety and subsequent risk of coronary heart disease, a 2-year follow-up study was conducted of a cohort of 33,999 US male health professionals, aged 42 to 77 years in 1988, who were free of diagnosed cardiovascular disease at baseline. Levels of phobic anxiety were assessed using the Crown-Crisp index, a short, diagnostic self-rating scale used for common phobias. Main outcomes were incidents of coronary heart disease consisting of nonfatal myocardial infarction (MI) and fatal coronary heart disease (CHD). One hundred sixty-eight incident cases of CHD occurred during 2 years of follow-up (128 cases of nonfatal MI and 40 cases of fatal CHD). The age-adjusted relative risk of fatal CHD among men with highest levels of phobic anxiety (scoring 4 or higher on the Crown-Crisp index) was 3.01 (95% confidence interval, 1.31 to 6.90) compared with men with the lowest levels of anxiety (scoring 0 or 1 on the phobia index). Risk of fatal CHD increased with levels of phobic anxiety (P trend = .002). When fatal CHD was further categorized into sudden and nonsudden coronary death, the excess risk was confined to sudden death (relative risk among men scoring 3 or higher on the phobia index was 6.08 95% confidence interval, 2.35 to 15.73). No association was found between phobic anxiety and risk of nonfatal MI. These findings remained essentially unchanged after adjusting for a broad range of cardiovascular risk factors. The specificity, strength, and dose-response gradient of the association, together with the consistency and biological plausibility of the experimental and epidemiologic evidence, support a strong causal association between phobic anxiety and fatal CHD.
Publisher: Oxford University Press (OUP)
Date: 10-1990
DOI: 10.1093/OXFORDJOURNALS.AJE.A115704
Abstract: Evidence for an independent role of increased physical activity in the primary prevention of coronary heart disease has grown in recent years. The authors apply the techniques of meta-analysis to data extracted from the published literature by Powell et al. (Ann Rev Public Health 1987 :253-87), as well as more recent studies addressing this relation, in order to make formal quantitative statements and to explore features of study design that influence the observed relation between physical activity and coronary heart disease risk. They find, for ex le, a summary relative risk of death from coronary heart disease of 1.9 (95% confidence interval 1.6-2.2) for sedentary compared with active occupations. The authors also find that methodologically stronger studies tend to show a larger benefit of physical activity than less well-designed studies.
Publisher: Oxford University Press (OUP)
Date: 04-1988
DOI: 10.1093/OXFORDJOURNALS.AJE.A114851
Abstract: The relation of the presence of moles (nevi) on all four limbs to risk of cutaneous malignant melanoma was explored among 98 incident cases aged 32-59 years at diagnosis and 190 age-matched controls drawn from the Nurses' Health Study, a prospective cohort of female nurses in the United States. Cases diagnosed during follow-up from 1976 to 1982 were included in this study. Participants reported counts of all moles and raised moles alone on postal questionnaires. Distributions of moles were similar for right and left sides on upper and lower limbs for cases and controls. Counts declined with increasing age for all women, from a median of 15 for the youngest tertile of controls (aged 36-46 years) to three for the oldest (aged 54-62 years). Cases had more moles than did controls (medians of 23 and 9, respectively, for total moles on all four limbs): The presence of any mole on a limb gave relative risks for melanoma ranging from 2.2 (95% confidence interval (CI) = 1.2-4.0) for one or more moles on an arm to 2.9 (95% CI = 1.6-5.3) for one or more moles on the lower limb. For raised moles, relative risks were 1.7 (95% CI = 1.0-2.7) for arm, 2.1 (95% CI = 1.3-3.5) for lower limb, and 3.5 (95% CI = 2.0-6.3) for leg (below knee). The highest site-specific risk (i.e., for any moles on the same limb as the melanoma vs. no moles on that limb) was for moles on the lower limb (relative risk = 5.0 (95% CI = 1.8-13.5)). There were positive and significant trends in overall and site-specific risk with increasing numbers of moles on all limbs when absolute mole counts were considered, e.g., for total moles on all four limbs combined, chi for trend = 4.0, one-sided p less than 0.001, with relative risk for more than 100 moles versus none of 6.0. Inclusion of sun exposure and other constitutional factors in logistic regression analyses did not alter these observed relations between the presence of moles and risk of melanoma.
Publisher: American Association for Cancer Research (AACR)
Date: 07-2019
DOI: 10.1158/1538-7445.AM2019-1585
Abstract: BACKGROUND: Progesterone is a proliferative hormone in the breast. Combined estrogen plus progestin use in postmenopausal women increases mammographic density a very strong risk for breast cancer. Circulating progesterone and genetic variations in progesterone receptor (PGR)-related genes are positively associated with mammographic density in postmenopausal women, but there are limited data in premenopausal women, with conflicting results. Notably, besides hormone therapy, genetic variation in PGR genes are known to modulate circulating progesterone levels. We, therefore, investigated the associations of genetic variations in PGR-related genes (PGR and Progesterone Receptor Membrane Component 1 (PGRMC1) with mammographic density in premenopausal women and determine, for the first time, whether these associations are mediated via circulating progesterone. METHODS: We genotyped 179 PGR-related single nucleotide polymorphisms (SNPs) (155 for PGR and 24 for PGRMC1 - 17 of which were synonymous variants and were filtered) in 364 cancer-free premenopausal women who had screening mammography at the Joanne Knight Breast Health Center at Washington University School of Medicine, St. Louis in 2016. We used Volpara to determine volumetric percent density, and dense volume. Variants were coded in dominant mode of inheritance. For causal mediation analysis, multivaraite linear regression models were applied to both the mediator (circulating PGR in logarithm scale) with variants and volumetric percent density, and dense volume with variant, PGR in logarithm scale and their interaction, both adjusting for age, body mass index, family history of breast cancer, and parity. The causal mediation effect, direct effect and total effect, by gentoype and averaged across genotypes were estimated with 95% confidence intervals and p values. Significance was claimed with p-value≤0.05. RESULTS: The mean age of the study participants was 47.5 years. Most participants (42.1%) had volumetric percent density between 3.5-7.5%, equivalent to BI-RADS® category b. Rs2020875 (PGR11) had a positive average direct effect (estimate=0.22, 95% CI, 0.016~0.44, p-value=0.024) and rs645213 (PGR11) had a borderline inverse direct effect (-0.25, -0.48~0.0004, p-value=0.052) on volumetric percent density. Further, rs11224565 (PGR11): 0.19, 0.04~0.34, p-value=0.028 had positive average direct effects on dense volume. None of the mediation effects were statistically signficiant. CONCLUSIONS: SNPs in PGR-related genes are associated with mammographic density in premenopausal women. Circulating progesterone levels did not mediate the associations between variants in PGR-related genes and mammographic density. Larger studies are needed to confirm our findings. Citation Format: Favour A. Akinjiyan, Yunan Han, Jingqin R. Luo, Aldi Kraja, Catherine M. Appleton, Graham A. Colditz, Adetunji T. Toriola. Genetic variations in progesterone receptor (PGR)-related genes and mammographic density in premenopausal women: Are the associations mediated by circulating progesterone [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019 2019 Mar 29-Apr 3 Atlanta, GA. Philadelphia (PA): AACR Cancer Res 2019 (13 Suppl):Abstract nr 1585.
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2012
Abstract: To examine the combined effect of alcohol and folate intake during adolescence on the risk of proliferative benign breast disease (BBD). We used data from 29 117 women in the Nurses’ Health Study II who completed both adolescent alcohol consumption questions in 1989 and an adolescent diet questionnaire in 1998. A total of 659 women with proliferative BBD diagnosed between 1991 and 2001 were confirmed by central pathology review. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals (CIs), adjusted for established risk factors of breast cancer. Adolescent alcohol consumption was dose-dependently associated with an increased risk of proliferative BBD (hazard ratio = 1.15 per 10 g/day consumption 95% CI, 1.03–1.28). There was no significant association between adolescent folate intake and the risk of proliferative BBD. Stratified analyses showed that each 10-g/day alcohol intake during adolescence was associated with a 21% (95% CI, 1.01–1.45) increase in the risk of proliferative BBD among women with low folate intake during adolescence, which was not significantly different from the alcohol-associated risk among women with moderate and high folate intake during adolescence (P for interaction = 0.18). Adolescent alcohol consumption is associated with increased risk of proliferative BBD, which may not be reduced by increased folate intake during adolescence.
Publisher: American Medical Association (AMA)
Date: 11-1999
DOI: 10.1001/ARCHPEDI.153.11.1184
Abstract: To assess prospectively the relation of peer and media influences on the risk of development of purging behaviors. Prospective cohort study. One year follow-up of 6982 girls aged 9 to 14 years in 1996 who completed questionnaires in 1996 and 1997 and reported in 1996 that they did not use vomiting or laxatives to control weight. Self-report of using vomiting or laxatives at least monthly to control weight. During 1 year of follow-up, 74 girls began using vomiting or laxatives at least monthly to control weight. Tanner stage of pubic hair development was predictive of beginning to purge (odds ratio [OR] = 1.8 95% confidence interval [CI], 1.3-2.4). Independent of age and Tanner stage of pubic hair development, importance of thinness to peers (OR = 2.3 95% CI, 1.8-3.0) and trying to look like females on television, in movies, or in magazines (OR= 1.9 95% CI, 1.6-2.3) were predictive of beginning to purge at least monthly. Regardless of the covariates included in the logistic regression model, the risk of beginning to purge increased approximately 30% to 40% per 1-category increase in frequency of trying to look like females on television, in movies, or in magazines. Both peers and popular culture, independent of each other, exert influence on girls' weight control beliefs and behaviors. Therefore, to make eating disorder prevention programs more effective, efforts should be made to persuade the television, movie, and magazine industries to employ more models and actresses whose weight could be described as healthy, not underweight.
Publisher: American Society of Hematology
Date: 02-12-2016
DOI: 10.1182/BLOOD.V128.22.3250.3250
Abstract: Background: Persons of African ancestry (AA) have a 2-3-fold higher risk of multiple myeloma (MM) than persons of European ancestry (EA). Like other B-cell malignancies, genome-wide association scans (GWAS) have identified MM risk variants in the HLA region in persons of EA. We conducted a case-control analysis with data from the National Marrow Donor Program (NMDP)1comprising MM patients typed for bone marrow transplant to donor controls matched by race-ethnicity, and found associations between specific HLA alleles/haplotypes and MM risk that varied by race and ethnicity. To confirm our results and identify additional novel signals, we have now investigated associations between HLA alleles and haplotypes and MM risk in the African American Multiple Myeloma Study (AAMMS) Cohort. Methods: The source of subjects was the AAMMS, in which AA MM patients were identified from 10 cancer centers and 4 Surveillance, Epidemiology and End-Results (SEER) Program cancer registries in order to identify genetic risk factors for MM among AAs. A GWAS was conducted using the Illumina Human Core BeadChip array on DNA s les from 1,305 AA MM patients in the AAMMS comparing results to those from 7,078 AA controls with GWAS data generated from the Illumina 1MDuo2. The major histocompatibility complex (MHC) region single nucleotide polymorphisms (SNPs) were imputed to classical HLA variants using HIBAG. Unconditional logistic regression was used to estimate HLA associations, adjusting for sex, age and the first 2 principal components. P-values were adjusted for false discovery rate (FDR) for each locus group. Results: We did not identify any single HLA alleles associated with MM risk among AAs. However, several B*07:02-containing haplotypes were associated with MM risk (odds ratios [OR] ranging from 2.38 to 2.64 and FDR P-values ranging from 1.43 x 10-6 to 3.57 x 10-8). We found associations between MM risk and genotypes containing DRB3*02:02, including DRB3*02:02~DRB1*11:01+ DRB3*02:02~DRB1*11:01 (OR=1.93, PFDR= 9.36 x 10-5) similar to those observed in the NMDP study1. Novel findings included associations between MM risk and HLA Class I haplotypes B*53:01+ B*57:01 (OR=1.94, PFDR= 0.003) and C04:01~B*53:01+C*06:02~B*57:01 (OR=1.96, PFDR= 0.0050). Results from an ongoing meta-analysis between the two data sets (one based on an imputed GWAS and one based on NMDP HLA typing) will be presented. Conclusions: This study is the second to examine HLA alleles and risk of MM among AA's and is by far the largest. We confirmed a previously observed association between an HLA Class II DRB3 variant and MM risk and confirmed an association with B*07 haplotypes previously observed among EAs1. We also identified novel associations between other HLA Class I haplotypes and MM risk in AA's. Because HLA is highly polymorphic, many HLA alleles are rare variants for which genetic associations are difficult to detect without very large s le sizes. Further investigation with large s le sizes will be necessary to refine these associations in order to better identify the underlying causal alleles and determine the functional significance of these HLA associations. 1Beksac M, Gragert L, Fingerson S, et al.: HLA polymorphism and risk of multiple myeloma.Leukemia. 2016 Jul 27. doi: 10.1038/leu.2016.199. 2Rand KA, Song C, Hwang AE, et al. Genetic susceptibility markers of multiple myeloma in African-Americans. Abstract # 2030, 56th Annual American Society of Hematology Meeting, San Francisco, California, 2014. Ailawadhi: Pharmacyclics: Consultancy Novartis: Consultancy Amgen Inc: Consultancy Takeda Oncology: Consultancy. Nooka:Spectrum, Novartis, Onyx pharmaceuticals: Consultancy. Zonder:Pharmacyclics: Other: DSMC membership Prothena: Consultancy, Honoraria Celgene: Consultancy, Honoraria, Research Funding Bristol Myers Squibb: Consultancy, Honoraria Seattle Genetics: Consultancy, Honoraria Takeda: Consultancy, Honoraria Janssen: Consultancy, Honoraria. Lonial:BMS: Consultancy Novartis: Consultancy Millenium: Consultancy Celgene: Consultancy Janssen: Consultancy Merck: Consultancy Celgene: Consultancy BMS: Consultancy Novartis: Consultancy Onyx: Consultancy Janssen: Consultancy Onyx: Consultancy.
Publisher: Oxford University Press (OUP)
Date: 28-08-2007
DOI: 10.1093/AJE/KWM157
Abstract: Although oral contraceptives are protective for ovarian cancer, it is unclear how long this protection persists. The authors prospectively assessed this question as well as associations of other, less studied contraceptive methods (tubal ligation, rhythm method, diaphragm, condoms, intrauterine device, foam, spousal vasectomy) and infertility with ovarian cancer risk among 107,900 participants in the US Nurses' Health Study. During 28 years of follow-up (1976-2004), 612 cases of invasive epithelial ovarian cancer were confirmed. Duration of oral contraceptive use was inversely associated with risk (p-trend = 0.02), but no clear trend was observed for years since last use. However, for women using oral contraceptives for >5 years, the rate ratio for ovarian cancer for 20 years since last use (rate ratio (RR) = 0.92, 95% CI: 0.61, 1.39). Tubal ligation (RR = 0.66, 95% CI: 0.50, 0.87) was associated with decreased ovarian cancer risk, whereas intrauterine device use (RR = 1.76, 95% CI: 1.08, 2.85) and infertility (RR = 1.36, 95% CI: 1.07, 1.75) were associated with an increased risk. Results suggest that the beneficial effect of oral contraceptives on ovarian cancer risk attenuates after 20 years since last use. Furthermore, tubal ligation, intrauterine device use, and infertility were associated with ovarian cancer risk.
Publisher: Wiley
Date: 09-2009
DOI: 10.1002/IJC.24709
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-1996
DOI: 10.1097/00005650-199605000-00002
Abstract: Nicotine polacrilex ("nicotine gum") is effective in helping persons to quit smoking cigarettes. Because many persons try to quit without formal assistance, it may be an appropriate product for over-the-counter (OTC) purchase. Some smokers, however, might use such a product in lieu of more effective methods of cessation, and still others might use it to cope with enforced periods of nicotine abstinence (eg, at the work place) and thereby delay their decision to quit. The study's objective was to assess the public health benefits and risks of OTC availability of nicotine gum. A Markov model was developed and used to contrast two alternative policy scenarios: one in which nicotine gum was assumed to remain available only by prescription, and another in which it was assumed to be made available for OTC purchase. Various data sources were used to estimate the model, including the Health Promotion and Disease Prevention Supplement to the 1991 National Health Interview Survey and the 1986 Adult Use of Tobacco Survey. Primary outcome measures included the numbers of persons who would try to quit smoking, the numbers who would use various methods of smoking cessation, including OTC nicotine gum, and the numbers of current adult smokers who would be abstinent at the end of 10 years. Findings suggest that an average of 3 million persons each year would use OTC nicotine gum. As a consequence of OTC availability, an additional 450,000 smokers would be abstinent at the end of 10 years. These results are sensitive to assumptions regarding the effectiveness of OTC nicotine gum, as well as to the effect of OTC availability on the use of other methods of smoking cessation. The number of persons who would quit smoking, however, increases under a fairly wide range of assumptions. Over-the-counter availability of nicotine gum may confer significant public health benefits.
Publisher: American Medical Association (AMA)
Date: 23-04-2007
DOI: 10.1001/ARCHINTE.167.8.814
Abstract: Induced abortion has been inconsistently associated with breast cancer risk in case-control studies. Retrospective cohort studies using registry information in Scandinavia have not suggested an increase in the incidence of breast cancer, although data on in idual reproductive factors were not accounted for. We examined the association between induced and spontaneous abortion and the incidence of breast cancer in a prospective cohort of young women, the Nurses' Health Study II. The study included 105 716 women 29 to 46 years old at the start of follow-up in 1993. Information on induced or spontaneous abortions was collected in 1993 and updated biennially. During 973 437 person-years of follow-up between 1993 and 2003, 1458 newly diagnosed cases of invasive breast cancer were ascertained. A total of 16 118 participants (15%) reported a history of induced abortion, and 21 753 (21%) reported a history of spontaneous abortions. The hazard ratio for breast cancer among women who had 1 or more induced abortions was 1.01 (95% confidence interval, 0.88-1.17) after adjustment for established breast cancer risk factors among women with 1 or more spontaneous abortions, the covariate-adjusted hazard ratio was 0.89 (95% confidence interval, 0.78-1.01). The relation between induced abortion and the incidence of breast cancer did not differ materially by number of abortions (P for trend = .98), age at abortion (P for trend = .68), parity (P for interaction = .54), or timing of abortion with respect to a full-term pregnancy (P for interaction = .10). Among this predominantly premenopausal population, neither induced nor spontaneous abortion was associated with the incidence of breast cancer.
Publisher: Elsevier BV
Date: 08-2003
Abstract: Alcohol consumption has been linked to a lower risk of gallstone disease. However, the magnitude of the association is uncertain, and little is known about the relation of alcohol consumption patterns and in idual types of alcoholic beverages to gallstone disease risk. We prospectively examined the association between alcohol intake and cholecystectomy, a surrogate for symptomatic gallstone disease, in a large cohort of women. Women from the Nurses' Health Study who had no history of gallstone disease in 1980 (n = 80,898) were followed for 20 y. Alcohol consumption, which was measured every 2-4 y by food-frequency questionnaires, was used to predict subsequent cholecystectomy through multivariate analysis. We ascertained 7831 cases of cholecystectomy. Relative to subjects who had no alcohol intake, subjects who had alcohol intakes of 0.1-4.9, 5.0-14.9, 15.0-29.9, 30.0-49.9, and >/=50.0 g/d had multivariate relative risks of cholecystectomy of 0.95, 0.86, 0.80, 0.67, and 0.62 (95% CI: 0.49, 0.79), respectively. Relative to subjects who never consumed alcohol, subjects who consumed alcohol 1-2, 3-4, 5-6, and 7 d/wk had multivariate relative risks of cholecystectomy of 0.94, 0.88, 0.87, and 0.73 (0.63, 0.84), respectively. All alcoholic beverage types were inversely associated with cholecystectomy risk, independent of consumption patterns (for quantity of alcohol consumed, P = 0.04, 0.001, and 0.003 for wine, beer, and liquor, respectively for frequency of alcohol consumption, P = 0.01, 0.07, and <0.0001 for wine, beer, and liquor, respectively). The intake of all alcoholic beverage types is inversely associated with the risk of cholecystectomy. Recommendations regarding the benefit of consuming moderate quantities of alcohol should be weighed against the potential health hazards.
Publisher: Elsevier BV
Date: 10-1998
Publisher: Oxford University Press (OUP)
Date: 1991
DOI: 10.1093/IJE/20.4.886
Abstract: The association of dietary intakes with blood pressure levels was examined in a cross-sectional s le of 805 men aged 40-69 years free from clinical hypertension, coronary heart disease or cancer. After controlling for age, body habitus, and alcohol consumption, blood pressure levels were inversely associated with the intake of fruit (r = -0.09, p less than 0.05, for both systolic (SBP) and diastolic (DBP) blood pressure) and of fruit fibre (r = -0.07, p = 0.05 for SBP r = -0.07, p = 0.07 for DBP). This association was independent of the intake of minerals and fibre from other sources. Calcium and magnesium intake were not significantly associated with blood pressure levels, but our results are statistically compatible with the modest inverse associations previously reported. These cross-sectional data suggest that some component of fruit has a blood pressure lowering effect.
Publisher: American Association for Cancer Research (AACR)
Date: 10-2013
DOI: 10.1158/1557-3125.ADVBC-B117
Abstract: Background: Women with ductal carcinoma in situ (DCIS) are at increased risk of breast cancer in either ipsilateral or contralateral breasts. However, it is inconclusive about the factors predicting the risk of second breast cancer after DCIS. Methods: We used US Surveillance, Epidemiology, and End Results data on women with first unilateral DCIS diagnosed between 1988 and 2009. Relative risks (RRs) were estimated using cox regression models to identify the factors associated with the risks of second DCIS and second invasive breast cancer (IBC). Results: Of the 74,285 eligible DCIS patients, 6,140 (8.3%) had subsequent breast cancer during 8.5 years of follow-up (714 ipsilateral DCIS, 2,003 ipsilateral IBC, 997 contralateral DCIS, and 2,426 contralateral IBC). Patients & years (RR=1.45 95% confidence interval (CI), 1.29-1.64), black patients (RR=1.60 95% CI, 1.39-1.83), patients with comedo DCIS (RR=1.19 95% CI, 1.07-1.32), and patients with poorly differentiated DCIS (RR=1.45 95% CI, 1.15-1.82) were more likely to develop ipsilateral breast cancer. Solid histologic type was more strongly associated with increased risk of ipsilateral IBC (RR=1.49 95% CI, 1.12-1.99). The risk of contralateral breast cancer was increased among black women (RR=1.33 95% CI, 1.16-1.52) and was decreased among young women and women with comedo DCIS, which was more obvious for contralateral IBC. Conclusion: The risk factors were different for second breast cancer in the ipsilateral breast and in the contralateral breast. Improved follow-up of young patients, black patients, patients with poorly differentiated DCIS, and patients with comedo or solid DCIS may reduce the risk of second IBC. Further investigations are needed to identify molecular features of DCIS that predict risk of second breast cancer and/or mediate racial and age differences in second cancer risk. Citation Format: Ying Liu, Graham Colditz. Risk factors of second breast cancer among patients with ductal carcinoma in situ. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Breast Cancer Research: Genetics, Biology, and Clinical Applications Oct 3-6, 2013 San Diego, CA. Philadelphia (PA): AACR Mol Cancer Res 2013 (10 Suppl):Abstract nr B117.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814287.V1
Abstract: Supplementary Table 7 shows the association between composite sleep score and EAC risk by BMI group
Publisher: American Medical Association (AMA)
Date: 14-02-1996
Publisher: Elsevier BV
Date: 05-2015
Publisher: Wiley
Date: 11-01-2013
DOI: 10.3322/CAAC.21172
Publisher: Wiley
Date: 2000
DOI: 10.1002/1097-0142(20001201)89:11<2176::AID-CNCR5>3.0.CO;2-6
Abstract: Although physical and emotional function after the diagnosis of breast carcinoma have been described in clinic populations, to the authors' knowledge no previous study has measured change from the preillness level of functional health status in community-dwelling women. The authors conducted a 4-year (1992-96) prospective study of functional recovery after breast carcinoma in a large s le of women, aged 54-73 years. They collected multidimensional measures of self-reported functional health status in 1992, before diagnosis of breast carcinoma, and again in 1996, to examine the risk of decline associated with incident breast carcinoma. After adjustment for age, baseline functional health status, and multiple covariates, women who developed incident breast carcinoma were more likely to have experienced reduced physical function, role function, vitality, and social function and increased bodily pain compared with women who remained free of breast carcinoma. Risk of decline was attenuated with increasing time since diagnosis. Risk of decline in physical function was evident across all stages of breast carcinoma, even after adjustment for women undergoing treatment for persistent or recurrent disease. We found evidence that the risk of decline among breast carcinoma cases compared with healthy women was largest among those who were most socially isolated. Breast carcinoma results in persistent declines in multiple dimensions of functional health status. These prospective data suggest that previous studies reporting no difference in physical function among breast carcinoma cases compared with disease free women underestimated the deleterious effect of the disease on function. Socially isolated women are an especially vulnerable group.
Publisher: Springer Science and Business Media LLC
Date: 02-2009
Publisher: Oxford University Press (OUP)
Date: 26-02-2020
Abstract: Due to mixed reports from smaller studies, we examined associations of race with mammographic breast density and evaluated racial differences in the determinants of breast density. Participants included 37,839 women (23,166 non-Hispanic White, and 14,673 African American women) receiving screening mammograms at the Joanne Knight Breast Health Center at Washington University School of Medicine, St. Louis, Missouri from June 2010 to December 2015. Mammographic breast density was assessed using Breast Imaging Reporting and Data System (5th edition). To determine the association of race and participant characteristics with mammographic breast density, we used multivariable polytomous logistic regression models (reference group: almost entirely fatty). African American women had increased odds of extremely dense (adjusted odds ratio (AOR) = 1.31, 95% CI = 1.13–1.52) and reduced odds of heterogeneously dense breasts (AOR= 0.91, 95% CI = 0.84 – 0.99) compared to non-Hispanic White women. Altogether, race, parity and age at first birth, age, current body mass index (BMI), BMI at age 18, menarche, family history of breast cancer, oral contraceptive use, alcohol, and menopausal status explained 33% of the variation in mammographic breast density. Among African American and non-Hispanic White women these factors explained nearly 28.6% and 33.6% of the variation in mammographic density, respectively. Current BMI provided the greatest explanation of breast density (26.2% overall, 22.2% in African American, and 26.2% in non-Hispanic White women). The determinants of mammographic breast density were generally similar between African-American women and non-Hispanic white women. After adjustments for confounders, African Americans had higher likelihood of extremely dense breast but lower likelihood of heterogeneously dense breast. The greatest explanation of breast density was provided by BMI, regardless of race.
Publisher: BMJ
Date: 09-1994
DOI: 10.1136/HRT.72.3.269
Abstract: The association between coffee drinking and risk of coronary heart disease remains controversial despite many epidemiological studies. A meta-analysis was carried out on these studies to resolve some of the uncertainties. Particular attention was paid to details of study design. Eight case-control studies and 15 cohort studies were analysed. Weighted, fixed effects linear regression of log relative risks (or odds ratios) was used to pool the study results. The pooling procedures were performed separately by study design, sex, coronary heart disease end points, smoking habit, and period of study. The pooled case-control odds ratio (for the effect of drinking five cups of coffee/day v none) was 1.63 (95% confidence interval (95% CI) 1.50 to 1.78). The pooled cohort study relative risk (five cups/day v none) was 1.05 (95% CI 0.99 to 1.12). The discrepancy between the pooled case-control and cohort study results could not be attributed to differences in the end points chosen, period of study, or to confounding by smoking status or sex. The cohort study data suggest very little excess risk of coronary heart disease among habitual coffee drinkers. The case-control data do not rule out an increased risk of heart disease among a subgroup of people who acutely increase their coffee intake. Further epidemiological studies are needed to assess the risk of drinking boiled or decaffeinated coffee.
Publisher: Cambridge University Press (CUP)
Date: 2009
DOI: 10.1017/S1368980008002036
Abstract: Low-carbohydrate diets could lead to reduced fruit and vegetable intake, which may be protective against CVD. The role of carbohydrate intake in modifying the association between fruits and vegetables and CVD has not been evaluated. To evaluate whether carbohydrate intake affects the association between fruits and vegetables and CVD. We included participants from two large prospective studies, the Nurses’ Health Study (NHS) and the Health Professionals’ Follow-Up Study (HPFS). We followed 70 870 eligible NHS females for 16 years and 38 918 eligible HPFS males for 14 years. Diet was assessed from an FFQ updated every 4 years. Our primary outcome was ischaemic CVD (fatal and non-fatal myocardial infarction and ischaemic stroke). We used Cox proportional hazards models to evaluate the relationship between fruits and vegetables and ischaemic CVD within groups with low, moderate or high carbohydrate intake. Fruit intake was strongly related with carbohydrate intake, but vegetables showed a very small correlation. Vegetable intake showed stronger associations with ischaemic CVD among the low carbohydrate group (multivariate risk ratio (RR) = 0·82 for an increment of 3 servings/d 95 % CI 0·68, 0·99) green leafy vegetables and carotene-rich fruits and vegetables followed a similar pattern. Total fruit intake was associated with a lower risk of ischaemic CVD only among participants with moderate carbohydrate intake (RR = 0·81 comparing extreme quintiles 95 % CI 0·70, 0·94). Total vegetables, green leafy vegetables and carotene-rich fruits and vegetables showed stronger associations with ischaemic CVD among the low carbohydrate group. No consistent trends were observed for fruit intake.
Publisher: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
Date: 06-2019
Publisher: American Association for Cancer Research (AACR)
Date: 07-2019
DOI: 10.1158/1538-7445.AM2019-1567
Abstract: Introduction: Compared with white women, black American women are less likely to develop hormone receptor-positive breast cancer, but experience higher mortality of the disease. The 21-gene recurrence scores (RS) predict in idualized benefit of chemotherapy for early hormone receptor-positive breast cancer. We hypothesize that the RS scores in early hormone receptor-positive breast cancer are higher in black women than in white women and this contributes to the worse outcomes among black women with hormone receptor-positive breast cancer. Methods: Utilizing the Surveillance, Epidemiology, and End Results database, we identified 75,861 women (75.7% non-Hispanic white, 7.9% non-Hispanic black, 8.0% Asian/Pacific Islander, and 8.5% Hispanic) with stage I-III hormone receptor-positive breast cancer diagnosed between 2004 and 2014. RS scores were categorized into low, medium, and high groups using traditional cutoffs (18 and 30) and the cutoffs used in the TAILORx clinical trial (11 and 25). We performed multivariable logistic regression to evaluate odds ratios (ORs) of RS categories, and Cox proportional hazard regression to estimate hazard ratios (HRs) for breast cancer-specific mortality and overall mortality. Results: The multivariable adjusted least square mean of RS was significantly higher in black (23.2) than other racial/ethnic groups (white 22.9, Asian/PI 22.5, Hispanic 22.4 p& .0001). Compared with white women, black women were more frequently in the high RS category defined by a cutoff of 30 (case-only OR=1.24, 95% CI: 1.11-1.39), Asian/PI (OR=0.88, 95% CI: 0.79-0.98) and Hispanic (OR=0.80, 95% CI: 0.72-0.89) were less frequently in the high RS category defined by a cutoff of 25. Compared with white women, the HR of breast cancer-specific mortality was 1.37 (95% CI: 1.10-1.69) in black women, and 0.65 (95% CI: 0.48-0.90) in Asian/PI women, after adjustment for demographic factors, RS categories and other tumor characteristics, and treatment. This association did not significantly vary by RS categories. The multivariable-adjusted associations between race/ethnicity and overall mortality were similar to those for breast cancer-specific mortality. Conclusions: Racial/ethnic differences in early hormone receptor-positive breast cancer outcomes could not be explained by RS scores. Potential differences in tumor biology that are not related to the genes in the 21-gene assay may contribute to the worse prognosis of black women with hormone receptor-positive breast cancer. Citation Format: Yunan Han, Graham A. Colditz, Ying Liu. Race, RNA-based recurrence scores, and survival of early hormone receptor-positive breast cancer: A population-based study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019 2019 Mar 29-Apr 3 Atlanta, GA. Philadelphia (PA): AACR Cancer Res 2019 (13 Suppl):Abstract nr 1567.
Publisher: Wiley
Date: 25-02-2020
DOI: 10.1002/CNCR.32798
Abstract: Advanced glycation end products (AGEs) are reactive metabolites produced as a by‐product of sugar metabolism and are consumed through the diet in high‐fat and highly processed foods. They are associated with chronic inflammatory diseases, and evidence suggests that they play a role in carcinogenesis. The authors evaluated the association of dietary AGE intake and the risk of postmenopausal invasive breast cancer. This was a prospective cohort study of 183,548 postmenopausal women in the National Institutes of Health‐AARP Diet and Health Study. The main outcome was incident invasive breast cancer. AGE intake was estimated from food‐frequency questionnaires. Incident breast cancer cases were identified through state cancer registries. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals for developing breast cancer according to AGE intake quintiles. Multivariable regression models were adjusted for breast cancer risk factors. The mean follow‐up was 12.8 years, and 9851 breast cancers (1978 advanced stage) were identified. The median AGE daily intake was 5932 kilo units per 100 kilocalories (KU/1000 kcal). Women with higher intake tended to have lower education levels, higher body mass index, less physical activity, were current smokers, and had higher fat and meat intake. The highest quintile of AGE intake (compared with the lowest) was associated with an increased risk of breast cancer (HR, 1.09 95% CI, 1.02‐1.16 P = .03) after adjusting for breast cancer risk factors and particularly was associated with 37% of advanced‐stage tumors (HR, 1.37 95% CI, 1.09‐1.74 P .02) after adjusting for risk factors and fat and meat intake. Dietary AGEs may play a role in the development of postmenopausal breast cancer.
Publisher: American Association for Cancer Research (AACR)
Date: 04-2014
DOI: 10.1158/1055-9965.EPI-13-1209
Abstract: Cancer prevention postdoctoral fellowships have existed since the 1970s. The National Cancer Institute facilitated a meeting by a panel of experts in April 2013 to consider four important topics for future directions for cancer prevention postdoctoral training programs: (i) future research needs (ii) underrepresented disciplines (iii) curriculum and (iv) career preparation. Panelists proffered several areas needing more research or emphasis, ranging from computational science to culture. Health care providers, along with persons from nontraditional disciplines in scientific training programs such as engineers and lawyers, were among those recognized as being underrepresented in training programs. Curriculum suggestions were that fellows receive training in topics such as leadership and human relations, in addition to learning the principles of epidemiology, cancer biologic mechanisms, and behavioral science. For career preparation, there was a clear recognition of the ersity of employment options available besides academic positions, and that program leaders should do more to help fellows identify and prepare for different career paths. The major topics and strategies covered at this meeting can help form the basis for cancer prevention training program leaders to consider modifications or new directions, and keep them updated with the changing scientific and employment climate for doctoral degree recipients and postdoctoral fellows. Cancer Epidemiol Biomarkers Prev 23(4) 679–83. ©2014 AACR.
Publisher: Springer Science and Business Media LLC
Date: 08-2022
DOI: 10.1186/S12885-022-09946-X
Abstract: Despite benefits of endocrine therapy (ET) for patients with hormone-receptor (HR)-positive breast cancer, many patients do not initiate or discontinue ET against recommendations. We identified variables associated with ET initiation and continuation, analyzing pooled data from two longitudinal studies at a National Cancer Institute comprehensive cancer center in St. Louis, Missouri. The s le included 533 women with newly diagnosed, non-metastatic, HR-positive breast cancer who completed interviews at enrollment and 6, 12, and 24 months after definitive surgical treatment. Logistic regression models estimated the adjusted odds ratio and 95% confidence interval (aOR [95% CI]) for each of self-reported ET initiation by the 12-month interview and continuation for ≥12 months by the 24-month interview in association with self-reported diabetes, elevated depressed mood, menopausal-symptom severity and obesity, adjusting for race, age, insurance status, chemotherapy, and radiation therapy. Overall, 81.4% (434/533) of patients initiated ET, and 86.5% (371/429) continued ET ≥12 months. Patients with diabetes had lower odds of initiating ET (0.50 [0.27-0.91]). Patients reporting greater menopausal-symptom severity had lower odds of continuing ET (0.72 [0.53-0.99]). Efforts to increase ET initiation among patients with diabetes and better manage severe menopausal symptoms among ET users might promote ET continuation. ClinicalTrials.gov : #NCT00929084.
Publisher: American Association for Cancer Research (AACR)
Date: 05-2015
DOI: 10.1158/1538-7445.SABCS14-P6-09-01
Abstract: Obesity is well established as a cause of postmenopausal breast cancer incidence and mortality. Furthermore, adiposity in early life – through premenopausal years reduces breast cancer incidence. However, studies using measures of adiposity at age 18 also report inverse relations with premenopausal breast cancer and for some but not all subtypes of breast cancer defined by molecular status. To assess the relations of adiposity in childhood, in late adolescence, and in adult years as well as change in weight in relation to total invasive breast cancer and subtype defined by receptor status we fit models based on the Rosner-Colditz log-incidence model of breast cancer. The Nurses’ Health Study cohort was established in 1976 when 121,701 female US registered nurses ages 30-55 responded to a mail questionnaire inquiring about risk factors for breast cancer including reproductive factors, hormone use, anthropometric variables, benign breast disease (BBD), and family history of breast cancer. The risk factors have been updated by repeat questionnaires every 2 years. We followed a cohort of 77,232 women from 1980 to 2006 (1,445,578 person-years) documenting 4,196 incident cases of invasive breast cancer. ER and PR status were obtained from pathology reports and medical records. A total of 2,033 ER+/PR+ tumors, 595 ER-/PR- tumors, 512 ER+/PR- tumors were identified among women with complete information on breast cancer risk factors. Overall, weight at age 18 was inversely related to incidence. The relative risk per 25 lb weight difference was 0.89 (0.85, 0.93). After controlling for weight at age 18, long-term weight change was positively related to total incident breast cancer risk among both premenopausal (RR per 25 lb weight gain since age 18=1.08 95% CI=1.05-1.12) and postmenopausal women (RR per 25 lb weight gain since menopause=1.16 95% CI=1.09-1.23). In addition, we focus on the effect of short-term weight gain (over past 4 years) on breast cancer risk while controlling for weight at age 18 and long-term change in weight during premenopause and postmenopause. We found a significant effect of short-term weight change and breast cancer risk (RR=1.20 95% CI=1.09-1.33) for a 4-year weight gain of ≥ 15 lbs vs no change (≤ 5lbs) (RR per 25 lb weight gain=1.13 95% CI=1.06-1.21, p& .001). However, the effect was stronger for premenopausal women (≥ 15 lb weight gain vs no change, RR=1.38 95% CI=1.13-1.69) (RR per 25 lb weight gain=1.26 95% CI=1.08-1.48, p=0.004) than for postmenopausal women (≥ 15 lb weight gain vs no change, RR=1.10 95% CI=0.97-1.25) (RR per 25 lb weight gain=1.08 95% CI=1.00-1.16, p=0.063). The effect of short-term weight gain during premenopause was stronger for ER+/PR- (RR per 25 lb weight gain=2.19 95% CI=1.33-3.61, p=0.002) and ER-/PR- breast cancer (RR per 25 lb weight gain=1.61 95% CI=1.09-2.38, p=0.016) than for ER+/PR+ breast cancer (RR per 25 lb weight gain=1.13 95% CI=0.89-1.43, p=0.32). In conclusion, adiposity in childhood has a protective lifelong relation to breast cancer risk, though mechanisms remain largely unexplained. There are long-term deleterious effects of weight change both pre- and post-menopause and deleterious effects of short-term weight gain during premenopausal years. Citation Format: Graham A Colditz, Heather Eliassen, Adetunji T Toriola, Susan E Hankinson, Walter C Willett, Loki Natarajan, Bernard Rosner. Recent weight gain and increased breast cancer risk varies by receptor classification among pre and postmenopausal women [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13 San Antonio, TX. Philadelphia (PA): AACR Cancer Res 2015 (9 Suppl):Abstract nr P6-09-01.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 31-01-2006
DOI: 10.1161/CIRCULATIONAHA.105.574087
Abstract: Background— The comparative importance of physical inactivity and obesity as predictors of coronary heart disease (CHD) risk remains unsettled. Methods and Results— We followed 88 393 women, 34 to 59 years of age, in the Nurses’ Health Study from 1980 to 2000. These participants did not have cardiovascular disease and cancer at baseline. We documented 2358 incident major CHD events (including nonfatal myocardial infarction and fatal CHD) during 20 years of follow-up, including 889 cases of fatal CHD and 1469 cases of nonfatal myocardial infarction. In a multivariate model adjusting for cardiovascular risk factors, overweight and obesity were significantly associated with increased risk of CHD, whereas increasing levels of physical activity were associated with a graded reduction in CHD risk ( P .001). In joint analyses of body mass index (BMI) and physical activity in women who had a healthy weight (BMI, 18.5 to 24.9 kg/m 2 ) and were physically active (exercise ≥3.5 h/wk) as the reference group, the relative risks of CHD were 3.44 (95% confidence interval [CI], 2.81 to 4.21) for women who were obese (BMI ≥30 kg/m 2 ) and sedentary (exercise h/wk), 2.48 (95% CI, 1.84 to 3.34) for women who were active but obese, and 1.48 (95% CI, 1.24 to 1.77) for women who had a healthy weight but were sedentary. In combined analyses of waist-hip ratio and physical activity, both waist-hip ratio and physical activity were significant predictors of CHD, and the highest risk was among women in the lowest category of physical activity and the highest tertile of waist-hip ratio (relative risk=3.03 95% CI, 1.96 to 4.18). Even a modest weight gain (4 to 10 kg) during adulthood was associated with 27% (95% CI, 12% to 45%) increased risk of CHD compared with women with a stable weight after adjusting for physical activity and other cardiovascular risk factors. Conclusions— Obesity and physical inactivity independently contribute to the development of CHD in women. These data underscore the importance of both maintaining a healthy weight and regular physical activity in preventing CHD.
Publisher: CRC Press
Date: 09-12-2003
Publisher: Springer New York
Date: 2001
Publisher: Elsevier BV
Date: 03-2017
Publisher: American Medical Association (AMA)
Date: 03-08-2005
Publisher: Elsevier BV
Date: 11-1993
DOI: 10.1097/00004583-199311000-00019
Abstract: To assess the relationships of concern with weight and shape, frequency of dieting, body mass index (weight/height2), and energy intake among 431 preadolescent and adolescent girls from a working-class New England suburb. A cross-sectional study design used self-report measures of concern with weight, frequency of dieting, and average dietary intake. Approximately 30% of the girls in each age stratum were above the national age-standardized 85th percentile for body mass index (BMI). Body mass index was positively associated with concern about weight and shape (r = 0.46, p = 0.0001) and frequency of dieting (r = 0.49, p = 0.0001). Extreme concern with weight and shape was most common among the obese preadolescent and adolescent girls however, dissatisfaction was also present among the underweight females. Fifty percent of the girls who were below the national age-standardized 15th percentile for BMI reported their ideal weight is less than their current weight, implying that among young women thinness is not adequate protection against dissatisfaction with weight and shape. Frequency of dieting was positively associated with concern about weight and shape (r = 0.53, p = 0.001) but not physical activity (r = -0.04, p = 0.36). Overall, we did not find strong evidence that dieters were eating less than their nondieting peers. Only among high school students was there a significant negative association between frequency of dieting and energy intake (r = -0.20, p = 0.01), suggesting that "dieting" may have a different meaning to preadolescents and adults. These findings indicate that self-reported frequent dieting in preadolescent and young adolescent girls is more indicative of extreme concern with weight than of decreased energy intake. Furthermore, extreme concern with weight and shape is most common among the obese preadolescent and adolescent girls.
Publisher: American Association for Cancer Research (AACR)
Date: 2008
DOI: 10.1158/0008-5472.CAN-07-3234
Abstract: Colony stimulating factor-1 (CSF1) and its receptor (CSF1-R) are important in mammary gland development and have been implicated in breast carcinogenesis. In a nested case-control study in the Nurses' Heath Study of 726 breast cancer cases diagnosed between June 1, 1992, and June 1, 1998, and 734 matched controls, we prospectively evaluated whether circulating levels of CSF1 (assessed in 1989–1990) are associated with breast cancer risk. The association varied by menopausal status (Pheterogeneity = 0.009). CSF1 levels in the highest quartile (versus lowest) were associated with an 85% reduced risk of premenopausal breast cancer [relative risk (RR), 0.15 95% confidence interval (95% CI), 0.03–0.85 Ptrend = 0.02]. In contrast, CSF1 levels in the highest quartile conferred a 33% increased risk of postmenopausal breast cancer (RR, 1.33 95% CI, 0.96–1.86 Ptrend = 0.11), with greatest risk for invasive (RR, 1.45 95% CI, 1.02–2.07 Ptrend = 0.06) and ER+/PR+ tumors (RR, 1.72 95% CI, 1.11–2.66 Ptrend = 0.04). Thus, the association of circulating CSF1 levels and breast cancer varies by menopausal status. [Cancer Res 2008 (1):18–21]
Publisher: Springer Science and Business Media LLC
Date: 31-05-2019
Publisher: Massachusetts Medical Society
Date: 22-09-1983
DOI: 10.1056/NEJM198309223091206
Abstract: Rotator cuff lesion with shoulder stiffness is a major cause of shoulder pain and motionlessness. Subacromial bursa fibrosis is a prominent pathological feature of the shoulder disorder. MicroRNA-29a (miR-29a) regulates fibrosis in various tissues however, the miR-29a action to subacromial bursa fibrosis remains elusive. Here, we reveal that subacromial synovium in patients with rotator cuff tear with shoulder stiffness showed severe fibrosis, hypertrophy, and hyperangiogenesis histopathology along with significant increases in fibrotic matrices collagen (COL) 1A1, 3A1, and 4A1 and inflammatory cytokines, whereas miR-29a expression was downregulated. Supraspinatus and infraspinatus tenotomy-injured shoulders in transgenic mice overexpressing miR-29a showed mild swelling, vascularization, fibrosis, and regular gait profiles as compared to severe rotator cuff damage in wild-type mice. Treatment with miR-29a precursor compromised COL3A1 production and hypervascularization in injured shoulders. In vitro, gain of miR-29a function attenuated COL3A1 expression through binding to the 3'-untranslated region (3'-UTR) of COL3A1 in inflamed tenocytes, whereas silencing miR-29a increased the matrix expression. Taken together, miR-29a loss is correlated with subacromial bursa inflammation and fibrosis in rotator cuff tear with shoulder stiffness. miR-29a repressed subacromial bursa fibrosis through directly targeting COL3A1 mRNA, improving rotator cuff integrity and shoulder function. Collective analysis offers a new insight into the molecular mechanism underlying rotator cuff tear with shoulder stiffness. This study also highlights the remedial potential of miR-29a precursor for alleviating the shoulder disorder.
Publisher: Springer Science and Business Media LLC
Date: 06-03-2013
Publisher: Wiley
Date: 02-2006
DOI: 10.1002/CNCR.21660
Abstract: Cervical carcinoma is the fifth most common cancer among African American women in the U.S. Although the Papanicolaou (Pap) smear is an efficacious screening tool in the early detection of the disease, disparities are known to persist in the utilization of this procedure across socioeconomic groups. Data regarding cervical carcinoma screening and covariates were obtained from the 59,090 Black Women's Health Study participants across the U.S. via a mailed questionnaire in 1995. Logistic regression and multilevel techniques were used to assess the independent effects of the covariates on nonrecent cervical carcinoma screening. In all, 8.3% of the 40,009 women in the present analysis had not undergone a Pap smear examination within the previous 2 years (nonrecent screening). Lower educational attainment, older age, obesity, smoking, and neighborhood poverty were found to be independently related to increased risk of nonrecent screening. The adjusted odds ratio for nonrecent screening was 1.2 (95% confidence interval [95% CI], 1.1-1.4) for women residing in neighborhoods with 20% or more poverty compared with those in neighborhoods with less than 5% poverty. State of residence was also associated with nonrecent cervical carcinoma screening. These results suggest that among black women, residence in high-poverty (20%) neighborhoods is associated with an increased risk of nonrecent cervical carcinoma screening, independent of in idual level risk factors.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-1990
DOI: 10.1097/00004836-199004000-00005
Abstract: We reviewed the indications for and results of 788 consecutive upper gastrointestinal radiographs (UGIs) performed for ambulatory patients. Sixty-three percent of tests were ordered for the evaluation of abdominal pain, dyspepsia, or esophageal reflux. Of these tests, only 4.8% yielded results of major clinical importance to patient management. The yield for patients greater than 50 years of age was greater than for patients less than 50, 6.9 versus 3.0% (p = 0.04). There was a significant increase in yield with increasing age (chi trend = 11.6, p less than 0.001). Among patients with an indication of esophageal reflux alone (n = 62), there were no patients younger than age 60 with a test result that would significantly affect therapy or outcome. Among patients evaluated for fecal occult blood or weight loss (n = 120), 11.7% of tests ordered showed a finding of major clinical importance. In this group, the yield was higher in those greater than or equal to 50 years of age than in those less than 50, 14.7 versus 6.7%, (p = 0.2). These results indicate that UGIs ordered to evaluate pain or symptoms of esophageal reflux in the absence of bleeding or weight loss rarely yield results that significantly influence therapy. Such patients may be best served by an initial trial of empiric therapy or some other test. The UGI has greatest value when indications for it include bleeding or weight loss.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Oxford University Press (OUP)
Date: 15-01-1992
DOI: 10.1093/JNCI/84.2.91
Abstract: Rates of colorectal cancer in various countries are strongly correlated with per-capita consumption of red meat and animal fat and inversely associated with fiber consumption. There have been few studies, however, of dietary risk factors for colorectal adenomas, which are precursors of cancer. Our purpose was to determine prospectively the relationship between dietary factors and risk of colorectal adenomas. Using data from the Health Professionals Follow-up Study, we documented 170 cases of adenomas of the left colon or rectum in 7284 male health professionals who completed a food-frequency questionnaire in 1986 and who had a colonoscopy or sigmoidoscopy between 1986 and 1988. Relative risk (RR) of adenoma was determined according to quintiles of nutrient intakes. After adjustment for total energy intake, saturated fat was positively associated with risk of colorectal adenoma (P for trend = .006) RR for the highest versus the lowest quintile of intake was 2.0 (95% confidence interval [CI] = 1.2-3.2). Dietary fiber was inversely associated with risk of adenoma (P for trend less than .0001) RR for men in the highest versus the lowest quintile was 0.36 (95% CI = 0.22-0.60). All sources of fiber (vegetables, fruits, and grains) were associated with decreased risk of adenoma. For subjects on a high-saturated fat, low-fiber diet, the RR was 3.7 (95% CI = 1.5-8.8) compared with those on a low-saturated fat, high-fiber diet. The ratio of the intake of red meat to the intake of chicken and fish was positively associated with risk of adenoma (P for trend = .02). These prospective data provide evidence for the hypothesis that a diet high in saturated fat and low in fiber increases the risk of colorectal adenoma. They also support existing recommendations to substitute chicken and fish for red meat in the diet and to increase intake of vegetables, fruits, and grains to reduce risk of colorectal cancer.
Publisher: Wiley
Date: 28-02-1995
Abstract: Many meta-analyses use a random-effects model to account for heterogeneity among study results, beyond the variation associated with fixed effects. A random-effects regression approach for the synthesis of 2 x 2 tables allows the inclusion of covariates that may explain heterogeneity. A simulation study found that the random-effects regression method performs well in the context of a meta-analysis of the efficacy of a vaccine for the prevention of tuberculosis, where certain factors are thought to modify vaccine efficacy. A smoothed estimator of the within-study variances produced less bias in the estimated regression coefficients. The method provided very good power for detecting a non-zero intercept term (representing overall treatment efficacy) but low power for detecting a weak covariate in a meta-analysis of 10 studies. We illustrate the model by exploring the relationship between vaccine efficacy and one factor thought to modify efficacy. The model also applies to the meta-analysis of continuous outcomes when covariates are present.
Publisher: Massachusetts Medical Society
Date: 18-02-2016
Publisher: Elsevier BV
Date: 1994
Abstract: The linear theory used to extrapolate the cancer risk of radon exposure from high levels where direct data are available to low levels encountered in homes is tested by comparing lung cancer rates, m, and average radon levels, r, in numerous U.S. states and counties. It is shown that most problems normally associated with ecological studies do not apply here. The data show a very strong tendency for lung cancer rates, corrected for smoking prevalence (S), to decrease with increasing r, in sharp contrast to the opposite behavior predicted by the theory. It is shown that even a perfect negative r-S correlation cannot explain this discrepancy. Actual r-S correlations are only a few percent. Several other possible explanations for the discrepancy are explored, but none can reduce it by more than about 25%.
Publisher: Springer Science and Business Media LLC
Date: 26-06-2008
DOI: 10.1007/S10549-007-9631-7
Abstract: Mammographic density is a strong risk factor for breast cancer however the mechanism that underlies this association is unclear. We hypothesized that measures of energy balance early in life and in adulthood may be associated with mammographic density. We conducted a cross-sectional analysis of 1,398 women in the Nurses' Health Study to examine associations between physical activity, childhood and current body fatness, weight gain from age 18 years to present and mammographic density. Percent mammographic density was measured from digitized mammograms by a computer-assisted method. Demographic and lifestyle data were obtained from prospectively collected questionnaires. For all analyses, subjects were stratified into three groups: premenopausal women, postmenopausal women not currently taking hormones, and postmenopausal women currently taking hormones. Childhood body fatness was inversely associated with mammographic density. The correlations ranged from -0.15 to -0.19 in the three strata of women (P<or=0.001). The difference in mean percent mammographic density between the leanest and heaviest body types ranged from 6.2 to 9.9%. Similarly, adult body fatness was inversely associated with percent mammographic density. The correlations ranged from -0.41 to -0.48 in the three strata of women (P<0.0001). The difference in mean percent mammographic density between the leanest and heaviest body types ranged from 22.3 to 35.1%. Weight gain from age 18 was also inversely associated with mammographic density. There was no association between recent physical activity and mammographic density. These findings indicate that childhood and adult body fatness and weight change from age 18 are inversely associated with mammographic density.
Publisher: American Association for Cancer Research (AACR)
Date: 15-07-2016
DOI: 10.1158/1538-7445.AM2016-2576
Abstract: Objectives: To examine the relationship between radiation therapy delay and risk of subsequent breast events in the ipsilateral breast and to identify factors that are associated with delay in women with ductal carcinoma in situ (DCIS). Methods: From the Missouri Cancer Registry, we identified the women who were diagnosed with first primary DCIS between 1996 and 2011 and treated with breast conserving surgery (BCS). Radiation therapy delay was defined as the first radiation therapy that was delivered greater than eight weeks after BCS. Propensity scores were calculated for radiation therapy delay and no radiation therapy during the first course of treatment. A propensity score-adjusted Cox proportional hazards regression analysis was conducted to estimate the hazard ratio (HR) of ipsilateral breast tumors. Logistic regression analysis was conducted to identify factors associated with delay. Results: Among 5,916 patients, 1,053 (17.8%) received radiation therapy greater than eight weeks after BCS and 1,702 (28.8%) did not receive radiation therapy during the first course of treatment. During the 72- month follow-up, 182 (3.1%) developed ipsilateral breast tumors. After adjustment for propensity scores, the HR of ipsilateral breast tumors was 1.26 (95% CI, 1.00-1.59 p = 0.049) for radiation therapy delay and 1.35 (95% CI, 1.03-1.76 p = 0.03) for no radiation therapy compared with timely radiation therapy. Radiation therapy delay was associated with black race, being non-married and on Medicaid, later years of diagnosis, larger tumor size micropapillary architecture, and positive surgical margin. Conclusions: Receipt of radiation therapy greater than eight weeks after BCS was associated with a significantly increased risk of ipsilateral breast tumors in women with DCIS. Timeliness of radiation therapy should be improved, particularly for black and Medicaid patients. Citation Format: Ying Liu, Shumei Yun, Min Lian, Graham Colditz. Radiation therapy delay and risk of ipsilateral breast tumors in women with ductal carcinoma in situ. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research 2016 Apr 16-20 New Orleans, LA. Philadelphia (PA): AACR Cancer Res 2016 (14 Suppl):Abstract nr 2576.
Publisher: Springer Science and Business Media LLC
Date: 22-03-2016
DOI: 10.1245/S10434-016-5121-7
Abstract: Postoperative complications (POCs) can negatively impact survival after oncologic resection. POCs may also decrease the rate of adjuvant therapy completion. We evaluated the impact of complications on gastric cancer survival and analyzed the combined effect of complications and adjuvant therapy on survival. We analyzed 824 patients from 7 institutions of the U.S. Gastric Cancer Collaborative who underwent curative resection for gastric adenocarcinoma between 2000 and 2012. POC were graded using the modified Clavien-Dindo system. Survival probabilities were estimated using the method of Kaplan and Meier and analyzed using multivariate Cox regression. Median follow-up was 35 months. The overall complication rate was 41 %. The 5-year overall survival (OS) and recurrence-free survival (RFS) of patients who experienced complications were 27 and 23 %, respectively, compared with 43 and 40 % in patients who did not have complications (p < 0.0001 for OS and RFS). On multivariate analysis, POC remained an independent predictor for decreased OS and RFS (HR 1.3, 95 % CI 1.1-1.6, p = 0.03 for OS HR 1.3, 95 % CI 1.01-1.6, p = 0.03 for RFS). Patients who experienced POC were less likely to receive adjuvant therapy (OR 0.5, 95 % CI 0.3-0.7, p < 0.001). The interaction of complications and failure to receive adjuvant therapy significantly increased the hazard of death compared with patients who had neither complications nor adjuvant therapy (HR 2.3, 95 % CI 1.6-3.2, p < 0.001). Postoperative complications adversely affect long-term outcomes after gastrectomy for gastric cancer. Not receiving adjuvant therapy in the face of POC portends an especially poor prognosis following gastrectomy for gastric cancer.
Publisher: American Medical Association (AMA)
Date: 11-08-1993
Publisher: Wiley
Date: 11-08-2014
DOI: 10.1111/BJU.12778
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 1985
DOI: 10.1093/AJCN/41.1.32
Abstract: In a prospective cohort study of 1271 Massachusetts residents 66 years of age or older, we examined the association between consumption of carotene-containing vegetables and subsequent five year mortality. Dietary information was obtained by food frequency questionnaire in 1976. The relative risk of cancer mortality was examined within quintiles of green and yellow vegetable score (calculated from intake of carrots or squash, tomatoes, salads or leafy vegetables, dried fruits, fresh strawberries or fresh melon, and broccoli or brussel sprouts). After controlling for age and smoking behavior, those in the highest quintile of intake of these carotene-containing vegetables had a risk of cancer mortality which was 0.3 (95% confidence limits 0.10-0.96) that of those in the lowest quintile. The trend of decreased cancer risk with increasing intake of carotene containing vegetables was significant (p = .026). This relationship is consistent with the hypothesis that carotene may act as an inhibitor of carcinogenesis.
Publisher: American Association for Cancer Research (AACR)
Date: 15-02-2016
DOI: 10.1158/1538-7445.SABCS15-P4-09-11
Abstract: Background: Women with DCIS have increased risk for invasive breast cancer. Limited abilities to accurately identify aggressive DCIS have resulted in inappropriate treatment for many women with mammographically-detected DCIS. miRNAs play a critical role in tumorigenesis. It remains unknown if miRNAs are associated with recurrence and refine risk assessment for DCIS patients. Methods: The study included 16 DCIS cases that developed ipsilateral recurrence (cases) and 32 DCIS cases that did not develop any type of recurrence (controls). Cases and controls were treated with breast conserving surgery and matched on age, race, and year of diagnosis. Expression of 96 cancer-related miRNAs was quantified using RT-PCR. Results: Two miRNAs were differentially expressed between cases and controls (p& .05). A combination of the two miRNA markers was significantly associated with recurrence risk (odd ratio=2.60 per 1-unit increase, 95% confidence interval=1.14-8.13), which was independent of family history of breast cancer, radiation and endocrine therapy. The miRNA-based score (c-statistic=0.73) performed better than in idual miRNAs (c-statistic=0.64-0.69) in discriminating DCIS cases who did and did not develop recurrence. Conclusion: miRNA expression in DCIS was associated with recurrence risk, which warrants further investigations to identify new miRNA markers by including more DCIS cases and analyzing all breast cancer-related miRNAs. Citation Format: Liu Y, Baker C, Wang X, Colditz G. microRNA markers and risk of recurrence in women with ductal carcinoma in situ. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12 San Antonio, TX. Philadelphia (PA): AACR Cancer Res 2016 (4 Suppl):Abstract nr P4-09-11.
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 17-04-2014
DOI: 10.5888/PCD11.130150
Publisher: American Association for Cancer Research (AACR)
Date: 08-2005
DOI: 10.1158/1055-9965.EPI-04-0722
Abstract: Several lines of evidence suggest that vitamin D may reduce incidence of breast cancer, but few epidemiologic studies have addressed the relation of plasma vitamin D metabolites to the risk of this disease. We prospectively examined the relationship between plasma levels of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] and risk of breast cancer in a case-control study nested within the Nurses' Health Study cohort. Blood s les were collected from study participants in 1989-1990. Breast cancer cases developing between blood collection and June 1, 1996, were matched to cancer-free controls on the basis of age, menopausal status, and other factors. Stored plasma s les from 701 cases and 724 controls were available for metabolite analysis. Cases had a lower mean 25(OH)D level than controls (P = 0.01), but mean 1,25(OH)2D levels were similar (P = 0.49). High levels of both metabolites were associated with a nonsignificant lower risk of breast cancer. Women in the highest quintile of 25(OH)D had a relative risk of 0.73 (95% confidence interval = 0.49-1.07 Ptrend = 0.06) compared with those in the lowest quintile. For 1,25(OH)2D, the comparable relative risk was 0.76 (95% confidence interval = 0.52-1.11 Ptrend = 0.39). For both metabolites, the association was stronger in women ages 60 years and older, but results were not statistically significant. Our findings suggest that high levels of 25(OH)D, and perhaps 1,25(OH)2D, may be modestly associated with reduced risk of breast cancer.
Publisher: American Association for Cancer Research (AACR)
Date: 03-2004
DOI: 10.1158/1055-9965.398.13.3
Abstract: Objective: To investigate the association between smoking and invasive breast cancers characterized by their estrogen receptor status in a large prospective study of mainly premenopausal women. Method: 112,844 women aged 25–42 years in 1989 were followed 10 years questionnaire information on medical illnesses and risk factors was collected biennially and information on diet was collected in 1991 and 1995. During this period of follow-up (1,077,536 person-years), 1009 incident breast cancer cases were documented. Results: In the multivariate-adjusted models, smoking status was not significantly related to overall breast cancer risk: compared with never smokers, the relative risks (RRs) were 1.18 [95% confidence interval (CI) 1.02–1.36] for past smokers and 1.12 (95% CI 0.92–1.37) for current smokers. Increasing duration of smoking before the first pregnancy was associated with a greater risk of breast cancer, although little increase was seen in the highest category: compared with never smokers, RRs were 1.42 (95% CI 1.10–1.83) for 15–19 years of smoking and 1.10 (95% CI 0.80–1.52) for ≥20 years of smoking (P for trend = 0.01). Smoking was related most strongly to the risk of estrogen receptor-positive breast cancers. For women who had smoked for ≥20 years, the RR of estrogen receptor-positive cancer was 1.37 (95% CI 1.07–1.74) and the RR of estrogen receptor-negative cancer was 1.04 (95% CI 0.71–1.53). For smoking before age 15, the RRs were 1.49 (95% CI 1.03–2.17) for estrogen receptor-positive cancer and 1.19 (95% CI 0.69–2.08) for estrogen receptor-negative cancer. Conclusion: Our results suggest that longer duration of smoking may be related to the risk of estrogen receptor-positive breast cancer but possibly less so for estrogen receptor-negative breast cancer.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.CLML.2019.04.014
Abstract: The incidence of multiple myeloma is increasing as the proportion of older adults is growing rapidly. A critical evaluation of the evidence available is needed to guide the management of older patients with myeloma. A systematic review was conducted to report the prognostic value of geriatric assessment and frailty scores in older patients with multiple myeloma. We conducted a literature search in February and August 2018. Two researchers extracted the data and assessed the quality of the studies. Geriatric assessment and frailty scores were defined as those evaluating at least 2 geriatric domains. Main outcomes were mortality or toxicity. We estimated the pooled hazard ratios (HR) with 95% confidence intervals (CIs) using a random-effects model. We screened titles and abstracts of 1672 citations for eligibility. Seven studies were included in the qualitative analysis, of which 3 were included in the meta-analysis. Two studies reported similar risks of hematologic adverse events in intermediate-fit and in frail patients compared to frail, but a significantly increased risk of nonhematologic adverse events in frail patients compared to fit patients. In meta-analysis, a significantly increased HR for death was observed in patients with activity of daily living score ≤ 4 (pooled HR = 1.576 95% CI, 1.051-2.102 χ
Publisher: BMJ
Date: 16-08-1997
Abstract: To examine the association between birth weight and non-fatal adult cardiovascular disease while controlling for potential confounders such as socioeconomic group and adult lifestyle. Retrospective self report of birth weight in an ongoing longitudinal cohort of nurses followed up by postal questionnaire every two years. Nurses' health study, a cohort of 121700 women followed up since 1976. Non-fatal cardiovascular disease, including myocardial infarction, coronary revascularisation, and stroke. Among the 70297 women free of cardiovascular disease at baseline who reported birth weight in the 1992 questionnaire there were 1309 first cases of non-fatal cardiovascular disease. Increasing birth weight was associated with decreasing risk of non-fatal cardiovascular disease. There were 1216 first cases of non-fatal cardiovascular disease among women who were singletons and had been born full term their relative risks adjusted for several cardiovascular risk factors were 1.49 (95% confidence interval 1.05 to 2.10) for birth weight < 2268 g ( 2495-3175 g (> 5 lb 8 oz to 7 lb 0 oz) 1.00 (referent) for birth weight > 3175-3856 g (> 7 lb 0 oz to 8 lb 8 oz) 0.96 (0.80 to 1.15) for birth weight > 3856-4536 g (> 8 lb 8 oz to 10 lb 0 oz) and 0.68 (0.46 to 1.00) for birth weight > 4536 g (> 10 lb 0 oz) (P value for trend = 0.0004). The inverse trend was apparent for both coronary heart disease and stroke. These data provide strong evidence of an association between birth weight and adult coronary heart disease and stroke.
Publisher: Springer Science and Business Media LLC
Date: 11-2002
Publisher: Elsevier
Date: 2008
Publisher: American Academy of Pediatrics (AAP)
Date: 07-2000
Abstract: Tuberculosis (TB) control programs have been less successful among children than among adults in the United States. Between 1992 and 1997, the rate of decline of TB cases among 0- to 14-year-old children was less than the rate of decline among any other age group of US-born persons. Because of the higher prevalence of active TB among adults and their higher infectivity, most programs for TB in the United States have targeted adults. The inherent assumption has been that by targeting adults, from whom children may become infected, TB morbidity and mortality among children also will be reduced effectively. Using a semi-Markov model that ided the US population into age groups & years old and ≥15 years old and into 18 clinical states based on the risk for or presence of TB and human immunodeficiency virus infection, we developed a computer-based simulation model to examine the effect of a range of potential TB control strategies on projected TB cases and deaths in children. We compare the impact of interventions targeted at children with the impact of interventions targeted at adults on pediatric morbidity and mortality. After 10 years, a 5% increase in the number of adults with TB who enter treatment would only lead to a .05% decline in TB cases among children, compared with predicted cases without this intervention. Improving treatment efficacy among those adults who are already receiving treatment for their TB leads to a smaller decline in cases among children of only .003%. In contrast, a 5% increase in the number of children who enter treatment leads to a 25% decline, after 10 years, in the number of TB cases among children and a 16% decline in the number of TB deaths. In the presence of immigration of tuberculin-positive children, the benefit of targeting programs directly at children is magnified. Marginal changes in programs targeted directly at children are significantly more effective at further reducing pediatric TB morbidity and mortality than the same changes in programs targeted at adults with the indirect goal of reducing spread to children. Marginal increases in the number of children who enter treatment are far more effective at decreasing morbidity and mortality than equivalent marginal increases in treatment effectiveness. Unfortunately, declining insurance coverage and increasing restrictions on services to immigrants have made it harder for those who are at greatest risk of TB to get medical care. Marginal increases in preventive therapy rates substantially reduce future pediatric TB cases and deaths among children with TB infection and human immunodeficiency virus.
Publisher: Oxford University Press (OUP)
Date: 15-02-2000
DOI: 10.1093/OXFORDJOURNALS.AJE.A010220
Abstract: With the use of data from the Nurses' Health Study, the authors confirm the recent argument by Pike et al. (Am J Epidemiol 1998 :718-21) that various ways of assigning ages at menopause to women with simple hysterectomy produce relative risks for the effect of hormone replacement therapy (HRT) that are biased downward. Different methods of including women with simple hysterectomy consistently produced relative risks for the association between a 1-year increase in duration of HRT use and breast cancer that were underestimates compared with the relative risk obtained when these women were excluded from analysis. The authors used longitudinal data on recalled age at menopause to demonstrate another source of error related to age at menopause: error in recall of age at menopause that increases with time since menopause.
Publisher: Elsevier BV
Date: 10-2020
Publisher: American Association for Cancer Research (AACR)
Date: 02-2017
DOI: 10.1158/1538-7755.DISP16-C51
Abstract: Purpose: We designed an intervention combining the Zuum health risk assessment tool, healthcare provider, and text messaging (SMS) to deliver critical health messages to erse populations. Zuum is a mobile version of the evidence-based and scientifically-validated Your Disease Risk suite of health risk assessment tools. Our aim was to assess feasibility and acceptance of integrating the intervention into the primary care setting of Federally-Qualified Health Centers (FQHC). Background: Chronic diseases caused largely by modifiable risk factors are the leading causes of death in the United States. Rates of these diseases and their risk factors are higher among many minorities and the poor. As most adults from all backgrounds have a primary care source, this can be an effective intervention setting. However, provider time remains a major barrier to prevention counseling. Health risk assessment tools can help facilitate counseling, as they have demonstrated improvements in patient risk knowledge and accuracy, integration into primary care and promotion of patient-provider risk discussions. Yet, its influence on health behavior and intentions is not well supported. Supplementing these with interventions shown to directly influence behavior change might improve their efficacy. SMS has shown promising ability to improve health behavior and intentions and may enhance the impact of the risk assessment tool. Procedures: The intervention was conducted in urban FQHCs in St. Louis, Missouri. Eligible patients were adults in the waiting room for a scheduled primary care visit. Participants completed the mobile Zuum assessment and received a summary of their risks for 6 chronic diseases with recommendations to lower those risks. Their physician was given an abridged version to help guide preventative counseling during their appointment. For three months, participants received weekly text messages on lifestyle modification tailored to their risk results and behaviors. Results: We enrolled 107 patients, 85% African-American and ages 20 to 70. Most were high risk for at least one chronic disease (82%), and nearly half for two or more (47%). Most patients screened were interested in participating (69%) and had compatible phones (89%). The majority (95%) had time to complete the Zuum assessment before their appointment. We delivered 5,750 (89%) of generated messages, averaging 4-5 messages weekly. Most participants strongly agreed that answering Zuum questions was easy (95%), the texts were clear (90%) and texting is good method to improve health (84%). Most would recommend health text messages (90%) and the Zuum assessment (73%) to friends and family. The patient level of agreement with the Zuum risk labels was high across all diseases (80-92%). Conclusions: The Zuum intervention integrated well into the FQHC clinic setting and was highly accepted by the FQHC patients. This study advances the knowledge base on the feasibility of harnessing the power of mobile health to deliver effective, efficient, and personalized prevention messages to erse and underserved patient populations. Findings suggest that the Zuum app, and other interventions like it, are tools that may help meet that need in settings where time and resources are limited. Citation Format: Graham Colditz, Sonya Izadi, Hank Dart, Erika Waters, Aimee James. Integrating a Health Risk Assessment Mobile App into Diverse Primary Care Settings - a Pilot Project. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved 2016 Sep 25-28 Fort Lauderdale, FL. Philadelphia (PA): AACR Cancer Epidemiol Biomarkers Prev 2017 (2 Suppl):Abstract nr C51.
Publisher: Springer Science and Business Media LLC
Date: 28-04-2020
DOI: 10.1186/S40814-020-00599-W
Abstract: There is a need for workplace programs promoting healthy eating and activity that reach low-wage employees and are scalable beyond the study site. Interventions designed with dissemination in mind aim to utilize minimal resources and to fit within existing systems. Technology-based interventions have the potential to promote healthy behaviors and to be sustainable as well as scalable. We developed an interactive obesity treatment approach (iOTA), to be delivered by SMS text messaging, and therefore accessible to a broad population. The aim of this pilot study was to evaluate participant engagement with, and acceptability of, this iOTA to promote healthy eating and activity behaviors among low-wage workers with obesity. Twenty participants (self-reporting body mass index ≥ 30 kg/m 2 ) of a single workgroup employed by a university medical practice billing office had access to the full intervention and study measures and provided feedback on the experience. Height and weight were measured by trained research staff at baseline. Each participant was offered a quarterly session with a health coach. Measured weight and a self-administered survey, including dietary and activity behaviors, were also collected at baseline, 3, 6, 12, 18, and 24 months. Participant engagement was assessed through responsiveness to iOTA SMS text messages throughout the 24-month pilot. A survey measure was used to assess satisfaction with iOTA at 3 months. Due to the small s le size and pilot nature of the current study, we conducted descriptive analyses. Engagement, weight change, and duration remaining in coaching are presented in idually for each study participant. The pilot was originally intended to last 3 months, but nearly all participants requested to continue we thus continued for 24 months. Most (14/20) participants remained in coaching for 24 months. At the 3-month follow-up, eight (47%) of the remaining 17 participants had lost weight by 24 months, five (36%) of the remaining 14 participants had lost weight (one had bariatric surgery). Participants reported very high satisfaction. This pilot provides important preliminary results on acceptability and participant engagement with iOTA, which has significant potential for dissemination and sustainability.
Publisher: Informa UK Limited
Date: 03-2006
DOI: 10.1080/10810730500526695
Abstract: To make treatment decisions, patients should consider not only a treatment option's potential consequences but also the probability of those consequences. Many laypeople, however, have difficulty using probability information. This Internet-based study (2,601 participants) examined a hypothetical medical tradeoff situation in which a treatment would decrease one risk but increase another. Accuracy was assessed in terms of the ability to determine correctly whether the treatment would increase or decrease the total risk. For these tradeoff problems, accuracy was greater when the following occurred: (1) the amount of cognitive effort required to evaluate the tradeoff was reduced (2) probability information was presented as a graphical display rather than as text only and (3) information was presented as percentages rather than as frequencies (n in 100). These findings provide suggestions of ways to present risk probabilities that may help patients understand their treatment options.
Publisher: Oxford University Press (OUP)
Date: 15-04-1994
DOI: 10.1093/OXFORDJOURNALS.AJE.A117079
Abstract: A modification of the model of Pike et al. (Nature 1983 : 767-70) was applied to 91,523 women in the Nurses' Health Study who did not report prevalent cancer initially and who were followed for 14 years (1,212,855 person-years and 2,341 incident breast cancers). The model took into account current age, age at all births, age at menopause, and age at menarche in predicting the annual and cumulative incidence of breast cancer. The authors found that ages both at first birth and at subsequent births have long-term influence on breast cancer incidence. The incidence density for parous women was greater than for nulliparous women for 20-30 years after the time of the first birth. However, cumulative incidence up to age 70 years was about 20% lower, 10% lower, or 5% higher for parous versus nulliparous women if their first birth was at age 20, 25, or 35 years, respectively. The authors also observed a significantly lower incidence after each additional birth as well as after menopause for women of the same age. Overall, the effect of reproductive factors (other than age at menarche) appears to influence cumulative incidence to age 70 years by a maximum of approximately 50% when women with multiple births with an early age at first birth are compared with women with a single birth at a late age.
Publisher: Oxford University Press (OUP)
Date: 20-06-2001
Abstract: It has been hypothesized that physical activity may reduce the risk of ovarian cancer by decreasing estrogen levels, reducing body fat, and reducing the frequency of ovulation. Epidemiologic studies of this relationship have obtained inconsistent results. The only prospective study to date reported a positive association between frequent vigorous exercise and ovarian cancer risk. We further evaluated this relationship in the Nurses' Health Study cohort. Participation in recreational physical activity was assessed by questionnaire in 1980, 1982, 1986, 1988, 1992, and 1994, with questions assessing exercise frequency, duration, and intensity. Results were adjusted for age, parity, oral contraceptive use, tubal ligation, and other risk factors for ovarian cancer. All statistical tests were two-sided. During a 16-year follow-up (from 1980 to 1996), 1.2 million person-years were accrued by 92 825 cohort members, and 377 cases of epithelial ovarian cancer were confirmed. The relative risk (RR) of ovarian cancer for women engaging in recreational physical activity for 7 hours or more per week compared with those reporting less than 1 hour per week was 0.80 (95% confidence interval [CI] = 0.49 to 1.32 P(trend) =.59). When both the frequency and intensity of activity were taken into account, activity level was also not associated with a reduced risk of ovarian cancer. Compared with inactive women, participants reporting high activity in terms of metabolic equivalent task hours (MET hours) were at greater risk of ovarian cancer (RR for 20 to 30 MET hours/week = 1.27 [95% CI = 0.75 to 2.14]). Overall, results did not suggest an inverse association between recreational physical activity and ovarian cancer. The possibility of a modest increase in risk with frequent vigorous activity requires further investigation.
Publisher: American Psychiatric Association Publishing
Date: 12-2004
DOI: 10.1176/APPI.AJP.161.12.2295
Abstract: Physicians' suicide rates have repeatedly been reported to be higher than those of the general population or other academics, but uncertainty remains. In this study, physicians' suicide rate ratios were estimated with a meta-analysis and systematic quality assessment of recent studies. Studies of physicians' suicide rates were located in MEDLINE, PsycINFO, AARP Ageline, and the EBM Reviews: Cochrane Database of Systematic Reviews with the terms "physicians," "doctors," "suicide," and "mortality." Studies were included if they were published in or after 1960 and gave estimates of age-standardized suicide rates of physicians and their reference population or reported extractable data on physicians' suicide 25 studies met the criteria. Reviewers extracted data and scored each study for quality. The studies were tested for heterogeneity and publication bias and were stratified by publication year, follow-up, and study quality. Effect sizes were pooled by using fixed-effects (women) and random-effects (men) models. The aggregate suicide rate ratio for male physicians, compared to the general population, was 1.41, with a 95% confidence interval (CI) of 1.21-1.65. For female physicians the ratio was 2.27 (95% CI=1.90-2.73). Visual inspection of funnel plots from tests of publication bias revealed randomness for men but some indication of bias for women, with a relative, nonsignificant lack of studies in the lower right quadrant. Studies on physicians' suicide collectively show modestly (men) to highly (women) elevated suicide rate ratios. Larger studies should help clarify whether female physicians' suicide rate is truly elevated or can be explained by publication bias.
Publisher: American Association for Cancer Research (AACR)
Date: 07-2005
DOI: 10.1158/1055-9965.EPI-05-0120
Abstract: Objective: Although pancreatic cancer has an extremely high case fatality rate, little is known about differences in mortality by histologic types. We examined median survival and risk of mortality for endocrine pancreatic tumors and two types of exocrine tumors, adenocarcinomas, and mucinous tumors. Method: This analysis included 35,276 pancreatic cancer cases reported to the nine population-based cancer registries participating in the Surveillance, Epidemiology, and End Results program from 1973 to 2000. Survival among cases with pancreatic adenocarcinomas, mucinous tumors, and endocrine tumors were compared using Kaplan-Meier plots. Comparative risks of mortality were evaluated using multivariate adjusted Cox regression models. Results: Endocrine pancreatic cancer cases had a median survival of 27 months compared with a median survival of 4 months for adenocarcinoma and mucinous tumor cases. Compared with adenocarcinoma cases, endocrine tumor cases had a 0.28-fold lower risk of mortality [95% confidence interval (95% CI), 0.26-0.30], and mucinous tumor cases had a 0.88-fold lower risk (95% CI, 0.84-0.91). These results were similar for men and women. Within histologic types, advanced tumor stage, older diagnosis age, surgery, and Black race were associated with increased risks of mortality, whereas female sex and more recent year of diagnosis were associated with decreased risks. Conclusion: This study confirms the clinical observation that patients with endocrine pancreatic cancer survive longer than patients with exocrine tumors. A better understanding of these differences could contribute to identifying the underlying causes of pancreatic cancer and to improving survival rates across all histologic types.
Publisher: Springer Science and Business Media LLC
Date: 17-01-2018
Publisher: American Society of Hematology
Date: 18-11-2011
DOI: 10.1182/BLOOD.V118.21.3142.3142
Abstract: Abstract 3142 Advancing age is associated with poorer prognosis in patients with multiple myeloma (MM). Comorbidities increase in prevalence with age, but the impact of comorbidities on survival in patients with MM is not known. The purpose of this study was to examine the impact of comorbidities on survival in multiple myeloma. Methods: All patients (pts) with MM diagnosed and treated at Washington University School of Medicine in St. Louis, Missouri from 1999–2010 were identified from the Barnes-Jewish Hospital Oncology Data Services Database. The institution's cancer registrars retrospectively collect clinical, demographic and survival data in accordance with the American College of Surgeons Commission on Cancer guidelines. Comorbidities are graded as None, Mild, Moderate or Severe using the ACE-27 comorbidity index [Piccirillo et al. J Reg Mgmt 1999]. Patients without data on comorbidities were excluded from the study. The primary endpoint was overall survival (OS), calculated from the date of diagnosis and censored at the time of last follow-up. OS was estimated using the Kaplan-Meier method, and compared between comorbidity groups using the Log-Rank test. The independent effects of age and comorbidities were evaluated using Cox Proportional Hazards Modeling. Results: 569 patients were identified in the database. Median age of patients was 59 years (range 33–91 years) 54.8% were male, 45.2% were female 74.9% were white, 23.2% were black, and 1.9% were other races/ethnicities. Based on the ACE-27 comorbidity index, 181 pts (31.8%) had no comorbid medical conditions, 226 (39.7%) had mild comorbidities, 115 (20.2%) had moderate comorbidities, 47 (8.3%) had severe comorbidities. In the entire cohort, the median OS was 49.2 months [95% confidence intervals (CI) 42.9 – 55.6 months]. Survival by comorbidity category and age group are shown in table 1. The differences in survival between comorbidity groups in each age group and the entire cohort were statistically significant (log-rank p .001). Severe comorbidities were associated with a significantly increased risk of death after controlling for age (HR 1.97, P=0.002). Conclusion: The presence and severity of comorbidities confer a poorer prognosis in patients with MM. Further study is needed to determine to what extent comorbidities directly impact survival versus impacting therapeutic decision-making and tolerance of therapy. Vij: Celgene: Honoraria, Research Funding, Speakers Bureau Bristol-Myers Squibb: Honoraria, Speakers Bureau.
Publisher: American Medical Association (AMA)
Date: 09-04-2012
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22533794
Abstract: Flow chart of participant inclusion and exclusion criteria and the number of women in the Nurses' Health Study (NHS) and men in the Health Professional Follow-up Study (HPFS).
Publisher: Oxford University Press (OUP)
Date: 09-2009
DOI: 10.1093/AJE/KWP210
Publisher: American Medical Association (AMA)
Date: 08-2020
Publisher: Elsevier BV
Date: 09-2018
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22533791
Abstract: Baseline age and age-standardized characteristics of cohort participants who developed colon cancer (cases) and those who remained free from cancer (noncases) among women in the Nurses' Health Study and men in the Health Professionals Follow-up Study in 1986
Publisher: American Association for Cancer Research (AACR)
Date: 31-03-2015
DOI: 10.1158/1055-9965.EPI-14-0909-T
Abstract: Background: The association between body fatness before adulthood and later risk of colorectal cancer remains unclear. We hypothesized that, independent of adult body fatness, early life body fatness would be associated with a higher risk of developing colorectal cancer. Methods: We assessed body fatness during childhood and adolescence using a validated 9-level somatotype and inquired body weight in young adulthood in the Nurses' Health Study and Health Professionals Follow-up Study. We used the Cox proportional hazard regression modeling to estimate relative risks [RR, 95% confidence intervals (CI)] adjusting for adult body mass index (BMI) and other known colorectal cancer risk factors. Results: We identified 2,100 incident colorectal cancer cases (1,292 in women and 808 in men) during 22 years of follow-up. Among women, the RR (95% CI) for childhood body fatness of level 5 or higher versus level 1 was 1.28 (1.04–1.58 Ptrend = 0.08) and for adolescent body fatness, it was 1.27 (1.01–1.60 Ptrend = 0.23). The corresponding RRs for men were 1.04 (0.82–1.31 Ptrend = 0.48) and 0.98 (0.75–1.27 Ptrend = 0.20), respectively. Results were generally similar across anatomic subsites within the colorectum. In addition, the RRs comparing BMI categories ≥27.5 to & kg/m2 were 1.44 (1.06–1.95, at age 18 Ptrend = 0.009) for women and 1.18 (0.84–1.65, at age 21 Ptrend = 0.57) for men. Conclusion: Increased body fatness in early life, independent of adult obesity, might be a risk factor for colorectal cancer in women, but we observed a weaker association in men. Impact: Our findings support the growing evidence that early life body fatness affects the risk of colorectal cancer many decades later. Cancer Epidemiol Biomarkers Prev 24(4) 690–7. ©2015 AACR.
Publisher: American Association for Cancer Research (AACR)
Date: 11-2018
DOI: 10.1158/1055-9965.EPI-17-0430
Abstract: Background: Cancer incidence and mortality rates in the United States are declining, but this decrease may not be observed in rural areas where residents are more likely to live in poverty, smoke, and forego cancer screening. However, there is limited research exploring national rural–urban differences in cancer incidence and trends. Methods: We analyzed data from the North American Association of Central Cancer Registries' public use dataset, which includes population-based cancer incidence data from 46 states. We calculated age-adjusted incidence rates, rate ratios, and annual percentage change (APC) for: all cancers combined, selected in idual cancers, and cancers associated with tobacco use and human papillomavirus (HPV). Rural–urban comparisons were made by demographic, geographic, and socioeconomic characteristics for 2009 to 2013. Trends were analyzed for 1995 to 2013. Results: Combined cancers incidence rates were generally higher in urban populations, except for the South, although the urban decline in incidence rate was greater than in rural populations (10.2% vs. 4.8%, respectively). Rural cancer disparities included higher rates of tobacco-associated, HPV-associated, lung and bronchus, cervical, and colorectal cancers across most population groups. Furthermore, HPV-associated cancer incidence rates increased in rural areas (APC = 0.724, P & 0.05), while temporal trends remained stable in urban areas. Conclusions: Cancer rates associated with modifiable risks—tobacco, HPV, and some preventive screening modalities (e.g., colorectal and cervical cancers)—were higher in rural compared with urban populations. Impact: Population-based, clinical, and/or policy strategies and interventions that address these modifiable risk factors could help reduce cancer disparities experienced in rural populations. Cancer Epidemiol Biomarkers Prev 27(11) 1265–74. ©2017 AACR.
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22533788
Abstract: Relative risks of colon cancer associated with risk factors modeled as simplified categorical variables and as continuous variables among women in the Nurses' Health Study and men in the Health Professionals Follow-up Study, 1986-2010
Publisher: Elsevier BV
Date: 11-2015
Publisher: American Medical Association (AMA)
Date: 26-08-1992
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Publisher: American Society of Hematology
Date: 06-12-2014
DOI: 10.1182/BLOOD.V124.21.2061.2061
Abstract: Introduction: Multiple Myeloma (MM) is a hematologic malignancy that is universally preceded by Monoclonal Gammopathy of Undetermined Significance (MGUS). Obesity is the only known modifiable risk factor for the development of MM, though it is unclear if this is due to increased MGUS incidence or transition of MGUS to MM. In an effort to better understand how obesity may influence the progression of MGUS to MM, we analyzed patient data from the U.S. Veterans Health Administration (VHA). Methods: The VHA database was used to identify patients diagnosed with MGUS between October 1, 1999 and December 31, 2009 using ICD-9 code 273.1. Data was obtained on patient demographics, myeloma direct treatments, weight, height, and other clinical characteristics. Transition to MM was identified using two occurrences of ICD-9 code 203.0 or use of myeloma directed therapy within six months of a single use of ICD-9 code 203.0. Additionally, two investigators reviewed patient records to confirm the diagnosis and verify the diagnosis date. The World Health Organization (WHO) Body Mass Index (BMI) classification (normal-weight: 18.5≤BMI , overweight: 25≤BMI , and obese: BMI ) was utilized to categorize BMI. Weight recorded closest to the MGUS diagnosis date was used for BMI calculations. Multivariate survival analysis (controlling for sex, race, BMI, marital status, estimated household income level, modified Charlson co-morbidity score, and creatinine level) was conducted by parametric accelerated failure time left-censored analysis with Weibull-modeled survival time. Results: There were 9,430 unique MGUS patients identified in the VHA database. Progression to MM was noted in 501 (5.3%) patients overall, with a frequency of 98/2139 (4.6%), 236/3932 (6.0%), and 167/3359 (5.0%) of the normal weight, overweight and obese BMI groups, respectively. Survival analysis revealed a statistically significant difference in progression from MGUS to MM in overweight and obese patients compared to normal-weight patients. After controlling for other variables, multivariate analysis demonstrated that obese (HR: 1.53 95% CI 1.19-1.98) and overweight (HR: 1.45 95% CI 1.14-1.84) patients were at increased risk of progression from MGUS to MM. Black patients (HR: 1.78 95% CI 1.46-2.17) were also at increased risk of progression to MM. Conclusions: Patients with Monoclonal Gammopathy of Unknown Significance who are overweight or obese at the time of MGUS diagnosis are at increased risk of progression to Multiple Myeloma compared to normal weight counterparts. Also the data is suggestive that an obese BMI is associated with a higher risk of progression to MM compared to being overweight. Elevated BMI is a modifiable risk factor for progression of MGUS to MM and weight loss is a potential strategy to decrease the risk of progression. Carson: Celgene: Consultancy, Honoraria, Research Funding, Speakers Bureau Millennium: Consultancy, Research Funding.
Publisher: Elsevier BV
Date: 03-1996
DOI: 10.14219/JADA.ARCHIVE.1996.0208
Abstract: Nearly 32 percent of U.S. women aged 65 to 69 years have no teeth. Because some tooth loss may reflect systemic osteoporosis, and because estrogen therapy seems to protect against osteoporosis, the authors examined the risk of tooth loss in relation to hormone use in a prospective study of 42,171 post-menopausal women. The risk of tooth loss was lower in women who currently used hormones. Although few studies have examined this issue, this research suggests that estrogen may reduce tooth loss.
Publisher: Elsevier BV
Date: 2007
DOI: 10.1016/J.ANNEPIDEM.2006.07.014
Abstract: Longitudinal epidemiologic studies often relate adiposity changes to suspected causal factors. In growing adolescents, this becomes complicated. Many investigators use within-child change in body mass index (BMI) z scores (Delta z) from sex- and age-specific BMI charts developed by the Centers for Disease Control and Prevention (CDC). These charts, derived from cross-sectional data, may not represent BMI growth patterns of real children. Furthermore, because cross-sectional BMIs are not Gaussian, these z scores are from month-specific transformed distributions, with possible unintended consequences when used longitudinally. Alternatively, we can directly analyze BMI change (Delta BMI). We compare these two widely used measures of change in adiposity. With real adolescent data, we show that annual Delta BMIs have nonlinear peaks that are inconsistent with the CDC curves. We also show that a specified Delta z represents a broad range of adiposity changes for children measured at the same two ages. To see how this affects power, we performed simulation studies confirming that analyzing Delta BMIs in models with hypothesized factors is more powerful than analyzing Delta zs. In longitudinal studies of adolescent adiposity, investigators should be encouraged to analyze Delta BMI rather than Delta z because analyses using BMI are more powerful and findings presented in BMI units are more interpretable.
Publisher: Wiley
Date: 14-09-2021
DOI: 10.1111/BJHP.12558
Abstract: (1) Test whether a mental imagery‐based self‐regulation intervention increases physical activity behaviour over 90 days (2) Examine cognitive and affective precursors of change in physical activity behaviour. A randomized control trial with participants ( N = 500) randomized to one of six intervention conditions in a 3 (risk communication format: bulleted list, table, risk ladder) x 2 (mental imagery behaviour: physical activity, active control [sleep hygiene]) factorial design. After receiving personalized risk estimates via a website on a smartphone, participants listened to an audiorecording that guided them through a mental imagery activity related to improving physical activity (intervention group) or sleep hygiene behaviour (active control). Participants received text message reminders to complete the imagery for 3 weeks post‐intervention, 4 weekly text surveys to assess behaviour and its cognitive and affective precursors, and a mailed survey 90 days post‐baseline. Physical activity increased over 90 days by 19.5 more minutes per week (95%CI: 2.0, 37.1) in the physical activity than the active control condition. This effect was driven by participants in the risk ladder condition, who exercised 54.8 more minutes (95%CI 15.6, 94.0) in the physical activity condition than participants in the active control sleep hygiene group. Goal planning positively predicted physical activity behaviour (b = 12.2 minutes per week, p = 0.002), but self‐efficacy, image clarity, and affective attitudes towards behaviours did not ( p 0.05). Mental imagery‐based self‐regulation interventions can increase physical activity behaviour, particularly when supported by personalized disease risk information presented in an easy‐to‐understand format.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.NUT.2018.02.017
Abstract: Several randomized controlled trials (RCTs) have assessed the effects of nut consumption on inflammatory markers. However, the results have been inconsistent. The aim of this meta-analysis of RCTs was to quantitatively evaluate the effects of nut consumption on selected inflammatory markers. PubMed, Embase, Cochrane Library database, and Google Scholar were searched for published RCTs that reported the effects of nuts on inflammatory markers as primary or secondary outcomes in an adult population (aged ≥18 y). Summary estimates of weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated using random-effects meta-analysis. Twenty-three RCTs met the inclusion criteria. Overall, nut consumption significantly reduced the levels of intercellular adhesion molecule (ICAM)-1 (WMD, -0.17 95% CI, -0.32 to -0.03 P = 0.01), but had no significant effect on other inflammatory markers. In the subgroup analyses by nut types, mixed nuts had a significant effect on ICAM-1 reduction. The significant effect of nuts on ICAM-1 reduction was only observed in parallel, but not crossover RCTs. Additionally, nut consumption significantly reduced ICAM-1 and vascular cell adhesion molecule-1 levels in long-term (≥12 wk), but not short-term (<12 wk) RCTs. No significant heterogeneity or publication bias was observed in the studies included. Nut consumption significantly reduced ICAM-1 levels, but had no effect on other inflammatory markers. More studies are needed to assess the effects of nuts on inflammation.
Publisher: JSTOR
Date: 12-1999
DOI: 10.2307/3434564
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22533785
Abstract: Reclassification of predicted risk by two colon cancer risk prediction models among women in the Nurses' Health Study: the model with categorized predictor variables versus the model with continuous predictor variables (reference).
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2005
Publisher: Springer Science and Business Media LLC
Date: 06-2006
DOI: 10.1007/S10552-005-0453-9
Abstract: To examine the association between tanning bed use and weight concerns, health risk behaviors, and peer influence. The Growing Up Today Study (GUTS) is an ongoing prospective cohort study of adolescents established in 1996. In 1999, a total of 6,373 adolescent females ages 12-18 (offspring of participants in the Nurses Health Study 2) completed the survey. Almost nine percent (8.6%) of the adolescent girls had used a tanning bed 1-9 times and an additional 5.4% had used tanning beds at least 10 times in the past year (frequent users). Logistic regression models revealed that frequent tanning bed use was associated with being highly concerned about weight (OR = 1.5, 95%CI = 1.1, 2.0), frequently dieting to lose weight (OR = 1.5, 95%CI = 1.1, 2.0), using laxatives or vomiting to control weight (OR = 3.6 95%CI = 2.2-5.8), having friends who placed a lot of importance on being thin (OR = 2.6 95%CI = 1.3-5.1), smoking cigarettes (OR=1.7, 95%CI = 1.1, 2.6), binge drinking (OR = 2.1, 95%CI = 1.3, 3.1), using recreational drugs (OR = 3.0 95%CI = 2.4, 3.8), and trying to look like females in the media (sometimes retty much: OR = 1.3, 95%CI = 1.0, 1.8). Frequent tanning bed use among adolescent females is associated with a range of health risk behaviors. This effect may be mediated by peer influence and a desire to look like other females in the media. Multi-pronged approaches, particularly those that target attitudes of young females, are needed to combat increased use of tanning beds.
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22533782
Abstract: Reclassification of predicted risk by two colon cancer risk prediction models among men in the Health Professionals Followup Study: the model with categorized predictor variables versus the model with continuous predictor variables (reference).
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814308.V1
Abstract: Supplementary Table 1 shows the associations between SNPs and EAC risk
Publisher: Springer Science and Business Media LLC
Date: 1994
DOI: 10.2165/00019053-199400051-00007
Abstract: Obesity is associated with an increased risk of many major chronic diseases. We estimated the economic costs of obesity-associated non-insulin-dependent diabetes mellitus, cardiovascular disease, gallbladder disease, cancer, and musculoskeletal disorders in 1990 US dollars, using a prevalence-based approach to cost-of-illness. In addition to direct costs, indirect costs were also estimated. The indirect cost of morbidity was estimated by calculating the costs associated with work days lost, and mortality costs were estimated on the basis of lifetime earnings lost. In 1990, the direct cost of obesity-associated disease in the US was $US45.8 billion, and the indirect cost of obesity was estimated to be $US23.0 billion. Therefore the total economic cost of obesity was estimated to be $US68.8 billion in 1990.
Publisher: Springer Science and Business Media LLC
Date: 19-07-2019
Publisher: Springer Science and Business Media LLC
Date: 03-02-2013
Publisher: Elsevier BV
Date: 04-2004
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814299.V1
Abstract: Supplementary Table 4 shows the association between finer composite sleep score and EAC risk
Publisher: Elsevier BV
Date: 2022
Publisher: Oxford University Press (OUP)
Date: 06-09-1995
Abstract: Alcohol use, height, and postmenopausal adiposity have each been positively associated with postmenopausal breast cancer risk in most epidemiologic studies. The mechanism underlying these associations is unclear, although an effect of these factors on hormone levels has been hypothesized. Few previous studies have evaluated the relationship of either alcohol consumption or height with plasma hormone levels. A positive association between adiposity and plasma estrogen levels in postmenopausal women has been reported consistently. Using archived frozen plasma s les and corresponding data from participants in the Nurses' Health Study, we determined plasma hormone levels and assessed these levels in relation to alcohol consumption, height, and adiposity among postmenopausal women. Blood s les were collected from a subset of participants in the Nurses' Health Study in 1989 and 1990, then stored in liquid nitrogen. Hormone concentrations in 217 archived plasma s les (from healthy postmenopausal women) were analyzed in 1993. Spearman correlation coefficients were calculated to assess the linear association between alcohol consumption during the previous year (mean daily intake in grams per day ascertained from semiquantitative food-frequency questionnaires completed in 1990 or 1991), height, and adiposity (as measured by body mass index [BMI] in kg/m2, with weight reported at time of blood collection), and plasma hormone levels. Two-sided P values were also calculated. After controlling for age, height, smoking status, and BMI, alcohol consumption was positively associated with estrone sulfate concentrations (r = .17 P = .02) no statistically significant association was noted for the other plasma hormones measured. Mean plasma estrone sulfate levels were 159 pg/mL in women who reported no alcohol use versus 211 pg/mL in women consuming 30 g or more of alcohol per day. After adjusting for the other covariates, we observed a strong positive correlation between BMI and plasma estrogens (r ranging from .37 for estrone and estrone sulfate to .63 for bioavailable estradiol, with all P values < or = .01 prolactin was the only hormone unassociated with BMI, r = -.01). Height was unrelated to either plasma estrogens or prolactin. BMI and alcohol use were positively associated with postmenopausal plasma estrogen and estrone sulfate levels, respectively. The association of alcohol consumption and postmenopausal obesity with subsequent breast cancer risk might be mediated, at least in part, through an influence on postmenopausal plasma estrogen levels. Additional studies are needed to further quantify the relationship between alcohol consumption and plasma hormone levels and to elucidate the physiologic basis for this association.
Publisher: American Astronomical Society
Date: 05-01-2023
Abstract: Convergent disk migration has long been suspected to be responsible for forming planetary systems with a chain of mean-motion resonances (MMRs). Dynamical evolution over time could disrupt the delicate resonant configuration. We present TOI-1136, a 700 ± 150 Myr old G star hosting at least six transiting planets between ∼2 and 5 R ⊕ . The orbital period ratios deviate from exact commensurability by only 10 −4 , smaller than the ∼10 −2 deviations seen in typical Kepler near-resonant systems. A transit-timing analysis measured the masses of the planets (3–8 M ⊕ ) and demonstrated that the planets in TOI-1136 are in true resonances with librating resonant angles. Based on a Rossiter–McLaughlin measurement of planet d, the star’s rotation appears to be aligned with the planetary orbital planes. The well-aligned planetary system and the lack of a detected binary companion together suggest that TOI-1136's resonant chain formed in an isolated, quiescent disk with no stellar flyby, disk warp, or significant axial asymmetry. With period ratios near 3:2, 2:1, 3:2, 7:5, and 3:2, TOI-1136 is the first known resonant chain involving a second-order MMR (7:5) between two first-order MMRs. The formation of the delicate 7:5 resonance places strong constraints on the system’s migration history. Short-scale (starting from ∼0.1 au) Type-I migration with an inner disk edge is most consistent with the formation of TOI-1136. A low disk surface density (Σ 1 au ≲ 10 3 g cm −2 lower than the minimum-mass solar nebula) and the resultant slower migration rate likely facilitated the formation of the 7:5 second-order MMR.
Publisher: American Medical Association (AMA)
Date: 23-11-1998
DOI: 10.1001/ARCHINTE.158.21.2349
Abstract: Benign prostatic hyperplasia (BPH) leading to prostatic enlargement and lower urinary tract symptoms is highly prevalent among older men. Sympathetic nervous system activity, which is decreased by physical activity, is associated with increased prostatic smooth-muscle tone and prostatic symptoms. Therefore, we assessed whether physical activity leads to fewer lower urinary tract symptoms in the Health Professionals Follow-up Study. We observed men who were aged 40 to 75 years at baseline in 1986 for subsequent incidence of surgery for BPH. The men were free of diagnosed cancer, including prostate cancer at baseline and during follow-up, had not had a radical prostatectomy, and provided data on physical activity. Cases were men who under-went BPH surgery between 1986 and 1994 (n = 1890) or, among those who did not have surgery, who scored 15 or more points of 35 (n = 1853) on 7 questions about lower urinary tract symptoms modified from the American Urological Association Symptom Index. Noncases were men who scored 7 points or less (n = 21745). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from multiple logistic regression models. After controlling for age, race or ethnicity, alcohol consumption, and smoking, physical activity was inversely related with total BPH (extreme quintiles: OR, 0.75 95% CI, 0.67-0.85 P for trend, <.001), surgery for BPH (OR, 0.76 95% CI, 0.64-0.90 P for trend, <.001), and symptomatic BPH (OR, 0.75 95% CI, 0.64-0.87 P for trend, <.001). Walking, the most prevalent activity, was inversely related to BPH risk men who walked 2 to 3 h/wk had a 25% lower risk of total BPH. Our results indicate that more physically active men have a lower frequency of lower urinary tract symptoms.
Publisher: American Association for the Advancement of Science (AAAS)
Date: 12-01-2007
Abstract: Identification of genetic variants affecting complex traits such as obesity is confounded by many types of bias, especially when effect sizes are small. Given our findings of a positive association between rs7566605 and body mass index in four out of five separate s les, a false positive finding cannot be ruled out with certainty but seems unlikely. Meta-analyses of multiple large studies will help refine the estimate of the effects of rs7566605 on body mass index.
Publisher: American Medical Association (AMA)
Date: 06-2023
DOI: 10.1001/JAMAONCOL.2023.0434
Abstract: Although breast density is an established risk factor for breast cancer, longitudinal changes in breast density have not been extensively studied to determine whether this factor is associated with breast cancer risk. To prospectively evaluate the association between change in mammographic density in each breast over time and risk of subsequent breast cancer. This nested case-control cohort study was s led from the Joanne Knight Breast Health Cohort of 10 481 women free from cancer at entry and observed from November 3, 2008, to October 31, 2020, with routine screening mammograms every 1 to 2 years, providing a measure of breast density. Breast cancer screening was provided for a erse population of women in the St Louis region. A total of 289 case patients with pathology-confirmed breast cancer were identified, and approximately 2 control participants were s led for each case according to age at entry and year of enrollment, yielding 658 controls with a total number of 8710 craniocaudal-view mammograms for analysis. Exposures included screening mammograms with volumetric percentage of density, change in volumetric breast density over time, and breast biopsy pathology-confirmed cancer. Breast cancer risk factors were collected via questionnaire at enrollment. Longitudinal changes over time in each woman’s volumetric breast density by case and control status. The mean (SD) age of the 947 participants was 56.67 (8.71) years at entry 141 were Black (14.9%), 763 were White (80.6%), 20 were of other race or ethnicity (2.1%), and 23 did not report this information (2.4%). The mean (SD) interval was 2.0 (1.5) years from last mammogram to date of subsequent breast cancer diagnosis (10th percentile, 1.0 year 90th percentile, 3.9 years). Breast density decreased over time in both cases and controls. However, there was a significantly slower decrease in rate of decline in density in the breast that developed breast cancer compared with the decline in controls (estimate = 0.027 95% CI, 0.001-0.053 P = .04). This study found that the rate of change in breast density was associated with the risk of subsequent breast cancer. Incorporation of longitudinal changes into existing models could optimize risk stratification and guide more personalized risk management.
Publisher: Springer Science and Business Media LLC
Date: 27-12-2007
DOI: 10.1007/S10995-006-0155-2
Abstract: To assess diet quality of pregnant women in the WIC program in North Dakota and to compare Native Americans with whites, we used a DQI-P (diet quality index for pregnancy) among low-income pregnant women enrolled in WIC, a special supplemental program for women, infants, and children. Dietary information was collected for all participants using the Harvard Service Food Frequency Questionnaire (HSFFQ). DQI-P scores were based on 10 components previously used in other diet quality indices: percent recommended intake of grains, vegetables, fruits, folate, calcium, and iron total fat, saturated fat, and cholesterol and dietary ersity. Each component contributed 10 points to the total possible DQI-P score of 100. The mean DQI-P score was 53.9. Native Americans (51.8) had significantly lower DQI-P scores (51.8 vs. 54.2 p<0.0001) significantly higher scores for iron and folate and significantly lower scores for cholesterol, total fat intake, and saturated fat components than did whites. As DQI-P scores increased, diet improved and scores for in idual components increased. While there were significant differences between the diet quality of Native American and white pregnant women, the differences were minimal. The DQI-P scores for all women in this population indicate that their diets are not meeting dietary recommendations. Interventions should focus on decreasing fat intake and increasing iron and folate intake to meet national dietary recommendations. More emphasis should be placed on eating whole fruit and vegetables.
Publisher: American Association for Cancer Research (AACR)
Date: 02-06-2022
DOI: 10.1158/1055-9965.EPI-21-1471
Abstract: Identifying risk factors for aggressive forms of breast cancer is important. Tumor factors (e.g., stage) are important predictors of prognosis, but may be intermediates between prediagnosis risk factors and mortality. Typically, separate models are fit for incidence and mortality postdiagnosis. These models have not been previously integrated to identify risk factors for lethal breast cancer in cancer-free women. We combined models for breast cancer incidence and breast cancer–specific mortality among cases into a multi-state survival model for lethal breast cancer. We derived the model from cancer-free postmenopausal Nurses’ Health Study women in 1990 using baseline risk factors. A total of 4,391 invasive breast cancer cases were diagnosed from 1990 to 2014 of which 549 died because of breast cancer over the same period. Some established risk factors (e.g., family history, estrogen plus progestin therapy) were not associated with lethal breast cancer. Controlling for age, the strongest risk factors for lethal breast cancer were weight gain since age 18: & 30 kg versus ± 5 kg, RR = 1.94 [95% confidence interval (CI) = 1.38–2.74], nulliparity versus age at first birth (AAFB) & 25, RR = 1.60 (95% CI = 1.16–2.22), and current smoking ≥ 15 cigarettes/day versus never, RR = 1.42 (95% CI = 1.07–1.89). Some breast cancer incidence risk factors are not associated with lethal breast cancer other risk factors for lethal breast cancer are not associated with disease incidence. This multi-state survival model may be useful for identifying prediagnosis factors that lead to more aggressive and ultimately lethal breast cancer.
Publisher: BMJ
Date: 02-2002
DOI: 10.1136/JECH.56.2.95
Abstract: Although stress is thought to be a risk factor for suicide, most research has been retrospective or has focused on attempted suicides or suicide ideation. This study examined prospectively the associations between self perceived stress, diazepam use, and death from suicide among adult women. A cohort study was conducted with 14 years of follow up. Stress at home and at work were assessed by questionnaire and scored on a four point scale: minimal, light, moderate, or severe. Eleven states within the United States. Female nurses (n=94 110) who were 36 to 61 years of age when they answered questions on stress and diazepam use in 1982. During 1 272 000 person years of observation 73 suicides were identified. After adjustment for age, smoking, coffee consumption, alcohol intake, and marital status, the relation between self reported stress and suicide remained U shaped. Compared with the light home and work stress categories, which had the lowest incidences of suicide, risks were increased among women reporting either severe (relative risk (RR) = 3.7, 95% confidence intervals (CI) 1.7 to 8.3) or minimal (RR=2.1, 95% CI 1.0 to 4.5) home stress and either severe (RR=1.9, 95% CI 0.8 to 4.7) or minimal (RR=2.4, 95% CI 0.9 to 6.1) work stress. When responses to home and work stress were combined, there was an almost fivefold increase in risk of suicide among women in the high stress category. Risk of suicide was over eightfold among women reporting high stress or diazepam use compared with those reporting low stress and no diazepam use. The relation between self reported stress and suicide seems to be U shaped among adult women. The excess risk for those reporting minimal stress may reflect denial or undiagnosed depression or an association with some other unmeasured risk factor for suicide.
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 05-11-2020
DOI: 10.5888/PCD17.200202
Publisher: Oxford University Press (OUP)
Date: 05-08-1998
Abstract: Increased physical activity has been hypothesized to be a means of breast cancer prevention. We examined the associations between physical activity at two different times in life and breast cancer risk. We analyzed data from the Nurses' Health Study II, a prospective study of women aged 25-42 years in 1989. On the baseline survey, women were asked, "While in high school and between the ages 18 and 22 years, how often did you participate in strenuous physical activity at least twice a week?" We averaged answers to these two questions to develop a measure of late adolescent activity. Women were also asked at baseline to report the number of hours per week they currently spent in different nonoccupational activities. During 6 years of follow-up, we identified 372 cases of invasive breast cancer. Data were analyzed by use of multivariate pooled logistic regression to produce relative risk (RR) and confidence intervals (CIs) of being diagnosed with the disease. Women who were more active in late adolescence were not at reduced risk of breast cancer compared with less active women. For those women who reported engaging in strenuous activity at least twice per week for 10-12 months per year in late adolescence, the RR of cancer, compared with those who never engaged in such activity, was 1.1 (95% CI = 0.8-1.6). Similarly, higher levels of recent nonoccupational physical activity were not associated with reduced risk of breast cancer (RR for > or = 7 hours of activity/week relative to < 1 hour/week = 1.1 95% CI = 0.8-1.5). Our findings do not support a link between physical activity, in late adolescence or in the recent past, and breast cancer risk among young adult women.
Publisher: American Medical Association (AMA)
Date: 14-06-2010
Abstract: Persuasive evidence has demonstrated that increased physical activity is associated with substantial reduction in risk of coronary heart disease. However, the role of physical activity in the prevention of stroke is less well established. To examine the association between physical activity and risk of total stroke and stroke subtypes in women. The Nurses' Health Study, a prospective cohort study of subjects residing in 11 US states. A total of 72,488 female nurses aged 40 to 65 years who did not have diagnosed cardiovascular disease or cancer at baseline in 1986 and who completed detailed physical activity questionnaires in 1986, 1988, and 1992. Incident stroke occurring between baseline and June 1, 1994, compared among quintiles of physical activity level as measured by metabolic equivalent tasks (METs) in hours per week. During 8 years (560,087 person-years) of follow-up, we documented 407 incident cases of stroke (258 ischemic strokes, 67 subarachnoid hemorrhages, 42 intracerebral hemorrhages, and 40 strokes of unknown type). In multivariate analyses controlling for age, body mass index, history of hypertension, and other covariates, increasing physical activity was strongly inversely associated with risk of total stroke. Relative risks (RRs) in the lowest to highest MET quintiles were 1. 00, 0.98, 0.82, 0.74, and 0.66 (P for trend=.005). The inverse gradient was seen primarily for ischemic stroke (RRs across increasing MET quintiles, 1.00, 0.87, 0.83, 0.76, and 0.52 P for trend=.003). Physical activity was not significantly associated with subarachnoid hemorrhage or intracerebral hemorrhage. After multivariate adjustment, walking was associated with reduced risk of total stroke (RRs across increasing walking MET quintiles, 1.00, 0. 76, 0.78, 0.70, and 0.66 P for trend=.01) and ischemic stroke (RRs across increasing walking MET quintiles, 1.00, 0.77, 0.75, 0.69, and 0.60 P for trend=.02). Brisk or striding walking pace was associated with lower risk of total and ischemic stroke compared with average or casual pace. These data indicate that physical activity, including moderate-intensity exercise such as walking, is associated with substantial reduction in risk of total and ischemic stroke in a dose-response manner. JAMA. 2000.
Publisher: Springer Science and Business Media LLC
Date: 27-12-2017
Publisher: Elsevier BV
Date: 04-2001
Publisher: American Association for Cancer Research (AACR)
Date: 08-2008
DOI: 10.1158/1055-9965.EPI-08-0037
Abstract: Background: Adolescence may be a period of increased susceptibility to breast cancer due to regular ision of undifferentiated cells that occurs between puberty and first birth. Red meat consumption during early adult life has been associated with breast cancer, but intake during adolescence has not been examined prospectively. We aimed to assess the relationship between red meat intake during adolescence and premenopausal breast cancer. Methods: We examined the incidence of invasive premenopausal breast cancer prospectively within the Nurses' Health Study II. A total of 39,268 premenopausal women who completed a validated 124-item food frequency questionnaire on their diet during high school, were followed for 7 years, from 1998 to 2005. Cox proportional hazards regression was used to estimate relative risks (RR) and 95% confidence intervals (95% CI). Results: 455 cases of invasive premenopausal breast cancer were diagnosed between 1998 and 2005. Compared with women in the lowest quintile of red meat intake during high school, the multivariate-adjusted RR for the highest quintile of intake was 1.34 (95% CI, 0.94-1.89 Ptrend = 0.05). A significant linear association was observed with every additional 100 g of red meat consumed per day (RR, 1.20 95% CI, 1.00-1.43 P = 0.05). This association was more pronounced in hormone receptor–positive tumors (RR, 1.36 95% CI, 1.08-1.70 P = 0.008) and was not significant in hormone receptor–negative tumors (RR, 0.99 95% CI, 0.61-1.61, P = 0.97). Conclusion: Higher red meat intake in adolescence may increase the risk of premenopausal breast cancer. (Cancer Epidemiol Biomarkers Prev 2008 (8):2146–51)
Publisher: Springer Science and Business Media LLC
Date: 11-02-2017
Publisher: Oxford University Press (OUP)
Date: 08-1997
DOI: 10.1093/IJE/26.4.693
Abstract: Obesity is a world-wide problem, especially the child obesity, with the complication of various metabolic diseases. Child obesity can be developed as early as the age between 2 and 6. The expansion of fat mass in child age includes both hyperplasia and hypertrophy of adipose tissue, suggesting the importance of proliferation and adipogenesis of preadipocytes. The changed composition of gut microbiota is associated with obesity, revealing the roles of lipopolysaccharide (LPS) on manipulating adipose tissue development. Studies suggest that LPS enters the circulation and acts as a pro-inflammatory regulator to facilitate pathologies. Nevertheless, the underlying mechanisms behind LPS-modulated obesity are yet clearly elucidated. This study showed that LPS enhanced the expression of cyclooxygenase-2 (COX-2), an inflammatory regulator of obesity, in preadipocytes. Pretreating preadipocytes with the scavenger of reactive oxygen species (ROS) or the inhibitors of NADPH oxidase or p42 44 MAPK markedly decreased LPS-stimulated gene expression of COX-2 together with the phosphorylation of p47
Publisher: American Medical Association (AMA)
Date: 04-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2018
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1055-9965.22494715
Abstract: Banner authorship list
Publisher: Mary Ann Liebert Inc
Date: 02-1997
Abstract: The Nurses' Health Study was designed as a prospective follow-up study to examine relations between contraception and breast cancer. With follow-up questionnaires mailed every 2 years, investigators have added extensive details of lifestyle practices. The study, currently in its 20th year, has maintained high follow-up with > 90% of participants responding to each of the follow-up cycles since 1988. The relations between use of hormones, diet, exercise, and other lifestyle practices have been related to the development of a wide range of chronic illnesses among women. This review describes the methods used to follow up the study participants and summarizes the major findings that have been described over the first 20 years of the study. We highlight additional areas added to the study in recent years to address emerging issues in women's health. Special emphasis is placed on the recent findings from the study, including relations between weight gain and heart disease, diabetes, and mortality, the lack of relation between calcium and osteoporotic fractures, and the positive relation between postmenopausal use of hormones and risk of breast cancer.
Publisher: Oxford University Press (OUP)
Date: 07-03-2001
Abstract: Women and their clinicians are increasingly encouraged to use risk estimates derived from statistical models, primarily that of Gail et al., to aid decision making regarding potential prevention options for breast cancer, including chemoprevention with tamoxifen. We evaluated both the goodness of fit of the Gail et al. model 2 that predicts the risk of developing invasive breast cancer specifically and its discriminatory accuracy at the in idual level in the Nurses' Health Study. We began with a cohort of 82 109 white women aged 45-71 years in 1992 and applied the model of Gail et al. to these women over a 5-year follow-up period to estimate a 5-year risk of invasive breast cancer. All statistical tests were two-sided. The model fit well in the total s le (ratio of expected [E] to observed [O] numbers of cases = 0.94 95% confidence interval [CI] = 0.89 to 0.99). Underprediction was slightly greater for younger women (<60 years), but in most age and risk factor strata, E/O ratios were close to 1.0. The model fit equally well (E/O ratio = 0.93 95% CI = 0.87 to 0.99) in a subset of women reporting recent screening (i.e., within 1 year before the baseline) among women with an estimated 5-year risk of developing invasive breast cancer of 1.67% or greater, the E/O ratio was 1.04 (95% CI = 0.96 to 1.12). The concordance statistic, which indicates discriminatory accuracy, for the Gail et al. model 2 when used to estimate 5-year risk was 0.58 (95% CI = 0.56 to 0.60). Only 3.3% of the 1354 cases of breast cancer observed in the cohort arose among women who fell into age-risk strata expected to have statistically significant net health benefits from prophylactic tamoxifen use. The Gail et al. model 2 fit well in this s le in terms of predicting numbers of breast cancer cases in specific risk factor strata but had modest discriminatory accuracy at the in idual level. This finding has implications for use of the model in clinical counseling of in idual women.
Publisher: Oxford University Press
Date: 29-03-2012
Publisher: Annual Reviews
Date: 1996
DOI: 10.1146/ANNUREV.PU.17.050196.000245
Abstract: Synthesis of research findings has long been a part of reviewing and summarizing a field of study. Public health decisions are made on the available evidence. We summarize the approaches to research synthesis that draw on the best available evidence and the use of quantitative summaries through meta-analysis. We focus on observational studies. Heterogeneity offers the potential to observe a relation across study populations and circumstances. We emphasize the benefits of heterogeneity in overviews and the need to explore and describe the sources of heterogeneity. Random effects approaches to combining data are recommended, and the use of regression approaches is emphasized. Excluding studies with extreme results may bias a research synthesis and underestimate the true variance of the results, thus contributing to misleading inference. Thorough searching is the best guard against publication bias. We conclude with guidelines for combining epidemiological studies.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516027
Abstract: Supplementary Table 8 shows the joint associations between composite sleep score and genetic risk with EAC risk
Publisher: Oxford University Press (OUP)
Date: 02-1996
Publisher: Wiley
Date: 2006
DOI: 10.1002/CNCR.22136
Abstract: An association between histologic category of benign breast disease (BBD) and breast cancer risk has been well documented. However, the influence of a positive family history (FH) on breast cancer risk among women with biopsy-confirmed BBD is less certain. The authors conducted a nested case-control study of BBD and breast cancer risk among 2005 women who were enrolled in the Nurses' Health Study. Cases were women with breast cancer who had a previous benign breast biopsy (n = 395 women). Controls were women who also had previous biopsy-confirmed BBD but were free from breast cancer at the time the corresponding case was diagnosed (n = 1610 women). BBD slides were reviewed and categorized as either nonproliferative lesions, proliferative lesions without atypia, or atypical hyperplasia (AH). Compared with women who had nonproliferative lesions and no FH, women who had proliferative lesions without atypia and a positive FH had a higher breast cancer risk (odds ratio [OR], 2.45 95% confidence interval [95% CI], 1.61-3.70) than women with no FH (OR, 1.51 95% CI, 1.12-2.06 P = .07). Among women who had AH, the OR for the development of breast cancer was 4.38 (95% CI, 2.93-6.55) for those with no FH and 5.37 (95% CI, 3.01-9.58) for those with a positive FH (P = .57). There was no significant interaction between the type of BBD and FH (P = .74). A positive FH of breast cancer slightly increased the breast cancer risk among women who had proliferative lesions without atypia. The increase in risk of breast cancer associated with FH was not significant among women who had AH.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2021
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-0004
DOI: 10.1158/1055-9965.23516024
Abstract: Supplementary Table 9 shows the additive interaction between composite sleep score and genetic risk with EAC risk
Publisher: American Public Health Association
Date: 11-2020
Abstract: The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge for society, affecting those already subject to unacceptable health inequalities and resulting in vast economic impacts. The pandemic reminds everyone of the value and necessity of public health. In the context of an era that will be shaped by COVID-19, we outline the coming series of challenges and transitions in public health and the needed actions over the next 5 years to reinvent our public health systems. Multiple limitations in current US and global public health systems have been uncovered by the pandemic, including insufficient preparedness and surveillance capabilities complicated by long-standing and worsening health inequalities and the rapid spread of misinformation that needs to be countered. We foresee 3 phases for public health over the next 5 years: (1) reactive crisis management, (2) efforts to maintain initial gains, and (3) efforts to sustain and enhance progress. A reinvented public health system will depend highly on leadership and political will, rethinking how we categorize and address population-level risk, employing 21st-century data sciences, and applying new communication skills.
Publisher: Oxford University Press
Date: 07-11-2012
Publisher: Wiley
Date: 05-1993
DOI: 10.1111/J.1749-6632.1993.TB39195.X
Abstract: Taken together, the results from these studies clearly indicate that alcohol and cigarette smoking may both decrease serum or plasma beta-carotene levels after controlling for dietary intake and lipid profile. The variation among studies in the magnitude of the association and statistical significance may reflect, in part, the joint distribution of smoking and alcohol intake in the populations. For ex le, in the supplementation study reported by Costantino, 89% consumed alcohol, considerably higher than population averages. Further, one-third of the men in that study consumed more than 65 ml (52 gm) of pure alcohol per day. This contrasts with the data from the Health Professionals Follow-up Study, where the mean intake of alcohol was 12.3 gm/day with a standard deviation of 15.8. Even lower alcohol intakes are reported in women, further attenuating the relation and the statistical power to detect a relation between alcohol and beta-carotene levels. Measurement error in assessing dietary intake of beta-carotene could explain some of the association between smoking, alcohol and serum beta-carotene levels because of incomplete control (residual confounding) of dietary intake. Methods for statistically adjusting for error in measurement have not yet been implemented in analyses of this nature.
Publisher: Oxford University Press (OUP)
Date: 17-03-1999
Abstract: Data on intake of specific carotenoids and breast cancer risk are limited. Furthermore, studies of vitamins A, C, and E in relation to breast cancer risk are inconclusive. We have conducted a large, prospective study to evaluate long-term intakes of these nutrients and breast cancer risk. We examined, by use of multivariate analysis, associations between intakes of specific carotenoids, vitamins A, C, and E , consumption of fruits and vegetables, and breast cancer risk in a cohort of 83234 women (aged 33-60 years in 1980) who were participating in the Nurses' Health Study. Through 1994, we identified 2697 incident cases of invasive breast cancer (784 premenopausal and 1913 postmenopausal). Intakes of beta-carotene from food and supplements, lutein/zeaxanthin, and vitamin A from foods were weakly inversely associated with breast cancer risk in premenopausal women. Strong inverse associations were found for increasing quintiles of alpha-carotene, beta-carotene, lutein/zeaxanthin, total vitamin C from foods, and total vitamin A among premenopausal women with a positive family history of breast cancer. An inverse association was also found for increasing quintiles of beta-carotene among premenopausal women who consumed 15 g or more of alcohol per day. Premenopausal women who consumed five or more servings per day of fruits and vegetables had modestly lower risk of breast cancer than those who had less than two servings per day (relative risk [RR] = 0.77 95% confidence interval [CI] = 0.58-1.02) this association was stronger among premenopausal women who had a positive family history of breast cancer (RR = 0.29 95% CI = 0.13-0.62) or those who consumed 15 g or more of alcohol per day (RR = 0.53 95% CI = 0.27-1.04). Consumption of fruits and vegetables high in specific carotenoids and vitamins may reduce premenopausal breast cancer risk.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929352.V1
Abstract: Supplementary Figure S3: Pearson correlation separated by view and case control status.
Publisher: American Association for Cancer Research (AACR)
Date: 07-07-2023
DOI: 10.1158/1940-6207.CAPR-22-0499
Abstract: Expanding use of digital mammography and repeated screening provides opportunities for risk assessment. To use these images for risk estimates and guide risk management in real time requires efficient processing. Evaluating the contribution of different views to prediction performance can guide future applications for risk management in routine care.
Publisher: Oxford University Press (OUP)
Date: 17-03-1999
Abstract: The remarkable similarity of lifestyle and environmental risk factors for type 2 (non-insulin-dependent) diabetes mellitus and colon cancer has led to the hypothesis that diabetes may increase the risk of this cancer. We prospectively examined the relationship between diabetes and risk of colorectal cancer in a cohort of 118403 women aged 30 through 55 years who were without previously diagnosed cancer at baseline in 1976. The women, who were enrolled in the Nurses' Health Study, were assessed for history of diabetes at baseline and during follow-up by use of biennial questionnaires. Self-reported diabetes was validated by information obtained from a supplemental questionnaire on symptoms and treatment and was confirmed by medical record review in a s le of the participants. Incident cases of colorectal cancer were ascertained through medical record review. All reported P values are two-sided. During 18 years of follow-up (201061 person-years), we documented 892 new cases of colorectal cancer. After adjustment for age, body mass index (weight in kg/height in m2), physical activity, and other covariates, relative risks (RRs) were 1.43 (95% confidence interval [CI] = 1.10-1.87 P = .009) for colorectal cancer, 1.49 (95% CI = 1.09-2.06 P = .01) for colon cancer, 1.11 (95% CI = 0.56-2.21 P = .76) for rectal cancer, 1.56 (95% CI = 1.07-2.28 P = .02) for advanced colorectal cancer, and 2.39 (95% CI = 1.46-3.92 P = .0005) for fatal colorectal cancer. Our data provide support for the hypothesis that diabetes is associated with an increased risk of colorectal cancer in women.
Publisher: Wiley
Date: 02-2004
DOI: 10.1038/OBY.2004.34
Abstract: To assess the role of weight cycling independent of BMI and weight change in predicting the risk of developing type 2 diabetes. A six-year follow-up of 46,634 young and middle-aged women in the Nurses' Health Study II was conducted. Women who had intentionally lost > or = 20 lbs at least three times between 1989 and 1993 were classified as severe weight cyclers. Women who had intentionally lost > or = 10 lbs at least three times were classified as mild weight cyclers. The outcome was physician-diagnosed type 2 diabetes. Between 1989 and 1993, approximately 20% of the women were mild weight cyclers, and 1.6% were severe weight cyclers. BMI in 1993 was positively associated with weight-cycling status (p or = 35 kg/m(2) were 63 times more likely to be diagnosed with type 2 diabetes. After adjustment for BMI, neither mild (relative risk = 1.11, 95% confidence interval, 0.89 to 1.37) nor severe (relative risk = 1.39, 95% confidence interval, 0.90 to 2.13) weight cycling predicted risk of diabetes. Weight cycling was strongly associated with BMI, but it was not independently predictive of developing type 2 diabetes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2015
Publisher: Oxford University Press (OUP)
Date: 17-09-1997
Abstract: Breast cancer mortality and incidence rates vary by geographic region in the United States. Previous analytic studies have measured mortality, not incidence, and have used regional prevalences to control for geographic variation in risk factors rather than adjusting for risk factors measured at the level of the in idual. We prospectively evaluated regional variation in breast cancer incidence rates in the Nurses' Health Study and assessed the influence of breast cancer risk factors measured at the in idual level. The Nurses' Health Study cohort was established in 1976 when 121700 female nurses aged 30-55 years living in 11 U.S. states were enrolled. These states represent all four regions of the continental United States. We identified 3603 incident cases of invasive breast cancer through 1992 (1794565 person-years of follow-up). We calculated relative risks (RRs) adjusted for age and for age and established risk factors (i.e., multivariate-adjusted analysis), comparing California, the Northeast, and the Midwest with the South. For premenopausal women, there was little evidence of regional variation in breast cancer incidence rates, either in age-adjusted or in multivariate-adjusted analyses. For postmenopausal women in California, age-adjusted risk was modestly elevated (RR = 1.24 95% confidence interval [CI] = 1.05-1.47) after adjusting for age and for established risk factors, the excess rate in California was attenuated by 25% (RR = 1.18 95% CI = 1.00-1.40). No excess of breast cancer incidence was observed for postmenopausal women in either the Northeast or the Midwest. Little regional variation in age-adjusted breast cancer incidence rates was observed, with the exception of a modest excess for postmenopausal women in California. Adjustment for differences in the distribution of established risk factors explained some of the excess risk in California.
Publisher: Annual Reviews
Date: 18-03-2013
DOI: 10.1146/ANNUREV-PUBLHEALTH-031912-114444
Abstract: Implementation science studies the use of strategies to adapt and use evidence-based interventions in targeted settings (e.g., schools, workplaces, health care facilities, public health departments) to sustain improvements to population health. This nascent field of research is in the early stages of developing theories of implementation and evaluating the properties of measures. Stakeholder engagement, effectiveness studies, research synthesis, and mathematical modeling are some of the methods used by implementation scientists to identify strategies to embed evidence-based interventions in clinical and public health programs. However, for implementation science to reach its full potential to improve population health the existing paradigm for how scientists create evidence, prioritize publications, and synthesize research needs to shift toward greater stakeholder input and improved reporting on external validity. This shift will improve the relevance of the research that is produced and provide information that will help guide decision makers in their selection of research-tested interventions.
Publisher: Springer Science and Business Media LLC
Date: 21-12-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-1998
Publisher: Oxford University Press (OUP)
Date: 07-04-2022
DOI: 10.1093/IJE/DYAC072
Abstract: The link between oral diseases and mortality remains under-explored. We aimed to evaluate the associations between tooth count, untreated caries and risk of all-cause and cause-specific mortality. Data on 24 029 adults from the National Health and Nutrition Examination Survey 1988–94/1999–2010, with mortality linkage to the National Death Index to 31 December 2015, were analysed. Baseline total number of permanent teeth and any untreated caries were assessed by trained dental professionals. During up to 27 years of follow-up, 5270 deaths occurred. Fewer permanent teeth were associated with higher all-cause mortality, including heart disease and cancer mortality (all P & .05 for trend) but not cerebrovascular disease mortality. For every 10 teeth missing, the multivariable-adjusted hazard ratios (HRs) were 1.13 (95% CI: 1.08 to 1.18) for all-cause, 1.16 (95% CI: 1.05, 1.29) for heart disease and 1.19 (95% CI: 1.09, 1.29) for cancer mortality. Untreated caries was associated with increased all-cause (HR: 1.26, 95% CI: 1.15, 1.39) and heart disease mortality (HR: 1.48, 95% CI: 1.17, 1.88) but not cerebrovascular disease/cancer mortality, after adjusting for tooth count, periodontitis and sociodemographic/lifestyle factors. Compared with those without untreated caries and with 25–28 teeth, in iduals with untreated caries and 1–16 teeth had a 53% increased risk of all-cause mortality (HR: 1.53, 95% CI: 1.27, 1.85) and 96 % increased risk of heart disease mortality (HR: 1.96, 95% CI: 1.28, 3.01). In nationally representative cohorts, fewer permanent teeth and untreated caries were associated with all-cause and heart disease mortality. Fewer teeth were also associated with higher cancer mortality.
Publisher: MDPI AG
Date: 23-05-2022
Abstract: Community-based participatory strategies are a promising approach to addressing disparities in community health outcomes. This paper details the efforts of Siteman Cancer Center to achieve breast health equity over the past 15+ years. We begin by describing the activities and successes arising from our breast health community partnerships including identifying priorities, developing recommendations, and implementing patient navigation services to advance breast health. This system-wide coordinated navigation approach that includes primary and specialty care providers helped to increase potential impact on reducing breast health disparities by expediting care, increasing care efficiency, and standardizing referral procedures across systems for all women including those who are uninsured and underinsured. We also discuss a mobile mammography unit that has been deployed to serve women living in both urban and rural regions. The van reached a particularly vulnerable population that was mostly poor, uninsured, and with limited educational backgrounds regardless of their zip code of service. This work shows that collaborations between academic and community partners have resulted in decreased late stage at diagnosis and improved access to mammography. Furthermore, we offer lessons learned and recommendations that may be applicable to other communities.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.C.6695939
Abstract: AbstractBackground: Risk factors contributing to more than 10-fold increase in esophageal cancer in the last 50 years remain underexplored. We aim to examine the associations of sleep behaviors with esophageal adenocarcinoma (EAC) and squamous cell carcinoma (ESCC). Methods: We prospectively assessed the associations between sleep behaviors (chronotype, duration, daytime napping, daytime sleepiness, snoring, and insomnia) and EAC and ESCC risk in 393,114 participants in the UK Biobank (2006–2016). Participants with 0, 1, and ≥2 unhealthy behaviors, including sleep or h/d, daytime napping, and usual daytime sleepiness were classified as having a good, intermediate, and poor sleep. For EAC, we also examined interactions with polygenic risk score (PRS). Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: We documented 294 incident EAC and 95 ESCC. Sleep h/d (HR, 2.05 95% CI, 1.18–3.57) and sometimes daytime napping (HR, 1.36 95% CI, 1.06–1.75) were in idually associated with increased EAC risk. Compared with in iduals with good sleep, those with intermediate sleep had a 47% (HR, 1.47 95% CI, 1.13–1.91) increased EAC risk, and those with poor sleep showed an 87% (HR, 1.87 95% CI, 1.24–2.82) higher risk ( i P /i sub trend /sub 0.001). The elevated risks for EAC were similar within strata of PRS ( i P /i sub interaction /sub = 0.884). Evening chronotype was associated with elevated risk of ESCC diagnosed after 2 years of enrollment (HR, 2.79 95% CI, 1.32–5.88). Conclusions: Unhealthy sleep behaviors were associated with an increased risk of EAC, independent of genetic risk. Impact: Sleep behaviors may serve as modifiable factors for the prevention of EAC. /
Publisher: American Association for Cancer Research (AACR)
Date: 11-2005
DOI: 10.1158/1055-9965.EPI-05-0558
Abstract: Background: Mammographic density is one of the strongest predictors of breast cancer risk. The mechanism by which breast density increases breast cancer risk is unclear although it has been hypothesized that breast density reflects cumulative exposure to estrogens. Methods: To evaluate this hypothesis, we conducted a cross-sectional study among 520 postmenopausal women in the Nurses' Health Study that examined the relation between circulating sex hormones and mammographic density. Women were postmenopausal and not taking exogenous hormones at the time of blood collection and mammogram. Percent breast density was measured from digitized mammograms using a computer-assisted method. Circulating estrone, estradiol, androstenedione, testosterone, DHEA, DHEA sulfate, sex hormone–binding globulin, progesterone, and prolactin were measured in plasma. Results: In contrast to the prior hypothesis, circulating estrogens were inversely related to percent mammographic density. The mean percent mammographic density was 25.6% among women in the lowest quartile of circulating estradiol compared with 14.4% among women in the highest quartile [Spearman correlation (r) = −0.22, P & 0.0001]. Circulating estrogens alone explained 1% to 5% of the variation of mammographic density. Body mass index was positively associated with circulating estradiol levels (r = 0.45, P & 0.0001) and inversely related to percent mammographic density (r = −0.51, P & 0.0001). After adjustment for body mass index, there was no association between estradiol and breast density (r = 0.01, P = 0.81). Likewise, there was no relation between the other sex hormones measured or prolactin and mammographic density after adjustment for body mass index. Conclusion: These findings indicate that in postmenopausal women, mammographic density is independent of circulating sex hormone levels.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2017
Publisher: American Public Health Association
Date: 2005
Abstract: Objectives. We estimated health care expenditures associated with overweight and obesity and examined the influence of age, race, and gender. Methods. Using 1998 Medical Expenditure Panel Survey data, we employed 2-stage modeling to estimate annual health care expenditures associated with high body mass index (BMI) and examine interactions between demographic factors and BMI. Results. Overall, the mean per capita annual health care expenditure (converted to December 2003 dollars) was $3338 before adjustment. While the adjusted expenditure was $2127 (90% confidence interval [CI]=$1927, $2362) for a typical normal-weight White woman aged 35 to 44 years, expenditures were $2358 (90% CI=$2128, $2604) for women with BMIs of 25 to 29.9 kg/m 2 , $2873 (90% CI=$2530, $3236) for women with BMIs of 30 to 34.9 kg/m 2 , $3058 (90% CI=$2529, $3630) for women with BMIs of 35 to 39.9 kg/m 2 , and $3506 (90% CI=$2912, $4228) for women with BMIs of 40 kg/m 2 or higher. Expenditures related to higher BMI rose dramatically among White and older adults but not among Blacks or those younger than 35 years. We found no interaction between BMI and gender. Conclusions. Health care costs associated with overweight and obesity are substantial and vary according to race and age.
Publisher: American Association for Cancer Research (AACR)
Date: 10-2014
DOI: 10.1158/1538-7445.AM2014-3852
Abstract: African-American ethnicity, male sex, older age and obesity are accepted risk factors for multiple myeloma (MM). Obesity early in life is a risk factor for many cancers, including MM most studies have focused on populations of European origin. African-Americans have a higher prevalence of obesity than other populations, and may have a distinct genetic contribution to this condition. We established a multi-center study to investigate possible explanations for the excess risk of MM among African-Americans. The aim of the present case-case analysis was to determine whether body mass index (BMI) was associated with clinical characteristics at presentation in African-American MM patients. 1,065 patients diagnosed with active MM from January 1, 2009 through September 30, 2013 were recruited through nine outpatient centers at academic medical centers and 3 SEER population-based cancer registries. Information on weight and height at 20 years of age and at 5 years prior to diagnosis was obtained from questionnaires. Clinical information collected from the medical records and interviews included age at diagnosis, stage, percent plasmacytosis on bone marrow biopsy, B2 microglobulin level, immunoglobulin class and presence of lytic bone lesions. Molecular profiling abstracted from pathology reports included chromosomal gain/deletions (1P-, 1Q+, +3, +5, +7, +9, +11, 12P-, Del(13), +15, Del(17P), Del(17P13)), translocations (4 ), (11 ), and (14 ). Analysis of Variance (ANOVA) was used to test the null hypothesis that age at diagnosis was similar across BMI categories. A T-test was used to test the null hypothesis that the mean age at diagnosis in underweight/normal patients was not different than that for overweight and obese patients. The Mantel-Haenszel Chi square test for trend was used to test the null hypothesis that the proportion of cytogenetic and molecular abnormalities was similar across BMI categories. The study population consists of 306 African American male and 396 African American female MM patients. In both, obesity at 20 years of age was associated with younger age at diagnosis, compared to a normal/underweight (p=0.0015). Among males only, obesity at 5 years prior to diagnosis was also associated with younger age at diagnosis (p=0.03). A trend between increasing BMI and molecular characteristics associated with a poor prognosis was suggested. We observed a strong association between obesity at age 20 and younger age at diagnosis among males and females, and in males only at 5 years prior to diagnosis. Obesity is one of the few known potentially modifiable risk factors for MM. Younger age at diagnosis reflects an earlier accumulation of either or both genetic and environmental risk factors. We also observed a link between obesity at each of the two time points and specific molecular markers of poor prognosis. Additional studies are needed to determine biological significance of the results. Citation Format: Amie E. Hwang, Sikander Ailwadhi, Carol Ann Huff, Leon Bernal-Mizrachi, Christopher A. Haiman, Edward Peters, Seema Singhal, Karen Pawlish, Cathryn Bock, Todd Zimmerman, David J. Van Den Berg, David V. Conti, Brenda B. Birmann, Jayesh Mehta, John J. Graff, Daniel O. Stram, Niquelle Brown, Yang Yu, Moosa Azadian, Laurence Kolonel, Brian E. Henderson, Ann Mohrbacher, Graham Colditz, Brian-C Chiu, Michael Tomasson, Jeffrey Zonder, Robert Z. Orlowski, Sagar Lonial, Wendy Cozen. Obesity is associated with clinical characteristics in African American multiple myeloma patients. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research 2014 Apr 5-9 San Diego, CA. Philadelphia (PA): AACR Cancer Res 2014 (19 Suppl):Abstract nr 3852. doi:10.1158/1538-7445.AM2014-3852
Publisher: Springer Science and Business Media LLC
Date: 10-1989
DOI: 10.1007/BF01537107
Publisher: Oxford University Press (OUP)
Date: 27-05-2004
DOI: 10.1093/IJE/DYH125
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-1995
DOI: 10.1161/01.CIR.92.11.3178
Abstract: Background The purpose of this study was to examine prospectively the relation of shift work to risk of coronary heart disease (CHD) in a cohort of women. Methods and Results An ongoing prospective cohort of US female nurses, in whom we assessed (in 1988) the total number of years during which they worked rotating night shifts (at least three nights per month in addition to day and evening shifts), included 79 109 women, 42 to 67 years old in 1988, who were free of diagnosed CHD and stroke. Incident CHD was defined as nonfatal myocardial infarction and fatal CHD. During 4 years of follow-up (1988 to 1992), 292 cases of incident CHD (248 nonfatal myocardial infarction and 44 fatal CHD) occurred. The age-adjusted relative risk of CHD was 1.38 (95% CI, 1.08 to 1.76) in women who reported ever doing shift work compared with those who had never done so. The excess risk persisted after adjustment for cigarette smoking and a variety of other cardiovascular risk factors. Compared with women who had never done shift work, the multivariate adjusted relative risks of CHD were 1.21 (95% CI, 0.92 to 1.59) among women reporting less than 6 years and 1.51 (95% CI, 1.12 to 2.03) among those reporting 6 or more years of rotating night shifts. Conclusions These data are compatible with the possibility that 6 or more years of shift work may increase the risk of CHD in women.
Publisher: Oxford University Press
Date: 29-03-2012
Publisher: Springer Science and Business Media LLC
Date: 16-04-2014
Publisher: American Medical Association (AMA)
Date: 13-11-2002
Abstract: Physical activity can reduce the risk of hip fractures in older women, although the required type and duration of activity have not been determined. Walking is the most common activity among older adults, and evidence suggests that it can increase femoral bone density and reduce fracture risk. To assess the relationship of walking, leisure-time activity, and risk of hip fracture among postmenopausal women. Prospective analysis begun in 1986 with 12 years of follow-up in the Nurses' Health Study cohort of registered nurses within 11 US states. A total of 61,200 postmenopausal women (aged 40-77 years and 98% white) without diagnosis of cancer, heart disease, stroke, or osteoporosis at baseline. Incident hip fracture resulting from low or moderate trauma, analyzed by intensity and duration of leisure-time activity and by time spent walking, sitting, and standing, measured at baseline and updated throughout follow-up. From 1986 to 1998, 415 incident hip fracture cases were identified. After controlling for age, body mass index, use of postmenopausal hormones, smoking, and dietary intakes in proportional hazards models, risk of hip fracture was lowered by 6% (95% confidence interval [CI], 4%-9% P<.001) for each increase of 3 metabolic equivalent (MET)-hours per week of activity (equivalent to 1 h/wk of walking at an average pace). Active women with at least 24 MET-h/wk had a 55% lower risk of hip fracture (relative risk [RR], 0.45 95% CI, 0.32-0.63) compared with sedentary women with less than 3 MET-h/wk. Even women with a lower risk of hip fracture due to higher body weight experienced a further reduction in risk with higher levels of activity. Risk of hip fracture decreased linearly with increasing level of activity among women not taking postmenopausal hormones (P<.001), but not among women taking hormones (P =.24). Among women who did no other exercise, walking for at least 4 h/wk was associated with a 41% lower risk of hip fracture (RR, 0.59 95% CI, 0.37-0.94) compared with less than 1 h/wk. More time spent standing was also independently associated with lower risks. Moderate levels of activity, including walking, are associated with substantially lower risk of hip fracture in postmenopausal women.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-12-2006
Abstract: Postmenopausal estrogen use has been shown to decrease the incidence of colorectal cancer, but there is limited information regarding the effect of estrogen use on survival after diagnosis of colorectal cancer. We examined the influence of postmenopausal estrogen use on mortality among 834 women participating in the Nurses' Health Study who were diagnosed with colorectal cancer between 1976 and 2000 and observed until death or June 2004, whichever came first. Colorectal cancer–specific mortality and overall mortality according to categories of hormone use were assessed. Cox proportional hazards models were used to calculate hazard ratios (HRs) adjusted for other risk factors for cancer survival. Postmenopausal estrogen use before diagnosis of colorectal cancer was associated with significant reduction in mortality. Compared with women with no prior estrogen use, those reporting current use before diagnosis had an adjusted HR of 0.64 (95% CI, 0.47 to 0.88) for colorectal cancer–specific mortality and 0.74 (95% CI, 0.56 to 0.97) for overall mortality. This inverse association between hormone use and mortality was most evident among women whose duration of use was less than 5 years. Longer durations and past use were not associated with significant survival benefit. Assessment of estrogen use after diagnosis demonstrated similar findings. Current postmenopausal estrogen use before diagnosis of colorectal cancer was associated with improved colorectal cancer–specific and overall mortality. This benefit was principally limited to women who initiated estrogens within 5 years of diagnosis. Additional efforts to understand mechanisms through which estrogens influence colorectal carcinogenesis and cancer progression seem warranted.
Publisher: American Medical Association (AMA)
Date: 02-12-1998
Abstract: Obesity is a well-established risk factor for coronary heart disease (CHD), but whether regional fat distribution contributes independently to risk remains unclear. To compare waist-hip ratio (WHR) and waist circumference in determining risk of CHD in women. Prospective cohort study among US female registered nurses participating in the Nurses' Health Study conducted between 1986, when the nurses completed a questionnaire, and follow-up in June 1994. A total of 44702 women aged 40 to 65 years who provided waist and hip circumferences and were free of prior CHD, stroke, or cancer in 1986. Incidence of CHD (nonfatal myocardial infarction or CHD death). During 8 years of follow-up 320 CHD events (251 myocardial infarctions and 69 CHD deaths) were documented. Higher WHR and greater waist circumference were independently associated with a significantly increased age-adjusted risk of CHD. After adjusting for body mass index (BMI) (defined as weight in kilograms ided by the square of height in meters) and other cardiac risk factors, women with a WHR of 0.88 or higher had a relative risk (RR) of 3.25 (95% confidence interval [CI], 1.78-5.95) for CHD compared with women with a WHR of less than 0.72. A waist circumference of 96.5 cm (38 in) or more was associated with an RR of 3.06 (95% CI, 1.54-6.10). The WHR and waist circumference were independently strongly associated with increased risk of CHD also among women with a BMI of 25 kg/m2 or less. After adjustment for reported hypertension, diabetes, and high cholesterol level, a WHR of 0.76 or higher or waist circumference of 76.2 cm (30 in) or more was associated with more than a 2-fold higher risk of CHD. The WHR and waist circumference are independently associated with risk of CHD in women.
Publisher: Wiley
Date: 05-2004
DOI: 10.1038/OBY.2004.94
Abstract: The increase in consumption of sugar-added beverages over recent decades may be partly responsible for the obesity epidemic among U.S. adolescents. Our aim was to evaluate the relationship between BMI changes and intakes of sugar-added beverages, milk, fruit juices, and diet soda. Our prospective cohort study included >10,000 boys and girls participating in the U.S. Growing Up Today Study. The participants were 9 to 14 years old in 1996 and completed questionnaires in 1996, 1997, and 1998. We analyzed change in BMI (kilograms per meter squared) over two 1-year periods among children who completed annual food frequency questionnaires assessing typical past year intakes. We studied beverage intakes during the year corresponding to each BMI change, and in separate models, we studied 1-year changes in beverage intakes, adjusting for prior year intakes. Models included all beverages simultaneously further models adjusted for total energy intake. Consumption of sugar-added beverages was associated with small BMI gains during the corresponding year (boys: +0.03 kg/m2 per daily serving, p = 0.04 girls: +0.02 kg/m2, p = 0.096). In models not assuming a linear dose-response trend, girls who drank 1 serving/d of sugar-added beverages gained more weight (+0.068, p = 0.02) than girls drinking none, as did girls drinking 2 servings/d (+0.09, p = 0.06) or 3+ servings/d (+0.08, p = 0.06). Analyses of year-to-year change in beverage intakes provided generally similar findings boys who increased consumption of sugar-added beverages from the prior year experienced weight gain (+0.04 kg/m2 per additional daily serving, p = 0.01). Children who increased intakes by 2 or more servings/d from the prior year gained weight (boys: +0.14, p = 0.01 girls +0.10, p = 0.046). Further adjusting our models for total energy intake substantially reduced the estimated effects, which were no longer significant. Consumption of sugar-added beverages may contribute to weight gain among adolescents, probably due to their contribution to total energy intake, because adjustment for calories greatly attenuated the estimated associations.
Publisher: Springer Science and Business Media LLC
Date: 21-04-2007
DOI: 10.1007/S10552-007-0130-2
Abstract: To describe the association between breastfeeding and ovarian cancer risk in two prospective cohorts. We pooled data from the Nurses' Health Study and Nurses' Health Study II. There were 391 cases of epithelial ovarian cancer diagnosed among 149,693 parous women with up to 16 years of follow-up. Data were analyzed using multivariate Cox proportional hazards models, controlling for age, parity, duration of oral contraceptive use, tubal ligation, and age at menarche. Ever breastfeeding was associated with a non-significant reduction in ovarian cancer risk compared with never breastfeeding (RR=0.86, 95% CI 0.70-1.06) the median duration of breastfeeding among women who breastfed was nine months. Breastfeeding of 18 or more months was associated with a significant decrease in ovarian cancer risk compared to never breastfeeding (RR=0.66, 95% CI 0.46-0.96). For each month of breastfeeding the relative risk decreased by 2% (RR=0.98 per month, 95% CI 0.97-1.00). These data support a linear inverse association between breastfeeding and risk of epithelial ovarian cancer.
Publisher: Oxford University Press (OUP)
Date: 31-05-2022
DOI: 10.1093/JNCI/DJAB104
Publisher: Springer Science and Business Media LLC
Date: 16-06-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-1991
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-1990
DOI: 10.1097/00005650-199009000-00012
Abstract: In recent years, many new over-the-counter (OTC) medications have resulted from the granting of OTC status by the U.S. Food and Drug Administration to drug entities that previously were available only by prescription (Rx). While the benefits to consumers of Rx-to-OTC switches may be substantial, they also involve some degree of risk, as usage typically expands and physician supervision diminishes. This study explores the potential utility of techniques of decision analysis in evaluating the balance of these benefits and risks. Histamine H2 receptor antagonists (H2-blockers), which are currently available only by prescription, are presented as a case study and were examined to determine how OTC availability of these agents would alter the patterns, effectiveness, and risks of self-treatment for acid-peptic disorders. Currently, about 5.7 million persons experience an episode of dyspepsia during any given quarter, of whom 3.5 million self-medicate with antacids. Study results indicate that OTC availability of H2-blockers would: 1) increase the proportion of persons with dyspepsia who self-medicate from 61.8% currently to 64.1% 2) increase the proportion of persons who experience complete relief of their symptoms while self-medicating from 37.9% currently to 43.2% 3) result in 14 additional cases of serious hematologic disorders and an additional 22,000 instances of minor side effects per quarter, but cause the overall rate of side effects among persons who self-medicate to decline 4) cause an additional 300 persons per quarter with gastric cancer to self-medicate before seeking professional care, but cause no change in the median time between onset of symptoms and the decision to seek such care and 5) decrease by 277,000 the number of persons per quarter who seek professional care for dyspepsia. On balance, results suggest that OTC H2-blockers may be a relatively safe and effective means of self-care for acid-peptic disorders, and may substantially reduce the number of patient encounters with the medical care system for minor gastrointestinal complaints. This study also illustrates the potential utility of the techniques of decision analysis to the formulation of drug regulatory policy.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2013
DOI: 10.1200/JCO.2013.31.15_SUPPL.9559
Abstract: 9559 Background: In randomized trials, ASCT improves survival in MM patients (pts) age 65. The impact of ASCT on survival in older adults with MM is unknown. Methods: In a retrospective cohort study, all pts ≥ age 65 with MM diagnosed between 2000 and 2010 were identified from the Barnes-Jewish Hospital Oncology Data Services Registry (N=199), including demographic, comorbidity (ACE-27 index) and survival data. Medical records were reviewed for stage, ECOG Performance Status (PS) and treatment. Pts age 77 or who received only steroids/supportive care were excluded (N=53). The primary endpoint was overall survival (OS), defined as time from diagnosis to death, censored at last follow-up. Univariate analyses for factors associated with undergoing ASCT were performed using Fisher’s exact test or nonparametric rank-sum test multivariate logistic regression was used to create propensity scores for ASCT. The association between ASCT and OS was assessed using a multivariate Cox proportional hazard model with propensity scores adjustment missing values in predictors were imputed using multiple imputations. Results: Of 146 pts included, the median age was 68 (range 65-77) 53% were male, 81% Caucasian 43% underwent ASCT. Comorbidities were common (43.9% mild, 21.6% moderate and 9.3% severe). Durie-Salmon Stages were I – 9.5%, II-18.1%, III-72.4%. PS at diagnosis was 0 - 18.3%, 1 - 51.0%, 2 - 21.2% and 3 - 9.6%. Most received novel agents (thalidomide, lenalidomide or bortezomib) in their initial treatment (25.2% alkylators only, 58.6% novel single agents ± steroids, 16.2% novel combination regimens). Age (p .0001) and insurance ayer (p=0.02) were associated with ASCT. On univariate analysis, ASCT [Hazard Ratio (HR) 0.54 (95% confidence intervals (CI) 0.35-0.82)] and PS [PS 1: HR 2.3 (CI 1.0-4.9), PS2: HR 3.3 (1.4-7.9) PS 3: HR 3.5 (CI 1.3-9.3)] were associated with mortality. On multivariate analysis controlling for PS, comorbidity, stage and propensity to undergo ASCT, ASCT was associated with reduced mortality [HR 0.52 (CI 0.30-0.92), p=0.02]. Conclusions: In pts over age 65 with MM, ASCT is associated with better OS after adjusting for propensity to undergo ASCT.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2014
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929340.V1
Abstract: Supplementary Figure S7: The proportional hazards assumption is deemed reasonable by checking the Schoenfeld residuals plot for Full-VPD.
Publisher: Oxford University Press (OUP)
Date: 03-1996
DOI: 10.1093/OXFORDJOURNALS.AJE.A008767
Abstract: Dietary protein increases urinary calcium losses and has been associated with higher rates of hip fracture in cross-cultural studies. However, the relation between protein and risk of osteoporotic bone fractures among in iduals has not been examined in detail. In this prospective study, usual dietary intake was measured in 1980 in a cohort of 85,900 women, aged 35-59 years, who were participants in the Nurses' Health Study. A mailed food frequency questionnaire was used and incident hip (n = 234) and distal forearm (n = 1,628) fractures were identified by self-report during the following 12 years. Information on other factors related to osteoporosis, including obesity, use of postmenopausal estrogen, smoking, and physical activity, was collected on biennial questionnaires. Dietary measures were updated in 1984 and 1986. Protein was associated with an increased risk of forearm fracture (relative risk (RR) = 1.22, 95% confidence interval (Cl) 1.04-1.43, p for trend = 0.01) for women who consumed more than 95 g per day compared with those who consumed less than 68 g per day. A similar increase in risk was observed for animal protein, but no association was found for consumption of vegetable protein. Women who consumed five or more servings of red meat per week also had a significantly increased risk of forearm fracture (RR = 1.23, 95% Cl 1.01-1.50) compared with women who ate red meat less than once per week. Recall of teenage diet did not reveal any increased risk of forearm fracture for women with higher consumption of animal protein or red meat during this earlier period of life. No association was observed between adult protein intake and the incidence of hip fractures, though power to assess this association was low.
Publisher: American Association for Cancer Research (AACR)
Date: 11-2020
DOI: 10.1158/1055-9965.EPI-20-0723
Abstract: Manual qualitative and quantitative measures of terminal duct lobular unit (TDLU) involution were previously reported to be inversely associated with breast cancer risk. We developed and applied a deep learning method to yield quantitative measures of TDLU involution in normal breast tissue. We assessed the associations of these automated measures with breast cancer risk factors and risk. We obtained eight quantitative measures from whole slide images from a benign breast disease (BBD) nested case–control study within the Nurses' Health Studies (287 breast cancer cases and 1,083 controls). Qualitative assessments of TDLU involution were available for 177 cases and 857 controls. The associations between risk factors and quantitative measures among controls were assessed using analysis of covariance adjusting for age. The relationship between each measure and risk was evaluated using unconditional logistic regression, adjusting for the matching factors, BBD subtypes, parity, and menopausal status. Qualitative measures and breast cancer risk were evaluated accounting for matching factors and BBD subtypes. Menopausal status and parity were significantly associated with all eight measures select TDLU measures were associated with BBD histologic subtype, body mass index, and birth index (P & 0.05). No measure was correlated with body size at ages 5–10 years, age at menarche, age at first birth, or breastfeeding history (P & 0.05). Neither quantitative nor qualitative measures were associated with breast cancer risk. Among Nurses' Health Studies women diagnosed with BBD, TDLU involution is not a biomarker of subsequent breast cancer. TDLU involution may not impact breast cancer risk as previously thought.
Publisher: Oxford University Press (OUP)
Date: 20-03-2002
Abstract: Calcium has been hypothesized to reduce the risk of colon cancer, and in a recent randomized trial, calcium supplementation was associated with reduction in the risk of recurrent colorectal adenomas. We examined the association between calcium intake and colon cancer risk in two prospective cohorts, the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS). Our study population included 87 998 women in NHS and 47 344 men in HPFS who, at baseline (1980 for NHS and 1986 for HPFS), completed a food frequency questionnaire and provided information on medical history and lifestyle factors. Dietary information was updated at least every 4 years. During the follow-up period (1980 to May 31, 1996 for the NHS cohort 1986 to January 31, 1996 for the HPFS cohort), 626 and 399 colon cancer cases were identified in women and men, respectively. Pooled logistic regression was used to estimate relative risks (RRs), and all statistical tests were two-sided. In women and men considered together, we found an inverse association between higher total calcium intake (>1250 mg/day versus < or =500 mg/day) and distal colon cancer (women: multivariate RR = 0.73, 95% confidence interval [CI] = 0.41 to 1.27 men: RR = 0.58, 95% CI = 0.32 to 1.05 pooled RR = 0.65, 95% CI = 0.43 to 0.98). No such association was found for proximal colon cancer (women: RR = 1.28, 95% CI = 0.75 to 2.16 men: RR = 0.92, 95% CI = 0.45 to 1.87 pooled RR = 1.14, 95% CI = 0.72 to 1.81). The incremental benefit of additional calcium intake beyond approximately 700 mg/day appeared to be minimal. Higher calcium intake is associated with a reduced risk of distal colon cancer. The observed risk pattern was consistent with a threshold effect, suggesting that calcium intake beyond moderate levels may not be associated with a further risk reduction. Future investigations on this association should concentrate on specific cancer subsites and on the dose-response relationship.
Publisher: American Medical Association (AMA)
Date: 18-12-1996
Publisher: Public Library of Science (PLoS)
Date: 15-10-2015
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2007
Abstract: OBJECTIVE. The goal was to examine the longitudinal associations of changes in television viewing and other sources of sedentary behavior with changes in leisure-time moderate/vigorous physical activity in adolescence. METHODS. We studied a cohort of 6369 girls and 4487 boys who were 10 to 15 years of age in 1997. During each of 4 years of follow-up assessments, participants self-reported their weekly hours of television viewing. By using a seasonal questionnaire, we also obtained detailed information on physical activities over the previous year, from which we calculated total leisure-time moderate/vigorous physical activity. We performed linear regression analyses to assess the longitudinal associations between 1-year changes in television viewing and 1-year changes in leisure-time moderate/vigorous physical activity during the same year, using data from 1997 through 2001. RESULTS. One-year changes (mean ± SD) were −0.13 ± 7.2 hours/week for leisure-time moderate/vigorous physical activity, −0.55 ± 7.0 hours/week for television viewing, and −1.02 ± 11.0 hours/week for total sedentary behaviors. In longitudinal models adjusted for age, age2, gender, race/ethnicity, Tanner stage, menarche (in girls), baseline physical activity, and baseline television viewing, we found no substantive relationship between year-to-year changes in television viewing and changes in leisure-time moderate/vigorous physical activity (0.03 hours/week, for each 1-hour/week change in television viewing). There were no material associations in age or gender subgroups. CONCLUSIONS. In this longitudinal study, changes in television viewing were not associated with changes in leisure-time moderate/vigorous physical activity. Our findings suggest that television viewing and leisure-time physical activity are separate constructs, not functional opposites.
Publisher: American Association for Cancer Research (AACR)
Date: 16-05-2023
DOI: 10.1158/1055-9965.EPI-23-0101
Abstract: Risk factors contributing to more than 10-fold increase in esophageal cancer in the last 50 years remain underexplored. We aim to examine the associations of sleep behaviors with esophageal adenocarcinoma (EAC) and squamous cell carcinoma (ESCC). We prospectively assessed the associations between sleep behaviors (chronotype, duration, daytime napping, daytime sleepiness, snoring, and insomnia) and EAC and ESCC risk in 393,114 participants in the UK Biobank (2006–2016). Participants with 0, 1, and ≥2 unhealthy behaviors, including sleep & or & h/d, daytime napping, and usual daytime sleepiness were classified as having a good, intermediate, and poor sleep. For EAC, we also examined interactions with polygenic risk score (PRS). Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). We documented 294 incident EAC and 95 ESCC. Sleep & h/d (HR, 2.05 95% CI, 1.18–3.57) and sometimes daytime napping (HR, 1.36 95% CI, 1.06–1.75) were in idually associated with increased EAC risk. Compared with in iduals with good sleep, those with intermediate sleep had a 47% (HR, 1.47 95% CI, 1.13–1.91) increased EAC risk, and those with poor sleep showed an 87% (HR, 1.87 95% CI, 1.24–2.82) higher risk (Ptrend & 0.001). The elevated risks for EAC were similar within strata of PRS (Pinteraction = 0.884). Evening chronotype was associated with elevated risk of ESCC diagnosed after 2 years of enrollment (HR, 2.79 95% CI, 1.32–5.88). Unhealthy sleep behaviors were associated with an increased risk of EAC, independent of genetic risk. Sleep behaviors may serve as modifiable factors for the prevention of EAC.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2004
DOI: 10.1097/00008571-200412000-00008
Abstract: Endogenous oestrogens play a crucial role in endometrial cancer pathogenesis, with most endometrial cancer risk factors causing an increase in oestrogens. Adipose tissue, where androgens are converted to oestrogens by the enzyme aromatase, is an important source of endogenous oestrogen production in the postmenopausal woman. The peroxisome proliferator-activated receptor-gamma (PPARgamma), a key transcriptional regulator of adipogenesis, may also play a role in the regulation of aromatase expression in adipose tissue. We hypothesized that the functional PPARgamma ProAla polymorphism may alter aromatase expression, ultimately affecting endometrial cancer susceptibility. We genotyped the PPARgamma ProAla polymorphism in a study of invasive endometrial cancer cases (n = 222) and matched controls (n = 666) nested within the Nurses' Health Study Cohort. We found little or no evidence of an association between the Ala allele of the PPARgamma codon 12 polymorphism and endometrial cancer risk (adjusted odds ratio = 1.18, 95% confidence interval = 0.80-1.76). Furthermore, we found no association with the PPARgamma ProAla polymorphism and the ratio of oestrone to androstenedione or oestradiol to testosterone plasma hormone levels, measures of aromatase activity. Consistent with previous findings for breast cancer, these results suggest that the PPARgamma ProAla polymorphism does not play a major role in mediating circulating oestrogen levels or endometrial cancer susceptibility.
Publisher: Massachusetts Medical Society
Date: 24-08-2000
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516051
Abstract: Supplementary Figure 1 shows the s le selection process
Publisher: Oxford University Press (OUP)
Date: 20-03-1996
Abstract: Family history of breast cancer is an established risk factor for this disease and is used to identify women at higher risk, although the impact of risk factors for breast cancer among women with a family history is not well defined. Using a modified extended log-incidence Pike model, we prospectively examined the impact of risk factors for breast cancer among women with and without a family history of the disease. Data analyzed were obtained prospectively from the Nurses' Health Study. Two thousand two hundred forty-nine incident cases of invasive breast cancer were identified in a cohort of 89,132 women aged 30-55 years in 1976 followed biennially through 1990 (1.1 million person years of follow-up). With the use of proportional hazards models, we evaluated the association between risk factors for breast cancer and risk among women with and those without a family history of the disease. We then fit a modified extended log-incidence Pike model to these data. Among women with a family history of breast cancer, reproductive risk factors has associations that were different from those observed among women without a family history of the disease. In particular, we observed little protection from later age at menarche, no protection from multiple births when compared with nulliparity, nor from early, as compared with later, age at first birth. Fitting these data to a model of breast cancer incidence on the basis of reproductive risk factors, we observed an adverse effect of first pregnancy on risk of breast cancer among women with a family history of breast cancer that was approximately 50% greater in magnitude than among women without a family history. Additional births after the first birth conveyed little protection for women with a family history. History of benign breast disease, past use of oral contraceptives, and use of postmenopausal hormones showed relative risks that did not differ between women with a family history and those without a family history of the disease. We observed a consistent increase in risk of breast cancer among women with a mother or sister history of the disease that was exacerbated by first pregnancy. Among women with a family history of breast cancer, the adverse effect of pregnancy persisted so that to age 70 years, parous women were at higher risk of breast cancer than nulliparous women. Among women without a family history of the disease, first pregnancy was associated with a smaller increase in risk, and early pregnancy and higher number of births were each associated with reduced breast cancer incidence.
Publisher: Wiley
Date: 10-04-2007
DOI: 10.1002/IJC.22575
Abstract: We examined whether a history of smoking is associated with an increased risk of death from any cause or from breast cancer, among women diagnosed with breast cancer. This was a prospective observational study among 5,056 women from the Nurses' Health Study with Stages I-III invasive breast cancer diagnosed between 1978 and 2002 and for whom we had information on smoking, and who were followed until January 2002 or death, whichever came first. Subjects were classified as current, former or never smokers based upon smoking status at the biennial questionnaire immediately preceding the breast cancer diagnosis. In multivariate-adjusted analyses, compared with never smokers, women who were current smokers had a 43% increased adjusted relative risk (RR) [95% confidence interval (95% CI): 1.24-1.65] of death from any cause. A strong linear gradient was observed with the number of cigarettes per day smoked, p-trend <0.0001 the RR (95% CI) for 1-14, 15-24 and 25 or more cigarettes per day was 1.27 (1.01-1.61), 1.30 (1.08-1.57) and 1.79 (1.47-2.19). In contrast, there was no association with current smoking and breast cancer death the RR (95% CI) was 1.00 (0.83-1.19). Current and past smokers were more likely than never smokers to die from primary lung cancer, chronic obstructive pulmonary disease and other lung diseases. We conclude that a history of smoking increased mortality following diagnosis with breast cancer, but did not increase mortality from breast cancer.
Publisher: American Medical Association (AMA)
Date: 11-10-1999
DOI: 10.1001/ARCHINTE.159.18.2177
Abstract: Obesity is an established risk factor for several chronic diseases. The lifetime health and economic consequences of obesity for in idual patients have not been documented. To estimate the lifetime health and economic consequences of obesity. We developed a dynamic model of the relationship between body mass index and the risks and associated costs of 5 obesity-related diseases: hypertension, hypercholesterolemia, type 2 diabetes mellitus, coronary heart disease, and stroke. The model was estimated using data from the Third National Health and Nutrition Examination Survey, the Framingham Heart Study, and other secondary sources. We used this model to estimate (1) risks of hypertension, hypercholesterolemia, and type 2 diabetes mellitus at future ages (2) lifetime risks of coronary heart disease and stroke (3) life expectancy and (4) expected lifetime medical care costs of these 5 diseases for men and women aged 35 to 64 years with body mass indexes of 22.5, 27.5, 32.5, and 37.5 kg/m2 (nonobese and mildly, moderately, and severely obese, respectively). Disease risks and costs increase substantially with increased body mass index. The risk of hypertension for moderately obese 45- to 54-year-old men, for ex le, is roughly 2-fold higher than for their nonobese peers (38.1% vs 17.7%), whereas the risk of type 2 diabetes mellitus is almost 3-fold higher (8.1% vs 3.0%). Lifetime risks of coronary heart disease and stroke are similarly elevated (41.8% vs 34.9% and 16.2% vs 13.9%, respectively), whereas life expectancy is reduced by 1 year (26.5 vs 27.5 years). Total discounted lifetime medical care costs for the treatment of these 5 diseases are estimated to differ by $10,000 ($29,600 vs $19,600). Similar results were obtained for women. The lifetime health and economic consequences of obesity are substantial and suggest that efforts to prevent or reduce this problem might yield significant benefits.
Publisher: American Medical Association (AMA)
Date: 02-06-1999
Abstract: Epidemiological studies of men suggest that dietary fiber intake protects against coronary heart disease (CHD), but data on this association in women are sparse. To examine the association between long-term intake of total dietary fiber as well as fiber from different sources and risk of CHD in women. The Nurses' Health Study, a large, prospective cohort study of US women followed up for 10 years from 1984. Dietary data were collected in 1984, 1986, and 1990, using a validated semiquantitative food frequency questionnaire. A total of 68782 women aged 37 to 64 years without previously diagnosed angina, myocardial infarction (MI), stroke, cancer, hypercholesterolemia, or diabetes at baseline. Incidence of acute MI or death due to CHD by amount of fiber intake. Response rate averaged 80% to 90% during the 10-year follow-up. We documented 591 major CHD events (429 nonfatal MIs and 162 CHD deaths). The age-adjusted relative risk (RR) for major CHD events was 0.53 (95% confidence interval [CI], 0.40-0.69) for women in the highest quintile of total dietary fiber intake (median, 22.9 g/d) compared with women in the lowest quintile (median, 11.5 g/d). After controlling for age, cardiovascular risk factors, dietary factors, and multivitamin supplement use, the RR was 0.77 (95% CI, 0.57-1.04). For a 10-g/d increase in total fiber intake (the difference between the lowest and highest quintiles), the multivariate RR of total CHD events was 0.81 (95% CI, 0.66-0.99). Among different sources of dietary fiber (eg, cereal, vegetables, fruit), only cereal fiber was strongly associated with a reduced risk of CHD (multivariate RR, 0.63 95% CI, 0.49-0.81 for each 5-g/d increase in cereal fiber). Our findings in women support the hypothesis that higher fiber intake, particularly from cereal sources, reduces the risk of CHD.
Publisher: American Diabetes Association
Date: 31-12-2014
DOI: 10.2337/DC14-1453
Abstract: This study analyzed the lifetime health care expenditures and life years lost associated with diabetes in the U.S. Data from the National Health Interview Survey (NHIS), the Medical Expenditure Panel Survey from 1997 to 2000, and the NHIS Linked Mortality Public-use Files with a mortality follow-up to 2006 were used to estimate age-, race-, sex-, and BMI-specific risk of diabetes, mortality, and annual health care expenditures for both patients with diabetes and those without diabetes. A Markov model populated by the risk and cost estimates was used to compute life years and total lifetime health care expenditures by age, race, sex, and BMI classifications for patients with diabetes and without diabetes. Predicted life expectancy for patients with diabetes and without diabetes demonstrated an inverted U shape across most BMI classifications, with highest life expectancy being for the overweight. Lifetime health care expenditures were higher for whites than blacks and for females than males. Using U.S. adults aged 50 years as an ex le, we found that diabetic white females with a BMI & kg/m2 had 17.9 remaining life years and lifetime health expenditures of $185,609, whereas diabetic white females with normal weight had 22.2 remaining life years and lifetime health expenditures of $183,704. Our results show that diabetes is associated with large decreases in life expectancy and large increases in lifetime health care expenditures. In addition to decreasing life expectancy by 3.3 to 18.7 years, diabetes increased lifetime health care expenditures by $8,946 to $159,380 depending on age-race-sex-BMI classification groups.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.C.6695939.V1
Abstract: AbstractBackground: Risk factors contributing to more than 10-fold increase in esophageal cancer in the last 50 years remain underexplored. We aim to examine the associations of sleep behaviors with esophageal adenocarcinoma (EAC) and squamous cell carcinoma (ESCC). Methods: We prospectively assessed the associations between sleep behaviors (chronotype, duration, daytime napping, daytime sleepiness, snoring, and insomnia) and EAC and ESCC risk in 393,114 participants in the UK Biobank (2006–2016). Participants with 0, 1, and ≥2 unhealthy behaviors, including sleep or h/d, daytime napping, and usual daytime sleepiness were classified as having a good, intermediate, and poor sleep. For EAC, we also examined interactions with polygenic risk score (PRS). Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: We documented 294 incident EAC and 95 ESCC. Sleep h/d (HR, 2.05 95% CI, 1.18–3.57) and sometimes daytime napping (HR, 1.36 95% CI, 1.06–1.75) were in idually associated with increased EAC risk. Compared with in iduals with good sleep, those with intermediate sleep had a 47% (HR, 1.47 95% CI, 1.13–1.91) increased EAC risk, and those with poor sleep showed an 87% (HR, 1.87 95% CI, 1.24–2.82) higher risk ( i P /i sub trend /sub 0.001). The elevated risks for EAC were similar within strata of PRS ( i P /i sub interaction /sub = 0.884). Evening chronotype was associated with elevated risk of ESCC diagnosed after 2 years of enrollment (HR, 2.79 95% CI, 1.32–5.88). Conclusions: Unhealthy sleep behaviors were associated with an increased risk of EAC, independent of genetic risk. Impact: Sleep behaviors may serve as modifiable factors for the prevention of EAC. /
Publisher: Oxford University Press (OUP)
Date: 06-2006
Publisher: Oxford University Press (OUP)
Date: 13-02-2013
Publisher: Elsevier BV
Date: 04-2006
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.C.6695939.V2
Abstract: AbstractBackground: Risk factors contributing to more than 10-fold increase in esophageal cancer in the last 50 years remain underexplored. We aim to examine the associations of sleep behaviors with esophageal adenocarcinoma (EAC) and squamous cell carcinoma (ESCC). Methods: We prospectively assessed the associations between sleep behaviors (chronotype, duration, daytime napping, daytime sleepiness, snoring, and insomnia) and EAC and ESCC risk in 393,114 participants in the UK Biobank (2006–2016). Participants with 0, 1, and ≥2 unhealthy behaviors, including sleep or h/d, daytime napping, and usual daytime sleepiness were classified as having a good, intermediate, and poor sleep. For EAC, we also examined interactions with polygenic risk score (PRS). Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: We documented 294 incident EAC and 95 ESCC. Sleep h/d (HR, 2.05 95% CI, 1.18–3.57) and sometimes daytime napping (HR, 1.36 95% CI, 1.06–1.75) were in idually associated with increased EAC risk. Compared with in iduals with good sleep, those with intermediate sleep had a 47% (HR, 1.47 95% CI, 1.13–1.91) increased EAC risk, and those with poor sleep showed an 87% (HR, 1.87 95% CI, 1.24–2.82) higher risk ( i P /i sub trend /sub 0.001). The elevated risks for EAC were similar within strata of PRS ( i P /i sub interaction /sub = 0.884). Evening chronotype was associated with elevated risk of ESCC diagnosed after 2 years of enrollment (HR, 2.79 95% CI, 1.32–5.88). Conclusions: Unhealthy sleep behaviors were associated with an increased risk of EAC, independent of genetic risk. Impact: Sleep behaviors may serve as modifiable factors for the prevention of EAC. /
Publisher: Oxford University Press (OUP)
Date: 08-1986
DOI: 10.1093/OXFORDJOURNALS.AJE.A114401
Abstract: There is no scientific consensus on the optimal specification of the time trade-off (TTO) task. As a consequence, studies using TTO to value health states may share the core element of trading length of life for quality of life, but can differ considerably on many other elements. While this pluriformity in specifications advances the understanding of TTO from a methodological point of view, it also results in incomparable health state values. Health state values are applied in health technology assessments, and in that context comparability of information is desired. In this article, we discuss several alternative specifications of TTO presented in the literature. The defining elements of these specifications are identified as being either methodological, procedural or analytical in nature. Where possible, it is indicated how these elements affect health state values (i.e., upward or downward). Finally, a checklist for TTO studies is presented, which incorporates a list of choices to be made by researchers who wish to perform a TTO task. Such a checklist enables other researchers to align methodologies in order to enhance the comparability of health state values.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 11-2000
DOI: 10.1200/JCO.2000.18.21.3668
Abstract: PURPOSE: To examine the relationship between plasma levels of reproductive sex steroid hormones in postmenopausal women and their reported fat intake. METHODS: We measured plasma sex steroid hormones levels in plasma collected in 1989 and 1990 from 381 healthy postmenopausal women. For each woman, we measured fat intake in 1986 and 1990 by a food-frequency questionnaire. The cross-sectional associations between the percentage of energy from total and specific types of dietary fat intake and plasma hormone levels were assessed by linear regression, controlling for energy intake, obesity, and protein intake. RESULTS: The plasma estradiol level was 4.3% lower (95% confidence limits, −8.3%, −0.2%) for a substitution of 5% of energy from fat intake for an equivalent amount of energy from carbohydrate when adjusted for obesity and other covariates. Estradiol was also inversely associated with all other fat types except trans fat the inverse associations with vegetable fat and marine omega-3 fats were statistically significant. CONCLUSION: We observed an inverse association between total fat intake averaged over 4 to 5 years and estradiol levels. This result is inconsistent with the hypothesis that fat intake predisposes to breast cancer risk by raising endogenous estrogen levels.
Publisher: Oxford University Press (OUP)
Date: 20-03-1996
Abstract: In 1983, Pike et al. developed a mathematical model to quantify the effects of reproductive risk factors on the incidence of breast cancer. In 1994, we modified that model to correct some deficiencies in the original model, including a lack of terms for spacing of births and an inability to easily accommodate births after age 40 years. Our extended Pike model, while improving on the original, still has serious disadvantages, such as difficulty in translating model parameters into relative risks (RRs) and an incomplete fit to data that slightly overestimated incidence for premenopausal women with an early age at first birth and that underestimated incidence for post-menopausal women with a late age at first birth. We undertook both the development of a new mathematical model to quantify the effects of reproductive risk factors on breast cancer incidence and validation of the model. A new log-incidence model of breast cancer incidence was developed using nonlinear regression methods, and a study population consisting of 89,132 women in the Nurses' Health Study from which a total of 2249 incident cases of breast cancer were identified. Subjects were followed from the return of the 1976 Nurses' Health Study questionnaire until June 1, 1990, or until the last questionnaire was returned, until the development of any cancer, or until death, yielding 1,148,593 person-years of follow-up. The log-incidence models were fitted using iteratively reweighted least squares analysis. The log-incidence model provided a better fit to that data than the extended Pike model, with parameter estimates interpretable in terms of RRs. This new model can be fitted using standard commercially available statistical software. In the model, younger parous women are generally at slightly higher risk than nulliparous women, which is true for both the observed and expected RRs, and older parous women, aged 55-64 years with an early age at first birth, are at lower risk than nulliparous women,while older women with a late age at first birth are at substantially higher risk than nulliparous women. Log-incidence models, such as this one, provide an efficient framework for modeling the effect of lifestyle risk factors on breast cancer incidence that may be specifically targeted to certain time periods of a woman's reproductive life.
Publisher: WHO Press
Date: 09-12-2013
Publisher: American Diabetes Association
Date: 07-2002
DOI: 10.2337/DIACARE.25.7.1142
Abstract: OBJECTIVE—To examine the relationship of obesity, measured as BMI, and weight change to incidence of coronary heart disease (CHD) among women with diabetes. RESEARCH DESIGN AND METHODS—We followed 5,897 women with type 2 diabetes in the Nurses’ Health Study for ≤20 years. Women were aged 40–74 years and had no history of cardiovascular disease or cancer at the beginning of the follow-up period. BMI values from three time points (age 18 years, year 1976, and current) were derived from the reported height (1976) and corresponding reported weight. Weight changes between age 18 years and 1976 and after diagnosis of diabetes were calculated. Women reported diagnoses of diabetes and CHD every 2 years. Incident CHD cases were confirmed by medical record review. RESULTS—During follow-up, we documented 418 incident cases of CHD (236 of nonfatal myocardial infarction and 182 of fatal CHD). After adjustment for age, smoking, and other coronary risk factors, current BMI was strongly associated with increased risk of CHD among diabetic women. The multivariate relative risks across increasing categories of BMI (& .0, 23.0–24.9, 25.0–26.9, 27.0–29.9, 30.0–34.9, and ≥35.0 kg/m2) were 1.0, 1.58, 1.85, 1.95, 2.80, and 3.21, respectively (P for trend & .001). Increasing BMI values from age 18 years to 1976, before diagnosis of diabetes, were also positively associated with risk of CHD. Weight gain before the diagnosis of diabetes was related to increased risk of CHD. In contrast, weight change after diagnosis of diabetes was not associated with risk of CHD. CONCLUSIONS—These findings provide strong evidence that obesity and weight gain before diagnosis of diabetes are associated with future risk of CHD among women with type 2 diabetes.
Publisher: American Medical Association (AMA)
Date: 06-1991
Publisher: Elsevier BV
Date: 06-2018
Publisher: Elsevier BV
Date: 09-2004
DOI: 10.1097/01.CHI.0000131139.93862.10
Abstract: To examine sexual orientation group differences in eating disorder symptoms in adolescent girls and boys. Cross-sectional associations were examined using multivariate regression techniques using data gathered in 1999 from 10,583 adolescents in the Growing Up Today Study, a cohort of children of women participating in the Nurses' Health Study II. Ninety-two percent of the cohort described themselves as heterosexual, 5% as mostly heterosexual, 1% as lesbian/gay/bisexual, and 2% as unsure. Both mostly heterosexual girls and boys had greater concerns with weight and appearance and were less happy with their bodies compared with same-gender heterosexuals (all p < .05). Compared with heterosexual girls, the mostly heterosexual girls were more likely to vomit/use laxatives to control weight (odds ratio 1.7 95% confidence interval = 1.2-2.6) and to binge eat (odds ratio 2.3 95% confidence interval = 1.4-3.8) in the past year. Compared with heterosexual boys, gay/bisexual boys were more concerned with trying to look like men in the media (p < .05) and more likely to binge (odds ratio 15.2 95% confidence interval = 3.3-69). Compared with heterosexual girls, lesbian/bisexual girls were happier with their bodies (p < .05) and less concerned with trying to look like women in the media (p < .05). Mostly heterosexual girls and boys are a newly identified group at increased risk of eating disorder symptoms. Gay/bisexual boys were also at increased risk.
Publisher: Wiley
Date: 23-05-2002
DOI: 10.1002/CNCR.10575
Abstract: African-American women are at increased risk for breast cancer mortality compared with white American women, and the extent to which socioeconomic factors account for this outcome disparity is unclear. A MEDLINE search was conducted to identify published studies that used a Cox proportional hazards regression model to evaluate the outcome of African-American women and white American women with breast carcinoma after adjusting for socioeconomic status. A meta-analysis was performed using specialized statistical software the random-effects method of statistical evaluation was used because of the a priori impression that the studies reviewed would be at least moderately heterogeneous in study design and patient populations. The initial literature search yielded 3962 studies. Fourteen studies met all criteria for inclusion in the meta-analysis, resulting in a s le size of 10,001 African-American patients and 42,473 white American patients with breast carcinoma. There was substantial variation in the method used for defining socioeconomic status. Summary statistics revealed a significant odds ratio of 1.22 (95% confidence interval, 1.13-1.30) for the adverse effect of African-American ethnicity on breast cancer mortality. Subset meta-analyses yielded similar results, supporting the robustness of this finding. This meta-analysis revealed that African-American ethnicity is an independent predictor of a worse breast cancer outcome. The pooled analysis has added strength because of the aggregate s le size and indicates that the true biologic and/or therapeutic determinants of disparities in breast cancer outcome for different ethnic groups and for different socioeconomic strata are incompletely understood.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2014
Publisher: Oxford University Press (OUP)
Date: 03-02-2004
DOI: 10.1093/JNCI/DJH025
Abstract: Evaluations of epidemiologic risk factors in relation to breast cancer classified jointly by estrogen receptor (ER) and progesterone receptor (PR) status have been inconsistent. To address this issue, we conducted a prospective evaluation of risk factors for breast cancer classified according to receptor status. During 1 029 414 person-years of follow-up of 66 145 women participating in the Nurses' Health Study from 1980 through 2000, we identified 2096 incident cases of breast cancer for which information on ER/PR status was available: 1281 were ER+/PR+, 318 were ER+/PR-, 80 were ER-/PR+, and 417 were ER-/PR-. We fit a log-incidence model of breast cancer and used polychotomous logistic regression to compare coefficients for breast cancer risk factors in patients with different ER/PR status. To test for differences in risk factor odds ratios based on marginal ER/PR categories, we evaluated ER status controlling for PR status and vice versa. The predictive ability of our log-incidence model to discriminate between women who would develop ER+/PR+ breast cancer and those who would not (and similarly for ER-/PR- breast cancer) was evaluated by using receiver operator characteristic curve analysis. All statistical tests were two-sided. We observed statistically significant heterogeneity among the four ER/PR categories for some risk factors (age, menopausal status, body mass index [BMI] after menopause, the one-time adverse effect of first pregnancy, and past use of postmenopausal hormones) but not for others (benign breast disease, family history of breast cancer, alcohol use, and height). The one-time adverse association of first pregnancy with incidence was present for PR- but not for PR+ tumors after controlling for ER status (P =.007). However, the association of BMI after menopause with incidence was present for PR+ but not PR- tumors (P =.005). Statistically significant differences in the incidence of ER+ and ER- tumors were seen with age, both before and after menopause (P =.003), and with past use of postmenopausal hormones (P =.01). Area under the receiver operator characteristic curve, adjusted for age, was 0.64 (95% confidence interval [CI] = 0.63 to 0.66) for ER+/PR+ tumors and 0.61 (95% CI = 0.58 to 0.64) for ER-/PR- tumors. Incidence rates and risk factors for breast cancer differ according to ER and PR status. Thus, to accurately estimate breast cancer risk, breast cancer cases should be ided according to the ER and PR status of the tumor.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516039
Abstract: Supplementary Table 4 shows the association between finer composite sleep score and EAC risk
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516036
Abstract: Supplementary Table 5 shows the association between weighted sleep score and EAC risk
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516033
Abstract: Supplementary Table 6 shows the association between composite sleep score and EAC risk with deaths as competing events
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516030
Abstract: Supplementary Table 7 shows the association between composite sleep score and EAC risk by BMI group
Publisher: Elsevier BV
Date: 02-2006
Publisher: American Academy of Pediatrics (AAP)
Date: 10-1999
Abstract: To examine the cross-sectional relationships between weight concerns, weight control behaviors, and initiation of tobacco use among youths. Smoking status, weight concerns, and weight control behaviors were assessed in a cross-sectional s le of 16 862 children, 9 to 14 years of age, in 1996. Logistic regression was used to examine the relationship between weight concerns, weight control behaviors, and early stages of smoking initiation (precontemplation, contemplation, and experimentation). All analyses were adjusted for age, body mass index, and known predictors of initiation. Approximately 9% of participants had experimented with cigarettes, and 6% were contemplating cigarette smoking. Contemplation of tobacco use was associated with misperception of being overweight (boys: odds ratio [OR], 1.65 95% confidence interval [CI], 1.10–2.48), unhappiness with appearance (girls: OR, 2.05 95% CI, 1.48–2.84 boys: OR, 1.60 95% CI, 1.05–2.42), and a tendency to change eating patterns around peers (girls: OR, 2.87 95% CI, 2.28–3.62 boys: OR, 1.83 95% CI, 1.25–2.66). Experimentation with cigarettes was associated with daily exercise to control weight among boys (OR, 1.92 95% CI, 1.07–3.43) and with monthly purging (OR, 2.54 95% CI, 1.27–5.07) and daily dieting among girls (OR, 1.79 95% CI, 1.09–2.96). Our findings suggest that, among both girls and boys, contemplation of smoking is positively related to weight concerns. Experimentation seems to be positively related to weight control behaviors. It is important for both pediatricians and comprehensive school health programs to address healthy methods of weight maintenance and to dispel the notion of tobacco use as a method of weight control.
Publisher: The Endocrine Society
Date: 06-2004
DOI: 10.1210/JC.2004-0288
Publisher: BMJ
Date: 31-10-2014
DOI: 10.1136/BMJ.G6356
Abstract: To determine whether use of oral contraceptives is associated with all cause and cause specific mortality. Prospective cohort study. Nurses' Health Study, data collected between 1976 and 2012. 121,701 participants were prospectively followed for 36 years lifetime oral contraceptive use was recorded biennially from 1976 to 1982. Overall and cause specific mortality, assessed throughout follow-up until 2012. Cox proportional hazards models were used to calculate the relative risks of all cause and cause specific mortality associated with use of oral contraceptives. In our population of 121,577 women with information on oral contraceptive use, 63,626 were never users (52%) and 57,951 were ever users (48%). After 3.6 million person years, we recorded 31,286 deaths. No association was observed between ever use of oral contraceptives and all cause mortality. However, violent or accidental deaths were more common among ever users (hazard ratio 1.20, 95% confidence interval 1.04 to 1.37). Longer duration of use was more strongly associated with certain causes of death, including premature mortality due to breast cancer (test for trend P<0.0001) and decreased mortality rates of ovarian cancer (P=0.002). Longer time since last use was also associated with certain outcomes, including a positive association with violent or accidental deaths (P=0.005). All cause mortality did not differ significantly between women who had ever used oral contraceptives and never users. Oral contraceptive use was associated with certain causes of death, including increased rates of violent or accidental death and deaths due to breast cancer, whereas deaths due to ovarian cancer were less common among women who used oral contraceptives. These results pertain to earlier oral contraceptive formulations with higher hormone doses rather than the now more commonly used third and fourth generation formulations with lower estrogen doses.
Publisher: American Diabetes Association
Date: 1996
Abstract: To determine the frequency of screening for gestational diabetes mellitus (GDM) among a population receiving regular prenatal care and to assess the extent to which National Diabetes Data Group (NDDG) criteria for the diagnosis of GDM are used by practicing obstetricians. We studied participants in the Nurses' Health Study II, a large prospective cohort study of 116,678 nurses aged 25–42 years in 1989. A total of 422 women who reported a first diagnosis of GDM between 1989 and 1991 were sent supplementary questionnaires regarding diagnosis and treatment, and medical records were requested for a subset of 120 to validate self-reported GDM and assess criteria used for diagnosis. A s le of 100 women who reported a pregnancy not complicated by GDM were sent questionnaires addressing GDM screening and prenatal care. Among a s le of 93 women who reported a pregnancy not complicated by GDM and responded to the supplementary questionnaire, 16 (17%) reported no glucose loading test 69% of unscreened women had one or more risk factors for GDM. Among a s le of 114 women who self-reported GDM in a singleton pregnancy and whose medical records were available for review, a physician diagnosis of GDM was confirmed in 107 (94%). Records and supplementary questionnaires indicated that oral glucose tolerance tests (OGTTs) were performed in 96 (86%) of these women. Of women with a physician diagnosis of GDM whose OGTT results were available, 25% failed to meet NDDG criteria for this diagnosis, although all had evidence of abnormal glucose homeostasis. Screening for GDM is not universal, even among a group of health professionals in whom screening prevalence is likely to be higher than in the general population. Diagnostic criteria for GDM among obstetricians in practice remain nonstandard despite NDDG recommendations. Better understanding of the implications of differing degrees of glucose intolerance and of varying GDM screening and management strategies is required to make policy recommendations for appropriate and cost-effective care.
Publisher: American Psychiatric Association Publishing
Date: 09-2004
Publisher: Elsevier BV
Date: 03-2007
Abstract: Carotenoids may reduce lung carcinogenesis because of their antioxidant properties however, few studies have examined the relation between intakes of in idual carotenoids and lung cancer risk. The aim of this study was to examine the relation between lung cancer risk and intakes of alpha-carotene, beta-carotene, lutein, lycopene, and beta-cryptoxanthin in 2 large cohorts. During a 10-y follow-up period, 275 new cases of lung cancer were diagnosed in 46924 men during a 12-y follow-up period, 519 new cases were diagnosed in 77283 women. Carotenoid intakes were derived from the reported consumption of fruit and vegetables on food-frequency questionnaires administered at baseline and during follow-up. The data were analyzed separately for each cohort and the results were pooled to compute overall relative risks (RRs). In the pooled analyses, alpha-carotene and lycopene intakes were significantly associated with a lower risk of lung cancer the association with beta-carotene, lutein, and beta-cryptoxanthin intakes were inverse but not significant. Lung cancer risk was significantly lower in subjects who consumed a diet high in a variety of carotenoids (RR: 0.68 95% CI: 0.49, 0.94 for highest compared with lowest total carotenoid score category). Inverse associations were strongest after a 4-8-y lag between dietary assessment and date of diagnosis. In subjects who never smoked, a 63% lower incidence of lung cancer was observed for the top compared with the bottom quintile of alpha-carotene intake (RR: 0.37 95% CI: 0.18, 0.77). Data from 2 cohort studies suggest that several carotenoids may reduce the risk of lung cancer.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 10-09-2010
Abstract: Patients with cancer increasingly ask what they can do to change their lifestyles and improve outcomes. Risk factors for onset of cancer may differ substantially from those that modify survival with implications for counseling. This review focuses on recent data derived from population-based studies of causes of cancer and of patients with cancer to contrast risk factors for etiology with those that impact survival. For different cancer sites, the level of information to inform the timing of lifestyle exposures and risk of disease onset or progression after diagnosis is often limited. For breast cancer, timing of some exposures, such as radiation, is particularly important. For other exposures, such as physical activity, higher levels may prevent onset and also improve survival. For colon cancer, study of precursor polyps has provided additional insight to timing. Extensive data indicate that physical activity reduces risk of colon cancer, and more limited data suggest that exposure after diagnosis improves survival. Dietary factors including folate and calcium may also reduce risk of onset. More limited data on prostate cancer point to obesity increasing risk of aggressive or advanced disease. Timing of change in lifestyle for change in risk of onset and for survival is important but understudied among patients with cancer. Counseling patients with cancer to increase physical activity and avoid weight gain may improve outcomes. Advice to family members on lifestyle may become increasingly important for breast and other cancers where family history is a strong risk factor.
Publisher: Springer Science and Business Media LLC
Date: 2002
Publisher: Elsevier BV
Date: 02-2018
Publisher: Elsevier BV
Date: 03-2019
Publisher: Wiley
Date: 03-11-2008
DOI: 10.1002/CNCR.23879
Publisher: Springer Science and Business Media LLC
Date: 2002
Abstract: We examined prospectively intakes of vitamins A. C, and E, folate, and specific carotenoids in relation to the risk of basal cell carcinoma of the skin (BCC) in women. Dietary intake was assessed by food-frequency questionnaires every two-four years and the first diagnosis of BCC was ascertained by self-report every two years. We used logistic regression to model the association between dietary intake and the risk of BCC adjusting for various health, sun exposure, and sun sensitivity factors. During 12 years of follow-up we recorded 5392 cases. We did not find any significant inverse associations between these dietary factors and BCC. On the contrary. weak positive trends were seen with vitamins A, C, and E, and folate. The multivariate relative risks (RRs) comparing the top to bottom quintile were 1.20 (95% CI = 1.10-1.31) for folate, 1.16 (95% CI = 1.06-1.26) for vitamin A. 1.13 (95% CI = 1.03-1.23) for vitamin C, and 1.15 (95% CI = 1.06-1.26) for vitamin E. Exploration of latency periods did not suggest different associations with a particular duration. We did not find evidence that vitamins A, C, and E. and folate. or specific carotenoids play an important protective role against the incidence of BCC.
Publisher: Elsevier BV
Date: 07-2004
Publisher: Massachusetts Medical Society
Date: 03-03-2011
DOI: 10.1056/NEJMP1006634
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516048
Abstract: Supplementary Table 1 shows the associations between SNPs and EAC risk
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516045
Abstract: Supplementary Table 2 shows the weights used to construct the weighted sleep score
Publisher: American Association for Cancer Research (AACR)
Date: 12-2005
DOI: 10.1158/1055-9965.EPI-05-0525
Abstract: Proliferative benign breast disease is a marker of increased breast cancer risk, yet little is known about its etiology. Most studies of benign breast disease have focused only on risk factors in adulthood, despite growing evidence that factors in early life influence breast cancer risk. We explored the relations of several early life factors with incidence of proliferative benign breast disease among 71,896 premenopausal women in the Nurses' Health Study II who recalled their body fatness at young ages, physical activity in adolescence, birthweight, and history of being breastfed. Between 1991 and 1997, 901 of these women were identified as having proliferative benign breast disease from a centralized pathology review. Relative risks (RR) and 95% confidence intervals (95% CI) were estimated from Cox proportional hazards models. Greater childhood body fatness (ages 5-10) was associated with decreased risk of proliferative benign breast disease the multivariate RR (95% CI) for the most overweight compared with the most lean was 0.61 (0.44-0.86 Ptrend & 0.0001) and remained significant after adjustment for current body mass index. Body mass index at age 18 was also inversely associated with incidence of proliferative benign breast disease, with a multivariate RR (95% CI) of 0.67 (0.52-0.88) for those who were ≥25 kg/m2 compared with those who were & kg/m2 (Ptrend = 0.001). There were no clear associations for physical activity in adolescence, birthweight, or being breastfed. These results indicate that premenopausal women who were heavier at young ages have lower incidence of proliferative benign breast disease, consistent with previous findings for breast cancer. (Cancer Epidemiol Biomarkers Prev 2005 (12):2889–97)
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516042
Abstract: Supplementary Table 3 shows the sensitivity analyses for the association between sleep and EAC and ESCC by excluding cancer cases diagnosed within 2 years of enrollment
Publisher: American Medical Association (AMA)
Date: 15-08-2001
Abstract: The rate of tuberculosis (TB) among US homeless persons may be 20 times that of the general adult population. Studies suggest that the majority of urban homeless TB cases are attributable to ongoing transmission of TB. Optimal TB-control strategies in both chronically and transiently homeless populations are not known. To examine the effects of TB-control strategies on projected TB cases and deaths in US homeless populations using a computer-based simulation model. The US general population and a theoretical population of 2 million homeless in iduals in 1995 were ided into 18 clinical states based on the risk for or presence of TB and human immunodeficiency virus (HIV) infection in a semi-Markov model. Prevalence of transiently and chronically homeless in iduals with active TB and deaths from TB as a function of public health measures taken to control and eliminate TB, including improvement of treatment effectiveness, improvement in access to treatment, and vaccination with BCG. A 10% increase in access to treatment among homeless persons with active TB produced larger declines in predicted TB cases and deaths after 10 years (cases and deaths among chronically homeless persons decreased 12.5% and 19.8% and among transiently homeless persons dropped 35.9% and 32.4%, respectively) than improvements in the effectiveness of treatment programs (cases and deaths among chronically homeless persons declined 7.2% and 3.1% and among transiently homeless persons dropped 10.9% and 4.1%, respectively). A 10% increase in access to treatment among homeless persons with latent TB infection led to a 6.7% decline in TB among chronically homeless persons and a 5.7% decline among transiently homeless persons, while a 10% improvement in effectiveness of treatment for latent TB infection was associated with declines of 3.0% and 3.3%, respectively. When treatment for latent TB infection was modeled to be the same in vaccinated and nonvaccinated populations, BCG vaccination led to TB case declines of 15.4% and 21.5% in chronically and transiently homeless populations, respectively. Overcoming barriers faced by homeless in iduals in accessing TB treatment programs will be crucial to reducing the burden of TB in this high-risk group. Increased treatment access, improvement in the effectiveness of treatment programs, and BCG vaccination of HIV-negative homeless in iduals have the best chance to markedly decrease TB morbidity and mortality.
Publisher: Springer Science and Business Media LLC
Date: 1997
Publisher: No publisher found
Date: 2008
DOI: 10.1016/J.AMEPRE.2008.05.009
Abstract: In the past few decades, significant advances have been made related to understanding, preventing, and treating chronic disease. Given these many advances across multiple disciplines, it is unclear why the potential for yielding substantial reduction in disease has not been achieved overall and across various subgroups. Socioeconomic and racial/ethnic disparities in a wide range of disease outcomes persist, and a number of studies highlight the importance of further improving behavioral risk-factor prevalence on a population level. The goal of this paper is to explore the role of transdisciplinary collaboration in the translation of research related to these vexing public health problems, and, in particular, to explore factors that appear to facilitate effective and sustainable translation. Transdisciplinary collaboration also has great potential to speed the rate of adoption of evidence-based practices. Ex les of transdisciplinary collaborations in academic and community settings are provided, along with factors that may influence the long-term outcomes of transdisciplinary efforts.
Publisher: Oxford University Press (OUP)
Date: 06-2001
Abstract: The authors examined use of in idual supplements of vitamins A, C, and E only and multivitamins in relation to risk of non-Hodgkin's lymphoma in prospective cohorts of 88,410 women in the Nurses' Health Study (1980-1996), with 261 incident cases during 16 years of follow-up, and of 47,336 men in the Health Professionals Follow-Up Study (1986-1996), with 111 incident cases during 10 years of follow-up. Multivitamin use was associated with a higher risk of non-Hodgkin's lymphoma among women but not among men the multivariate relative risks for long-term duration (10 or more years) were 1.48 (95% confidence interval (CI): 1.01, 2.16) for women and 0.85 (95% CI: 0.45, 1.58) for men. The pooled multivariate relative risk from the two cohorts was 1.18 (95% CI: 0.70, 2.02). Use of in idual supplements of vitamins A, C, and E only was not associated with risk among men. An increased risk associated with the use of in idual supplements of vitamins A, C, and E only among women appeared to be secondary to the use of multivitamins by the same persons. Because an elevated risk among multivitamin users was not observed consistently in the two cohorts and the pooled data were not significant, the elevated risk among women may be the result of chance.
Publisher: American Association for Cancer Research (AACR)
Date: 03-2019
DOI: 10.1158/1055-9965.EPI-18-0773
Abstract: Colorectal cancer is a leading cause of cancer death. Biomarkers to predict treatment outcomes are needed, as is evidence whether postdiagnosis diet and lifestyle can affect well-being and clinical outcomes. The international ColoCare Consortium aims to identify new biologic markers (e.g., metabolomic, transcriptomic, metagenomic, genetic, epigenetic, proteomic markers) that predict clinical outcomes, and to characterize associations between modifiable risk factors (e.g., diet, supplement use, physical activity) with short-term and long-term patient-reported and clinical outcomes among patients with colorectal cancer. Methods/Results: ColoCare is recruiting newly diagnosed patients with colorectal cancer across six sites in the United States and one site in Germany. As of April 2018, we have recruited & ,000 patients across all sites. Our projected enrollment is & ,000 multiethnic patients with colorectal cancer. The study includes uniformly collected, comprehensive sets of data and biospecimens at multiple time points up to 5 years after diagnosis. Treatment and clinical data are abstracted from medical records and centrally harmonized. Biospecimens are archived according to standardized procedures. Our initial studies demonstrated metabolic differences in adipose tissue types. We further reported on associations of biological factors (e.g., inflammation, DNA methylation, metabolomics) with lifestyle factors (e.g., adiposity, smoking, physical activity, dietary supplement use) or joint associations with clinical outcomes. ColoCare is a consortium for the investigation of multilevel factors relevant to colorectal cancer survivorship. The combination of a comprehensive set of biospecimens collected at multiple time points, jointly with detailed assessments of health behaviors and other prognostic factors, results in a unique resource that facilitates wide-ranging, innovative, and impactful research on colorectal cancer.
Publisher: Mary Ann Liebert Inc
Date: 10-2009
Publisher: Elsevier BV
Date: 08-2000
DOI: 10.1016/S1047-2797(00)00054-5
Abstract: Alcohol consumption has been implicated in the pathogenesis of cataract in some, but not all analytic studies. To date, no prospective analysis of the relationship between alcohol consumption and cataract has been conducted in women. We examined the association between alcohol consumption and cataract extraction in a prospective cohort of female registered nurses. In 1980, 50,461 women were included and others were added as they became 45 years of age for a total of 77,466 women. Information on alcohol consumption and incidence of senile cataract extraction was ascertained during 12 years of follow-up with biennial questionnaires. We observed 1468 cases of cataract extraction in 761,036 person-years of follow-up. Compared to nondrinkers, those consuming alcohol were not at increased risk of cataract, even up to 25 grams or more per day (2 or more drinks). Results remained unchanged after controlling for cataract risk factors including cigarette smoking, body mass index, and diabetes. When risk was examined for specific cataract subtypes only, those in the highest category of consumption had a multivariate relative risk of 1.10 for nuclear cataracts and 1.50 for posterior subcapsular cataracts only. These prospective data suggest that there is no substantial overall increased risk of senile cataract due to alcohol intake. The possibility that alcohol consumption leads to a modest increased risk of posterior subcapsular type opacities requiring extraction merits further exploration.
Publisher: Massachusetts Medical Society
Date: 20-11-1997
DOI: 10.1056/NEJM199711203372102
Abstract: The purpose of this study is to compare serum pancreatic polypeptide (PP), insulin, C-peptide, and glucagon in different glucose tolerance stages analyze the influencing factors of PP secretion and further explore the role of PP in the pathogenesis of diabetes mellitus. Data were collected from 100 subjects from hospital. According to the results of oral glucose tolerance test (OGTT), the subjects were ided into a normal glucose tolerance (NGT) group, an impaired glucose regulation (IGR) group, and a newly diagnosed type 2 diabetes mellitus (T2DM) group. PP and the related parameters were measured, and the area under the curve (AUC) 120 min after OGTT was calculated. AUC Postprandial 60 min PP in the IGR group was higher than those in the NGT group (2973.80 [±547.49] pg·h/mL vs 2663.55 [±594.89] pg·h/mL, p < 0.05). AUC Compared with NGT subjects, IGR and T2DM patients have an enhanced postprandial PP secretion. In T2DMs, the secretion of PP is mainly affected by BMI and blood glucose.
Publisher: American Medical Association (AMA)
Date: 17-07-2002
Publisher: Oxford University Press (OUP)
Date: 24-06-2019
Abstract: Although obesity is an established modifiable risk factor for multiple myeloma (MM), several nuanced aspects of its relation to MM remain unelucidated, limiting public health and prevention messages. We analyzed prospective data from the Nurses’ Health Study and Health Professionals Follow-Up Study to examine MM risk associated with 20-year weight patterns in adulthood, body shape trajectory from ages 5 to 60 years, and body fat distribution. For each aforementioned risk factor, we report hazard ratios (HRs) and 95% confidence intervals (CIs) for incident MM from multivariable Cox proportional-hazards models. We documented 582 incident MM cases during 4 280 712 person-years of follow-up. Persons who exhibited extreme weight cycling, for ex le, those with net weight gain and one or more episodes of intentional loss of at least 20 pounds or whose cumulative intentional weight loss exceeded net weight loss with at least one episode of intentional loss of 20 pounds or more had an increased MM risk compared with in iduals who maintained their weight (HR = 1.71, 95% CI = 1.05 to 2.80) the association was statistically nonsignificant after adjustment for body mass index. We identified four body shape trajectories: lean-stable, lean-increase, medium-stable, and medium-increase. MM risk was higher in the medium-increase group than in the lean-stable group (HR = 1.62, 95% CI = 1.22 to 2.14). Additionally, MM risk increased with increasing hip circumference (HR per 1-inch increase: 1.03, 95% CI = 1.01 to 1.06) but was not associated with other body fat distribution measures. Maintaining a lean and stable weight throughout life may provide the strongest benefit in terms of MM prevention.
Publisher: Oxford University Press (OUP)
Date: 21-05-2010
DOI: 10.1093/AJE/KWQ085
Publisher: Massachusetts Medical Society
Date: 30-04-1987
DOI: 10.1056/NEJM198704303161801
Abstract: Rationality principles are the bedrock of normative theories of decision-making in biology and microeconomics, but whereas in microeconomics, consistent choice underlies the notion of utility in biology, the assumption of consistent selective pressures justifies modelling decision mechanisms as if they were designed to maximize fitness. In either case, violations of consistency contradict expectations and attract theoretical interest. Reported violations of rationality in non-humans include intransitivity (i.e. circular preferences) and lack of independence of irrelevant alternatives (changes in relative preference between options when embedded in different choice sets), but the extent to which these observations truly represent breaches of rationality is debatable. We tested both principles with starlings (Sturnus vulgaris), training subjects either with five options differing in food delay (exp. 1) or with six options differing in reward probability (exp. 2), before letting them choose repeatedly one option out of several binary and trinary sets of options. The starlings conformed to economic rationality on both tests, showing strong stochastic transitivity and no violation of the independence principle. These results endorse the rational choice and optimality approaches used in behavioural ecology, and highlight the need for functional and mechanistic enquiring when apparent violations of such principles are observed.
Publisher: Oxford University Press (OUP)
Date: 09-1991
DOI: 10.1093/OXFORDJOURNALS.AJE.A116117
Abstract: The authors examined the relation between sun exposure and melanoma risk and tested the previously published site-specific association of bikini use and melanoma of the trunk in a study of 130 cases incident between 1976 and 1984 and 300 controls nested within the Nurses' Health Study. A summary variable derived from four measures of sun sensitivity was more closely associated with melanoma than any component measure. There was no association of bikini use at ages 15-20 years with trunk melanoma risk (relative risk (RR) = 0.8, p = 0.7), and the 95% confidence interval (CI) (0.3-2.6) excludes the previously published estimate. High frequency of swimsuit use outdoors at ages 15-20 years was associated with increased melanoma risk among sun-sensitive women (RR = 6.4, 95% CI 1.7-23.8, p = 0.006), but appeared to be protective among sun-resistant women (RR = 0.3, 95% CI 0.1-1.0, p = 0.06). These findings suggest that the risk of trunk melanoma associated with bikini use is at most modest and that sun-sensitive women may increase their risk of melanoma with frequent sun exposures, but that sun-resistant women do not, presumably because they develop a photoprotective tan.
Publisher: Springer Science and Business Media LLC
Date: 06-2003
DOI: 10.1186/BCR583
Abstract: Early life exposures, including diet, have been implicated in the etiology of breast cancer. A nested case-control study was conducted among participants in the Nurses' Health Study who completed a 24-item questionnaire about diet during high school. There were 843 eligible cases diagnosed between onset of study (1976) and before the return of the high school diet questionnaire (1986), who were matched 10:1 with controls on the basis of age. Women who had, during adolescence, a higher consumption of eggs, vegetable fat and fiber had a lower risk of breast cancer, whereas risk of breast cancer was increased among women who consumed more butter. A possible association of elements of adolescent diet with risk of breast cancer is reported, but the findings require confirmation in prospective study.
Publisher: Springer Science and Business Media LLC
Date: 26-09-2003
Publisher: SAGE Publications
Date: 31-03-2017
Publisher: Oxford University Press (OUP)
Date: 29-03-2018
DOI: 10.1093/ABM/KAY004
Abstract: Breast cancer survivors rank fatigue (e.g., decreased vitality) as their number one concern affecting quality of life. Excess adiposity is associated with decreased vitality in breast cancer survivors, yet weight loss intervention trials report inconsistent effects on this parameter. This is a secondary analysis of the Exercise and Nutrition to Enhance Recovery and Good Health for You trial, in which 692 overweight or obese breast cancer survivors ≤5 years from diagnosis, initiated weight loss interventions, and completed assessments semi-annually for 2 years. Assessments included the Godin Leisure-Time Exercise Questionnaire and the SF-36 MOS vitality subscale as an inverse measure of fatigue. Multilevel structural equation models estimated the direct effects of physical activity on vitality and indirect effects through body mass index (BMI) changes. Within-person findings show that at assessments with greater physical activity, BMI was significantly lower (B = −0.07, p & 0.001) and vitality was higher (B = 0.22, p & 0.001). However, there was no direct relationship between lower BMI and higher vitality (B = −0.11, p = 0.262) after controlling for the relationship of physical activity with BMI and physical activity with vitality. The between-person indirect effect of physical activity change through BMI change to vitality was significant (B = 0.03, p & 0.001). Participants whose physical activity was above the mean (B = 0.37, p & 0.001) and whose BMI was below the mean (B = −1.05, p & 0.001) were more likely to report greater vitality. Improvements in vitality are primarily associated with increases in physical activity rather than BMI changes in this trial. Vitality was lower among survivors with higher BMI, although within-in idual changes in BMI had no effect on vitality. Physical activity and weight loss share mechanistic links to vitality with physical activity potentially increasing (e.g., in an additive or synergistic manner) the effect of BMI reduction on vitality.
Publisher: Oxford University Press (OUP)
Date: 02-11-2021
DOI: 10.1093/JNCI/DJAA173
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2009
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2001
DOI: 10.1111/J.1572-0241.2001.03611.X
Abstract: The authors prospectively examined the association between bowel movement frequency (used as a proxy for intestinal transit), laxative use, and the risk of symptomatic gallstone disease. A total of 79,829 women, aged 36-61 yr, without a history of symptomatic gallstone disease and free of cancer, responded to a mailed questionnaire in 1982 that assessed bowel movement frequency and use of laxatives. Between 1984 and 1996, 4,443 incident cases of symptomatic gallstone disease were documented. Relative risks (RRs) of symptomatic gallstone disease and 95% confidence intervals (CIs) were calculated using logistic regression. After controlling for age and established risk factors, the multivariate RRs were, compared to women with daily bowel movements, 0.97 (95% CI 0.86-1.08) for women with bowel movements every third day or less, and 1.00 (95% CI 0.91-11.1) for women with bowel movement more than once daily. No trend was evident. As compared to women who never used laxatives in 1982, a significant modest inverse association was seen for monthly laxative use, with a multivariate RR of 0.84 (95% CI 0.72-0.98), and weekly to daily laxative use was associated with a RR of 0.88 (95% CI 0.78-1.02). These findings do not support an association between infrequent bowel movements and risk of symptomatic gallstone disease in women, and indicate that simple questions directed at bowel movement frequency are unlikely to enhance our ability to predict risk of symptomatic gallstone disease. The slightly inverse association between use of laxatives and risk of symptomatic gallstone disease may be due to a mechanism that is not related to bowel movement frequency.
Publisher: American Association for Cancer Research (AACR)
Date: 05-2020
DOI: 10.1158/1055-9965.EPI-19-1366
Abstract: New technologies are being developed for early detection of multiple types of cancer simultaneously. To quantify the potential benefit, we estimated reductions in absolute cancer–related deaths that could occur if cancers diagnosed after metastasis (stage IV) were instead diagnosed at earlier stages. We obtained stage-specific incidence and survival data from the Surveillance, Epidemiology, and End Results Program for 17 cancer types for all persons diagnosed ages 50 to 79 years in 18 geographic regions between 2006 and 2015. For a hypothetical cohort of 100,000 persons, we estimated cancer-related deaths under assumptions that cancers diagnosed at stage IV were diagnosed at earlier stages. Stage IV cancers represented 18% of all estimated diagnoses but 48% of all estimated cancer-related deaths within 5 years. Assuming all stage IV cancers were diagnosed at stage III, 51 fewer cancer-related deaths would be expected per 100,000, a reduction of 15% of all cancer-related deaths. Assuming one third of metastatic cancers were diagnosed at stage III, one third diagnosed at stage II, and one third diagnosed at stage I, 81 fewer cancer-related deaths would be expected per 100,000, a reduction of 24% of all cancer-related deaths, corresponding to a reduction in all-cause mortality comparable in magnitude to eliminating deaths due to cerebrovascular disease. Detection of multiple cancer types earlier than stage IV could reduce at least 15% of cancer-related deaths within 5 years, affecting not only cancer-specific but all-cause mortality. Detecting cancer before stage IV, including modest shifts to stage III, could offer substantial population benefit.
Publisher: Wiley
Date: 05-2007
DOI: 10.1111/J.1752-7325.2004.TB02755.X
Abstract: This paper evaluates the relation of tooth loss to incidence of coronary heart disease in two large cohort studies. Participants included 41,407 men and 58,974 women free of any cardiovascular diseases at baseline. We recorded 1,654 incident coronary heart disease events (562 fatal events) among men during 12 years of follow-up and 544 events (158 fatal events) among women during 6 years of follow-up. After controlling for important cardiovascular risk factors, compared to men with 25-32 teeth at baseline, men with 0-10 teeth had a significantly higher risk of coronary heart disease (relative risk [RR]= 1.36 95 percent confidence interval [CI]=1.11, 1.67). The relative risk increased to 1.79 (95% CI=1.34, 2.40) when limited to fatal events. Women with 0-10 teeth were also at increased risk of coronary heart disease compared to women with 25-32 teeth (RR=1.64 95% CI=1.31, 2.05). The association was similar for fatal events (RR= 1.65 95% CI=1.11, 2.46). The association between number of teeth and incidence of coronary heart disease was similar between men with and without a history of periodontal disease, and there was no significant association between tooth loss during follow-up and coronary heart disease. This study showed a significant association between number of teeth at baseline and risk of coronary heart disease and the mechanisms to explain this association should be further clarified.
Publisher: Oxford University Press (OUP)
Date: 20-04-1994
Abstract: The Gail et al. model is considered the best available means for estimating an in idual woman's risk of developing breast cancer. Such estimates are useful in decision making on the part of women, in designing prevention trials, and in targeting screening and prevention efforts. Our purpose was to evaluate the ability of the model to accurately predict in idual breast cancer risk, using a large population independent of the one from which the model was derived. We compared the number of cancer cases predicted by the model to the actual number of cases observed in the Nurses' Health Study. The study population was 115,172 women who did not have breast cancer at the beginning of the study. Questionnaires were sent to participants every 2 years, seeking data on risk factors and diagnoses of breast cancer. Follow-up compliance was 95% over the 12-year study period. The model over-predicted absolute breast cancer risk by 33% (95% confidence interval [CI] = 28%-39%), with the overprediction more than twofold among premenopausal women (95% CI = 1.9-2.2), among women with extensive family history of breast cancer (95% CI = 1.1-3.9), and among women with age at first birth younger than 20 years (95% CI = 1.3-4.7). The correlation coefficient between observed and predicted risk was 0.67, indicating that the model is less than satisfactory for ranking in idual levels of breast cancer risk. Overprediction occurred at all deciles of predicted risk. The model's performance is unsatisfactory for estimating breast cancer risk for in idual women aged 25-61 years who do not participate in annual screening. Lower mammography screening rates in the Nurses' Health Study may account for some, but not all, of the discrepancy between observed and predicted cases. A recent modification of the model by the tamoxifen trial investigators is likely to have provided accurate power calculations. This modified form of the model should be useful for planning other large, population-based studies.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516027.V1
Abstract: Supplementary Table 8 shows the joint associations between composite sleep score and genetic risk with EAC risk
Publisher: BMJ
Date: 25-05-2010
Publisher: Springer Science and Business Media LLC
Date: 24-04-2023
DOI: 10.1186/S13058-023-01636-1
Abstract: Modifiable risk factors (alcohol, smoking, obesity, hormone use, and physical activity) affect a woman’s breast cancer (BC) risk. Whether these factors affect BC risk in women with inherited risk (family history, BRCA1/2 mutations, or familial cancer syndrome) remains unclear. This review included studies on modifiable risk factors for BC in women with inherited risk. Pre-determined eligibility criteria were used and relevant data were extracted. The literature search resulted in 93 eligible studies. For women with family history, most studies indicated that modifiable risk factors had no association with BC and some indicated decreased (physical activity) or increased risk (hormonal contraception (HC)/menopausal hormone therapy (MHT), smoking, alcohol). For women with BRCA mutations, most studies reported no association between modifiable risk factors and BC however, some observed increased (smoking, MHT/HC, body mass index (BMI)/weight) and decreased risk (alcohol, smoking, MHT/HC, BMI/weight, physical activity). However, measurements varied widely among studies, s le sizes were often small, and a limited number of studies existed. An increasing number of women will recognize their underlying inherited BC risk and seek to modify that risk. Due to heterogeneity and limited power of existing studies, further studies are needed to better understand how modifiable risk factors influence BC risk in women with inherited risk.
Publisher: American Society of Hematology
Date: 06-12-2014
DOI: 10.1182/BLOOD.V124.21.2075.2075
Abstract: Multiple myeloma (MM) is a malignancy of plasma B-cells that is invariably preceded by monoclonal gammopathy of undetermined significance (MGUS), a pre-neoplastic plasma cell proliferative disorder. C57Bl/KaLwRij (KaLwRij) is a spontaneous inbred mouse strain predisposed to benign idiopathic paraproteinemia (BIP), a plasma cell dyscrasia that parallels many features of human pathology including progression to myeloma. In both humans and mice, the genetic basis for MGUS/MM risk is unknown. We sought to identify the genetic basis for MGUS/MM risk in KaLwRij mice to shed light on genes or pathways that mediate disease risk in humans. Using an integrative approach, we combined KaLwRij x B6 haplotype analysis (418 genes) and a MM patient association study (180 genes) to identify five candidate genes likely to contribute to both murine BIP-susceptibility and human MM risk. Surprisingly, we found KaLwRij mice had homozygous germline deletion of one of the five candidate genes, Samsn1, a putative negative regulator of B-cell activation. Consistent with the reported inhibitory function of SAMSN1 in B-cells, KaLwRij mice had enhanced naïve B-cell response in vitro following stimulation with IL4 and LPS and in vivo following immunization. We found that re-expression of Samsn1 in KaLwRij-derived myeloma cell line 5TGM1 decreased MM tumor growth in vitro, suggesting that loss of Samsn1 contributes to tumor growth in part through a cell intrinsic mechanism. Importantly, germline risk alleles may also influence cell types beyond the pre-malignant B-cells. It is established that the host environment also plays a critical role in supporting myeloma growth in KaLwRij mice. We found that Samsn1 is highly expressed in macrophages, but not in other MM-supportive cell types including osteoclasts and bone marrow stromal cells. Myeloma-associated macrophages play critical roles in supporting tumor growth and are broadly classified as anti-tumor M1 macrophages and tumor-promoting M2 macrophages. Microarray analysis of macrophages from B6 and KaLwRij mice prior to onset of BIP revealed three differentially expressed genes, but only one, Samsn1, is conserved in the human genome. We found that both unpolararized primary peritoneal and MCSF cultured bone marrow macrophages from healthy KaLwRij mice had markedly elevated expression of pro-tumorigenic M2 macrophage markers FIZZ1 and YM1 compared to B6 controls, despite the absence of activating cytokines. To confirm that loss of Samsn1 influenced macrophage activation and M2 polarization, we obtained bone marrow macrophages from mice with a targeted deletion of Samsn1 and found that unpolarized Samsn1-/- cells had similarly increased pro-tumor M2 macrophage marker expression. To evaluate the biologic significance of Samsn1 loss in macrophages on MM tumor growth, we established 5TGM1 MM tumors and injected M2 polarized macrophages from B6, KaLwRij, or Samsn1-/- mice. We found that MM tumor burden was markedly enhanced by the addition of a Samsn1-/- or KaLwRij macrophages compared to wild type macrophages. Thus, we found that loss of Samsn1 in macrophages enhances M2 polarization, prior to MGUS/MM development and can promote established myeloma tumor growth. Together, this data suggests that Samsn1 is a gene contributing to BIP-susceptibility in KaLwRij mice through mutually exclusive functions in multiple cell types including B-cells and macrophages. It is likely that SAMSN1 and its pathway members contribute to human MM progression, and may represent a point for preventative therapeutic intervention. No relevant conflicts of interest to declare.
Publisher: Springer Science and Business Media LLC
Date: 03-06-2011
Publisher: Oxford University Press (OUP)
Date: 27-04-2019
Abstract: The limited data on specific dietary components and risk of multiple myeloma (MM) show no consistent association. Studies have not examined the association of dietary pattern with MM risk. In prospective cohorts of 69 751 women (Nurses’ Health Study, 1984–2014) and 47 232 men (Health Professionals Follow-up Study, 1986–2014), we examined the association between dietary pattern and risk of MM using Cox proportional hazard models. Diet was assessed repeatedly every 4 years with food frequency questionnaires and was used to calculate dietary patterns including the Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension, Prudent and Western patterns, the empirical dietary inflammatory pattern (EDIP), and empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH). During 2 792 257 person-years of follow-up, we identified 478 incident MM cases (215 women, 263 men). In men, high EDIP was statistically significantly associated with a 16% increase in MM risk (hazard ratio [HR] = 1.16, 95% confidence interval [CI] = 1.02 to 1.32 per 1-SD increase). Moreover, EDIR and EDIH had a suggestive positive association (EDIR: HR = 1.09, 95% CI = 0.96 to 1.24 and EDIH: HR = 1.11, 95% CI = 0.97 to 1.28 per 1-SD increase). We observed no other associations with MM risk in men and no associations for any dietary pattern with MM risk in women. We present the first evidence for a role of diets with higher inflammatory or insulinemic potential in MM development. Further studies are warranted to explore these associations in other populations, including the apparent restriction to men.
Publisher: Springer Science and Business Media LLC
Date: 12-07-2011
Publisher: American Society of Clinical Oncology (ASCO)
Date: 08-2006
Abstract: Physically active in iduals have a lower risk of developing colorectal cancer but the influence of exercise on cancer survival is unknown. By a prospective, observational study of 573 women with stage I to III colorectal cancer, we studied colorectal cancer–specific and overall mortality according to predefined physical activity categories before and after diagnosis and by change in activity after diagnosis. To minimize bias by occult recurrences, we excluded women who died within 6 months of their postdiagnosis physical activity assessment. Increasing levels of exercise after diagnosis of nonmetastatic colorectal cancer reduced cancer-specific mortality (P for trend = .008) and overall mortality (P for trend = .003). Compared with women who engaged in less than 3 metabolic equivalent task [MET] -hours per week of physical activity, those engaging in at least 18 MET-hours per week had an adjusted hazard ratio for colorectal cancer–specific mortality of 0.39 (95% CI, 0.18 to 0.82) and an adjusted hazard ratio for overall mortality of 0.43 (95% CI, 0.25 to 0.74). These results remained unchanged even after excluding women who died within 12 and 24 months of activity assessment. Prediagnosis physical activity was not predictive of mortality. Women who increased their activity (when comparing prediagnosis to postdiagnosis values) had a hazard ratio of 0.48 (95% CI, 0.24 to 0.97) for colorectal cancer deaths and a hazard ratio of 0.51 (95% CI, 0.30 to 0.85) for any-cause death, compared with those with no change in activity. Recreational physical activity after the diagnosis of stages I to III colorectal cancer may reduce the risk of colorectal cancer–specific and overall mortality.
Publisher: Springer Science and Business Media LLC
Date: 05-2014
DOI: 10.1038/BJC.2014.224
Publisher: American Medical Association (AMA)
Date: 02-11-2011
Publisher: Springer Science and Business Media LLC
Date: 22-10-2016
Publisher: Wiley
Date: 28-07-2020
DOI: 10.1002/SIM.8670
Abstract: Three‐level cluster randomized trials (CRTs) are increasingly used in implementation science, where 2fold‐nested‐correlated data arise. For ex le, interventions are randomly assigned to practices, and providers within the same practice who provide care to participants are trained with the assigned intervention. Teerenstra et al proposed a nested exchangeable correlation structure that accounts for two levels of clustering within the generalized estimating equations (GEE) approach. In this article, we utilize GEE models to test the treatment effect in a two‐group comparison for continuous, binary, or count data in three‐level CRTs. Given the nested exchangeable correlation structure, we derive the asymptotic variances of the estimator of the treatment effect for different types of outcomes. When the number of clusters is small, researchers have proposed bias‐corrected sandwich estimators to improve performance in two‐level CRTs. We extend the variances of two bias‐corrected sandwich estimators to three‐level CRTs. The equal provider and practice sizes were assumed to calculate number of practices for simplicity. However, they are not guaranteed in practice. Relative efficiency (RE) is defined as the ratio of variance of the estimator of the treatment effect for equal to unequal provider and practice sizes. The expressions of REs are obtained from both asymptotic variance estimation and bias‐corrected sandwich estimators. Their performances are evaluated for different scenarios of provider and practice size distributions through simulation studies. Finally, a percentage increase in the number of practices is proposed due to efficiency loss from unequal provider and/or practice sizes.
Publisher: Wiley
Date: 06-1999
DOI: 10.1002/(SICI)1097-0142(19990601)85:11<2400::AID-CNCR15>3.0.CO;2-O
Abstract: Breast carcinoma risk may be modified by early life factors, including physical growth and development, diet, and life-style factors of preadolescence and adolescence, as well as genetic factors. The authors tested their hypothesis that adolescent growth and development are related to breast carcinoma incidence by evaluating 65,140 women who participated in the Nurses' Health Study. During 16 years of follow-up, 806 women were diagnosed with breast carcinoma prior to menopause, and another 1485 were diagnosed after menopause. Because adolescent growth was not directly observed in this cohort, the peak height growth velocity for each participant was estimated by using a model from another longitudinal study. Finally, Cox proportional hazards regression models were used to study associations between breast carcinoma incidence and adolescent factors in the Nurses' Health Study. Later menarche (relative risk [RR] = 0.52 for > or =15 vs. or =67 vs. < or =62 inches). Higher peak height growth velocity, derived from these 3 variables, was associated with increased risk of both premenopausal (RR = 1.31 for highest vs. lowest quintile) and postmenopausal (RR = 1.40) breast carcinoma. These analyses controlled for birth cohort, other possible risk factors from the adolescent period, and family history. These associations persisted after controlling for age at the birth of a first child, parity, adult adiposity, and age at menopause. Post-hoc analyses suggested that, although childhood body fatness was associated with lower risk, increasing body fatness between ages 10 and 20 years was not protective against either premenopausal or postmenopausal breast carcinoma. Earlier menarche, extremely lean body mass at age 10 years, and taller adult height were predictive of elevated breast carcinoma risk. The same three factors were also predictive of higher peak growth velocities during adolescence, lending credence to the hypothesis that more rapid adolescent growth may increase the risk of breast carcinoma development.
Publisher: Annual Reviews
Date: 03-2010
DOI: 10.1146/ANNUREV.PUBLHEALTH.121208.131051
Abstract: Several key factors bear on the interpretation of prevention trials and observational studies that inform prevention strategies. These factors include the underlying disease process and aspects of the intervention: sustainability of behavior change, the time course of the intervention within the disease process, dose and duration of exposure needed to effect risk reduction, durability of the impact of intervention, and methodological problems in implementing and interpreting randomized trials and observational studies to evaluate prevention strategies. The question asked through an intent-to-treat analysis of a randomized controlled trial (RCT) differs from that in the observational setting. Furthermore, the long duration necessary to conduct prevention trials and the resulting lack of adherence to therapy can bias results toward the null. A broader range of approaches to evaluate prevention interventions and programs with improved knowledge synthesis and translation to public health practice will speed our progress toward achieving public health and prevention of chronic diseases.
Publisher: Springer Science and Business Media LLC
Date: 14-05-2019
Publisher: Wiley
Date: 14-03-2017
DOI: 10.1002/IJC.30627
Publisher: American Association for Cancer Research (AACR)
Date: 15-02-2006
DOI: 10.1158/0008-5472.CAN-05-3574
Abstract: The 17β-hydroxysteroid dehydrogenase 1 gene (HSD17B1) encodes 17HSD1, which catalyzes the final step of estradiol biosynthesis. Despite the important role of HSD17B1 in hormone metabolism, few epidemiologic studies of HSD17B1 and breast cancer have been conducted. This study includes 5,370 breast cancer cases and 7,480 matched controls from five large cohorts in the Breast and Prostate Cancer Cohort Consortium. We characterized variation in HSD17B1 by resequencing and dense genotyping a multiethnic s le and identified haplotype-tagging single nucleotide polymorphisms (htSNP) that capture common variation within a 33.3-kb region around HSD17B1. Four htSNPs, including the previously studied SNP rs605059 (S312G), were genotyped to tag five common haplotypes in all cases and controls. Conditional logistic regression was used to estimate odds ratios (OR) for disease. We found no evidence of association between common HSD17B1 haplotypes or htSNPs and overall risk of breast cancer. The OR for each haplotype relative to the most common haplotype ranged from 0.98 to 1.07 (omnibus test for association: X2 = 3.77, P = 0.58, 5 degrees of freedom). When cases were sub ided by estrogen receptor (ER) status, two common haplotypes were associated with ER-negative tumors (test for trend, Ps = 0.0009 and 0.0076 n = 353 cases). HSD17B1 variants that are common in Caucasians are not associated with overall risk of breast cancer however, there was an association among the subset of ER-negative tumors. Although the probability that these ER-negative findings are false-positive results is high, these findings were consistent across each cohort examined and warrant further study. (Cancer Res 2006 66(4): 2468-75)
Publisher: Elsevier BV
Date: 1999
DOI: 10.1016/S0002-9343(98)00358-1
Abstract: To study the possible association of silicone-breast-implant exposure and immunologic abnormalities within the Nurses' Health Study, an ongoing prospective cohort study of women. From this cohort, we randomly selected 200 women who had been exposed to silicone breast implants and who had never reported connective tissue diseases during 14 years of follow-up, and 500 age-matched, nonexposed women, including 100 with definite connective tissue diseases validated by medical record review, 100 with at least one symptom of a connective tissue disease, 100 with diabetes, and 200 healthy controls. Assays for antinuclear antibodies (ANA), including anti-dsDNA, anti-ssDNA, anti-Sm/RNP/Ro/La, and anti-Scl-70, rheumatoid factor, immunoglobulins, serum complement, and C-reactive protein level, and anticardiolipin, antithyroglobulin, antithyroid microsomal, and antisilicone antibodies were performed by standard techniques in blood s les collected in 1989 or 1990 before collection of silicone-breast-implant exposure data in 1992. ANA was positive (> or = 1:40) in 14% of women with silicone breast implants compared with 20% of healthy women (P = 0.11). Rheumatoid factor was positive (> or = 1:40) in 5% of women with silicone breast implants and 2% of healthy women (P = 0.16). Women with silicone breast implants had a significantly higher frequency of anti-ssDNA antibodies than healthy women (41% and 29%, P = 0.012). Duration of implant was associated with a higher frequency of anti-ssDNA antibodies (P = 0.03) but not with ANA or rheumatoid factor. No other significant differences in the frequencies of autoantibodies were observed in silicone breast implant-exposed women. Antisilicone antibodies were not found in any s le. We found no increased frequency of any immunologic abnormalities in women exposed to silicone breast implants, except for anti-ssDNA, which has unknown clinical relevance.
Publisher: Elsevier BV
Date: 06-2019
Publisher: Springer Science and Business Media LLC
Date: 05-2005
DOI: 10.1038/NRC1608
Abstract: The Nurses' Health Study has grown from a simple questionnaire-based study initiated in 1976 to a rich resource of information collected over 29 years. Important details about lifestyle have been collected throughout the study and, as the study has progressed, blood s les and DNA from buccal cells have been collected and stored. Tumour s les have also been collected from participants who developed cancer. Through analyses that integrate information from these various sources we are advancing our understanding of the causes of cancer and the potential for prevention.
Publisher: Elsevier BV
Date: 05-2008
Publisher: Elsevier BV
Date: 02-2021
Publisher: Massachusetts Medical Society
Date: 22-12-1994
DOI: 10.1056/NEJM199412223312501
Abstract: Mitochondria are specialized eukaryotic organelles that have a dedicated function in oxygen respiration and energy production. They evolved about 2 billion years ago from a free-living bacterial ancestor (probably an alphaproteobacterium), in a process known as endosymbiosis
Publisher: JMIR Publications Inc.
Date: 15-12-2021
Abstract: etastatic breast cancer (MBC) remains incurable despite significant treatment advances. Coordinating care for patients with MBC can be challenging given the various treatment options, available clinical trials, and frequent need for ancillary services. To optimize MBC care, we designed a project for adapting and developing an academic and community practice collaborative care model for MBC care (Project ADAPT), based on the Ending Metastatic Breast Cancer for Everyone (EMBRACE) program developed at Dana Farber Cancer Institute. e aim to describe the implementation science–based study design and innovative components of Project ADAPT. roject ADAPT uses the Dynamic Adaptation Process informed by the Exploration, Preparation, Implementation, Sustainment framework. Washington University School of Medicine (WUSM) partnered with 3 community hospitals in the St. Louis region covering rural and urban settings. The exploration and preparation phases provide patient and provider feedback on current referral practices to finalize the approach for the implementation phase. At the implementation phase, we will enroll patients with MBC at these 3 community sites to evaluate potential collaborative care at WUSM and assess the impact of this collaborative care model on referral satisfaction and acceptability for patients with MBC and their providers. Patients may then return to their community site for care or continue to receive part of their care at WUSM. We are incorporating virtual and digital health strategies to improve MBC care coordination in order to minimize patient burden. he exploration phase is ongoing. As of August 2021, we have recruited 21 patient and provider participants to complete surveys of the current collaborative care process at WUSM. Using a 2-tailed paired i t /i test, 44 patients (including 10 patients from the exploration phase) and 32 oncologists are required to detect an effect size of 0.5 with 80% power at a level of significance of .05. Throughout this phase and in preparation for the implementation phase, we have iteratively updated and refined our surveys for the implementation phase based on testing of our data collection instruments. Our partner sites are in various stages of the single institutional review board (IRB) approval process. We have ongoing engagement with all partner sites, which has helped solidify our participant recruitment strategies and design patient-friendly recruitment materials. In addition, we have included a patient advocate on the research team. Members of the research team have launched a single IRB Support Network at WUSM to create a repository of the single IRB procedures in order to streamline the partner site onboarding process and facilitate enhanced collaboration across institutions. ith this robust model, we expect that patients with MBC will receive optimal care regardless of geographical location and the model will improve patient and provider experiences when navigating the health system. ERR1-10.2196/35736
Publisher: Wiley
Date: 07-1978
Publisher: Oxford University Press (OUP)
Date: 1995
Abstract: Bacille Calmette-Guérin (BCG) vaccination for the prevention of tuberculosis has been used in humans since 1921. Furthermore, for > 60 years it has been possible to separate BCG strains (defined here as a BCG vaccine maintained in a particular laboratory and used in a particular trial or set of trials) on the basis of in vitro and in vivo tests. Investigators have concluded that differences in the BCG strains used in efficacy trials on humans may be responsible for the wide range in levels of protection from tuberculosis reported in those trials. We review the development of the separate strains used in the trials included in a recent meta-analysis and examine data for and against the protective efficacy of different BCG strains. The difficulties in correlating results of in vitro and in vivo tests with protective efficacy in humans are discussed. The limited data available from human studies suggest that the BCG strain used for vaccination is not a significant determinant of the overall efficacy in the prevention of tuberculosis.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929355.V1
Abstract: Supplementary Figure S2: Pearson correlation between our algorithm and Volpara shows strong positive linear relationship of 0.81.
Publisher: Wiley
Date: 05-11-2010
Publisher: American Public Health Association
Date: 07-1996
Abstract: OBJECTIVES. The purpose of this study was to examine prospectively whether exercise can modify weight gain after smoking cessation in women. METHODS. Data were analyzed from a 2-year follow-up period (1986-1988) in the Nurses' Health Study, an ongoing cohort of 121,700 US women aged 40 to 75 in 1986. RESULTS. The average weight gain over 2 years was 3.0 kg in the 1474 women who stopped smoking, and 0.6 kg among the 7832 women who continued smoking. Among women smoking 1 to 24 cigarettes per day, those who quit without changing their levels of exercise gained an average of 2.3 kg more (95% confidence interval [CI] = 1.9, 2.6) than women who continued smoking. Women who quit and increased exercise by between 8 to 16 MET-hours (the work metabolic rate ided by the resting metabolic rate) per week gained 1.8 kg (95% CI = 1.0, 2.5), and the excess weight gain was only 1.3 kg (95% CI = 0.7, 1.9) in women who increased exercise by more than 16 MET-hours per week. CONCLUSIONS. Smoking cessation is associated with a net excess weight gain of about 2.4 kg in middle-aged women. However, this weight gain is minimized if smoking cessation is accompanied by a moderate increase in the level of physical activity.
Publisher: Elsevier BV
Date: 03-1998
DOI: 10.1016/S0090-4295(97)00626-2
Abstract: There is debate about the validity of the clinical distinction between filling and voiding symptoms of benign prostatic hyperplasia (BPH). We examined empirically the evidence for the existence of these clinical constructs. We analyzed responses to the American Urological Association Symptom Index (AUA SI) among men from a large cohort s le (the Health Professionals Follow-up Study, n = 7753) and a subs le with physician-diagnosed BPH (n = 1856). We used factor analysis, which is a data reduction tool that allowed us to determine empirically the relationships among lower urinary tract symptoms thought to be clinically related by pathogenesis, physiology, or treatment response. The results of the factor analysis indicated that responses to the AUA SI items could be grouped into one of two subscales: one describing voiding problems and the other describing filling problems. Analyses of internal consistency reliability indicated that the AUA SI as well as the filling and voiding subscales have sound internal reliability. We found empirical support for the clinical conceptualization of lower urinary tract symptoms into filling and voiding problems. These findings provide support for using the total score on the AUA SI as a reliable measure of overall symptom severity in BPH, as well as for separately summing the voiding and filling items to measure these distinctive types of lower urinary tract symptomatology. Further research is needed to determine whether these symptom groupings better distinguish responses to one treatment type over another. If so, targeting treatment based on the relative severity of voiding and filling symptoms might improve patient outcomes.
Publisher: American Public Health Association
Date: 04-2001
Abstract: OBJECTIVES: This study examined the association between recreational physical activity and mortality in middle-aged and older women and the possibility that physical activity serves as an important marker of health. METHODS: Analyses were conducted among participants in the Nurses' Health Study. Levels of physical activity were assessed by questionnaire in 1980 and updated every 2 to 4 years. RESULTS: Levels of physical activity were inversely associated with mortality risk however, each activity level above the reference level had approximately the same level of risk reduction (20%-30%). The inverse association was stronger for cardiovascular deaths than for cancer deaths and was strongest for respiratory deaths. Women who died of noncardiovascular, noncancer causes were more likely to have reported that poor health limited their physical activity than were women who died of other causes or who remained alive. CONCLUSIONS: Part of the link between physical activity and mortality risk is probably spurious and difficult to remove analytically however, on the basis of epidemiologic evidence, much of the health benefit of activity is real.
Publisher: Elsevier BV
Date: 05-2001
DOI: 10.1016/S0749-3797(01)00296-3
Abstract: In large cohort studies of older children, self-report is the only practical way to assess physical activity. Assessing usual activity over the entire year is desirable, but children and adolescents may overestimate activities with high seasonal variability. Use of questionnaires in which in iduals report each activity by season may improve accuracy. A total of 6782 girls and 5110 boys, aged 9-14 years in 1996, completed self-administered activity questionnaires in 1996 and in 1997. In 1996, participants reported the average time spent in each of 17 activities during the previous 12 months in 1997, we also asked for the average time spent in the previous year, but within each of the four seasons. Girls reported a median of 12.8 hours/week total activity in 1996 and 10.4 hours/week in 1997. For boys, the estimates were 15.5 hours/week and 13.4 hours/week, respectively. Girls and boys within 1-year age strata (e.g., comparison of 10-year olds in 1996 with 10-year olds in 1997) reported an average of 3.7 and 3.1 fewer hours per week, respectively, on the 1997 seasonal format versus the 1996 annual format questionnaire. In longitudinal analyses, the difference between the annual and the seasonal estimates was greater if participants did the activity in fewer seasons in 1997. In comparison to an annual format questionnaire, a seasonal format questionnaire may improve accuracy of self-report of physical activity by reducing over-reporting of activities in which pre-adolescents and adolescents engage in fewer seasons.
Publisher: Elsevier BV
Date: 05-2014
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516039.V1
Abstract: Supplementary Table 4 shows the association between finer composite sleep score and EAC risk
Publisher: Massachusetts Medical Society
Date: 19-06-1997
DOI: 10.1056/NEJM199706193362501
Abstract: In this study, a square wave voltammetric method for determination of theophylline in tablet formulation based on EDTA salt modified carbon paste electrode is presented. CV, FT-IR, and EIS results confirmed modification of the carbon paste with EDTA salt. In contrast to the unmodified carbon paste electrode, the modified carbon paste electrode showed irreversible oxidation of theophylline with considerable current enhancement. Investigation of the effect of scan rate on the Ip and Ep response of the modified electrode for theophylline revealed predominantly diffusion controlled oxidation kinetics. Under the optimized conditions, square wave oxidative peak current of theophylline in pH 7.0 PBS showed linear dependence on concentration in the range 10-200 μM with determination coefficient (R2), limit of detection, and limit of quantification of 0.99782, 0.0257 μM, and 0.0857 μM, respectively. Detection of an amount of theophylline in the analyzed tablet formulation with 1.85% error from its nominal content (120 mg/tablet) confirmed the accuracy of the developed method. Spike and interference recovery results of 98.59%, and 95.7-100%, respectively validated the applicability of the developed method for determination of theophylline content in tablet s les.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929331.V1
Abstract: Supplementary Table S3: Hazards ratio for association between baseline risk factors and breast cancer risk among postmenopausal women using Full-VPD only.
Publisher: Springer Science and Business Media LLC
Date: 09-2013
Publisher: American Public Health Association
Date: 03-2001
Publisher: Oxford University Press (OUP)
Date: 1995
Abstract: For 60 years vaccination with bacille Calmette-Guérin (BCG) has been used for the prevention of tuberculosis in health care workers. In 1988 the U.S. Advisory Committee on Immunization Practices removed the category of health care worker from the list of persons for whom vaccination with BCG should be considered. Nosocomial epidemics of tuberculosis, especially those caused by multidrug-resistant strains, have led to the reconsideration of vaccination with BCG for this population. We review the available studies of the efficacy of BCG vaccine in health care workers. Although the studies had too many methodological flaws to be combined in a quantitative meta-analysis, they suggest that vaccination with BCG is effective in reducing the incidence of tuberculosis among health care workers.
Publisher: Oxford University Press (OUP)
Date: 27-07-2011
DOI: 10.1093/JNCI/DJR225
Publisher: Elsevier BV
Date: 07-2013
Publisher: American Association for Cancer Research (AACR)
Date: 14-11-2017
DOI: 10.1158/0008-5472.CAN-17-1225
Abstract: Bone metastases occur in approximately 70% of metastatic breast cancer patients, often leading to skeletal injuries. Current treatments are mainly palliative and underscore the unmet clinical need for improved therapies. In this study, we provide preclinical evidence for an antimetastatic therapy based on targeting integrin β3 (β3), which is selectively induced on breast cancer cells in bone by the local bone microenvironment. In a preclinical model of breast cancer, β3 was strongly expressed on bone metastatic cancer cells, but not primary mammary tumors or visceral metastases. In tumor tissue from breast cancer patients, β3 was significantly elevated on bone metastases relative to primary tumors from the same patient (n = 42). Mechanistic investigations revealed that TGFβ signaling through SMAD2/SMAD3 was necessary for breast cancer induction of β3 within the bone. Using a micelle-based nanoparticle therapy that recognizes integrin αvβ3 (αvβ3-MPs of ∼12.5 nm), we demonstrated specific localization to breast cancer bone metastases in mice. Using this system for targeted delivery of the chemotherapeutic docetaxel, we showed that bone tumor burden could be reduced significantly with less bone destruction and less hepatotoxicity compared with equimolar doses of free docetaxel. Furthermore, mice treated with αvβ3-MP-docetaxel exhibited a significant decrease in bone-residing tumor cell proliferation compared with free docetaxel. Taken together, our results offer preclinical proof of concept for a method to enhance delivery of chemotherapeutics to breast cancer cells within the bone by exploiting their selective expression of integrin αvβ3 at that metastatic site. Cancer Res 77(22) 6299–312. ©2017 AACR.
Publisher: Oxford University Press (OUP)
Date: 1996
DOI: 10.1093/IJE/25.1.122
Abstract: Recent evidence suggests potential associations between birthweight and infant feeding history and risk of a variety of health outcomes during adulthood. Because studies may rely on self-reported birthweight and infant feeding history, it is important to assess the validity of this information. The authors compared birthweights reported by a s le of 538 women, 27-44 years of age, participating in the Nurses' Healthy Study II (NHSII) cohort, with birthweights recalled by their mothers and with those from state birth records. In addition, we compared participants' self-reported history of having breastfed with their breastfeeding history reported by their mothers. For birthweight, the correlation between reports by the cohort participants and by their mothers was high (Spearman r = 0.75). Compared with weights recorded on state birth records, correlations were 0.74 for reports by cohort participants and 0.85 for reports by their mothers. When comparing NHSII participants' self-report of ever having been breastfed with their mothers' report, sensitivity was 82% and specificity was 86%. For duration of breastfeeding, the Spearman correlation between mother and daughter reports was 0.74. In analyses stratified by four ethnic groups (African-American, Asian, Caucasian, and Hispanic) we observed substantial differences in distribution of birthweight and breastfeeding patterns however, the degree of validity in reporting them was similar. The validity of self-reported birthweight and breastfeeding history by these middle-aged women appears to be high.
Publisher: Springer Science and Business Media LLC
Date: 12-07-2017
DOI: 10.1007/S10549-017-4384-4
Abstract: We investigated the associations of adolescent adiposity, changes in adiposity during adulthood, and attained adiposity with volumetric mammographic density measures. We recruited 383 premenopausal women who had a routine screening mammogram at the Breast Health Center, Washington University in St. Louis, MO from December 2015 to October 2016. Trained research personnel assessed current adiposity measures. Weight at ages 18 and 30 were self-reported. We evaluated mammographic density measures: volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV) using Volpara. Multivariable linear regression models were used to evaluate the associations of adiposity measures with volumetric mammographic density measures. All attained adiposity measures, BMI at age 18, age 30, and weight change were significantly inversely associated with VPD, and positively associated with DV and NDV. One unit increase in body fat % was associated with a 4.9% decrease in VPD and a 6.5% increase in NDV (p-values 25 kg, respectively, compared to women who gained less than 5 kg during this time period (p-values <0.001). Irrespective of BMI at age 18, VPD significantly decreased and NDV increased among women who were currently obese. There is a need for mechanistic studies focusing on early adulthood to provide a better understanding of how adiposity in early life relates to mammographic density, and possibly breast cancer development in premenopausal women.
Publisher: Health Affairs (Project Hope)
Date: 11-2019
DOI: 10.1377/HLTHAFF.2019.00316
Abstract: To determine how low-income Asian American, Native Hawaiian, and Pacific Islander (AANHPI) adults gained health insurance coverage-specifically, via Medicaid or private insurance-under the Affordable Care Act, we used a difference-in-differences approach to compare uninsurance rates in 2010-13 and 2015-16. In Medicaid expansion states, adjusted Medicaid coverage gains were 9.67 percentage points larger than in nonexpansion states however, adjusted private coverage gains in expansion states were 10.19 percentage points lower. These results indicate that, in contrast to the case for other racial/ethnic groups, for AANHPI the Medicaid coverage increases in expansion states were of similar magnitude to the private insurance coverage increases in nonexpansion states. Reasons for this may include differences in willingness to enroll in public versus private coverage, barriers related to language or citizenship status, or other factors. Future studies are needed to understand these patterns and promote health equity for this population.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2002
Publisher: Oxford University Press (OUP)
Date: 1985
DOI: 10.1093/IJE/14.2.336
Abstract: This article reports on a longitudinal test of a developmental model of early drinking that specifies transactions among personality, learning, and behavior in the risk process. The model was tested on 1,906 children making the transition from elementary school to middle school across 3 time points: the spring of 5th grade, the fall of 6th grade, and the spring of 6th grade. In a transaction that has been referred to as acquired preparedness, in idual differences in the trait positive urgency at the end of 5th grade were associated with increases in expectancies for social facilitation from alcohol at the start of 6th grade, which then predicted drinker status at the end of 6th grade. In addition, the alcohol expectancy and drinker status predicted each other reciprocally across time. Multiple factors appear to transact to predict early drinking behavior.
Publisher: Elsevier BV
Date: 10-2011
Publisher: American Medical Association (AMA)
Date: 23-06-1999
Publisher: Springer Science and Business Media LLC
Date: 16-10-2019
DOI: 10.1186/S13058-019-1190-4
Abstract: The benefits of chemotherapy in node-negative, hormone receptor-positive, and human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients with the 21-gene recurrence score (RS) of 18–30, particularly those with RS 26–30, are not known. Using the Surveillance, Epidemiology, and End Results (SEER) data, we retrospectively identified 29,137 breast cancer patients with the 21-gene RS of 18–30 diagnosed between 2004 and 2015. Mortality risks according to the RS and chemotherapy use were compared by the Kaplan-Meier method and Cox’s proportional hazards model. Among the breast cancer patients with the RS 18–30, 21% of them had RS 26–30. Compared to breast cancer patients with RS 18–25, patients with RS 26–30 had more aggressive tumor characteristics and chemotherapy use and increased risk of breast cancer-specific mortality and overall mortality. In breast cancer patients who were aged ≤ 70 years and had RS of 26–30, chemotherapy administration was associated with a 32% lower risk of breast cancer-specific mortality (hazard ratio [HR], 0.68 95% confidence interval [CI], 0.47–0.99) and a 42% lower risk of overall mortality (HR, 0.58 95% CI, 0.44–0.76). Survival benefits were most pronounced in breast cancer patients who were younger or had grade III tumor. The 21-gene RS of 18–30 showed heterogeneous outcomes, and the RS 26–30 was a significant prognostic factor for an increased risk of mortality. Adjuvant chemotherapy could improve the survival of node-negative, hormone receptor-positive, and HER2-negative breast cancer patients with the 21-gene RS 26–30 and should be considered for patients, especially younger patients or patients with high-grade tumors.
Publisher: Oxford University Press (OUP)
Date: 04-09-2002
Abstract: Laboratory data suggest that calcium and vitamin D, found at high levels in dairy products, might reduce breast carcinogenesis. However, epidemiologic studies regarding dairy products and breast cancer have yielded inconsistent results. We examined data from a large, long-term cohort study to evaluate whether high intake of dairy products, calcium, or vitamin D is associated with reduced risk of breast cancer. We followed 88 691 women in the Nurses' Health Study cohort from the date of return of their food-frequency questionnaire in 1980 until May 31, 1996. Dietary information was collected in 1980 and updated in 1984, 1986, 1990, and 1994. We identified 3482 women (premenopausal = 827, postmenopausal = 2345, and uncertain menopausal status = 310) with incident invasive breast cancer. We used pooled logistic regression to estimate multivariable relative risks (RRs) using 2-year time increments. The RRs and 95% confidence intervals (CIs) were calculated for each category of intake compared with the lowest intake group. All statistical tests were two-sided. Intakes of dairy products, calcium, or vitamin D were not statistically significantly associated with breast cancer risk in postmenopausal women. In premenopausal women, however, consumption of dairy products, especially of low-fat dairy foods and skim/low-fat milk, was inversely associated with risk of breast cancer. The multivariable RRs comparing highest (>1 serving/day) and lowest ( 800 mg/day versus 500 IU/day versus <or=150 IU/day RR = 0.72, 95% CI = 0.55 to 0.94), and lactose (quintile 5 versus quintile 1 RR = 0.68, 95% CI = 0.54 to 0.86] also had inverse associations with premenopausal breast cancer risk. By taking into account supplemental calcium and vitamin D intake, we found that association with calcium was due mainly to dairy sources whereas the association with vitamin D may be independent of dairy intake. We found no association between intake of dairy products and breast cancer in postmenopausal women. Among premenopausal women, high intake of low-fat dairy foods, especially skim/low-fat milk, was associated with reduced risk of breast cancer. Similar inverse associations were seen with components (calcium and vitamin D) of dairy foods, but their independent associations with breast cancer are difficult to distinguish.
Publisher: Springer Science and Business Media LLC
Date: 29-07-2021
DOI: 10.1186/S12885-021-08608-8
Abstract: Supervised physical activity interventions improve functional health during cancer survivorship, but remain costly and inaccessible for many. We previously reported on the benefits of a DVD-delivered physical activity program ( FlexToBa™) in older adults. This is a secondary analysis of the intervention effects among cancer survivors in the original s le. Low active, older adults who self-reported a history of cancer ( N = 46 M time since diagnosis = 10.7 ± 9.4 years) participated in a 6-month, home-based physical activity intervention. Participants were randomized to either the DVD-delivered physical activity program focused on flexibility, toning, and balance ( FlexToBa™ n = 22) or an attentional control condition ( n = 24). Physical function was assessed by the Short Physical Performance Battery (SPPB) at baseline, end of intervention, and at 12 and 24 months after baseline. Repeated measures linear mixed models indicated a significant group*time interaction for the SPPB total score (β = − 1.14, p = 0.048), driven by improved function from baseline to six months in the FlexToBa™ group. The intervention group also had improved balance (β = − 0.56, p = 0.041) compared with controls. Similar trends emerged for the SPPB total score during follow-up the group*time interaction from 0 to 12 months approached significance (β = − 0.97, p = 0.089) and was significant from 0 to 24 months (β = − 1.84, p = 0.012). No significant interactions emerged for other outcomes ( p s 0.11). A DVD-delivered physical activity intervention designed for cancer-free older adults was capable of eliciting and maintaining clinically meaningful functional improvements in a subgroup of cancer survivors, with similar effects to the original full s le. These findings inform the dissemination of evidence-based physical activity programs during survivorship. ClinicalTrials.gov NCT01030419 . Registered 11 December 2009
Publisher: Oxford University Press (OUP)
Date: 26-04-2021
DOI: 10.1093/JNCI/DJAB074
Abstract: Cancer risk prediction models have the potential to revolutionize the science and practice of cancer prevention and control by identifying the likelihood that a patient will develop cancer at some point in the future, likely experience more benefit than harm from a given intervention, and survive their cancer for a certain number of years. The ability of risk prediction models to produce estimates that are valid and reliable for people from erse socio-demographic backgrounds—and consequently their utility for broadening the reach of precision medicine to marginalized populations—depends on ensuring that the risk factors included in the model are represented as thoroughly and as accurately as possible. However, cancer risk prediction models created in the United States have a critical limitation, the origins of which stem from the country’s earliest days: they either erroneously treat the social construct of race as an immutable biological factor (ie, they “essentialize” race), or they exclude from the model those socio-contextual factors that are associated with both race and health outcomes. Models that essentialize race and/or exclude socio-contextual factors sometimes incorporate “race corrections” that adjust a patient’s risk estimate up or down based on their race. This commentary discusses the origins of race corrections, potential flaws with such corrections, and strategies for developing cohorts for developing risk prediction models that do not essentialize race or exclude key socio-contextual factors. Such models will help move the science of cancer prevention and control towards its goal of eliminating cancer disparities and achieving health equity.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929343.V1
Abstract: Supplementary Figure S6: The proportional hazards assumption is deemed reasonable by checking the Schoenfeld residuals plot for MLO-VPD.
Publisher: Elsevier BV
Date: 2017
Publisher: American Medical Association (AMA)
Date: 26-01-2005
Publisher: American Astronomical Society
Date: 31-01-2022
Abstract: Exoplanet systems with multiple transiting planets are natural laboratories for testing planetary astrophysics. One such system is HD 191939 (TOI 1339), a bright ( V = 9) and Sun-like (G9V) star, which TESS found to host three transiting planets (b, c, and d). The planets have periods of 9, 29, and 38 days each with similar sizes from 3 to 3.4 R ⊕ . To further characterize the system, we measured the radial velocity (RV) of HD 191939 over 415 days with Keck/HIRES and APF/Levy. We find that M b = 10.4 ± 0.9 M ⊕ and M c = 7.2 ± 1.4 M ⊕ , which are low compared to most known planets of comparable radii. The RVs yield only an upper limit on M d ( .8 M ⊕ at 2 σ ). The RVs further reveal a fourth planet (e) with a minimum mass of 0.34 ± 0.01 M Jup and an orbital period of 101.4 ± 0.4 days. Despite its nontransiting geometry, secular interactions between planet e and the inner transiting planets indicate that planet e is coplanar with the transiting planets (Δ i 10°). We identify a second high-mass planet (f) with 95% confidence intervals on mass between 2 and 11 M Jup and period between 1700 and 7200 days, based on a joint analysis of RVs and astrometry from Gaia and Hipparcos. As a bright star hosting multiple planets with well-measured masses, HD 191939 presents many options for comparative planetary astronomy, including characterization with JWST.
Publisher: American Public Health Association
Date: 1996
DOI: 10.2105/AJPH.86.1.25
Abstract: OBJECTIVES. This study undertook to examine relationships between nonsedentary activity level, time spent watching television (TV)/videocassette recorder (VCR), and risk of overweight among men. METHODS. Men participating in the Health Professionals Follow-Up Study were mailed surveys. Cross-sectional analyses examined the prevalence and odds of being overweight, prospective analyses determined cumulative incidence rates and relative risks of becoming overweight over 2 years of follow-up. RESULTS. Cross-sectionally, odds of being overweight were 50% (95% confidence interval [CI] = 45% 55%) lower for men in the highest quintile of nonsedentary activity level when compared with men in the lowest quintile. Among men watching 41 or more hours of TV/VCR per week, the odds of being overweight were 406 (95% CI = 2.67, 6.17) times greater than those for men watching no more than 1 hour per week. Prospectively, higher levels is of nonsedentary activity and lower levels of TV/VCR viewing were independently associated with lower relative risks for becoming overweight between survey years. CONCLUSIONS. Both a lack of nonsedentary activity and time spent watching TV/VCR contribute to the development of overweight in men. Sedentary and nonsedentary activities represent separate domains, each with independent risks for overweight.
Publisher: Oxford University Press (OUP)
Date: 15-01-2001
Abstract: Limited prospective data have examined the association between living arrangements and emotional wellbeing. The authors assessed whether older women living with a spouse were less likely to experience a decline in mental health, vitality, or physical function compared with women living alone or with nonspouse others. The association between living arrangement and 4-year change in functional health status was examined prospectively among 28,324 women aged 60-72 years in the Nurses' Health Study. After adjustment for age, baseline function, comorbid conditions, and health behaviors, women living alone had lower risk of decline in mental health (relative risk (RR) = 0.73, 95 percent confidence interval (CI): 0.65, 0.81) and vitality (RR = 0.72, 95 percent CI: 0.65, 0.80) compared with those living with a spouse. Contact with friends and relatives and level of social engagement were significantly protective against a decline in mental health among women living alone but not among women living with a spouse. These results suggest that women living independently are neither socially isolated nor at increased risk for decline in functional health status. In fact, these women actually fare better on measures of psychologic function than do women living with a spouse.
Publisher: American Medical Association (AMA)
Date: 13-11-2006
DOI: 10.1001/ARCHINTE.166.20.2253
Abstract: The association between red meat intake and breast cancer is unclear, but most studies have assessed diet in midlife or later. Although breast tumors differ clinically and biologically by hormone receptor status, few epidemiologic studies of diet have made this distinction. Red meat intake and breast cancer risk were assessed among premenopausal women aged 26 to 46 years in the Nurses' Health Study II. Red meat intake was assessed with a food frequency questionnaire administered in 1991, 1995, and 1999, with respondents followed up through 2003. Breast cancers were self-reported and confirmed by review of pathologic reports. During 12 years of follow-up of 90,659 premenopausal women, we documented 1021 cases of invasive breast carcinoma. Greater red meat intake was strongly related to elevated risk of breast cancers that were estrogen and progesterone receptor positive (ER+/PR+ n = 512) but not to those that were estrogen and progesterone receptor negative (ER-/PR- n = 167). Compared with those eating 3 or fewer servings per week of red meat, the multivariate relative risks (95% confidence intervals) for ER+/PR+ breast cancer with increasing servings of red meat intake were 1.14 (0.90-1.45) for more than 3 to 5 or fewer servings per week, 1.42 (1.06-1.90) for more than 5 per week to 1 or fewer servings per day, 1.20 (0.89-1.63) for more than 1 to 1.5 or fewer servings per day, and 1.97 (1.35-2.88) for more than 1.5 servings per day (test for trend, P = .001). The corresponding relative risks for ER-/PR- breast cancer were 1.34 (0.89-2.00), 1.21 (0.73-2.00), 0.69 (0.39-1.23), and 0.89 (0.43-1.84) (test for trend, P = .28). Higher intakes of several in idual red meat items were also strongly related to elevated risk of ER+/PR+ breast cancer. Higher red meat intake may be a risk factor for ER+/PR+ breast cancer among premenopausal women.
Publisher: Springer Science and Business Media LLC
Date: 07-09-2023
Publisher: Elsevier BV
Date: 06-1990
Abstract: Patterns of weight change for 31,940 non-smoking women aged 30-55 y in 1976 were examined for 8 y of follow-up. Each woman reported her weight every 2 y on questionnaires, and diet was assessed in 1980 with a semiquantitative food frequency questionnaire. Self-reported weight was highly correlated over time, decreasing from r = 0.95 over 2 y to r = 0.89 over 8 y. Weight gain was inversely related to age (r = -0.06). Weight change in a given 2-y interval was inversely related to change in weight over the subsequent 2 y (r = -0.30). Age, relative weight, and prior weight change were stronger predictors of recent weight change than were intake patterns of specific nutrients. Recent prior weight change was the strongest predictor of subsequent weight change. In a population of free-living women, prior weight loss and younger age are far stronger predictors of subsequent weight gain than are the qualitative aspects of diet.
Publisher: American Association for Cancer Research (AACR)
Date: 03-2006
Publisher: American Medical Association (AMA)
Date: 23-04-2019
Publisher: Wiley
Date: 23-08-2007
DOI: 10.1002/IJC.23009
Publisher: American Medical Association (AMA)
Date: 07-2021
Publisher: Oxford University Press (OUP)
Date: 09-1990
DOI: 10.1093/OXFORDJOURNALS.AJE.A115686
Abstract: To determine the relation of body mass index (weight/height2) with the risk of clinical non-insulin-dependent diabetes, the authors analyzed data from a cohort of 113,861 US women aged 30-55 years in 1976. During 8 years of follow-up (826,010 person-years), 873 definite cases were identified among women initially free from diagnosed diabetes. Among women of average body mass index, 23-23.9 kg/m2, the relative risk was 3.6 times that of women having a body mass index less than 22 kg/m2. The risk continued to increase above this level of body mass index. The authors observed a much weaker positive association with weight at age 18, and this association was eliminated after adjustment for current body mass index. Thus, weight gain after age 18 was a major determinant of risk. For an increase of 20-35 kg, the relative risk was 11.3, and for an increase of more than 35 kg, the relative risk was 17.3. Adjusting for family history did not appreciably alter the strong relation observed among women at average levels of body mass index. These data indicate that, at even average weight, women are at increased risk of clinical non-insulin-dependent diabetes and that the relation between body mass index and risk of diabetes is continuous.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2003
Abstract: Objective. Obesity increases risk of many adverse outcomes, but its early origins are obscure. Gestational diabetes mellitus (GDM) reflects a metabolically altered fetal environment associated with high birth weight, itself associated with later obesity. Previous studies of GDM and offspring obesity, however, have been few and conflicting. The objectives of this study were to examine associations of birth weight and GDM with adolescent body mass index (BMI) and to determine the extent to which the effect of GDM is explained by its influence on birth weight or by maternal adiposity. Methods. We conducted a survey of 7981 girls and 6900 boys, 9 to 14 years of age, who are participants in the Growing Up Today Study, a US nationwide study of diet, activity, and growth. In 1996, participants reported height, weight, diet, activity, and other variables by self-administered mailed questionnaire. We linked these data with information reported by their mothers, participants in the Nurses’ Health Study II, including GDM, height, current weight, and child’s birth weight. We excluded births & weeks’ gestation and mothers who had preexisting diabetes. We defined overweight as BMI (kg/m2) & th percentile, and at risk for overweight as 85th to 95th percentile, for age and gender from US national data. Results. Mean birth weight was 3.4 kg for girls and 3.6 kg for boys. Among the 465 subjects whose mothers had GDM, 17.1% were at risk for overweight and 9.7% were overweight in early adolescence. In the group without maternal diabetes, these estimates were 14.2% and 6.6%, respectively. In multiple logistic regression analysis, controlling for age, gender, and Tanner stage, the odds ratio for adolescent overweight for each 1-kg increment in birth weight was 1.4 (95% confidence interval: 1.2–1.6). Adjustment for physical activity, television watching, energy intake, breastfeeding duration, mother’s BMI, and other maternal and family variables reduced the estimate to 1.3 (1.1–1.5). For offspring of mothers with GDM versus no diabetes, the odds ratio for adolescent overweight was 1.4 (1.1–2.0), which was unchanged after controlling for energy balance and socioeconomic factors. Adjustment for birth weight slightly attenuated the estimate (1.3 0.9–1.9) adjustment for maternal BMI reduced the odds ratio to 1.2 (0.8–1.7). Conclusions. Higher birth weight predicted increased risk of overweight in adolescence. Having been born to a mother with GDM was also associated with increased adolescent overweight. However, the effect of GDM on offspring obesity seemed only partially explained by its influence on birth weight, and adjustment for mother’s own BMI attenuated the GDM associations. Our results only modestly support a causal role of altered maternal-fetal glucose metabolism in the genesis of obesity in the offspring. Alternatively, GDM may program risk for a postnatal insult leading to obesity, or it may merely be a risk marker, not in the causal pathway.
Publisher: Springer Science and Business Media LLC
Date: 18-11-2015
Publisher: Oxford University Press (OUP)
Date: 08-2000
DOI: 10.1093/IJE/29.4.622
Abstract: There is conflicting evidence on whether stress is a risk factor for breast cancer. The present study examined prospectively the relationship between stress at work and risk of breast cancer. Participants comprised 26 936 postmenopausal women in the Nurses' Health Study ages 46-72 who were in paid employment, and who had no previous history of cancer. Multivariate-adjusted regression analysis was used to examine the relationship between job strain (measured by the Karasek Job Content Questionnaire in 1992) and risk of incident invasive and in situ breast cancer. From 1992 through 1994, 219 women were diagnosed with breast cancer. No evidence was found for a relationship between job stress and risk of breast cancer. Compared with women in low strain jobs, the multivariate-adjusted relative risks of breast cancer were RR = 0.78 (95% CI : 0.52-1.16) for high-strain jobs RR = 0.76 (95% CI : 0.49-1.17) for active jobs and RR = 0.94 (95% CI : 0.67-1.34) for passive jobs. Although job strain was related to less breast cancer screening among women in highly demanding jobs, it was not associated with tumour size. Job stress was not related to an increase in the incidence of breast cancer in the present cohort of nurses.
Publisher: American Astronomical Society
Date: 12-08-2022
Abstract: We report the discovery of an eccentric hot Neptune and a non-transiting outer planet around TOI-1272. We identified the eccentricity of the inner planet, with an orbital period of 3.3 days and R p,b = 4.1 ± 0.2 R ⊕ , based on a mismatch between the observed transit duration and the expected duration for a circular orbit. Using ground-based radial velocity (RV) measurements from the HIRES instrument at the Keck Observatory, we measured the mass of TOI-1272b to be M p,b = 25 ± 2 M ⊕ . We also confirmed a high eccentricity of e b = 0.34 ± 0.06, placing TOI-1272b among the most eccentric well-characterized sub-Jovians. We used these RV measurements to also identify a non-transiting outer companion on an 8.7 day orbit with a similar mass of M p,c sin i = 27 ± 3 M ⊕ and e c ≲ 0.35. Dynamically stable planet–planet interactions have likely allowed TOI-1272b to avoid tidal eccentricity decay despite the short circularization timescale expected for a close-in eccentric Neptune. TOI-1272b also maintains an envelope mass fraction of f env ≈ 11% despite its high equilibrium temperature, implying that it may currently be undergoing photoevaporation. This planet joins a small population of short-period Neptune-like planets within the “Hot Neptune Desert” with a poorly understood formation pathway.
Publisher: American Association for Cancer Research (AACR)
Date: 10-2014
DOI: 10.1158/1538-7445.AM2014-2169
Abstract: Background: Diabetes is a risk factor for pancreatic cancer however, its association with survival from pancreatic cancer is poorly understood. Because diabetes is a para-neoplastic manifestation of pancreatic cancer, it is vital for studies evaluating this association to establish history of diabetes before pancreatic cancer diagnosis, but such studies are lacking. Our objective was to investigate for the first time the association of diabetes with survival among pancreatic cancer patients in a cohort-based study where diabetes history was ascertained before pancreatic cancer diagnosis. Methods: We evaluated survival by baseline (1993-2001) self-reported diabetes history (n=62) among 504 participants that developed exocrine pancreatic cancer within the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. The PLCO Screening Trial is a randomized, two-armed, controlled trial that enrolled 154,901 men and women aged 55-74 years from 10 centers in the United States between November 1993 and July 2001. Pancreatic cancer stage was abstracted at the PLCO centers in categories of localized, locally advanced, and metastatic in 2010 from previously collected pathology reports and medical records used for cancer confirmation. Information on deaths and causes of death were obtained by linking the study population to the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using Cox proportional hazards model, adjusted for age, body mass index, race, smoking, and stage. Results: Median survival was shorter among those with diabetes (92 days) than those without diabetes (139 days, p-value=0.05). The multivariable adjusted HR for mortality comparing participants with diabetes to those without was 1.52 (95%CI 1.13-2.03, p-value & .0001). After excluding those diagnosed with pancreatic cancer within 3 years of study enrollment, HR for mortality among those with diabetes was 1.40 (95%CI 1.05-1.99, p-value= 0.02). The association appeared to be stronger among men (HR=1.73, 95%CI 1.17-2.57, p-value= 0.006) than women (HR=1.36, 95%CI=0.84-2.22, p-value=0.216). Conclusion: In this survival analysis using incident cases ascertained from the PLCO prospective cohort, a history of diabetes prior to pancreatic cancer diagnosis was associated with higher mortality among pancreatic cancer patients. Studies characterizing the molecular mechanisms driving this association are needed as these can provide insights into relevant pathways that could be targeted for possible therapeutic interventions. Citation Format: Adetunji T. Toriola, Lara Dalidowitz, David Linehan, Rachael Stolzenberg-Solomon, Graham A. Colditz. Diabetes and pancreatic cancer survival: a prospective cohort study. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research 2014 Apr 5-9 San Diego, CA. Philadelphia (PA): AACR Cancer Res 2014 (19 Suppl):Abstract nr 2169. doi:10.1158/1538-7445.AM2014-2169
Publisher: Elsevier BV
Date: 05-2016
Publisher: American Medical Association (AMA)
Date: 02-01-1991
Publisher: Oxford University Press (OUP)
Date: 30-08-2006
DOI: 10.1093/IJE/DYL197
Abstract: Constitutional factors and sun exposure are associated with skin cancer risk. However, these relations are complex and differ according to skin cancer type. We examined the associations of constitutional risk factors and sun exposure with the risks of three types of skin cancer simultaneously and evaluated the interaction between constitutional susceptibility and sun exposure in a nested case-control study within the Nurses' Health Study [200 melanoma, 275 squamous cell carcinoma (SCC), and 283 basal cell carcinoma (BCC) cases, and 804 controls]. Information regarding skin cancer risk factors was obtained from the retrospective supplementary questionnaire. Constitutional susceptibility was an independent risk factor for all three types of skin cancer. Sunl usage or tanning salon attendance was a risk factor for melanoma after adjusting for potential confounding variables (OR for ever vs never usage, 2.06, 95% CI 1.30-3.26). Higher sun exposure while wearing a bathing suit was an independent risk factor for all three types of skin cancer. We observed a significant interaction between constitutional susceptibility and sun exposure while wearing a bathing suit on melanoma risk (P, interaction, 0.03) women with the highest susceptibility and highest exposure had an OR of 8.37 (95% CI 3.07-22.84). This interaction was weaker and non-significant for SCC and BCC. These data largely confirm past studies on risk factors for skin cancer but provide evidence of difference on the strength of these risk factors for melanoma compared with SCC and BCC.
Publisher: Springer Science and Business Media LLC
Date: 24-05-2012
Publisher: Springer Science and Business Media LLC
Date: 27-03-2021
DOI: 10.1186/S12894-021-00816-5
Abstract: Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40 p-trend for continuous BMI 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RR overweight : 1.13, 95% CI 1.07–1.21 RR obese : 1.10, 95% CI 1.02–1.19 p-trend for continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RR normal to overweight : 1.09, 95% CI 0.98–1.22 RR normal to obese : 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RR normal to overweight : 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.
Publisher: Springer Science and Business Media LLC
Date: 18-02-2005
DOI: 10.1186/BCR998
Publisher: Informa UK Limited
Date: 1981
DOI: 10.3109/01421598109081741
Abstract: Several different methods are used throughout the world for the allocation of pre-registration posts to graduating medical students. This article describes the ballot method of allocating such posts used in Brisbane, Australia. Using this system, only six per cent of students in the 1979 graduating class missed out on their hospital of first choice. The advantages and disadvantages of the procedure are considered.
Publisher: Elsevier BV
Date: 08-2012
Publisher: Oxford University Press (OUP)
Date: 04-06-2003
Abstract: Exposure to light at night suppresses the physiologic production of melatonin, a hormone that has antiproliferative effects on intestinal cancers. Although observational studies have associated night-shift work with an increased risk of breast cancer, the effect of night-shift work on the risk of other cancers is not known. We prospectively examined the relationship between working rotating night shifts and the risk of colorectal cancers among female participants in the Nurses' Health Study. We documented 602 incident cases of colorectal cancer among 78 586 women who were followed up from 1988 through 1998. Compared with women who never worked rotating night shifts, women who worked 1-14 years or 15 years or more on rotating night shifts had multivariate relative risks of colorectal cancer of 1.00 (95% confidence interval [CI] = 0.84 to 1.19) and 1.35 (95% CI = 1.03 to 1.77), respectively (P(trend) =.04). These data suggest that working a rotating night shift at least three nights per month for 15 or more years may increase the risk of colorectal cancer in women.
Publisher: Springer Science and Business Media LLC
Date: 12-2005
Abstract: Food frequency questionnaires (FFQs) have been validated in pregnant women, but few studies have focused specifically on low-income women and minorities. The purpose of this study was to examine the validity of the Harvard Service FFQ (HSFFQ) among low-income American Indian and Caucasian pregnant women. The 100-item HSFFQ was administered three times to a s le of pregnant women, and two sets of 24-hour recalls (six total) were collected at approximately 12 and 28 weeks of gestation. The s le included a total of 283 pregnant women who completed Phase 1 of the study and 246 women who completed Phase 2 of the study. Deattenuated Pearson correlation coefficients were used to compare intakes of 24 nutrients estimated from the second and third FFQ to average intakes estimated from the week-12 and week-28 sets of diet recalls. Deattenuated correlations ranged from 0.09 (polyunsaturated fat) to 0.67 (calcium) for Phase 1 and from 0.27 (sucrose) to 0.63 (total fat) for Phase 2. Average deattenuated correlations for the two phases were 0.48 and 0.47, similar to those reported among other groups of pregnant women. The HSFFQ is a simple self-administered questionnaire that is useful in classifying low-income American Indian and Caucasian women according to relative dietary intake during pregnancy. Its use as a research tool in this population may provide important information about associations of nutrient intakes with pregnancy outcomes and may help to identify groups of women who would benefit most from nutritional interventions.
Publisher: Public Library of Science (PLoS)
Date: 10-02-2022
DOI: 10.1371/JOURNAL.PONE.0263718
Abstract: The objective of this study is to identify how predisposing characteristics, enabling factors, and health needs are jointly and in idually associated with epidemiological patterns of outpatient healthcare utilization for patients who already interact and engage with a large healthcare system. We retrospectively analyzed electronic medical record data from 1,423,166 outpatient clinic visits from 474,674 patients in a large healthcare system from June 2018-March 2019. We evaluated patients who exclusively visited rural clinics versus patients who exclusively visited urban clinics using Chi-square tests and the generalized estimating equation Poisson regression methodology. The outcome was healthcare use defined by the number of outpatient visits to clinics within the healthcare system and independent variables included age, gender, race, ethnicity, smoking status, health status, and rural or urban clinic location. Supplementary analyses were conducted observing healthcare use patterns within rural and urban clinics separately and within primary care and specialty clinics separately. Patients in rural clinics vs. urban clinics had worse health status [χ 2 = 935.1, df = 3, p .0001]. Additionally, patients in rural clinics had lower healthcare utilization than patients in urban clinics, adjusting for age, race, ethnicity, gender, smoking, and health status [2.49 vs. 3.18 visits, RR = 0.61, 95%CI = (0.55,0.68), p .0001]. Further, patients in rural clinics had lower utilization for both primary care and specialty care visits. Within the large healthcare system, patients in rural clinics had lower outpatient healthcare utilization compared to their urban counterparts despite having potentially elevated health needs reflected by a higher number of unique health diagnoses documented in their electronic health records after adjusting for multiple factors. This work can inform future studies exploring the roots and ramifications of rural-urban healthcare utilization differences and rural healthcare disparities.
Publisher: Springer Science and Business Media LLC
Date: 12-09-2022
DOI: 10.1186/S12887-022-03562-1
Abstract: Childhood cancer survivors are at high risk for developing new cancers (such as cervical and anal cancer) caused by persistent infection with the human papillomavirus (HPV). HPV vaccination is effective in preventing the infections that lead to these cancers, but HPV vaccine uptake is low among young cancer survivors. Lack of a healthcare provider recommendation is the most common reason that cancer survivors fail to initiate the HPV vaccine. Strategies that are most successful in increasing HPV vaccine uptake in the general population focus on enhancing healthcare provider skills to effectively recommend the vaccine, and reducing barriers faced by the young people and their parents in receiving the vaccine. This study will evaluate the effectiveness and implementation of an evidence-based healthcare provider-focused intervention (HPV PROTECT) adapted for use in pediatric oncology clinics, to increase HPV vaccine uptake among cancer survivors 9 to 17 years of age. This study uses a hybrid type 1 effectiveness-implementation approach. We will test the effectiveness of the HPV PROTECT intervention using a stepped-wedge cluster-randomized trial across a multi-state s le of pediatric oncology clinics. We will evaluate implementation (provider perspectives regarding intervention feasibility, acceptability and appropriateness in the pediatric oncology setting, provider fidelity to intervention components and change in provider HPV vaccine-related knowledge and practices [e.g., providing vaccine recommendations, identifying and reducing barriers to vaccination]) using a mixed methods approach. This multisite trial will address important gaps in knowledge relevant to the prevention of HPV-related malignancies in young cancer survivors by testing the effectiveness of an evidence-based provider-directed intervention, adapted for the pediatric oncology setting, to increase HPV vaccine initiation in young cancer survivors receiving care in pediatric oncology clinics, and by procuring information regarding intervention delivery to inform future implementation efforts. If proven effective, HPV PROTECT will be readily disseminable for testing in the larger pediatric oncology community to increase HPV vaccine uptake in cancer survivors, facilitating protection against HPV-related morbidities for this vulnerable population. ClinicalTrials.gov Identifier: NCT04469569, prospectively registered on July 14, 2020.
Publisher: Springer Science and Business Media LLC
Date: 2000
Publisher: Springer Science and Business Media LLC
Date: 10-1998
Abstract: To compare levels of physical function, across levels of body mass index (BMI), among middle- to older-aged women. Cross-sectional study. Physical function, body weight and other covariates were measured in 1992. 56510 women aged 45-71 y, free of cardiovascular disease and cancer, participating in the Nurses' Health Study. The four physical function scores on the Medical Outcomes Study (MOS) Short Form-36 (SF36) Health Survey: physical functioning, vitality, bodily pain and role limitations. After adjusting for age, race, smoking status, menopausal status, physical activity and alcohol consumption, there was a significant dose-response gradient between increasing levels of BMI in 1992 and reduced function. For ex le, women with a BMI between 30-34.9 kg/m2 averaged: 9.0 point lower physical functioning score (95% Confidence interval (CI) -9.5, -8.5), 5.6 point lower vitality score (95% CI: -6.1, -5.1), and 7.0 point lower freedom from pain score (95% CI: -7.6, -6.4). These declines represent an approximate 10% loss of function compared to the reference category of women with BMIs ranging from 22.0-23.9 kg/m2. For the same BMI comparison, heavier women were at 66% increased risk of limitations in ability to work or perform other roles (RR = 1.66 95% odds ratio (OR) CI: 1.56, 1.76). These findings were replicated when the s le was restricted to women who had maintained their BMI over a ten year period. In addition to increasing risk of chronic health conditions, greater adiposity is associated with lower every day physical functioning, such as climbing stairs or other moderate activities, as well as lower feelings of well-being and greater burden of pain.
Publisher: Informa UK Limited
Date: 25-09-2018
Publisher: American Medical Association (AMA)
Date: 18-11-2009
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-04-2005
Abstract: Incidence and mortality of cutaneous melanoma is rising rapidly in the United States therefore, identifying risk factors for melanoma and integrating them into a clinical and population risk estimation tool may help guide prevention efforts and identify participants for preventive interventions. We examined risk factors for melanoma in three large prospective studies of women and men. We observed 152,949 women and 25,206 men free of cancer at baseline for up to 14 years. A total of 535 incident cases of invasive melanoma (444 women and 91 men) were included in the analysis. We combined the three studies to examine risk factors and to build a risk model to calculate melanoma risk score. Older age, male sex, family history of melanoma, higher number of nevi, history of severe sunburn, and light hair color were each associated with significantly elevated risk of melanoma and were included in the final risk prediction. Participants at the highest decile of risk had a more than three-fold increase in risk of melanoma compared with those in the lowest decile (observed relative risk, 3.61 expected relative risk, 4.20). The measure of discriminatory accuracy as summarized by an age-and sex-adjusted concordance statistic of 0.62 (95% CI, 0.58 to 0.65) indicated that the model had reasonable ability to differentiate those who will develop melanoma and those who will remain free from the disease. We identified several risk factors for melanoma and developed statistical models with adequate performance and discriminatory accuracy.
Publisher: Oxford University Press (OUP)
Date: 05-04-2021
DOI: 10.1093/JNCI/DJAB054
Publisher: Oxford University Press (OUP)
Date: 08-1997
DOI: 10.1093/OXFORDJOURNALS.AJE.A009261
Abstract: The return of fertility for women who discontinue oral contraceptives takes longer as compared with women who discontinue other methods of contraception. It remains unclear, however, whether subsequent fertility differs according to duration or age at first use. The authors performed a nested case-control study within a cohort of 116,686 female registered nurses residing in 14 US states. Baseline information was reported on mailed questionnaires in 1989. Cases comprised 1,917 married nurses without previous pregnancy who were unable to become pregnant for at least 1 year and were subsequently diagnosed with primary ovulatory infertility. Controls comprised 44,521 married parous nurses with no history of infertility and no pregnancies lasting less than 6 months. After allowing for 2 years of suppressed fertility following discontinuation of oral contraceptive use and excluding women with signs of menstrual or hormonal disorder, the authors found that the multivariate relative risk for ovulatory causes of delayed fertility was 1.2 (95% confidence interval 0.7-1.9) for ever users. There was no statistically significant trend of increasing risk with increasing duration of use and younger age at first use. The fact that 88 percent of cases reported an eventual pregnancy by 1993 suggests that absolute fertility was not impaired.
Publisher: American Society of Hematology
Date: 29-11-2018
DOI: 10.1182/BLOOD-2018-99-113025
Abstract: Background: Multiple myeloma (MM) is a lethal malignancy with 5- and 10-year survival rates of 46.7% and 20.6%, respectively. Marked advancements in treatment have improved survival within the last decade but are expensive and do not achieve cure. It is known that inflammation is important in MM pathogenesis, and regular aspirin use has been shown to confer a reduced risk of incident MM. However, the influence of aspirin on survival after diagnosis of MM is unknown. We investigated this question prospectively in two large cohorts. Methods: We identified 567 men and women diagnosed with MM between 1980 and 2012 in the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS). Participants in both cohorts reported aspirin intake biennially on follow-up questionnaires beginning in 1986 in HPFS and 1980 in NHS. Using multivariable Cox proportional hazards regression models, we estimated hazard ratios (HR) and 95% confidence intervals (CI) for MM-specific and overall mortality through 2015 according to aspirin use patterns. We also examined differences in MM clinical characteristics by aspirin use patterns in a subset of participants with available clinical data. Results: After a median follow-up of 40 months, there were 135 total deaths (76%) and 107 MM−specific deaths (60%) among 177 participants who used aspirin after MM diagnosis, compared with 222 total deaths (90%) and 195 MM−specific deaths (79%) among 247 participants who did not use aspirin. Compared with nonusers, participants who used aspirin after diagnosis had a multivariable HR for MM−specific mortality of 0.55 (95% confidence interval [CI], 0.41, 0.73) and for overall mortality of 0.58 (95% CI, 0.45, 0.75), after adjustment for age at diagnosis, year of diagnosis, sex, body mass index, pre-diagnosis aspirin use, and number of comorbidities. We also observed evidence of a dose response association between postdiagnosis aspirin quantity for both MM-specific and overall mortality (P-trend .01). The association between postdiagnosis aspirin use and MM-specific and overall mortality were not materially different in models that excluded deaths that occurred within 12 months of completing the postdiagnosis aspirin assessment. We could not adjust for first line therapy, but adjustment for year of diagnosis may partially control for first line therapy in these cohorts. In a subs le (n=225) of participants with clinical data available, we did not observe statistically significant differences in the clinically presenting features of MM by post diagnosis aspirin use. We also did not observe statistically significant associations between pre-diagnosis quantity or duration of aspirin use and MM-specific or overall mortality. Conclusions: Although lack of adjustment for clinical parameters is a limitation, the findings suggest that aspirin use after MM diagnosis is associated with a lower risk of MM−specific and overall mortality. Ghobrial: Celgene: Consultancy BMS: Consultancy Janssen: Consultancy Takeda: Consultancy.
Publisher: Springer Science and Business Media LLC
Date: 29-03-2009
DOI: 10.1038/NG.353
Publisher: Oxford University Press
Date: 29-03-2012
Publisher: Informa UK Limited
Date: 1996
Publisher: The Sax Institute
Date: 2016
DOI: 10.17061/PHRP2631628
Abstract: The Nurses' Health Study, a cohort of 121 701 female registered nurses, was established in 1976 to prospectively address the relationship between the use of oral contraceptives and the risk of breast cancer. Through follow-up questionnaires every 2 years, exposures have been updated and new exposure assessments added. Repeated measures have allowed a broad range of analyses, including change measures and risk according to time since exposure. Responding to emerging public health issues and accessing new measures (such as exposure to silicone implants, air pollution and the built environment) has allowed investigators to address an evolving spectrum of topics. Prospective data on a wide range of chronic conditions have allowed assessment of preventable fractions of diseases, development of risk prediction models, and other applications that bring data to bear on translation of epidemiologic findings to health policy and practice. The aim of this report is to highlight the features of the Nurses' Health Study and other cohorts that demonstrate continuing contributions to the changing epidemiology of chronic conditions.
Publisher: American Diabetes Association
Date: 06-2003
DOI: 10.2337/DIACARE.26.6.1752
Abstract: OBJECTIVE—Hyperinsulinemia may promote mammary carcinogenesis. Insulin resistance has been linked to an increased risk of breast cancer and is also characteristic of type 2 diabetes. We prospectively evaluated the association between type 2 diabetes and invasive breast cancer incidence in the Nurses’ Health Study. RESEARCH DESIGN AND METHODS—A total of 116,488 female nurses who were 30–55 years old and free of cancer in 1976 were followed through 1996 for the occurrence of type 2 diabetes and through 1998 for incident invasive breast cancer, verified by medical records and pathology reports. RESULTS—During 2.3 million person-years of follow-up, we identified 6,220 women with type 2 diabetes and 5,189 incident cases of invasive breast cancer. Women with type 2 diabetes had a modestly elevated incidence of breast cancer (hazard ratio [HR] = 1.17 95% CI 1.01–1.35) compared with women without diabetes, independent of age, obesity, family history of breast cancer, history of benign breast disease, reproductive factors, physical activity, and alcohol consumption. This association was apparent among postmenopausal women (1.16 0.98–1.62) but not premenopausal women (0.83 0.48–1.42). The association was predominant among women with estrogen receptor-positive breast cancer (1.22 1.01–1.47). CONCLUSIONS—Women with type 2 diabetes may have a slightly increased risk of breast cancer.
Publisher: American Medical Association (AMA)
Date: 24-05-1999
DOI: 10.1001/ARCHINTE.159.10.1061
Abstract: Early natural menopause has been postulated to increase the risk of cardiovascular disease. To examine the relation of age at natural menopause with risk of coronary heart disease (CHD) and stroke in the Nurses' Health Study. Analysis was restricted to 35 616 naturally postmenopausal women who never used estrogen replacement therapy and with no diagnosed cardiovascular disease at baseline, followed up from 1976 to 1994. Information on menopausal status, age at menopause, and other risk factors was obtained in 1976 and updated every 2 years by mailed questionnaires. During 354326 person-years of follow-up, we documented 757 incident cases of CHD and 350 incident cases of stroke. After adjusting for age, smoking status, and other cardiovascular risk factors, the relative risks (RRs) across categories of age at natural menopause ( or = 55 years) were 1.53, 1.42, 1.10, 1.00 (reference), and 0.95, respectively the RR for each 1-year decrease in age at natural menopause was 1.03 (95% confidence interval, 1.01-1.05). Elevated risk with younger age at menopause was observed among current smokers (RR, 1.04 [95% CI, 1.01-1.07] for each 1-year decrease in age at natural menopause) but not among never smokers (RR, 1.00 95% CI, 0.96-1.04). Age at natural menopause was not significantly associated with ischemic stroke (RR, 1.01 95% CI, 0.97-1.04) or hemorrhagic stroke (RR, 1.03 95% CI, 0.97-1.10). We observed an overall significant association between younger age at menopause and higher risk of CHD among women who experienced natural menopause and never used hormone therapy. This increased risk was observed among current smokers but not among never smokers. The apparent elevated risk of CHD with decreased age at natural menopause among smokers might reflect residual confounding by smoking.
Publisher: Wiley
Date: 30-11-1998
DOI: 10.1002/(SICI)1097-0258(19981130)17:22<2537::AID-SIM953>3.0.CO;2-C
Abstract: Earlier work showed how to perform fixed-effects meta-analysis of studies or trials when each provides results on more than one outcome per patient and these multiple outcomes are correlated. That fixed-effects generalized-least-squares approach analyzes the multiple outcomes jointly within a single model, and it can include covariates, such as duration of therapy or quality of trial, that may explain observed heterogeneity of results among the trials. Sometimes the covariates explain all the heterogeneity, and the fixed-effects regression model is appropriate. However, unexplained heterogeneity may often remain, even after taking into account known or suspected covariates. Because fixed-effects models do not make allowance for this remaining unexplained heterogeneity, the potential exists for bias in estimated coefficients, standard errors and p-values. We propose two random-effects approaches for the regression meta-analysis of multiple correlated outcomes. We compare their use with fixed-effects models and with separate-outcomes models in a meta-analysis of periodontal clinical trials. A simulation study shows the advantages of the random-effects approach. These methods also facilitate meta-analysis of trials that compare more than two treatments.
Publisher: Springer Science and Business Media LLC
Date: 18-07-2014
Publisher: Wiley
Date: 05-1999
Publisher: Elsevier BV
Date: 03-1999
DOI: 10.1016/S0002-9343(99)00022-4
Abstract: To examine the effects of cigarette smoking and smoking cessation on the risk of hip fracture in women. We studied 116,229 female nurses, 34 to 59 years of age at baseline in 1980, who were followed for up to 12 years. Smoking habits and the occurrence of incident hip fractures (n = 377) due to low or moderate trauma were self-reported on biennial mailed questionnaires. Compared with women who had never smoked, the age-adjusted relative risk (RR) of hip fracture among current smokers was 1.3 (95% confidence interval [CI] 1.0 to 1.7). The risk of hip fracture increased linearly (P = 0.09) with greater cigarette consumption (RR = 1.6, 95% CI 1.1 to 2.3 for 25 or more cigarettes per day). These associations were somewhat reduced by adjusting for other risk factors for osteoporosis (menopausal status, use of postmenopausal estrogen, physical activity, and intakes of calcium, alcohol, and caffeine): RR = 1.2, 95% CI 0.8 to 1.3 for all current smokers RR = 1.4, 95% CI 0.9 to 2.1 for 25 or more cigarettes per day. Relative risks were further reduced when body mass index was added to the model. There was no apparent benefit from quitting smoking until 10 years after cessation. After 10 years, former smokers had a reduced risk of hip fracture (adjusted RR = 0.7, 95% CI 0.5 to 0.9) compared with current smokers. Smokers are at increased risk of hip fracture and their risk rises with greater cigarette consumption. Risk declines among former smokers, but the benefit is not observed until 10 years after cessation. Both the increased risk among current smokers and the decline in risk after smoking cessation are in part accounted for by differences in body weight.
Publisher: Springer Science and Business Media LLC
Date: 1995
DOI: 10.1007/BF00051680
Publisher: BMJ
Date: 09-10-2020
DOI: 10.1136/GUTJNL-2020-321661
Abstract: Factors that lead to metabolic dysregulation are associated with increased risk of early-onset colorectal cancer (CRC diagnosed under age 50). However, the association between metabolic syndrome (MetS) and early-onset CRC remains unexamined. We conducted a nested case–control study among participants aged 18–64 in the IBM MarketScan Commercial Database (2006–2015). Incident CRC was identified using pathologist-coded International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, and controls were frequency matched. MetS was defined as presence of ≥3 conditions among obesity, hypertension, hyperlipidaemia and hyperglycaemia/type 2 diabetes, based on ICD-9-CM and use of medications. Multivariable logistic regressions were used to estimate ORs and 95% CIs. MetS was associated with increased risk of early-onset CRC (n=4673 multivariable adjusted OR 1.25 95% CI 1.09 to 1.43), similar to CRC diagnosed at age 50–64 (n=14 928 OR 1.21 95% CI 1.15 to 1.27). Compared with in iduals without a metabolic comorbid condition, those with 1, 2 or ≥3 conditions had a 9% (1.09 95% CI 1.00 to 1.17), 12% (1.12 95% CI 1.01 to 1.24) and 31% (1.31 95% CI 1.13 to 1.51) higher risk of early-onset CRC (p trend .001). No associations were observed for one or two metabolic comorbid conditions and CRC diagnosed at age 50–64. These positive associations were driven by proximal (OR per condition 1.14 95% CI 1.06 to 1.23) and distal colon cancer (OR 1.09 95% CI 1.00 to 1.18), but not rectal cancer (OR 1.03 95% CI 0.97 to 1.09). Metabolic dysregulation was associated with increased risk of early-onset CRC, driven by proximal and distal colon cancer, thus at least in part contribute to the rising incidence of early-onset CRC.
Publisher: Massachusetts Medical Society
Date: 05-08-1999
Publisher: Elsevier BV
Date: 2016
Publisher: Elsevier BV
Date: 09-2019
Publisher: American Association for Cancer Research (AACR)
Date: 12-04-2018
DOI: 10.1158/0008-5472.CAN-17-3043
Abstract: In contrast to the convincing evidence that obesity (measured by body mass index, BMI) increases the risk of many different types of cancer, there is an ambiguity in the role of obesity in survival among cancer patients. Some studies suggested that higher BMI decreased mortality risk in cancer patients, a phenomenon called the obesity paradox. The spurious positive association between BMI and cancer survival is likely to be explained by several methodologic limitations including confounding, reverse causation, and collider stratification bias. Also, the inadequacy of BMI as a measure of body fatness in cancer patients commonly experiencing changes in body weight and body composition may have resulted in the paradox. Other factors contributing to the ergent results in literature are significant heterogeneity in study design and method (e.g., study population, follow-up length) time of BMI assessment (pre-, peri-, or post-diagnosis) and lack of consideration for variability in the strength and directions of associations by age, sex, race/ethnicity, and cancer subtype. Robust but practical methods to accurately assess body fatness and body compositions and weight trajectories in cancer survivors are needed to advance this emerging field and to develop weight guidelines to improve both the length and the quality of cancer survival. Cancer Res 78(8) 1898–903. ©2018 AACR.
Publisher: Elsevier BV
Date: 10-2021
DOI: 10.1093/JN/NXAB241
Abstract: Although fruit and vegetable intake during adolescence, a potentially sensitive time period for prostate cancer (PCa) development, has been proposed to protect against PCa risk, few studies have investigated the role of adolescent plant product intake in PCa development. Intake of various vegetables, fruit, and grains by males at ages 12-13 y was examined in relation to later PCa risk and mortality in the NIH-AARP Diet and Health Study. Cox proportional hazards regression was used to calculate HRs and 95% CIs of nonadvanced (n = 14,238) and advanced (n = 2,170) PCa incidence and PCa mortality (n = 760) during 1,729,896 person-years of follow-up. None of the plant products examined were associated consistently with all PCa outcomes. However, greater adolescent intakes of tomatoes (P-trend = 0.004) and nonstarch vegetables (P-trend = 0.025) were associated with reduced risk of nonadvanced PCa, and greater intakes of broccoli (P-trend = 0.050) and fruit juice (P-trend = 0.019-0.025) were associated with reduced risk of advanced PCa and/or PCa mortality. Positive trends were also observed for greater intakes of fruit juice (P-trend = 0.002), total fruit (P-trend = 0.014), and dark bread (P-trend = 0.035) with nonadvanced PCa risk and for greater intakes of legumes (P-trend < 0.001), fiber (P-trend = 0.001), and vegetable protein (P-trend = 0.013-0.040) with advanced PCa risk or PCa mortality. Our findings do not provide strong evidence to suggest that adolescent plant product intake is associated with reduced PCa risk.
Publisher: American Association for Cancer Research (AACR)
Date: 2012
DOI: 10.1158/1940-6207.CAPR-11-0322
Abstract: Several studies indicate that screening in combination with lifestyle modification may produce a greater reduction in colorectal cancer rates than screening alone. To identify national opportunities for the primary prevention of colorectal cancer, we assessed the prevalence of modifiable lifestyle risk factors in the United States. We used nationally representative, cross-sectional data from 5 NHANES cycles (1999–2000, n = 2,753 2001–2002, n = 3,169 2003–2004, n = 2,872 2005–2006, n = 2,993 2007–2008, n = 3,438). We evaluated the 5 colorectal cancer risk factors deemed “convincing” by the World Cancer Research Fund (obesity, physical inactivity, intake of red meat, processed meat, alcohol), and cigarette smoking, a “suggestive” risk factor in the Surgeon General's report. We estimated the prevalence of each risk factor separately and jointly, and report it overall, and by sex, race/ethnicity, age, and year. In 2007 to 2008, 81% percent of U.S. adults, aged 20 to 69 years, had at least one modifiable risk factor for colorectal cancer. More than 15% of those younger than 50 years had 3 or more risk factors. There was no change in the prevalence of risk factors between 1999 and 2008. The most common risk factors were risk factors for other chronic diseases. Our findings provide additional support for the prioritization of preventive services in health care reform. Increasing awareness, especially among young adults, that lifestyle factors influence colorectal cancer risk, and other chronic diseases, may encourage lifestyle changes and adherence to screening guidelines. Complementary approaches of screening and lifestyle modification will likely provide the greatest reduction of colorectal cancer. Cancer Prev Res 5(1) 138–45. ©2011 AACR.
Publisher: American Medical Association (AMA)
Date: 12-02-1997
Publisher: Springer Science and Business Media LLC
Date: 23-11-2020
DOI: 10.1038/S41523-020-00206-4
Abstract: Adolescent drinking is associated with higher risks of proliferative benign breast disease (BBD) and invasive breast cancer (BC). Furthermore, adolescent nut and fiber consumptions are associated with lower risks of benign lesions and premenopausal BC. We hypothesize that diet (nuts, fiber) may mitigate the elevated BBD risk associated with alcohol. A prospective cohort of 9031 females, 9–15 years at baseline, completed questionnaires in 1996–2001, 2003, 2005, 2007, 2010, 2013, and 2014. Participants completed food frequency questionnaires in 1996–2001. In 2005, participants ( =18 years) began reporting biopsy-confirmed BBD ( N = 173 cases). Multivariable logistic regression estimated associations between BBD and cross-classified intakes (14–17 years) of alcohol and peanut butter/nuts (separately, total dietary fiber). Only 19% of participants drank in high school drinking was associated with elevated BBD risk (OR = 1.75, 95% CI: 1.20–2.56 p = 0.004) compared to nondrinkers. Participants consuming any nuts/butter had lower BBD risk (OR = 0.64, 95% CI: 0.45–0.90 p = 0.01) compared to those consuming none. Participants in top 75% fiber intake had lower risk (OR = 0.57, 95% CI: 0.40–0.81 p = 0.002) compared to bottom quartile. Testing our hypothesis that consuming nuts/butter mitigates the elevated alcohol risk, analyzing alcohol and nuts combined found that those who consumed both had lower risk (RR = 0.47, 95% CI: 0.24–0.89 p = 0.02) compared to drinkers eating no nuts. Our analysis of alcohol and fiber together did not demonstrate risk mitigation by fiber. For high school females who drink, their BBD risk may be attenuated by consuming nuts. Due to modest numbers, future studies need to replicate our findings in adolescent/adult females. However, high school students may be encouraged to eat nuts and fiber, and to avoid alcohol, to reduce risk of BBD and for general health benefits.
Publisher: American Association for Cancer Research (AACR)
Date: 07-2018
DOI: 10.1158/1538-7445.AM2018-1228
Abstract: Background: Young-onset colorectal cancer, the majority of which are sporadic, may have distinct molecular characteristics and etiologies. However, thus far, the genomic landscape of young-onset CRCs has remained largely uncharacterized. This study aimed to compare somatic mutation differences between young-onset and late-onset CRCs using the AACR GENIE data, a consortium of patients treated at 8 global cancer centers. Methods: Clinical and DNA mutation data on 2,081 CRC s les were downloaded from Sage Bionetworks (Synapse ID: syn7222066). A total of 162 s les from CRC patients who had more than one s les or were likely to have Lynch syndrome were excluded. Young-onset CRCs were defined as cancers arising at age & years old while late-onset CRCs were defined as cancers arising at age ≥50 years old. Mutation rate per megabase (Mb) was calculated for each CRC and compared between groups by Wilcoxon rank sum test. The mutation frequency of each gene in young-onset and late-onset CRC was calculated separately for primary CRCs and metastatic CRCs. Mutation frequency differences between young- vs late-onset CRCs were tested by the Fisher's exact test with significance defined at the 5% alpha level. Results: Mutation data on 613 genes were analyzed on 955 primary and 676 metastatic CRCs. Overall, the most frequently mutated genes with a & % mutation frequency include: TP53 (66.86%), APC (59.46%), KRAS (47.42%), PIK3CA (18.40%), SMAD4 (12.71%) and BRAF (10.06%). The metastatic CRCs were on average slightly older than primary CRCs (mean age=56.96 vs. 55.90, two s le t test P=0.09). Comparing gene mutation between 300 young-onset versus 655 late-onset primary CRCs, mutation rate per Mb was slightly but not significantly higher in the latter (median=3.74 vs. 4.14, P=0.2199). DOT1L (9.82% vs. 1.95%, P=0.0014), IGF1R (6.12% vs. 1.72%, P=0.0057), BRCA1 (5.61% vs. 1.47%, P=0.0069), JUN (6.25% vs. 1.17%, P=0.0104), PTCH1 (7.14% vs. 2.7%, P=0.0151), TSHR (5.36% vs. 1.17%, P=0.0253), EIF1AX (3.06% vs. 0%, P=0.02811), JAK2 (2.0% vs. 0.46%, P=0.0311), EP300 (8.67% vs. 4.41%, P=0.0414), PHOX2B (2.20% vs. 0.27%, P=0.0419), SMC1A (3.57% vs. 0%, P=0.0446) and CSF1R (3.02% vs. 1.03%, P=0.0439) had a significantly higher mutation rate in the young-onset primary CRCs. Meanwhile, KRAS was mutated more frequently in late-onset primary CRCs (44.0% vs. 51.3%, P=0.03679). For metastatic CRCs, NTRK1 was found mutated in 12 (3.80%) out of 316 later-onset metastatic CRCs but none out of 129 young-onset metastatic CRCs (P=0.0223). Meanwhile, CIC was mutated in only 1 out of 103 young-onset metastatic CRCs but 17 (6.44%) out of 264 late-onset metastatic CRCs (P=0.0302) and TP53 had a nearly 8% higher mutation rate in young-onset metastatic CRCs (79.01% vs. 71.19%, P=0.0488). Conclusions: Mutation rates were found significantly higher in many genes among young-onset primary CRCs compared to late-onset primary CRCs. Citation Format: Jingqin Luo, Marios Giannakis, Graham Colditz, Jean Wang, William Chapman, Adetunji T. Toriola, Yoshiko Mito, Reiko Nishihara, Jonathan Nowak, Charles Fuchs, Edward Giovannucci, Andrew T. Chan, Adam Bass, Shuji Ogino, Ryan Fields, Yin Cao. Comparative genomic analysis of young-onset and late-onset colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018 2018 Apr 14-18 Chicago, IL. Philadelphia (PA): AACR Cancer Res 2018 (13 Suppl):Abstract nr 1228.
Publisher: American Medical Association (AMA)
Date: 08-05-2006
DOI: 10.1001/ARCHINTE.166.9.1027
Abstract: Although short-term unopposed estrogen use does not seem to increase breast cancer risk, the effect of longer-term estrogen use remains unclear. We sought to assess the relationship between longer-term use of unopposed estrogen and the risk of invasive breast cancer over an extended follow-up period. Within the Nurses' Health Study, a prospective cohort study, we observed 11 508 postmenopausal women who had a hysterectomy and reported information on estrogen use at baseline (1980). The study population was expanded every 2 years to include women who subsequently became postmenopausal and had a hysterectomy, so that 28 835 women were included in the final follow-up period (2000-2002). Estrogen use was assessed from self-reported data on biennial questionnaires. The main outcome was invasive breast cancer. A total of 934 invasive breast cancers were included in the analysis. Breast cancer risk increased with duration of unopposed estrogen use among longer-term users with the highest risk seen in cancers positive for estrogen receptor (ER+) and progesterone receptor (PR+). The multivariate relative risks (RRs) and 95% confidence intervals (CIs) for breast cancer with current use of unopposed estrogen for less than 5 years, 5 to 9.9 years, 10 to 14.9 years, 15 to 19.9 years, and 20 years or longer were, respectively, 0.96 (95% CI, 0.75-1.22), 0.90 (95% CI, 0.73-1.12), 1.06 (95% CI, 0.87-1.30), 1.18 (95% CI, 0.95-1.48), and 1.42 (95% CI, 1.13-1.77) (P for trend <.001). The risk of ER+/PR+ breast cancers was noted to be statistically significant after 15 years of current use (RR, 1.48 95% CI, 1.05-2.07). Users of unopposed estrogen were at increased risk of breast cancer but only after longer-term use.
Publisher: Springer Science and Business Media LLC
Date: 1998
Abstract: The purpose of this study was to describe the effect of screening endoscopy (sigmoidoscopy or colonoscopy) on colorectal cancer incidence and mortality. We used data from a prospective cohort study of 24,744 men aged 40 to 75 years in 1986, free from cancer and colon polyps, followed until 1994. The outcomes are diagnosis of colorectal cancer and death from colorectal cancer. Screening endoscopy in 1986-87 was associated with a lower risk of all colorectal cancer (multivariate relative risk [RR] = 0.58, 95 percent confidence interval [CI] = 0.36-0.96) cancer in the distal colon or rectum (multivariate RR = 0.40, CI = 0.19-0.84) Dukes stage A&B (multivariate RR = 0.66, CI = 0.35-1.25) and Dukes stage C&D (multivariate RR = 0.50, CI = 0.20-1.26) colorectal cancer and death from colorectal cancer (multivariate RR = 0.56, CI = 0.20-1.60), after adjusting for age and a wide range of colon cancer risk factors. Screening endoscopy in 1988-87 appeared to provide strong protection against distal stage C&D cancers (age-adjusted RR = 0.16, CI = 0.02-1.23) but no protection against proximal stage C&D cancers (age-adjusted RR = 0.96, CI = 0.32-2.91). This study provides strong evidence for a protective effect of screening sigmoidoscopy on colorectal cancer incidence and mortality and supports recommendations for screening sigmoidoscopy as an approach to colon cancer prevention.
Publisher: American Association for Cancer Research (AACR)
Date: 02-2022
DOI: 10.1158/1055-9965.EPI-21-0946
Abstract: Inflammation is important in multiple myeloma pathogenesis, and regular aspirin use has been shown to confer a reduced risk of multiple myeloma. The influence of aspirin on survival after multiple myeloma diagnosis is unknown. We identified 436 men and women diagnosed with multiple myeloma between 1980 and 2016 in the Health Professionals Follow-up Study and the Nurses' Health Study who reported aspirin intake biennially on follow-up questionnaires. Using multivariable Cox proportional hazards regression models, we estimated HRs and 95% confidence intervals (CI) associated with the effect of aspirin use on multiple myeloma–specific and overall mortality. Compared with nonusers, participants who used aspirin after diagnosis had a multivariable HR for multiple myeloma–specific mortality of 0.61 (95% CI, 0.46–0.79) and for overall mortality of 0.63 (95% CI, 0.49–0.80), after adjustment for age at diagnosis, year of diagnosis, sex, body mass index, prediagnosis aspirin use, and number of comorbidities. For postdiagnosis aspirin quantity, we observed a modest trend of reduction in multiple myeloma–specific and all-cause mortality with increasing number of 325-mg tablets of aspirin per week, although the CIs for 1 to & and ≥6 tablets overlapped. Results were not materially different before or after the availability of novel therapies (before vs. after the year 2000). Prediagnosis frequency or duration of aspirin use was not significantly associated with multiple myeloma–specific or overall mortality. These findings support the use of aspirin as a complementary strategy to enhance multiple myeloma survival. Confirmation in s les that have comprehensive clinical information is encouraged.
Publisher: Oxford University Press (OUP)
Date: 05-2001
Abstract: Oxidative damage to proteins in the human lens is believed to be important in the etiology of age-related cataract. Because free radical-mediated oxidative damage to lipoproteins may accelerate atherosclerosis, the authors hypothesized that the development of cataract might be a marker for such damage and therefore might be associated with future risk of coronary heart disease (CHD). The authors followed 60,657 women aged 45--63 years and without known coronary disease, stroke, or cancer in 1984. During 10 years of follow-up (674,283 person-years), the authors documented 887 incident cases of CHD and 2,322 deaths. After adjustment for age, smoking, and other coronary risk factors, cataract extraction was significantly associated with higher risk of CHD (relative risk (RR) = 1.88, 95% confidence interval (CI): 1.41, 2.50) for total CHD, 2.44 (95% CI: 1.54, 3.89) for fatal CHD, and 1.63 (95% CI: 1.14, 2.34) for nonfatal myocardial infarction). The positive association between cataract extraction and total CHD was stronger among women with a history of diabetes (RR = 2.80, 95% CI: 1.77, 4.42) than among those without reported diabetes (RR = 1.51, 95 percent CI: 1.04, 2.18). In multivariate analyses, cataract extraction was associated with significantly increased overall mortality (RR = 1.37, 95 percent CI: 1.13, 1.66), which was entirely explained by the increased mortality from cardiovascular disease (RR = 1.84, 95% CI: 1.29, 2.64). These findings are compatible with current hypotheses relating oxidative damage and tissue aging to the development of cataract and CHD.
Publisher: Oxford University Press (OUP)
Date: 07-2002
DOI: 10.1093/AJE/KWF008
Abstract: Several studies have suggested that high intake of fats and fat-rich foods may increase the risk of ovarian cancer. The authors examined these relations in the Nurses' Health Study cohort. Dietary intake was assessed in 1980, 1984, 1986, and 1990 by using a self-administered food frequency questionnaire. Food data were used to calculate intake of various fats and fatty acids. For best reflection of long-term intake, an updated, cumulative, averaged measure of fat intake was used to predict incidence of ovarian cancer. Between 1980 and 1996, 301 incident cases of invasive epithelial ovarian cancer were confirmed among the 80,258 participants who completed the baseline food frequency questionnaire. There was no evidence of a positive association between intake of any type of fat and ovarian cancer risk, even after adjustment of fat subtypes for one another. Women in the highest quintile of total fat intake were not at increased risk compared with those in the lowest quintile (multivariate relative risk = 1.03, 95 percent confidence interval: 0.72, 1.45, p for trend = 0.97). Intakes of fat-rich foods were also not appreciably associated with ovarian cancer risk, although an increase in risk with frequent intake of eggs was observed. Overall, results suggest no association between intake of any type of fat and ovarian cancer.
Publisher: American Medical Association (AMA)
Date: 21-04-1999
Abstract: Reduction in egg consumption has been widely recommended to lower blood cholesterol levels and prevent coronary heart disease (CHD). Epidemiologic studies on egg consumption and risk of CHD are sparse. To examine the association between egg consumption and risk of CHD and stroke in men and women. Two prospective cohort studies, the Health Professionals Follow-up Study (1986-1994) and the Nurses' Health Study (1980-1994). A total of 37851 men aged 40 to 75 years at study outset and 80082 women aged 34 to 59 years at study outset, free of cardiovascular disease, diabetes, hypercholesterolemia, or cancer. Incident nonfatal myocardial infarction, fatal CHD, and stroke corresponding to daily egg consumption as determined by a food-frequency questionnaire. We documented 866 incident cases of CHD and 258 incident cases of stroke in men during 8 years of follow-up and 939 incident cases of CHD and 563 incident cases of stroke in women during 14 years of follow-up. After adjustment for age, smoking, and other potential CHD risk factors, we found no evidence of an overall significant association between egg consumption and risk of CHD or stroke in either men or women. The relative risks (RRs) of CHD across categories of intake were less than 1 per week (1.0), 1 per week (1.06), 2 to 4 per week (1.12), 5 to 6 per week (0.90), and > or =1 per day (1.08) (P for trend = .75) for men and less than 1 per week (1.0), 1 per week (0.82), 2 to 4 per week (0.99), 5 to 6 per week (0.95), and > or =1 per day (0.82) (P for trend = .95) for women. In subgroup analyses, higher egg consumption appeared to be associated with increased risk of CHD only among diabetic subjects (RR of CHD comparing more than 1 egg per day with less than 1 egg per week among diabetic men, 2.02 [95% confidence interval, 1.05-3.87 P for trend = .04], and among diabetic women, 1.49 [0.88-2.52 P for trend = .008]). These findings suggest that consumption of up to 1 egg per day is unlikely to have substantial overall impact on the risk of CHD or stroke among healthy men and women. The apparent increased risk of CHD associated with higher egg consumption among diabetic participants warrants further research.
Publisher: Elsevier BV
Date: 09-1997
Abstract: High calcium intakes are thought to be associated with strong bones and lower risk of fractures. However, findings from epidemiologic studies have not been consistent. In addition, the vast majority of such studies were conducted among women, leading to a relative lack of data concerning men. The objective of this study therefore was to investigate the relation between adult calcium intake and risk of fractures among men in the Health Professionals Follow-up Study (HPFS). During 331,234 person-years of follow-up over an 8-y period, 201 forearm and 56 hip fractures due to low or moderate trauma were reported among 43,063 men 40-75 y of age in 1986 when they first completed a questionnaire about diet and lifestyle factors. After controlling for age, smoking status, body mass index (BMI), physical activity, alcohol consumption and total energy intake, the relative risk (RR) of forearm fractures for men in the highest quintile of calcium intake (from foods plus supplements) compared with those in the lowest quintile was 0.98 [95% confidence interval (CI) = 0.59-1.61 P for trend = 0.78] for hip fractures, the comparable RR was 1.19 (95% CI = 0.42-3.35 P for trend = 0.58). Relative risks for consuming >2.5 glasses (600 mL) of milk per day compared with one (240 mL) or fewer per week were 1.06 (95% CI = 0.69-1.62 P for trend = 0.82) for forearm fractures and 0.97 (95% CI = 0.39-2.42 P for trend = 0.56) for hip fractures. In conclusion, these results do not support a relation between calcium intake and the incidence of forearm or hip fractures in men.
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Publisher: Wiley
Date: 05-1997
Abstract: To examine the relationship between past use of oral contraceptives (OCs) and development of systemic lupus erythematosus (SLE). Prospective cohort study of 121,645 women who were followed up every 2 years between 1976 and 1990 as part of the Nurses' Health Study. Women were classified as never users or past users of OCs based on self-report. Incidence of SLE was defined by 1) strict American College of Rheumatology (ACR) classification criteria (> or = 4 ACR criteria), 2) > or = 4 ACR criteria and any physician's diagnosis, 3) > or = 4 ACR criteria and diagnosis by an ACR-certified rheumatologist, 4) > or = 3 ACR criteria, or 5) diagnosis by a physician even if the patient did not meet the ACR criteria. Compared with never users of OCs, and after adjusting for age and ever use of postmenopausal hormones, the relative risk (95% confidence interval [95% CI]) for the incidence of SLE in the women who had definite cases of SLE (> or = 4 ACR criteria) (n = 99) was 1.4 (0.9-2.1) for past users of OCs. Using the most stringent case definition (ACR criteria plus a diagnosis of SLE by an ACR member) (n = 58), the relative risk for past users compared with never users was 1.9 (95% CI 1.1-3.3). No relationship was observed between duration of OC use or time since first use and the risk of developing SLE. Past use of OCs was associated with a slightly increased risk of developing SLE. The decision to use hormonal contraception must be in idualized, but the small absolute risk observed for the development of SLE in white women should not be a dominant factor in the decision.
Publisher: Elsevier BV
Date: 07-2012
Publisher: Springer Science and Business Media LLC
Date: 2003
Abstract: To review epidemiologic evidence that asthma is a risk factor for lung cancer, with particular attention to the role of smoking on this association. Through MEDLINE computer searches (January 1966 to April 2002) and a review of references, we identified studies with quantitative data on the relation of asthma to lung cancer. Summary estimates of relative risks (RR) were calculated using the fixed-effects model or the random-effects model as appropriate. The combined results from five case-control studies--that presented data limited to in iduals who had never smoked--showed a 1.8-fold increase in lung cancer risk among asthmatics (95% confidence interval (CI) = 1.3-2.3). The results from six case-control and four cohort studies, which controlled for smoking history also were significant (RR = 1.7 95% CI = 1.3-2.2). Finally, to illustrate the potential confounding by tobacco, we combined data from seven cohort studies that did not control for smoking history and found an overall RR of 1.4 (95% CI = 1.2-1.6). The increased risk of lung cancer among never smoking in iduals with asthma supports a direct relation between asthma and lung cancer. There is biological evidence to support this association.
Publisher: American Medical Association (AMA)
Date: 22-12-1993
Publisher: American Association for Cancer Research (AACR)
Date: 08-2007
Publisher: American Medical Association (AMA)
Date: 26-01-2000
Publisher: Wiley
Date: 23-08-2010
DOI: 10.1002/CNCR.25195
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814284.V1
Abstract: Supplementary Table 8 shows the joint associations between composite sleep score and genetic risk with EAC risk
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Publisher: Wiley
Date: 19-03-2014
DOI: 10.3322/CAAC.21225
Abstract: Despite recent calls to intensify the search for new risk factors for breast cancer, acting on information that we already have could prevent thousands of cases each year. This article reviews breast cancer primary prevention strategies that are applicable to all women, discusses the underutilization of chemoprevention in high-risk women, highlights the additional advances that could be made by including young women in prevention efforts, and comments on how the molecular heterogeneity of breast cancer affects prevention research and strategies.
Publisher: Informa UK Limited
Date: 1996
Publisher: Wiley
Date: 05-12-2018
DOI: 10.1002/CNCR.31857
Publisher: Elsevier BV
Date: 2000
Publisher: American Psychological Association (APA)
Date: 03-2007
Publisher: Elsevier BV
Date: 06-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2005
DOI: 10.1097/01.EDE.0000164557.81694.63
Abstract: Pike has proposed "protected time" as one summary method for modeling reproductive risk factors in relation to ovarian cancer incidence. We evaluate this and other approaches to summarizing risk for ovarian cancer. We identified 472 incident cases of ovarian cancer during 2,298,068 person-years of follow-up of 24- to 55-year-old premenopausal women at cohort inception. Reproductive exposures, use of oral contraceptives, and history of tubal ligation were evaluated. Age at menopause is directly related to cumulative risk of ovarian cancer up to age 70 years (age 55 vs. age 45, risk increase = 62% 95% confidence interval = 36 to 96%) and age at menarche is inversely related to risk (age 15 vs. 11, risk reduction = 31% 27-34%). Use of oral contraceptives for 5 years before age 30 decreases risk of ovarian cancer to age 70 by 37% (32 to 41%). Tubal ligation reduces risk up to age 70 by 21% (-2 to 38%). Parity reduces risk, independent of age at first birth and age at last birth. A model summarizing years of ovulation offers a fit comparable to a more complex modeling of reproductive variables. The model fit is good, with a concordance statistic of 0.60 (0.57 to 0.62) indicating reasonable ability to differentiate those who will develop ovarian cancer from those who will remain disease free. This model may be applied in the identification of women at high risk for ovarian cancer, for ex le, in selecting candidates for prevention trials.
Publisher: Springer Science and Business Media LLC
Date: 06-12-2008
DOI: 10.1007/S10552-007-9094-5
Abstract: We analyzed lung cancer incidence among non-smokers, continuing smokers, and ex-smokers in the Nurses Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) using the two-stage clonal expansion (TSCE) model. Age-specific lung cancer incidence rates among non-smokers are identical in the two cohorts. Within the framework of the model, the main effect of cigarette smoke is on the promotion of partially altered cells on the pathway to cancer. Smoking-related promotion is somewhat higher among women, whereas smoking-related malignant conversion is somewhat lower. In both cohorts the relative risk for a given daily level of smoking is strongly modified by duration. Among smokers, the incidence in NHS relative to that in HPFS depends both on smoking intensity and duration. The age-adjusted risk is somewhat larger in NHS, but not significantly so. After smokers quit, the risk decreases over a period of many years and the temporal pattern of the decline is similar to that reported in other recent studies. Among ex-smokers, the incidence in NHS relative to that in HPFS depends both on previous levels of smoking and on time since quitting. The age-adjusted risk among ex-smokers is somewhat higher in NHS, possibly due to differences in the age-distribution between the two cohorts.
Publisher: Oxford University Press (OUP)
Date: 02-01-2021
Abstract: A positive relationship has generally been observed between plasma estrogen levels and breast cancer risk in postmenopausal women, but most of these studies have been small and few have evaluated specific estrogen fractions (such as percent bioavailable estradiol). In addition, few studies have evaluated plasma androgen levels in relation to breast cancer risk, and their results have been inconsistent. We prospectively evaluated relationships between sex steroid hormone levels in plasma and risk of breast cancer in postmenopausal women by use of a case-control study nested within the Nurses' Health Study. Blood s les were collected during the period from 1989 through 1990. Among postmenopausal women not using hormone replacement therapy at blood collection (n = 11,169 women), 156 women were diagnosed with breast cancer after blood collection but before June 1, 1994. Two control subjects were selected per case subject and matched with respect to age, menopausal status, month and time of day of blood collection, and fasting status at the time of blood collection. From comparisons of highest and lowest (reference) quartiles, we observed statistically significant positive associations with risk of breast cancer for circulating levels of estradiol (multivariate relative risk [RR] = 1.91 95% confidence interval [CI] = 1.06-3.46), estrone (multivariate RR = 1.96 95% CI = 1.05-3.65), estrone sulfate (multivariate RR = 2.25 95% CI = 1.23-4.12), and dehydroepiandrosterone sulfate (multivariate RR = 2.15 95% CI = 1.11-4.17). We found no substantial associations with percent free or percent bioavailable estradiol, androstenedione, testosterone, or dehydroepiandrosterone. The positive relationships were substantially stronger among women with no previous hormone replacement therapy. Our data, in conjunction with past epidemiologic and animal studies, provide strong evidence for a causal relationship between postmenopausal estrogen levels and the risk of breast cancer.
Publisher: American Medical Association (AMA)
Date: 03-03-1999
Abstract: Spontaneous reporting systems like MEDWATCH can be effective in revealing unusual or rare adverse events that occur with the use of medications, and such reports may often be sufficient to assign causality. However, spontaneous reports do not reliably detect adverse drug reactions (ADRs) that occur widely separated in time from the original use of the drug or that represent an increased risk of an adverse event that occurs commonly in populations not exposed to the drug. In these situations, spontaneous reports alone do not provide sufficient evidence to conclude that the adverse event was an ADR. Identification of ADRs associated with long-term administration of drugs for chronic diseases also remains problematic. Methods to evaluate ADRs using data from clinical trials, medical records, and computerized databases of medication users and nonusers must be developed to complement spontaneous reporting systems. Without these methods, potentially important ADRs will remain undetected, and spurious associations between adverse outcomes and medications or devices will remain unchallenged.
Publisher: American College of Physicians
Date: 15-12-1995
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2000
Publisher: BMJ
Date: 04-03-1995
Abstract: To examine the association between smoking, alcohol consumption, and the incidence of non-insulin dependent diabetes mellitus in men of middle years and older. Cohort questionnaire study of men followed up for six years from 1986. The health professionals' follow up study being conducted across the United States. 41,810 male health professionals aged 40-75 years and free of diabetes, cardiovascular disease, and cancer in 1986 and followed up for six years. Incidence of non-insulin dependent diabetes mellitus diagnosed in the six years. During 230,769 person years of follow up 509 men were newly diagnosed with diabetes. After controlling for known risk factors men who smoked 25 or more cigarettes daily had a relative risk of diabetes of 1.94 (95% confidence interval 1.25 to 3.03) compared with non-smokers. Men who consumed higher amounts of alcohol had a reduced risk of diabetes (P for trend < 0.001). Compared with abstainers men who drank 30.0-49.9 g of alcohol daily had a relative risk of diabetes of 0.61 (95% confidence interval 0.44 to 0.91). Cigarette smoking may be an independent, modifiable risk factor for non-insulin dependent diabetes mellitus. Moderate alcohol consumption among healthy people may be associated with increased insulin sensitivity and a reduced risk of diabetes.
Publisher: American Medical Association (AMA)
Date: 10-02-2003
DOI: 10.1001/ARCHINTE.163.3.309
Abstract: Several foods and nutrients have been implicated in the development of colon and rectal cancers. In this study, we prospectively assessed the associations between major dietary patterns and the risks of these 2 cancers in women. Using dietary information collected in 1984, 1986, 1990, and 1994 from 76 402 women aged 38 to 63 years without a history of cancer in 1984, we conducted factor analysis and identified 2 major dietary patterns: "prudent" and "Western." We calculated factor scores for each participant and examined prospectively the associations between dietary patterns and colon and rectal cancer risks. The prudent pattern was characterized by higher intakes of fruits, vegetables, legumes, fish, poultry, and whole grains, while the Western pattern, by higher intakes of red and processed meats, sweets and desserts, french fries, and refined grains. During 12 years of follow-up, we identified 445 cases of colon cancer and 101 cases of rectal cancer. After adjusting for potential confounders, we observed a relative risk for colon cancer of 1.46 (95% confidence interval, 0.97-2.19) when comparing the highest with the lowest quintiles of the Western pattern (P value for trend across quintiles, .02). The prudent pattern had a nonsignificant inverse association with colon cancer (relative risk for fifth quintile compared with the first, 0.71 95% confidence interval, 0.50-1.00 P for trend across quintiles, .31). We did not observe any significant association between dietary patterns and rectal cancer. We found a significant positive association between the Western dietary pattern and the risk of colon cancer.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 13-02-2001
Abstract: Background —Dietary animal fat and protein have been inversely associated with a risk of intraparenchymal hemorrhage in ecological studies. Methods and Results —In 1980, 85 764 women in the Nurses’ Health Study cohort, who were 34 to 59 years old and free of diagnosed cardiovascular disease and cancer, completed dietary questionnaires. From these questionnaires, we calculated fat and protein intake. By 1994, after 1.16 million person-years of follow-up, 690 incident strokes, including 74 intraparenchymal hemorrhages, had been documented. Multivariate-adjusted risk of intraparenchymal hemorrhage was higher among women in the lowest quintile of energy-adjusted saturated fat intake than at all higher levels of intake (relative risk [RR], 2.36 95% CI, 1.10 to 5.09 P =0.03). For trans unsaturated fat, the corresponding RR was 2.50 (95% CI, 1.35 to 4.65 P =0.004). Animal protein intake was inversely associated with risk (RR in the highest versus lowest quintiles, 0.32 95% CI, 0.10 to 1.00 P =0.04). The excess risk associated with low saturated fat intake was observed primarily among women with a history of hypertension (RR, 3.66 95% CI, 1.09 to 12.3 P =0.04), but such an interaction was not seen for trans unsaturated fat or animal protein. These nutrients were not related to risk of other stroke subtypes. Dietary cholesterol and monounsaturated and polyunsaturated fat were not related to risk of any stroke subtype. Conclusions —Low intake of saturated fat and animal protein was associated with an increased risk of intraparenchymal hemorrhage, which may help to explain the high rate of this stroke subtype in Asian countries. The increased risk with low intake of saturated fat and trans unsaturated fat is compatible with the reported association between low serum total cholesterol and risk.
Publisher: British Editorial Society of Bone & Joint Surgery
Date: 03-2020
DOI: 10.1302/0301-620X.102B3.BJJ-2019-0875.R1
Abstract: Few risk factors for rotator cuff disease (RCD) and corresponding treatment have been firmly established. The aim of this study was to evaluate the relationship between numerous risk factors and the incidence of surgery for RCD in a large cohort. A population-based cohort of people aged between 40 and 69 years in the UK (the UK Biobank) was studied. People who underwent surgery for RCD were identified through a link with NHS inpatient records covering a mean of eight years after enrolment. Multivariate Cox proportional hazards regression was used to calculate hazard ratios (HRs) as estimates of associations with surgery for RCD accounting for confounders. The risk factors which were considered included age, sex, race, education, Townsend deprivation index, body mass index (BMI), occupational demands, and exposure to smoking. Of the 421,894 people who were included, 47% were male. The mean age at the time of enrolment was 56 years (40 to 69). A total of 2,156 people were identified who underwent surgery for RCD. Each decade increase in age was associated with a 55% increase in the incidence of RCD surgery (95% confidence interval (CI) 46% to 64%). Male sex, non-white race, lower deprivation score, and higher BMI were significantly associated with a higher risk of surgery for RCD (all p 0.050). Greater occupational physical demands were significantly associated with higher rates of RCD surgery (HR = 2.1, 1.8, and 1.4 for ‘always’, ‘usually’, and ‘sometimes’ doing heavy manual labour vs ‘never’, all p 0.001). Former smokers had significantly higher rates of RCD surgery than those who had never smoked (HR 1.23 (95% CI 1.12 to 1.35), p 0.001), while current smokers had similar rates to those who had never smoked (HR 0.94 (95% CI 0.80 to 1.11)). Among those who had never smoked, the risk of surgery was higher among those with more than one household member who smoked (HR 1.78 (95% CI 1.08 to 2.92)). The risk of RCD surgery was not significantly related to other measurements of secondhand smoking. Many factors were independently associated with surgery for RCD, including older age, male sex, higher BMI, lower deprivation score, and higher occupational physical demands. Several of the risk factors which were identified are modifiable, suggesting that the healthcare burden of RCD might be reduced through the pursuit of public health goals, such as reducing obesity and modifying occupational demands. Cite this article: Bone Joint J 2020 -B(3):352–359
Publisher: American Medical Association (AMA)
Date: 18-10-2001
Abstract: A recent expert panel recommended that persons at average risk of colorectal cancer (CRC) begin screening for CRC at age 50 years using 1 of several strategies. However, many aspects of different CRC screening strategies remain uncertain. To assess the consequences, costs, and cost-effectiveness of CRC screening in average-risk in iduals. Cost-effectiveness analysis from a societal perspective using a Markov model. Hypothetical subjects representative of the 50-year-old US population at average risk for CRC. Simulated clinical practice in the United States. Discounted lifetime costs, life expectancy, and incremental cost-effectiveness (CE) ratio, compared used 22 different CRC screening strategies, including those recommended by the expert panel. In 1 base-case analysis, compliance was assumed to be 60% with the initial screen and 80% with follow-up or surveillance colonoscopy. The most effective strategy for white men was annual rehydrated fecal occult blood testing (FOBT) plus sigmoidoscopy (followed by colonoscopy if either a low- or high-risk polyp was found) every 5 years from age 50 to 85 years, which resulted in a 60% reduction in cancer incidence and an 80% reduction in CRC mortality compared with no screening, and an incremental CE ratio of $92,900 per year of life gained compared with annual unrehydrated FOBT plus sigmoidoscopy every 5 years. In a base-case analysis in which compliance with screening and follow-up is assumed to be 100%, screening more often than every 10 years was prohibitively expensive annual rehydrated FOBT plus sigmoidoscopy every 5 years had an incremental CE ratio of $489,900 per life-year gained compared with the same strategy every 10 years. Other strategies recommended by the expert panel were either less effective or cost more per year of life gained than the alternatives. Colonoscopy every 10 years was less effective than the combination of annual FOBT plus sigmoidoscopy every 5 years. However, a single colonoscopy at age 55 years achieves nearly half of the reduction in CRC mortality obtainable with colonoscopy every 10 years. Because of increased life expectancy among white women and increased cancer mortality among blacks, CRC screening was even more cost-effective in these groups than in white men. Screening for CRC, even in the setting of imperfect compliance, significantly reduces CRC mortality at costs comparable to other cancer screening procedures. However, compliance rates significantly affect the incremental CE ratios. In this model of CRC, 60% compliance with an every 5-year schedule of screening was roughly equivalent to 100% compliance with an every 10-year schedule. Mathematical modeling used to inform clinical guidelines needs to take into account expected compliance rates. JAMA. 2000 :1954-1961.
Publisher: Massachusetts Medical Society
Date: 07-05-1987
DOI: 10.1056/NEJM198705073161902
Abstract: Bats are the natural reservoirs of a number of high-impact viral zoonoses. We present a quantitative analysis to address the hypothesis that bats are unique in their propensity to host zoonotic viruses based on a comparison with rodents, another important host order. We found that bats indeed host more zoonotic viruses per species than rodents, and we identified life-history and ecological factors that promote zoonotic viral richness. More zoonotic viruses are hosted by species whose distributions overlap with a greater number of other species in the same taxonomic order (sympatry). Specifically in bats, there was evidence for increased zoonotic viral richness in species with smaller litters (one young), greater longevity and more litters per year. Furthermore, our results point to a new hypothesis to explain in part why bats host more zoonotic viruses per species: the stronger effect of sympatry in bats and more viruses shared between bat species suggests that interspecific transmission is more prevalent among bats than among rodents. Although bats host more zoonotic viruses per species, the total number of zoonotic viruses identified in bats (61) was lower than in rodents (68), a result of there being approximately twice the number of rodent species as bat species. Therefore, rodents should still be a serious concern as reservoirs of emerging viruses. These findings shed light on disease emergence and perpetuation mechanisms and may help lead to a predictive framework for identifying future emerging infectious virus reservoirs.
Publisher: American Medical Association (AMA)
Date: 03-03-1999
Abstract: Synthesis of research findings has a long-standing tradition in science. While synthesis is currently required in the US food and drug regulatory process, formal meta-analysis may substitute for a pivotal study or broaden the generalizability of drug efficacy through a preplanned meta-analysis. Preplanned meta-analysis of in idual trials with deliberately introduced heterogeneity may maximize the generalizability of results from randomized trials. Combining observational data may help to support an alternative claim or to quantify adverse events. In this setting, methods to address potentially greater sources of bias are required. Overall, meta-analysis adds evidence through the synthesis study findings and permits examination of how treatment effects vary across of subgroups, such as age and sex, and across study settings.
Publisher: Wiley
Date: 15-12-1999
DOI: 10.1002/(SICI)1097-0142(19991215)86:12<2707::AID-CNCR15>3.0.CO;2-L
Publisher: BMJ
Date: 05-05-2018
Abstract: To investigate associations between active transport, employment status and objectively measured moderate-to-vigorous physical activity (MVPA) in a representative s le of US adults. Cross-sectional analyses of data from the National Health and Nutrition Examination Survey. A total of 5180 adults (50.2 years old, 49.0% men) were classified by levels of active transportation and employment status. Outcome measure was weekly time spent in MVPA as recorded by the Actigraph accelerometer. Associations between active transport, employment status and objectively measured MVPA were examined using multivariable linear regression models adjusted for age, body mass index, race and ethnicity, education level, marital status, smoking status, working hour duration (among the employed only) and self-reported leisure time physical activity. Patterns of active transport were similar between the employed (n=2897) and unemployed (n=2283), such that 76.0% employed and 77.5% unemployed engaged in no active transport. For employed adults, those engaging in high levels of active transport (≥90 min/week) had higher amount of MVPA than those who did not engage in active transport. This translated to 40.8 (95% CI 15.7 to 65.9) additional minutes MVPA per week in men and 57.9 (95% CI 32.1 to 83.7) additional minutes MVPA per week in women. Among the unemployed adults, higher levels of active transport were associated with more MVPA among men (44.8 min/week MVPA, 95% CI 9.2 to 80.5) only. Findings from the present study support interventions to promote active transport to increase population level physical activity. Additional strategies are likely required to promote physical activity among unemployed women.
Publisher: American Association for Cancer Research (AACR)
Date: 07-0004
DOI: 10.1158/1940-6207.CAPR-16-0288
Abstract: Several multivariable risk prediction models have been developed to asses an in idual's risk of developing specific cancers. Such models can be used in a variety of settings for prevention, screening, and guiding investigations and treatments. Models aimed at predicting future disease risk that contains lifestyle factors may be of particular use for targeting health promotion activities at an in idual level. This type of cancer risk prediction is not yet available in the UK. We have adopted the approach used by the well-established U.S.-derived "YourCancerRisk" model for use in the UK population, which allow users to quantify their in idual risk of developing in idual cancers relative to the population average risk. The UK version of “YourCancerRisk" computes 10-year cancer risk estimates for 11 cancers utilizing UK figures for prevalence of risk factors and cancer incidence. Because the prevalence of risk factors and the incidence rates for cancer are different between the U.S. and the UK population, this UK model provides more accurate estimates of risks for a UK population. Using an ex le of breast cancer and data from UK Biobank cohort, we demonstrate that the in idual risk factor estimates are similar for the U.S. and UK populations. Assessment of the performance and validation of the multivariate model predictions based on a binary score confirm the model's applicability. The model can be used to estimate absolute and relative cancer risk for use in Primary Care and community settings and is being used in the community to guide lifestyle change. Cancer Prev Res 10(7) 421–30. ©2017 AACR.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2012
DOI: 10.1161/STROKEAHA.111.639435
Abstract: Light-to-moderate alcohol consumption has been consistently associated with lower risk of heart disease, but data for stroke are less certain. A lower risk of stroke with light-to-moderate alcohol intake has been suggested, but the dose response among women remains uncertain and the data in this subgroup have been sparse. A total of 83 578 female participants of the Nurses' Health Study who were free of diagnosed cardiovascular disease and cancer at baseline were followed-up from 1980 to 2006. Data on self-reported alcohol consumption were assessed at baseline and updated approximately every 4 years, whereas stroke and potential confounder data were updated at baseline and biennially. Strokes were classified according to the National Survey of Stroke criteria. We observed 2171 incident strokes over 1 695 324 person-years. In multivariable adjusted analyses, compared to abstainers, the relative risks of stroke were 0.83 (95% CI, 0.75–0.92) for g/d, 0.79 (95% CI, 0.70–0.90) for 5 to 14.9 g/d, 0.87 (0.72–1.05) for 15 to 29.9 g/d, and 1.06 (95% CI, 0.86–1.30) for 30 to 45 g/d. Results were similar for ischemic and hemorrhagic stroke. Light-to-moderate alcohol consumption was associated with a lower risk of total stroke. In this population of women with modest alcohol consumption, an elevated risk of total stroke related to alcohol was not observed.
Publisher: Wiley
Date: 11-01-2005
DOI: 10.1002/IJC.20821
Abstract: An inverse association between smoking and endometrial cancer has generally been observed, primarily among current smokers. To assess this association, we analyzed data from the prospective Nurses' Health Study. From 1976 to 2000, 702 cases of invasive endometrial cancer were identified during 1.8 million person-years of follow-up. Smoking status was assessed in 1976 and updated every 2 years. Cox proportional hazards models were used to calculate multivariate relative risks (RRs), controlling for endometrial cancer risk factors. Compared to never smokers, the multivariate RR of endometrial cancer was significantly lower among both current smokers (RR = 0.63 95% CI = 0.50-0.79) and past smokers (RR = 0.73 95% CI = 0.62-0.87). When additionally adjusting for body mass index (BMI), the RR for current smokers was attenuated (RR = 0.72 95% CI = 0.57-0.90), but the RR for past smokers did not change. Risk was lower among women who smoked 35 or more cigarettes a day (RR = 0.60 95% CI = 0.39-0.91) and among those who smoked for 40 or more years (RR = 0.63 95% CI = 0.45-0.87). Tests for trend, which excluded never smokers, were not statistically significant for any of the smoking variables analyzed. These data indicate that both current and past smoking are associated with a lower risk of endometrial cancer. The findings provide insight into disease etiology and suggest that the influence of smoking on endometrial cancer risk occurs even in early adulthood, is long-lasting, and may not be attributed solely to short-term hormonal modulation.
Publisher: Springer Science and Business Media LLC
Date: 16-12-2014
Publisher: Elsevier BV
Date: 07-1988
Publisher: Springer Science and Business Media LLC
Date: 1999
Abstract: Physical function is a significant component of health-related quality of life among older adults. Potential correlates of healthy aging, including health behaviors and social network characteristics, were examined among 56,436 US women aged 55-72 in 1992. Healthy aging was assessed by maintenance of physical function measured by four subscales of the Medical Outcomes Study Short Form (SF)-36 Health Survey: physical functioning role limitations freedom from bodily pain and vitality. In idual health behaviors, defined as current smoking, alcohol consumption, sedentary behavior, and being overweight each contributed to significant decrements in functioning across all age-groups. After controlling for these health behaviors and other confounders (age, race, education, and co-morbid conditions), elements of a woman's social network were significantly correlated with functional status. Strong predictors of high functioning among older women were having close friends and relatives and presence of a confidant. For ex le, the absence of a confidant was associated with a 4.44 point reduction in physical functioning (95% CI: -7.0, -1.9), and a 5.68 point reduction in vitality (95% CI: -7.9, -3.4). These effects were comparable in magnitude to those observed among heavy smokers, or women in the highest category of body mass index.
Publisher: Mary Ann Liebert Inc
Date: 04-1999
Abstract: The role of estrogen replacement therapy (ERT) in the etiology of breast cancer continues to be debated. The implications for counseling women about a causal relation between hormones and breast cancer with regard to long-term use of postmenopausal hormones remain controversial. The literature on hormones and breast cancer, including articles on cell proliferation, endogenous hormone levels, epidemiologic studies, and the risk of breast cancer, is reviewed. A cause of cancer is defined as a factor that increases the probability that cancer will develop in an in idual. A causal relation between female hormones and breast cancer is based on duration of use, dose-response, biologic plausibility, temporality, strength of association, and coherence. The magnitude of the increase in risk of breast cancer caused by using hormone replacement therapy (HRT) is comparable to that seen in delayed menopause. The positive relation between endogenous hormone levels and risk of breast cancer supports a biologic mechanism for this relationship. The increase in risk of breast cancer with increasing duration of use, which does not vary substantially across studies, offers further evidence for a causal relation. The reduction in total mortality with short-term use of hormones, although strongest among women with risk factors for cardiovascular disease, adds complexity to the risk-benefit tradeoff associated with the use of hormones for longer durations. All evidence supports a causal relation between both endogenous estrogens and the use of postmenopausal estrogens and progestins and breast cancer incidence in postmenopausal women. Among postmenopausal women, prior use of oral contraceptives is not related to risk of breast cancer. Strategies for relief of menopausal symptoms and long-term prevention of osteoporosis and heart disease that do not cause breast cancer are urgently needed.
Publisher: Mary Ann Liebert Inc
Date: 03-2007
Publisher: Wiley
Date: 18-11-2015
DOI: 10.1111/CTS.12356
Publisher: American Association for Cancer Research (AACR)
Date: 08-2005
DOI: 10.1158/1055-9965.EPI-05-0083
Abstract: Folate plays an important role in DNA methylation, and aberrant methylation of the estrogen receptor (ER) gene may be related to the loss of ER gene expression in breast tumors. Thus, deficient folate status has been hypothesized to be associated primarily with ER gene–negative breast tumors, but data relating folate intake to breast cancer risk according to ER status are sparse. We conducted a prospective cohort analysis of folate intake among 88,744 women in the Nurses' Health Study who completed a food frequency questionnaire in 1980 and every 2 to 4 years thereafter. During 20 years of follow-up, 2,812 ER+ and 985 ER− invasive breast cancer cases were documented. Higher total folate intake was significantly associated with lower risk of developing ER− but not ER+ breast cancer the multivariable relative risks (RR) and 95% confidence intervals (95% CI) comparing the highest to the lowest quintile were 0.81 (0.66-0.99) for ER− tumors and 1.00 (0.89-1.14) for ER+ tumors. The inverse association between total folate intake and ER− breast cancer was mainly present among women consuming at least 15 g/d of alcohol (multivariable RR, 0.46 95% CI, = 0.25-0.86 top versus bottom quintile). These findings support the hypothesis that higher folate intake reduces the risk of developing ER− breast cancer. Ensuring adequate folate intake seems particularly important for women at higher risk of breast cancer because of alcohol consumption.
Publisher: American Association for Cancer Research (AACR)
Date: 07-2007
DOI: 10.1158/1055-9965.EPI-07-0143
Abstract: Several studies have reported a positive relation of baseline body mass index (BMI) with multiple myeloma, but data on other correlates of energy balance are limited. We undertook the present analyses to further examine the role of energy balance in multiple myeloma etiology in two large prospective cohorts with biennially updated exposure data. We followed members of the Nurses' Health Study and Health Professionals Follow-up Study cohorts from baseline until multiple myeloma diagnosis, death, or 2002. Adult height and current weight were reported at enrollment, and weight every 2 years thereafter. Physical activity was queried at baseline and updated every 2 to 4 years. We computed age-adjusted relative risks (RR) of multiple myeloma for categories of BMI and physical activity using Cox proportional hazards regression. We conducted analyses on each cohort separately and on both cohorts combined. We confirmed 215 incident cases of multiple myeloma in the combined cohort of 136,623 in iduals (& .1 million person-years at risk). BMI was positively associated with multiple myeloma in all analyses. The association was strongest in men with a BMI of ≥30 kg/m2 (versus a BMI of & .0 kg/m2 RR, 2.4 95% confidence interval, 1.0-6.0) and modest in overweight (BMI, 25-29.9 kg/m2) and obese (BMI, ≥30 kg/m2) women [versus BMI of & .0 kg/m2 RR (95% confidence interval), 1.6 (1.0-2.7) and 1.2 (0.7-2.2), respectively]. Physical activity was not significantly related to multiple myeloma risk, although an inverse association was suggested in women. In conclusion, obesity seems to have an etiologic role in multiple myeloma, but the role of other correlates of energy balance remains uncertain. (Cancer Epidemiol Biomarkers Prev 2007 (7):1474–8)
Publisher: Oxford University Press (OUP)
Date: 06-09-1989
Abstract: In 1976, 118,273 female nurses 30-55 years of age with no history of cancer completed a questionnaire regarding possible risk factors. By 1986, after 1,137,415 person-years of follow-up, we had documented 1,799 newly diagnosed cases of breast cancer. Compared with the risk of breast cancer for nonusers of oral contraceptives, the multivariate relative risks were 1.07 (95% confidence interval, 0.97-1.19) for all users, 1.06 (95% confidence interval, 0.96-1.18) for past users, and 1.53 (95% confidence interval, 1.06-2.19) for current users--women who used oral contraceptives up to 2 years before diagnosis of breast cancer. We conclude that overall past use of oral contraceptives is not associated with a substantial increase in the risk of breast cancer. Although we did not find women who used oral contraceptives before the first pregnancy to have an increased risk of breast cancer, the number of women who used oral contraceptives for a long duration in early reproductive life was too small to permit firm conclusions regarding the risk in this subgroup.
Publisher: American Association for Cancer Research (AACR)
Date: 07-2018
DOI: 10.1158/1538-7445.AM2018-223
Abstract: Multiple myeloma (MM) is twice as common in African Americans (AA) compared to European Americans (EA). The reported familial clustering and the elevated MM risk among first-degree relatives of cases implicate genetic susceptibility. Previous genome-wide association studies (GWAS) in EA have identified 16 novel risk loci. In this study, we tested the generalizability of the established risk alleles to AA and conducted a meta-GWAS analysis using two sets of AA to identify additional novel common MM risk variants. In the first study, we genotyped 1,305 incident AA MM cases from the African American Multiple Myeloma Study (AAMMS) using the Illumina HumanCore GWAS array and compared them to 7,078 AA controls from the African Ancestry Prostate Cancer Consortium (AAPC) and African Ancestry Breast Cancer Consortium (AABC) using the Illumina 1M-Duo. In the second study, 95 additional AAMMS cases and 435 AA MM cases from the University of Arkansas for Medical Sciences (UAMS) were genotyped using the Illumina MegaBead Chip and compared to 2,390 AA controls from the Multiethnic Cohort. The Haplotype Reference Consortium (HRC) was used to impute the overlapping typed SNPS from each GWAS case and control set together. Per-allele risk associations were tested for 8,715,278 overlapping genotyped and imputed variants with & % frequency and & .8 imputation score using unconditional logistic regression in both sets, and the combined effects were estimated using a fixed-effect meta-analysis. Of the 16 reported risk loci discovered in EA, directional consistency was present for 15 variants eight of these replicated at nominal significance p& .05, with the most statistically significant variant being rs4487645 at 7p15.3 (OR=1.38, p=3.56×10-6). AA in iduals with polygenic risk scores from these 16 variants (PRS) in the top 10% stratum had a 1.44-fold increased MM risk compared to those with a PRS in the 25th -75th percentiles. Additionally, we identified three suggestive novel loci located at 12q12, 9p24.3 and 9p13.1 at p& ×10-6, with ORs ranging from 1.25-1.55, but none reached genome-wide significance. The variant at 9p24.3 is located in an intron in the KANK1 gene and a correlated SNP in EAs (r2=0.5) is strongly associated with gene expression in neoplastic plasma cells (unpublished, Weinhold and Morgan). Our study replicated most of the reported risk loci discovered among EA, demonstrated that a PRS constructed using the 16 reported risk alleles was associated with MM risk, and provides suggestive evidence for additional loci associated with MM risk in AAs. Citation Format: Zhaohui Du, Chi Song, Kristin Rand, Niels Weinhold, David Van Den Berg, Amie Hwang, Xin Sheng, Victor Hom, Sikander Ailawadhi, Ajay K. Nooka, Seema Singhal, Karen Pawlish, Edward S. Peters, Cathryn Bock, Ann Mohrbacher, Alexander Stram, Sonja I. Berndt, William Blot, John David Carpten, Antoinette Stroup, Andrew Olshan, Wei Zhang, African Ancestry Breast & Prostate Consortium, Stephen Chanock, Jayesh Mehta, Graham A. Colditz, Jeffrey Wolf, Thomas G. Martin, Michael Tomasson, Mark A. Fiala, Howard Terebelo, Nalini Janakiraman, Laurence Kolonel, Loic LeMarchand, Elad Ziv, Daniel Stram, Ravi Vij, Leon Bernal-Mizrachi, Gareth J. Morgan, Jeffrey A. Zonder, Carol Ann Huff, Sagar Lonial, Robert Z. Orlowski, David V. Conti, Christopher A. Haiman, Wendy Cozen. A meta-analysis of genome-wide association studies of multiple myeloma among African Americans [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018 2018 Apr 14-18 Chicago, IL. Philadelphia (PA): AACR Cancer Res 2018 (13 Suppl):Abstract nr 223.
Publisher: Oxford University Press (OUP)
Date: 08-2004
DOI: 10.1093/AJE/KWH214
Publisher: Project MUSE
Date: 2015
Publisher: Massachusetts Medical Society
Date: 31-08-1989
DOI: 10.1056/NEJM198908313210902
Abstract: To examine the efficacy of an intervention based on the transtheoretical model (TTM) for increasing fruit and vegetable consumption among economically disadvantaged African-American adolescents. Pretest-posttest quasi-experimental study. Youth services agencies located in New York, New Jersey, and Pennsylvania. Agencies were assigned to computer intervention (CIN) and nonintervention control study arms. A total of 507 African-American adolescents ages 11 to 14 years. Youths in the CIN arm completed four 30-minute intervention sessions tailored on TTM stages and processes of change. Self-reported fruit and vegetable consumption and stages, pros, cons, and self-efficacy for consumption. Intervention effects were examined with analysis of covariance models that were controlled for demographic variables and baseline measures of each outcome. Chi-square analyses were used to examine between-arm differences in youths' stage progressions. After adjustment by covariates, pros (p < .025) and fruit and vegetable consumption (p < .001) varied significantly with study arm. Youths in the CIN arm had higher pro scores and fruit and vegetable consumption than controls. More youths in the CIN arm than in the control arm progressed to later stages and maintained recommended intake levels (p < .05). A TTM-based intervention can increase fruit and vegetable intake and effect positive changes in TTM variables related to intake among economically disadvantaged African-American adolescents.
Publisher: BMJ
Date: 14-11-1998
DOI: 10.1136/BMJ.317.7169.1341
Abstract: To examine the relation between nut consumption and risk of coronary heart disease in a cohort of women from the Nurses' Health Study. Prospective cohort study. Nurses' Health Study. 86 016 women from 34 to 59 years of age without previously diagnosed coronary heart disease, stroke, or cancer at baseline in 1980. Major coronary heart disease including non-fatal myocardial infarction and fatal coronary heart disease. 1255 major coronary disease events (861 cases of non-fatal myocardial infarction and 394 cases of fatal coronary heart disease) occurred during 14 years of follow up. After adjusting for age, smoking, and other known risk factors for coronary heart disease, women who ate more than five units of nuts (one unit equivalent to 1 oz of nuts) a week (frequent consumption) had a significantly lower risk of total coronary heart disease (relative risk 0.65, 95% confidence interval 0.47 to 0.89, P for trend=0.0009) than women who never ate nuts or who ate less than one unit a month (rare consumption). The magnitude of risk reduction was similar for both fatal coronary heart disease (0.61, 0.35 to 1.05, P for trend=0.007) and non-fatal myocardial infarction (0.68, 0.47 to 1.00, P for trend=0.04). Further adjustment for intakes of dietary fats, fibre, vegetables, and fruits did not alter these results. The inverse association persisted in subgroups stratified by levels of smoking,use of alcohol, use of multivitamin and vitamin E supplements, body mass index, exercise, and intake of vegetables or fruits. Frequent nut consumption was associated with a reduced risk of both fatal coronary heart disease and non-fatal myocardial infarction. These data, and those from other epidemiological and clinical studies, support a role for nuts in reducing the risk of coronary heart disease.
Publisher: Oxford University Press (OUP)
Date: 15-11-2000
Abstract: Diets high in fruits and vegetables have been shown to be associated with a lower risk of lung cancer. beta-Carotene was hypothesized to be largely responsible for the apparent protective effect, but this hypothesis was not supported by clinical trials. We examined the association between lung cancer risk and fruit and vegetable consumption in 77 283 women in the Nurses' Health Study and 47 778 men in the Health Professionals' Follow-up Study. Diet was assessed with the use of a food-frequency questionnaire that included 15 fruits and 23 vegetables. We used logistic regression models to estimate relative risks (RRs) of lung cancer within each cohort. All statistical tests were two-sided. We documented 519 lung cancer cases among the women and 274 among the men. Total fruit and vegetable consumption was associated with a modestly lower risk of lung cancer among the women but not among the men. The RR for the highest versus lowest quintile of intake was 0.79 (95% confidence interval [CI] = 0.59-1.06) among the women and 1.12 (95% CI = 0.74-1.69) among the men after adjustment for smoking status, quantity of cigarettes smoked per day, time since quitting smoking, and age at initiation of smoking. However, total fruit and vegetable consumption was associated with a lower risk of lung cancer among never smokers in the combined cohorts, although the reduction was not statistically significant (RR = 0.63 95% CI = 0.35-1.12 in the highest tertile). Higher fruit and vegetable intakes were associated with lower risks of lung cancer in women but not in men. It is possible that the inverse association among the women remained confounded by unmeasured smoking characteristics, although fruits and vegetables were protective in both men and women who never smoked.
Publisher: Wiley
Date: 04-05-2020
DOI: 10.1002/NAU.24381
Publisher: Oxford University Press (OUP)
Date: 16-04-2020
DOI: 10.1093/ABM/KAAA020
Abstract: Little is known about the effect of health professionals’ advice on promoting healthy lifestyle behaviors (diet and exercise) among breast cancer patients. To identify predictors of receiving lifestyle advice from health professionals and its impact on healthy lifestyle behaviors. We used data from a randomized controlled trial of an interactive, cancer-communication video program using African American breast cancer survivor stories for newly diagnosed African American breast cancer patients (Stages 0–III). Participants completed five interviews over 2 years. This intervention did not significantly affect changes in quality-of-life outcomes. In secondary analysis, we examined differences in baseline variables between women with and without diabetes. Logistic regression models identified independent predictors of receiving advice from “a doctor or other health professional” to improve diet and exercise and of self-reported change in diet and exercise habits at 2 year follow-up. Of 193 patients included (85% of 228 enrolled), 53 (28%) had diabetes. At 2 year follow-up, a greater proportion of women with (vs. without) diabetes reported receiving advice by a doctor/health professional to improve their diet (73% vs. 57%, p = .04,). Predictors of receiving dietary advice were obesity, diabetes, and breast-conserving surgery (each p & .05). Women receiving dietary advice were 2.75 times more likely to report improving their diet (95% confidence interval: 1.17, 6.46) at follow-up, but receiving physical activity advice was not significantly associated with patients reporting an increase in exercise. Although receiving dietary advice predicted dietary improvements, receiving exercise advice did not lead to an increase in physical activity. Trial Number NCT00929084.
Publisher: Wiley
Date: 15-03-2022
DOI: 10.1111/BIOM.13611
Abstract: Screening mammography aims to identify breast cancer early and secondarily measures breast density to classify women at higher or lower than average risk for future breast cancer in the general population. Despite the strong association of in idual mammography features to breast cancer risk, the statistical literature on mammogram imaging data is limited. While functional principal component analysis (FPCA) has been studied in the literature for extracting image‐based features, it is conducted independently of the time‐to‐event response variable. With the consideration of building a prognostic model for precision prevention, we present a set of flexible methods, supervised FPCA (sFPCA) and functional partial least squares (FPLS), to extract image‐based features associated with the failure time while accommodating the added complication from right censoring. Throughout the article, we hope to demonstrate that one method is favored over the other under different clinical setups. The proposed methods are applied to the motivating data set from the Joanne Knight Breast Health cohort at Siteman Cancer Center. Our approaches not only obtain the best prediction performance compared to the benchmark model, but also reveal different risk patterns within the mammograms.
Publisher: American Medical Association (AMA)
Date: 15-01-1992
Publisher: Massachusetts Medical Society
Date: 11-02-1999
Publisher: Elsevier BV
Date: 08-1991
DOI: 10.1016/0140-6736(91)90542-W
Abstract: Although an inverse association between alcohol consumption and risk of coronary artery disease has been consistently found in several types of studies, some have argued that the association is due at least partly to the inclusion in the non-drinking reference group of men who abstain because of pre-existing disease. The association between self-reported alcohol intake and coronary disease was studied prospectively among 51,529 male health professionals. In 1986 the participants completed questionnaires about food and alcohol intake and medical history, heart disease risk factors, and dietary changes in the previous 10 years. Follow-up questionnaires in 1988 sought information about newly diagnosed coronary disease. 350 confirmed cases of coronary disease occurred. After adjustment for coronary risk factors, including dietary intake of cholesterol, fat, and dietary fibre, increasing alcohol intake was inversely related to coronary disease incidence (p for trend less than 0.001). Exclusion of 10,302 current non-drinkers or 16,342 men with disorders potentially related to coronary disease (eg, hypertension, diabetes, and gout) which might have led men to reduce their alcohol intake, did not substantially affect the relative risks. These findings support the hypothesis that the inverse relation between alcohol consumption and risk of coronary disease is causal.
Publisher: Springer Science and Business Media LLC
Date: 2004
Publisher: Springer Science and Business Media LLC
Date: 22-07-2015
DOI: 10.1038/NPJBCANCER.2015.9
Abstract: The age-specific rate of breast cancer rises rapidly through premenopausal years and significantly more slowly after menopause. Reproductive factors affect cell proliferation and the accumulation of genetic changes. Lifetime risk of breast cancer is linearly related to the length of the interval from menarche to first birth. Lifestyle changes that accompany industrialization, together with shifting reproductive patterns, drive up incidence rates. Prevention must begin early in the life as almost one-quarter of cases are diagnosed before age 50 in high-income countries. This requires greater emphasis on prevention across the life course to address the global burden of breast cancer.
Publisher: Elsevier BV
Date: 02-2001
Abstract: The relation between intakes of total fat and specific types of fat and age-related macular degeneration (AMD) remains unclear. Our objective was to examine prospectively the association between fat intake and AMD. We conducted a prospective follow-up study of participants in the Nurses' Health Study and the Health Professionals Follow-up Study. At baseline (1984 for women and 1986 for men), the study included 42743 women and 29746 men aged > or = 50 y with no diagnosis of AMD who were followed until 1996. Fat intake was assessed with a food-frequency questionnaire. We accrued 567 patients with AMD with a visual loss of 20/30 or worse. The pooled multivariate relative risk (RR) for the highest compared with the lowest quintile of total fat intake was 1.54 (95% CI: 1.17, 2.01 P for trend = 0.008). Linolenic acid was positively associated with risk of AMD (top versus bottom quintile of RR: 1.49 95% CI: 1.15, 1.94 P for trend = 0.0009). Docosahexaenoic acid had a modest inverse relation with AMD (top versus bottom quintile of RR: 0.70 95% CI: 0.52, 0.93 P for trend = 0.05), and >4 servings of fish/wk was associated with a 35% lower risk of AMD compared with < or = 3 servings/mo (RR: 0.65 95% CI: 0.46, 0.91 P for trend = 0.009). Total fat intake was positively associated with risk of AMD, which may have been due to intakes of in idual fatty acids, such as linolenic acid, rather than to total fat intakes per se. A high intake of fish may reduce the risk of AMD.
Publisher: Elsevier BV
Date: 05-1992
DOI: 10.1016/1047-2797(92)90055-U
Abstract: We conducted a prospective study of diet in relation to the incidence of basal cell carcinoma of the skin in a cohort of 73,366 women who were 34 to 59 years old in 1980 and without previous skin or other cancer. During 4 years of follow-up, 771 incident cases of basal cell carcinoma were diagnosed. When adjusted for other risk factors, women in the highest quintile of energy intake were at higher risk of basal cell carcinoma compared with those in the lowest quintile (relative risk, 1.28 95% confidence interval, 1.02 to 1.60). No significant associations were observed between risk of basal cell carcinoma and energy-adjusted intake of dietary fat, carotenoids with vitamin A activity, and retinol, vitamin C, vitamin D, and vitamin E, either with or without supplements. Use of specific vitamin A, C, D, or E supplements, or multivitamins, did not materially alter risk. Although the period of follow-up was relatively short, these data are most consistent with no major role for these nutrients in the etiology of basal cell carcinoma.
Publisher: Elsevier BV
Date: 11-1997
Abstract: To address limited longitudinal nutrition data on children and adolescents, a self-administered food frequency questionnaire was designed for older children and adolescents. Initially, the Youth/Adolescent Questionnaire (YAQ) was developed and demonstrated to be reproducible. This study was conducted to evaluate its validity. The form was administered twice to a s le of 261 youths (ages 9 to 18) at an approximate interval of 1 year (1993-1994), and three 24-hr dietary recalls were collected during this period. Pearson correlation coefficients were calculated on nutrient data. Validity was first evaluated by comparing the average of the three 24-hr recalls to the average of the two YAQs. Similar mean nutrients were found by both methods. Correlation coefficients between the mean energy-adjusted nutrients computed by the two methods ranged from 0.21 for sodium to 0.58 for folate. After correction for within-person error, the average correlation coefficient was 0.54, similar to that found among adults. A simple self-administered questionnaire completed by older children and adolescents can provide nutritional information about this age group.
Publisher: Wiley
Date: 23-05-2014
DOI: 10.1111/BJH.12935
Publisher: American Medical Association (AMA)
Date: 14-09-1994
Publisher: Wiley
Date: 09-1997
DOI: 10.1002/(SICI)1099-0496(199709)24:3<187::AID-PPUL4>3.0.CO;2-K
Abstract: Childhood obesity is associated with a range of adverse consequences, and the prevalence is increasing in developed nations. Most of the literature on obesity and ventilatory function in children concerns s les selected for gross obesity with relatively little detail available from random population s les. This report examines the effect of total body fat as a percentage of weight (TBF%) on ventilatory function in a nationally representative s le of 2,464 Australian school children aged 9, 12, and 15 years. Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were used as measures of ventilatory function. TBF% was estimated from skinfold thickness measurements. Ventilatory function was adjusted (for height and then for both height and weight) using linear regression on a logarithmic scale. Adjustment was performed within separate strata of age and gender. Analysis of covariance was used for hypothesis testing. Height-adjusted FVC and FEV1 values increased significantly with increasing weight within each age and gender group and for all subjects combined (P < 0.0001). The effect of TBF% independent of lean tissue was examined using FVC and FEV1 values adjusted for both height and weight, because body weight measures both lean and fat mass. Adjusted FVC and FEV1 values decreased significantly with increasing TBF% within each age and gender group and for all subjects combined (P < 0.0001). Ventilatory function decreased with increasing proportions of body fat. This is consistent with previous findings on lean tissue mass and ventilatory function. Although the magnitude of the effect was relatively small in clinical terms, from a public health perspective our findings indicate yet another adverse consequence of childhood obesity.
Publisher: Oxford University Press (OUP)
Date: 29-10-2009
DOI: 10.1093/AJE/KWP304
Publisher: Elsevier BV
Date: 04-2003
Publisher: Oxford University Press (OUP)
Date: 02-07-2022
Abstract: Reduced methylation of DNA may contribute to loss of the normal controls on proto-oncogene expression. In humans, hypomethylation of DNA has been observed in colorectal cancers and in their adenomatous polyp precursors. Accumulation of DNA methylation abnormalities, observed during progression of human colorectal neoplasia, may be influenced by certain dietary factors. The apparent protective effect of fresh fruits and vegetables, the major folate sources, on colorectal cancer incidence suggests that a methyl-deficient diet contributes to occurrence of this malignancy. Low dietary folate and methionine and high intake of alcohol may reduce levels of S-adenosylmethionine, which is required for DNA methylation. To determine if dietary factors that may influence methyl availability are related to colorectal adenomas, we prospectively examined the association of folate, methionine, and alcohol intakes and risk of colorectal adenoma. We assessed dietary intake for a 1-year period for women of the Nurses' Health Study, started in 1976, and for men of the Health Professionals Follow-up Study, started in 1986--using a semiquantitative food frequency questionnaire. Adenomatous polyps of the left colon or rectum were diagnosed in 564 of 15,984 women who had had an endoscopy between 1980 and 1990 and in 331 of 9490 men who had undergone an endoscopy between 1986 and 1990. High dietary folate was inversely associated with risk of colorectal adenoma in women (multivariate relative risk [RR] = 0.66 95% confidence interval [CI] = 0.46-0.95 between high and low quintiles of intake) and in men (RR = 0.63 95% CI = 0.41-0.98) after adjusting for age, family history, indications for endoscopy, history of previous endoscopy, total energy intake, saturated fat intake, dietary fiber, and body mass index. Relative to nondrinkers, drinkers of more than 30 g of alcohol daily (about two drinks) had an elevated risk of adenoma (in women, RR = 1.84, 95% CI = 1.19-2.86 in men, RR = 1.64, 95% CI = 0.92-2.93). Methionine intake was inversely associated with risk of adenomas 1 cm or larger (RR = 0.62 95% CI = 0.46-0.85, combining men and women). Folate, alcohol, and methionine could influence methyl group availability, and a methyl-deficient diet may be linked to early stages of colorectal neoplasia. A dietary pattern that increases methyl availability could reduce incidence of colorectal cancer. These data support efforts to increase dietary folate in segments of the population having diets with low intakes of this nutrient.
Publisher: Elsevier BV
Date: 05-2018
Publisher: American Medical Association (AMA)
Date: 14-02-2000
DOI: 10.1001/ARCHINTE.160.3.334
Abstract: The American College of Chest Physicians addressed the dilemma of identifying optimal therapy for venous thromboembolism (VTE) prophylaxis and published their Fourth Consensus Conference on Antithrombotic Therapy in 1995, with recommendations for prophylactic therapy. Despite these recommendations, appropriate VTE prophylactic therapy is underused. To examine routine practices in the prevention of VTE in high-risk surgical patients and to determine the extent of adoption of grade A prophylactic therapies as recommended by the American College of Chest Physicians. Retrospective medical record review in 10 teaching or community-based hospitals located in the United States. Medical charts of 1907 patients were randomly selected for review from the population of patients who underwent high-risk major abdominal surgery, total hip replacement, hip fracture repair, or total knee replacement between January 1, 1996, and February 28, 1997. Of 1907 patients, VTE prophylaxis was used in 89.3% use was 93.7% in each of the 3 orthopedic surgery groups and 75.2% in the high-risk major abdominal surgery group. The percentage of patients receiving grade A therapy was highest in the hip replacement group (84.3%) vs. the other groups (knee replacement, 75.9% hip fracture repair, 45.2% abdominal surgery, 50.3%). The use of grade A prophylaxis was related to the type of surgery, with the highest use seen in total hip replacement and the lowest in hip fracture repair. One in 4 patients who underwent high-risk major abdominal surgeries failed to receive any form of VTE prophylaxis. Publication of consensus statements alone may be insufficient to ensure the incorporation of important new clinical information into routine practice.
Publisher: Springer Science and Business Media LLC
Date: 30-12-2022
DOI: 10.1186/S13058-022-01600-5
Abstract: This systematic review aimed to assess the methods used to classify mammographic breast parenchymal features in relation to the prediction of future breast cancer. The databases including Medline (Ovid) 1946-, Embase.com 1947-, CINAHL Plus 1937-, Scopus 1823-, Cochrane Library (including CENTRAL), and Clinicaltrials.gov were searched through October 2021 to extract published articles in English describing the relationship of parenchymal texture features with the risk of breast cancer. Twenty-eight articles published since 2016 were included in the final review. The identification of parenchymal texture features varied from using a predefined list to machine-driven identification. A reduction in the number of features chosen for subsequent analysis in relation to cancer incidence then varied across statistical approaches and machine learning methods. The variation in approach and number of features identified for inclusion in analysis precluded generating a quantitative summary or meta-analysis of the value of these features to improve predicting risk of future breast cancers. This updated overview of the state of the art revealed research gaps based on these, we provide recommendations for future studies using parenchymal features for mammogram images to make use of accumulating image data, and external validation of prediction models that extend to 5 and 10 years to guide clinical risk management. Following these recommendations could enhance the applicability of models, helping improve risk classification and risk prediction for women to tailor screening and prevention strategies to the level of risk.
Publisher: Oxford University Press (OUP)
Date: 11-1987
DOI: 10.1093/OXFORDJOURNALS.AJE.A114723
Abstract: Reproductive events in women are associated with alterations in blood lipids and blood pressure and may therefore influence determinants of coronary heart disease. To investigate the risk of coronary heart disease in relation to age at menarche, parity, and age at first birth, the authors evaluated prospectively the experience of 119,963 US women aged 30-55 years who were free from coronary heart disease in 1976 and were followed through 1982. During 700,809 person-years of observation, 308 incident cases of nonfatal myocardial infarction or fatal coronary heart disease occurred. Younger age at menarche was weakly associated with coronary heart disease (age-adjusted rate ratio of 1.3 for menarche before age 11 years compared with menarche at age 13 years chi, Mantel extension test for trend = -1.1, p = 0.2). Nulliparous women experienced only a slightly higher rate of coronary heart disease than parous women (rate ratio = 1.2, 95 per cent confidence interval 0.8-1.8). Among parous women, there was no alteration in risk with increasing number of births. Likewise, there was no significant association between age at first birth and coronary heart disease (chi, Mantel extension test for trend = -0.4, p = 0.4). Established risk factors for coronary heart disease nevertheless showed expected relations. These findings show no important association between reproductive experiences and risk of coronary heart disease.
Publisher: Springer Science and Business Media LLC
Date: 20-06-2019
Publisher: Elsevier BV
Date: 09-2021
DOI: 10.1016/J.YGYNO.2021.06.007
Abstract: To evaluate the ability of a personalized text-message-based intervention to increase weight loss among endometrial cancer survivors with obesity. In this randomized, controlled trial, endometrial cancer survivors with obesity (BMI ≥30 kg/m Between May 18 and December 31, 2017, 80 endometrial cancer survivors with obesity consented to participate in the randomized trial. There were no differences in clinical characteristics between the two arms. Weight changes were similar in the two arms (P = 0.08). At 6 months, no differences in quality of life, physical activity, or body image were noted. Of 358 eligible patients, 80 became trial participants and 278, non-participants. Trial participants were younger (59.3 vs. 63.4 years, P < 0.001), more likely non-white (P = 0.02), on fewer medications (4 vs. 7, P < 0.001), and had a higher median BMI (38.7 vs. 37.6 kg/m This text-message-based intervention did not increase weight loss among endometrial cancer survivors with obesity, nor did participation in the trial. Other weight management interventions should be promoted to increase weight loss. ClinicalTrials.gov, www.clinicaltrials.gov, NCT03169023.
Publisher: Oxford University Press (OUP)
Date: 05-03-2003
Abstract: In several epidemiologic investigations, folate intake has appeared to reduce the elevated risk of breast cancer associated with moderate alcohol consumption. However, data relating plasma folate levels to breast cancer risk are sparse. We investigated the association between plasma folate and other vitamins with breast cancer in a prospective, nested case-control study. Blood s les were obtained during 1989 and 1990 from 32 826 women in the Nurses' Health Study who were followed through 1996 for the development of breast cancer. We identified 712 breast cancer case patients and selected 712 in idually matched control subjects. Dietary information was obtained using food frequency questionnaires given in 1980, 1984, 1986, and 1990. Logistic regression was used to estimate the relative risks (RRs) of breast cancer (after adjustment for potential risk factors), and a generalized linear model was used to calculate the Pearson correlation coefficients between plasma estimates of folate, vitamin B(6), vitamin B(12), and homocysteine, and intakes of folate, vitamin B(6), and vitamin B(12). All statistical tests were two-sided. The multivariable RR comparing women in the highest quintile of plasma folate with those in the lowest was 0.73 (95% confidence interval [CI] = 0.50 to 1.07 P(trend) =.06). The inverse association between plasma folate and breast cancer risk was highly statistically significant among women consuming at least 15 g/day (i.e., approximately 1 drink/day) of alcohol (multivariable RR = 0.11, 95% CI = 0.02 to 0.59 for highest versus lowest quintile) in contrast with that of women consuming less than 15 g/day (multivariable RR = 0.72, 95% CI = 0.49 to 1.05). The multivariable RR comparing women in the highest quintile of plasma vitamin B(6) levels with those in the lowest quintile was 0.70 (95% CI = 0.48 to 1.02 P(trend) =.09). Plasma vitamin B(12) levels were inversely associated with breast cancer risk among premenopausal women (multivariable RR = 0.36, 95% CI = 0.15 to 0.86 for highest versus lowest quintile) but not among postmenopausal women. Plasma homocysteine was not associated with breast cancer risk. Higher plasma levels of folate and possibly vitamin B(6) may reduce the risk of developing breast cancer. Achieving adequate circulating levels of folate may be particularly important for women at higher risk of developing breast cancer because of higher alcohol consumption.
Publisher: Elsevier BV
Date: 07-2002
DOI: 10.1097/00004583-200207000-00018
Abstract: To assess the relation between beginning to binge-eat or purge, beginning to smoke, and getting drunk for the first time. Prospective study of 11,358 girls and boys, 10 to 15 years of age, in an ongoing cohort study who completed questionnaires in 1997 and 1998. The outcome measures were beginning to engage in bulimic behaviors, beginning to smoke, and getting drunk for the first time between 1997 and 1998. During 1 year, 4.3% of girls and 3.8% of boys started smoking, 5.3% of girls and 4.8% of boys started getting drunk, and 2.4% of girls and 0.8% of boys started engaging in bulimic behaviors. Among the girls, weight concerns in 1997 were predictive of beginning to smoke (odds ratio [OR] = 2.2), get drunk (OR = 1.7), purge (OR = 3.8), and binge-eat (OR = 2.6). Adolescents who reported smoking in 1997 were more likely than nonsmokers to get drunk for the first time (girls: OR = 5.7 boys: OR = 7.1). The reverse association, getting drunk as a predictor of starting to smoke, was of lesser magnitude (OR = 2.3-2.6). The three unhealthy behaviors were associated prospectively with each other. The results suggest that prevention efforts should target weight concerns and multiple risk behaviors.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2004
Publisher: Elsevier BV
Date: 1999
DOI: 10.1093/AJCN/69.1.74
Abstract: Vitamin K mediates the gamma-carboxylation of glutamyl residues on several bone proteins, notably osteocalcin. High serum concentrations of undercarboxylated osteocalcin and low serum concentrations of vitamin K are associated with lower bone mineral density and increased risk of hip fracture. However, data are limited on the effects of dietary vitamin K. We investigated the hypothesis that high intakes of vitamin K are associated with a lower risk of hip fracture in women. We conducted a prospective analysis within the Nurses' Health Study cohort. Diet was assessed in 72327 women aged 38-63 y with a food-frequency questionnaire in 1984 (baseline). During the subsequent 10 y of follow-up, 270 hip fractures resulting from low or moderate trauma were reported. Women in quintiles 2-5 of vitamin K intake had a significantly lower age-adjusted relative risk (RR: 0.70 95% CI: 0.53, 0.93) of hip fracture than women in the lowest quintile (< 109 microg/d). Risk did not decrease between quintiles 2 and 5 and risk estimates were not altered when other risk factors for osteoporosis, including calcium and vitamin D intakes, were added to the models. Risk of hip fracture was also inversely associated with lettuce consumption (RR: 0.55 95% CI: 0.40, 0.78) for one or more servings per day compared with one or fewer servings per week), the food that contributed the most to dietary vitamin K intakes. Low intakes of vitamin K may increase the risk of hip fracture in women. The data support the suggestion for a reassessment of the vitamin K requirements that are based on bone health and blood coagulation.
Publisher: Springer Science and Business Media LLC
Date: 28-06-2016
Publisher: Elsevier BV
Date: 05-1987
DOI: 10.1016/0002-9343(87)90149-5
Abstract: A number of methods of prophylaxis can reduce the risk of postoperative venous thromboembolism in patients undergoing general surgery. The cost-effectiveness of several of these--low-dose subcutaneous heparin, intermittent pneumatic compression, graduated compression stockings, heparin plus dihydroergotamine, heparin plus stockings, and intermittent pneumatic compression plus stockings--was assessed by pooling data from published reports of randomized controlled trials. Using clinical protocols, costs for prophylaxis, diagnosis, and treatment of venous thromboembolism were determined. The expected outcomes and costs of each strategy were then calculated using techniques of decision analysis. The results indicate that stockings are the only prophylactic method that is actually cost-saving. Costs of care average $34 less per admission for patients using stockings than for those receiving no prophylaxis. Most other methods of prophylaxis further reduce thromboembolic risk, but increase costs by $50 to $88 per patient relative to costs for the use of stockings. Differences in the cost-effectiveness of these prophylaxis are more marked, ranging from about $50,000 to almost $500,000 per additional life saved.
Publisher: Springer Science and Business Media LLC
Date: 03-1991
DOI: 10.1007/BF00053131
Publisher: American Association for Cancer Research (AACR)
Date: 05-2005
DOI: 10.1158/1055-9965.EPI-04-0632
Abstract: It has been hypothesized that cutaneous melanoma at different anatomic sites develops through ergent pathways. We examined this hypothesis prospectively. We followed 152,949 women and 25,204 men free of cancer at baseline for up to 14 years in three large prospective studies. We examined risk factors for melanoma by anatomic location (head or neck, trunk, upper extremity, and lower extremity). Polytomous logistic regression was used to test the difference among risk factors by location of melanoma. A total of 511 incident cases of invasive melanoma (49 head or neck, 188 trunk, 98 upper extremity, and 176 lower extremity) were included in the analysis. Compared with females, males had a higher risk of developing melanoma on the head or neck and trunk. History of severe and painful sunburn was most strongly related to melanoma of upper extremity in iduals with & burns had a 6.86-fold (95% confidence interval, 2.62-18.00) higher risk of melanoma of upper extremity compared with those with no burns (P for trend & 0.0001 P for difference by body site = 0.04). Number of moles was most strongly related to melanoma of the trunk the multivariate relative risk for having & moles was 4.67 (95% confidence interval, 3.07-7.11) compared with having no moles (P for trend & 0.0001 P for difference by body site = 0.04). Age, family history of melanoma, and hair color did not statistically differ by anatomic site of the cancer. These data support ergent etiologic pathways of melanoma development by anatomic sites.
Publisher: American Medical Association (AMA)
Date: 22-09-2020
Publisher: Springer Science and Business Media LLC
Date: 04-02-2019
Publisher: Elsevier BV
Date: 12-11-1998
Publisher: Oxford University Press (OUP)
Date: 13-06-2016
DOI: 10.1093/JNCI/DJW141
Publisher: American College of Physicians
Date: 15-01-1998
DOI: 10.7326/0003-4819-128-2-199801150-00001
Abstract: Obesity increases the risk for hypertension, but the effects of modest long-term weight changes have not been precisely quantified. To investigate body mass index (BMI) and weight change in relation to risk for hypertension. Cohort study. General community. Cohort of 82,473 U.S. female nurses 30 to 55 years of age followed every 2 years since 1976. The follow-up rate was 95%. Primary risk factors examined were 1) BMI at age 18 years and midlife and 2) long-term and medium-term weight changes. The outcome was incident cases of hypertension. By 1992, 16,395 incident cases of hypertension had been diagnosed. After adjustment for multiple covariates, BMI at 18 years of age and midlife were positively associated with occurrence of hypertension (P for trend < 0.001). Long-term weight loss after 18 years of age was related to a significantly lower risk for hypertension, and weight gain dramatically increased the risk for hypertension (compared with weight change or = 10 kg, 1.74 for a gain of 5.0 to 9.9 kg, and 5.21 for a gain > or = 25.0 kg). Among women in the top tertile of baseline BMI at age 18 years, weight loss had a greater apparent benefit. The association between weight change and risk for hypertension was stronger in younger ( or = 55 years of age). Medium-term weight changes after 1976 showed similar relations to risk for hypertension. Excess weight and even modest adult weight gain substantially increase risk for hypertension. Weight loss reduces the risk for hypertension.
Publisher: SAGE Publications
Date: 06-2006
Publisher: American Association for Cancer Research (AACR)
Date: 09-2005
DOI: 10.1158/1055-9965.EPI-05-0059
Abstract: Background: A history of diabetes mellitus and a diet high in glycemic load are both potential risk factors for pancreatic cancer. Sugar-sweetened soft drinks are a prevalent source of readily absorbable sugars and have been associated with an increased risk of obesity and diabetes. We investigated whether higher consumption of sugar-sweetened soft drinks increases the risk of pancreatic cancer. Methods: We examined the relation between consumption of sugar-sweetened soft drinks and the development of pancreatic cancer in the Nurses' Health Study and the Health Professionals Follow-up Study. Among 88,794 women and 49,364 men without cancer at baseline, we documented 379 cases of pancreatic cancer during up to 20 years of follow-up. Soft drink consumption was first assessed at baseline (1980 for the women, 1986 for the men) and updated periodically thereafter. Results: Compared with participants who largely abstained from sugar-sweetened soft drinks, those who consumed more than three sugar-sweetened soft drinks weekly experienced overall a multivariate relative risk (RR) of pancreatic cancer of 1.13 [95% confidence interval (95% CI), 0.81-1.58 P for trend = 0.47]. Women in the highest category of sugar-sweetened soft drink intake did experience a significant increase in risk (RR, 1.57 95% CI, 1.02-2.41 P for trend = 0.05), whereas there was no association between sweetened soft drink intake and pancreatic cancer among men. Among women, the risk associated with higher sugar-sweetened soft drink was limited to those with elevated body mass index (& kg/m2 RR, 1.89 95% CI, 0.96-3.72) or with low physical activity (RR, 2.02 95% CI, 1.06-3.85). In contrast, consumption of diet soft drinks was not associated with an elevated pancreatic cancer risk in either cohort. Conclusion: Although soft drink consumption did not influence pancreatic cancer risk among men, consumption of sugar-sweetened soft drinks may be associated with a modest but significant increase in risk among women who have an underlying degree of insulin resistance.
Publisher: American Society of Hematology
Date: 16-11-2012
DOI: 10.1182/BLOOD.V120.21.760.760
Abstract: Abstract 760 The incidence of multiple myeloma (MM) increases with age, and the prognosis worsens. Comorbidities increase in prevalence with age, yet little is known about the impact of comorbid medical conditions on outcomes in MM. In a retrospectively-assembled cohort study, all patients with MM diagnosed between 1998 and 2009 at a Veterans' Administration (VA) hospital were identified in the VA central cancer registry. Patients who received no treatment within 6 months of diagnosis were excluded, eliminating those with smoldering myeloma or who received supportive care only. Comorbidities were ascertained from ICD-9 codes present prior to the diagnosis of MM, and categorized using the Romano adaptation of the Charlson Comorbidity Index (CCI). The independent effects of age, race and comorbidities were examined using Cox proportional hazards modeling. The impact of in idual comorbidities on survival was also examined, controlling for age and race. A total of 2,968 patients were identified. The median age was 69 (range 27–92). The vast majority of patients (98%) were male 28.6% of the patients were black. The median Charlson Comorbidity Index score was 2 (range 0–13). The frequencies of selected comorbidities were: diabetes (31%), renal impairment (23.8%), cardiovascular comorbidities (38.8%) and pulmonary (26.6%). The median overall survival (OS) for the entire cohort was 28.6 months at a median follow up of 26.8 months (range 0–137 months). On multivariate analysis, age was significantly associated with mortality [Hazard Ratio (HR) 1.03 per year (95% confidence intervals (CI) 1.03–1.04), p .0001]. Race was not significantly associated with survival [HR 0.99 (95% CI 0.90–1.09), p=0.81]. The median OS, adjusted for age and race, was 36.5 months for patients with no comorbidities, 33.9 months for patients with a CCI score of 1–2, 25.6 months for patients with a CCI score of 3–4 and 20.2 months for patients with a CCI score ≥5. The impact of comorbidities on survival violated the proportional hazards assumption, with a cut-point at 1 year, indicating that the influence of comorbidities varied over time. Relative to those with no comorbidities, the HR for death among those with a CCI score 1–2 was 1.20 (0.97–1.48) in the first year, and 1.03 (95% CI 0.89–1.18) subsequent to the first year among those with a CCI score 3–4, the HR for death was 1.67 (95% CI 1.34–2.08) in the first year and 1.23 (95% CI 1.05–1.45) subsequently among those with a CCI score ≥5, the risk of death in the first year doubled [HR 2.15 (95% CI 1.73–2.67)] and was increased 40% subsequently [HR 1.42 (95% CI 1.19–1.69)]. In idual prevalent comorbidities were then examined. Cardiovascular disease, renal impairment, and pulmonary disease were all significantly associated with mortality. In the first year after diagnosis, cardiovascular disease was associated with a 55% increase in mortality [HR 1.55 (95% CI 1.35–1.78)] while, subsequent to the first year, the risk was only increased about 20% [HR 1.19 (95% CI 1.07–1.39)]. The impact of renal impairment and pulmonary impairment did not vary over time both were associated with a 25% increased risk of death [renal impairment HR 1.26 (95% CI 1.14–1.38) pulmonary disease HR 1.24 (95% CI 1.13–1.37)]. Diabetes was not associated with survival (HR 1.02, p=0.64) after controlling for age, race and cardiovascular, pulmonary or renal impairment. Age and comorbidities are independently associated with increased risk of mortality in MM. The influence of comorbidities varies over time, with the greatest impact noted in the first year after diagnosis of MM among those with a CCI score ≥3 and with cardiovascular disease. Further study is needed to determine whether this increased early mortality is related to increased risk of toxicity of therapy, inadequate MM therapy or both. No relevant conflicts of interest to declare.
Publisher: Springer Science and Business Media LLC
Date: 14-11-2019
DOI: 10.1186/S13058-019-1219-8
Abstract: Lobular carcinoma in situ (LCIS) of the breast is a risk factor of developing invasive breast cancer. We evaluated the racial differences in the risks of subsequent invasive breast cancer following LCIS. We utilized data from the Surveillance, Epidemiology, and End Results registries to identify 18,835 women diagnosed with LCIS from 1990 to 2015. Cox proportional hazards regression was used to estimate race/ethnicity-associated hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of subsequent invasive breast cancer. During a median follow-up of 90 months, 1567 patients developed invasive breast cancer. The 10-year incidence was 7.9% for Asians, 8.2% for Hispanics, 9.3% for whites, and 11.2% for blacks ( P = 0.046). Compared to white women, black women had significantly elevated risks of subsequent invasive breast cancer (HR 1.33 95% CI 1.11, 1.59), and invasive cancer in the ipsilateral breast (HR 1.37 95% CI 1.08, 1.72) and in the contralateral breast (HR 1.33 95% CI 1.00, 1.76). Black women had significantly higher risks of invasive subtypes negative for both estrogen receptor and progesterone receptor (HR 1.86 95% CI 1.14, 3.03) and invasive subtypes positive for one or both of receptors (HR 1.30 95% CI 1.07, 1.59). The risk of subsequent invasive breast cancer was comparable in Asian women and Hispanic women compared with white women. Black women had a significantly higher risk of developing invasive breast cancer, including both hormone receptor-positive and hormone receptor-negative subtypes, after LCIS compared with white counterparts. It provides an opportunity to address health disparities.
Publisher: American Medical Association (AMA)
Date: 25-12-1996
Publisher: Elsevier BV
Date: 04-2016
Publisher: American Medical Association (AMA)
Date: 17-11-1989
Abstract: Persons with diabetes experience elevated risks of a variety of other illnesses-- including circulatory, visual, neurological, renal, and skin disorders--relative to their nondiabetic peers. Previous estimates of the economic burden of diabetes, however, have not taken full account of this related morbidity and mortality and have therefore understated the cost to the nation due to this disease. Accordingly, we estimated the economic costs of type II, or non-insulin-dependent, diabetes mellitus, reflecting its contribution to the total burden of disease in the United States. In 1986, non-insulin-dependent diabetes mellitus was responsible for $11.6 billion in health care expenditures, including $6.8 billion for diabetic care and $4.8 billion attributable to an excess prevalence of related (principally cardiovascular) conditions. The human toll of non-insulin-dependent diabetes mellitus included 144,000 deaths -- about 6.8% of total US mortality -- and the total disability of 951,000 persons. The total economic burden of non-insulin-dependent diabetes mellitus in 1986, including health care expenditures and productivity forgone due to disability and premature mortality, was $19.8 billion.
Publisher: Wiley
Date: 31-05-2006
DOI: 10.1002/MC.20190
Abstract: The p53 gene is involved in the control of cell-cycle arrest and apoptosis. The germline Arg72Pro polymorphism alters the protein's biochemical functions, and may confer in idual susceptibility to skin cancer. We evaluated the association of the Arg72Pro polymorphism with skin cancer risk among Caucasians in a nested case-control study within the Nurses' Health Study (NHS) (219 melanoma, 286 squamous cell carcinoma (SCC), and 300 basal cell carcinoma (BCC) and 874 controls). Compared to the Arg/Arg genotype, the Pro/Pro genotype had an OR of 1.57 (95%CI, 0.81-3.06) for melanoma risk, and an OR of 1.79 (95%CI, 1.01-3.17) for BCC risk. The positive association of the Pro allele with BCC risk was only limited to women with two or fewer lifetime sunburns (P, trend, 0.002 P, interaction, 0.02). No association was observed between the polymorphism and SCC risk. We also observed that the Pro allele was inversely associated with the risk of childhood sunburn among Caucasian participants pooled from four nested case-control studies within the NHS. This study suggests that the Arg72Pro polymorphism may play a role in skin carcinogenesis.
Publisher: American Astronomical Society
Date: 27-06-2023
Abstract: We present the stellar and planetary properties for 85 TESS Objects of Interest (TOIs) hosting 108 planet candidates that compose the TESS-Keck Survey (TKS) s le. We combine photometry, high-resolution spectroscopy, and Gaia parallaxes to measure precise and accurate stellar properties. We then use these parameters as inputs to a light-curve processing pipeline to recover planetary signals and homogeneously fit their transit properties. Among these transit fits, we detect significant transit-timing variations among at least three multiplanet systems (TOI-1136, TOI-1246, TOI-1339) and at least one single-planet system (TOI-1279). We also reduce the uncertainties on planet-to-star radius ratios R p / R ⋆ across our s le, from a median fractional uncertainty of 8.8% among the original TOI Catalog values to 3.0% among our updated results. With this improvement, we are able to recover the Radius Gap among small TKS planets and find that the topology of the Radius Gap among our s le is broadly consistent with that measured among Kepler planets. The stellar and planetary properties presented here will facilitate follow-up investigations of both in idual TOIs and broader trends in planet properties, system dynamics, and the evolution of planetary systems.
Publisher: American Medical Association (AMA)
Date: 10-04-1991
Publisher: Oxford University Press (OUP)
Date: 05-04-2005
DOI: 10.1093/JNCI/DJI094
Abstract: Diabetes appears to be associated with the development of pancreatic cancer. Three large prospective cohort studies observed a statistically significant relation between obesity and pancreatic cancer risk. Dietary patterns have been associated with fasting insulin levels and risk of diabetes. To determine whether dietary patterns are associated with pancreatic cancer risk, we analyzed data from two large prospective cohort studies. We combined data for men and women to obtain a total of 366 cases of incident pancreatic cancer from a total of 124,672 eligible participants. Dietary data were obtained from food frequency questionnaires in 1986 for men and in 1984 for women. We identified two major dietary patterns, prudent and western, by factor analysis. The prudent pattern was characterized by high fruit and vegetable intake the western pattern was characterized by high meat and high fat intakes. Multivariable relative risks (RRs) were adjusted for potential confounders, including smoking and body mass index. In the pooled analysis of men and women, no associations were observed between the prudent pattern (RR = 1.32, 95% confidence interval [CI] = 0.66 to 2.63, for highest versus lowest quintile) or the western pattern (RR = 0.91, 95% CI = 0.57 to 1.47, for highest versus lowest quintile) and the risk of pancreatic cancer. Stratifying by body mass index or physical activity did not change the associations. Dietary patterns were not associated with the risk of pancreatic cancer in two large cohort studies of men and women.
Publisher: Springer Science and Business Media LLC
Date: 26-05-2020
Publisher: American Medical Association (AMA)
Date: 10-04-1991
Publisher: Oxford University Press (OUP)
Date: 23-09-2008
DOI: 10.1093/JNCI/DJN305
Publisher: Elsevier BV
Date: 02-2019
Publisher: Elsevier BV
Date: 09-2005
DOI: 10.1016/J.JCLINEPI.2005.03.004
Abstract: To address methodologic issues in searching for observational studies by presenting database search methods and results. Results of two literature searches for publications reporting on observational studies of alcohol consumption and the risk of breast cancer and large bowel cancer were compared, to evaluate the sensitivity of various bibliographic databases and search strategies, including hand-searching reviews and meta-analyses. The target sensitivity of 90% of publications in the breast cancer search was achieved by starting with Medline, then adding Biosis, Embase, and SCI EXPANDED-SSCI, which provided a total of 72 (91%) of the 79 relevant publications. To reach a similar 89% sensitivity for large bowel cancer, at least Biosis, Dissertation Abstracts Online, Embase, ETOH, and Medline had to be searched, with the addition of hand search of reviews and meta-analyses. Limiting a search to one or two databases when conducting meta-analyses of observational studies will not provide a thorough summary of the existing literature. The findings support recommendations to implement a comprehensive search of electronic databases and the reference lists of recent review articles and meta-analyses.
Publisher: Oxford University Press (OUP)
Date: 20-04-2005
DOI: 10.1093/JNCI/DJI099
Abstract: Sex hormone concentrations are associated with breast cancer risk among women not using postmenopausal hormones (PMH) however, whether a relationship exists among PMH users is unknown. Therefore, we conducted a prospective, nested case-control study within the Nurses' Health Study (NHS) cohort to examine the association between plasma sex hormone concentrations and postmenopausal breast cancer among women using PMH at blood collection. Blood s les were collected from 1989 to 1990. During follow-up through May 31, 2000, 446 women developed breast cancer and were matched by age, date and time of day of blood collection, and fasting status to 459 control subjects (PMH users) who did not develop cancer. We used conditional logistic regression to estimate relative risks (RRs) and 95% confidence intervals (CIs). We compared hormone concentrations of the 459 control subjects with those of 363 postmenopausal NHS participants not taking PMH. All statistical tests were two-sided. PMH users had statistically significantly higher estradiol, free estradiol, sex hormone-binding globulin, and testosterone, and lower free testosterone concentrations than non-PMH users. Among PMH users, we found modest associations with breast cancer risk when comparing the highest versus lowest quartiles of free estradiol (RR = 1.7, 95% CI = 1.1 to 2.7 P(trend) = .06), free testosterone (RR = 1.6, 95% CI = 1.1 to 2.4 P(trend) = .03), and sex hormone-binding globulin (RR = 0.7, 95% CI = 0.5 to 1.1 P(trend) = .04), but not of estradiol or of testosterone. However, estradiol and free estradiol were statistically significantly positively associated with breast cancer risk among women older than 60 years (RR = 2.8, 95% CI = 1.5 to 5.0 P(trend) = .002 and 2.6, 95% CI = 1.4 to 4.7 P(trend) = .001, respectively) and among women with a body mass index of less than 25 kg/m2 (RR = 1.8, 95% CI = 1.1 to 3.1, P(trend) = .01 and 2.4, 95% CI = 1.4 to 4.0, P(trend) = .003, respectively). Although women using PMH have a different hormonal profile than those not using PMH, plasma sex hormone concentrations appear to be associated with breast cancer risk among PMH users.
Publisher: Wiley
Date: 2000
DOI: 10.1002/1097-0215(20000715)87:2<204::AID-IJC8>3.0.CO;2-3
Publisher: Informa UK Limited
Date: 10-2014
DOI: 10.2147/OAJCT.S39758
Publisher: Springer Science and Business Media LLC
Date: 05-03-2016
Publisher: Elsevier BV
Date: 06-2003
Publisher: American Public Health Association
Date: 02-2013
Abstract: Objectives. We evaluated the association between the county sprawl index, a measure of residential density and street accessibility, and physical activity and body mass index (BMI). Methods. We conducted a multilevel cross-sectional analysis in a s le of Nurses’ Health Study participants living throughout the United States in 2000 to 2001 (n = 136 592). Results. In analyses adjusted for age, smoking status, race, and husband’s education, a 1-SD (25.7) increase in the county sprawl index (indicating a denser, more compact county) was associated with a 0.13 kilograms per meters squared (95% confidence interval [CI] = −0.18, −0.07) lower BMI and 0.41 (95% CI = 0.17, 0.65) more metabolic equivalent (MET) hours per week of total physical activity, 0.26 (95% CI = 0.19, 0.33) more MET hours per week of walking, and 0.47 (95% CI = 0.34, 0.59) more MET hours per week of walking, bicycling, jogging, and running. We detected potential effect modification for age, previous disease status, husband’s education level (a proxy for socioeconomic status), and race. Conclusions. Our results suggest that living in a dense, compact county may be conducive to higher levels of physical activity and lower BMI in women.
Publisher: American Association for Cancer Research (AACR)
Date: 07-2019
DOI: 10.1158/1538-7445.AM2019-LB-164
Abstract: Purpose: Obesity, poor diet and physical inactivity increase the burden of cancer by increasing risk of incident cancer, mortality, and long term adverse treatment effects. It is critical that scientists receive training in conducting rigorous and impactful energy balance and cancer research. To address this need, we developed an annual one-week, in residence NCI-R25-funded Transdisciplinary Research in Energetics and Cancer (TREC) Training Course for early career investigators in basic, clinical and population sciences. This analysis examined the impact of the TREC Training Program on course satisfaction, knowledge gained, publications and awards among TREC Year 1 program participants (i.e., TREC Fellows). Methods: The TREC program consists of two components: an intensive, in-person, one-week Course, followed by a one-year TREC mentorship program. TREC Faculty are comprised of a TD team of ~20 international expert faculty members. TREC Faculty and Fellows completed surveys before and immediately after the course. The Wilcoxon Signed Rank Test was used to determine course-related changes in knowledge and skills. At the end of the one-year mentorship period, a survey was sent inquiring about TREC-related research productivity and collaborations. Number of publications and grant-funding between June 2017 and December 2018 was compiled and summarized for the 20 TREC Fellows participating in the inaugural TREC course. Results: Information about the program was shared with ~30 organizations, resulting in 77 applications for the inaugural course. Twenty TREC Fellows completed the program, including three basic, seven clinical, and 10 population scientists. Sixteen of the TREC fellows were junior faculty and four were postdoctoral fellows. The 5-day course included over 50 lectures, small-group breakouts and Faculty-Fellow sessions. Attendees rated the course as very high, with an average 96.7% of responses scoring in the top two categories of “good” or “very good”. Knowledge related to conducting energy balance and cancer research significantly improved in 37 out of 39 competencies (94.8%). Between the end of the TREC Year 1 program in June 2017 and December 2018, TREC Year 1 Fellows published 20 manuscripts, with 15 co-authored with other TREC Fellows and/or Faculty. Fifteen % of manuscripts were published in journals with an impact factor & 10. A total of 19 grant applications were funded to TREC Fellows (i.e., five NIH awards, three ACS awards, three foundation awards, and eight internal pilot awards). Seven TREC Fellows were appointed or promoted in academic positions. Conclusion: The overall impact of the TREC Program will be defined by the degree to which TREC Fellows produce innovative research approaches and discoveries that could improve the health of populations at risk for cancer as well as cancer survivors. Upon completion of the 5th year of the TREC Training Program in 2021, we will disseminate the TREC Training Program material for adoption by the broader research and clinical community. Citation Format: Melinda L. Irwin, Diana K. Lowry, Marian L. Neuhouser, Jennifer Ligibel, Kathryn Schmitz, Ruth E. Patterson, Graham Colditz, Fangyong Li, Linda Nebeling. Transdisciplinary research in energetics and cancer (TREC) early career investigator training program: First year results [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019 2019 Mar 29-Apr 3 Atlanta, GA. Philadelphia (PA): AACR Cancer Res 2019 (13 Suppl):Abstract nr LB-164.
Publisher: Springer Science and Business Media LLC
Date: 03-01-2018
Publisher: Wiley
Date: 02-05-2001
DOI: 10.1002/ANA.1052
Abstract: Results of case-control studies and of a prospective investigation in men suggest that consumption of coffee could protect against the risk of Parkinson's disease, but the active constituent is not clear. To address the hypothesis that caffeine is protective against Parkinson's disease, we examined the relationship of coffee and caffeine consumption to the risk of this disease among participants in two ongoing cohorts, the Health Professionals' Follow-Up Study (HPFS) and the Nurses' Health Study (NHS). The study population comprised 47,351 men and 88,565 women who were free of Parkinson's disease, stroke, or cancer at baseline. A comprehensive life style and dietary questionnaire was completed by the participants at baseline and updated every two to four years. During the follow-up (10 years in men, 16 years in women), we documented a total of 288 incident cases of Parkinson's disease. Among men, after adjustment for age and smoking, the relative risk of Parkinson's disease was 0.42 (95% CI: 0.23-0.78 p for trend < 0.001) for men in the top one-fifth of caffeine intake compared to those in the bottom one-fifth. An inverse association was also observed with consumption of coffee (p for trend = 0.004), caffeine from noncoffee sources (p for trend < 0.001), and tea (p for trend = 0.02) but not decaffeinated coffee. Among women, the relationship between caffeine or coffee intake and risk of Parkinson's disease was U-shaped, with the lowest risk observed at moderate intakes (1-3 cups of coffee/day, or the third quintile of caffeine consumption). These results support a possible protective effect of moderate doses of caffeine on risk of Parkinson's disease.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2018
Publisher: American Association for Cancer Research (AACR)
Date: 06-2020
DOI: 10.1158/1538-7755.DISP18-A011
Abstract: Introduction: The relative dearth of financial and human resources in rural areas complicates the delivery of timely medical expertise and treatment to its inhabitants. Travel distances between patients and their providers pose transportation barriers that contribute to low colorectal cancer screening rates in rural areas. Increasing applications of telemedicine technologies in health care may reduce or mitigate problems associated with transportation and insufficient availability of local providers. The objective of this study was to conduct a scoping review to compare types of telemedicine interventions for colorectal cancer screening in rural areas to those that have been studied more broadly, evaluate the quality of existing evidence, and suggest opportune areas for further investigation and application. Methods: Searches were conducted in Ovid Medline, EMBASE, and Cochrane databases with the guidance of a librarian. We included peer-reviewed full text articles in English and Spanish about telemedicine interventions in CRC screening. Telemedicine interventions for CRC screening were operationally defined as the use of telephone and Internet-based technologies to aid patient decision making, reduce transportation barriers, and circumvent lack of local human resources from the first moment of screening awareness through cancer diagnosis. We did not exclude articles based on study design type. Risk of bias was assessed through measures including randomization, blinding, and incomplete outcome reporting. Quality was defined by factors such as risk of bias and representativeness of s led populations. Results: Of 2223 non-duplicate studies, 167 articles fell into the following intervention categories: feasibility and logistics, decision aids, reminders, motivational interviewing, and remote expert evaluation. Reminders were the most robust area of the literature, with more RCTs and large-scale studies conducted. Many studies compared the efficacy of automated screening reminders with those performed by staff. Common outcomes that were measured in all categories except remote expert evaluation were patient acceptability and CRC screening completion within designated time frames. Articles about decision aids exhibited heterogeneity of dissemination method and types of informational materials included. Studies on remote expert evaluation were variable in scope and reported results for interobserver reliability and sensitivity. Of the studies included, nine took place or were targeted for application in rural or remote areas. Of those nine studies, five were about reminders, reflecting trends in the wider literature. Discussion: Given the paucity of CRC screening interventions that were studied in rural areas, further investigation is needed to determine whether broadly studied telemedicine interventions are applicable, particularly since underserved populations in rural areas stand to benefit disproportionately from evidence-based telemedicine interventions. Citation Format: Chanelle Y. Chua, Carolyn Stoll, Julia Maki, Graham Colditz, Aimee James. Opportunities for connection: A scoping review of telemedicine interventions in colorectal cancer screening in rural and nonrural settings [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved 2018 Nov 2-5 New Orleans, LA. Philadelphia (PA): AACR Cancer Epidemiol Biomarkers Prev 2020 (6 Suppl):Abstract nr A011.
Publisher: Springer Science and Business Media LLC
Date: 19-06-2018
Publisher: American Medical Association (AMA)
Date: 22-08-2001
Abstract: Diabetes mellitus and elevated postload plasma glucose levels have been associated with an increased risk of pancreatic cancer in previous studies. By virtue of their influence on insulin resistance, obesity and physical inactivity may increase risk of pancreatic cancer. To examine obesity, height, and physical activity in relation to pancreatic cancer risk. Two US cohort studies conducted by mailed questionnaire, the Health Professionals Follow-up Study (initiated in 1986) and the Nurses' Health Study (initiated in 1976), with 10 to 20 years of follow-up. A total of 46 648 men aged 40 to 75 years and 117 041 women aged 30 to 55 years who were free of prior cancer at baseline and had complete data on height and weight. Relative risk of pancreatic cancer, analyzed by self-reported body mass index (BMI), height, and level of physical activity. During follow-up, we documented 350 incident pancreatic cancer cases. In iduals with a BMI of at least 30 kg/m(2) had an elevated risk of pancreatic cancer compared with those with a BMI of less than 23 kg/m(2) (multivariable relative risk [RR], 1.72 95% confidence interval [CI], 1.19-2.48). Height was associated with an increased pancreatic cancer risk (multivariable RR, 1.81 95% CI, 1.31-2.52 for the highest vs lowest categories). An inverse relation was observed for moderate activity (multivariable RR, 0.45 95% CI, 0.29-0.70 for the highest vs lowest categories P for trend <.001). Total physical activity was not associated with risk among in iduals with a BMI of less than 25 kg/m(2) but was inversely associated with risk among in iduals with a BMI of at least 25 kg/m(2) (pooled multivariable RR, 0.59 95% CI, 0.37-0.94 for the top vs bottom tertiles of total physical activity P for trend =.04). In 2 prospective cohort studies, obesity significantly increased the risk of pancreatic cancer. Physical activity appears to decrease the risk of pancreatic cancer, especially among those who are overweight.
Publisher: American College of Physicians
Date: 04-1995
DOI: 10.7326/0003-4819-122-7-199504010-00001
Abstract: To examine the relation between adult weight change and the risk for clinical diabetes mellitus among middle-aged women. Prospective cohort study with follow-up from 1976 to 1990. 11 U.S. states. 114,281 female registered nurses aged 30 to 55 years who did not have diagnosed diabetes mellitus, coronary heart disease, stroke, or cancer in 1976. Non-insulin-dependent diabetes mellitus. 2204 cases of diabetes were diagnosed during 1.49 million person-years of follow-up. After adjustment for age, body mass index was the dominant predictor of risk for diabetes mellitus. Risk increased with greater body mass index, and even women with average weight (body mass index, 24.0 kg/m2) had an elevated risk. Compared with women with stable weight (those who gained or lost less than 5 kg between age 18 years and 1976) and after adjustment for age and body mass index at age 18 years, the relative risk for diabetes mellitus among women who had a weight gain of 5.0 to 7.9 kg was 1.9 (95% CI, 1.5 to 2.3). The corresponding relative risk for women who gained 8.0 to 10.9 kg was 2.7 (CI, 2.1 to 3.3). In contrast, women who lost more than 5.0 kg reduced their risk for diabetes mellitus by 50% or more. These results were independent of family history of diabetes. The excess risk for diabetes with even modest and typical adult weight gain is substantial. These findings support the importance of maintaining a constant body weight throughout adult life and suggest that the 1990 U.S. Department of Agriculture guidelines that allow a substantial weight gain after 35 years of age are misleading.
Publisher: Elsevier BV
Date: 12-2015
Publisher: MDPI AG
Date: 28-04-2020
DOI: 10.3390/NU12051247
Abstract: Background: Obesity, defined by body mass index (BMI), measured at colorectal cancer (CRC) diagnosis has been associated with postoperative complications and survival outcomes. However, BMI does not allow for a differentiation between fat and muscle mass. Computed tomography (CT)-defined body composition more accurately reflects different types of tissue and their associations with health-related quality of life (HRQoL) during the first year of disease, but this has not been investigated yet. We studied the role of visceral and subcutaneous fat area (VFA and SFA) and skeletal muscle mass (SMM) on longitudinally assessed HRQoL in CRC patients. Methods: A total of 138 newly diagnosed CRC patients underwent CT scans at diagnosis and completed questionnaires prior to and six and twelve months post-surgery. We investigated the associations of VFA, SFA, and SMM with HRQoL at multiple time points. Results: A higher VFA was associated with increased pain six and twelve months post-surgery (β = 0.06, p = 0.04 and β = 0.07, p = 0.01) and with worse social functioning six months post-surgery (β = −0.08, p = 0.01). Higher SMM was associated with increased pain twelve months post-surgery (β = 1.03, p 0.01). Conclusions: CT-quantified body composition is associated with HRQoL scales post-surgery. Intervention strategies targeting a reduction in VFA and maintaining SMM might improve HRQoL in CRC patients during the first year post-surgery.
Publisher: American Medical Association (AMA)
Date: 25-05-2005
Abstract: Physical activity has been shown to decrease the incidence of breast cancer, but the effect on recurrence or survival after a breast cancer diagnosis is not known. To determine whether physical activity among women with breast cancer decreases their risk of death from breast cancer compared with more sedentary women. Prospective observational study based on responses from 2987 female registered nurses in the Nurses' Health Study who were diagnosed with stage I, II, or III breast cancer between 1984 and 1998 and who were followed up until death or June 2002, whichever came first. Breast cancer mortality risk according to physical activity category ( or =24 metabolic equivalent task [MET] hours per week). Compared with women who engaged in less than 3 MET-hours per week of physical activity, the adjusted relative risk (RR) of death from breast cancer was 0.80 (95% confidence interval [CI], 0.60-1.06) for 3 to 8.9 MET-hours per week 0.50 (95% CI, 0.31-0.82) for 9 to 14.9 MET-hours per week 0.56 (95% CI, 0.38-0.84) for 15 to 23.9 MET-hours per week and 0.60 (95% CI, 0.40-0.89) for 24 or more MET-hours per week (P for trend = .004). Three MET-hours is equivalent to walking at average pace of 2 to 2.9 mph for 1 hour. The benefit of physical activity was particularly apparent among women with hormone-responsive tumors. The RR of breast cancer death for women with hormone-responsive tumors who engaged in 9 or more MET-hours per week of activity compared with women with hormone-responsive tumors who engaged in less than 9 MET-hours per week was 0.50 (95% CI, 0.34-0.74). Compared with women who engaged in less than 3 MET-hours per week of activity, the absolute unadjusted mortality risk reduction was 6% at 10 years for women who engaged in 9 or more MET-hours per week. Physical activity after a breast cancer diagnosis may reduce the risk of death from this disease. The greatest benefit occurred in women who performed the equivalent of walking 3 to 5 hours per week at an average pace, with little evidence of a correlation between increased benefit and greater energy expenditure. Women with breast cancer who follow US physical activity recommendations may improve their survival.
Publisher: SAGE Publications
Date: 10-07-2016
Abstract: Background. Side effects prompt some patients to forego otherwise-beneficial therapies. This study explored which characteristics make side effects particularly aversive. Methods. We used a psychometric approach, originating from research on risk perception, to identify the factors (or components) underlying side effect perceptions. Women ( N = 149) aged 40 to 74 years were recruited from a patient registry to complete an online experiment. Participants were presented with hypothetical scenarios in which an effective and necessary medication conferred a small risk of a single side effect (e.g., nausea, dizziness). They rated a broad range of side effects on several characteristics (e.g., embarrassing, treatable). In addition, we collected 4 measures of aversiveness for each side effect: choosing to take the medication, willingness to pay to avoid the side effect (WTP), negative affective attitude associated with the side effect, and how each side effect ranks among others in terms of undesirability. A principal components analysis (PCA) was used to identify the components underlying side effect perceptions. Then, for each aversiveness measure separately, regression analyses were used to determine which components predicted differences in aversiveness among the side effects. Results. The PCA revealed 4 components underlying side effect perceptions: affective challenge (e.g., frightening), social challenge (e.g., disfiguring), physical challenge (e.g., painful), and familiarity (e.g., common). Side effects perceived as affectively and physically challenging elicited the highest levels of aversiveness across all 4 measures. Conclusions. Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice.
Publisher: Massachusetts Medical Society
Date: 22-06-1995
Publisher: American Medical Association (AMA)
Date: 11-03-1996
Publisher: Wiley
Date: 05-01-1999
DOI: 10.1002/(SICI)1097-0215(19990105)80:1<13::AID-IJC3>3.0.CO;2-W
Abstract: Heterocyclic amines (HAs) are carcinogens produced by high-temperature cooking of meat and animal protein metabolism of HA is influenced by polymorphisms in the N-acetyltransferase-2 (NAT-2) gene. Data from a variety of sources suggest that HA may play a role in human carcinogenesis. We examined the associations between meat intake and cooking method, acetylator genotype and breast cancer risk in a sub-cohort of 32,826 women in the Nurses' Health Study who gave a blood s le in 1989-1990. Women who were diagnosed with breast cancer (n = 466) after blood draw and prior to June 1, 1994, were matched to 466 controls. Overall, rapid acetylators were not at increased risk of breast cancer compared with slow acetylators (multivariate OR = 1.1, 95% CI 0.8-1.5), and there were no associations between meat intake or cooking method of meat and breast cancer risk. Rapid acetylators with the highest red meat intake (one or more servings per day) were not at increased risk of breast cancer compared with slow acetylators with the lowest red meat intake (OR = 1.1, 95% CI 0.7-1.8). Frequent intake of charred meat among rapid acetylators (one or more times per week) was not associated with increased risk (OR = 1.2, 95% CI 0.6-2.3) compared with slow acetylators who ate charred meat less than once per month. We observed no significant associations for rapid acetylators who frequently consumed beef, pork or lamb cooked with high-temperature cooking methods, such as barbecuing (OR = 0.9, 95% CI 0.4-1.9) or roasting (OR = 0.9, 95% CI 0.5-1.6). Our data suggest that HAs may not be a major cause of breast cancer, although we cannot exclude misclassification of HA intake as the reason for the lack of association. We observed no evidence of differential susceptibility to these exposures by NAT2 genotype.
Publisher: Springer Science and Business Media LLC
Date: 1997
Abstract: Skin cancer is the most common malignancy in the United States accounting for more than 840,000 cases and 9,400 deaths annually. It is estimated that 90% of non-melanoma skin cancers and much of melanoma incidence can be attributed to sun exposure. The evidence suggests that regular use of sunscreen (Sun Protective Factor (SPF) of 15 or higher), wearing protective, tightly woven clothing and wide brimmed hats, and avoiding sun exposure when the ultraviolet rays are strongest (between 11:00 a.m. and 3:00 p.m.) can dramatically reduce the risk of skin cancer. Interventions to promote sun-protection behaviors that target children and adults are necessary to reduce the growing incidence rate of skin cancer in the United States.
Publisher: Springer Science and Business Media LLC
Date: 25-09-2007
Publisher: Public Library of Science (PLoS)
Date: 25-04-2019
Publisher: American Association for Cancer Research (AACR)
Date: 2009
DOI: 10.1158/1055-9965.EPI-08-0778
Abstract: Insulin-like growth factor (IGF)-1 and interleukin (IL)-6 promote the proliferation and survival of multiple myeloma cells. Variation in genes related to IGF-1 and IL-6 signaling may influence susceptibility to multiple myeloma. To assess their etiologic role, we examined the association of 70 tagging single nucleotide polymorphisms (SNP) in seven IGF-1 and three IL-6 pathway genes with multiple myeloma risk in two prospective cohorts, the Nurses' Health Study and the Health Professionals Follow-up Study. Among the participants who provided DNA specimens, we identified 58 women and 24 men with multiple myeloma and matched two controls per case. We used multivariable logistic regression models to assess the association of the SNPs or tagged haplotypes with multiple myeloma risk. Several SNPs had suggestive associations with multiple myeloma based on large odds ratios (OR), although the corresponding omnibus P values were not more than nominally significant (i.e., at P & 0.05). These SNPs included rs1801278 in the gene encoding insulin receptor substrate-1 [IRS1 C/T versus C/C genotypes OR, 4.3 95% confidence interval (CI), 1.5-12.1] and three IL-6 receptor SNPs: rs6684439 (T/T versus C/C OR, 2.9 95% CI, 1.2-7.0), rs7529229 (C/C versus T/T OR, 2.5 95% CI, 1.1-6.0), and rs8192284 (C/C versus A/A OR, 2.5, 95% CI, 1.1-6.0). Additional SNPs in genes encoding IGF-1, IGF binding protein-2, IRS2, and gp130 also showed suggestive associations with multiple myeloma risk. We conducted a large number of statistical tests, and the findings may be due to chance. Nonetheless, the data are consistent with the hypothesis that IGF-1- and IL-6-related gene variation influences susceptibility to multiple myeloma and warrant confirmation in larger populations. (Cancer Epidemiol Biomarkers Prev 2009 (1):282–8)
Publisher: Massachusetts Medical Society
Date: 24-10-1985
DOI: 10.1056/NEJM198510243131703
Abstract: Interleukin (IL)-1 signaling plays an important role in inflammatory processes, but also in malignant processes. The essential downstream event in IL-1 signaling is the activation of nuclear factor (NF)-κB, which leads to the expression of several genes that are involved in cell proliferation, invasion, angiogenesis and metastasis, among them VEGF-A. As microenvironment-derived IL-1β is required for invasion and angiogenesis in malignant tumors, also in chondrosarcomas, we investigated IL-1β-induced signal transduction and VEGF-A expression in C3842 and SW1353 chondrosarcoma cells. We additionally performed in vitro angiogenesis assays and NF-κB-related gene expression analyses. Curcumin is a substance which inhibits IL-1 signaling very early by preventing the recruitment of IL-1 receptor associated kinase (IRAK) to the IL-1 receptor. We demonstrate that IL-1 signaling and VEGF-A expression are blocked by Curcumin in chondrosarcoma cells. We further show that Curcumin blocks IL-1β-induced angiogenesis and NF-κB-related gene expression. We suppose that IL-1 blockade is an additional treatment option in chondrosarcoma, either by Curcumin, its derivatives or other IL-1 blocking agents.
Publisher: American Medical Association (AMA)
Date: 04-2004
Publisher: Cold Spring Harbor Laboratory
Date: 18-11-2021
DOI: 10.1101/2021.11.16.21266374
Abstract: This systematic review aimed to assess the methods used to classify mammographic breast parenchymal features in relation to prediction of future breast cancer including the time from mammogram to diagnosis of breast cancer, and methods for the identification of texture features and selection of features for inclusion in analysis. The databases including Medline (Ovid) 1946-, Embase.com 1947-, CINAHL Plus 1937-, Scopus 1823-, Cochrane Library (including CENTRAL), and Clinicaltrials.gov . were searched through October 2021 to extract published articles in English describing the relationship of parenchymal texture features with risk of breast cancer. Twenty-eight articles published since 2016 were included in the final review. Of these, 7 assessed texture features from film mammograms images, 3 did not report details of the image used, and the others used full field mammograms from Hologic, GE and other manufacturers. The identification of parenchymal texture features varied from using a predefined list to machine-driven identification. Reduction in number of features chosen for analysis in relation to cancer incidence then varied across statistical approaches and machine learning methods. The variation in approach and number of features identified for inclusion in analysis precluded generating a quantitative summary or meta-analysis of the value of these to improve predicting risk of future breast cancers. This updated overview of the state of the art revealed research gaps based on these, we provide recommendations for future studies using parenchymal features for mammogram images to make use of accumulating image data, and external validation of prediction models that extend to 5 and 10 years to guide clinical risk management. By following these recommendations, we expect to improve risk classification and risk prediction for women to tailor screening and prevention strategies to level of risk.
Publisher: FapUNIFESP (SciELO)
Date: 08-2000
Publisher: Informa UK Limited
Date: 22-04-2011
DOI: 10.1080/10810730.2010.546482
Abstract: The purpose of this study was to characterize the literacy demands of print materials used to encourage diabetes prevention on the Crow Reservation. Diabetes-prevention materials included p hlets, booklets, and fact sheets provided to Crow people. Readability was assessed using the SMOG formula. Diabetes related vocabulary was assessed to determine whether medical/scientific words were used and if they were defined. Numeracy demand was assessed by counting the number of times different numeracy concepts were used in each material. Lists, charts, and graphs were assessed using the PMOSE/IKIRSCH tool. We found that materials were written at a readability level higher than recommended. Across all materials, vocabulary terms were used often but not always defined. Numeric terms were not often used, but when used they were not defined. Most of the materials required the reader to read numbers or count. However, overall numeracy demand was relatively low. The PMOSE/IKIRSCH scores for materials were adequate. The authors found a mismatch between the level of skills required in some of the materials and the skills of the average person, including adults on the Crow Reservation. This study highlights the need for designing materials specifically for the intended audience, including rigorous pilot testing of materials.
Publisher: AMPCo
Date: 02-1983
Publisher: Springer Science and Business Media LLC
Date: 1998
Abstract: A lower risk of prostate cancer among diabetics has been suggested by several but not all studies. However, the studies have not always accounted for time since diagnosis of diabetes mellitus, or have not examined confounding factors such as diet and diagnostic bias. We thus examined this relationship in the Health Professionals Follow-Up Study from 1986 and 1994, in which 1,369 new cases of non-stage A1 prostate cancer were documented in 47,781 men. A prior history of a diagnosis of diabetes (mostly adult-onset) was associated with a reduced risk of prostate cancer (multivariate relative risk [RR] = 0.75 95 percent confidence interval [CI] = 0.59-0.95) controlling for age, body mass index (wt/ht2) at age 21, and, in 1986, race, vasectomy, and intakes of total energy, total fat, calcium, fructose, and lycopene. After excluding the first year of follow-up after the diagnosis of diabetes, the RR was 0.63 (CI = 0.54-0.89). Prostate cancer was not reduced in the first five years after diagnosis (RR = 1.24, CI = 0.87-1.77), but was lower in the next five years (RR = 0.66, CI = 0.39-1.10) and lowest after 10 years (RR = 0.54, CI = 0.37-0.78) P-value for trend across time = 0.004. Similar associations were noted for advanced cases. Detection bias was unlikely to account for our findings. The basis of this relationship is unclear but may reflect hormonal changes related to diabetes, perhaps low testosterone levels.
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22533791.V1
Abstract: Baseline age and age-standardized characteristics of cohort participants who developed colon cancer (cases) and those who remained free from cancer (noncases) among women in the Nurses' Health Study and men in the Health Professionals Follow-up Study in 1986
Publisher: Springer Science and Business Media LLC
Date: 19-12-2006
Publisher: American Medical Association (AMA)
Date: 16-05-1990
Publisher: Elsevier BV
Date: 1991
DOI: 10.1016/0091-7435(91)90006-P
Abstract: Considerable epidemiological evidence has accumulated regarding the effect of postmenopausal estrogens on coronary heart disease risk. Five hospital-based case-control studies yielded inconsistent but generally null results however, these are difficult to interpret due to the problems in selecting appropriate controls. Six population-based case-control studies found decreased relative risks among estrogen users, though only 1 was statistically significant. Three cross-sectional studies of women with or without stenosis on coronary angiography each showed markedly less atherosclerosis among estrogen users. Of 16 prospective studies, 15 found decreased relative risks, in most instances, statistically significant. The Framingham study alone observed an elevated risk, which was not statistically significant when angina was omitted. A reanalysis of the data showed a nonsignificant protective effect among younger women and a nonsignificant increase in risk among older women. Overall, the bulk of the evidence strongly supports a protective effect of estrogens that is unlikely to be explained by confounding factors. This benefit is consistent with the effect of estrogens on lipoprotein subfractions (decreasing low-density lipoprotein levels and elevating high-density lipoprotein levels). A quantitative overview of all studies taken together yielded a relative risk of 0.56 (95% confidence interval 0.50-0.61), and taking only the internally controlled prospective and angiographic studies, the relative risk was 0.50 (95% confidence interval 0.43-0.56).
Publisher: Springer Science and Business Media LLC
Date: 2002
Abstract: We sought to evaluate the association between ovarian cancer risk and use of aspirin and nonsteroidal anti-inflammatories. We prospectively assessed use of aspirin, nonsteroidal anti-inflammatories (NSAIDs), and acetaminophen use in relation to ovarian cancer risk among 76,821 participants in the Nurses' Health Study who had no history of cancer other than non-melanoma skin cancer. Women reported known and suspected ovarian cancer risk factors in biennial mailed questionnaires from 1976 to 1996, along with new diagnoses of ovarian cancer. Aspirin use was assessed in 1980, 1982, 1984, and 1988-1994. We assessed NSAID use in 1980, and both NSAID and acetaminophen use in 1990, 1992, and 1994. During 16 years of follow-up and 1,222,412 person-years, 333 cases of invasive epithelial ovarian cancer were confirmed. We used pooled logistic regression to control for age, body mass index, oral contraceptive use, smoking history, parity, postmenopausal hormone use, tubal ligation, and other potential ovarian cancer risk factors. Aspirin use was not associated with ovarian cancer risk overall (RR for users compared with nonusers, 1.00, 95% confidence interval (CI 0.80-1.25). We found no association between aspirin dose (in number of weekly tablets) and ovarian cancer risk (RR for those taking 15 or more tablets weekly compared with nonusers, 0.98, 95% CI 0.63-1.52). Similarly, duration of aspirin use was not associated with risk (RR for aspirin use of 20 or more years, 0.99, 95% CI 0.69-1.43). In separate models assessing the relation between NSAID use and ovarian cancer risk we found a 40% reduction in risk among NSAID users versus nonusers (RR 0.60, 95% CI 0.38-0.95). However, when we examined this relationship in terms of days of NSAID use per month, we did not observe a dose-response with increasing NSAID use. We observed no association between aspirin use, dose, or duration and epithelial ovarian cancer risk. Although we found a modest reduction in risk associated with NSAID use, there was no dose-effect.
Publisher: American Association for Cancer Research (AACR)
Date: 09-2007
DOI: 10.1158/1055-9965.EPI-07-0313
Abstract: Greater body fatness during childhood is associated with reduced risk of premenopausal breast cancer, but few studies have addressed the relation of adiposity with sex hormones in girls. We prospectively examined associations between adiposity and circulating levels of sex hormones and sex hormone–binding globulin (SHBG) among 286 girls in the Dietary Intervention Study in Children. Participants were 8 to 10 years old at baseline and were followed for an average of 7 years. Anthropometric measurements were taken at baseline and at subsequent annual visits, and blood s les were collected every 2 years. Concentrations of dehydroepiandrosterone sulfate (DHEAS) during follow-up were higher among girls with greater body mass index (BMI) at baseline. The mean for the lowest BMI quartile was 63.0 μg/dL compared with 78.8 μg/dL for the highest quartile, and each kg/m2 increment in baseline BMI was associated with a 4.3% increase (95% confidence interval, 1.6-7.0%) in DHEAS levels during follow-up (Ptrend = 0.002). Concentrations of SHBG during follow-up were lower among girls with greater BMI at baseline. The mean for the lowest BMI quartile was 94.8 nmol compared with 57.5 nmol for the highest quartile, and each kg/m2 increment in baseline BMI was associated with an 8.8% decrease (95% confidence interval, 7.0-10.6%) in SHBG levels during follow-up (Ptrend & 0.0001). Estrogen and progesterone concentrations were similar across BMI quartiles. These findings suggest that adiposity may alter DHEAS and SHBG levels in girls. Whether and how these differences affect breast development and carcinogenesis requires further research. (Cancer Epidemiol Biomarkers Prev 2007 (9):1880–8)
Publisher: American Association for Cancer Research (AACR)
Date: 02-2004
DOI: 10.1158/0008-5472.CAN-03-3295
Abstract: UDP-glucuronosyltransferase (UGT) 1A1 is involved in the inactivation of estradiol (E2) and its oxidized metabolites. These metabolites have been shown to contribute to the development of endometrial cancer in animal studies. Thus UGT1A1 represents a candidate gene in endometrial carcinogenesis. In this study, we established the substrate specificity of UGT1A1 for E2 and its 2- and 4-hydroxylated metabolites. Intrinsic clearances indicated that UGT1A1 had a preference for the glucuronidation of 2-hydroxyestradiol, a metabolite associated with antiproliferative activity. Expression analysis demonstrated that UGT1A1 is present in the nonmalignant endometrium. Subsequently, we sought to determine whether the common UGT1A1 promoter allele, UGT1A1*28 [A(TA)7TAA], which decreases gene transcription, was associated with endometrial cancer risk in a case-control study nested within the Nurses’ Health Study (222 cases, 666 matched controls). Conditional logistic regression demonstrated a significant inverse association with the UGT1A1*28 allele and endometrial cancer risk. Compared with women homozygous for the UGT1A1*1 [A(TA)6TAA] allele, the adjusted odds ratio (OR) was 0.81 [95% confidence interval (CI), 0.56–1.16] for the UGT1A1*1/*28 genotype and 0.40 (95% CI, 0.21–0.75) for the homozygous UGT1A1*28 genotype (Ptrend = 0.007). There was a suggestion of an interaction by menopausal status [OR = 0.39 (95% CI, 0.18–0.85) for premenopausal women and OR = 0.79 (95% CI, 0.55–1.13) for postmenopausal women who carry the UGT1A1*28 allele (Pinteraction = 0.05)]. These observations suggest that lower expression of UGT1A1 decreases the risk of endometrial cancer by reducing the excretion of 2-hydroxyestradiol, the antiproliferative metabolite of E2, in the endometrium.
Publisher: American Association for Cancer Research (AACR)
Date: 04-2007
DOI: 10.1158/0008-5472.CAN-06-3591
Abstract: Two recent studies independently identified polymorphisms in the 8q24 region, including a single nucleotide polymorphism (rs1447295), strongly associated with prostate cancer risk. Here, we replicate the overall association in a large nested case-control study from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium using 6,637 prostate cancer cases and 7,361 matched controls. We also examine whether this polymorphism is associated with breast cancer among 2,604 Caucasian breast cancer cases and 3,118 matched controls. The rs1447295 marker was strongly associated with prostate cancer among Caucasians (P = 1.23 × 10−13). When we exclude the Multiethnic Cohort s les, previously reported by Freedman et al., the association remains highly significant (P = 8.64 × 10−13). Compared with wild-type homozygotes, carriers with one copy of the minor allele had an ORAC = 1.34 (99% confidence intervals, 1.19–1.50) and carriers with two copies of the minor allele had an ORAA = 1.86 (99% confidence intervals, 1.30–2.67). Among African Americans, the genotype association was statistically significant in men diagnosed with prostate cancer at an early age (P = 0.011) and nonsignificant for those diagnosed at a later age (P = 0.924). This difference in risk by age at diagnosis was not present among Caucasians. We found no statistically significant difference in risk when tumors were classified by Gleason score, stage, or mortality. We found no association between rs1447295 and breast cancer risk (P = 0.590). Although the gene responsible has yet to be identified, the validation of this marker in this large s le of prostate cancer cases leaves little room for the possibility of a false-positive result. [Cancer Res 2007 (7):2951–6]
Publisher: Springer Science and Business Media LLC
Date: 22-08-2017
DOI: 10.1038/BJC.2017.282
Publisher: Elsevier BV
Date: 2004
DOI: 10.1016/S1047-2797(03)00074-7
Abstract: To examine prospectively the relationship between job insecurity and incidence of coronary heart disease (CHD) among women. We conducted the study in 36,910 women from the Nurses' Health Study, a prospective cohort of female registered nurses residing in 11 US states. These women were 46 to 71 years old, and did not have diagnosed CHD, stroke, or cancer at baseline (1992). We collected information on job insecurity in 1992 and coronary heart disease incidence between baseline (June 1, 1992) and return of the 1996 questionnaire. During 4 years of follow-up, we documented 154 incident cases of CHD (113 non-fatal cases of myocardial infarction (MI) and 41 CHD deaths). After adjustment for a wide array of potential confounders, the relative risk (RR) of total CHD over 2-year follow-up was 1.35 (95% CI, 0.78-2.34) and 1.04 (95% CI, 0.69-1.57) over 4-year follow-up. Job insecurity appeared to significantly increase the risk of non-fatal MI in the short term (2-year follow-up: RR=1.89, 95% CI, 1.03-3.50), though not over a longer follow-up period (RR=1.28, 95% CI, 0.82-2.00), nor fatal CHD in the short term (RR=0.49, 95% CI, 0.22-2.08). These data suggest that job insecurity may increase the short-term risk of non-fatal MI in women.
Publisher: Oxford University Press (OUP)
Date: 27-04-2242
DOI: 10.1093/IJE/DYH258
Publisher: Elsevier BV
Date: 04-2020
Publisher: Springer Science and Business Media LLC
Date: 22-03-2021
DOI: 10.1186/S12887-021-02594-3
Abstract: To maximize the benefit of parent-directed, positive sensory exposures in the NICU, a structured sensory-based program titled the Supporting and Enhancing NICU Sensory Experiences (SENSE) program was developed that includes specific doses and targeted timing of evidence-based sensory exposures. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was used to systematically evaluate the SENSE program as an implementation strategy. One-hundred preterm infants ≤32 weeks gestation were studied (61 receiving the SENSE program and 39 standard-of-care). Parent education time and infant sensory exposures were tracked, and parents completed a questionnaire that probed their perceptions about the SENSE program. One-hundered thirty-one families were recruited, and 100 (76%) enrolled. The SENSE program was initiated at an average postmenstrual age of 29.8 (±2.4) weeks 4.9 (±5.6) days after birth. The average number of education sessions with families was 4.8 (±3.7) amounting to 72.3 (±37.4) total minutes over hospitalization. The total time of logged tactile and auditory exposures among SENSE recipients over the length of hospitalization was a median (IQ range) of 9325 (5295-15,694) minutes over an average of 10.1 (±7.6) weeks of hospitalization. There were differences in the proportion of tactile and auditory exposure targets received by the infant among those receiving the SENSE program compared to standard-of-care (91% compared to 48% p 0.0001). Ninety-five percent of infants tolerated the SENSE program as defined, with 5% of infants requiring intermittent adaptations or the interventions being stopped for a period that typically lasted 1–2 weeks. Earlier parent education was related to more parent participation in SENSE program interventions ( p = 0.04). Eighty-five percent of participants receiving the SENSE program had most of the sensory interventions completed by parents, as opposed to the medical or sensory support team. Seventy-two percent of infants had at least 100% of the auditory and tactile doses conducted over the length of stay. Parents reported acceptability. The SENSE program had good reach, was effective and acceptable with minimal cost, was adopted, and had good fidelity. Insights from implementation of the SENSE program (within a research study) informed future strategies to aid maintenance during dissemination.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516042.V1
Abstract: Supplementary Table 3 shows the sensitivity analyses for the association between sleep and EAC and ESCC by excluding cancer cases diagnosed within 2 years of enrollment
Publisher: American Association for Cancer Research (AACR)
Date: 31-07-2016
DOI: 10.1158/1055-9965.EPI-16-0120
Abstract: Background: There has been growing evidence showing that inflammatory markers play an important role in the development of ovarian cancer. We conducted a meta-analysis on the associations between circulating levels of C-reactive protein (CRP), interleukin 6 (IL6), tumor necrosis factor α (TNFα), and soluble TNFα receptor 2 (TNFR2), and the risk of ovarian cancer. Methods: A systematic search of PubMed and EMBASE up until January 19, 2016 was conducted to retrieve prospective studies. The summary risk estimates were pooled using random-effects models. The dose–response relationship was assessed using generalized least-squares trend estimation. Results: Seven nested case–control studies and one prospective cohort study were included in the review. For circulating CRP, women in the highest category had a significantly increased risk of ovarian cancer than women in the lowest category, with no significant between-study heterogeneity [pooled relative risk (RR) = 1.91 95% confidence intervals (CI) 1.51–2.40 P & 0.001 I2 = 0.0%]. Influence analyses further supported this positive association. A positive dose–response relationship was also observed (pooled RR = 1.15 95% CI, 1.03–1.30 per 5 mg/L of CRP). Publication bias was found. However, the association persisted after correction using the trim-and-fill method. No significant association was observed for circulating IL6, TNFα, and soluble TNFR2. Conclusion: This meta-analysis provides evidence that elevated levels of CRP, but not circulating IL6, TNFα, or soluble TNFR2, are significantly associated with an increased risk of ovarian cancer. Impact: These results suggest that circulating CRP may play a role in the etiology of ovarian cancer. Cancer Epidemiol Biomarkers Prev 25(8) 1231–9. ©2016 AACR.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 20-05-1997
DOI: 10.1161/01.CIR.95.10.2374
Abstract: Background Several epidemiological studies have suggested an association of passive smoking with coronary heart disease (CHD). However, few studies have taken account of exposure to passive smoking in the workplace. Additionally, several studies have been unable to control for the full range of potential confounding factors. We examined prospectively the relationship of passive smoking with risk of CHD in a cohort of women. Methods and Results The study was carried out in an ongoing prospective cohort of US female nurses, in whom we assessed exposure to passive smoking at home and at work as well as duration of years spent living with someone who smoked regularly. We studied 32 046 women 36 to 61 years of age in 1982 who had never smoked and were free of diagnosed CHD, stroke, and cancer. During 10 years of follow-up (1982 to 1992), 152 incident cases of CHD (127 nonfatal myocardial infarction and 25 fatal CHD) occurred. Compared with women not exposed to passive smoking, the relative risks of total CHD—adjusted for a broad range of cardiovascular risk factors—were 1.58 (95% CI, 0.93 to 2.68) among those reporting occasional exposure and 1.91 (95% CI, 1.11 to 3.28) among women reporting regular exposure to passive smoking at home or work. There was no relation apparent between duration of living with a smoker and risk of CHD. Conclusions Despite the fact that exposure to passive smoking was assessed by self-report and only at baseline (as well as other limitations), these data suggest that regular exposure to passive smoking at home or work increases the risk of CHD among nonsmoking women.
Publisher: Wiley
Date: 20-12-2008
DOI: 10.1002/IJC.23346
Publisher: Springer Science and Business Media LLC
Date: 1999
Abstract: The consistently observed epidemiologic associations of obesity and physical activity with colorectal cancer and precursor adenoma risk suggest that insulin and glucose control may be contributory. We evaluated the association of glycosylated hemoglobin (HbA1c), a clinical indicator of average glycemia over the previous 2 months, and possibly, indirectly, a marker of average blood insulin level, with colorectal carcinogenesis. Among women in the Nurses' Health Study, who provided blood in 1989-90 and were diagnosed subsequently in 1989-94, we included 79 colorectal cancer cases and 156 matched controls, and 201 distal colorectal adenoma cases and 201 matched controls. HbA1c concentrations in red blood cells were determined blindly by turbidometric immunoinhibition. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from conditional logistic regression models. HbA1c level did not significantly differ between colorectal cancer cases (median 5.5%) and controls (5.5%, p = 0.5), although a small difference between adenoma cases (5.6%) and controls (5.5%, p = 0.06) was noted. Compared to the lowest tertile of HbA1c (median 5.2%), women in the middle (median 5.5%, OR = 1.2, CI = 0.6-2.5) and upper (5.8%, OR = 1.2, CI = 0.6-2.7) tertiles were not at an increased risk for colorectal cancer. A modestly elevated risk of distal colorectal adenoma in the upper (median 5.8%, OR = 1.4, CI = 0.9-2.3) versus lower (median 5.3%) tertile could not be excluded. These associations were not appreciably altered after adjusting for known and suspected colorectal cancer risk factors. Over the range of levels observed in this relatively small s le of middle-aged women, prediagnostic HbA1c does not clearly predict colorectal cancer and adenoma risk.
Publisher: Oxford University Press (OUP)
Date: 14-03-2013
DOI: 10.1093/JNCI/DJT052
Publisher: American Medical Association (AMA)
Date: 03-2014
Publisher: Wiley
Date: 08-09-2010
DOI: 10.1002/IJC.24674
Publisher: Elsevier BV
Date: 07-1992
DOI: 10.1016/0002-9343(92)90674-Z
Abstract: To examine prospectively the association between parity and subsequent incidence of non-insulin-dependent diabetes mellitus (NIDDM). Most previous studies have not controlled for potential confounding by age and obesity. In a prospective cohort study, 113,606 United States registered nurses aged 30 to 55 years and free of diagnosed diabetes, coronary heart disease, stroke, and cancer at baseline were followed for 12 years. Endpoint was incidence of confirmed NIDDM. During 1,278,188 person-years of follow-up, we confirmed 2,310 incident cases of NIDDM. An apparent association between parity and diabetes was observed in unadjusted analyses (relative risk = 1.56 [95% confidence interval (CI), 1.27 to 1.91] among women with six or more births compared with that in nulliparous women) (p, trend less than 0.00001). This association was attenuated after adjustment for age (relative risk = 1.19 [CI 0.97 to 1.48], p, trend = 0.06) and was completely abolished after adjustment for both age and body mass index (relative risk = 0.95 [CI 0.75 to 1.19], p, trend = 0.19). Multivariate adjustment for family history of diabetes, age at first birth, hormone use, and other variables did not materially alter these findings. There was no important modifying effect of family history of diabetes on these associations. Despite a temporary diabetogenic effect of pregnancy, parity is not associated with an increased risk of subsequent clinical NIDDM. These data underscore the importance of control for confounding by age and obesity in evaluating these associations.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Springer Science and Business Media LLC
Date: 11-05-2015
DOI: 10.1038/BMT.2015.106
Publisher: American Medical Association (AMA)
Date: 20-10-1999
Abstract: Although many studies suggest that physical activity may reduce risk of type 2 diabetes, the role of moderate-intensity activity such as walking is not well understood. To examine the relationship of total physical activity and incidence of type 2 diabetes in women and to compare the benefits of walking vs vigorous activity as predictors of subsequent risk of type 2 diabetes. The Nurses' Health Study, a prospective cohort study that included detailed data for physical activity from women surveyed in 11 US states in 1986, with updates in 1988 and 1992. A total of 70,102 female nurses aged 40 to 65 years who did not have diabetes, cardiovascular disease, or cancer at baseline (1986). Risk of type 2 diabetes by quintile of metabolic equivalent task (MET) score, based on time spent per week on each of 8 common physical activities, including walking. During 8 years of follow-up (534, 928 person-years), we documented 1419 incident cases of type 2 diabetes. After adjusting for age, smoking, alcohol use, history of hypertension, history of high cholesterol level, and other covariates, the relative risks (RRs) of developing type 2 diabetes across quintiles of physical activity (least to most) were 1.0, 0.77, 0.75, 0.62, and 0.54 (P for trend <.001) after adjusting for body mass index (BMI), RRs were 1.0, 0.84, 0.87, 0.77, and 0.74 (P for trend = .002). Among women who did not perform vigorous activity, multivariate RRs of type 2 diabetes across quintiles of MET score for walking were 1.0, 0.91,0.73, 0.69, and 0.58 (P for trend <.001). After adjusting for BMI, the trend remained statistically significant (RRs were 1.0, 0.95, 0.80, 0.81, 0.74 P for trend = .01). Faster usual walking pace was independently associated with decreased risk. Equivalent energy expenditures from walking and vigorous activity resulted in comparable magnitudes of risk reduction. Our data suggest that greater physical activity level is associated with substantial reduction in risk of type 2 diabetes, including physical activity of moderate intensity and duration.
Publisher: Elsevier BV
Date: 10-1999
Abstract: Oxidation of lens proteins plays a central role in the formation of age-related cataracts, suggesting that dietary antioxidants may play a role in prevention. However, the relation between specific antioxidants and risk of cataract remains uncertain. Our objective was to examine prospectively the association between carotenoid and vitamin A intakes and cataract extraction in women. A prospective cohort of registered female nurses aged 45-71 y and free of diagnosed cancer was followed in 1980, 50461 were included and others were added as they became 45 y of age for a total of 77466. Information on nutrient intake was assessed by repeated administration of a food-frequency questionnaire during 12 y of follow-up. During 761762 person-years of follow-up, 1471 cataracts were extracted. After age, smoking, and other potential cataract risk factors were controlled for, those with the highest intake of lutein and zeaxanthin had a 22% decreased risk of cataract extraction compared with those in the lowest quintile (relative risk: 0.78 95% CI: 0.63, 0.95 P for trend = 0.04). Other carotenoids (alpha-carotene, beta-carotene, lycopene, and beta-cryptoxanthin), vitamin A, and retinol were not associated with cataract in multivariate analysis. Increasing frequency of intakes of spinach and kale, foods rich in lutein, was associated with a moderate decrease in risk of cataract. Lutein and zeaxanthin and foods rich in these carotenoids may decrease the risk of cataracts severe enough to require extraction.
Publisher: American Academy of Pediatrics (AAP)
Date: 04-2006
Abstract: OBJECTIVE. Family history of skin cancer is an important determinant of skin cancer risk for offspring. No previous study of the effect of personal or family history of skin cancer on the sun protection behaviors of the offspring has been published. METHODS. A retrospective study was conducted of the sun protection behaviors of the adolescent participants in the Growing Up Today Study (GUTS), who were offspring of mothers from the Nurses Health Study II. Adolescents' surveys were matched with their mothers' reports of a personal or family history of skin cancer and compared with adolescents whose mothers did not report a personal or family history of skin cancer. The outcome measures were (1) occurrence of frequent sunburns during the past summer, (2) use of a tanning bed during the past year, and (3) routine use of sunscreen. Frequent sunburns were defined as the report of ≥3 sunburns during the past summer. We compared those who reported having used a tanning bed in the past year at least once with those who reported no tanning bed use in the past year. Routine use of sunscreen was defined as a respondent who replied that he or she “always” or “often” used sunscreen with sun protection factor of 15 or more when he or she was outside for & minutes on a sunny day during the past summer. General estimating equations were used to calculate odds ratios and 95% confidence intervals adjusted for gender, age, color of untanned skin, and number of friends who were tanned. We also conducted an additional analysis restricted to children whose mothers had received a diagnosis of skin cancer in which we assessed sun protection behaviors according to the child's age and mother's age at the time of the mother's diagnosis and the number of years that had passed since the diagnosis of the mother's skin cancer. RESULTS. In 1999, 9943 children reported their sun protection behaviors 8697 of their mothers had not received a diagnosis of skin cancer or reported a family history of melanoma, 463 participants' mothers had received a diagnosis of skin cancer, and 783 participants' mothers reported a family history of melanoma. Between 1989 and 1999, 371 mothers of GUTS participants received a diagnosis of skin cancer: melanoma (n = 44), squamous cell (n = 39), and basal cell cancer(n = 311) 23 mothers received a diagnosis of & type of skin cancer. Because GUTS includes siblings from the same family, the 371 mothers with skin cancer had 463 offspring in GUTS. Offspring of mothers with skin cancer were slightly more likely to report frequent sunburns in the past year compared with those with neither maternal diagnosis nor family history (39% vs 36%). Tanning bed use was not significantly different among those with either a maternal diagnosis of skin cancer or family history of melanoma as compared with nonaffected adolescents (8% vs 9% vs 10%). Sunscreen use among offspring of mothers with skin cancer was higher than among those whose mothers had a family history of melanoma or mothers with no personal history of skin cancer (42% vs 33% vs 34%). Tan-promoting attitudes were also similar across all groups. Only 25% thought that a natural skin color was most attractive, and on average, 25% in each group agreed that it was worth burning to get a tan. Children of mothers who had received a diagnosis & years in the past were less likely to use sunscreen, more likely to sunburn, and more likely to use tanning beds than children of mothers with a more recent diagnosis, although the results did not reach statistical significance. CONCLUSION. Frequent sunburns, suboptimal sunscreen use, and high rates of tanning bed use are commonplace even among the children of health professionals who are at risk for developing skin cancer themselves as a result of personal or family history. With new information on family risk, pediatricians can use the potential of a teachable moment to ensure optimal sun protection for children who are at risk.
Publisher: American Medical Association (AMA)
Date: 06-04-2011
Publisher: Oxford University Press (OUP)
Date: 08-07-2007
Abstract: Folate and vitamin D have been shown to be influenced by ultraviolet (UV) radiation. UVA radiation can break down plasma folate, whereas vitamin D can be synthesized in UVB-exposed skin. Folate metabolism is involved in DNA synthesis and repair, and vitamin D processes anti-proliferative effects. The functions of both nutrients are implicated in skin carcinogenesis. We evaluated genetic polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene (C677T and A1298C) and the vitamin D receptor (VDR) gene (Fok1, Bsm1 and Cdx2) with skin cancer risk in a nested case-control study within the Nurses' Health Study [219 melanoma, 286 squamous cell carcinoma (SCC), 300 basal cell carcinoma (BCC) and 873 controls]. No significant associations were observed for the two MTHFR polymorphisms on skin cancer risk. We observed an interaction between the C677T polymorphism and total folate intake on SCC risk (P, interaction=0.04) the highest risk was observed among women with TT genotype and low folate intake (OR=2.14 95% CI=1.01-4.50). The VDR Bsm1 BB genotype was significantly associated with an increased SCC risk (OR=1.51 95% CI=1.00-2.28). An interaction between the Bsm1 polymorphism and total vitamin D intake on SCC was observed, with the highest risk seen in women with the BB genotype and high vitamin D intake (OR=2.38 95% CI=1.22-4.62) (P, interaction=0.08). This study suggests a possible role of the polymorphisms in MTHFR and VDR interacting with dietary intakes of folate and vitamin D in skin cancer development, especially for SCC. Due to a large number of comparisons and tests, the possible associations should be interpreted with caution and confirmed by other studies.
Publisher: Oxford University Press (OUP)
Date: 26-04-2006
DOI: 10.1093/AJE/KWJ156
Publisher: American College of Physicians
Date: 10-1998
DOI: 10.7326/0003-4819-129-7-199810010-00002
Abstract: High intake of folate may reduce risk for colon cancer, but the dosage and duration relations and the impact of dietary compared with supplementary sources are not well understood. To evaluate the relation between folate intake and incidence of colon cancer. Prospective cohort study. 88,756 women from the Nurses' Health Study who were free of cancer in 1980 and provided updated assessments of diet, including multivitamin supplement use, from 1980 to 1994. 442 women with new cases of colon cancer. Multivariate relative risk (RR) and 95% CIs for colon cancer in relation to energy-adjusted folate intake. Higher energy-adjusted folate intake in 1980 was related to a lower risk for colon cancer (RR, 0.69 [95% CI, 0.52 to 0.93] for intake > 400 microg/d compared with intake < or = 200 microg/d) after controlling for age family history of colorectal cancer aspirin use smoking body mass physical activity and intakes of red meat, alcohol, methionine, and fiber. When intake of vitamins A, C, D, and E and intake of calcium were also controlled for, results were similar. Women who used multivitamins containing folic acid had no benefit with respect to colon cancer after 4 years of use (RR, 1.02) and had only nonsignificant risk reductions after 5 to 9 (RR, 0.83) or 10 to 14 years of use (RR, 0.80). After 15 years of use, however, risk was markedly lower (RR, 0.25 [CI, 0.13 to 0.51]), representing 15 instead of 68 new cases of colon cancer per 10,000 women 55 to 69 years of age. Folate from dietary sources alone was related to a modest reduction in risk for colon cancer, and the benefit of long-term multivitamin use was present across all levels of dietary intakes. Long-term use of multivitamins may substantially reduce risk for colon cancer. This effect may be related to the folic acid contained in multivitamins.
Publisher: Springer Science and Business Media LLC
Date: 17-05-2021
DOI: 10.1186/S12894-021-00845-0
Abstract: To examine one-year trajectories of urinary and sexual outcomes, and correlates of these trajectories, among prostate cancer patients treated by radical prostatectomy (RP). Study participants were recruited from 2011 to 2014 at two US institutions. Self-reported urinary and sexual outcomes were measured at baseline before surgery, and 5 weeks, 6 months and 12 months after surgery, using the modified Expanded Prostate Cancer Index Composite-50 (EPIC-50). Changes in EPIC-50 scores from baseline were categorized as improved (beyond baseline), maintained, or impaired (below baseline), using previously-reported minimum clinically important differences. Of the 426 eligible participants who completed the baseline survey, 395 provided data on at least one EPIC-50 sub-scale at 5 weeks and 12 months, and were analyzed. Although all mean EPIC-50 scores declined markedly 5 weeks after surgery and then recovered to near (incontinence-related outcomes) or below (sexual outcomes) baseline levels by 12 months post-surgery, some men experienced improvement beyond their baseline levels on each sub-scale (3.3–51% depending on the sub-scale). Having benign prostatic hyperplasia (BPH) at baseline (prostate size ≥ 40 g an International Prostate Symptom Index Score ≥ 8 or using BPH medications) was associated with post-surgical improvements in voiding dysfunction-related bother at 5 weeks (OR = 3.9, 95% CI: 2.1–7.2) and 12 months (OR = 3.3, 95% CI: 2.0–5.7) and in sexual bother at 5 weeks (OR = 5.7, 95% CI:1.7–19.3) and 12 months (OR = 3.0, 95% CI: 1.2–7.1). Our findings provide additional support for considering baseline BPH symptoms when selecting the best therapy for early-stage prostate cancer.
Publisher: Oxford University Press (OUP)
Date: 06-07-2004
DOI: 10.1093/JNCI/DJH185
Abstract: Studies in animals have suggested that calcium may reduce the risk of colorectal cancer. However, results from epidemiologic studies of intake of calcium or dairy foods and colorectal cancer risk have been inconclusive. We pooled the primary data from 10 cohort studies in five countries that assessed usual dietary intake by using a validated food frequency questionnaire at baseline. For most studies, follow-up was extended beyond that in the original publication. The studies included 534 536 in iduals, among whom 4992 incident cases of colorectal cancer were diagnosed between 6 and 16 years of follow-up. Pooled multivariable relative risks for categories of milk intake and quintiles of calcium intake and 95% confidence intervals (CIs) were calculated. All statistical tests were two-sided. Milk intake was related to a reduced risk of colorectal cancer. Compared with the lowest category of intake ( or =250 g/day) of milk intake were 0.94 (95% CI = 0.86 to 1.02), 0.88 (95% CI = 0.81 to 0.96), and 0.85 (95% CI = 0.78 to 0.94), respectively (P(trend)<.001). Calcium intake was also inversely related to the risk of colorectal cancer. The relative risk for the highest versus the lowest quintile of intake was 0.86 (95% CI = 0.78 to 0.95 P(trend) =.02) for dietary calcium and 0.78 (95% CI = 0.69 to 0.88 P(trend)<.001) for total calcium (combining dietary and supplemental sources). These results were consistent across studies and sex. The inverse association for milk was limited to cancers of the distal colon (P(trend)<.001) and rectum (P(trend) =.02). Higher consumption of milk and calcium is associated with a lower risk of colorectal cancer.
Publisher: Wiley
Date: 27-06-2002
DOI: 10.1002/IJC.10490
Abstract: A major risk factor for breast cancer is having a first-degree family history of the disease. Benign breast disease (BBD), particularly atypical hyperplasia, is also associated with an increased risk of breast cancer. However, the relationship between family history of breast cancer and BBD is unclear. From 1989 through 1997, 80,995 participants in the Nurses' Health Study II were followed 16,849 reported a first diagnosis of BBD. Pathology slides were reviewed for 1,465 women who reported having a tissue biopsy, and these were classified as nonproliferative BBD, proliferative BBD without atypia or atypical hyperplasia. Women with a family history of breast cancer were more likely to report a physician diagnosis of BBD [rate ratio (RR) = 1.38, 95% confidence interval (CI) 1.29-1.46]. The magnitude of this association declined with age from RR = 1.96 (95% CI 1.55-2.47) at 25-29 years to RR = 1.20 (95% CI 0.95-1.52) at age 45-50 years. Among women with proliferative disease, those with a family history of breast cancer were almost 3 times as likely to have atypia (prevalence odds ratio = 2.72, 95% CI 1.23-5.89) than those with no family history. In conclusion, women with a family history of breast cancer appear to be at increased risk of being diagnosed with BBD, in particular the high-risk types of BBD associated with a greatly increased risk of breast cancer. This link adds weight to the belief that BBD with atypia is a precursor or marker lesion for breast cancer.
Publisher: Wiley
Date: 04-06-2019
DOI: 10.1002/SIM.8153
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2015
Publisher: Oxford University Press (OUP)
Date: 08-1987
Abstract: The reproducibility and validity of self-reported menopausal status were evaluated among the 121,700 female US registered nurses aged 30-55 years in 1976 who are participants in the Nurses' Health Study, a prospective cohort study of diseases in women. When questioned in 1978, 6,591 of the women who were premenopausal in 1976 reported that their menses had ceased and provided their age at menopause. Two years later, in 1980, 98.8 per cent of the 6,591 women again reported that they were postmenopausal and again gave the reasons for menopause (natural or surgical). Among those women who reported surgical menopause during the 1976-1978 follow-up interval, age at menopause was reported to within one year on both the 1978 and 1980 questionnaires by 95 per cent of women. Among those reporting natural menopause during the 1976-1978 period, 82 per cent of women reported their age at menopause to within one year on the two follow-up questionnaires. A random s le of 255 women reporting surgical menopause between 1982 and 1984 was identified and medical records were obtained for 200. For all but two women, there was complete agreement between self-report and medical record for details of hysterectomy and extent of ovarian surgery. The reproducibility of self-reported age at menopause was assessed among 31,405 women who were menopausal in 1976. Reported age at menopause on consecutive questionnaires showed increasing within-person variance with increasing duration since menopause.(ABSTRACT TRUNCATED AT 250 WORDS)
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929331
Abstract: Supplementary Table S3: Hazards ratio for association between baseline risk factors and breast cancer risk among postmenopausal women using Full-VPD only.
Publisher: Oxford University Press (OUP)
Date: 05-1986
DOI: 10.1093/OXFORDJOURNALS.AJE.A114319
Abstract: To assess the validity of self-reported illnesses, medical records were reviewed for participants reporting major illnesses on the biennial follow-up questionnaires used in a prospective cohort study which began in 1976. In over 90% of cases of cancer of the breast, skin, large bowel, and thyroid, histopathology reports confirmed the subjects' self-report. Lower levels of confirmation were obtained for cancers of the lung, ovary, and uterus. Application of strict diagnostic criteria also gave lower levels of confirmation for myocardial infarction (68%) and stroke (66%). Among random s les of women reporting fractures and hypertension all records obtained confirmed self-reports. For self-reported elevated cholesterol levels 85.7% of self-reports were confirmed. Self-report is a valuable epidemiologic tool but may require additional documentation when the disease is diagnostically complex.
Publisher: Cold Spring Harbor Laboratory
Date: 19-02-2020
DOI: 10.1101/2020.02.17.952994
Abstract: With the exponential growth in data collection, multiple time-varying biomarkers are commonly encountered in clinical studies, along with rich set of baseline covariates. This paper is motivated by addressing a critical issue in the field of Alzheimer’s disease (AD) in which we aim to predict the time for AD conversion in people with mild cognitive impairment to inform prevention and early treatment decisions. Conventional joint models of biomarker trajectory with time-to-event data rely heavily on model assumptions and may not be applicable when the number of covariates is large. This thus motivated us to consider a functional ensemble survival tree framework to characterize the joint effects of both functional and baseline covariates in predicting disease progression. The proposed framework incorporates multivariate functional principal component analysis to characterize the changing patterns of multiple time-varying neurocognitive biomarker trajectories and then nest these features within an ensemble survival tree in predicting the progression of AD. We provide a fast implementation of the algorithm that accommodates personalized dynamic prediction that can be updated as new observations are gathered to reflect the patient’s latest prognosis. The algorithm is empirically shown to perform well in simulation studies and is illustrated through the analysis of data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). We provide implementation of our proposed method in R package funest .
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929337
Abstract: Supplementary Table S1: Hazards ratio for association between baseline risk factors and breast cancer risk among postmenopausal women using CC-VPD only.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929334
Abstract: Supplementary Table S2: Hazards ratio for association between baseline risk factors and breast cancer risk among postmenopausal women using MLO-VPD only.
Publisher: Springer Science and Business Media LLC
Date: 2000
Abstract: Infrequent bowel movements and use of laxatives have been hypothesized to increase risk of colorectal neoplasia. However, the few existing epidemiologic studies in humans have been inconclusive. To investigate prospectively the associations of bowel movement frequency and laxative use with the occurrence of adenomatous colorectal polyps in women. A total of 17,400 women 36-61 years of age, without previous diagnosis of cancer or polyps, responded to a mailed questionnaire in 1982 that assessed bowel movement frequency and use of laxatives and had an endoscopy between 1984 and 1996. Between 1984 and 1996, 906 cases of adenomatous polyps (496 classified as small ( or = 1 cm) and 52 unclassified) were documented. Relative risks (RRs) of adenomas and 95% confidence intervals (CIs) were calculated using logistic regression. After controlling for adenoma risk factors, the multivariate RRs associated with having bowel movements every third day or less compared to once daily were 0.9 (95% CI: 0.7-1.2) for total colorectal adenomas, 1.0 (95% CI: 0.7-1.5) for large adenomas and 1.0 (95% CI: 0.7-1.3) for adenomas of the colon only. The multivariate RRs associated with weekly to daily laxative use compared to never use were 0.9 (95% CI: 0.7-1.1) for total colorectal adenomatous polyps, 1.0 (95% CI: 0.7-1.5) for large adenomas and 0.8 (95% CI: 0.6-1.2) for colon adenomatous polyps only. These findings do not support an association between infrequent bowel movement or laxative use and risk of colorectal adenomas.
Publisher: American College of Physicians
Date: 20-04-2004
DOI: 10.7326/0003-4819-140-8-200404200-00007
Abstract: Epidemiologic studies have generally reported positive associations between alcohol consumption and risk for colorectal cancer. However, findings related to specific alcoholic beverages or different anatomic sites in the large bowel have been inconsistent. To examine the relationship of total alcohol intake and intake from specific beverages to the incidence of colorectal cancer and to evaluate whether other potential risk factors modify the association. Pooled analysis of primary data from 8 cohort studies in 5 countries. North America and Europe. 489,979 women and men with no history of cancer other than nonmelanoma skin cancer at baseline. Alcohol intake was assessed in each study at baseline by using a validated food-frequency questionnaire. During a maximum of 6 to 16 years of follow-up across the studies, 4687 cases of colorectal cancer were documented. In categorical analyses, increased risk for colorectal cancer was limited to persons with an alcohol intake of 30 g/d or greater (approximately > or =2 drinks/d), a consumption level reported by 4% of women and 13% of men. Compared with nondrinkers, the pooled multivariate relative risks were 1.16 (95% CI, 0.99 to 1.36) for persons who consumed 30 to less than 45 g/d and 1.41 (CI, 1.16 to 1.72) for those who consumed 45 g/d or greater. No significant heterogeneity by study or sex was observed. The association was evident for cancer of the proximal colon, distal colon, and rectum. No clear difference in relative risks was found among specific alcoholic beverages. The study included only one measure of alcohol consumption at baseline and could not investigate lifetime alcohol consumption, alcohol consumption at younger ages, or changes in alcohol consumption during follow-up. It also could not examine drinking patterns or duration of alcohol use. A single determination of alcohol intake correlated with a modest relative elevation in colorectal cancer rate, mainly at the highest levels of alcohol intake.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2019
DOI: 10.1097/AOG.0000000000003105
Abstract: To estimate the clinical effectiveness, as determined by positive pregnancy test, of letrozole compared with clomiphene citrate for ovarian stimulation in patients with unexplained infertility. We conducted a systematic review and meta-analysis of data from electronic databases including Ovid-MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and ClinicalTrials.gov. We searched for concepts of unexplained infertility, letrozole, clomiphene citrate, and clinical outcomes including pregnancy and live birth. Studies were included if they were randomized controlled trials (RCTs) comparing clomiphene citrate with letrozole in patients with unexplained infertility. Eight RCTs including 2,647 patients with unexplained infertility were included. Primary outcome was positive pregnancy test per patient. Secondary outcomes included positive pregnancy test per cycle, clinical pregnancy, live birth, spontaneous miscarriage, twin gestation, mean serum estradiol (E2), endometrial thickness, and number of dominant follicles. The Cochrane Q test and Higgin's I 2 were used to assess heterogeneity. Random effects models were used to obtain pooled relative risks (RR) and 95% CIs. In analysis per patient, there was no significant difference in positive pregnancy test between patients treated with letrozole compared with clomiphene citrate (24% vs 23%, pooled RR 1.08, 95% CI 0.85–1.36). Significant heterogeneity was noted between studies (I 2 =60.8%). There were no significant differences in clinical pregnancy (pooled RR 1.15, 95% CI 0.71–1.85), live birth (pooled RR 0.94, 95% CI 0.83–1.08), spontaneous miscarriage (pooled RR 0.92, 95% CI 0.61–1.38), or twin gestation (pooled RR 0.81, 95% CI 0.39–1.68). Mean serum E2 was significantly lower in the letrozole group than in the clomiphene citrate group. Although limited by heterogeneity, studies of ovarian stimulation in women with unexplained infertility show no difference in clinical outcomes between letrozole and clomiphene citrate.
Publisher: Oxford University Press (OUP)
Date: 16-11-2006
DOI: 10.1093/AJE/KWK009
Abstract: Dietary carotenoids have been hypothesized to protect against epithelial cancers. The authors analyzed the associations between intakes of specific carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein + zeaxanthin, and lycopene) and risk of colorectal cancer using the primary data from 11 cohort studies carried out in North America and Europe. Carotenoid intakes were estimated from food frequency questionnaires administered at baseline in each study. During 6-20 years of follow-up between 1980 and 2003, 7,885 incident cases of colorectal cancer were diagnosed among 702,647 participants. The authors calculated study-specific multivariate relative risks and then combined them using a random-effects model. In general, intakes of specific carotenoids were not associated with colorectal cancer risk. The pooled multivariate relative risks of colorectal cancer comparing the highest quintile of intake with the lowest ranged from 0.92 for lutein + zeaxanthin to 1.04 for lycopene only for lutein + zeaxanthin intake was the result borderline statistically significant (95% confidence interval: 0.84, 1.00). The associations observed were generally similar across studies, for both sexes, and for colon cancer and rectal cancer. These pooled data did not suggest that carotenoids play an important role in the etiology of colorectal cancer.
Publisher: American Medical Association (AMA)
Date: 17-02-1993
Publisher: Springer Science and Business Media LLC
Date: 11-05-2020
DOI: 10.1186/S13012-020-00994-0
Abstract: There is a continued need to evaluate training programs in dissemination and implementation (D& I) research. Scientific products yielded from trainees are an important and objective measure to understand the capacity growth within the D& I field. This study evaluates our mentored training program in terms of scientific productivity among applicants. Post-doctoral and early-career cancer researchers were recruited and applied to the R25 Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) between 2014 and 2017. Using application details and publicly available bibliometric and funding data, we compared selected fellows with unsuccessful applicants (nonfellows). We extracted Scopus citations and US federal grant funding records for all applicants ( N = 102). Funding and publication abstracts were de-identified and coded for D& I focus and aggregated to the applicant level for analysis. Logistic regression models were explored separately for the odds of (1) a D& I publication and (2) US federal grant funding post year of application among fellows ( N = 55) and nonfellows ( N = 47). Additional models were constructed to include independent variables that attenuated the program’s association by 5% or more. Only US-based applicants ( N = 87) were included in the grant funding analysis. Fellows and nonfellows were similar across several demographic characteristics. Fellows were more than 3 times more likely than nonfellows to have grant funding after MT-DIRC application year (OR 3.2 95% CI 1.1–11.0) while controlling for time since application year the association estimate was 3.1 (95% CI 0.98–11.0) after adjusting for both cancer research area and previous grant funding. For publications, fellows were almost 4 times more likely to publish D& I-focused work adjusting for time (OR 3.8 95% CI 1.7–9.0). This association lessened after adjusting for previous D& I publication and years since undergraduate degree (OR 2.9 95% CI 1.2–7.5). We document the association of a mentored training approach with built-in networks of peers to yield productive D& I researchers. Future evaluation efforts could be expanded to include other forms of longer-term productivity such as policy or practice change as additional objective measures. D& I research trainings in the USA and internationally should consider common evaluation measures.
Publisher: Elsevier BV
Date: 05-2020
Publisher: American Medical Association (AMA)
Date: 26-02-1997
Publisher: American Medical Association (AMA)
Date: 17-02-1993
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929322
Abstract: Supplementary Table S6: Hazards ratio of association among premenopausal women for baseline risk factors and breast cancer risk utilizing FULL-VPD
Publisher: Springer Science and Business Media LLC
Date: 09-08-2016
DOI: 10.1038/NCOMMS12498
Abstract: Resistance to oestrogen-deprivation therapy is common in oestrogen-receptor-positive (ER+) breast cancer. To better understand the contributions of tumour heterogeneity and evolution to resistance, here we perform comprehensive genomic characterization of 22 primary tumours s led before and after 4 months of neoadjuvant aromatase inhibitor (NAI) treatment. Comparing whole-genome sequencing of tumour/normal pairs from the two time points, with coincident tumour RNA sequencing, reveals widespread spatial and temporal heterogeneity, with marked remodelling of the clonal landscape in response to NAI. Two cases have genomic evidence of two independent tumours, most obviously an ER− ‘collision tumour’, which was only detected after NAI treatment of baseline ER+ disease. Many mutations are newly detected or enriched post treatment, including two ligand-binding domain mutations in ESR1 . The observed clonal complexity of the ER+ breast cancer genome suggests that precision medicine approaches based on genomic analysis of a single specimen are likely insufficient to capture all clinically significant information.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929325
Abstract: Supplementary Table S5: Hazards ratio (95% Confidence Interval) for association inure-menopausal women between baseline risk factors and breast cancer risk utilizing MLOL-VPD
Publisher: American Society of Hematology
Date: 13-12-2012
DOI: 10.1182/BLOOD-2012-03-417253
Abstract: Insulin-like growth factor-1 (IGF-1), insulin, and IL-6 are dysregulated in multiple myeloma pathogenesis and may also contribute to multiple myeloma etiology. To examine their etiologic role, we prospectively analyzed concentrations of serologic markers in 493 multiple myeloma cases and 978 controls from 8 cohorts in the Multiple Myeloma Cohort Consortium. We computed odds ratios (ORs) and 95% confidence intervals (CIs) for multiple myeloma per 1-SD increase in biomarker concentration using conditional logistic regression. We examined heterogeneity by time since blood collection (≤ 3, 4- ≤ 6, and 6 years) in stratified models. Fasting IGF binding protein-1 concentration was associated with multiple myeloma risk within 3 years (OR, 95% CI per 1-SD increase: 2.3, 1.4-3.8, P = .001) and soluble IL-6 receptor level was associated within 6 years after blood draw (OR ≤ 3 years, 95% CI, 1.4, 1.1-1.9, P = .01 OR4- ≤ 6 years, 95% CI, 1.4, 1.1-1.7, P = .002). No biomarker was associated with longer-term multiple myeloma risk (ie, 6 years). Interactions with time were statistically significant (IGF binding protein-1, P-heterogeneity = .0016 sIL6R, P-heterogeneity = .016). The time-restricted associations probably reflect the bioactivity of tumor and microenvironment cells in transformation from monoclonal gammopathy of undetermined significance or smoldering multiple myeloma to clinically manifest multiple myeloma.
Publisher: American Medical Association (AMA)
Date: 08-2003
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929328
Abstract: Supplementary Table S4: Hazards ratio (95% Confidence Interval) for association between baseline risk factors and breast cancer risk among pre-menopausal women using CC-VPD only.
Publisher: Springer Science and Business Media LLC
Date: 29-08-2016
Publisher: American Association for Cancer Research (AACR)
Date: 05-2009
DOI: 10.1158/1055-9965.EPI-08-1210
Abstract: Background: Random periareolar fine needle aspiration (RPFNA) is a research technique developed to assess short-term breast cancer risk in women at increased risk of breast cancer. Although there is increasing acceptance of RPFNA, neither the reproducibility nor the inter–institutional compatibility of RPFNA has been established. To address these key limitations, the Cancer and Leukemia Group B (CALGB) Prevention Group tested the reproducibility of RPFNA in a multi-institutional cross-sectional study. Methods: Sixty-three high-risk women from five CALGB institutions (Duke, Ohio State, Roswell Park, Dana Farber, and Vermont) underwent RPFNA from July 1, 2007 to June 30, 2008. Duplicate bilateral RPFNA was performed on each woman by a single investigator on a single day. Masood Cytology Index score was assessed by a single blinded cytopathologist. Results: There was a high degree of statistical agreement in the Masood Cytology Index scores of duplicate RPFNA s les from the same breast, with a Spearman correlation coefficient of 0.8312 (P & 0.0001). Importantly, although there was agreement in duplicate s les from the same breast, there was lack of agreement between duplicate s les from the opposite breast. Conclusions: This multi-institutional study shows that RPFNA is a highly reproducible measure of breast cytology in a cooperative group cross-sectional trial. RPFNA did not show a high degree of agreement between breasts, suggesting that breast cancer risk and progression may occur at different rates in in idual breasts from a single woman. These studies provide proof-of-principle for future RPFNA-based cooperative group prevention studies. (Cancer Epidemiol Biomarkers Prev 2009 (5):1379–85)
Publisher: Elsevier BV
Date: 05-2014
Publisher: Massachusetts Medical Society
Date: 09-09-1999
Publisher: American Medical Association (AMA)
Date: 20-06-1990
Publisher: American College of Physicians
Date: 16-02-1999
DOI: 10.7326/0003-4819-130-4_PART_1-199902160-00005
Abstract: Previous reports have suggested an association between birthweight and type 2 diabetes mellitus. To investigate the association between birthweight and type 2 diabetes in a large cohort of adult women, taking into account potential explanatory factors in childhood and adult life. Cohort study. Birthweight was ascertained at the end of follow-up. The Nurses' Health Study, a cohort of 121,701 U.S. women born from 1921 to 1946 who have been followed since 1976. 69,526 women in the Nurses' Health Study who were free of diabetes at baseline and reported their own birthweight on the 1992 questionnaire. 2123 cases of confirmed type 2 diabetes diagnosed from 1976 to 1992. Low birthweight was associated with increased risk for type 2 diabetes. Age-adjusted relative risks suggested a reverse J-shape association between birthweight and risk for type 2 diabetes. However, after adjustment for adult body mass index and maternal history of diabetes, an inverse association across the entire range of birthweight became apparent compared with the reference group, relative risks by ascending birthweight category were 1.83 (95% CI, 1.55 to 2.16) for birthweight less than 5.0 lb, 1.76 (CI, 1.49 to 2.07) for birthweight 5.0 to 5.5 lb, 1.23 (CI, 1.11 to 1.37) for birthweight 5.6 to 7.0 lb, 0.95 (CI, 0.82 to 1.10) for birthweight 8.6 to 10.0 lb, and 0.83 (CI, 0.63 to 1.07) for birthweight of more than 10 lb (P for trend < 0.001). Adjustment for ethnicity, childhood socioeconomic status, and adult lifestyle factors did not substantially alter this association. The association between birthweight and risk for type 2 diabetes was strongest among women whose mothers had no history of diabetes. Birthweight is inversely associated with risk for type 2 diabetes during adulthood. Examination of prenatal nutrition and other potential in utero determinants of both birthweight and risk for type 2 diabetes may yield new means to prevent type 2 diabetes.
Publisher: American Medical Association (AMA)
Date: 08-2015
Publisher: Oxford University Press (OUP)
Date: 07-1990
DOI: 10.1093/OXFORDJOURNALS.AJE.A115629
Abstract: The relation between lactation and risk of breast cancer was examined in a cohort of 89,413 parous female US registered nurses aged 30-55 years and free from cancer in 1976 who provided information on total duration of lactation in 1986. Between 1976 and 1986, 1,262 cases of breast cancer occurred during 785,958 person-years of follow-up. There was no independent association between lactation and the risk of breast cancer. After adjustment for age and parity, compared with women who had never lactated, the relative risks (and 95% confidence intervals (CI] were 0.95 (95% CI 0.84-1.08) for women with less than 7 months of lactation, 0.87 (95% CI 0.71-1.08) for 7-11 months, 0.94 (95% CI 0.77-1.14) for 12-23 months, and 0.98 (95% CI 0.76-1.28) for greater than or equal to 24 months (test for trend: z = -0.80, p = 0.42). The association did not differ by age or menopausal status. These results do not confirm reports that relatively short durations of lactation reduce the risk of breast cancer among younger women.
Publisher: Wiley
Date: 27-06-2002
DOI: 10.1002/IJC.10473
Abstract: Insulin-like growth factor-1 (IGF-I), a potent mitogen, is hypothesized to influence breast cancer risk. In 3 previous studies, a polymorphism in the IGF-1 gene (sequence repeat length) was associated with plasma IGF-I level. We evaluated prospectively the relationships among a (CA)(n) repeat polymorphism in the IGF-1 gene, IGF-I level and breast cancer risk in a nested case-control study conducted within the Nurses' Health Study. Blood s les were collected in 1989-1990 up to June 1994, we identified 463 cases of breast cancer. One to 2 controls were selected per case, matched by age, menopausal status, postmenopausal hormone use, month and time of day of blood collection and fasting status, for a total of 622 controls. Although no significant trend was observed, plasma IGF-I levels were significantly lower among controls, with no copy of the 19 allele, compared with those homozygous for the 19 (CA)(n) repeat length (146 and 173 ng/ml, respectively p-value for pairwise mean comparison = 0.005). In conditional logistic regression, controlling for established breast cancer risk factors, we observed no significant association between (CA)(n) repeat length genotype and risk of breast cancer [compared with repeat genotype 19/19-18/19 genotype relative risk (RR) = 0.96, 95% confidence interval (CI) = 0.56-1.64 18/20 genotype RR = 0.92, 95% CI = 0.39-2.19 19/20 genotype RR = 1.16, 95% CI = 0.82-1.64 19/21 genotype RR = 0.69, 95% CI = 0.42-1.14 20/20 genotype RR = 0.55, 95% CI = 0.28-1.10 20/21 genotype RR = 0.72, 95% CI = 0.29-1.79]. Results did not vary substantially when evaluated according to menopausal status, tumor receptor status or category of other breast cancer risk factors. Although a modest association cannot be excluded, our data do not support an important relation between this IGF-1 gene polymorphism and breast cancer risk.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929355
Abstract: Supplementary Figure S2: Pearson correlation between our algorithm and Volpara shows strong positive linear relationship of 0.81.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929352
Abstract: Supplementary Figure S3: Pearson correlation separated by view and case control status.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929358
Abstract: Supplementary Figure S1: Cohort recruit and follow up chart.
Publisher: Springer Science and Business Media LLC
Date: 04-2013
DOI: 10.1007/S10549-013-2500-7
Abstract: While debate continues regarding short-term changes in breast cancer incidence and the impact of screening on mortality, a long-term view of trends in incidence and mortality may better inform our understanding of the changing patterns of disease and ultimately guide in population-based prevention. Although many factors have influenced breast cancer incidence over the past seven decades, some have played more prominent roles at various times. Changing reproductive patterns, greater longevity, and post-menopausal hormone (estrogen + progesterone) were important in the steady increase before 1980, while mammographic screening, probably in conjunction with escalating combined estrogen + progesterone use, played dominant roles in the post-1980 surge. Accruing evidence also indicates that the rapid drop in 2003 was mostly due to a sharp decline in estrogen + progesterone use. The most paradoxical observation relates to the ergence in incidence and mortality trends most noticeable when mortality rates started to decline shortly after the surge in incidence rates started in 1980. In addition to the dynamic changes in risk factor profiles, the ergence reflects wider uptake of screening mammography, better characterization of tumor biology, and improvements in treatment. The rise in incidence rates over the past three decades is due to an increase in estrogen receptor positive (ER+) tumors, which respond favorably to treatment. On the other hand, the incidence of estrogen receptor negative (ER-) tumors, which respond poorly to hormonal therapy, has been decreasing for almost three decades. Furthermore, widespread adoption of screening mammography has led to tumors being diagnosed at earlier stages when treatment is effective and advances in treatment have ensured adoption of targeted and better tolerated therapies. To achieve long-term success in the primary prevention of breast cancer, a greater understanding of factors responsible for the decrease in ER- tumors is essential. In addition, improving the sensitivity of breast cancer screening to facilitate earlier detection of tumors with very aggressive phenotypes would go a long way in bridging the ergence between incidence and mortality.
Publisher: Springer Science and Business Media LLC
Date: 11-2005
DOI: 10.1007/S10552-005-0349-8
Abstract: We prospectively investigated the independent association of hypertension, thiazide use, body mass index, weight change, and smoking with the risk of renal cell carcinoma among men and women using biennial mailed questionnaires. The study population included 118,191 women participating in the Nurses' Health Study and 48,953 men participating in the Health Professionals Follow-up Study. During 24 years of follow-up for women and 12 years for men, 155 and 110 incident cases of renal cell carcinoma were confirmed, respectively. In multivariate models including age, body mass index (BMI), smoking and hypertension, higher BMI was confirmed as a risk factor for women and smoking as a risk factor for men and women. After adjusting for age, updated BMI and smoking, an updated diagnosis of hypertension was associated with renal cell carcinoma (RCC) the relative risk (RR) was 1.9 (95% CI 1.4-2.7) for women and 1.8 (95% CI 1.2-2.7) for men. Based on limited data regarding the use of thiazide diuretics, we did not observe a risk associated with their use, independent of the diagnosis of hypertension. Diagnosis of hypertension, higher BMI, and increasing pack-years of smoking appear to independently increase the risk of renal cell carcinoma.
Publisher: Oxford University Press (OUP)
Date: 07-1990
DOI: 10.1093/OXFORDJOURNALS.AJE.A115623
Abstract: To assess the validity of the selenium concentration in human toenails as a measure of selenium intake and to determine other correlates of toenail selenium level, the authors examined the predictors of toenail selenium within two subgroups of a large cohort study of US women. Mean toenail selenium was higher among 38 consumers of selenium supplements (0.904 micrograms/g, standard deviation (SD) 0.217) than among 96 nonusers (0.748 micrograms/g, SD 0.149 p less than 0.001), and a dose-response relation was observed among supplement users (Spearman's r = 0.32 p = 0.05). In a second subgroup of 677 women, selenium supplement use was also associated with higher mean toenail selenium (0.906 micrograms/g, SD 0.214, among 18 users and 0.801 micrograms/g, SD 0.148, among 659 nonusers p = 0.02), and the dose-response relation was also significant (Spearman's r = 0.50 p = 0.03). The geographic variation in toenail selenium levels was consistent with the geographic distribution of selenium in forage crops. Toenail selenium declined with age and was significantly reduced among cigarette smokers (mean = 0.746, SD 0.124, among 146 current smokers and mean = 0.817, SD 0.159, among 311 never smokers p less than 0.001) but was not materially affected by alcohol consumption. A dietary selenium score calculated from a food frequency questionnaire failed to predict toenail selenium level, demonstrating the suspected inability of diet questionnaires to measure in idual selenium intake because of the highly variable selenium composition of different s les of the same food.(ABSTRACT TRUNCATED AT 250 WORDS)
Publisher: Elsevier BV
Date: 03-2020
Publisher: Cold Spring Harbor Laboratory
Date: 11-11-2021
DOI: 10.1101/2021.11.10.21266200
Abstract: This systematic review aimed to assess methods used to relate repeated mammographic images to breast cancer risk, including the time from mammogram to diagnosis of breast cancer, and methods for analysis of data from either one or both breasts (averaged or assessed in idually). A systematic review was performed. The databases including Medline (Ovid) 1946-, Embase.com 1947-, CINAHL Plus 1937-, Scopus 1823-, Cochrane Library (including CENTRAL), and Clinicaltrials.gov were searched through October 2021 to extract published articles in English describing the relationship of change in mammographic features with risk of breast cancer. Women with mammogram images. Breast cancer incidence. Twenty articles were included in the final review. We found that BIRADs and Cumulus were most commonly used for classifying mammographic density and automated assessment was used on more recent digital mammograms. Time between mammograms varied from 1 to median of 4.1 years, and only 9 of the studies used more than 2 mammograms to quantify features. One study used a prediction horizon of 5 and 10 years, one used 5 years only and another 10 years only, while in the others the prediction horizon was not clearly defined with investigators using the next screening mammogram. This review provided an updated overview of the state of the art and revealed research gaps based on these, we provide recommendations for future studies using repeated measure methods for mammogram images to make the use of accumulating image data. By following these recommendations, we expect to improve risk classification and risk prediction for women to tailor screening and prevention strategies to level of risk. To the best of our knowledge, this is the most recent systematic review on the topic of using multiple mammogram images to define risk of breast cancer. This review was performed strictly following systematic review guidelines including a medical librarian with expertise in searching, multiple independent reviewers involved in study selection and data extraction, and reporting following PRISMA 2020 guidelines. Due to heterogeneity of methods for assessment and classification (categorical and continuous) of mammographic features including breast density and time to breast cancer, we did not perform risk of bias or conduct a meta-analysis. Few studies looked at repeated measures of non-density features.
Publisher: Elsevier BV
Date: 02-2020
Publisher: American Medical Association (AMA)
Date: 10-1997
Publisher: Springer Science and Business Media LLC
Date: 12-03-2018
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929340
Abstract: Supplementary Figure S7: The proportional hazards assumption is deemed reasonable by checking the Schoenfeld residuals plot for Full-VPD.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929343
Abstract: Supplementary Figure S6: The proportional hazards assumption is deemed reasonable by checking the Schoenfeld residuals plot for MLO-VPD.
Publisher: Springer Science and Business Media LLC
Date: 07-2007
DOI: 10.1038/NCPONC0851
Abstract: It is increasingly being recognized that breast cancer does not represent a single homogeneous disease instead, the hormone-receptor status defines important clinical and etiologic differences. We review the epidemiologic data on differences in risk-factor associations by hormone-receptor status and highlight major trends in the literature. We discuss the development and evaluation of breast cancer risk models, with a focus on the Rosner and Colditz model, which can separately estimate the risk of hormone-receptor-positive and hormone-receptor-negative breast cancers. We also discuss the clinical implications of accounting for hormone-receptor status in breast cancer risk-prediction models.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 10-2020
DOI: 10.1200/JOP.19.00639
Abstract: Multiple myeloma (MM) treatment has changed tremendously, with significant improvement in patient out-comes. One group with a suboptimal benefit is patients with high-risk cytogenetics, as tested by conventional karyotyping or fluorescence in situ hybridization (FISH). Methodology for these tests has been published, but not necessarily standardized. We address variability in the testing and reporting methodology for MM cytogenetics in the United States using the ongoing African American Multiple Myeloma Study (AAMMS). We evaluated clinical and cytogenetic data from 1,221 patients (1,161 with conventional karyotyping and 976 with FISH) tested between 1998 and 2016 across 58 laboratories nationwide. Interlab and intralab variability was noted for the number of cells analyzed for karyotyping, with a significantly higher number of cells analyzed in patients in whom cytogenetics were normal (P 5.0025). For FISH testing, CD138-positive cell enrichment was used in 29.7% of patients and no enrichment in 50% of patients, whereas the remainder had unknown status. A significantly smaller number of cells was analyzed for patients in which CD138 cell enrichment was used compared with those without such enrichment (median, 50 v 200 P, .0001). A median of 7 loci probes (range, 1-16) were used for FISH testing across all laboratories, with variability in the loci probed even within a given laboratory. Chromosome 13–related abnormalities were the most frequently tested abnormality (n5956 97.9%), and t(14 ) was the least frequently tested abnormality (n 5 119 12.2%). We report significant variability in cytogenetic testing across the United States for MM, potentially leading to variability in risk stratification, with possible clinical implications and personalized treatment approaches.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929346
Abstract: Supplementary Figure S5: The proportional hazards assumption is deemed reasonable by checking the Schoenfeld residuals plot for CC-VPD.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
DOI: 10.1097/AOG.0000000000002249
Abstract: To estimate the association of implementation of evidence-based bundles with surgical site infection rates after cesarean delivery. We searched MEDLINE through PubMed, EMBASE, Scopus, the Cochrane Database of Systematic Reviews, Google Scholar, and ClinicalTrials.gov. We searched electronic databases for randomized controlled trials and observational studies comparing evidence-based infection prevention bundles for cesarean delivery, defined as implementation of three or more processes proven to prevent surgical site infection such as chlorhexidine skin preparation, antibiotic prophylaxis, and hair clipping, with usual care. The primary outcome was overall surgical site infection, defined using Centers for Disease Control and Prevention's National Healthcare Safety Network criteria. Secondary outcomes were superficial or deep surgical site infection and endometritis. Quality of studies and heterogeneity were assessed using validated measures. Pooled relative risks (RRs) with 95% CIs were calculated using random-effects models. Numbers needed to treat were estimated for outcomes with significant reduction. We found no randomized controlled trials. Fourteen preintervention and postintervention studies met inclusion criteria. Eight were full-text articles, and six were published abstracts. Quality of most of the primary studies was adequate with regard to the intervention, but modest in terms of implementation. The rate of surgical site infection was significantly lower after implementing an evidence-based bundle (14 studies: pooled rates 6.2% baseline compared with 2.0% intervention, pooled RR 0.33, 95% CI 0.25–0.43, number needed to treat=24). Evidence-based bundles were also associated with a lower rate of superficial or deep surgical site infection (six studies: pooled rate 5.9% baseline compared with 1.1% intervention, pooled RR 0.19, 95% CI 0.12–0.32, number needed to treat=21). The rate of endometritis was low at baseline and not significantly different after intervention (six studies: pooled rate 1.3% baseline compared with 0.9% intervention, pooled RR 0.57, 95% CI 0.31–1.06). Evidence-based bundles are associated with a significant reduction in surgical site infection after cesarean delivery.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929349
Abstract: Supplementary Figure S4: The linearity assumption is checked with Martingale residual plots.
Publisher: American Association for Cancer Research (AACR)
Date: 15-07-2016
DOI: 10.1158/1538-7445.AM2016-2600
Abstract: Background: Risk prediction models have important public health implications for targeted disease prevention by identifying women at higher risk who would most likely benefit from screening, chemoprevention, or other risk-reducing regimens. Among such models, the Gail and Rosner-Colditz models have been well validated and used to identify high-risk women. Each of these models generally includes only traditional breast cancer risk factors (e.g., parity and family history of breast cancer). No prior study has examined the joint contribution of a genetic risk score (GRS), mammographic density (MD), and postmenopausal endogenous hormone levels to these models. Method: We conducted a nested-case control study within the Nurses’ Health Study (NHS, follow-up 1990-2010) and NHS II (1997-2009). We created a breast cancer GRS based on 67 single-nucleotide polymorphism (SNPs). We measured percent MD as well as circulating testosterone, estrone sulfate, and prolactin levels in prediagnostic plasma s les. Using receiver-operating-characteristic curve analyses, we calculated the area under the curve (AUC), adjusting for age, as a measure of discrimination for the 5-year risk of invasive breast cancer and estrogen receptor (ER) and progesterone receptor (PR) positive disease (ER+PR+) by menopausal status, after adding GRS, MD, and/or circulating hormones to the modified Gail and Rosner-Colditz models. Results: We documented 11,880 women (4,006 cases/7,874 controls age range: 34-80 yr) for Gail model and 8,210 women (2,665 cases/5,455 controls) for Rosner-Colditz model analyses. In both models, about 45% women were premenopausal, 25% were postmenopausal women not using postmenopausal hormone (HT), and 30% were postmenopausal women using HT at blood draw. The AUC was statistically significantly improved by 7.0 units in premenopausal women (Gail+GRS+MD), 11.8 units in postmenopausal women not using HT (Gail+GRS+MD+hormones), and 6.1 units in postmenopausal women using HT (Gail+GRS+MD+prolactin, all p-value& .001). For the Rosner-Colditz model, the corresponding AUC improved by 5.4 units, 7.9 units, and 5.4 units (all p-value& .001). For ER+PR+ tumors specifically, among postmenopausal women not using HT, the AUC was improved by 13.2 units for the Gail model and 9.9 units for the Rosner-Colditz model (all p-values& .001). Conclusion: While each of genetic markers, percent MD, and hormones independently improved risk prediction for invasive breast cancer and ER+PR+ disease, incorporating all of these factors simultaneously improved models the most, especially among postmenopausal women not using HT. If validated in independent populations, our findings could help identify women at a higher risk, who would most benefit from chemoprevention, other risk-reducing regimens or screening. Citation Format: Xuehong Zhang, Megan Rice, Shelley S. Tworoger, Bernard A. Rosner, A. Heather Eliassen, Rulla M. Tamimi, Jing Qian, Graham A. Colditz, Walter C. Willett, Susan E. Hankinson. Improving breast cancer risk prediction models: the addition of a genetic risk score, mammographic density, and endogenous hormones. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research 2016 Apr 16-20 New Orleans, LA. Philadelphia (PA): AACR Cancer Res 2016 (14 Suppl):Abstract nr 2600.
Publisher: Springer Science and Business Media LLC
Date: 23-04-2013
Publisher: Elsevier BV
Date: 03-1992
Abstract: Although obesity is a well-recognized risk factor for gallstones, the excess risks associated with higher levels of obesity and recent weight change are poorly quantified. We evaluated these issues in the Nurses' Health Study. Among 90,302 women aged 34-59 y at baseline followed from 1980 to 1988, 2122 cases of newly diagnosed symptomatic gallstones occurred during 607,104 person-years of follow-up. From 1980 to 1986, 488 cases of newly diagnosed unremoved gallstones were documented. We observed a striking monotonic increase in gallstone disease risk with obesity women with a body mass index (BMI) greater than 45 kg/m2 had a sevenfold excess risk compared with those whose BMI was less than 24 kg/m2. Women with a BMI greater than 30 kg/m2 had a yearly gallstone incidence of greater than 1% and those with a BMI greater than or equal to 45 kg/m2 had a rate of approximately 2%/y. Recent weight loss was associated with a modestly increased risk after adjustment for BMI before weight loss. Current smoking was an independent risk factor women smoking greater than or equal to 35 cigarettes/d had a relative risk of 1.5 (95% CI 1.2-1.9).
Publisher: Wiley
Date: 07-2018
Publisher: Wiley
Date: 2004
DOI: 10.1002/CNCR.20499
Abstract: Observational studies and randomized trials have demonstrated that hormone replacement therapy (HRT) increases the recipient's risk of developing breast carcinoma. Because it is known that some breast malignancies are hormonally responsive and that others are not, it has been hypothesized that HRT may be associated with the development of estrogen receptor (ER)-positive rogesterone receptor (PR)-positive breast carcinoma more so than with the development of ER-negative/PR-negative breast carcinoma. The Nurses' Health Study is a prospective cohort study that enrolled 121,700 female registered nurses ages 30-55 years in 1976. In the current study, the authors analyzed 2548 malignancies that developed among eligible postmenopausal women in that cohort between 1980 and 2000 and for which data on ER and PR status were available. Compared with women who had never used HRT, current long-term users of HRT were more likely to develop ER-positive/PR-positive breast carcinoma (multivariate risk ratio [RR], 1.80 95% confidence interval [CI], 1.52-2.12) but were not any more likely to develop ER-negative/PR-negative disease (multivariate RR, 1.00 95% CI, 0.72-1.39). This effect grew stronger with increasing duration of current HRT use and was also more pronounced among women with body mass index < 25 kg/m2. Furthermore, the association between HRT use and ER-positive/PR-positive disease was stronger among patients receiving combined HRT (CHRT) regimens, which included estrogen and progesterone, than among users of estrogen alone (ERT). In addition, tumors tended to develop more quickly in current users of CHRT than in ERT users. The finding that current users of HRT were more likely to develop ER-positive/PR-positive tumors than they were to develop ER-negative/PR-negative ones suggests that both endogenous and exogenous hormonal factors may influence breast tumor characteristics. In analyses of the effects of hormonal factors on breast tumor development, ER-positive/PR-positive tumors and ER-negative/PR-negative tumors should be considered separately from each other.
Publisher: Wiley
Date: 17-11-2020
DOI: 10.1002/CNCR.33330
Publisher: Annual Reviews
Date: 21-04-2012
DOI: 10.1146/ANNUREV-PUBLHEALTH-031811-124627
Abstract: Whereas models of cancer disparities and variation in cancer burden within population groups now specify multiple levels of action from biologic processes to in idual risk factors and social and physical contextual factors, approaches to estimating the preventable proportion of cancer use more traditional direct models often from single exposures to cancer at specific organ sites. These approaches are reviewed, and the strengths and limitations are presented. The need for additional multilevel data and approaches to estimation of preventability are identified. International or regional variation in cancer may offer the most integrated exposure assessment over the life course. For the four leading cancers, which account for 50% of incidence and mortality, biologic, social, and physical environments play differing roles in etiology and potential prevention. Better understanding of the interactions and contributions across these levels will help refine prevention strategies.
Publisher: Oxford University Press (OUP)
Date: 06-2004
DOI: 10.1093/JNCI/DJH143
Abstract: Recent case-control studies suggest that, given equal smoking exposure, women may have a higher relative risk of developing lung cancer than men. Despite prospective data that conflict with this hypothesis, mechanistic studies to find a biologic basis for a sex difference continue. We addressed the hypothesis directly by analyzing prospective data from former and current smokers in two large cohorts--the Nurses' Health Study of women and the Health Professionals Follow-up Study of men. We calculated incidence rates and hazard ratios of lung cancer in women compared with men, adjusting for age, number of cigarettes smoked per day, age at start of smoking, and time since quitting, using Cox proportional hazards models. We also reviewed published results from prospective analyses. From 1986 through 2000, 955 and 311 primary lung cancers were identified among 60 296 women and 25 397 men, respectively, who ranged in age from 40 to 79 years. Incidence rates per 100 000 person-years for women and men were 253 and 232, respectively, among current smokers and 81 and 73, respectively, among former smokers. The hazard ratio in women ever smokers compared with men was 1.11 (95% confidence interval = 0.95 to 1.31). Six published prospective cohort studies allowed assessment of comparative susceptibility to lung cancer by sex. None supported an excess risk of lung cancer for women. Women do not appear to have a greater susceptibility to lung cancer than men, given equal smoking exposure. Research should be focused on enhancing preventive interventions for all.
Publisher: American Medical Association (AMA)
Date: 08-09-2008
Publisher: Wiley
Date: 11-11-2005
DOI: 10.1002/IJC.21582
Abstract: Tubal sterilization methods may damage surrounding tissue, potentially disrupting the ovarian blood supply and hormonal functioning, and may decrease breast cancer risk. We examined this hypothesis, within the Nurses' Health Study, among 77,511 women, aged 30-55 years and free of cancer at the start of follow-up in 1976. We documented 4,176 cases of invasive breast cancer from 1976 to 2000. Cox proportional hazards models, adjusting for multiple breast cancer risk factors, provided rate ratios (RR) and 95% confidence intervals (CI). Overall, tubal sterilization was not associated with breast cancer risk (RR=0.95, 95% CI=0.88-1.03). However, tubal sterilizations performed from 1970 to 1974 were inversely associated with risk (RR=0.84, 95% CI=0.73-0.97), while procedures performed in other years were not associated with risk. Among women with procedures performed in 1970-1974, those who were >or=35 years old at the time of sterilization were at the lowest risk (RR=0.81, 95% CI=0.66-0.98), while younger women had a suggested decreased risk (RR=0.87, 95% CI=0.72-1.06). Overall, tubal sterilization was not associated with breast cancer risk. However, a modest inverse association was observed at a time when the potentially destructive unipolar electrocautery method was commonly used, providing some support for an association between lower lifetime exposure to hormones and a decreased risk of breast cancer.
Publisher: American Medical Association (AMA)
Date: 27-04-1994
Publisher: Oxford University Press (OUP)
Date: 1994
DOI: 10.1093/OXFORDJOURNALS.AJE.A116931
Abstract: A high intake of calcium, vitamin D, or specific dairy products is thought to reduce the incidence of colorectal cancer. The association of these nutrients and foods with the occurrence of colorectal adenomas, precursors of cancer, was studied in two large US cohort studies. Cases were patients with a diagnosis of adenomatous polyps of the left colon or rectum (331 men, 1986-1990 350 women, 1980-1988), and controls were persons with endoscopic findings negative for adenoma (9,159 men and 8,585 women). After adjustment for age, total energy, family history of colorectal cancer, body mass index, alcohol consumption, folate, intake of saturated fat and fiber, indications for endoscopy, and previous endoscopy, total calcium intake was not associated with the risk for adenoma (relative risk (RR), highest vs. lowest quintile of intake: men, 1.13, 95% confidence interval (CI) 0.76-1.66 women, 1.17, 95% CI 0.81-1.69). Total vitamin D intake was unrelated to the risk for adenoma in men (RR = 1.29, 95% CI 0.87-1.93). An inverse nonsignificant association was observed in women in the 1980-1988 analyses (RR = 0.68, 95% CI 0.41-1.13, trend p = 0.09), mainly attributable to the intake of multivitamin supplements, but an analysis of 4-year data (1984-1988) using a more detailed dietary assessment showed no association with vitamin D (RR = 1.04, 95% CI 0.65-1.67). Milk consumption and intake of total fermented dairy products were not related to adenoma risk. In conclusion, the occurrence of colorectal adenoma was neither related to calcium intake nor to milk consumption, whereas vitamin D from supplements but not diet was slightly, but not significantly, inversely associated with risk among women only.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2002
DOI: 10.1097/00001648-200203000-00013
Abstract: Few studies have examined whether activity and adiposity levels typical of American women affect their risk of ovulatory disorder infertility, and none has examined moderate and vigorous intensity exercise separately. We investigated these associations in the Nurses' Health Study II, comparing prospectively collected data on adiposity and activity for 830 cases of incident ovulatory infertility and 26,125 pregnancies. We observed a U-shaped association between body mass index (BMI) and relative risk of ovulatory infertility, with increased risk for BMI below 20.0 or above 24.0 kg/m2. On the basis of the BMI distribution of U.S. women, these findings suggest that 12% (95% confidence interval = 7-20%) of ovulatory infertility in the U.S. may be attributable to underweight (BMI or = 25.0). An increase in vigorous activity (but not moderate activity) was associated with reduced relative risk of ovulatory infertility. Each hour per week of vigorous activity was associated with a 7% (95% CI = 4-10%) lower relative risk of ovulatory infertility. After adjustment for BMI, a 5% (95% CI = 2-8%) reduction in relative risk per hour of weekly activity remained. These data suggest that, among American women, more ovulatory infertility is attributable to overweight and a sedentary lifestyle than to underweight and overexertion.
Publisher: American Public Health Association
Date: 10-1999
Abstract: OBJECTIVES: This study estimated the lifetime health and economic benefits of sustained modest weight loss among obese persons. METHODS: We developed a dynamic model of the relationship between body mass index (BMI) and the risks and costs of 5 obesity-related diseases: hypertension, hypercholesterolemia, type 2 diabetes, coronary heart disease (CHD), and stroke. We then calculated the lifetime health and economic benefits of a sustained 10% reduction in body weight for men and women aged 35 to 64 years with mild, moderate, and severe obesity. RESULTS: Depending on age, gender, and initial BMI, a sustained 10% weight loss would (1) reduce the expected number of years of life with hypertension, hypercholesterolemia, and type 2 diabetes by 1.2 to 2.9, 0.3 to 0.8, and 0.5 to 1.7, respectively (2) reduce the expected lifetime incidence of CHD and stroke by 12 to 38 cases per 1000 and 1 to 13 cases per 1000, respectively (3) increase life expectancy by 2 to 7 months and (4) reduce expected lifetime medical care costs of these 5 diseases by $2200 to $5300. CONCLUSIONS: Sustained modest weight loss among obese persons would yield substantial health and economic benefits.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516030.V1
Abstract: Supplementary Table 7 shows the association between composite sleep score and EAC risk by BMI group
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929328.V1
Abstract: Supplementary Table S4: Hazards ratio (95% Confidence Interval) for association between baseline risk factors and breast cancer risk among pre-menopausal women using CC-VPD only.
Publisher: Springer Science and Business Media LLC
Date: 30-10-2014
Publisher: The Endocrine Society
Date: 11-1994
DOI: 10.1210/JC.79.5.1310
Publisher: Elsevier BV
Date: 04-2006
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-01-2016
DOI: 10.1200/JCO.2016.34.3_SUPPL.181
Abstract: 181 Background: In 2014, an ASPO position statement was released calling for action regarding cancer survivors’ needs for weight management. Reduction of body weight is hypothesized to affect several cancer-related biological pathways. Methods: The Exercise and Nutrition to Enhance Recovery and Good health for You (ENERGY) trial is the largest weight loss trial completed to date among breast cancer survivors. In it, 692 stage Ic-IIIc breast cancer survivors were randomized to an intensive, group-based weight loss intervention with 26 contacts over one year or to a non-intensive intervention with two contacts over the same time period. Results recently reported in JCO showed significantly greater weight loss in the intensive intervention arm compared to the non-intensive arm. A pilot study exploring baseline to 6-month changes in gene methylation and expressed biomarkers was undertaken in 30 chemo-naïve, post-menopausal, non-Hispanic white women who participated in this study. Results: Several significant differences in mean change scores (standard error) between the intensive vs. non-intensive groups were noted, i.e., insulin: -4.19(0.80) vs. 0.42 (1.01) = 0.0016 c-peptide: -0.49(0.14) vs. 0.40(0.19) = 0.0009 leptin: -15.73(1.79) vs. 2.53(1.78) 0.0001 adiponectin:leptin ratio: 0.67(0.15) vs. 0.010(0.064) = 0.0007 homeostasis model of insulin resistance (HOMA-IR): 20.00(4.65) vs. 9.57(5.00) = 0.0003 sex hormone binding globulin 20.45(4.61) vs. 8.65(8.00) = 0.023 and Follistatin-Related Protein-3 (FSTL3): 0.48(0.19) vs. -0.88(0.55) = 0.0497. While effects were in the direction hypothesized for c-reactive protein, interleukin-6, vascular endothelial growth factor, and tumor necrosis factor no significant differences were noted. Significant differences in DNA methylation also were noted for genes encoding for Follistatin Related Protein (corresponds to FSTL3), and those on hormonal/growth pathways (e.g., AMOTL1, ESR, EGR3), inflammatory pathways (e.g., TNFRS10A/TRAIL-R1, C14orf106), and metabolic pathways (e.g., ZBED3, GABRA). Conclusions: While results are based on a small s le and not corrected for multiple testing, they provide evidence that weight loss affects several biomarkers and pathways that impact cancer and which warrant further investigation. Clinical trial information: NCT01112839.
Publisher: Mary Ann Liebert Inc
Date: 05-2020
Publisher: American Medical Association (AMA)
Date: 10-03-1999
Abstract: High intakes of fat and specific fatty acids, including total, animal, saturated, polyunsaturated, and trans-unsaturated fats, have been postulated to increase breast cancer risk. To determine whether intakes of fat and fatty acids are associated with breast cancer. Cohort study (Nurses' Health Study) conducted in the United States beginning in 1976. A total of 88795 women free of cancer in 1980 and followed up for 14 years. Relative risk (RR) of invasive breast cancer for an incremental increase of fat intake, ascertained by food frequency questionnaire in 1980, 1984, 1986, and 1990. A total of 2956 women were diagnosed as having breast cancer. Compared with women obtaining 30.1% to 35% of energy from fat, women consuming 20% or less had a multivariate RR of breast cancer of 1.15 (95% confidence interval [CI], 0.73-1.80). In multivariate models, the RR (95% CI) for a 5%-of-energy increase was 0.97 (0.94-1.00) for total fat, 0.98 (0.96-1.01) for animal fat, 0.97 (0.93-1.02) for vegetable fat, 0.94 (0.88-1.01) for saturated fat, 0.91 (0.79-1.04) for polyunsaturated fat, and 0.94 (0.88-1.00) for monounsaturated fat. For a 1% increase in energy from trans-unsaturated fat, the values were 0.92 (0.86-0.98), and for a 0.1% increase in energy from omega-3 fat from fish, the values were 1.09 (1.03-1.16). In a model including fat, protein, and energy, the RR for a 5% increase in total fat, which can be interpreted as the risk of substituting this amount of fat for an equal amount of energy from carbohydrate, was 0.96 (95% CI, 0.93-0.99). In similar models, no significant association of risk was evident with any major types of fat. We found no evidence that lower intake of total fat or specific major types of fat was associated with a decreased risk of breast cancer.
Publisher: Elsevier BV
Date: 11-2000
Abstract: Little is known about the overall health effects of adherence to the Dietary Guidelines for Americans. The healthy eating index (HEI), developed at the US Department of Agriculture, measures how well Americans' diets conform to these guidelines. We tested whether the HEI (scores range from 0 to 100 100 is best) calculated from food-frequency questionnaires (HEI-f) would predict risk of major chronic disease in women. A total of 67272 US female nurses who were free of major disease completed detailed questionnaires on diet and chronic disease risk factors in 1984 and repeatedly over 12 y. Major chronic disease was defined as fatal or nonfatal cardiovascular disease (myocardial infarction or stroke, n = 1365), fatal or nonfatal cancer (n = 5216), or other nontraumatic deaths (n = 496), whichever came first. We also examined cardiovascular disease and cancer as separate outcomes. After adjustment for smoking and other risk factors, the HEI-f score was not associated with risk of overall major chronic disease in women [relative risk (RR) = 0.97 95% CI: 0.89, 1.06 comparing the highest with the lowest quintile of HEI-f score]. Being in the highest HEI-f quintile was associated with a 14% reduction in cardiovascular disease risk (RR = 0.86 95% CI: 0.72, 1. 03) and was not associated with lower cancer risk (RR = 1.02 95% CI: 0.93, 1.12). These data suggest that adherence to the 1995 Dietary Guidelines for Americans, as measured by the HEI-f, will have limited benefit in preventing major chronic disease in women.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2002
DOI: 10.1097/00001648-200203000-00007
Abstract: The role of active and passive smoking in breast cancer remains controversial. Using data collected in the prospective Nurses' Health Study, we examined the influence of active and passive smoking on the incidence of invasive breast cancer. The analysis was based on women responding to the 1982 questionnaire, which included questions on passive smoking exposure. Information on active smoking was collected in biennial questionnaires. A total of 78,206 women were followed prospectively from 1982 until June 1996. Of these women, 3,140 reported a diagnosis of invasive breast cancer during follow-up. Compared with never active smoking, relative risks (RR) of breast cancer were 1.04 (95% CI = 0.94-1.15) for current active smoking and 1.09 (95% CI = 1.00-1.18) for past active smoking. The RR for regular passive exposure at work and at home was 0.90 (95% CI = 0.67-1.22). For active smoking, a modest increase in risk was confined to women who began smoking before the age of 17 (RR = 1.19 95% CI = 1.03-1.37). Results suggest that passive smoking is unrelated to breast cancer. However, results for active smoking are compatible with a small increase in risk when smoking is initiated at young ages.
Publisher: Springer Science and Business Media LLC
Date: 04-06-2013
Publisher: Oxford University Press (OUP)
Date: 04-1998
DOI: 10.1093/OXFORDJOURNALS.AJE.A009504
Abstract: Menstrual cycle characteristics and ovulatory infertility were evaluated in relation to breast cancer risk among 116,678 women in the Nurses' Health Study II, a prospective cohort study of female registered nurses who were aged 25-42 years and living in 14 US states at enrollment in 1989. During 396,299 person-years of follow-up between return of the baseline questionnaire and June 1993, 251 cases of breast cancer were identified in this cohort. The multivariate relative risk (RR) associated with age at menarche > 13 years compared with age < or = 12 years was 0.66 (95% confidence interval (CI) 0.44-0.99). Short and long menstrual cycle lengths at ages 18-22 years were associated with reduced risk. Compared with menstrual cycle length 26-31 days, the multivariate relative risks (95% CIs) for more extreme cycle lengths were: 39 days or too irregular for estimation of a usual cycle length, 0.41 (0.18-0.94). The multivariate relative risk associated with a history of ovulatory infertility, compared with no such history, was 0.41 (95% CI 0.18-0.93). These results are consistent with the hypothesis that reduced exposure to ovulatory menstrual cycles provides a protective effect against breast cancer.
Publisher: SAGE Publications
Date: 09-2005
Publisher: Wiley
Date: 05-01-2004
DOI: 10.1002/CNCR.20011
Publisher: American Society of Hematology
Date: 14-01-2020
DOI: 10.1182/BLOODADVANCES.2019000491
Abstract: Persons of African ancestry (AA) have a twofold higher risk for multiple myeloma (MM) compared with persons of European ancestry (EA). Genome-wide association studies (GWASs) support a genetic contribution to MM etiology in in iduals of EA. Little is known about genetic risk factors for MM in in iduals of AA. We performed a meta-analysis of 2 GWASs of MM in 1813 cases and 8871 controls and conducted an admixture mapping scan to identify risk alleles. We fine-mapped the 23 known susceptibility loci to find markers that could better capture MM risk in in iduals of AA and constructed a polygenic risk score (PRS) to assess the aggregated effect of known MM risk alleles. In GWAS meta-analysis, we identified 2 suggestive novel loci located at 9p24.3 and 9p13.1 at P & 1 × 10−6 however, no genome-wide significant association was noted. In admixture mapping, we observed a genome-wide significant inverse association between local AA at 2p24.1-23.1 and MM risk in AA in iduals. Of the 23 known EA risk variants, 20 showed directional consistency, and 9 replicated at P & .05 in AA in iduals. In 8 regions, we identified markers that better capture MM risk in persons with AA. AA in iduals with a PRS in the top 10% had a 1.82-fold (95% confidence interval, 1.56-2.11) increased MM risk compared with those with average risk (25%-75%). The strongest functional association was between the risk allele for variant rs56219066 at 5q15 and lower ELL2 expression (P = 5.1 × 10−12). Our study shows that common genetic variation contributes to MM risk in in iduals with AA.
Publisher: American College of Physicians
Date: 15-11-1993
DOI: 10.7326/0003-4819-119-10-199311150-00005
Abstract: To examine the temporal relationship between stopping smoking and total mortality rates among middle-aged women. Prospective cohort study with 12 years of follow-up. Registered nurses residing in the United States. 117,001 female registered nurses, ages 30 to 55 years, who were free of manifest coronary heart disease, stroke, and cancer (except nonmelanoma skin cancer) in 1976. Total mortality, further categorized into deaths from cardiovascular diseases, cancers, and violent deaths. A total of 2847 deaths (933 among "never smokers," 799 among former smokers, and 1115 among current smokers) occurred during 1.37 million person-years of follow-up. The multivariate relative risks for total mortality compared with never smokers were 1.87 (95% CI, 1.65 to 2.13) for current smokers and 1.29 (CI, 1.14 to 1.46) for former smokers. Participants who started smoking before the age of 15 years had the highest risks for total mortality (multivariate relative risk, 3.15 CI, 2.16 to 4.59), cardiovascular disease mortality (relative risk, 9.94 CI, 5.15 to 19.19), and deaths from external causes of injury (relative risk, 5.39 CI, 1.84 to 15.78). Compared with continuing smokers, former smokers had a 24% reduction in risk for cardiovascular disease mortality within 2 years of quitting. The excess risks for total mortality and both cardiovascular disease and total cancer mortality among former smokers approached the level of that for never smokers after 10 to 14 years of abstinence. The health benefits of cessation were clearly present regardless of the age at starting and daily number of cigarettes smoked. The risk of cigarette smoking on total mortality among former smokers decreases nearly to that of never smokers 10 to 14 years after cessation.
Publisher: Springer Science and Business Media LLC
Date: 17-08-2004
Publisher: Elsevier BV
Date: 10-1991
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22533794.V1
Abstract: Flow chart of participant inclusion and exclusion criteria and the number of women in the Nurses' Health Study (NHS) and men in the Health Professional Follow-up Study (HPFS).
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Publisher: BMJ
Date: 19-02-2008
Publisher: Massachusetts Medical Society
Date: 21-01-1999
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516051.V1
Abstract: Supplementary Figure 1 shows the s le selection process
Publisher: Wiley
Date: 05-07-2006
DOI: 10.1002/IJC.22096
Abstract: Adult height has been positively associated with breast cancer risk in epidemiologic studies, and recent evidence suggests that the timing and rate of growth may also influence risk. We examined both adult height and age at attained height, an indicator of the timing of the pubertal growth spurt, in relation to incidence of premenopausal breast cancer in the Nurses' Health Study II. Participants were 108,829 premenopausal women who reported their height in 1989 of these, 37,572 provided information on their age at attained height on a later supplementary questionnaire. During 12 years of follow-up, 1,041 cases of invasive breast cancer were identified (402 with age at attained height). Cox proportional hazards models were used to estimate relative risks (RRs) and 95% confidence intervals (CIs). Adult height was positively associated with breast cancer incidence the multivariate RR for participants 1.75 m or taller compared to those shorter than 1.60 m was 1.57 (95% CI: 1.23-2.01, p trend < 0.0001), and each 5-cm increment corresponded to an 11% increase in risk (95% CI: 6-17%). There was no overall association for age at attained height, however, with a multivariate RR of 0.96 (95% CI: 0.66-1.39) for women who attained their maximum height at age 18 or older compared to those who reached it before age 14 (p trend = 0.65). These results confirm previous findings that taller adult height is associated with increased risk of premenopausal breast cancer but do not provide evidence that age at attained height is related to risk.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2015
DOI: 10.1158/1538-7445.AM2015-5586
Abstract: Purpose: To update and build on the Rosner-Colditz breast cancer incidence model by evaluating the contributions to breast cancer risk of childhood and adolescent somatotype, fruit and vegetable intake, breastfeeding, and physical activity. Secondarily, we evaluated the contributions of these variables to breast cancer incidence models defined by ER and PR status of the tumor. Methods: Using data from the Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHSII), we added childhood somatotype (average of somatotype at ages 5 and 10 9 unit scale), adolescent somatotype (average of somatotype at ages 10 and 20 9 unit scale), fruit and vegetable intake (servings/day), breastfeeding (months), and physical activity (METs/week) to the Rosner-Colditz breast cancer incidence model to determine whether these variables improved the discriminatory power of the model. We evaluated the contribution of these variables to a model for all invasive breast cancer as well as to models for ER+/PR+, ER+/PR-, and ER-/PR- breast cancer. Results: In the NHS/NHSII, we accrued over 3000 cases of invasive breast cancer with complete data on the selected breast cancer risk factors. Compared to the original Rosner-Colditz model, the models that included childhood or adolescent somatotype were significantly improved (p& .001). The relative risk (RR) of invasive breast cancer for a 4 unit change in somatotype was 0.69 for childhood somatotype and 0.59 for adolescent somatotype. Including childhood somatotype increased the age-adjusted concordance statistic from 0.613 to 0.616 whereas including adolescent somatotype increased the age-adjusted concordance statistic from 0.613 to 0.618. Childhood and adolescent somatotypes also significantly improved ER+/PR+ and ER-/PR- breast cancer incidence models (p& .02). Breastfeeding and vegetable intake suggestively improved the ER-/PR- model. The RR for five servings of vegetables per day was 0.82, while the RR for 12 months of breastfeeding was 0.87. While these variables were significantly associated with ER-/PR- breast cancer risk in the updated models, the differences in concordance statistics comparing models with to models without these variables were not statistically significant. Conclusion: Childhood and adolescent somatotype significantly improved breast cancer risk classification in the NHS/NHSII. Citation Format: Megan Rice, Shelley Tworoger, Susan Hankinson, Rulla Tamimi, A Heather Eliassen, Graham Colditz, Bernard Rosner. Breast cancer risk prediction: An update to the Rosner-Colditz breast cancer incidence model. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research 2015 Apr 18-22 Philadelphia, PA. Philadelphia (PA): AACR Cancer Res 2015 (15 Suppl):Abstract nr 5586. doi:10.1158/1538-7445.AM2015-5586
Publisher: Elsevier BV
Date: 09-2017
Publisher: Elsevier BV
Date: 02-2002
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 1999
Publisher: Elsevier BV
Date: 09-2005
Publisher: American Diabetes Association
Date: 09-1994
Abstract: To investigate the relation between obesity, fat distribution, and weight gain through adulthood and the risk of non-insulin-dependent diabetes melli-tus (NIDDM). We analyzed data from a cohort of 51,529 U.S. male health professionals, 40-75 years of age in 1986, who completed biennial questionnaires sent out in 1986, 1988, 1990, and 1992. During 5 years of follow-up (1987-1992), 272 cases of NIDDM were diagnosed among men without a history of diabetes, heart disease, and cancer in 1986 and who provided complete health information. Relative risks (RRs) associated with different anthropometrie measures were calculated controlling for age, and multivariate RRs were calculated controlling for smoking, family history of diabetes, and age. We found a strong positive association between overall obesity as measured by body mass index (BMI) and risk of diabetes. Men with a BMI of ≥35 kg/m2 had a multivariate RR of 42.1 (95% confidence interval [CI] 22.0-80.6) compared with men with a BMI & .0 kg/m2. BMI at age 21 and absolute weight gain throughout adulthood were also significant independent risk factors for diabetes. Fat distribution, measured by waist-to-hip ratio (WHR), was a good predictor of diabetes only among the top 5%, while waist circumference was positively associated with the risk of diabetes among the top 20% of the cohort. These data suggest that waist circumference may be a better indicator than WHR of the relationship between abdominal adiposity and risk of diabetes. Although early obesity, absolute weight gain throughout adulthood, and waist circumference were good predictors of diabetes, attained BMI was the dominant risk factor for NIDDM even men of average relative weight had significantly elevated RRs.
Publisher: Massachusetts Medical Society
Date: 12-09-1991
Publisher: Springer Science and Business Media LLC
Date: 09-1993
DOI: 10.1007/BF00050863
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22533782.V1
Abstract: Reclassification of predicted risk by two colon cancer risk prediction models among men in the Health Professionals Followup Study: the model with categorized predictor variables versus the model with continuous predictor variables (reference).
Publisher: Elsevier BV
Date: 07-2001
Publisher: The Endocrine Society
Date: 04-2007
DOI: 10.1210/JC.2006-1975
Abstract: Previous retrospective case-control studies suggest that adiponectin, an obesity-related hormone, is inversely associated with breast cancer risk, particularly in postmenopausal women however, no prospective studies exist. Therefore, we conducted a prospective case-control study nested within the Nurses' Health Study (NHS) and NHSII cohorts examining the association between plasma adiponectin concentrations and breast cancer risk. Blood s les were collected from 1989 through 1990 (NHS) and 1996 through 1999 (NHSII) adiponectin was measured by RIA. The analysis included 1477 breast cancer cases diagnosed after blood collection and before June 2000 (NHS) or June 2003 (NHSII) who had one or two controls (n=2196) matched on age, menopausal status, postmenopausal hormone (PMH) use, fasting, and time of day and month of blood collection. We adjusted for body mass index at age 18, weight change from age 18 to blood draw, family history of breast cancer, history of benign breast disease, duration of PMH use, ages at menarche and first birth, and parity. Although we observed no association between adiponectin and breast cancer risk overall, there was a nearly significant interaction by menopausal status (P=0.08), with a relative risk, top vs. bottom quartile of 0.73 (95% confidence interval, 0.55-0.98 P trend=0.08) among postmenopausal women and 1.30 (95% confidence interval, 0.80-2.10 P trend=0.09) for premenopausal women. Among postmenopausal women, adiponectin appeared more strongly inversely associated in women who never used PMH (P heterogeneity=0.05) and women with low circulating estradiol levels (P heterogeneity=0.05). Our results suggest that adiponectin may be inversely associated with postmenopausal breast cancer risk, particularly in a low-estrogen environment.
Publisher: American Association for Cancer Research (AACR)
Date: 2004
DOI: 10.1158/1055-9965.EPI-038-3
Abstract: Intervention trials with supplemental β-carotene have observed either no effect or a harmful effect on lung cancer risk. Because food composition databases for specific carotenoids have only become available recently, epidemiological evidence relating usual dietary levels of these carotenoids with lung cancer risk is limited. We analyzed the association between lung cancer risk and intakes of specific carotenoids using the primary data from seven cohort studies in North America and Europe. Carotenoid intakes were estimated from dietary questionnaires administered at baseline in each study. We calculated study-specific multivariate relative risks (RRs) and combined these using a random-effects model. The multivariate models included smoking history and other potential risk factors. During follow-up of up to 7–16 years across studies, 3,155 incident lung cancer cases were diagnosed among 399,765 participants. β-Carotene intake was not associated with lung cancer risk (pooled multivariate RR = 0.98 95% confidence interval, 0.87–1.11 highest versus lowest quintile). The RRs for α-carotene, lutein/zeaxanthin, and lycopene were also close to unity. β-Cryptoxanthin intake was inversely associated with lung cancer risk (RR = 0.76 95% confidence interval, 0.67–0.86 highest versus lowest quintile). These results did not change after adjustment for intakes of vitamin C (with or without supplements), folate (with or without supplements), and other carotenoids and multivitamin use. The associations generally were similar among never, past, or current smokers and by histological type. Although smoking is the strongest risk factor for lung cancer, greater intake of foods high in β-cryptoxanthin, such as citrus fruit, may modestly lower the risk.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2012
Publisher: American Association for Cancer Research (AACR)
Date: 07-2018
DOI: 10.1158/1538-7445.AM2018-1193
Abstract: Introduction The age-standardized incidence rates of Korean breast cancer have significantly increased from 26.1 in 1999 to 63.9 in 2014, which coincides with changes in lifestyle, especially reproductive factors. We examined the contribution of temporal changes in reproductive factors to the increased incidence of breast cancer in Korea. Methods We estimated the means of age at menarche, number of pregnancy, age at first pregnancy and duration of breastfeeding by birth cohort using the nationwide Korean National Health and Nutrition Examination Survey 2007-2015 (n=20,522 women aged between 20 and 69 years with no history of cancer). Cohorts were ided into a ten-year interval of birth year from 1940s to 1970s. Analyses took into account the complex s le design by incorporating weights, stratification and clustering. The percent increase in breast cancer incidence due to a specific factor was calculated as 100 x (RRd - 1) (RR, relative risk for a specific factor and d, difference in the mean of a risk factor among birth cohorts). Results Weighted proportion of birth cohorts was 12.1% in 1940s (mean age=64.9y), 24.1% in 1950s (56.1y), 31.9% in 1960s (46.8y), and 31.9% in 1970s (36.9y). We observed notable changes in reproductive factors over time: younger menarche, lower number of pregnancies, older age at first pregnancy and shorter duration of breastfeeding. A decrease in the number of pregnancies from 5.0 in 1940s to 2.7 in 1970s cohorts contributed to an 18.3% increase in breast cancer incidence. Shorter duration of lactation, earlier onset of menarche and older age at first pregnancy also contributed to 16.5%, 10.7%, and 7.1% increase in the incidence rates, respectively. Conclusion We found that significant changes in reproductive factors in Korean women had appreciable impacts on the increase in breast cancer in Korea. Further study is warranted to evaluate the burden of breast cancer due to other modifiable risk factors such as adiposity, alcohol drinking and physical activity. Table. Changes in risk factors by birth cohorts and their contribution to incidence changeRisk factorsBirth cohortRR (/unit)Contribution to incidence change (1940s vs. 1970s)1940s1950s1960s1970sAge at menarche (years)16.0515.4014.4613.570.9610.65%Number of pregnancy (n)4.983.923.412.660.9318.34%Age at first pregnancy (years)23.8024.5326.0627.421.1 (/5 years)7.14%Duration of breastfeeding (months)50.5327.5313.7112.830.98 (/5 months)16.54% Citation Format: Seho Park, Hyunsoon Cho, Jee Ye Kim, Hyung Seok Park, Seung Il Kim, Young Up Cho, Byeong-Woo Park, Graham A. Colditz, Yikyung Park. The impact of rapid changes in reproductive factors on the increased incidence of breast cancer in Korea [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018 2018 Apr 14-18 Chicago, IL. Philadelphia (PA): AACR Cancer Res 2018 (13 Suppl):Abstract nr 1193.
Publisher: American Medical Association (AMA)
Date: 09-07-2001
DOI: 10.1001/ARCHINTE.161.13.1581
Abstract: Overweight adults are at an increased risk of developing numerous chronic diseases. Ten-year follow-up (1986-1996) of middle-aged women in the Nurses' Health Study and men in the Health Professionals Follow-up Study to assess the health risks associated with overweight. The risk of developing diabetes, gallstones, hypertension, heart disease, and stroke increased with severity of overweight among both women and men. Compared with their same-sex peers with a body mass index (BMI) (calculated as weight in kilograms ided by the square of height in meters) between 18.5 and 24.9, those with BMI of 35.0 or more were approximately 20 times more likely to develop diabetes (relative risk [RR], 17.0 95% confidence interval [CI], 14.2-20.5 for women RR, 23.4 95% CI, 19.4-33.2 for men). Women who were overweight but not obese (ie, BMI between 25.0 and 29.9) were also significantly more likely than their leaner peers to develop gallstones (RR, 1.9), hypertension (RR, 1.7), high cholesterol level (RR, 1.1), and heart disease (RR, 1.4). The results were similar in men. During 10 years of follow-up, the incidence of diabetes, gallstones, hypertension, heart disease, colon cancer, and stroke (men only) increased with degree of overweight in both men and women. Adults who were overweight but not obese (ie, 25.0 < or = BMI < or = 29.9) were at significantly increased risk of developing numerous health conditions. Moreover, the dose-response relationship between BMI and the risk of developing chronic diseases was evident even among adults in the upper half of the healthy weight range (ie, BMI of 22.0-24.9), suggesting that adults should try to maintain a BMI between 18.5 and 21.9 to minimize their risk of disease.
Publisher: American Medical Association (AMA)
Date: 19-02-1992
Publisher: Oxford University Press (OUP)
Date: 29-11-2023
DOI: 10.1093/JNCI/DJAC216
Publisher: Elsevier BV
Date: 07-1991
Abstract: In 1980, 84,484 US women aged 34-59 y completed an independently validated dietary questionnaire. During the ensuing 6 y, 593 forearm and 65 hip fractures occurred in association with mild to moderate trauma. We observed a positive relation between caffeine intake and risk of hip but not forearm fracture. After potential risk factors were controlled for the relative risk (RR) of hip fracture for women in the top quintile of caffeine consumption was 2.95 (95% CI = 1.18-7.38, P, trend = 0.003). Alcohol intake was independently associated with increased risk of both hip and forearm fractures and with a dose-response relation. Compared with nondrinkers, women consuming greater than or equal to 25 g alcohol/d had an RR of 2.33 (95% CI = 1.18-4.57) for hip fractures and an RR of 1.38 (95% CI = 1.09-1.74) for forearm fractures. These prospective data suggest that caffeine and alcohol consumption both increase the risk of osteoporotic fractures in middle-aged women.
Publisher: Springer Science and Business Media LLC
Date: 02-08-2020
Publisher: Elsevier BV
Date: 09-1989
DOI: 10.1016/S0002-9343(89)80151-2
Abstract: We pooled data from randomized, double-blind, placebo-controlled trials to determine the frequency of adverse reactions among patients treated with cimetidine for acute acid-peptic disorders. Meta-analysis was used to analyze data obtained from a search of English language reports of trials of cimetidine in the ambulatory treatment of acute acid-peptic disorders that were published between January 1982 and April 1987. Of 161 trials of cimetidine that we identified, 84 provided complete reporting of data on adverse reactions and, of these, 24 employed a randomized, double-blind, placebo-controlled design. Across these 24 trials, the overall rate of reported adverse reactions among 622 patients randomly assigned to receive cimetidine was 10.9% the corresponding rate among 516 patients randomly assigned to receive placebo was 10.1%. This difference was not statistically significant (p greater than 0.10), nor were any significant differences noted in the frequencies of reported central nervous system or gastrointestinal adverse reactions (p greater than 0.10). Rates of adverse reactions also did not differ by dosage or trial duration. The overall rate of adverse reactions reported in the 60 trials that did not utilize a randomized, double-blind, placebo-controlled design was similar to the rate reported in those that did. Our findings suggest that the frequency of adverse reactions among patients receiving cimetidine for acute acid-peptic disorders is not significantly different from that of patients receiving placebo.
Publisher: Oxford University Press (OUP)
Date: 19-04-2000
Publisher: Elsevier BV
Date: 09-1996
DOI: 10.1016/S0010-7824(15)30002-0
Abstract: The Collaborative Group on Hormonal Factors in Breast Cancer has brought together and reanalysed the worldwide epidemiological evidence on breast cancer risk and use of hormonal contraceptives. Original data from 54 studies, representing about 90% of the information available on the topic, were collected, checked and analysed centrally. The 54 studies were performed in 26 countries and include a total of 53,297 women with breast cancer and 100,239 women without breast cancer. The studies were varied in their design, setting and timing. Most information came from case-control studies with controls chosen from the general population most women resided in Europe or North America and most cancers were diagnosed during the 1980s. Overall 41% of the women with breast cancer and 40% of the women without breast cancer had used oral contraceptives at some time the median age at first use was 26 years, the median duration of use was 3 years, the median year of first use was 1968, the median time since first use was 16 years, and the median time since last use was 9 years. The main findings, summarised elsewhere, are that there is a small increase in the risk of having breast cancer diagnosed in current users of combined oral contraceptives and in women who had stopped use in the past 10 years but that there is no evidence of an increase in the risk more than 10 years after stopping use. In addition, the cancers diagnosed in women who had used oral contraceptives tended to be less advanced clinically than the cancers diagnosed in women who had not used them. Despite the large number of possibilities investigated, few factors appeared to modify the main findings either in recent or in past users. For recent users who began use before age 20 the relative risks are higher than for recent users who began at older ages. For women whose use of oral contraceptives ceased more than 10 years before there was some suggestion of a reduction in breast cancer risk in certain subgroups, with a deficit of tumors that had spread beyond the breast, especially among women who had used preparations containing the highest doses of oestrogen and progestogen. These findings are unexpected and need to be confirmed. Although these data represent most of the epidemiological evidence on the topic to date, there is still insufficient information to comment reliably about the effects of specific types of oestrogen or of progestogen. What evidence there is suggests, however, no major differences in the effects for specific types of oestrogen or of progestogen and that the pattern of risk associated with use of hormonal contraceptives containing progestogens alone may be similar to that observed for preparations containing both oestrogens and progestogens. On the basis of these results, there is little difference between women who have and have not used combined oral contraceptives in terms of the estimated cumulative number of breast cancers diagnosed during the period from starting use up to 20 years after stopping. The cancers diagnosed in women who have used oral contraceptives are, however, less advanced clinically than the cancers diagnosed in never users. Further research is needed to establish whether the associations described here are due to earlier diagnosis of breast cancer in women who have used oral contraceptives, to the biological effects of the hormonal contraceptives or to a combination of both. Little information is as yet available about the effects on breast cancer risk of oral contraceptive use that ceased more than 20 years before and as such data accumulate it will be necessary to re-examine the worldwide evidence.
Publisher: Elsevier BV
Date: 2000
Publisher: American Medical Association (AMA)
Date: 27-10-1999
Abstract: Overweight and obesity are increasing dramatically in the United States and most likely contribute substantially to the burden of chronic health conditions. To describe the relationship between weight status and prevalence of health conditions by severity of overweight and obesity in the US population. Nationally representative cross-sectional survey using data from the Third National Health and Nutrition Examination Survey (NHANES III), which was conducted in 2 phases from 1988 to 1994. A total of 16884 adults, 25 years and older, classified as overweight and obese (body mass index [BMI] > or =25 kg/m2) based on National Institutes of Health recommended guidelines. Prevalence of type 2 diabetes mellitus, gallbladder disease, coronary heart disease, high blood cholesterol level, high blood pressure, or osteoarthritis. Sixty-three percent of men and 55% of women had a body mass index of 25 kg/m2 or greater. A graded increase in the prevalence ratio (PR) was observed with increasing severity of overweight and obesity for all of the health outcomes except for coronary heart disease in men and high blood cholesterol level in both men and women. With normal-weight in iduals as the reference, for in iduals with BMIs of at least 40 kg/m2 and who were younger than 55 years, PRs were highest for type 2 diabetes for men (PR, 18.1 95% confidence interval [CI], 6.7-46.8) and women (PR, 12.9 95% CI, 5.7-28.1) and gallbladder disease for men (PR, 21.1 95% CI, 4.1-84.2) and women (PR, 5.2 95% CI, 2.9-8.9). Prevalence ratios generally were greater in younger than in older adults. The prevalence of having 2 or more health conditions increased with weight status category across all racial and ethnic subgroups. Based on these results, more than half of all US adults are considered overweight or obese. The prevalence of obesity-related comorbidities emphasizes the need for concerted efforts to prevent and treat obesity rather than just its associated comorbidities.
Publisher: Wiley
Date: 04-1979
Publisher: Wiley
Date: 23-05-2006
DOI: 10.1002/IJC.22074
Abstract: Melanocortin 1 receptor (MC1R) gene variants are associated with red hair and fair skin color. We assessed the associations of common MC1R genotypes with the risks of 3 types of skin cancer simultaneously in a nested case-control study within the Nurses' Health Study (219 melanoma, 286 squamous cell carcinoma (SCC), and 300 basal cell carcinoma (BCC) cases, and 873 controls). We found that the 151Cys, 160Trp and 294His variants were significantly associated with red hair, fair skin color and childhood tanning tendency. The MC1R variants, especially the 151Cys variant, were associated with increased risks of the 3 types of skin cancer, after controlling for hair color, skin color and other skin cancer risk factors. Carriers of the 151Cys variant had an OR of 1.65 (95% CI, 1.04-2.59) for melanoma, 1.67 (1.12-2.49) for SCC and 1.56 (1.03-2.34) for BCC. Women with medium or olive skin color carrying 1 nonred hair color allele and 1 red hair color allele had the highest risk of melanoma. A similar interaction pattern was observed for red hair and carrying at least 1 red hair color allele on melanoma risk. We also observed that the 151Cys variant contributed additional melanoma risk among red-haired women. The information on MC1R status modestly improved the risk prediction the increase was significant for melanoma and BCC (p, 0.004 and 0.05, respectively). These findings indicated that the effects of the MC1R variants on skin cancer risk were independent from self-reported phenotypic pigmentation.
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Publisher: American Association for Cancer Research (AACR)
Date: 05-2004
DOI: 10.1158/0008-5472.CAN-04-0246
Abstract: UV can cause a wide range of DNA lesions. UVA-induced oxidative DNA damage and blocked DNA replication by UVB-induced photoproducts can lead to double-strand breaks (DSBs). We selected 11 haplotype-tagging single nucleotide polymorphisms in three DSB repair genes XRCC2, XRCC3, and LigaseIV and evaluated their associations with skin cancer risk in a nested case-control study within the Nurses’ Health Study [219 melanoma, 286 squamous cell carcinoma (SCC), 300 basal cell carcinoma (BCC), and 873 controls]. We observed that the XRCC3 18085T (241Met) allele and its associated haplotype were significantly inversely associated with the risks of SCC and BCC, whereas the XRCC3 4552C allele along with its associated haplotype and the XRCC2 30833A allele were significantly associated with increased BCC risk. The LigaseIV 4044T and 4062T alleles were associated with decreased BCC risk two of four haplotypes were significantly associated with altered BCC risk. A trend toward decreased risk of nonmelanoma skin cancer was found in those harboring a greater number of putative low risk alleles (P for trend, 0.05 for SCC, & .0001 for BCC). The main effects of these genotypes were essentially null for melanoma risk. This study provides evidence to suggest the role of the DSB repair pathway in skin cancer development, especially for BCC.
Publisher: American Medical Association (AMA)
Date: 21-07-1993
Publisher: Springer Science and Business Media LLC
Date: 13-09-2013
Publisher: Oxford University Press (OUP)
Date: 12-2002
Abstract: Previous studies of job strain and coronary heart disease (CHD) in men have established job strain as a predictor of CHD risk. Despite the wealth of convincing evidence in men for an association between job strain and CHD, data in women remain sparse. We prospectively evaluated the relation between job strain and CHD risk in the Nurses' Health Study. In this analysis, we followed a s le of 35 038 US female nurses aged 46-71 years, who completed questions about job strain in 1992 and who were free of diagnosed CHD, stroke, and cancer at baseline. The main outcome measure was the incidence of CHD occurring between baseline (1 June 1992) and 31 May 1996. During 4 years of follow-up, we documented 146 incident cases of CHD (108 non-fatal cases of myocardial infarction and 38 CHD deaths). No evidence was found for a relationship between job strain and risk of CHD. In multivariate analyses controlling for age, smoking, alcohol intake, body mass index, history of hypertension, diabetes mellitus, and other covariates, women in high strain jobs did not have an increased risk of CHD (relative risk [RR] = 0.71, 95% CI: 0.42-1.19) compared with women in low strain jobs. Neither women in passive jobs (RR = 1.08, 95% CI: 0.69-1.68) nor those in active jobs (RR = 0.91, 95% CI: 0.54-1.53) had an increased risk of CHD. Job strain was not related to an increase in the incidence of CHD in the present cohort of nurses.
Publisher: Elsevier BV
Date: 07-2006
DOI: 10.1016/J.OPHTHA.2006.01.066
Abstract: To study the relation between type 2 diabetes mellitus (T2DM) and incident primary open-angle glaucoma (POAG) in women. Prospective cohort analysis. Seventy-six thousand three hundred eighteen women enrolled in the Nurses' Health Study (NHS). Women enrolled in the NHS from 1980 to 2000 were observed. Eligible participants were at least 40 years old, did not have POAG at baseline, and reported receiving eye examinations during follow-up. Potential confounders were assessed on biennial questionnaires, and a diagnosis of T2DM was confirmed on a validated supplemental questionnaire. During follow-up, 429 self-reported POAG cases confirmed by medical chart review were identified. Multivariable rate ratios (RRs) of POAG and associated 95% confidence intervals (CIs) obtained from proportional hazards models. After controlling for age, race, hypertension, body mass index, physical activity, alcohol intake, smoking, and family history of glaucoma, T2DM was positively associated with POAG (RR = 1.82 [95% CI = 1.23-2.70]). Nonetheless, the association did not strengthen with longer duration of diabetes: RR = 2.24 (95% CI = 1.31-3.84) for duration or = 5 years). In secondary analyses, to evaluate the potential for detection bias we controlled for additional factors such as the number of eye examinations, but T2DM remained positively associated with POAG. Type 2 diabetes mellitus is associated with an increased risk of POAG in women.
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.MATURITAS.2011.04.007
Abstract: This paper is the first to conduct cost-effectiveness analyses of bariatric surgery comparing obese patients with obesity-related diseases to obese people without comorbidities across different BMI categories, using the meta-analysis results of surgery outcomes for our effectiveness inputs. We find that surgery treatment is in general cost-effective for people whose BMI is greater than 35 kg/m(2) with or without obesity-related comorbidities, and it is even cost-saving for super obese (BMI ≥ 50 kg/m(2)) with obesity-related comorbidities. Our results also suggest that surgery can be cost-effective for the mildly obese (BMI ≥ 30 kg/m(2)). The bottom line is that bariatric surgery should be universally available to all classes of obese people.
Publisher: American Astronomical Society
Date: 29-04-2020
Publisher: Springer Science and Business Media LLC
Date: 16-10-2015
Publisher: Wiley
Date: 13-12-2018
DOI: 10.1111/JGS.15715
Publisher: American Academy of Pediatrics (AAP)
Date: 06-2002
Abstract: Objectives. To describe the association of sunscreen use, sunburning, and tanning bed use by age, sex, residence, and psychosocial variables associated with tan-seeking behaviors, and to compare these findings with sun protection recommendations from federal agencies and cancer organizations. Methods. A cross-sectional study, from all 50 states, of 10 079 boys and girls 12 to 18 years of age in 1999. Data were collected from self-report questionnaires with the children of the participants from the Nurses Health Study (Growing Up Today Study). Results. The prevalence of sunscreen use was 34.4% with girls more likely to use sunscreen than boys (40.0 vs 26.4, odds ratio: 1.86 95% confidence interval: 1.70–2.03). Eighty-three percent of respondents had at least 1 sunburn during the previous summer, and 36% had 3 or more sunburns. Nearly 10% of respondents used a tanning bed during the previous year. Girls were far more likely than boys to report tanning bed use (14.4 vs 2.4), and older girls (ages 15–18) were far more likely than younger girls (ages 12–14) to report tanning bed use (24.6% vs 4.7). Tanning bed use increased from 7% among 14-year-old girls to 16% by age 15, and more than doubled again by age 17 (35% N = 244). Multivariate analysis demonstrated that attitudes associated with tanning, such as the preference for tanned skin, having many friends who were tanned, and belief in the worth of burning to get a tan, were generally associated with sporadic sunscreen use, more frequent sunburns, and increased use of tanning beds. Conclusions. Our findings suggest that many children are at subsequent risk of skin cancer because of suboptimal sunscreen use, high rates of sunburning, and tanning bed use. Recommendations in the United States for improved sun protection and avoidance of tanning beds and sunburning, which began in the early 1990s, have been primarily unheeded. Nationally coordinated c aigns with strong policy components must be developed and sustained to prevent skin cancer in a new generation of children and adolescents.
Publisher: American Diabetes Association
Date: 04-1997
Abstract: Intake of carbohydrates that provide a large glycemic response has been hypothesized to increase the risk of NIDDM, whereas dietary fiber is suspected to reduce incidence. These hypotheses have not been evaluated prospectively. We examined the relationship between diet and risk of NIDDM in a cohort of 42,759 men without NIDDM or cardiovascular disease, who were 40–75 years of age in 1986. Diet was assessed at baseline by a validated semiquantitative food frequency questionnaire. During 6-years of follow-up, 523 incident cases of NIDDM were documented. The dietary glycemic index (an indicator of carbohydrate's ability to raise blood glucose levels) was positively associated with risk of NIDDM after adjustment for age, BMI, smoking, physical activity, family history of diabetes, alcohol consumption, cereal fiber, and total energy intake. Comparing the highest and lowest quintiles, the relative risk (RR) of NIDDM was 1.37 (95% CI, 1.02–1.83, P trend = 0.03). Cereal fiber was inversely associated with risk of NIDDM (RR = 0.70 95% CI, 0.51–0.96, P trend = 0.007 for & 8.1 g/day vs. & 3.2 g/day). The combination of a high glycemic load and a low cereal fiber intake further increased the risk of NIDDM (RR = 2.17, 95% CI, 1.04–4.54) when compared with a low glycemic load and high cereal fiber intake. These findings support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of NIDDM in men. Further, they suggest that grains should be consumed in a minimally refined form to reduce the incidence of NIDDM.
Publisher: Springer Science and Business Media LLC
Date: 05-10-2004
Abstract: To examine the changes in intake of fruits and vegetables in relation to risk of obesity and weight gain among middle-aged women. Prospective cohort study with 12 y of follow-up conducted in the Nurses' Health Study. A total of 74,063 female nurses aged 38-63 y, who were free of cardiovascular disease, cancer, and diabetes at baseline in 1984. Dietary information was collected using a validated food frequency questionnaire, and body weight and height were self-reported. During the 12-y follow-up, participants tended to gain weight with aging, but those with the largest increase in fruit and vegetable intake had a 24% of lower risk of becoming obese (BMI> or =30 kg/m2) compared with those who had the largest decrease in intake after adjustment for age, physical activity, smoking, total energy intake, and other lifestyle variables (relative risk (RR), 0.76 95% confidence interval (CI), 0.69-0.86 P for trend or =25 kg), women with the largest increase in intake of fruits and vegetables had a 28% lower risk compared to those in the other extreme group (RR, 0.72 95% CI, 0.55-0.93 P=0.01). Similar results were observed for changes in intake of fruits and vegetables when analyzed separately. Our findings suggest that increasing intake of fruits and vegetables may reduce long-term risk of obesity and weight gain among middle-aged women.
Publisher: Springer Science and Business Media LLC
Date: 16-06-2015
Publisher: BMJ
Date: 18-03-2011
DOI: 10.1136/EBN1137
Publisher: Massachusetts Medical Society
Date: 12-02-2015
DOI: 10.1056/NEJME1414318
Publisher: American Association for Cancer Research (AACR)
Date: 12-2019
DOI: 10.1158/1055-9965.EPI-19-0132
Abstract: Multiple myeloma is a common hematologic malignancy consistently preceded by monoclonal gammopathy of undetermined significance (MGUS). Little is known about postdiagnosis clinical predictors of progression of MGUS to multiple myeloma to guide MGUS management. This study aimed to investigate whether the rate of rise in serum monoclonal protein concentration during the year after MGUS diagnosis—M-protein velocity—predicts progression of MGUS to multiple myeloma. Data from the U.S. Veterans Health Administration system were used. A retrospective cohort of patients with MGUS who progressed to multiple myeloma were matched on age at MGUS diagnosis and race in a 1:4 ratio to the patients with MGUS using incidence density s ling. Kaplan–Meier curves were plotted. Univariable and multivariable conditional logistic regression analyses were fitted from the matched risk sets. A total of 128 cases and 490 matched controls were included. The case group contained a higher percentage of patients with M-protein velocity & .1 g/dL/year than the control group (44.5% vs. 28.2%, P & .0001). M-protein velocity of & .1 g/dL during the year following MGUS diagnosis was positively associated with progression of MGUS to multiple myeloma (multivariable-adjusted odds ratio = 2.15 95% confidence interval, 1.37–3.35). Patients with a positive M-protein velocity during the year after MGUS diagnosis may be considered for more frequent monitoring for early detection and timely treatment of multiple myeloma. Future prevention studies could target these patients for intervention evaluation. Our results suggest a new clinical predictor of progression to multiple myeloma following MGUS diagnosis, which has potential to identify high-risk patients for management and prevention.
Publisher: Elsevier BV
Date: 09-2005
Publisher: American Association for Cancer Research (AACR)
Date: 31-03-2016
DOI: 10.1158/1078-0432.CCR-14-1214
Abstract: When information is exchanged across disciplinary boundaries, resources are shared, and discipline-specific approaches are altered to achieve a common scientific goal, we create a new intellectual space for transdisciplinary research. This approach, fostered heavily by multiple NCI-funded initiatives, has the potential to forge new understanding of major public health issues. By breaking down disciplinary barriers, we work toward making real, meaningful, and lasting forward motion in addressing key public health issues. One of the transdisciplinary initiatives of the NCI is TREC: Transdisciplinary Research on Energetics and Cancer. In this article, we review the goals and scope of TREC, as well as the ways in which the initiative promotes transdisciplinary science. A particular focus is on multiple ex les of the most unique aspect of the initiative: the funding of developmental projects across multiple TREC centers, toward the goal of incubating high-risk science that has the potential to translate into major leaps forward in understanding energetics in cancer. As we enter an era of greater focus on investigator-initiated science, new approaches may be needed to ensure that the peer review process is not solely organized along disciplinary lines. Inclusion of expertise regarding transdisciplinarity, as well as representation from multiple scientific disciplines within a panel, may allow transdisciplinary research to receive an educated hearing. The body of researchers trained to work in a transdisciplinary research space is ideally suited to address these challenges. Clin Cancer Res 22(7) 1565–71. ©2016 AACR.
Publisher: Oxford University Press (OUP)
Date: 06-1990
DOI: 10.1093/OXFORDJOURNALS.AJE.A115598
Abstract: Measures of association in prospective studies can be distorted by incomplete follow-up. Various mailing strategies were used to contact 12,233 cohort members of the Health Professionals Follow-up Study who had not responded to three successive bulk-rate mailings. Response rates were highest, 79.5% overall, from participants who were sent a certified mailing in phase 1 (63.2%), followed by a repeat certified mailing to nonrespondents (44.3%). Although altering the physical appearance of the envelope and using other postal rates were tested, certified mail was the most effective approach for reaching study members who were nonrespondents to a mailed questionnaire.
Publisher: Massachusetts Medical Society
Date: 09-06-2011
DOI: 10.1056/NEJMC1103912
Publisher: Elsevier BV
Date: 02-01-1997
Publisher: Wiley
Date: 11-2007
DOI: 10.1038/OBY.2007.339
Abstract: The objective was to forecast BMI distribution in the U.S. population along with demographic changes based on past race-, sex-, and birth cohort-specific secular trends. We compiled data from 44,184 subjects from 4 National Health and Nutrition Examination Surveys (NHANES 1971 to 2004). By race and sex, we fit regression models to create smoothed mean BMI curves by age for 1970 to 2010. Linking corresponding birth cohorts across age- and year-specific mean BMI projections, we estimated the trajectory of relative BMI throughout each cohort's lifetime. These projections were validated using actual cohorts in the Nurses' Health Study and Health Professionals Follow-up Study. Combined with U.S. census, we predicted BMI distributions in 2010 and examined the joint impact of the obesity epidemic and population aging. BMI secular trends in the past 3 decades differ significantly by birth cohort, sex, and race. If these trends continue, the prevalence of obesity is expected to reach 35%, 36%, 33%, and 55% in 2010 among white men, white women, black men, and black women, respectively, far from the Healthy People 2010 goal of 15%. Such forecasts translate into 9.3 million more obese adults 20 to 74 years of age than in 2000, 8.3 million of whom would be 50 years of age or older, and 8.5 million of whom would be white. The mean age among obese men and women is also expected to rise from 47 to 49 years among whites and from 43 to 44 years among blacks. As the baby boom generation approaches retirement age, the continuing obesity epidemic signals a likely expansion in the population with obesity-related comorbidities. A framework to combine BMI and demographic trends is essential in evaluating the burden and disparity associated with the epidemic in the aging U.S. population.
Publisher: Wiley
Date: 19-03-2022
DOI: 10.1002/CAM4.4649
Abstract: Early life adiposity and changes in adiposity over the life course are associated with mammographic breast density among postmenopausal women. However, the underlying mechanisms are unknown therefore, we comprehensively examined the associations of early life body mass index (BMI) and changes in BMI from ages 10, 18 to age at mammogram with growth factor, RANK pathway, and sex hormone gene expression in 372 postmenopausal women. We estimated early life BMI at age 10 using the validated 9‐level Stunkard pictogram. We calculated BMI at other ages (18, 30, and current age at mammogram) by iding weight in kilograms at these ages with height in meters squared. Sequencing for gene expression was performed using the NanoString nCounter system. After adjusting for confounders, we estimated associations using multivariable linear regressions. A 10 kg/m 2 increase in early life BMI at age 10 was associated with a 17.2% decrease in RANKL gene expression (95% confidence interval [CI] = −30.8, −0.9) but was not associated with changes in other markers. BMI changes from ages 10, 18 to age at mammogram were associated with an increase in BMP2 and decreases in RANK, RANKL, and TNFRSF13B gene expression but were not associated with gene expression of other markers. A 10 kg/m 2 increase in early life BMI from age 10 to current age was associated with a 7.8% increase in BMP2 (95% CI = −1.4, 17.8), an 8.5% decrease in RANK (95% CI = −13.9, −2.8), a 10.4% decrease in RANKL (95% CI = −16.9, −3.3), and an 8.5% decrease in TNFRSF13B gene expression (95% CI = −13.8, −2.8). The results provide new insights into the biological mechanisms underlying the associations of adiposity changes from early life to adulthood and early life adiposity with mammographic breast density in postmenopausal women.
Publisher: Elsevier BV
Date: 05-2019
Publisher: Springer Science and Business Media LLC
Date: 20-07-2004
Publisher: American Medical Association (AMA)
Date: 12-2005
Publisher: Wiley
Date: 09-1997
DOI: 10.1002/J.1550-8528.1997.TB00669.X
Abstract: This study examined cross-sectional gender and racial/ ethnic differences in bulimic behaviors among adolescents. Subjects were 704 male and 621 female students at a large urban public high school in the Northeast. Approximately 61% of the girls and 43% of the boys reported trying to lose weight or maintain their current weight 2.0% of the students reported using laxatives or vomiting to control their weight. The use of these behaviors to control weight was only slightly more common among girls than boys (2.7% vs. 1.4%, p = 0.1). Although more black than white girls used laxatives or vomiting to control weight (odds ratio [OR] = 11.9, 95% confidence interval [CI] 1.5-95.3), there were no racial/ethnic differences in these behaviors among boys. However, Hispanic boys were twice as likely as white boys to binge eat at least monthly (OR = 2.0, 95% CI 1.1-3.6). Our results suggest that bulimic behaviors affect male and female adolescents from a variety of racial/ethnic backgrounds. In addition, in contrast to the large gender differences in the prevalence of dieting and binge eating, more modest differences were documented in the prevalence of using vomiting and laxatives to control weight.
Publisher: American Academy of Pediatrics (AAP)
Date: 08-2001
Abstract: Eliminating health disparities, including those that are a result of socioeconomic status (SES), is one of the overarching goals of Healthy People 2010. This article reports on the development of a new, adolescent-specific measure of subjective social status (SSS) and on initial exploratory analyses of the relationship of SSS to adolescents' physical and psychological health. A cross-sectional study of 10 843 adolescents and a subs le of 166 paired adolescent/mother dyads who participated in the Growing Up Today Study was conducted. The newly developed MacArthur Scale of Subjective Social Status (10-point scale) was used to measure SSS. Paternal education was the measure of SES. Indicators of psychological and physical health included depressive symptoms and obesity, respectively. Linear regression analyses determined the association of SSS to depressive symptoms, and logistic regression determined the association of SSS to overweight and obesity, controlling for sociodemographic factors and SES. Mean society ladder ranking, a subjective measure of SES, was 7.2 ± 1.3. Mean community ladder ranking, a measure of perceived placement in the school community, was 7.6 ± 1.7. Reliability of the instrument was excellent: the intraclass correlation coefficient was 0.73 for the society ladder and 0.79 for the community ladder. Adolescents had higher society ladder rankings than their mothers (μteen = 7.2 ± 1.3 vs μmom = 6.8 ± 1.2 P = .002). Older adolescents' perceptions of familial placement in society were more closely correlated with maternal subjective perceptions of placement than those of younger adolescents (Spearman's rhoteens & years = 0.31 vs Spearman's rhoteens ≥15 years = 0.45 P & .001 for both). SSS explained 9.9% of the variance in depressive symptoms and was independently associated with obesity (odds ratiosociety = 0.89, 95% confidence interval = 0.83, 0.95 odds ratiocommunity = 0.91, 95% confidence interval = 0.87, 0.97). For both depressive symptoms and obesity, community ladder rankings were more strongly associated with health than were society ladder rankings in models that controlled for both domains of SSS. This new instrument can reliably measure SSS among adolescents. Social stratification as reflected by SSS is associated with adolescents' health. The findings suggest that as adolescents mature, SSS may undergo a developmental shift. Determining how these changes in SSS relate to health and how SSS functions prospectively with regard to health outcomes requires additional research.
Publisher: Oxford University Press (OUP)
Date: 18-09-2013
DOI: 10.1634/THEONCOLOGIST.2013-0015
Abstract: Describe the association between baseline BMI, weight loss, and survival in MM. Explain the importance of BMI and baseline weight loss as part of the standard history obtained in patients with MM.
Publisher: American Medical Association (AMA)
Date: 28-03-2005
DOI: 10.1001/ARCHINTE.165.6.661
Abstract: Randomized trials have shown the efficacy of an office systems approach in improving colorectal cancer (CRC) screening behaviors its feasibility in real-world primary care practices has not been well studied. Between August 1, 2000, and December 1, 2001, we enrolled 185 primary care clinicians identified through purchased database lists. At the end of follow-up (December 31, 2002), 127 clinicians had completed preintervention and postintervention questionnaires. Trained staff from the American Cancer Society visited practices and identified areas for improvement in CRC screening. They provided clinicians with resources, tools, and support to facilitate positive change. We defined 5 clinician behavior areas related to successful CRC screening, including educating patients, identifying patients due for screening, enabling patient compliance, monitoring patient compliance, and notifying patients of their test results. We measured these areas before and after the intervention using questionnaires and data extracted from medical records. We demonstrated improvements in the passive use of posters and brochures about CRC screening (baseline, 20.5% and follow-up, 69.3% P<.001) and in the monitoring of fecal occult blood tests using manual tracking systems (baseline, 20.6% and follow-up, 37.3% P<.05). Based on medical records data among 551 patients, we found a statistically significant increase in the number of patients who became up-to-date with CRC screening recommendations and tests (P< .001 for both). Methods shown to improve CRC screening processes in protocol-driven randomized trials may be effective in community practice, and wider dissemination of these strategies shows promise to increase CRC screening.
Publisher: Impact Journals, LLC
Date: 17-05-2017
Publisher: Springer Science and Business Media LLC
Date: 27-01-1998
Abstract: Since the prevalence of adult obesity is increasing in the United States, we examined the effect of changing common habits (exercise, TV viewing, smoking and eating habits) on four year change in body weight. A prospective cohort study of US male health professionals with follow-up from 1988-1992. Participants were 19478 men aged 40-75 in 1986, who were free of cancer, coronary heart disease, stroke and diabetes. Multiple regression was used to determine the association between four year change in body weight (from 1988-1992) and common habits, after adjusting for baseline age, hypertension and hypercholesterolemia. For middle aged men, vigorous activity was associated with weight reduction and TV/VCR viewing and eating between meals with weight gain. Quitting smoking and a history of voluntary weight loss prior to the study period were consistently related to weight increase. Recently being on a diet was more strongly associated with weight loss among older men. Over the four year follow-up period, middle-aged men who increased their exercise, decreased TV viewing and stopped eating between meals, lost an average weight of -1.4 kg (95% confidence interval (CI) -1.6 - -1.1 kg), compared to a weight gain of 1.4 kg among the overall population. The prevalence of obesity among middle-aged men was lowest among those who maintained a relatively high level of vigorous physical activity, compared to those who were relatively sedentary. These data suggest that improvement in the mix of health habits, particularly increasing vigorous activity, as well as decreasing TV use and changing eating habits, results in weight maintenance or a modest weight loss over four years.
Publisher: Wiley
Date: 15-02-2011
DOI: 10.1002/CNCR.25692
Publisher: Oxford University Press (OUP)
Date: 02-2001
Abstract: Events during perinatal and early life may influence the incidence of breast cancer in adult life, and some case-control studies suggest that having been breastfed may reduce breast cancer risk. The authors studied this association among premenopausal and postmenopausal women by using data from the two Nurses' Health Studies, the Nurses' Health Study (using data from 1992 to 1996) and the Nurses' Health Study II (using data from 1991 to 1997). A history of being breastfed was self-reported by the study participants. During a total of 695,655 person-years, 1,073 cases of invasive breast cancer were diagnosed. The authors did not observe any important overall association between having been breastfed and the development of breast cancer later in life among premenopausal women (covariate-adjusted relative risk = 0.97, 95% confidence interval (CI): 0.78, 1.20) or postmenopausal women (covariate-adjusted relative risk = 1.12, 95% CI: 0.92, 1.37). No significant trend was observed with increasing duration of breastfeeding. The authors also used data on breastfeeding retrospectively collected from 2,103 mothers of participants of the two Nurses' Health Studies. With the mothers' reports, the covariate-adjusted odds ratio of breast cancer was 1.11 (95% CI: 0.88, 1.39) for women who were breastfed compared with those who were not. Data from these two large cohorts do not support the hypothesis that being breastfed confers protection against subsequent breast cancer.
Publisher: American Association for Cancer Research (AACR)
Date: 07-2018
DOI: 10.1158/1538-7445.AM2018-4256
Abstract: Aim: Cancer and cancer treatment-related cognitive impairments are frequently reported in cancer survivors, presenting as lack of attention, impaired executive function and short-term money loss. The aetiology of these impairments is largely unknown. Recently, serum level of brain-derived neurotrophic factor (BDNF) has been associated with cancer related cognitive impairments. BDNF is a neurotrophin, secreted in responses to muscle contraction. Meanwhile, muscle dysfunction, characterized by muscle strength and muscle composition, is common in cancer survivors. Yet its impact on cancer survivors' cognitive function is unknown. To address this gap we evaluated for the first time the associations of muscle strength determined by handgrip with two cognitive function outcomes in cancer survivors using data from the National Health and Nutrition Examination Survey (NHANES). Method: Data in two waves of NHANES (2011-2014) were aggregated. Handgrip strength in kilogram (kg) was measured with the Takei Digital Grip Strength Dynamometer, defined as the maximum value achieved using either hand. Data on two cognitive function tests were extracted, both were conducted among adults 60 years and older: the Animal Fluency Test (AFT) which examines categorical verbal fluency (a component of executive function), and the Digital Symbol Substitution test (DSST) which assesses processing speed, sustained attention and working memory. Survey analysis procedures were used to account for the complex s ling design of the NHANES. Gender-specific multivariable linear regression models were used to estimate associations of handgrip strength with cognitive test scores, adjusting for confounders (age, gender, race/ethnicity, education, marital status, smoking status, depression and leisure time physical activity). For explorative purpose, we further adjusted for handgrip strength squared. Results: There were 383 cancer survivors (mean age=70.9 years, mean BMI=29.3 kg/m2) with detailed data for analyses. Prevalent cancer types were breast (22.9%), prostate (16.4%), colon (6.9%) and cervix (6.2%). The prevalence of handgrip strength defined sarcopenia was 10.9% in men (& kg) and 20.4 % in women (& kg). Scores on AFT and DSST were 18.0 (s.e. 0.4) and 51.7 (s.e. 1.0), respectively. We observed significant linear associations of handgrip strength with both test scores in women. Each increase kg of handgrip strength was associated with 0.20 (95% CI: 0.08 to 0.33) higher score on AFT and 0.83 (95% CI: 0.30 to 1.35) higher score on DSST. In men, we observed inverted U-shape association between handgrip strength and DSST score, which peaked at handgrip strength of 40-42 kg. Conclusion: Handgrip determined muscle strength appears to be associated with aspects of cognitive functions in cancer survivors. Prospective studies are needed to identify the role of muscle on cancer related-cognitive impairments in men and women cancer survivors. Citation Format: Lin Yang, Lee Smith, Liang Hu, Graham A. Colditz, Adetunji T. Toriola, Davy Vanc fort, Mark Hamer, Brendon Stubbs, Thomas Waldhör. Handgrip strength and cognitive function in elderly cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018 2018 Apr 14-18 Chicago, IL. Philadelphia (PA): AACR Cancer Res 2018 (13 Suppl):Abstract nr 4256.
Publisher: Springer Science and Business Media LLC
Date: 23-03-2012
Publisher: Oxford University Press (OUP)
Date: 15-06-2003
DOI: 10.1093/AJE/KWG098
Abstract: Case-control studies suggest that meat and cholesterol intakes may be related to elevated risks of pancreatic cancer. Few prospective studies have examined associations between diet and pancreatic cancer, although in one recent study saturated fat consumption was related to higher risk. In a cohort of US women, the authors confirmed 178 pancreatic cancer cases over 18 years of follow-up. A mailed 61-item food frequency questionnaire was self-administered at baseline, and health and lifestyle variables were updated biennially. Analyses were performed using Cox proportional hazards models to adjust for potential confounders. Intakes of total fat, different types of fats, and cholesterol were not associated with pancreatic cancer risk. Similarly, total meat, red meat, and dairy products were not related to risk. In idual food items contributing to intakes of total meat and dairy products, as well as fish and eggs, did not reveal any specific association. Updating dietary exposures by using questionnaires from 1980, 1984, 1986, and 1990 produced similar findings. The authors' data do not support previous findings that meat or saturated fat intakes are related to pancreatic cancer risk. Future prospective studies should examine the influence of cooking practices as well as other dietary habits on the risk of pancreatic cancer.
Publisher: Wiley
Date: 03-12-2002
DOI: 10.1002/CNCR.11059
Publisher: American Association for Cancer Research (AACR)
Date: 30-04-2017
DOI: 10.1158/1538-7755.CARISK16-IA21
Abstract: Not very long ago scientific publication was viewed as the primary dissemination goal of scientific discovery. This viewpoint, however, has evolved substantially over the past 10 - 20 years. While scientific discovery and publication remain key to dissemination of findings, it is now often viewed as a single stage in the spectrum from discovery to the application of research results. The view of effective dissemination must now also include the practical world of policy makers, clinicians, health care organizations, and the public – groups that need good data and good tools to make informed decisions that drive in idual, national, and global health. The development of health risk assessment and prevention tools can play a key role in doing this. And such development moves through three general translation stages – with each subsequent stage marked by greater difficulty to achieve. 1) Creation of accurate risk prediction calculation(s) from current evidence base. 2) Development of a practical, usable tool that incorporates the calculation(s) and provides actionable messages – for clinical, public policy, or public use. 3) Integration of risk prediction tools with the social, structural, and financial support for translating recommended action messages into actual action – whether we're talking about doctors counseling patients, government representatives making health policy, or the public working to improve their own health. This process by necessity requires a multi-disciplinary approach – drawing on expertise from epidemiology, biostatistics, communication theory, coding, and design – among others. With the addition of precision medicine and big data to long-established data analysis techniques, the field of risk prediction is set to expand in coming years. Along with that expansion, it is important to assure that our efforts are valid, useful, reliable, and applicable. Citation Format: Graham A. Colditz. Translating evidence to action: Yourdiseaserisk.wustl.edu. [abstract]. In: Proceedings of the AACR Special Conference: Improving Cancer Risk Prediction for Prevention and Early Detection Nov 16-19, 2016 Orlando, FL. Philadelphia (PA): AACR Cancer Epidemiol Biomarkers Prev 2017 (5 Suppl):Abstract nr IA21.
Publisher: Elsevier BV
Date: 03-1996
Abstract: Given that overweight is clearly associated with increased risk of many major chronic diseases, the United States could have saved approximately $45.8 billion or 6.8% of health care expenditures in 1990 alone if obesity were prevented. The question then arises, economically and socially, what is a healthy body weight? Using a prevalence-based approach to cost of illness, we estimated the economic costs (1993 dollars) associated with illness at different strata of body mass indexes (BMIs, in kg/m2) and varying increments of weight gain to address the questions: At what body weight do we initiate preventive services? What are the direct costs associated with weight gain? Second, using the 1988 National Health Interview Survey (NHIS), we evaluated the marginal increase in certain social indexes reflective of functional impairment and morbidity (ie, restricted-activity days, bed days, and work-loss days) as well as physician visits associated with different strata of BMI. With respect to economic and social indexes, a healthy body weight appears to be a BMI < 25, and weight gain should be kept to < 5 kg throughout a lifetime.
Publisher: Springer Science and Business Media LLC
Date: 28-03-2013
DOI: 10.1007/S10620-013-2642-9
Abstract: It has been suggested that bowel preparation quality may influence decision-making about appropriate follow-up interval after screening colonoscopy. We sought: (1) to assess physician recommendations for timing of subsequent colonoscopy in average-risk patients with inadequate bowel preparation on initial screening, and (2) to measure the association between physician recommendations and patient adherence to repeat colonoscopy. Patients undergoing average-risk screening colonoscopy from 2004 to 2009 found to have inadequate bowel preparation were identified. Physician recommendations for timing of subsequent colonoscopy and patient adherence to repeat colonoscopy were assessed through examination of endoscopy records. Data from repeat colonoscopies were collected through August 2010. There were 373 patients with inadequate bowel preparation on initial screening colonoscopy. There was a wide range of physician recommendations for timing of repeat colonoscopy: next day (4.6 % of patients), 2 days to 6 months (9.9 %), 7 months to 1 year (34.0 %), 2-5 years (38.3 %), 6-10 years (5.1 %), and timing not specified (8.0 %). Physicians were significantly more likely to recommend repeat colonoscopy within 1 year if any polyps were detected (OR = 2.2, p = 0.001). Patients instructed to have next day follow-up were significantly more likely to adhere to the recommendation compared to patients who were instructed to return after longer intervals (OR 4.4, p = 0.005). Patients with inadequate bowel preparation on screening colonoscopy were subject to a wide range of physician recommendations for follow-up. Patient adherence to physician recommendations was significantly higher when repeat colonoscopy was recommended the next day.
Publisher: Elsevier BV
Date: 12-1988
DOI: 10.1016/0002-8703(88)90770-3
Abstract: The acquisition of a mesenchymal phenotype is a critical step in the metastatic progression of epithelial carcinomas. Adherens junctions (AJs) are required for suppressing this epithelial-mesenchymal transition (EMT) but less is known about the role of tight junctions (TJs) in this process. Here, we investigated the functions of blood vessel epicardial substance (BVES, also known as POPDC1 and POP1), an integral membrane protein that regulates TJ formation. BVES was found to be underexpressed in all stages of human colorectal carcinoma (CRC) and in adenomatous polyps, indicating its suppression occurs early in transformation. Similarly, the majority of CRC cell lines tested exhibited decreased BVES expression and promoter DNA hypermethylation, a modification associated with transcriptional silencing. Treatment with a DNA-demethylating agent restored BVES expression in CRC cell lines, indicating that methylation represses BVES expression. Reexpression of BVES in CRC cell lines promoted an epithelial phenotype, featuring decreased proliferation, migration, invasion, and anchorage-independent growth impaired growth of an orthotopic xenograft and blocked metastasis. Conversely, interfering with BVES function by expressing a dominant-negative mutant in human corneal epithelial cells induced mesenchymal features. These biological outcomes were associated with changes in AJ and TJ composition and related signaling. Therefore, BVES prevents EMT, and its epigenetic silencing may be an important step in promoting EMT programs during colon carcinogenesis.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2016
Publisher: Oxford University Press (OUP)
Date: 2021
DOI: 10.1111/RSSC.12449
Abstract: With the exponential growth in data collection, multiple time-varying biomarkers are commonly encountered in clinical studies, along with a rich set of baseline covariates. This paper is motivated by addressing a critical issue in the field of Alzheimer’s disease (AD) in which we aim to predict the time for AD conversion in people with mild cognitive impairment to inform prevention and early treatment decisions. Conventional joint models of biomarker trajectory with time-to-event data rely heavily on model assumptions and may not be applicable when the number of covariates is large. This motivated us to consider a functional ensemble survival tree framework to characterize the joint effects of both functional and baseline covariates in predicting disease progression. The proposed framework incorporates multivariate functional principal component analysis to characterize the changing patterns of multiple time-varying neurocognitive biomarker trajectories and then nest these features within an ensemble survival tree in predicting the progression of AD. We provide a fast implementation of the algorithm that accommodates personalized dynamic prediction that can be updated as new observations are gathered to reflect the patient’s latest prognosis. The algorithm is empirically shown to perform well in simulation studies and is illustrated through the analysis of data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (adni.loni.usc.edu/). We provide implementation of our proposed method in an R package funest.
Publisher: Oxford University Press (OUP)
Date: 19-04-2006
DOI: 10.1093/AJE/KWJ127
Abstract: With the growing number of epidemiologic publications on the relation between dietary factors and cancer risk, pooled analyses that summarize results from multiple studies are becoming more common. Here, the authors describe the methods being used to summarize data on diet-cancer associations within the ongoing Pooling Project of Prospective Studies of Diet and Cancer, begun in 1991. In the Pooling Project, the primary data from prospective cohort studies meeting prespecified inclusion criteria are analyzed using standardized criteria for modeling of exposure, confounding, and outcome variables. In addition to evaluating main exposure-disease associations, analyses are also conducted to evaluate whether exposure-disease associations are modified by other dietary and nondietary factors or vary among population subgroups or particular cancer subtypes. Study-specific relative risks are calculated using the Cox proportional hazards model and then pooled using a random- or mixed-effects model. The study-specific estimates are weighted by the inverse of their variances in forming summary estimates. Most of the methods used in the Pooling Project may be adapted for examining associations with dietary and nondietary factors in pooled analyses of case-control studies or case-control and cohort studies combined.
Publisher: Springer Science and Business Media LLC
Date: 66
DOI: 10.1186/BCR1414
Publisher: Wiley
Date: 09-2007
Publisher: Springer Science and Business Media LLC
Date: 21-01-2022
DOI: 10.1007/S10552-022-01554-1
Abstract: The Joanne Knight Breast Health Cohort was established to link breast cancer risk factors, mammographic breast density, benign breast biopsies and associated tissue markers, and blood markers in a erse population of women undergoing routine mammographic screening to study risk factors and validate models for breast cancer risk prediction. Women were recruited from November 2008 to April 2012 through the mammography service at the Joanne Knight Breast Health Center at Washington University in St. Louis, Missouri. Baseline questionnaire risk factors, blood, and screening mammograms were collected from 12,153 women. Of these, 1,672 were excluded for prior history of any cancer (except non-melanoma skin) or diagnosis of breast cancer within 6 months of blood draw/registration for the study, for a total of 10,481 women. Follow-up is through linking to electronic health records, tumor registry, and death register. Routine screening mammograms are collected every 1–2 years and incident benign breast biopsies and cancers are identified through record linkage to pathology and tumor registries. Formal fixed tissue s les are retrieved and stored for analysis. County-level measures of structural inequality were derived from publicly available resources. Cohort Composition: median age at entry was 54.8 years and 26.7% are African American. Through 2020, 74% of participants have had a medical center visit within the past year and 80% within the past 2 years representing an average of 9.7 person-years of follow-up from date of blood draw per participant. 9,997 women are continuing in follow-up. Data collected at baseline include breast cancer risk factors, plasma and white blood cells, and mammograms prior to baseline, at baseline, and during follow-up. This cohort assembled and followed in a routine mammography screening and care setting that serves a erse population of women in the St. Louis region now provides opportunities to integrate study of questionnaire measures, plasma and DNA markers, benign and malignant tissue markers, and repeated breast image features into prospective evaluation for breast cancer etiology and outcomes.
Publisher: CLOCKSS Archive
Date: 03-2000
Abstract: The proportion of children eating dinner with their families declines with age and has decreased over time. Few data exist concerning the nutritional effect of eating family dinner. To examine the associations between frequency of eating dinner with family and measures of diet quality. Cross-sectional. A national convenience s le. There were 8677 girls and 7525 boys in the study, aged 9 to 14 years, who were children of the participants in the ongoing Nurses' Health Study II. We collected data from a self-administered mailed survey, including food and nutrient intakes from a validated semiquantitative food frequency questionnaire. Main outcome measures included servings per day of selected foods and food groups, daily intakes of selected macronutrients and micronutrients, and frequency of multivitamin use. Approximately 17% of participants ate dinner with members of their family never or some days, 40% on most days, and 43% every day. More than half of the 9-year-olds ate family dinner every day, whereas only about one third of 14-year-olds did so. In age- and sex-adjusted logistic regression models, the odds ratios associated with a frequency of family dinner of most days compared with never or some days, or every day compared with most days, were as follows: for eating at least 5 servings per day of fruits and vegetables, 1.45 (95% confidence interval [CI], 1.37-1.53) for eating any fried foods away from home, 0.67 (95% CI, 0.64-0.70) and for drinking any soda, 0.73 (95% CI, 0.66-0.80). Multiple linear regression showed that an increased frequency of family dinner was also associated with substantially higher intake of several nutrients, including fiber, calcium, folate, iron, vitamins B6, B12, C, and E lower glycemic load and lower intake of saturated and trans fat as a percentage of energy. We observed little or no effect on intakes of whole dairy products, red meat, or snack foods. Patterns were similar for boys and girls. Eating family dinner was associated with healthful dietary intake patterns, including more fruits and vegetables, less fried food and soda, less saturated and trans fat, lower glycemic load, more fiber and micronutrients from food, and no material differences in red meat or snack foods.
Publisher: Institution of Engineering and Technology (IET)
Date: 2006
DOI: 10.1049/EL:20061631
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-1997
DOI: 10.1016/S0029-7844(97)00534-6
Abstract: To quantify the incidence of uterine leiomyoma confirmed by hysterectomy, ultrasound, or pelvic examination according to age and race among premenopausal women. From September 1989 through May 1993, 95,061 premenopausal nurses age 25-44 with intact uteri and no history of uterine leiomyoma were followed to determine incidence rates of uterine leiomyoma. The self-reported diagnosis was confirmed in 93% of the medical records obtained for a s le of cases. Using pooled logistic regression, we estimated relative risks (RRs) of uterine leiomyoma according to race and examined whether adjustment for other potential risk factors could explain the variation in the race-specific rates. During 327,065 woman-years, 4181 new cases of uterine leiomyoma were reported. The incidence rates increased with age, and the age-standardized rates of ultrasound- or hysterectomy-confirmed diagnoses per 1000 woman-years were 8.9 among white women and 30.6 among black women. After further adjustment for marital status, body mass index, age at first birth, years since last birth, history of infertility, age at first oral contraceptive use, and current alcohol consumption, the rates among black women were significantly greater for diagnoses confirmed by ultrasound or hysterectomy (RR 3.25 95% confidence interval [CI] 2.71, 3.88) and by hysterectomy (RR 1.82 95% CI 1.17, 2.82) compared with rates among white women. We observed similar RRs when the cohort was restricted to participants who reported undergoing a screening physical examination within the 2 years before baseline. A higher prevalence of known risk factors did not explain the excess rate of uterine leiomyoma among premenopausal black women.
Publisher: Elsevier BV
Date: 09-2004
Publisher: Wiley
Date: 14-11-2012
DOI: 10.1002/CNCR.26519
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2021
Publisher: Springer Science and Business Media LLC
Date: 1997
Abstract: This paper reviews the consistency of the relation between increased physical activity and reduced risk of colon cancer, estimates the potential prevention benefit from increasing population levels of physical activity, and considers social strategies to increase activity levels. The published literature was reviewed systematically and supplemented by MEDLINE searches through March 1997. Studies that reported a measure of physical activity and outcomes of colon cancer or colorectal cancer were included. We excluded the first report of a study that was expanded subsequently by extended follow-up, and any study that did not report the methods for measurement of physical activity. Data were extracted including details on study size, methods of classifying physical activity, and outcomes. A consistent inverse relation was observed such that increased physical activity was associated with reduced risk of colon cancer. About a 50 percent reduction in incidence was observed among those with the highest level of activity across numerous studies that used different measures of activity (occupational or leisure-time activity). This association persisted in studies using multivariate analyses to control for diet and other known or suspected risk factors for colon cancer. Risk reduction was attenuated in those studies that combined colon and rectal cancer. This review indicates that greater attention should be placed on social strategies to increase physical activity as a means of preventing colon cancer.
Publisher: Informa UK Limited
Date: 29-11-2010
Publisher: Springer Science and Business Media LLC
Date: 03-1996
DOI: 10.1007/BF00051301
Abstract: Several publications describing high-resolution structures of amyloid-β (Aβ) and other fibrils have demonstrated that magic-angle spinning (MAS) NMR spectroscopy is an ideal tool for studying amyloids at atomic resolution. Nonetheless, MAS NMR suffers from low sensitivity, requiring relatively large amounts of s les and extensive signal acquisition periods, which in turn limits the questions that can be addressed by atomic-level spectroscopic studies. Here, we show that these drawbacks are removed by utilizing two relatively recent additions to the repertoire of MAS NMR experiments-namely,
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-1990
DOI: 10.1097/00001648-199011000-00009
Abstract: Recent epidemiologic evidence indicates an association between fat distribution and many diseases. To assess the validity of circumference measurements obtained by self-report, the authors analyzed data from 123 men aged 40-75 years and 140 women aged 41-65 years, drawn from two large ongoing prospective studies. On mailed questionnaires, subjects were asked to measure and record their weight and waist and hip circumferences. These data were compared with standardized measurements taken approximately six months apart by technicians who visited participants at their homes. Crude Pearson correlations between self-reported waist circumferences and the average of two technician-measured waist circumferences were 0.95 for men and 0.89 for women. Similar correlations for hip measurements were 0.88 for men and 0.84 for women, and for waist-to-hip ratios, 0.69 for men and 0.70 for women. After adjusting for age and body mass index (kg/m2), correlations for waist-to-hip ratios were 0.55 for men and 0.58 for women. Correlations became stronger after correcting for random within-person variability from daily or seasonal fluctuations. Self-reported and measured weights were highly correlated: 0.97 for men and 0.97 for women. Self-reported waist, hip, and weight measurements appear reasonably valid. The moderate degree of measurement error for the ratio of self-reported waist and hip circumferences, however, implies that previously reported associations based on self-report of these measures may have been appreciably underestimated.
Publisher: BMJ
Date: 27-05-2000
DOI: 10.1136/BMJ.320.7247.1432
Abstract: To examine prospectively the relation between psychosocial work characteristics and changes in health related quality of life over four years in a cohort of working women in the United States. Longitudinal cohort study. United States. 21 290 female registered nurses who completed the Karasek's job content questionnaire and a modified version of the short form 36 questionnaire (SF-36) as used for a survey of health status by the medical outcomes study. Seven dimensions of health status: physical functioning, role limitations due to physical health problems, bodily pain, vitality, social functioning, role limitations due to emotional problems, and mental health. Examined separately low job control, high job demands, and low work related social support were associated with poor health status at baseline as well as greater functional declines over the four year follow up period. Examined in combination, women with low job control, high job demands, and low work related social support ("iso-strain" jobs) had the greatest functional declines. These associations could not be explained by age, body mass index, comorbid disease status, alcohol consumption, smoking status, education level, exercise level, employment status, marital status, or presence of a confidant. Adverse psychosocial work conditions are important predictors of poor functional status and its decline over time.
Publisher: Wiley
Date: 09-2004
DOI: 10.1038/OBY.2004.175
Abstract: To examine prospectively the relationship between alcohol and 8-year weight gain in women. A prospective study of 49,324 women 27 to 44 years old who did not have a history of cardiovascular disease, cancer, or diabetes, who were not pregnant during the study period, and who reported weights in 1991 and 1999. In cross-sectional analyses, there was a significant inverse relationship between alcohol and BMI even after adjustment for dietary factors and a wide range of confounders. In multivariate prospective analyses, a nonlinear relationship was seen between alcohol and weight gain (>or=5 kg) in all women. Compared with nondrinkers, the adjusted relative odds [95% confidence interval (CI)] of weight gain according to grams per day were 0.94 (0.89, 0.99) for those consuming 0.1 to 4.9 g/d, 0.92 (0.85,0.99) for 5 to 14.9 g/d, 0.86 (0.76, 0.78) for 15 to 29.9 g/d, and 1.07 (0.89,1.28) for those consuming 30+ g/d (p < 0.0001 for quadratic trend). Women who continued to drink heavily and those who became heavy drinkers showed similar increased odds of weight gain. The increased odds of weight gain associated with heavy drinking (30+ g/d) were most marked in the younger women (<35 years) (odds ratio 1.64 5% CI 1.03 to 2.61). In African-American women, light drinking was associated with increased odds of weight gain compared with nondrinkers (odds ratio = 2.43 95% CI 1.22 to 4.82). Our data suggest that light to moderate drinking (up to 30 g/d) is not associated with weight gain in women except possibly in African-American women. Heavier drinking may promote weight gain in women.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2015
Publisher: Wiley
Date: 03-12-2002
DOI: 10.1002/CNCR.11034
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2021
DOI: 10.1200/JCO.2021.39.15_SUPPL.572
Abstract: 572 Background: Breast cancer is the second leading cause of cancer death in U.S. women. On the molecular level, breast cancer is a heterogeneous disease. Heterogeneous expressions of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) are etiologically and clinically meaningful, as they map to distinct risk factors and different treatment strategies. Although breast cancer mortality has been declining since 1990, little is known about mortality trends according to molecular subtypes at the population level. Methods: We examined the incidence-based mortality rates and trends among women who were diagnosed with invasive breast cancer from 2010 through 2017 using the Surveillance, Epidemiology, and End Results (SEER) database. We defined incidence-based mortality using a moving 5-year calendar period starting in 2014. We further assessed mortality according to breast cancer molecular subtypes: luminal A (ER and/or PR positive, HER2 negative), luminal B (ER and/or PR positive, HER2 positive), HER2-enriched (HER2 over-expressed or lified, ER and PR negative) and triple-negative (ER and PR negative, HER2 negative) tumors. We calculated annual percent changes (APC) in incidence-based mortality using joinpoint regression models. Results: Overall, incidence-based mortality for breast cancer significantly decreased by 1.5% annually from 2014 through 2017 (APC, -1.5% 95% coefficient interval [CI], -2.3% to -0.7% p .001). Incidence-based mortality decreased annually by 2.0% for luminal A breast cancer (APC, -2.0% 95% CI, -3.7% to -0.3% p .001), 2.1% for luminal B breast cancer (APC, -2.1% 95% CI, -5.4% to 1.4% p=0.1), 1.1% for triple-negative breast cancer (TNBC) (APC, -1.1% 95% CI, -2.1% to -0.0% p .001). However, incidence-based mortality for HER2-enriched breast cancer increased 2.3% annually during the study period (APC, 2.3% 95% CI, -2.4% to 7.2% p=0.2). Conclusions: Between 2014 and 2017, incidence-based mortality for luminal A, luminal B, and TNBC decreased among U.S. women, with a larger decrease observed for luminal tumors. However, incidence-based mortality for HER2-enriched breast cancer increased. The favorable incidence-based mortality trends for luminal tumors and TNBC are likely due to the continuing improvement in treatments and early detection. The increasing trend of incidence-based mortality for HER2-enriched breast cancer constitutes a priority for cancer control activities and further research.
Publisher: American College of Physicians
Date: 03-02-2004
DOI: 10.7326/0003-4819-140-3-200402030-00006
Abstract: Randomized, double-blind, placebo-controlled trials have established that regular aspirin use reduces the risk for recurrent colorectal adenoma. However, the effect of dose and duration of use, particularly in an average-risk population, is not well understood. To examine the influence of dose and duration of aspirin use in the primary prevention of colorectal adenoma. Prospective cohort study. Nurses' Health Study. 27 077 women, 34 to 77 years of age, without a history of adenoma, cancer, inflammatory bowel disease, or familial polyposis, who underwent lower endoscopy between 1980 and 1998. 1368 cases of confirmed distal colorectal adenoma were diagnosed between 1980 and 1998. Self-reported data on aspirin use were collected from biennial questionnaires. After other risk factors for adenoma were adjusted, women who regularly used aspirin (> or =2 standard aspirin tablets/wk) had a multivariate relative risk for adenoma of 0.75 (95% CI, 0.66 to 0.84) compared with nonregular users. Compared with women who denied any aspirin use, the multivariate relative risks for adenoma were 0.80 (CI, 0.70 to 0.93) for women who used 0.5 to 1.5 standard tablets per week, 0.74 (CI, 0.62 to 0.88) for those who used 2 to 5 tablets per week, 0.72 (CI, 0.61 to 0.85) for those who used 6 to 14 tablets per week, and 0.49 (CI, 0.36 to 0.65) for those who used more than 14 tablets per week (P < 0.001 for trend). Similar dose-response relationships were found among regular short-term users (< or =5 years P 5 years P 0.2). Regular, short-term use of aspirin is inversely associated with risk for colorectal adenoma. However, the greatest protective effect is evident at substantially higher doses (>14 tablets/wk) than those recommended for the prevention of cardiovascular disease. Before aspirin can be recommended for chemoprevention in the general adult population, these results suggest the need for a more thorough evaluation of the risks and benefits of routine aspirin use at doses not previously considered.
Publisher: Massachusetts Medical Society
Date: 14-04-1988
Publisher: Elsevier BV
Date: 06-2016
Publisher: Oxford University Press (OUP)
Date: 11-1995
DOI: 10.1093/OXFORDJOURNALS.AJE.A117738
Abstract: Height has been inversely associated with coronary heart disease in several prospective studies in men, but data in women are sparse. The relation between height and cardiovascular disease was examined in 14 years of follow-up data from the Nurses' Health Study, a prospective cohort of 121,700 US female nurses aged 30-55 years in 1976. The relative risks associating height with coronary heart disease (nonfatal myocardial infarction (n = 1,000), fatal myocardial infarction (n = 304), confirmed angina (n = 1,343), or coronary revascularization (n = 901)) were estimated after adjustment for a large number of cardiovascular risk factors, including age and body mass index. Compared with the shortest women (< or = 61 inches ( or = 1.70 m) tall (p for trend < 0.0001). The inverse association was more pronounced for angina/coronary revascularization (p for trend < 0.0001 relative risk for 67 or more inches = 0.67 (95% CI 0.58-0.78)) than for myocardial infarction (p for trend = 0.03 relative risk for 67 or more inches = 0.78 (95% CI 0.64-0.95)). No trend was evident for height in relation to risk of stroke. These data support the hypothesis that height is inversely related to risk of coronary heart disease in women.
Publisher: Elsevier BV
Date: 07-1994
DOI: 10.1016/0010-7824(94)90076-0
Abstract: A risk-benefit analysis of five alternative approaches to fertility control among US women over the age of 30 was performed: tubal ligation, vasectomy, intrauterine device, barrier method (condom), and combined oral contraceptives. Taken into account were age-specific probabilities of contraceptive failure, fecundability, spontaneous abortion, reproductive mortality (ectopic pregnancy, delivery, or induced abortion), life table mortality, and mortality from specific cancer sites (ovarian, endometrial, breast, and prostate) and cardiovascular disease. Relative to women using no contraceptive precautions, the use of any method of contraception between the ages of 30 and 50 was associated with net benefit in terms of averted deaths. However, when duration of observation was extended up to age 80, we predicted an excess of about 880 deaths from prostate cancer per 100,000 users of vasectomy. Other methods continued to be associated with net benefit, ranging from 130 to 360 deaths averted per 100,000 users. It was concluded that the non-reproductive risks and benefits of contraceptive methods continue to be relevant long after the reproductive years. The balance of risks and benefits may differ in other countries with different cause-specific and life table mortality rates.
Publisher: American Society of Hematology
Date: 15-11-2013
DOI: 10.1182/BLOOD.V122.21.3154.3154
Abstract: The etiology of multiple myeloma remains unknown, but some heritable contribution is suspected. Very few genetic risk markers have been reported in more than one study population. A nested analysis (72 cases, 144 controls) in the Nurses’ Health Study (NHS) and Health Professionals Follow-up Study (HPFS) cohorts suggested a role in multiple myeloma susceptibility for single nucleotide polymorphisms (SNP) in the genes for the insulin receptor substrate type 1 (IRS1 rs17208470, rs1801278) and the interleukin (IL)-6 receptor (IL6R rs6684439, rs7529229, rs2228145). The NHS and HPFS cohort members are predominantly of European origin the present analysis further explored the IRS1 and IL6R loci in persons of European descent and in African Americans in a large pooled population comprised of five U.S. population-based studies. We used unconditional logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI) assuming a log-additive inheritance model and adjusting for age, sex, and study site. We performed all analyses separately in 824 participants of European origin (259 cases, 565 controls) and 298 African Americans (114 cases, 186 controls). We also calculated a risk allele score by summing all variant alleles across the five SNPs in the ∼95% of participants with no missing genotype data, and we used additional logistic regression models to estimate a race-specific multivariable OR and 95% CI for multiple myeloma risk per variant allele carried. All statistical tests were two-tailed and assumed an α-error of 0.05. In persons of European descent, at the locus rs17208470 (IRS1) we observed a statistically significant 42% increase in multiple myeloma risk per copy of the variant allele (OR, 95% CI: 1.42, 1.02-1.98 p=0.037). In IL6R, we observed a statistically significant association with multiple myeloma at rs6684439 (OR, 95% CI: 1.27, 1.01-1.58 p=0.037) and marginally significant associations with multiple myeloma at two loci: rs7529229 (1.24, 0.99-1.55, p=0.057) and rs2228145 (1.24, 0.99-1.55, p=0.056). The risk allele score analysis (240 cases, 532 controls of European origin with no missing genotype data) showed that the risk of multiple myeloma increased significantly by 11% per variant allele carried (OR, 95% CI per risk allele: 1.11, 1.03-1.19 p=0.008). In African Americans, two loci in IL6R, rs6684439 and rs7529229, showed suggestive non-significant associations with multiple myeloma risk (rs6684439, OR, 95% CI, p-value per copy of the minor allele: 1.37, 0.94-2.00, p=0.11 rs7529229: 1.39, 0.95-2.04, p=0.089). Neither SNP in IRS1 was associated with multiple myeloma in this group. The risk allele score analysis in African Americans (109 cases, 176 controls) suggested a 17% increase in multiple myeloma risk per variant allele carried (1.17, 0.99-1.38 p=0.067). Based on a priori hypotheses, we examined the association of five previously reported SNPs in IRS1 and IL6R with multiple myeloma in a larger series of persons of European descent than previously published, and for the first time, in African Americans. Both genes belong to biologic signaling pathways with important roles in multiple myeloma pathogenesis. In participants of European origin, SNPs in IRS1 and IL6R were at least marginally associated with multiple myeloma, and the risk of multiple myeloma increased significantly per risk allele carried. We observed slightly stronger ORs for the IL6R SNPs in African Americans, but no associations were statistically significant in that group, probably due to a lack of statistical power because of small numbers for this subgroup and/or because the true causal SNPs in these genes have differential linkage disequilibrium across racial groups. The nominally significant and suggestive associations that we observed are plausible and should be further evaluated in other large multi-ethnic studies of multiple myeloma susceptibility. Anderson: celgene: Consultancy onyx: Consultancy gilead: Consultancy sanofi aventis: Consultancy oncopep: Equity Ownership acetylon: Equity Ownership.
Publisher: Springer Science and Business Media LLC
Date: 06-06-2017
Publisher: Springer Science and Business Media LLC
Date: 04-11-2014
Publisher: Oxford University Press (OUP)
Date: 1986
DOI: 10.1093/OXFORDJOURNALS.AJE.A114223
Abstract: Among 121,964 women aged 30-55 years in 1976, 117,156 who were initially free from coronary heart disease provided information on a number of coronary risk factors including parental history of myocardial infarction and were followed prospectively. In 1976, 31,101 (26.5%) reported that at least one parent had suffered a myocardial infarction. Questionnaires in 1978 and 1980 identified women who had developed nonfatal myocardial infarction (n = 132) and angina pectoris (n = 101). Fatal coronary heart disease cases (n = 42) were ascertained by searches of state vital records. The age-adjusted relative risk of nonfatal myocardial infarction for women with a parental history of myocardial infarction less than or equal to 60 years of age compared with women with no family history was 2.8 (95% confidence limits (CL) 1.8, 4.3). For those with a parental history of myocardial infarction greater than 60 years of age, the age-adjusted relative risk of nonfatal myocardial infarction was 1.0 (CL 0.5, 1.8). The age-adjusted relative risks of fatal coronary heart disease were 5.0 (CL 2.7, 9.2) for parental history before age 61 and 2.6 (CL 1.1, 5.8) for parental history after age 60. The corresponding relative risks of angina pectoris were 3.4 (CL 2.2, 5.2) and 1.9 (CL 1.2, 3.2), respectively. These associations were only slightly altered by adjustment for history of hypertension, diabetes, high cholesterol, use of oral contraceptives, menopause, postmenopausal hormone use, obesity, or smoking, in in idual stratified analysis or in multivariate analyses. These data support the hypothesis that parental history of myocardial infarction has an independent effect on risk that is not explained solely by in idual risk factors.
Publisher: Massachusetts Medical Society
Date: 19-11-1987
DOI: 10.1056/NEJM198711193172102
Abstract: Papillomaviruses use rare codons with respect to the host. The reasons for this are incompletely understood but among the hypotheses is the concept that rare codons result in low protein production and this allows the virus to escape immune surveillance. We changed rare codons in the oncogenes E6 and E7 of the cottontail rabbit papillomavirus to make them more mammalian-like and tested the mutant genomes in our in vivo animal model. While the amino acid sequences of the proteins remained unchanged, the oncogenic potential of some of the altered genomes increased dramatically. In addition, increased immunogenicity, as measured by spontaneous regression, was observed as the numbers of codon changes increased. This work suggests that codon usage may modify protein production in ways that influence disease outcome and that evaluation of synonymous codons should be included in the analysis of genetic variants of infectious agents and their association with disease.
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.SOCSCIMED.2008.10.028
Abstract: Many young people do not meet recommended levels of participation in physical activity. Neighborhoods may play a role in supporting healthy behavior via social and physical environmental features. We examine whether neighborhood-levels of social cohesion, range of youth services and educational attainment were associated with participation in recreational programs and general physical activity among young people. Hierarchical regression analyses were carried out using data from 680 young people (ages 11-15 years at baseline) participating in the Project on Human Development in Chicago Neighborhoods. The participants' primary caregiver reported recreational program participation at baseline and self-reported general physical activity were assessed at follow-up 2-3 years later. Neighborhood-level characteristics were obtained from census data and via a community survey. Neighborhood social cohesion was inversely associated with participation in recreational programs at baseline, controlling for availability of neighborhood services for youth, neighborhood education status, race/ethnicity, in idual-level parental education, overweight status, sex, and age. Residing in an area with greater social cohesion was directly associated with frequency of reported general physical activity, independent of previously reported participation in recreational programs and other neighborhood and in idual-level covariates. The present findings suggest that neighborhood social cohesion influences participation in physical activity.
Publisher: Elsevier BV
Date: 02-2000
DOI: 10.1016/S0735-1097(99)00540-9
Abstract: To examine prospectively the association between snoring and incidence of cardiovascular disease (CVD) in women. Whether snoring increases risk of CVD remains unclear most previous studies have been small, not prospective and limited to men. Seventy-one thousand seven hundred seventy-nine female nurses 40 through 65 years of age and without previously diagnosed CVD or cancer at baseline in 1986 were followed up for eight years. Frequency of snoring was assessed using mailed questionnaires at baseline. During eight years of follow-up, we documented 1,042 incident cases of major CVD events (644 coronary heart disease [CHD] and 398 stroke). Compared with nonsnorers, the age-adjusted relative risks (RRs) of CVD were 1.46 (95% confidence interval 1.23 to 1.74) for occasional snorers and 2.02 (1.62 to 2.53) for regular snorers. The age-adjusted RRs of CHD were 1.43 (1.15 to 1.77) for occasional snorers and 2.18 (1.65 to 2.87) for regular snorers. The age-adjusted RRs of stroke were 1.60 (1.21 to 2.12) and 1.88 (1.29 to 2.74), respectively. After further adjustment for smoking, body mass index (BMI) and other covariates, the positive association between snoring and CVD was attenuated but remained statistically significant (RRs of CVD were 1.20 [1.01 to 1.43] for occasional snorers and 1.33 [1.06-1.67] for regular snorers. These data suggested that snoring is associated with a modest but significantly increased risk of CVD in women, independent of age, smoking, BMI and other cardiovascular risk factors. While further study is needed to elucidate the biological mechanism underlying this association, snoring may help clinicians identify in iduals at higher risk for CVD.
Publisher: American Association for Cancer Research (AACR)
Date: 10-2011
DOI: 10.1158/1055-9965.EPI-11-0605
Abstract: Intervention trials in cancer survivors play an important and growing role in complementing the wealth of knowledge obtained from observational studies about how lifestyle can improve clinical, physiologic, and psychological outcomes. As the number of intervention trials grows, attention to study design and reporting is essential to establishing a high-quality data pool from which to make evidence-based recommendations and guidelines. We highlight several key issues important to the design and interpretation of intervention trials in cancer survivors. Intervention dose and duration both matter in trials of cancer survivors, yet few trials have evaluated different intervention doses and few intervention trials with multiyear follow-up exist. Finally, there is a need for interventions both of longer duration and those that take a practical trials approach and reflect clinical practice to speed implementation within practice and improve outcomes for cancer survivors. Cancer Epidemiol Biomarkers Prev 20(10) 2078–84. ©2011 AACR.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2020
Publisher: American Association for Cancer Research (AACR)
Date: 05-2015
DOI: 10.1158/1538-7445.SABCS14-P1-09-33
Abstract: Background: The importance of bone health among postmenopausal breast cancer survivors cannot be overemphasized. In addition to bone loss due to aging, secondary bone loss resulting from treatment is a major concern. Although weight loss has adverse effects on bone health in postmenopausal women without cancer, the impact of weight loss on bone health in postmenopausal women with breast cancer is not known. Our objective in this study was to evaluate the effect of weight loss on bone health among overweight/obese postmenopausal breast cancer survivors participating in a weight loss trial. Methods: We conducted this study in a subset of women (postmenopausal, N=81) enrolled in the multi-site Exercise and Nutrition to Enhance Recovery and Good health for You (ENERGY) study. The ENERGY study is a randomized controlled clinical trial designed to achieve a sustained ≥7% loss in body weight among overweight/obese breast cancer survivors with stage I, II or IIIA disease. Weight loss was achieved largely through dietary modification with the addition of physical activity. Bone health was assessed in a subset of women at a single site using bone turnover markers (BTMs) and dual energy X-ray absorptiometry (DXA). Markers of bone formation: osteocalcin, bone-specific alkaline phosphatase (BALP), procollagen type I N-terminal propeptide (PINP) and bone resorption: N-telopeptides of type-I collagen (NTX), C-terminal telopeptide (CTX) were quantified in blood s les collected at baseline, 6 month and 12-month follow-up. DXA T-score was used to measure bone mineral density at baseline and at 12-month follow-up. Generalized estimating equations were used to assess differences in mean values over time as well as from baseline to 6- and 12-month follow-up. Data from intervention and control arm women were used and treated as a cohort. Results: The mean age and body mass index (BMI) of women enrolled in our sub-study were 56 years and 31.6kg/m2, respectively. Majority (54.3%) had stage 2 disease. Mean weight decreased by 5.6 pounds between baseline and 6-month follow-up and 4.3 pounds between baseline and 12-month follow-up. There were statistically significant decreases in mean osteocalcin (2.0ng/ml, p-value& .001), PINP (7.9ng/ml, p-value& .001) and NTx (3.65nM BCE/L, p-value& .001), but not BALP and CTX-1 levels between baseline and 12-month follow-up. No significant changes were observed in mean T-scores, pelvis and lumbar spine bone mineral densities between baseline and 12-month follow-up. Weight change from baseline to 12-month follow-up was weakly inversely associated with changes in DXA T-score (r=-0.25, p-value=0.04) and CTX (r=-0.22, p-value=0.07) but not with other BTMs over the same time period. Conclusion: Weight loss over a 12-month period was associated with decreases in markers of bone formation and resorption but no changes in BMD in overweight/obese postmenopausal women with stage I, II or IIIA breast cancer. Further studies on the association of weight loss and the possible modifying effect of physical activity are needed in order to personalize weight control strategies in overweight/obese breast cancer survivors. Citation Format: Adetunji T Toriola, Jingxia Liu, Patricia A Ganz, Graham A Colditz, Lin Yang, Sonya Izadi, Anna L Schwartz, Kathleen Y Wolin. Weight loss and bone health in postmenopausal breast cancer survivors [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13 San Antonio, TX. Philadelphia (PA): AACR Cancer Res 2015 (9 Suppl):Abstract nr P1-09-33.
Publisher: American Association for Cancer Research (AACR)
Date: 03-2016
DOI: 10.1158/1538-7755.DISP15-PR01
Abstract: Introduction: Colorectal cancer (CRC) is a leading cause of cancer death in the US. Although routine screening is effective in reducing CRC incidence and mortality, only 59% of adults are reportedly up-to-date. With even lower rates of screening and higher rates of late-stage diagnoses among under- and uninsured patients, there is a critical need for interventions that are effective, practical, and sustainable in this population. Many of these patients are served in the healthcare safety-net, including federally qualified health centers, which serve patients regardless of their insurance. System- or multi-level interventions have been effective at increasing screening in previous studies, but most have been implemented and evaluated in higher-resource settings. Using community based participatory research (CBPR) methods and a randomized trial design, we aim to select, implement, and test evidence-based systems-level strategies aimed at increasing CRC screening in safety-net healthcare settings that serve patients who are under- or uninsured. Methods: To meet CBPR principles, health centers were engaged in determining study procedures and interventions at their sites. After recruiting eleven safety-net health centers in two networks (one mostly urban, one mostly rural), six health centers were randomly assigned to the intervention arm. Provider reminders, changes to the patient materials, and patient reminders were the most common strategies selected. The primary outcome is CRC screening adherence at 12-months post-baseline as measured by self-report. Data were collected regarding patient socioeconomic factors, healthcare, and screening utilization. Data analysis included examination of bivariate associations as well as logistic regression with GEE robust standard error to assess CRC screening in intervention and control sites. Results: The study population included 490 participants at baseline from 11 health centers in 2 separate health networks 273 (55.7%) participants completed the 12-month follow-up survey. Of this final s le, most were black (53.5%), unemployed (53.9%), had a monthly income & $1200/month (63.4%), had public insurance (65.6%), and reported they had a particular doctor or health care provider (84.3%). Participants were also evenly ided between the 2 health networks (50.9% and 49.1%). Most participants were up-to-date with any type of CRC screening at 12 months (65.6%) compared to 46.1% at baseline. The up-to-date screening rate was not significantly different between intervention and control (OR=1.06, p& .05), in an adjusted model. Discussion: We reached a very low income s le, who experienced occasional homelessness, unexpected changes in contact information, and had relatively high unemployment rates. Participants had a relatively high baseline screening rate, but our participatory recruitment methods may have over-selected people who were already screened. The health centers were also under-resourced and faced challenges, particularly in helping patients access colonoscopy. Despite safety-net health centers adopting and adapting evidence-based intervention strategies to fit the needs of their patients, screening rates were not significantly higher in intervention clinics compared to control. There are several possible explanations. Control clinics may have been affected by the intervention, as they were in the same health network and there was occasional but unmeasured cross-over in terms of patients and providers. The lack of Medicaid expansion in Missouri meant that many patients remain uninsured. Also, the urban specialty clinic providing colonoscopy to under- and uninsured patients closed during the study, complicating access and creating long wait times for appointments. The study offers valuable insights into the challenges of implementing screening interventions with low-resource patients in low-resource settings. This abstract is also presented as Poster A43. Citation Format: Meera Muthukrishnan, Yan Yan, Jean Wang, Graham Colditz, Aimee S. James. Systems-level intervention to increase CRC screening in community health centers. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved Nov 13-16, 2015 Atlanta, GA. Philadelphia (PA): AACR Cancer Epidemiol Biomarkers Prev 2016 (3 Suppl):Abstract nr PR01.
Publisher: American Medical Association (AMA)
Date: 09-2016
Publisher: Oxford University Press (OUP)
Date: 15-05-2000
DOI: 10.1093/OXFORDJOURNALS.AJE.A010139
Abstract: The authors prospectively examined the association between bowel movement frequency, laxative use, and the risk of colorectal cancer in 84,577 women of the Nurses' Health Study living in the United States, 36-61 years of age and free of cancer in 1982. Between 1984 and 1996, 611 incident cases of colorectal cancer were documented. After controlling for age, body mass index, fiber intake, postmenopausal status and hormone use, physical activity, and use of laxatives, the relative risks associated with having bowel movements every third day or less, compared with those with bowel movements once daily, were 0.94 (95% confidence interval (CI): 0.69, 1.28) for colorectal cancer, 0.88 (95% CI: 0.62, 1.26) for colon cancer, and 1.18 (95% CI: 0.63, 2.20) for rectal cancer. Compared with women who never used laxatives, the multivariate relative risks associated with weekly to daily laxative use were 1.00 (95% CI: 0.72, 1.40) for colorectal cancer, 1.09 (95% CI: 0.76, 1.57) for colon cancer, and 0.68 (95% CI: 0.29, 1.57) for rectal cancer. These findings do not support an association between infrequent bowel movement, laxative use, and risk of colorectal cancer and indicate that simple questions directed at bowel movement frequency are unlikely to enhance our ability to predict colorectal cancer risk.
Publisher: American Astronomical Society
Date: 31-12-2020
Abstract: HD 106315 and GJ 9827 are two bright, nearby stars that host multiple super-Earths and sub-Neptunes discovered by K2 that are well suited for atmospheric characterization. We refined the planets’ ephemerides through Spitzer transits, enabling accurate transit prediction required for future atmospheric characterization through transmission spectroscopy. Through a multiyear high-cadence observing c aign with Keck/High Resolution Echelle Spectrometer and Magellan/Planet Finder Spectrograph, we improved the planets’ mass measurements in anticipation of Hubble Space Telescope transmission spectroscopy. For GJ 9827, we modeled activity-induced radial velocity signals with a Gaussian process informed by the Calcium II H& K lines in order to more accurately model the effect of stellar noise on our data. We measured planet masses of M b = 4.87 ± 0.37 M ⊕ , M c = 1.92 ± 0.49 M ⊕ , and M d = 3.42 ± 0.62 M ⊕ . For HD 106315, we found that such activity radial velocity decorrelation was not effective due to the reduced presence of spots and speculate that this may extend to other hot stars as well ( T eff 6200 K). We measured planet masses of M b = 10.5 ± 3.1 M ⊕ and M c = 12.0 ± 3.8 M ⊕ . We investigated all of the planets’ compositions through comparison of their masses and radii to a range of interior models. GJ 9827 b and GJ 9827 c are both consistent with a 50/50 rock-iron composition, GJ 9827 d and HD 106315 b both require additional volatiles and are consistent with moderate amounts of water or hydrogen/helium, and HD 106315 c is consistent with a ∼10% hydrogen/helium envelope surrounding an Earth-like rock and iron core.
Publisher: Oxford University Press (OUP)
Date: 15-07-1991
Publisher: Elsevier BV
Date: 06-2016
Publisher: American Society of Hematology
Date: 15-11-2013
DOI: 10.1182/BLOOD.V122.21.5357.5357
Abstract: The incidence of multiple myeloma (MM) increases with age, yet some cytogenetic changes are actually more common in younger patients with MM (Avet-Loiseau J Clin Oncol 2013). This suggests that a mechanism other than chromosomal changes underlies the increased incidence with age. Senescent cells secrete a number of proinflammatory cytokines, chemokines, growth factors and proteases resulting in the senescence-associated secretory phenotype (SASP), which can promote tumor growth. Preclinical data suggests that myeloma bone marrow stromal cells express the SASP (Andre PLOS ONE 2013). We hypothesized that SASP factors correlate with age in patients with MM. Peripheral blood serum and matched bone marrow aspirate plasma from patients with multiple myeloma were evaluated for selected factors associated with the SASP using quantitative multiplex immunoassay (Rules Based Medicine, Austin TX USA). SASP factors with a known role in MM [interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-15 (IL-15), granulocyte-macrophage colony-stimulating factor (GMCSF), intercellular adhesion molecule 1(ICAM1), osteoprotegerin (OPG), hepatocyte growth factor (HGF), insulin-like growth factor-binding protein(IGFBP-1), interleukin-1 beta (IL1b), monocyte chemotactic protein 1(MCP-1), macrophage inflammatory protein-1 alpha(MIP-1a), angiogenin, leptin, vascular endothelial growth factor receptor 1(VEGFR1) and stem cell factor(SCF)] were selected. The relationship between age and SASP factors were analyzed using Kendall tau rank correlation coefficient. S les from 25 patients (each with peripheral blood serum and matched bone marrow aspirate plasma) were analyzed. The median age was 62 (range 47 - 74). Disease states were as follows: 36% newly diagnosed/untreated, 24% pretransplant and 40% relapsed. ISS stage included 40% stage I, 28% stage II and 32% stage III. Three of the selected SASP factors in the peripheral blood correlated with age: IL-8 (Kendall Tau 0.334, p=0.027), OPG (Kendall Tau 0.289, p=0.046) and MCP-1 (Kendall Tau 0.332, p=0.022). No SASP factors tested in the bone marrow plasma were significantly correlated with age. We demonstrated age-associated differences in the SASP factors IL-8, OPG and MCP-1 in the peripheral blood of myeloma patients. Future research will examine differences between patients with myeloma and age-matched controls without cancer. Vij: Celgene : Honoraria, Research Funding, Speakers Bureau Millennium: Honoraria, Speakers Bureau Onyx: Honoraria, Research Funding, Speakers Bureau. Stockerl-Goldstein:Celgene : Speakers Bureau Celgene : Speakers Bureau Millennium: Speakers Bureau Millennium: Speakers Bureau.
Publisher: Springer Science and Business Media LLC
Date: 17-10-2020
DOI: 10.1007/S10552-020-01356-3
Abstract: The Your Disease Risk tool (yourdiseaserisk.wustl.edu) went live to the public in January 2000 and was one of the first personalized health risk assessment sites on the Internet. Its launch marked the culmination of years of work by a large, multi-disciplinary university team whose primary goal was to translate the science on cancer prevention into accurate, engaging, and useful messages for the public. Today, 20 years on, Your Disease Risk has expanded from its initial four cancers to include 18 different tools designed for today’s users. This commentary reviews important moments and lessons learned in the first two decades of Your Disease Risk.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2018
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-03-2006
Abstract: The extent to which socioeconomic disadvantages and inadequate health care access account for the disproportionately elevated mortality hazard observed in African American compared with white American patients with breast cancer is poorly defined. We identified 20 studies reported between January 1980 and June 2005 that provided survival analyses in patients with breast cancer after adjusting for ethnicity and some measurement of socioeconomic status. These studies also adjusted for age and stage of disease at time of diagnosis. The pooled outcome data yielded estimates for the mortality hazard in 14,013 African American and 76,111 white American patients with breast cancer. Studies varied in their methods for assigning socioeconomic status, with most relying on area-wide measures such as census tract and census block data. The combined analysis (adjusted for age, stage, and socioeconomic status) revealed that African American ethnicity was associated with a statistically significant excess mortality risk in overall survival (mortality hazard, 1.27 95% CI, 1.18 to 1.38) and in breast cancer-specific survival (mortality hazard, 1.19 95% CI, 1.10 to 1.29). Our pooled analysis demonstrated that African American ethnicity is a significant and independent predictor of poor outcome from breast cancer, even after accounting for socioeconomic status by conventional measures. These findings support the need for further investigation of the biologic, genetic, and sociocultural factors that may influence survival in African American patients with breast cancer.
Publisher: Oxford University Press (OUP)
Date: 19-04-2022
Abstract: Disrupted and delayed Medicaid coverage has been consistently associated with lower rates of cancer screening and early-stage cancer diagnosis compared with continuous coverage. However, the relationships between Medicaid coverage timing, breast cancer treatment delays, and survival are less clear. Using the linked Missouri Cancer Registry-Medicaid claims data, we identified 4583 women diagnosed with breast cancer between 2007 and 2016. We used logistic regression to estimate odds ratios (ORs) of late-stage diagnosis and treatment delays for prediagnosis (& days, & days, and & year before diagnosis) vs peridiagnosis enrollment. Cox proportional hazards models were used to estimate the hazard ratio (HR) of breast cancer-specific mortality for pre- vs postdiagnosis enrollment. Patients enrolled in Medicaid more than 30 days before diagnosis were less likely to be diagnosed at a late stage compared with those enrolled in Medicaid peridiagnosis (OR = 0.69, 95% confidence interval [CI] = 0.60 to 0.79). This result persisted using enrollment 90-day (OR = 0.64, 95% CI = 0.56 to 0.74) and 1-year thresholds (OR = 0.55, 95% CI = 0.47 to 0.65). We did not observe a difference in the likelihood of treatment delays between the 2 groups. After adjustment for sociodemographic factors, there was no statistically significant difference in the risk of breast cancer mortality for patients enrolled more than 30 days prediagnosis relative to patients enrolled peridiagnosis (HR = 0.98, 95% CI = 0.83 to 1.14), but a lower risk was observed for patients enrolled prediagnosis when using 90 days (HR = 0.85, 95% CI = 0.72 to 0.999) or 1 year (HR = 0.79, 95% CI = 0.66 to 0.96) as the threshold. Women with breast cancer who enroll in Medicaid earlier may benefit from earlier diagnoses, but only longer-term enrollment may have survival benefits.
Publisher: Elsevier BV
Date: 02-2018
Publisher: Springer Science and Business Media LLC
Date: 31-10-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2021
Publisher: Springer Science and Business Media LLC
Date: 06-03-2014
Publisher: Springer Science and Business Media LLC
Date: 22-10-0006
Publisher: Springer Science and Business Media LLC
Date: 31-05-2020
Publisher: American Diabetes Association
Date: 03-1997
Abstract: To examine prospectively the association between modern oral contraceptives with low doses of estrogen and progestin and subsequent incidence of NIDDM. In a prospective cohort study, 98,590 U.S. female nurses aged 25 to 42 and free of diagnosed diabetes, coronary heart disease, stroke, and cancer at baseline in 1989 were followed for 4 years. Endpoint was incidence of confirmed NIDDM. Oral contraceptive use was reported on mailed questionnaires. During 352,067 person-years follow-up, we confirmed 185 incident cases of NIDDM. After adjusting for age, BMI, cigarette smoking, family history of diabetes, parity, physical activity, alcohol intake, ethnicity, history of diagnosis of infertility, elevated cholesterol, and hypertension, women currently using oral contraceptives had a relative risk (RR) of 1.6 (95% CI, 0.9–3.1). For past users, the multivariate RR was 1.2 (95% CI, 0.8–1.8). This association was attenuated after restricting the analysis to symptomatic cases of NIDDM. For current users, RR = 1.3 (95% CI, 0.6–2.8), and for past users, RR = 0.9 (95% CI, 0.6–1.4), suggesting that increased surveillance may explain at least part of any excess risk. In this large prospective study, we found no appreciable increase in the 4-year risk of NIDDM among current users of oral contraceptives. There was no apparent increase in risk among past users. The small number of cases reflect the low absolute risk of NIDDM in this population of young women.
Publisher: Springer Science and Business Media LLC
Date: 05-1995
DOI: 10.1007/BF00051793
Abstract: Kinship is a fundamental and universal aspect of the structure of human society. The kinship category of 'grandparents' is socially salient, due to grandparents' investment in the care of the grandchildren as well as to older generations' control of wealth and cultural knowledge, but the evolutionary dynamics of grandparent terms has yet to be studied in a phylogenetically explicit context. Here, we present the first phylogenetic comparative study of grandparent terms by investigating 134 languages in Pama-Nyungan, an Australian family of hunter-gatherer languages. We infer that proto-Pama-Nyungan had, with high certainty, four separate terms for grandparents. This state then shifted into either a two-term system that distinguishes the genders of the grandparents or a three-term system that merges the 'parallel' grandparents, which could then transition into a different three-term system that merges the 'cross' grandparents. We find no support for the co-evolution of these systems with either community marriage organisation or post-marital residence. We find some evidence for the correlation of grandparent and grandchild terms, but no support for the correlation of grandparent and cross-cousin terms, suggesting that grandparents and grandchildren potentially form a single lexical category but that the entire kinship system does not necessarily change synchronously.
Publisher: American Association for Cancer Research (AACR)
Date: 09-2011
DOI: 10.1158/1055-9965.EPI-11-0628
Abstract: Background: The first 20 years of publication of Cancer Epidemiology, Biomarkers & Prevention occurred during a period of increased attention to health disparities and advances in knowledge about their determinants. Yet, despite clear documentation of disparities and advanced understanding of determinants, we have made little headway in reducing disparities at the population level. Multilevel models, such as one produced by the Centers for Population Health and Health Disparities (CPHHD), hold promise for understanding the complex determinants of cancer disparities and their interactions as well as translating scientific discoveries into solutions. The CPHHD model maps across a range of scientific disciplines, from the biological to the social, each with its own disciplinary language and methods. The ability to work effectively across disciplinary boundaries is essential to framing comprehensive solutions. Methods: After briefly characterizing the current state of knowledge about health disparities, we outline three major challenges faced by disparities researchers and practitioners and offer suggestions for addressing these challenges. Results: These challenges are how to consider race and ethnicity in disparities research, how best to translate discoveries into public health solutions to cancer disparities, and how to create a research environment that supports the successful execution of multilevel research. Conclusions: Attention to all three of the challenges outlined above is urgently needed to advance our efforts to eliminate cancer disparities. Impact: Addressing the challenges outlined above will help to eliminate disparities in the future.Cancer Epidemiol Biomarkers Prev 20(9) 1809–14. ©2011 AACR.
Publisher: Elsevier BV
Date: 07-1988
DOI: 10.1016/0002-8703(88)90263-3
Abstract: The efficacy of transdermal nitrate patches at 24 hours after application remains controversial. Definitive evaluation has been limited because most randomized trials have had relatively small s le sizes. Therefore, we performed a meta-analysis and combined the results of 17 trials. We assessed exercise test duration as the primary end point. At 3 to 4 hours after patch application, there was a 77-second increase in exercise duration (p = 0.02) for a 5 mg/24 hour dose and a 114-second increase in exercise duration (p = 0.001) for a 10 mg/24 hour dose. At 24 hours, however, the 29-second increase in exercise duration for a 10 mg/24 hour dose was not significant (p greater than 0.1), despite persistent decreases in systolic blood pressure, an increase in heart rate, and a "therapeutic" plasma nitroglycerin concentration. The findings indicate that the 10 mg/24 hour dose is not efficacious at 24 hours after application and support the hypothesis that nitroglycerin's effect on exercise performance is attenuated by nitrate tolerance even though hemodynamic effects and adequate blood levels persist.
Publisher: Springer Science and Business Media LLC
Date: 06-2004
DOI: 10.1207/S15430154JCE1902_9
Abstract: Risk appraisal instruments may be helpful in reinforcing prevention messages, although little is known about physician acceptance of such instruments. We explored perceived barriers to colon cancer risk counseling and responses to the colon cancer component of an Internet-based risk appraisal instrument. We qualitatively assessed provider perceptions of barriers to colon cancer prevention and screening, and their responses to the Harvard Cancer Risk Index using focus groups of primary care providers. Many providers commented that the risk appraisal instrument may be most helpful to reinforce messages by a health-care provider. The tool may increase awareness about modifiable risk factors for cancer and help patients prioritize changes as well as improve screening acceptance. With regard to barriers to counseling patients about colon cancer prevention and screening, providers expressed concerns that behaviors are too difficult to change. In addition, they were frustrated by limited time for prevention counseling and poor reimbursement. The Internet-based risk index was well accepted, although providers thought it would be most effective when used to complement provider messages about prevention. Use of an Internet-based risk index along with physician counseling could help improve cancer prevention practices and cancer screening acceptance.
Publisher: American Medical Association (AMA)
Date: 13-01-1993
Publisher: American Association for the Advancement of Science (AAAS)
Date: 14-04-2006
Abstract: Obesity is a heritable trait and a risk factor for many common diseases such as type 2 diabetes, heart disease, and hypertension. We used a dense whole-genome scan of DNA s les from the Framingham Heart Study participants to identify a common genetic variant near the INSIG2 gene associated with obesity. We have replicated the finding in four separate s les composed of in iduals of Western European ancestry, African Americans, and children. The obesity-predisposing genotype is present in 10% of in iduals. Our study suggests that common genetic polymorphisms are important determinants of obesity.
Publisher: SAGE Publications
Date: 10-2001
DOI: 10.1177/109019810102800506
Abstract: Low participation at the employee or worksite level limits the potential public health impact of worksite-based interventions. Ecological models suggest that multiple levels of influence operate to determine participation patterns in worksite health promotion programs. Most investigations into the determinants of low participation study the intrapersonal, interpersonal, and institutional influences on employee participation. Community- and policy-level influences have not received attention, nor has consideration been given to worksite-level participation issues. The purpose of this article is to discuss one macrosocial theoretical perspective—political economy of health—that may guide practitioners and researchers interested in addressing the community- and policy-level determinants of participation in worksite health promotion programs. The authors argue that using theory to investigate the full spectrum of determinants offers a more complete range of intervention and research options for maximizing employee and worksite levels of participation.
Publisher: American Medical Association (AMA)
Date: 22-12-1993
Publisher: American College of Physicians
Date: 15-08-1994
DOI: 10.7326/0003-4819-121-4-199408150-00001
Abstract: To determine whether regular use of aspirin decreases the risk for colorectal cancer. Prospective cohort study. Male health professionals throughout the United States. 47,900 male respondents to a mailed questionnaire in 1986, who were 40 to 75 years of age. Questionnaires in 1986, 1988, and 1990 about use of aspirin and other variables including occurrence of cancer. 251 new patients were diagnosed with colorectal cancer during the study period. Regular users of aspirin (> or = 2 times per week) in 1986 had a lower risk for total colorectal cancer (relative risk [RR] = 0.68 95% CI, 0.52 to 0.92) and advanced (metastatic and fatal) colorectal cancer (RR = 0.51 CI, 0.32 to 0.84) after controlling for age history of polyp previous endoscopy parental history of colorectal cancer smoking body mass physical activity and intakes of red meat, vitamin E, and alcohol. The incremental association was greater among men who reported regular use of aspirin consistently on subsequent questionnaires. The total number of colorectal adenomas discovered among aspirin users was lower with or without overt or occult fecal blood. Thus, earlier diagnosis and treatment of adenomas did not account for the inverse association between aspirin and cancer. These results support laboratory, clinical, and other epidemiologic evidence that regular use of aspirin is associated with a decreased risk for colorectal cancer.
Publisher: Elsevier BV
Date: 05-2019
Publisher: Oxford University Press (OUP)
Date: 15-06-1995
DOI: 10.1093/OXFORDJOURNALS.AJE.A117385
Abstract: Obesity, android fat distribution, and other anthropometric measures have been associated with coronary heart disease in long-term prospective studies. However, fluctuations in weight due to age-related hormonal changes and changes in lifestyle practices may bias relative risk estimates over a long follow-up period. The authors prospectively studied the association between body mass index (BMI) (kg/m2), waist-to-hip ratio, and height as independent predictors of incident coronary heart disease in a 3-year prospective study among 29,122 US men aged 40-75 years in 1986. The authors documented 420 incident coronary events during the follow-up period. Body mass index, waist-to-hip ratio, short stature, and weight gain since age 21 were associated with an increased risk of coronary heart disease. Among men younger than 65, after adjusting for other coronary risk factors, the relative risk was 1.72 (95% confidence interval (CI) 1.10-2.69) for men with BMI of 25-28.9, 2.61 (95% CI 1.54-4.42) for BMI of 29.0-32.9, and 3.44 (95% CI 1.67-7.09) for obese men with BMI > or = 33 compared with lean men with BMI or = 65 years of age, the association between BMI and risk of coronary heart disease was much weaker. However, in this age group, the waist-to-hip ratio was a much stronger predictor of risk (relative risk = 2.76, 95% CI 1.22-6.23 between extreme quintiles). These results suggest that for younger men, obesity, independent of fat distribution, is a strong risk factor for coronary heart disease. For older men, measures of fat distribution may be better than body mass index at predicting risk of coronary disease.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2004
DOI: 10.1249/01.MSS.0000117112.76067.D3
Abstract: To examine significance of missing data and describe physical activity patterns using recall and accelerometer measures among youth in a nonlaboratory setting. Fifty-four middle-school students wore TriTrac-R3D monitors (TTM) and completed an interviewer-prompted 24-h recall during two, 5-d monitoring sessions. We coded 2860 30-min recall intervals to a standard MET compendium. Complete TTM data were gathered for 43 students. Ordinal multinomial models tested for bias in TTM estimates of activity levels due to: 1) exclusion of subjects with incomplete TTM data, and 2) exclusion of intervals within days due to missing TTM data. Students with complete monitor data had an average 12.5 +/- 0.9 monitored hours per day over 5.5 +/- 2.1 d. Compared with students with incomplete monitoring data, they reported similar proportions of recall 30-min intervals at sedentary (68% vs 69%), light (14% vs 15%), moderate (11% vs 10%), and vigorous (7% vs 6%) intensity levels (P = 0.63). The proportion of recall intervals (within days) with and without simultaneous monitoring data did not differ by activity intensity (P = 0.64) across sedentary (69% vs 67%), light (14% vs 12%), moderate (11% vs 10%), and vigorous (6% vs 9%) categories. Recalls overestimated percent time per day in moderate and vigorous activity relative to TTM (22.8% vs 8.9%, P < 0.0001). Boys reported higher percent of time than girls in vigorous activity (10.9% vs 3.9%, P < 0.05). Girls reported more time than boys (9.5% vs 6.4%, P < 0.05) in light activities. No significant sex differences were observed using TTM. Missing TTM data did not bias estimates of activity levels. Self-reported activity measures overestimated moderate and vigorous activity relative to the TTM and varied by sex.
Publisher: Oxford University Press (OUP)
Date: 08-08-2007
DOI: 10.1093/JNCI/DJM082
Publisher: American College of Physicians
Date: 15-03-1995
DOI: 10.7326/0003-4819-122-6-199503150-00005
Abstract: To examine the relation between postmenopausal hormone use and development of systemic lupus erythematosus. Prospective cohort study. Nurses' Health Study. 69,435 women aged 30 to 55 years in 1976 who reported that they had completed menopause and did not have systemic lupus erythematosus or any connective tissue disease were followed every 2 years from 1976 to 1990. These women were classified as never- or ever-(current and past) users of postmenopausal hormones. Incidence rates of systemic lupus erythematosus and classification criteria from the American College of Rheumatology that were confirmed by chart review. With never-users of postmenopausal hormones as the reference group, age-adjusted relative risks for systemic lupus erythematosus (n = 45 women) were 2.1 (95% CI, 1.1 to 4.0) for ever-users, 2.5 (CI, 1.2 to 5.0) for current users, and 1.8 (CI, 0.8 to 4.1) for past users. A proportional increase in the risk for systemic lupus erythematosus was observed that was related to the duration of use of postmenopausal hormones (test for trend, P = 0.011). Postmenopausal hormone therapy is associated with an increased risk for developing systemic lupus erythematosus.
Publisher: Oxford University Press (OUP)
Date: 2018
DOI: 10.1373/CLINCHEM.2017.277376
Abstract: Mounting evidence, particularly from prospective epidemiologic studies but with additional support from animal models and mechanistic studies, supported conclusions in 2016 by the International Agency for Research on Cancer (IARC) in their review of the preventive effects of weight control on cancer risk. The workgroup concluded that obesity is causally related to cancer at 13 anatomic sites (esophagus: adenocarcinoma gastric cardia colon and rectum liver gallbladder pancreas breast: postmenopausal uterine endometrial ovary kidney: renal cell meningioma thyroid and multiple myeloma). Further, avoiding weight gain and excess body fat will prevent cancer. Evidence on weight loss and reduction in risk of cancer is more limited. Ongoing clinical trials address the benefits of weight loss interventions after diagnosis. Here, we review the evidence from the 2016 IARC that obesity is causally related to cancer at 13 anatomic sites and identify areas for future research, including the consequences of childhood adiposity, the relation between velocity of weight gain and cancer risk, and improved methods for analysis of life-course adiposity and cancer risk. Refining understanding of mechanisms may further inform prevention strategies.
Publisher: Springer Science and Business Media LLC
Date: 09-1989
DOI: 10.1007/BF02599683
Abstract: Both spectral and temporal integration of tones have been explored in detail, but integration of tones varying across both dimensions has received little attention. This study explores temporal integration of tone pulses that vary over a range of frequencies. Baseline thresholds were obtained for both spectral and temporal integration with the same signals and compared with prior research. The signals were then varied on both dimensions in several ways: with equivalent spectral and temporal step sizes, different spectral and temporal step sizes, and a random pattern of frequency presentation. The data were also analyzed by spectral step size, temporal step size, frequency range, direction and slope of frequency change, and predictability. The spectral and temporal integration conditions showed that the current procedures and signals yielded the same improvement in detection thresholds as prior studies. The spectrotemporal integration conditions showed the improvement for overall detection of the signals to be limited by spectral integration, with improvement related primarily to the number of tones, regardless of timing and frequency. Surprisingly, trial-by-trial random presentation of signal frequencies did not negatively influence detection. These results support the multiple looks hypothesis [Viemeister, N. F. and Wakefield, G. H. (1991). "Temporal integration and multiple looks," J. Acoust. Soc. Am. 90, 858-865] as applied to spectrotemporal integration.
Publisher: SAGE Publications
Date: 12-12-2019
Abstract: Recent studies have suggested that mental health disorders negatively affect postoperative outcomes in patients with femoroacetabular impingement (FAI). However, the outcome measures reported and the effect sizes have varied. Furthermore, it is unknown whether similar effects are present in young adults with other hip disorders such as acetabular dysplasia. To synthesize current evidence regarding the effect of baseline psychological impairment on postintervention outcomes in patients with prearthritic hip disorders. Systematic review and meta-analysis. In February 2019, the Ovid Medline, Embase, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov databases were searched for longitudinal studies that evaluated the effect of baseline psychological impairment (such as depression or anxiety) on a postintervention clinical outcome in patients with prearthritic hip disorders including FAI, acetabular dysplasia, and/or acetabular labral tears. Descriptive measures of study quality and bias were recorded, and studies that reported statistically comparable outcomes were analyzed in meta-analyses through use of random effects models. We identified 12 eligible studies, all of which specifically evaluated patients with FAI after hip arthroscopy. No eligible studies described patients with acetabular dysplasia. Of the included studies, 8 studies reported odds ratios (ORs). The other 4 studies reported mean postoperative scores on patient-reported outcome measures (PROMs), all of which were scored from 0 to 100, with higher numbers being favorable. Patients with psychological impairment were less likely to achieve a favorable outcome after arthroscopy (OR, 0.74 95% CI, 0.62 to 0.88 P .001), and they reported worse postoperative PROM scores compared with nonimpaired patients (weighted mean difference, −20.2 points 95% CI, −32.9 to −7.5 P .001). Baseline psychological impairment is associated with clinically significantly worse outcomes in patients with femoroacetabular impingement who undergo hip arthroscopy. More standardized reporting would facilitate improved understanding of this important, potentially modifiable risk factor. CRD42019124836 (PROSPERO).
Publisher: Elsevier BV
Date: 02-2003
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2012
DOI: 10.1200/JCO.2012.30.15_SUPPL.E18551
Abstract: e18551 Background: Autologous stem cell transplant (ASCT) improves survival in MM patients years and is applied to select patients ≥ age 65. We hypothesized that comorbidities (CM) are associated with increased length of stay (LOS), hospital charges, toxicity, and in-hospital mortality in older patients with MM undergoing ASCT. Methods: This is a retrospective cohort study of patients over the age of 65 with MM admitted to U.S. hospitals for ASCT in the 2008 NIS. CM were coded using the Comorbidity Software toxicities were determined by ICD-9-CM codes. Relationships between CM and toxicities, LOS, hospital charges, and in-hospital mortality were analyzed. Results: 206 patients MM ≥ 65 years who underwent ASCT were identified. Median age was 68 years (range 65-82). As defined by Elixhauser (Medical Care 1998), 83.5% of patients had ≥ 1 CM. Median LOS was 17 days (range 1-152). Median total charges were $162,998 (range $4289-$953,789). The most common complications coded were: neutropenic fever (29.6%), diarrhea (28.6%), bacteremia (13.6%), mucositis (8.7%) and pneumonia (6.8%). In-hospital mortality was % (precise percentage cannot be reported due to cell size ). Elixhauser CM did not predict LOS, total charges, in-hospital mortality, or toxicities. When CM were restricted to those in the Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI, Sorror et al 2005), only 35.4% of patients had CM. The presence of CM using a modified HCT-CI was associated with longer LOS (23.5 vs 17.6 days, p=0.0047) higher mean total charges [$189,896 (95% CI $154,333-225,459) vs $148,234 (95%CI $121,887-174,581), p=0.02] and increased risk of “complications of transplant” or “delirium” codes (p=0.035 precise percentage cannot be reported due to cell size ). Conclusions: ASCT was well-tolerated with low in-hospital mortality in a population-based cohort of older patients with MM.The Elixhauser CM method did not predict outcomes. Using a modified HCT-CI CM index predicted longer LOS, greater hospital charges, and some toxicities, highlighting differences in the utility of different CM indices. Further investigation must define the optimal CM index for studying hematopoietic cell transplantation using administrative data.
Publisher: Elsevier BV
Date: 09-1992
DOI: 10.1016/1047-2797(92)90011-E
Abstract: The potential influence of postmenopausal estrogen therapy on the subsequent development of non-insulin-dependent diabetes mellitus (NIDDM) is relatively unexplored, despite postulated effects of these hormones on glucose tolerance. We examined the association between postmenopausal hormone use and the subsequent incidence of NIDDM in a prospective cohort of 21,028 postmenopausal US women aged 30 to 55 years and free of diagnosed diabetes, cardiovascular disease, and cancer in 1976. During 12 years of follow-up (422,991 person-years), we confirmed 1249 cases of NIDDM. Current users of postmenopausal hormones had a relative risk of NIDDM of 0.80 (95% confidence interval, 0.67 to 0.96) as compared with never users, after adjustment for age and body mass index (BMI). Past users of these hormones had an age- and BMI-adjusted relative risk of 1.07 (0.93 to 1.23). These results were not materially altered by multivariate adjustment for age, BMI, family history of diabetes, and coronary risk factors. Comparable results were obtained when the analysis was restricted to symptomatic NIDDM as the outcome. We observed no appreciable modification of these associations by family history of diabetes or category of BMI. Duration of current or past use of postmenopausal hormones and dose of conjugated estrogen were not significantly related to incidence of NIDDM. Type of hormone (estrogen alone, progesterone alone, or combination) also did not appear to influence NIDDM risk. These prospective data indicate that postmenopausal hormone therapy is unlikely to be associated with a material increase in the incidence of NIDDM among women.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814290
Abstract: Supplementary Table 6 shows the association between composite sleep score and EAC risk with deaths as competing events
Publisher: American Academy of Pediatrics (AAP)
Date: 04-2000
Abstract: To examine the role of physical activity, inactivity, and dietary patterns on annual weight changes among preadolescents and adolescents, taking growth and development into account. We studied a cohort of 6149 girls and 4620 boys from all over the United States who were 9 to 14 years old in 1996. All returned questionnaires in the fall of 1996 and a year later in 1997. Each child provided his or her current height and weight and a detailed assessment of typical past-year dietary intakes, physical activities, and recreational inactivities (TV, videos/VCR, and video/computer games). Our hypotheses were that physical activity and dietary fiber intake are negatively correlated with annual changes in adiposity and that recreational inactivity (TV/videos/games), caloric intake, and dietary fat intake are positively correlated with annual changes in adiposity. Separately for boys and girls, we performed regression analysis of 1-year change in body mass index (BMI kg/m2). All hypothesized factors were in the model simultaneously with several adjustment factors. Larger increases in BMI from 1996 to 1997 were among girls who reported higher caloric intakes (.0061 ± .0026 kg/m2 per 100 kcal/day β ± standard error), less physical activity (−.0284 ± .0142 kg/m2/hour/day) and more time with TV/videos/games (.0372 ± .0106 kg/m2/hour/day) during the year between the 2 BMI assessments. Larger BMI increases were among boys who reported more time with TV/videos/games (.0384 ± .0101) during the year. For both boys and girls, a larger rise in caloric intake from 1996 to 1997 predicted larger BMI increases (girls: .0059 ± .0027 kg/m2 per increase of 100 kcal/day boys: .0082 ± .0030). No significant associations were noted for energy-adjusted dietary fat or fiber. For both boys and girls, a 1-year increase in BMI was larger in those who reported more time with TV/videos/games during the year between the 2 BMI measurements, and in those who reported that their caloric intakes increased more from 1 year to the next. Larger year-to-year increases in BMI were also seen among girls who reported higher caloric intakes and less physical activity during the year between the 2 BMI measurements. Although the magnitudes of these estimated effects were small, their cumulative effects, year after year during adolescence, would produce substantial gains in body weight. Strategies to prevent excessive caloric intakes, to decrease time with TV/videos/games, and to increase physical activity would be promising as a means to prevent obesity.
Publisher: Wiley
Date: 25-03-2018
Publisher: Wiley
Date: 04-02-2003
DOI: 10.1002/IJC.10910
Abstract: Intakes of animal protein, meat, and eggs have been associated with breast cancer incidence and mortality in ecological studies, but data from long-term prospective studies are limited. We therefore examined these relationships in the Nurses' Health Study. We followed 88,647 women for 18 years, with 5 assessments of diet by food frequency questionnaire, cumulatively averaged and updated over time. We calculated the relative risks (RR) and 95% confidence intervals (95% CI) for risk of developing invasive breast cancer, over categories of nutrient and food intake. During follow-up, 4,107 women developed invasive breast cancer. Compared to the lowest quintile of intake, the RR and 95% CI for the highest quintile of intake were 1.02 (0.92-1.14) for animal protein, 0.93 (0.83-1.05) for red meat and 0.89 (0.79-1.00) for all meat. Results did not differ by menopausal status or family history of breast cancer. We found no evidence that intake of meat or fish during mid-life and later was associated with risk of breast cancer.
Publisher: Massachusetts Medical Society
Date: 16-11-1995
Publisher: American Medical Association (AMA)
Date: 15-01-1992
Publisher: American Association for Cancer Research (AACR)
Date: 08-2015
DOI: 10.1158/1538-7445.AM2015-4629
Abstract: Genome-wide association studies (GWAS) of multiple myeloma (MM) in Northern Europeans have identified seven novel risk loci (2p23.3, 3p22.1, 3q26.2, 6p21.33, 7p15.3, 17p11.2, 22q13.1). We performed a multiethnic meta-analysis of these regions in 1,274 MM patients and 1,486 controls of European ancestry (EA) and 1,049 MM patients and 7,080 controls of African ancestry (AA), leveraging the differential linkage-disequilibrium of these populations in order to better localize the putative functional variants. We observed directionally consistent effects for all seven index SNPs in both populations, with four significantly associated (p& .05) with risk in EAs (3p22.1, 7p15.3, 17p11.2, 22q13.1), and two significantly associated with risk in AAs (7p15.3 and 22q13.1). In a fixed effects meta-analysis of six regions (excluding the HLA region on chromosome 6), variation in five of the regions (2p33.3, 3p22.1, 7p15.3, 17p11.2, 22q13.1) had statistically significant associations with risk (Table 1). In one region, the index variant had the strongest association [rs4487645 at 7p15.3, (OR = 1.30, p = 8.7×10−8)]. Five of the six most significantly associated variants identified in the multiethnic analyses overlapped with biologically relevant features indicating regulatory activity based on CD20+ (B lymphocyte) cells, showing evidence of potential function those included a missense variant in (17p11.2, rs34562254, Pro251Leu) in TNFRSF13B, which encodes a lymphocyte-specific protein in the tumor necrosis factor receptor family that interacts with the NF-kb pathway. Our study shows that these regions are important in MM risk across ethnicities and further supports the use of multiple ethnic groups in genetic studies to enhance identification of risk variants. Table 1.Most significant associations for each region in the multiethnic meta-analysis.In iduals of European AncestryIn iduals of African AncestryMulitethnic Metar2 with IndexcCHRSNPRAaFreqbORP-valueFreqbORP-valueORP-valueP-het2rs732075G0.591.222.0×10−30.621.122.0×10−21.162.6×10−40.280.09/0.283rs73069394A0.191.243.0×10−30.621.181.5×10−21.201.3×10−50.550.77/0.963rs12637184G0.761.136.0×10−20.921.192.7×10−11.151.0×10−20.640.94/1.007rs4487645C0.671.237.0×10−40.891.485.5×10−51.308.7×10−80.07-d17rs34562254A0.121.452.4×10−50.131.212.2×10−31.312.5×10−60.120.33/0.9022rs139400T0.491.224.0×10−40.531.172.1×10−31.191.2×10−60.630.63/0.96aRisk allelebFrequency of the risk allele in European and African ancestry studiescr2 metrics based on 1000 Genomes Project AFR/EUR populationsdIndex SNP Citation Format: Kristin A. Rand, Chi Song, Eric Dean, Daniel Serie, Karen Curtin, Dennis Hazelett, Amie E. Hwang, Xin Sheng, Alex Stram, David J. Van Den Berg, Carol Ann Huff, Leon Bernal-Mizrachi, Michael H. Tomasson, Sikander Ailawadhi, Anneclaire De Roos, Seema Singhal, Karen Pawlish, Edward Peters, Catherine Bock, David V. Conti, Graham Colditz, Todd Zimmerman, Scott Huntsman, John Graff, African Ancestry Prostate Cancer GWAS Consortium,African Ancestry Breast Cancer GWAS Consortium, Stephen J. Chanock, Michael Lieber, Jayesh Mehta, Eric A. Klein, Nalini Janakiraman, Richard K. Severson, Angela R. Brooks-Wilson, Vincent Rajkumar, Elizabeth E. Brown, Laurence Kolonel, Susan Slager, Brian E. Henderson, Graham G. Giles, John J. Spinelli, Brian Chiu, Kenneth C. Anderson, Jeffrey Zonder, Robert Z. Orlowski, Sagar Lonial, Nicola C , Celine Vachon, Elad Ziv, Dan O. Stram, Christopher A. Haiman, Wendy Cozen. Multiple myeloma susceptibility loci examined in African and European ancestry populations. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research 2015 Apr 18-22 Philadelphia, PA. Philadelphia (PA): AACR Cancer Res 2015 (15 Suppl):Abstract nr 4629. doi:10.1158/1538-7445.AM2015-4629
Publisher: Elsevier BV
Date: 02-1996
DOI: 10.1016/S0140-6736(96)90010-0
Abstract: The relation between breastfeeding and breast cancer risk has been examined in many studies some have reported no association, and others a reduced risk, particularly among premenopausal women. In the only prospective cohort study, no association was found. We have assessed prospectively the association between breastfeeding and incidence of breast cancer among 89,887 women in the US Nurses' Health Study. In 1986, participants were asked about the number of months they breastfed for all their children combined. Parous women with no history of cancer were included in this analysis. During 6 years of follow-up (513,015 person-years), 1,459 invasive breast cancer cases were diagnosed. Relative to women who had never breastfed, no significant overall association was found--after adjusting for established risk factors for breast cancer--between a history of having breastfed and subsequent development of breast cancer (relative risk [RR] 0.93, 95% CI 0.83 -1.03). No inverse trend was observed with duration of breastfeeding women who breastfed for 2 years of longer had a RR of 1.11 (0.90-1.38). Among women who had given birth only once, women who had breastfed their child experienced a lower incidence of breast cancer (RR 0.68, 0.46-1.00). Among premenopausal women, who tended to be near menopause due to the age structure of the cohort, the RR of breast cancer for those who had lactated was 1.16 (0.89-1.50). Premenopausal women who had lactated for 1 year or more had a RR of 1.10 (0.78-1.57). These data suggest that there is no important overall association between breast-feeding and the occurrence of breast cancer.
Publisher: Elsevier BV
Date: 03-1990
DOI: 10.1016/0002-9149(90)91043-6
Abstract: The relation between alcohol consumption and the risk of development of hypertension was studied among 58,218 US female registered nurses aged 39 to 59 years who were free of diagnosed systemic hypertension and other major diseases. In 1980, all of these women completed an independently validated dietary questionnaire, which included use of alcoholic beverages. During 4 years of follow-up, 3,275 women reported an initial diagnosis of hypertension validity of the self-report measure was demonstrated in a subs le. When compared to nondrinkers, women drinking 20 to 34 g of alcohol per day (about 2 or 3 drinks) had a significantly elevated relative risk of 1.4 the 95% confidence interval (CI) was 1.2 to 1.7 after adjustment for age and Quetelet's index. For women consuming greater than 35 g/day, the relative risk was 1.9 (95% CI 1.6 to 2.2). Adjustment for smoking and dietary variables did not alter these results. Independent significant associations were observed for the consumption of beer, wine and liquor. These prospective data suggest that alcohol intake of up to about 20 g/day does not increase the risk of hypertension among women, but beyond this level, the risk increases progressively.
Publisher: Oxford University Press (OUP)
Date: 31-01-2020
DOI: 10.1093/AJE/KWAA013
Abstract: Over the past century, the field of epidemiology has evolved and adapted to changing public health needs. Challenges include newly emerging public health concerns across broad and erse content areas, new methods, and vast data sources. We recognize the need to engage and educate the next generation of epidemiologists and prepare them to tackle these issues of the 21st century. In this commentary, we suggest a skeleton framework upon which departments of epidemiology should build their curriculum. We propose domains that include applied epidemiology, biological and social determinants of health, communication, creativity and ability to collaborate and lead, statistical methods, and study design. We believe all students should gain skills across these domains to tackle the challenges posed to us. The aim is to train smart thinkers, not technicians, to embrace challenges and move the expanding field of epidemiology forward.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814299
Abstract: Supplementary Table 4 shows the association between finer composite sleep score and EAC risk
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814293
Abstract: Supplementary Table 5 shows the association between weighted sleep score and EAC risk
Publisher: Wiley
Date: 15-07-2014
DOI: 10.1111/BJH.13026
Publisher: Elsevier BV
Date: 08-1999
Abstract: Ingestion of animal protein raises serum cholesterol in some experimental models but not in others, and ecologic studies have suggested a positive association between animal protein intake and risk of ischemic heart disease. Prospective data on the relation of protein intake to risk of ischemic heart disease are sparse. The objective was to examine the relation between protein intake and risk of ischemic heart disease. The study was a prospective cohort study. We examined the association between dietary protein intake and incidence of ischemic heart disease in a cohort of 80082 women aged 34-59 y and without a previous diagnosis of ischemic heart disease, stroke, cancer, hypercholesterolemia, or diabetes in 1980. Intakes of protein and other nutrients were assessed with validated dietary questionnaires. We documented 939 major instances of ischemic heart disease during 14 y of follow-up. After age, smoking, total energy intake, percentages of energy from specific types of fat, and other ischemic heart disease risk factors were controlled for, high protein intakes were associated with a low risk of ischemic heart disease when extreme quintiles of total protein intake were compared, the relative risk was 0.74 (95% CI: 0.59, 0.94). Both animal and vegetable proteins contributed to the lower risk. This inverse association was similar in women with low- or high-fat diets. Our data do not support the hypothesis that a high protein intake increases the risk of ischemic heart disease. In contrast, our findings suggest that replacing carbohydrates with protein may be associated with a lower risk of ischemic heart disease. Because a high dietary protein intake is often accompanied by increases in saturated fat and cholesterol intakes, application of these findings to public dietary advice should be cautious.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814281
Abstract: Supplementary Table 9 shows the additive interaction between composite sleep score and genetic risk with EAC risk
Publisher: Elsevier BV
Date: 02-2003
Abstract: Short trials of calcium supplementation show that it reduces loss of bone density in postmenopausal women longer observational studies do not generally find a lower risk of hip fracture with higher-calcium diets. Fewer studies have focused on vitamin D in preventing postmenopausal osteoporosis or fractures. We assessed relations between postmenopausal hip fracture risk and calcium, vitamin D, and milk consumption. In an 18-y prospective analysis in 72 337 postmenopausal women, dietary intake and nutritional supplement use were assessed at baseline in 1980 and updated several times during follow-up. We identified 603 incident hip fractures resulting from low or moderate trauma. Relative risks (RRs) from proportional hazards models were controlled for other dietary and nondietary factors. Women consuming > or = 12.5 microg vitamin D/d from food plus supplements had a 37% lower risk of hip fracture (RR = 0.63 95% CI: 0.42, 0.94) than did women consuming or = 1200 compared with < 600 mg/d). Milk consumption was also not associated with a lower risk of hip fracture (P for trend = 0.21). An adequate vitamin D intake is associated with a lower risk of osteoporotic hip fractures in postmenopausal women. Neither milk nor a high-calcium diet appears to reduce risk. Because women commonly consume less than the recommended intake of vitamin D, supplement use or dark fish consumption may be prudent.
Publisher: American Association for Cancer Research (AACR)
Date: 15-02-2023
DOI: 10.1158/1055-9965.EPI-22-0356
Abstract: Engaging erse populations in cancer genomics research is of critical importance and is a fundamental goal of the NCI Participant Engagement and Cancer Genome Sequencing (PE-CGS) Network. Established as part of the Cancer Moonshot, PE-CGS is a consortium of stakeholders including clinicians, scientists, genetic counselors, and representatives of potential study participants and their communities. Participant engagement is an ongoing, bidirectional, and mutually beneficial interaction between study participants and researchers. PE-CGS sought to set priorities in participant engagement for conducting the network's research. PE-CGS deliberatively engaged its stakeholders in the following four-phase process to set the network's research priorities in participant engagement: (i) a brainstorming exercise to elicit potential priorities (ii) a 2-day virtual meeting to discuss priorities (iii) recommendations from the PE-CGS External Advisory Panel to refine priorities and (iv) a virtual meeting to set priorities. Nearly 150 PE-CGS stakeholders engaged in the process. Five priorities were set: (i) tailor education and communication materials for participants throughout the research process (ii) identify measures of participant engagement (iii) identify optimal participant engagement strategies (iv) understand cancer disparities in the context of cancer genomics research and (v) personalize the return of genomics findings to participants. PE-CGS is pursuing these priorities to meaningfully engage erse and underrepresented patients with cancer and posttreatment cancer survivors as participants in cancer genomics research and, subsequently, generate new discoveries. Data from PE-CGS will be shared with the broader scientific community in a manner consistent with participant informed consent and community agreement.
Publisher: American Medical Association (AMA)
Date: 08-2003
Publisher: Oxford University Press (OUP)
Date: 24-07-2007
DOI: 10.1093/JNCI/DJM062
Abstract: Mammographic density and circulating sex hormones are two well-confirmed predictors of breast cancer risk. Whether mammographic density reflects levels of endogenous sex hormones is unclear. We examined whether these predictors are independently associated with breast cancer risk in a prospective study. We conducted a nested case-control study within the Nurses' Health Study cohort of 253 case subjects with breast cancer and 520 control subjects. All participants were postmenopausal women who were not using postmenopausal hormones at the time of both blood collection and mammography. Plasma levels of estradiol, free estradiol, testosterone, and free testosterone were evaluated. Mammographic density was assessed by use of computer-assisted analysis of mammograms. Logistic regression models that were adjusted for matching variables and potential confounders were used to calculate relative risks (RRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. Levels of circulating sex steroids and mammographic density were both statistically significantly and independently associated with breast cancer risk. The relative risk of breast cancer associated with mammographic density (RR for highest quartile compared with lowest quartile = 3.8, 95% CI = 2.2 to 6.6 P(trend)<.001) changed little when the analysis was adjusted for circulating estradiol (RR = 3.9, 95% CI = 2.2 to 6.9 P(trend)<.001) or circulating testosterone (RR = 4.1, 95% CI = 2.3 to 7.2 P(trend)<.001). Circulating levels of estradiol (RR = 2.4, 95% CI = 1.4 to 4.0) and of testosterone (RR = 2.0, 95% CI = 1.2 to 3.1) were both associated with breast cancer risk, before and after adjustment for mammographic density. In a joint analysis of mammographic density and plasma testosterone, the risk of breast cancer was highest in the highest tertiles of both relative to the lowest tertiles of both (RR = 6.0, 95% CI = 2.6 to 14.0). A similar pattern was observed in the joint analysis of estradiol and mammographic density (RR = 4.1, 95% CI = 1.7 to 9.8). Circulating sex steroid levels and mammographic density appear strongly and independently associated with the risk of breast cancer in postmenopausal women.
Publisher: Oxford University Press (OUP)
Date: 22-07-2010
DOI: 10.1093/AJE/KWQ155
Publisher: American College of Physicians
Date: 02-1992
DOI: 10.7326/0003-4819-116-3-238
Abstract: To determine whether published cost-effectiveness and cost-benefit analyses have adhered to basic analytic principles. Structured methodologic review of published articles. Seventy-seven articles published either from 1978 to 1980 or from 1985 to 1987 in general medical, general surgical, and medical subspecialty journals. Articles were reviewed to assess the use and reporting of six fundamental principles of analysis. These principles were derived by reviewing widely cited textbooks and articles describing the methods for performing economic analyses and by selecting the methods universally recommended. Overall performance was only fair. Three articles adhered to all six principles, and the median number of principles to which articles adhered was three. Among the problems noted were failure to make underlying assumptions explicit and, therefore, verifiable, and failure to test assumptions with sensitivity analyses. No improvement in performance was observed between 1978 and 1987. Articles in general medical journals, however, were more likely to use analytic methods appropriately than articles in the general surgical or medical subspecialty literature. Greater attention should be devoted to ensuring the appropriate use of analytic methods for economic analyses, and readers should make note of the methods used when interpreting the results of economic analyses.
Publisher: Elsevier BV
Date: 07-1998
DOI: 10.1016/S1047-2797(97)00236-6
Abstract: We conducted a pilot study of a mail food frequency questionnaire among a bi-racial s le of 200 persons 65 years and older, selected from participants of an ongoing community study. Up to three successive mailings were followed by personal contact with nonresponders. Response to the mail survey was higher in whites (81%) than in blacks (53%). Personal contact was important to achieving high and uniform response (94%) in both racial groups. Those responding to the mailed questionnaires were also more likely to be older and higher educated. The vast majority of questionnaires returned by mail were complete 85% had fewer than 15 missing items out of 152 questions. A mail nutritional survey is a feasible method of dietary assessment in older, white populations, but personal contact with nonresponders may be required for comparable participation among blacks.
Publisher: Springer Science and Business Media LLC
Date: 05-07-2011
Publisher: Massachusetts Medical Society
Date: 1987
DOI: 10.1056/NEJM198701013160105
Abstract: Postoperative complications resulting from bariatric surgery can lead to severe vitamin-deficiency states. A patient who underwent bariatric bypass surgery and later developed Wernicke's encephalopathy prompted us to present her interesting case history for discussion. Although bariatric surgery is known to be a risk factor for Wernicke's encephalopathy, this diagnosis is only rarely evoked in the postoperative course. We recommend that the occurrence of digestive, psychiatric or neurological symptoms after bariatric surgery should suggest a thiamine deficiency that must be promptly assessed. Without waiting for the results, thiamine supplementation should be initiated.
Publisher: American Association for Cancer Research (AACR)
Date: 30-04-2017
Publisher: Wiley
Date: 09-1999
DOI: 10.1002/(SICI)1097-0142(19990901)86:5<826::AID-CNCR19>3.0.CO;2-0
Abstract: Little is known regarding how specific dietary factors affect the survival of women with breast carcinoma. Female registered nurses were followed with biennial questionnaires in a prospective cohort with 18 years of follow-up. Participants were women with breast carcinoma (n = 1982) diagnosed between 1976-1990 who completed a food frequency questionnaire after diagnosis. The main outcome measure was time to death from any cause. Analysis was made by multivariate Cox proportional hazards models. In multivariate analyses of diet after diagnosis, no apparent association was found between fat intake and mortality. The relative risk (and 95% confidence interval) of mortality comparing the highest with the lowest quintile of protein intake was 0.65 (0.47-0.88). There was no association between red meat and mortality. These associations were similar in analyses with breast carcinoma death as the outcome. No survival advantage was found for a low fat diet after a diagnosis of breast carcinoma. However, increased survival was observed among women eating more protein, but not red meat. The findings suggest that differences in diet may affect survival after a diagnosis of breast carcinoma and should be examined in greater detail.
Publisher: American Medical Association (AMA)
Date: 04-1996
DOI: 10.1001/ARCHPEDI.1996.02170290022003
Abstract: The prevalence of obesity among children and adolescents has increased, and television viewing has been suggested as a cause. We examined the relation between hours of television viewed and the prevalence of overweight in 1990, and the incidence and remission of overweight from 1986 to 1990 in a nationally representative cohort of 746 youths aged 10 to 15 years in 1990 whose mothers were 25 to 32 years old. Overweight was defined as a body mass index higher than the 85th percentile for age and gender. We observed a strong dose-response relationship between the prevalence of overweight in 1990 and hours of television viewed. The odds of being overweight were 4.6 (95% confidence interval, 2.2 to 9.6) times greater for youth watching more than 5 hours of television per day compared with those watching 0 to 2 hours. When adjustments were made for previous overweight (in 1986), baseline maternal overweight, socioeconomic status, household structure, ethnicity, and maternal and child aptitude test scores, results were similar (odds ratio, 5.3 95% confidence interval, 2.3 to 12.1). We also found significant relations between television viewing and increased incidence and decreased remission of overweight during this 4-year period, adjusted for baseline covariates. The adjusted odds of incidence were 8.3 (95% confidence interval, 2.6 to 26.5) times greater for youth watching more than 5 hours of television per day compared with those watching for 0 to 2 hours. Estimates of attributable risk indicate that more than 60% of overweight incidence in this population can be linked to excess television viewing time. Television viewing affects overweight among youth, and reductions in viewing time could help prevent this increasingly common chronic health condition.
Publisher: American College of Physicians
Date: 15-05-1994
DOI: 10.7326/0003-4819-120-10-199405150-00002
Abstract: To examine prospectively the risk for mortality among women who had ever used oral contraceptives compared with those who had never used oral contraceptives. Prospective cohort study. Nurses' Health Study. 166,755 women aged 30 to 55 years in 1976, followed through 1988 (1.3 million person-years of follow-up). On the basis of 2879 deaths, we found no overall difference in mortality among women who had ever used oral contraceptives compared with women who had never used oral contraceptives the relative risk for ever-users, adjusted for age, body mass index, and cigarette smoking was 0.93 (95% CI, 0.85 to 1.01). We observed no trend in risk for total mortality with increasing duration of past use of oral contraceptives. After adjusting for age, body mass index, and cigarette smoking, women who had used oral contraceptives for 10 or more years had a relative risk of 1.06 (CI, 0.83 to 1.35). Use of oral contraceptives is safe no evidence from this study indicates that long durations of oral contraceptive use adversely affect long-term risk for mortality.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814287
Abstract: Supplementary Table 7 shows the association between composite sleep score and EAC risk by BMI group
Publisher: American Association for Cancer Research (AACR)
Date: 14-12-2009
DOI: 10.1158/0008-5472.CAN-09-1018
Abstract: Mammographic density is one of the strongest predictors of breast cancer risk. Recently, it has been suggested that reactive oxygen species may influence breast cancer risk through its influence on mammographic density. In the current study, we addressed this hypothesis and also assessed if the association between carotenoids and breast cancer risk varies by mammographic density. We conducted a nested case-control study consisting of 604 breast cancer cases and 626 controls with prospectively measured circulating carotenoid levels and mammographic density in the Nurses' Health Study. Circulating levels of α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein/zeaxanthin were measured. We used a computer-assisted thresholding method to measure percent mammographic density. We found no evidence that circulating carotenoids are inversely associated with mammographic density. However, mammographic density significantly modified the association between total circulating carotenoids and breast cancer (P heterogeneity = 0.008). Overall, circulating total carotenoids were inversely associated with breast cancer risk (P trend = 0.01). Among women in the highest tertile of mammographic density, total carotenoids were associated with a 50% reduction in breast cancer risk (odds ratio, 0.5 95% confidence interval, 0.3–0.8). In contrast, there was no inverse association between carotenoids and breast cancer risk among women with low mammographic density. Similarly, among women in the highest tertile of mammographic density, high levels of circulating α-carotene, β-cryptoxanthin, lycopene, and lutein/zeaxanthin were associated with a significant 40% to 50% reduction in breast cancer risk (P trend & 0.05). Our results suggest that plasma levels of carotenoids may play a role in reducing breast cancer risk, particularly among women with high mammographic density. [Cancer Res 2009 (24):9323–9]
Publisher: American Academy of Pediatrics (AAP)
Date: 08-2000
Abstract: To describe the association of cigar use with use of cigarettes, smokeless tobacco, and alcohol among adolescents and to examine the association of self-esteem, physical activity, and use of tobacco promotional items with cigar use. A cross-sectional study of 7104 girls and 5499 boys 10 to 15 years of age in 1997. Data were collected from self-report questionnaires. The prevalence of cigar use increased with age among both girls and boys. Among 11-year-olds, only 1% of girls and 3% of boys had used a cigar, whereas among 15-year-olds, 11% of girls and 25% of boys had used a cigar. Cigar users were much more likely than nonusers to have experimented with cigarettes (girls, odds ratio [OR]: 23.6 95% confidence interval [CI]: 17.2–32.3 boys, OR: 21.3 95% CI: 17.1–26.6), smokeless tobacco (girls, OR: 7.5 95% CI: 4.5–12.4 boys, OR: 13.0 95% CI: 9.8–17.4), and alcohol (girls, OR: 6.6 95% CI: 4.8–9.1 boys, OR: 6.8 95% CI: 5.3–8.8). There was a strong association between cigar use and binge drinking, especially among boys (girls, OR: 11.6 95% CI: 7.9–16.9 boys, OR: 34.8 95% CI: 19.4–62.3). Cigar users reported more hours of weekly physical activity than did nonusers. Additionally, cigar users were more likely to report high social self-esteem and to possess a tobacco promotional item. Adolescents who use cigars are more likely to use other tobacco products and alcohol, to report high social self-esteem, and to possess tobacco promotional items. Health care professionals and teachers should include cigar use in discussions with adolescents addressing substance use.
Publisher: Springer Science and Business Media LLC
Date: 09-1992
DOI: 10.1007/BF00051356
Abstract: This paper describes the GeneTests genetic testing information resource with a focus on the GeneReviews component. The need for authoritative genetic testing information and issues in the development and maintenance of GeneReviews are discussed: H ered by lack of currency and content deficits, traditional medical information resources such as textbooks and the published literature are generally inadequate sources of genetic testing information. Problems encountered in developing GeneReviews include the evolution of new authorship models and academic and genetics professionals' skepticism about the quality of Web-based publications. GeneTests is an authoritative, highly used, and well-regarded resource in the international medical community that is intended for health care providers. Future development issues to address include ways to (1) manage the increasing editing and updating load as content grows and (2) address technical and content issues that need to be considered in displaying GeneReviews as a "just in time" resource in the electronic medical record to achieve the project goal of integrating appropriate use of genetic testing into patient care.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814284
Abstract: Supplementary Table 8 shows the joint associations between composite sleep score and genetic risk with EAC risk
Publisher: Elsevier BV
Date: 12-2015
Publisher: Massachusetts Medical Society
Date: 17-11-1988
DOI: 10.1056/NEJM198811173192004
Abstract: Electron crystallography has evolved as a method that can be used either alternatively or in combination with three-dimensional crystallization and X-ray crystallography to study structure-function questions of membrane proteins, as well as soluble proteins. Screening for two-dimensional (2D) crystals by transmission electron microscopy (EM) is the critical step in finding, optimizing, and selecting s les for high-resolution data collection by cryo-EM. Here we describe the fundamental steps in identifying both large and ordered, as well as small 2D arrays, that can potentially supply critical information for optimization of crystallization conditions. By working with different magnifications at the EM, data on a range of critical parameters is obtained. Lower magnification supplies valuable data on the morphology and membrane size. At higher magnifications, possible order and 2D crystal dimensions are determined. In this context, it is described how CCD cameras and online-Fourier Transforms are used at higher magnifications to assess proteoliposomes for order and size. While 2D crystals of membrane proteins are most commonly grown by reconstitution by dialysis, the screening technique is equally applicable for crystals produced with the help of monolayers, native 2D crystals, and ordered arrays of soluble proteins. In addition, the methods described here are applicable to the screening for 2D crystals of even smaller as well as larger membrane proteins, where smaller proteins require the same amount of care in identification as our ex les and the lattice of larger proteins might be more easily identifiable at earlier stages of the screening.
Publisher: Elsevier BV
Date: 04-1997
Publisher: American Medical Association (AMA)
Date: 25-11-2002
Publisher: American Association for Cancer Research (AACR)
Date: 07-02-2010
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2008
Publisher: Bentham Science Publishers Ltd.
Date: 04-2004
Abstract: A large series of clinico-epidemiological studies, meta-analyses and experimental findings have concluded that there is a relationship between coronary heart disease (CHD) and passive smoking either after acute or chronic exposure. Cigarette smoking is the most important cause of premature death in industrialized countries because it is associated with an increased risk of developing several types of cancer and arterial disease. In family homes as well as in workplaces, environmental tobacco smoke (ETS) exposure is associated with an increased risk of CHD in exposed non-smokers when compared to un-exposed non-smokers. Different anatomical structures are damaged by ETS. The endothelium, artery wall and heart are target organs for passive smoking. Therefore, smoking cessation will benefit both smokers and those exposed to ETS.
Publisher: American Medical Association (AMA)
Date: 04-02-1998
Abstract: Hyperhomocysteinemia is caused by genetic and lifestyle influences, including low intakes of folate and vitamin B6. However, prospective data relating intake of these vitamins to risk of coronary heart disease (CHD) are not available. To examine intakes of folate and vitamin B6 in relation to the incidence of nonfatal myocardial infarction (MI) and fatal CHD. Prospective cohort study. In 1980, a total of 80082 women from the Nurses' Health Study with no previous history of cardiovascular disease, cancer, hypercholesterolemia, or diabetes completed a detailed food frequency questionnaire from which we derived usual intake of folate and vitamin B6. Nonfatal MI and fatal CHD confirmed by World Health Organization criteria. During 14 years of follow-up, we documented 658 incident cases of nonfatal MI and 281 cases of fatal CHD. After controlling for cardiovascular risk factors, including smoking and hypertension and intake of alcohol, fiber, vitamin E, and saturated, polyunsaturated, and trans fat, the relative risks (RRs) of CHD between extreme quintiles were 0.69 (95% confidence interval [CI], 0.55-0.87) for folate (median intake, 696 microg/d vs 158 microg/d) and 0.67 (95% CI, 0.53-0.85) for vitamin B6 (median intake, 4.6 mg/d vs 1.1 mg/d). Controlling for the same variables, the RR was 0.55 (95% CI, 0.41-0.74) among women in the highest quintile of both folate and vitamin B6 intake compared with the opposite extreme. Risk of CHD was reduced among women who regularly used multiple vitamins (RR=0.76 95% CI, 0.65-0.90), the major source of folate and vitamin B6, and after excluding multiple vitamin users, among those with higher dietary intakes of folate and vitamin B6. In a subgroup analysis, compared with nondrinkers, the inverse association between a high-folate diet and CHD was strongest among women who consumed up to 1 alcoholic beverage per day (RR =0.69 95% CI, 0.49-0.97) or more than 1 drink per day (RR=0.27 95% CI, 0.13-0.58). These results suggest that intake of folate and vitamin B6 above the current recommended dietary allowance may be important in the primary prevention of CHD among women.
Publisher: Springer Science and Business Media LLC
Date: 08-1999
Abstract: To assess the association of physical activity, television program viewing and other forms of video viewing with the prevalence of obesity among school children. Cross-sectional study. 712 children, 9-16 y old, from a low- and a middle-income town in the Mexico City area. Children completed a self administered questionnaire to assess time spent in physical activity and television viewing, and diet. Height weight and triceps skinfolds were measured. The outcome variable was obesity, and the covariates were hours of television programs and other video viewing, physical activity, energy intake, percentage of energy from fat, town of location of school, age, gender and perception of mother's weight status. Among 461 children with complete information, 24% were classified as obese. Children reported an average of 4.1 +/- 2.2 h/d watching television (2.4 +/- 1.5 h/d for TV programs and 1.7 +/- 1.5 h/d for video cassette recorder (VCR) or videogames), and 1.8 +/- 1.3 h/d in moderate and vigorous physical activities. Odds ratios (OR) of obesity were 12% higher for each hour of television program viewing per day (OR = 1.12, 95% confidence interval (CI) 1.02,-1.22), and 10% lower for each hour of moderate/vigorous physical activity per day (OR = 0.90, 95% CI 0.83-0.98), controlling for age, gender, town and perception of mother's weight status. Children in the middle-income town had higher adjusted odds of obesity (OR = 2.58, 95% CI 1.47-4.54). Physical activity and television viewing, but not VCR/videogames use, were related to obesity prevalence in Mexican children 9-16 y old.
Publisher: Wiley
Date: 09-1983
DOI: 10.1111/J.1365-2923.1983.TB00960.X
Abstract: As the scientific foundation of clinical practice has expanded the caring aspect of medicine has been given less emphasis. The development of a paradigm of medicine based on achieving a diagnosis has resulted in neglect of this caring aspect of medicine in education programmes. This has contributed to the current failing of doctors to meet community needs in terms of caring as opposed to curing in medicine. Change in the structure and emphasis of clinical training is necessary in order that graduates meet community needs.
Publisher: Springer Science and Business Media LLC
Date: 31-10-2022
DOI: 10.1038/S41416-022-02035-7
Abstract: Although adolescent diet has been proposed to contribute to prostate cancer (PCa) development, no studies have investigated the relation between adolescent dietary patterns and PCa risk or mortality. Using data from 164,079 men in the NIH-AARP Diet and Health Study, we performed factor analysis to identify dietary patterns at ages 12-13 years and then used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of total (n = 17,861), non-advanced (n = 15,499), advanced (n = 2362), and fatal PCa (n = 832). Although not entirely consistent across analyses, a higher adolescent plant-based pattern (characterised by vegetables, fruits, and dark bread) score was associated with slightly reduced risks of total (fully adjusted HR We found evidence to support a modest, protective role for a plant-based dietary pattern during adolescence on PCa risk. If confirmed in future studies, our findings may help to inform the development of new, primary prevention strategies for PCa.
Publisher: Elsevier BV
Date: 12-1997
DOI: 10.1016/S0895-4356(97)00220-5
Abstract: Empirical definitions of remission and recovery from eating disorders are needed to understand outcome data and compare results across studies. 106 treatment-seeking women with bulimia nervosa, who had abstained from binging and purging for at least 4 weeks, were followed prospectively. Relapse was defined as at least 4 consecutive weeks of either binging and purging weekly or binging two or more times per week, regardless of purging. Recovery was differentiated from remission based on the probability of relapse. The minimum number of weeks after which the risk of relapse leveled off was used as the cut-off to distinguish between the two outcomes. Kaplan-Meier methods were used to estimate the weekly probability of relapse. When defining remission as at least 4 weeks of being asymptomatic, a quarter of the women relapsed within 11 weeks. By 37 weeks, only 49% of the women remained asymptomatic (95% CI, 41-61). The probability of relapse was substantial for approximately a year after a woman ceased to binge and purge. Bulimia nervosa is an episodic disorder. As a conservative approach, periods of being asymptomatic that last less than 1 year should be labeled as remissions, not recoveries.
Publisher: Elsevier BV
Date: 12-2002
Abstract: Adherence to the Dietary Guidelines for Americans, measured with the US Department of Agriculture Healthy Eating Index (HEI), was associated with only a small reduction in major chronic disease risk. Research suggests that greater reductions in risk are possible with more specific guidance. We evaluated whether 2 alternate measures of diet quality, the Alternate Healthy Eating Index (AHEI) and the Recommended Food Score (RFS), would predict chronic disease risk reduction more effectively than did the HEI. A total of 38 615 men from the Health Professional's Follow-up Study and 67 271 women from the Nurses' Health Study completed dietary questionnaires. Major chronic disease was defined as the initial occurrence of cardiovascular disease (CVD), cancer, or nontraumatic death during 8-12 y of follow-up. High AHEI scores were associated with significant reductions in risk of major chronic disease in men [multivariate relative risk (RR): 0.80 95% CI: 0.71, 0.91] and in women (RR: 0.89 95% CI: 0.82, 0.96) when comparing the highest and lowest quintiles. Reductions in risk were particularly strong for CVD in men (RR: 0.61 95% CI: 0.49, 0.75) and in women (RR: 0.72 95% CI: 0.60, 0.86). In men but not in women, the RFS predicted risk of major chronic disease (RR: 0.93 95% CI: 0.83, 1.04) and CVD (RR: 0.77 95% CI: 0.64, 0.93). The AHEI predicted chronic disease risk better than did the RFS (or the HEI, in our previous research) primarily because of a strong inverse association with CVD. Dietary guidelines can be improved by providing more specific and comprehensive advice.
Publisher: Oxford University Press (OUP)
Date: 03-2001
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Publisher: Wiley
Date: 03-05-2021
DOI: 10.1002/PMRJ.12596
Abstract: Historically, marginalized patients were prescribed less opioid medication than affluent, white patients. However, because of persistent differential access to nonopioid pain treatments, this direction of disparity in opioid prescribing may have reversed. To compare social disadvantage and health in patients with chronic pain who were managed with versus without chronic opioid therapy. It was hypothesized that patients routinely prescribed opioids would be more likely to live in socially disadvantaged communities and report worse health. Cross‐sectional analysis of a retrospective cohort defined from medical records from 2000 to 2019. Single tertiary safety net medical center. Adult patients with chronic musculoskeletal pain who were managed longitudinally by a physiatric group practice from at least 2011 to 2015 ( n = 1173), subgrouped by chronic (≥4 years) adherent opioid usage ( n = 356) versus no chronic opioid usage ( n = 817). Not applicable. The primary outcome was the unadjusted between‐group difference in social disadvantage, defined by living in the worst national quartile of the Area Deprivation Index (ADI). An adjusted effect size was also calculated using logistic regression, with age, sex, race, and Patient‐Reported Outcomes Measurement Information System (PROMIS) Pain Interference and Physical Function scores as covariates. Secondary outcomes included adjusted differences in health by chronic opioid use (measured by PROMIS). Patients managed with chronic opioid therapy were more likely to live in a zip code within the most socially disadvantaged national quartile (34.9% 95% confidence interval [CI] 29.9–39.9% vs. 24.9% 95% CI 21.9–28.0% P .001), and social disadvantage was independently associated with chronic opioid use (odds ratio [OR] 1.01 per ADI percentile [1.01–1.02]). Opioid use was also associated with meaningfully worse PROMIS Depression (3.8 points [2.4–5.1]), Anxiety (3.0 [1.4–4.5]), and Pain Interference (2.6 [1.7–3.5]) scores. Patients prescribed chronic opioid treatment were more likely to live in socially disadvantaged neighborhoods, and chronic opioid use was independently associated with worse behavioral health. Improving access to multidisciplinary, nonopioid treatments for chronic pain may be key to successfully overcoming the opioid crisis.
Publisher: American Medical Association (AMA)
Date: 05-05-1993
Publisher: Wiley
Date: 31-10-2017
DOI: 10.1002/OBY.22021
Abstract: The aim of this study was to test the efficacy of technology‐based weight loss interventions for endometrial cancer (EC) survivors with obesity. EC survivors with obesity ( n = 196) from three medical centers completed assessments for knowledge of obesity as a risk for EC and interest in weight management. Forty‐one women were randomized to a 6‐month intervention: telemedicine with Wi‐Fi scales, text messaging (texting), or enhanced usual care (EUC). Changes in anthropometrics and psychosocial measures were analyzed. One‐third of survey participants lacked awareness that obesity increased the risk of EC, and 40% misclassified their body mass. There were no significant differences in weight loss across interventions (mean = −4.4 kg, SD = 6.5 kg). Telemedicine showed improvements in physical health and cancer‐related body image ( P s = 0.04) compared to texting and in sexual functioning compared to EUC ( P = 0.03). Total physical activity was increased in EUC compared with telemedicine (P = 0.01), and vigorous physical activity was increased in EUC compared with both interventions ( P = 0.01‐0.03) walking significantly increased in texting compared with telemedicine ( P = 0.02). Technology‐based lifestyle interventions in EC survivors with obesity were accessible and resulted in weight loss and improved quality of life. EUC also produced weight loss, demonstrating a potential for beginning weight management with information on specific diet and exercise goals.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 10-12-2016
Abstract: Evidence on overweight, obesity, and an increased risk of cancer continues to accumulate and was updated in the 2016 handbook on weight control from the International Agency for Research on Cancer (IARC). The underlying primary data, together with dose-response meta-analysis and, finally, pooled analysis of in idual participant data, add insight into the relation between obesity and cancer risk and prognosis. We summarize the evidence for mortality from prostate cancer, hematologic malignancies, and kidney cancer. We reviewed pooled analysis of rare end points across cohorts, regardless of primary results reported from the in idual studies, further reducing risk of publication bias. Of these cancer sites, only kidney cancer was included in the IARC 2002 report, although mortality from prostate cancer and hematologic malignancies was noted in the American Cancer Society prospective cohort study in 2003. The 2016 update from the IARC added details for prostate and hematologic malignancies, classifying the evidence as sufficient to conclude that avoiding excess body fatness lowers the risk of multiple myeloma but found that the evidence for it lowering the risk of prostate cancer mortality or diffuse large B-cell lymphoma was limited. A higher body mass index is associated with an increased risk of advanced prostate cancer and prostate cancer mortality and is associated with worse survival in most subtypes of hematologic malignancies, in a dose-response fashion. Evidence for kidney cancer is built mostly on retrospective data, which supports an obesity paradox in patients with the clear cell variant however, population-based cohort data indicate that a higher cohort-entry body mass index is associated with worse kidney cancer–specific survival. Together, these data add support to the evidence for a growing cancer burden caused by adiposity in both early adult and later adult life, yet leave open the question of the means of weight management after diagnosis as a strategy to improve survival.
Publisher: Oxford University Press (OUP)
Date: 04-1995
Abstract: In a meta-analysis of the efficacy of BCG vaccine for preventing tuberculosis, study sites at a greater distance from the equator were associated with a higher efficacy. In a random-effects regression analysis of prospective studies, geographic latitude alone accounted for 41% of the between-study variance. Many factors that vary with latitude may influence the effectiveness of BCG vaccine by modifying the susceptibility of human hosts, the pathogenecity of the organism, or host-agent interactions. These factors include socioeconomic conditions, genetic composition of the population, climate, exposure to sunlight, diet and nutrition, presence of nontuberculous mycobacteria in the environment, completeness of surveillance and follow-up in studies of BCG vaccine, virulence of locally prevalent strains of Mycobacterium tuberculosis, and storage and viability of BCG vaccine. This paper describes the biological plausibility, epidemiologic evidence, and other scientific data bearing on the influence of these factors on the efficacy of BCG vaccine.
Publisher: Springer Science and Business Media LLC
Date: 16-05-2005
DOI: 10.1186/BCR1039
Publisher: Oxford University Press (OUP)
Date: 15-06-1994
Publisher: Oxford University Press (OUP)
Date: 12-2004
DOI: 10.1093/AJE/KWH327
Abstract: Workers tend to perceive certain features of their jobs as harmful to health and are alert to associations between job stress and health outcomes, but few observational studies have evaluated the role of job stress in carcinogenesis. The authors prospectively assessed the association between job strain, measured by Karasek and Theorell's job content questionnaire in four categories (low strain, active, passive, and high strain), and breast cancer risk among participants in the Nurses' Health Study. A total of 37,562 US female registered nurses were followed for up to 8 years (1992-2000), and 1,030 cases of invasive breast cancer were ascertained during that period. All participants were still in the workforce at baseline and completed the job content questionnaire. Adjusted for age, reproductive history, and other breast cancer risk factors, the multivariate relative risks of breast cancer, in comparison with women who worked in low-strain jobs, were 0.83 (95% confidence interval (CI): 0.69, 0.99) for women in active jobs, 0.87 (95% CI: 0.73, 1.04) for women in high-strain jobs, and 0.90 (95% CI: 0.76, 1.06) for women in passive jobs. Findings from this study indicate that job stress is not related to any increase in breast cancer risk.
Publisher: BMJ
Date: 02-1995
DOI: 10.1136/JECH.49.1.10
Abstract: To examine prospectively the relationship of childhood socioeconomic status and risk of cardiovascular disease in middle aged women. A prospective cohort of women with 14 years follow up data (1976-90). A total of 117,006 registered female nurses aged 30 to 55 years in 1976 and free of diagnosed coronary heart disease, stroke, and cancer at baseline. Incident fatal coronary heart disease, non-fatal myocardial infarction, and stroke (fatal and non-fatal). Low socioeconomic status in childhood was associated with a modestly increased risk of incident non-fatal myocardial infarction and total cardiovascular disease in adulthood. Compared with middle aged women from white collar childhood backgrounds, the age adjusted risk of total cardiovascular disease for women from blue collar backgrounds was 1.13 (95% CI 1.02, 1.24) and that of non-fatal myocardial infarction was 1.23 (95% CI 1.06, 1.42). No significant increase in risk was observed for stroke or fatal coronary heart disease. Adjustment for differences in family and personal past medical history, medication use, exercise, alcohol intake, diet, birth weight, being breastfed in infancy, and adult socioeconomic circumstance somewhat attenuated the increased risks observed for women from blue collar childhood socioeconomic backgrounds. In multivariate analysis, women whose fathers had been manual labourers had the highest relative risk of total coronary heart disease (RR = 1.53 95% CI 1.09, 2.16) and non-fatal myocardial infarction (RR = 1.67 95% CI 1.11, 2.53) when compared with women whose fathers had been employed in the professions. In this group lower childhood socioeconomic status was associated with a small but significant increase in the risk of total coronary heart disease as well as non-fatal myocardial infarction. For women from the most socioeconomically disadvantaged childhood backgrounds, the association is not explained by differences in a large number of cardiovascular risk factors, by differences in adult socioeconomic status, or by differences in indices of nutrition during gestation or infancy.
Publisher: American Society of Hematology
Date: 15-11-2013
DOI: 10.1182/BLOOD.V122.21.397.397
Abstract: KaLwRij/C57Bl (KaLwRij, “Kal-ridge”) is a spontaneous mutant mouse strain predisposed to monoclonal gammopathy of uncertain significance (MGUS) and parallels many features of human pathology including progression to multiple myeloma (MM). In African Americans, an increased prevalence of MM is due to an increased risk of MGUS development (rather than increased rate of progression from MGUS) and is likely therefore mediated by germline MGUS risk alleles. In both humans and mice, the genetic basis for MGUS/MM risk is unknown. We sought to identify the genetic basis for MGUS/MM risk in KaLwRij mice to shed light on genes or pathways that might mediate risk in humans. We employed a novel integrative computational analysis, combining KaLwRij/B6 modified haplotype block analysis and low-power human MM/control single nucleotide polymorphism (SNP) data. We used high-density SNP arrays to establish genetic distances of KaLwRij from 11 another erse inbred strains and confirmed close homology to parent C57Bl/6. Haplotype block analysis identified genetic loci that erged from C57Bl/6 and included over 500 genes. We filtered the haplotype list using previously published RNA expression data from the bone marrow of C57Bl/6 and KaLwRij mice, to identify 71 differentially expressed genes. As a final filter, we used SNP data from a genome wide association study (GWAS) of human Caucasian MM case and normal volunteer s les (∼300 each) to identify SNPs differentially represented in MM patients. Combining these sets yielded four (4) candidate genes. Our top candidate, Samsn1 (Hacs1), is a negative regulator of B-cell activation and interestingly, was first identified as a gene differentially expressed in MM. Strikingly, we found that KaLwRij mice had a complete germline deletion of the Samsn1 gene. Samsn1 is expressed within the hematopoetic compartment, including B-cells, macrophages, and osteoclasts (OC), key cell types that participate in MM pathology. Consistent with the reported inhibitory function of SAMSN1, KaLwRij had enhanced naïve B-cell response and constitutive Lyn phosphorylation. Further, we found that KaLwRij macrophages and OC also have constitutive Lyn activation consistent activation of cytokine signaling pathways in stromal cells. Absence of Samsn1 may lead to unregulated B-cell and macrophage/OC activation, priming both a pro-tumor bone microenvironment and B-cells for development of MGUS and predisposition to MM. Our approach focused on germline loci rather than malignant cell genetic alterations, advancing our understanding of host predisposition. Identification of the gene or genes predisposing patients to MGUS/MM will provide novel targets for identifying at-risk in iduals and will potentially allow the develop of preventative therapeutics for MM. No relevant conflicts of interest to declare.
Publisher: Wiley
Date: 13-12-2005
DOI: 10.1002/IJC.21441
Abstract: Intakes of vitamins A, C and E and folate have been hypothesized to reduce lung cancer risk. We examined these associations in a pooled analysis of the primary data from 8 prospective studies from North America and Europe. Baseline vitamin intake was assessed using a validated food-frequency questionnaire, in each study. We calculated study-specific associations and pooled them using a random-effects model. During follow-up of 430,281 persons over a maximum of 6-16 years in the studies, 3,206 incident lung cancer cases were documented. Vitamin intakes were inversely associated with lung cancer risk in age-adjusted analyses the associations were greatly attenuated after adjusting for smoking and other risk factors for lung cancer. The pooled multivariate relative risks, comparing the highest vs. lowest quintile of intake from food-only, were 0.96 (95% confidence interval (CI) 0.83-1.11) for vitamin A, 0.80 (95% CI 0.71-0.91) for vitamin C, 0.86 (95% CI 0.76-0.99) for vitamin E and 0.88 (95% CI 0.74-1.04) for folate. The association with vitamin C was not independent of our previously reported inverse association with beta-cryptoxanthin. Further, vitamin intakes from foods plus supplements were not associated with a reduced risk of lung cancer in multivariate analyses, and use of multivitamins and specific vitamin supplements was not significantly associated with lung cancer risk. The results generally did not differ across studies or by sex, smoking habits and lung cancer cell type. In conclusion, these data do not support the hypothesis that intakes of vitamins A, C and E and folate reduce lung cancer risk.
Publisher: American Academy of Pediatrics (AAP)
Date: 08-2005
Abstract: Objective. To assess the prevalence and correlates of products used to improve weight and shape among male and female adolescents. Methods. A cross-sectional study was conducted of 6212 girls and 4237 boys who were 12 to 18 years of age and enrolled in the ongoing Growing Up Today Study. The outcome measure was at least weekly use of any of the following products to improve appearance, muscle mass, or strength: protein powder or shakes, creatine, amino acids/hydroxy methylbutyrate (HMB), dehydroepiandrosterone, growth hormone, or anabolic/injectable steroids. Results. Approximately 4.7% of the boys and 1.6% of the girls used protein powder or shakes, creatine, amino acids/HMB, dehydroepiandrosterone, growth hormone, or anabolic/injectable steroids at least weekly to improve appearance or strength. In multivariate models, boys and girls who thought a lot about wanting more defined muscles (boys: odds ratio [OR]: 1.6 95% confidence interval [CI]: 1.1–2.2 girls: OR: 2.3 95% CI: 1.2–3.2) or were trying to gain weight (boys: OR: 3.0 95% CI: 2.0–4.6 girls: OR: 4.3 95% CI: 1.6–11.4) were more likely than their peers to use these products. In addition, boys who read men’s, fashion, or health/fitness magazines (OR: 2.3 95% CI: 1.1–4.9) and girls who were trying to look like women in the media (OR: 2.9 95% CI: 1.4–4.0) were significantly more likely than their peers to use products to improve appearance or strength, but hours per week watching television, watching sports on television, and participation in team sports were not independently associated with using products to improve appearance or muscle mass. Conclusions. Girls and boys who frequently thought about wanting toned or well-defined muscles were at increased risk for using potentially unhealthful products to enhance their physique. These results suggest that just as girls may resort to unhealthful means to achieve a low body weight, girls and boys may also resort to unhealthful means to achieve other desired physiques.
Publisher: American Association for Cancer Research (AACR)
Date: 11-2018
DOI: 10.1158/1055-9965.EPI-17-1102
Abstract: Background: This study examines associations of neighborhood characteristics with treatment and outcomes of ductal carcinoma in situ (DCIS) of the breast. Methods: From the Missouri Cancer Registry, we identified 9,195 women with DCIS diagnosed between 1996 and 2011. A composite index using U.S. Census data and American Community Survey data was developed to assess census tract–level socioeconomic deprivation, and rural–urban commuting area codes were used to define rural census tracts. ORs and 95% confidence intervals (CIs) of the treatment were estimated using logistic regression. Hazard ratios (HRs) of DCIS outcomes were estimated using Cox proportional hazards regression. Results: Women in the most socioeconomically deprived census tracts were more likely than those in the least deprived to have mastectomy (OR = 1.44 95% CI, 1.25–1.66 Ptrend & 0.0001), no surgery (OR = 1.54 95% CI, 1.02–2.30 Ptrend = 0.04), no radiotherapy post-breast conserving surgery (OR = 1.90 95% CI, 1.56–2.31 Ptrend& .0001), delayed radiotherapy (OR = 1.26 95% CI, 1.01–1.57 Ptrend = 0.02), and ipsilateral breast tumors (HR = 1.59 95% CI, 1.07–2.38 Ptrend = 0.03). There was no significant difference in risk of contralateral breast tumors. Compared with urban women, rural women had significantly higher odds of underutilization of radiotherapy (OR = 1.29 95% CI, 1.08–1.53). Rural locations were not associated with risk of ipsilateral or contralateral breast tumors. Conclusions: Neighborhood socioeconomic deprivation was associated with higher risks of suboptimal treatment and ipsilateral breast tumors. While DCIS treatment significantly varied by rural/urban locations, we did not observe any statistically significant rural–urban differences in risks of second breast tumors. Impact: Neighborhood attributes may affect treatment and outcomes of patients with DCIS. Cancer Epidemiol Biomarkers Prev 27(11) 1298–306. ©2018 AACR.
Publisher: Oxford University Press (OUP)
Date: 15-06-1998
DOI: 10.1093/OXFORDJOURNALS.AJE.A009412
Abstract: The authors retrospectively evaluated the relation between birth weight and prostate cancer (1986-1994) among 21,140 men of the Health Professionals Follow-up Study who reported in 1994 their weight at birth. No relation between birth weight and prostate cancer (n=545) was observed in multivariate logistic models. For high stage/grade tumors (n=213), compared with birth weights <7.0 lbs ( or = 10 lbs (> or = 4,536 g). These findings do not support an overall association between birth weight and prostate cancer incidence, but the possibility of a modest positive association between birth weight and high stage/grade prostatic cancer cannot be excluded.
Publisher: Springer Science and Business Media LLC
Date: 31-01-2015
DOI: 10.1007/S10549-014-3254-6
Abstract: Benign breast disease (BBD) is a broad category of diagnoses reported to convey a variable degree of increased risk of developing breast cancer. A meta-analysis of the existing literature was performed to quantify the risk estimate associated with BBD. Pubmed, Google Scholar, and EMBASE databases were searched in January 2011. English retrospective and prospective observational studies published from 1972 to 2010 evaluating BBD and the risk of breast cancer were included with data acquisition reported from 1930 to 2007. Eligibility was performed independently following a standardized protocol for full-text publication review by a single reviewer and reviewed by a second author. Of the 3,409 articles retrieved from the literature search, 32 studies met the selection criteria. Reported risk estimates, including relative risk, odds ratio, standardized incidence ratios, rate ratio, hazards ratio, and incidence rate ratio, were the primary outcomes extracted. The most commonly reported pathologies were decided prior to extraction and organized into the following categories for analysis of the extracted risk estimate: non-proliferative disease (NPD), proliferative disease without atypia, benign breast disease not otherwise specified (BBD), and atypical hyperplasia not otherwise specified (AHNOS). The mean age at benign breast biopsy was 46.1 years and the mean age of developing breast cancer was 55.9 years. The mean follow-up length was 12.8 years (range 3.3-20.6). The summary risk estimate of developing breast cancer for NPD was 1.17 (N = 8 95% CI 0.94-1.47). Proliferative disease without atypia was associated with significantly increased risk of future breast cancer, summary relative risk 1.76 (N = 15 95% CI 1.58-1.95). The summary risk estimate for AHNOS was 3.93 (N = 13 95% CI 3.24-4.76). This meta-analysis demonstrates that proliferative benign breast disease with or without atypia is associated with a significant increase in risk of developing breast cancer. These data support management strategies for women with benign breast disease such as additional screening methods or chemoprevention.
Publisher: Springer Science and Business Media LLC
Date: 26-09-2008
DOI: 10.1186/BCR2141
Publisher: Oxford University Press (OUP)
Date: 15-11-2000
Abstract: Because of the temporal relations between reproductive risk factors and incidence of breast cancer, the authors developed a nonlinear Poisson regression that accounts for time and summarizes risk to age 70 years. Reproductive risk factors, benign breast disease, use of postmenopausal hormones, weight, and alcohol intake were evaluated as risk factors. Among 58,520 women aged 30-55 years in 1980, followed through June 1, 1994, 1,761 incident invasive breast cancer cases were identified. All risks are multivariate adjusted. History of benign breast disease is associated with a 57% increase (95% confidence interval (CI): 43%, 73%) in cumulative risk of breast cancer by age 70 years. Use of unopposed postmenopausal estrogen from ages 50-60 years increases risk of breast cancer to age 70 by 23% (95% CI: 6%, 42%) compared with a woman who never uses hormones. Ten years of use of estrogen plus progestin increases risk to age 70 years by 67% (95% CI: 18%, 136%). Compared with never drinking alcohol, one drink per day from age 18 years increases risk to age 70 by 7% (95% CI: 0%, 13%). Use of unopposed postmenopausal hormones for 10 years significantly increases the risk of breast cancer, and the addition of progestin further increases the risk.
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516033.V1
Abstract: Supplementary Table 6 shows the association between composite sleep score and EAC risk with deaths as competing events
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2009
Publisher: Springer Science and Business Media LLC
Date: 1998
Abstract: Women with a family history of breast cancer have an increased risk for the disease. However, the combined impact of family history and other risk factors on breast cancer risk is unclear. We conducted a large epidemiologic study to examine this issue. METHODS. In a population-based case-control study in all of Sweden, 3,345 women aged 50 to 74 years with invasive breast cancer (84 percent of all eligible), and 3,454 controls of similar age (82 percent of all selected) were included. Mailed questionnaires and telephone interviews were used to collect detailed information on potential breast cancer risk factors. Odds ratios (OR) and 95 percent confidence intervals (CI) were estimated through multiple logistic regression. Women with a history of breast cancer in any first-degree relative had an increased risk of breast cancer compared with those without such a history (OR = 1.96, CI = 1.67-2.30). There was no clear indication of a differential impact of hormonal risk factors (age at menarche, parity, age at first birth, age at menopause, use of exogenous hormones, and weight gain) or body build at age seven among women with and without a positive family history. Yet, benign breast disease and height clearly were related to breast cancer risk in subjects without a family history, whereas seemingly not so in women with a family history. Formal tests for interaction between family history and these factors, however, did not prove statistically significant. Our findings indicate that established risk factors entail similar associations with breast cancer risk among women with and without family history of the disease.
Publisher: American Association for Cancer Research (AACR)
Date: 04-2011
DOI: 10.1158/1538-7445.AM2011-3723
Abstract: While numerous models of breast cancer risk have been developed, few are used in routine clinical care. Thus women are not advised of potential strategies to reduce their future risk of breast cancer either SERMS for high risk women or weight control and physical activity, reduction in alcohol or other approaches for moderate risk women. Furthermore, few models incorporate the full range of known risk factors and provide easy access for clinical use. The Rosner-Colditz log incidence model of breast cancer was developed and validated on independent data sets within Nurses’ Health Study cohort 1. The model includes a full range of reproductive and lifestyle risk factors for breast cancer. We now have developed a tool for batch or in idual data input that provides 5-year risk, and risk to age 80. Input variables include current age, weigh at age 18, current weight, height, current alcohol intake and at age 18, age at menarche, age at menopause and type of menopause, family history of breast cancer and history of benign breast disease, hormone use (current, past, never) and type of hormone used, duration of postmenopausal hormone use, and age at each birth. Parameter estimates are drawn from Nurses’ Health Study data where we have shown the model performs with higher predictability (area under the ROC curve was 0.623) significantly better than the Gail model (area under the ROC 0.578) (p& .001). For the total cohort, Incidence of invasive breast cancer in the NHS is consistent with SEER data (O/E = 1.0 95%CI 0.98-1.03). For clinical use, risk estimates are adjusted for US mortality to provide incidence estimates to age 80 that account for competing risks. Clinical application requires assumptions regarding future weight change, duration of continued use of hormone therapy, and for premenopausal women, future age at menopause. 1. Colditz G, Rosner B. Cumulative risk of breast cancer to age 70 years according to risk factor status: data from the Nurses’ Health Study. Am J Epidemiol. 2000 (10):950-964. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research 2011 Apr 2-6 Orlando, FL. Philadelphia (PA): AACR Cancer Res 2011 (8 Suppl):Abstract nr 3723. doi:10.1158/1538-7445.AM2011-3723
Publisher: American Medical Association (AMA)
Date: 2008
DOI: 10.1001/ARCHPEDIATRICS.2007.11
Abstract: To determine whether subjective social standing in school predicts a change in body mass index (BMI) in adolescent girls during a 2-year period. Prospective cohort study. Self-report questionnaires from a community-based population of adolescent girls living across the United States from 1999 to 2001. Of 5723 girls aged 12 to 18 years participating in the Growing Up Today Study (GUTS), adequate information was available for 4446 (78%), who provided the analytic s le. Low subjective social status in the school. Change in BMI between 1999 and 2001 and multivariable odds ratio for a 2-U increase in BMI in girls with low subjective social status in the school compared with girls with higher subjective social status in the school. After adjusting for age, race/ethnicity, baseline BMI, diet, television viewing, depression, global and social self-esteem, menarche, height growth, mother's BMI, and pretax household income, adolescent girls who placed themselves on the low end of the school subjective social status scale had a 69% increased odds of having a 2-unit increase in BMI (odds ratio, 1.69 95% confidence interval, 1.10-2.60) during the next 2 years compared with other girls. Higher subjective social standing in school may protect against gains in adiposity in adolescent girls.
Publisher: American Medical Association (AMA)
Date: 12-07-2006
Abstract: Endogenous hormones are a primary cause of breast cancer. Adiposity affects circulating hormones, particularly in postmenopausal women, and may be a modifiable risk factor for breast cancer. To assess the associations of adult weight change since age 18 years and since menopause with the risk of breast cancer among postmenopausal women. Prospective cohort study within the Nurses' Health Study. A total of 87,143 postmenopausal women, aged 30 to 55 years and free of cancer, were followed up for up to 26 years (1976-2002) to assess weight change since age 18 years. Weight change since menopause was assessed among 49,514 women who were followed up for up to 24 years. Incidence of invasive breast cancer. Overall, 4393 cases of invasive breast cancer were documented. Compared with those who maintained weight, women who gained 25.0 kg or more since age 18 years were at an increased risk of breast cancer (relative risk [RR], 1.45 95% confidence interval [CI], 1.27-1.66 P<.001 for trend), with a stronger association among women who have never taken postmenopausal hormones (RR,1.98 95% CI, 1.55-2.53). Compared with weight maintenance, women who gained 10.0 kg or more since menopause were at an increased risk of breast cancer (RR, 1.18 95% CI, 1.03-1.35 P = .002 for trend). Women who had never used postmenopausal hormones, lost 10.0 kg or more since menopause, and kept the weight off were at a lower risk than those who maintained weight (RR, 0.43 95% CI, 0.21-0.86 P = .01 for weight loss trend). Overall, 15.0% (95% CI, 12.8%-17.4%) of breast cancer cases in this population may be attributable to weight gain of 2.0 kg or more since age 18 years and 4.4% (95% CI, 3.6%-5.5%) attributable to weight gain of 2.0 kg or more since menopause. Among those who did not use postmenopausal hormones, the population attributable risks are 24.2% (95% CI, 19.8%-29.1%) for a weight gain since age 18 years and 7.6% (95% CI, 5.9%-9.7%) for weight gain since menopause. These data suggest that weight gain during adult life, specifically since menopause, increases the risk of breast cancer among postmenopausal women, whereas weight loss after menopause is associated with a decreased risk of breast cancer. Thus, in addition to other known benefits of healthy weight, our results provide another reason for women approaching menopause to maintain or lose weight, as appropriate.
Publisher: American Public Health Association
Date: 09-2000
Abstract: OBJECTIVES: This study examined the association between intake of whole vs refined grain and the risk of type 2 diabetes mellitus. METHODS: We used a food frequency questionnaire for repeated dietary assessments to prospectively evaluate the relation between whole-grain intake and the risk of diabetes mellitus in a cohort of 75,521 women aged 38 to 63 years without a previous diagnosis of diabetes or cardiovascular disease in 1984. RESULTS: During the 10-year follow-up, we confirmed 1879 incident cases of diabetes mellitus. When the highest and the lowest quintiles of intake were compared, the age and energy-adjusted relative risks were 0.62 (95% confidence interval [CI] = 0.53, 0.71, P trend .0001) for whole grain, 1.31 (95% CI = 1.12, 1.53, P trend = .0003) for refined grain, and 1.57 (95% CI = 1.36, 1.82, P trend .0001) for the ratio of refined- to whole-grain intake. These findings remained significant in multivariate analyses. The findings were most evident for women with a body mass index greater than 25 and were not entirely explained by dietary fiber, magnesium, and vitamin E. CONCLUSIONS: These findings suggest that substituting whole- for refined-grain products may decrease the risk of diabetes mellitus.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-1999
Abstract: Background and Purpose —High intakes of calcium, potassium, and magnesium have been hypothesized to reduce risks of cardiovascular disease, but only a few prospective studies have examined intakes of these cations in relation to risk of stroke. Methods —In 1980, 85 764 women in the Nurses’ Health Study cohort, aged 34 to 59 years and free of diagnosed cardiovascular disease and cancer, completed dietary questionnaires from which we calculated intakes of calcium, potassium, and magnesium. By 1994, after 1.16 million person-years of follow-up, 690 incident strokes (129 subarachnoid hemorrhages, 74 intraparenchymal hemorrhages, 386 ischemic strokes, and 101 strokes of undetermined type) had been documented. Results —Intakes of calcium, potassium, and magnesium were each inversely associated with age- and smoking-adjusted relative risks of ischemic stroke, excluding embolic infarction of nonatherogenic origin (n=347). Adjustment for other cardiovascular risk factors, including history of hypertension, attenuated these associations, particularly for magnesium intake. In a multivariate analysis, women in the highest quintile of calcium intake had an adjusted relative risk of ischemic stroke of 0.69 (95% CI, 0.50 to 0.95 P for trend=0.03) compared with those in the lowest quintile for potassium intake the corresponding relative risk was 0.72 (95% CI, 0.51 to 1.01 P for trend=0.10). Further simultaneous adjustment for calcium and potassium intake suggested an independent association for calcium intake. The association of risk with calcium intake did not appear to be log linear the increase in risk was limited to the lowest quintile of intake, and intakes ≈600 mg/d did not appear to reduce risk of stroke further. The inverse association with calcium intake was stronger for dairy than for nondairy calcium intake. Intakes of calcium, potassium, and magnesium were not related to risk of other stroke subtypes. Conclusions —Low calcium intake, and perhaps low potassium intake, may contribute to increased risk of ischemic stroke in middle-aged American women. It remains possible that women in the lowest quintile of calcium intake had unknown characteristics that made them susceptible to ischemic stroke.
Publisher: American Association for Cancer Research (AACR)
Date: 04-12-2020
DOI: 10.1158/1055-9965.EPI-20-0900
Abstract: Clinical use of breast cancer risk prediction requires simplified models. We evaluate a simplified version of the validated Rosner–Colditz model and add percent mammographic density (MD) and polygenic risk score (PRS), to assess performance from ages 45–74. We validate using the Mayo Mammography Health Study (MMHS). We derived the model in the Nurses' Health Study (NHS) based on: MD, 77 SNP PRS and a questionnaire score (QS lifestyle and reproductive factors). A total of 2,799 invasive breast cancer cases were diagnosed from 1990–2000. MD (using Cumulus software) and PRS were assessed in a nested case–control study. We assess model performance using this case–control dataset and evaluate 10-year absolute breast cancer risk. The prospective MMHS validation dataset includes 21.8% of women age & , and 434 incident cases identified over 10 years of follow-up. In the NHS, MD has the highest odds ratio (OR) for 10-year risk prediction: ORper SD = 1.48 [95% confidence interval (CI): 1.31–1.68], followed by PRS, ORper SD = 1.37 (95% CI: 1.21–1.55) and QS, ORper SD = 1.25 (95% CI: 1.11–1.41). In MMHS, the AUC adjusted for age + MD + QS 0.650 for age + MD + QS + PRS 0.687, and the NRI was 6% in cases and 16% in controls. A simplified assessment of QS, MD, and PRS performs consistently to discriminate those at high 10-year breast cancer risk. This simplified model provides accurate estimation of 10-year risk of invasive breast cancer that can be used in a clinical setting to identify women who may benefit from chemopreventive intervention. See related commentary by Tehranifar et al., p. 587
Publisher: Oxford University Press (OUP)
Date: 31-12-2016
DOI: 10.1093/JNCI/DJW264
Publisher: American Medical Association (AMA)
Date: 25-08-2004
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2012
Publisher: American Medical Association (AMA)
Date: 02-01-2002
Abstract: Ingestion of toxic amounts of vitamin A affects bone remodeling and can have adverse skeletal effects in animals. The possibility has been raised that long-term high vitamin A intake could contribute to fracture risk in humans. To assess the relationship between high vitamin A intake from foods and supplements and risk of hip fracture among postmenopausal women. Prospective analysis begun in 1980 with 18 years of follow-up within the Nurses' Health Study. General community of registered nurses within 11 US states. A total of 72 337 postmenopausal women aged 34 to 77 years. Incident hip fractures resulting from low or moderate trauma, analyzed by quintiles of vitamin A intake and by use of multivitamins and vitamin A supplements, assessed at baseline and updated during follow-up. From 1980 to 1998, 603 incident hip fractures resulting from low or moderate trauma were identified. After controlling for confounding factors, women in the highest quintile of total vitamin A intake (>/=3000 microgram/d of retinol equivalents [RE]) had a significantly elevated relative risk (RR) of hip fracture (RR, 1.48 95% confidence interval [CI], 1.05-2.07 P for trend =.003) compared with women in the lowest quintile of intake (<1250 microgram/d of RE). This increased risk was attributable primarily to retinol (RR, 1.89 95% CI, 1.33-2.68 P for trend /=2000 microgram/d vs /=6300 microgram/d vs /=1000 microgram/d vs <400 microgram/d). Long-term intake of a diet high in retinol may promote the development of osteoporotic hip fractures in women. The amounts of retinol in fortified foods and vitamin supplements may need to be reassessed.
Publisher: Wiley
Date: 05-2005
DOI: 10.1038/OBY.2005.104
Abstract: The purpose of this study was to examine both cross-sectional and longitudinal associations between frequency of family dinner and overweight status in a large s le of 9- to 14-year-old children. We studied a cohort of 7784 girls and 6647 boys, 9 to 14 years of age at baseline in 1996, participating in the Growing Up Today Study. From annual mailed surveys, we calculated BMI from self-reported height and weight and assessed frequency of family dinner over the previous year. We defined "overweight" as age- and sex-specific BMI >85th percentile. We performed multiple logistic regression analyses the longitudinal analyses assessed the association of previous year family dinner consumption with 1-year incidence of becoming overweight, using prospective data from 1996 through 1999. At baseline in 1996, 16% of participants had family dinner "never or some days," 40% on "most days," and 44% "every day." Across these categories, overweight prevalence for girls was 19.4%, 16.6%, and 16.7% and for boys was 24.6%, 23.3%, and 22.7%, respectively. In cross-sectional analyses, adjusting for potential confounders, the odds of being overweight was 0.85 [95% confidence interval (CI): 0.76, 0.96] among children who ate family dinner on "most days" or "every day" compared with those who ate family dinner "never or some days." In longitudinal multivariate models, the odds ratios between previous year frequency of eating family dinner and 1-year incidence of becoming overweight were 0.95 (95% CI: 0.78, 1.16) and 1.04 (95% CI: 0.85, 1.27) for children who ate family dinner on "most days" and "every day," respectively, compared with those who ate family dinner "never or some days." The frequency of eating family dinner was inversely associated with overweight prevalence at baseline but not with likelihood of becoming overweight in longitudinal analyses.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Elsevier BV
Date: 12-2016
Publisher: Wiley
Date: 29-05-2019
DOI: 10.1111/BJU.14783
Publisher: Elsevier BV
Date: 07-1996
DOI: 10.1097/00004583-199607000-00020
Abstract: DSM-IV subtypes anorexia nervosa by the presence or absence of bulimic symptoms. Assessing whether bulimic symptoms are related to the probability of recovery can provide justification for subtyping of anorexia. Two hundred twenty-five treatment-seeking women with anorexia and/or bulimia nervosa were interviewed every 3 months for up to 4 years. Survival methods were used for analyses. Less than half of the entire cohort recovered however, the great majority of the women became less symptomatic over time. Contrary to findings from previous studies, bulimic anorexics had a higher rate of recovery than restricting anorexics. Differences in course provide some support for the subtyping of anorexia nervosa. Additional prospective studies are needed before subtyping can be warranted.
Publisher: American Association for Cancer Research (AACR)
Date: 2022
DOI: 10.1158/1538-7755.DISP21-PO-220
Abstract: Patients insured by Medicaid present with more late-stage breast cancer and poorer survival than privately insured patients. Delayed coverage may contribute to these disparities, since, in many states, diagnoses of cancer and other illnesses influence Medicaid eligibility. Prior studies have linked post-diagnosis Medicaid coverage with lower rates of screening mammography and greater risk of late-stage cancer, but less is known about its impacts on risks of breast cancer treatment delays and mortality. In this study, we examined the relations of timing of Medicaid enrollment in Missouri to breast cancer stage at diagnosis, treatment delays, and mortality. Using Medicaid administrative claims linked to the Missouri Cancer Registry, we identified 4,583 women ages 18 to 65 who were enrolled in Medicaid and diagnosed with breast cancer between 2007 and 2016. We used logistic regression to estimate the odds ratio (OR) of late-stage diagnosis for pre-diagnosis (≥30 days before diagnosis) versus post-diagnosis (within 30 days before diagnosis or later) enrollment, adjusting for age, race/ethnicity, marital status, and ten census tract-level socioeconomic variables. We performed similar regression to analyze odds of treatment delay, further adjusting for tumor characteristics. Cox proportional hazards models were used to estimate the hazard ratio (HR) of breast cancer-specific mortality for pre- versus post-diagnosis enrollment, sequentially adjusting for sociodemographic factors, tumor characteristics, and treatment. Timing of Medicaid enrollment was also defined using two other cutoffs, 90 days and 1 year. Patients enrolled in Medicaid ≥30 days before diagnosis were significantly less likely to be diagnosed at a late stage compared to those who enrolled in Medicaid after diagnosis (OR=0.69, 95% CI=0.60-0.79). This result persisted using 90-day (OR=0.64, 95% CI=0.56-0.74) and 1-year thresholds (OR=0.55, 95% CI=0.47-0.65). We did not observe any significant difference in the likelihood of treatment delays between the two groups using the 30-day (OR=0.93, 95% CI=0.80-1.10), 90-day (OR=1.00, 95% CI=0.85-1.18) or 1-year thresholds (OR=0.93, 95% CI=0.77-1.12). After adjustment for sociodemographic factors, there was no significant difference in the risk of breast cancer mortality for patients enrolled in Medicaid ≥30 days pre-diagnosis relative to patients enrolled post-diagnosis (HR=0.98, 95% CI=0.83-1.14). The same model, however, showed a lower risk of mortality for patients enrolled in Medicaid before diagnosis when using 90 days (HR=0.85, 95% CI=0.72-0.999) or 1 year (HR=0.79, 95% CI=0.66-0.96) as the threshold. These findings suggest that women who enroll in Medicaid earlier may benefit from earlier diagnoses, but only longer-term enrollment may have survival benefits. Timing of Medicaid enrollment does not appear to play a role in timely initiation of breast cancer treatment. Citation Format: Evaline Xie, Graham A. Colditz, Min Lian, Tracy Greever-Rice, Chester Schmaltz, Jill Lucht, Ying Liu. Associations of timing of Medicaid enrollment with stage at diagnosis, treatment delays, and mortality in women with breast cancer [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved 2021 Oct 6-8. Philadelphia (PA): AACR Cancer Epidemiol Biomarkers Prev 2022 (1 Suppl):Abstract nr PO-220.
Publisher: Springer Science and Business Media LLC
Date: 04-2006
Publisher: American Association for Cancer Research (AACR)
Date: 14-06-2023
DOI: 10.1158/1055-9965.23516045.V1
Abstract: Supplementary Table 2 shows the weights used to construct the weighted sleep score
Publisher: Springer Science and Business Media LLC
Date: 10-2016
DOI: 10.1007/S10549-016-3994-6
Abstract: The Great Chinese Famine afflicted almost all Chinese people between 1959 and 1961. No study has explicitly assessed the association between an exposure to Chinese Famine and risk of overall breast cancer and tumor subtype. We evaluated the unique historical environmental influences of famine exposure on breast cancer subtypes. 16,469 Chinese women who were diagnosed with invasive breast cancer in the Fudan University Shanghai Cancer Center (FUSCC) from 1999 to 2014 were analyzed. Four tumor subtypes were defined by both estrogen-receptor (ER) and progesterone-receptor (PR) status. Multinomial logistic regression models were used to estimate the odds ratios (ORs) of ER-PR-, ER+PR-, and ER-PR+ relative to ER+PR+ breast cancer for exposure to famine and age at the exposure. Compared with cases not exposed to the Famine, exposed cases were more likely to be diagnosed with ER-PR- (OR 1.60, 95 % CI 1.43-1.81), ER-PR+ (OR 4.85, 95 % CI 3.80-6.19), and ER+PR- (OR 1.99, 95 % CI 1.67-2.37) than ER+PR+ breast cancer after controlling for established breast cancer risk factors. Women exposed to Famine after first birth had a higher risk of EP-PR- (OR 1.66, 95 % CI 1.28-2.15), ER-PR+ (OR 9.75, 95 % CI 5.85-16.25), and ER+PR- (OR 2.35, 95 % CI 1.69-3.26) compared to those with ER+PR+ breast cancer. Women exposed to the Famine, particularly those exposed after first birth, were more likely to be diagnosed with ER-PR-, ER-PR+, and ER+PR- breast cancer. This retrospective analysis suggests that famine, malnutrition, or the associated lack of fruit and vegetable consumption in adulthood may be related to epidemiological heterogeneity within breast cancer subtypes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-1999
Abstract: Background and Purpose —In secondary prevention, aspirin reduces risk of ischemic stroke. In primary prevention of stroke, however, the role of aspirin is uncertain, especially in women. Methods —In 1980, 79 319 women in the Nurses’ Health Study cohort, 34 to 59 years of age and free of diagnosed cardiovascular disease, cancer, and rheumatoid arthritis, completed questionnaires that included information on aspirin use. Data on aspirin use were updated in 1982, 1984, and 1988. By 1994, after 994 231 person-years of follow-up, 503 incident strokes (295 ischemic strokes, 100 subarachnoid hemorrhages, 52 intraparenchymal hemorrhages, and 56 strokes of undetermined type) were documented. Results —There was no clear relationship between aspirin use and risk of total stroke risk was slightly reduced among women who took 1 to 6 aspirin per week and slightly increased among women who took 7 or more aspirin per week. Women who took 1 to 6 aspirin per week had a lower risk of large-artery occlusive infarction compared with women who reported no aspirin use after simultaneous adjustment for other cardiovascular risk factors and selected nutrients, the multivariate relative risk was 0.50 (95% CI 0.29 to 0.85, P =0.01). Women who took 15 or more aspirin per week had an excess risk of subarachnoid hemorrhage the multivariate relative risk was 2.02 (95% CI 1.04 to 3.91, P for trend=0.02). The reduction in large-artery occlusive infarction with aspirin was of greater magnitude for older, hypertensive, or smoking women than for younger, nonhypertensive, or nonsmoking women the elevation in subarachnoid hemorrhage with aspirin was also more apparent for older or hypertensive women than for younger or nonhypertensive women. Aspirin use was not associated with risk of other subtypes of stroke. Conclusions —These prospective data indicate that women who take 1 to 6 aspirin per week have a reduced risk of large-artery occlusive infarction, but those who use 15 or more aspirin per week have an increased risk of subarachnoid hemorrhage. This observational study suggests benefits of aspirin for ischemic stroke with low frequency of use and hazards for hemorrhagic stroke with high frequency of use, particularly among older or hypertensive women. Thus, the effect on total stroke will depend on the dose of aspirin and the distribution of stroke subtypes and risk factors in the population.
Publisher: Elsevier BV
Date: 05-1999
Publisher: Informa UK Limited
Date: 03-2004
DOI: 10.1080/10810730490425295
Abstract: We developed a computer-based tailored risk presentation and risk communication aid for colorectal cancer prevention. To evaluate the effectiveness of the tool, we randomized 353 participants to receive different risk presentation formats (relative plus absolute risk vs. absolute risk only vs. none) and different levels of engagement with the risk communication (active vs. passive). Findings suggest the tool to be useful for correcting misperceptions about personal risk. Of those with inaccurate risk perception at baseline, more than half of the participants in intervention groups had corrected risk perceptions at post-test, compared to only 12% in the control group.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929349.V1
Abstract: Supplementary Figure S4: The linearity assumption is checked with Martingale residual plots.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-1998
DOI: 10.1097/00003246-199812000-00044
Abstract: To review the basic physiologic principles that support the role for high-frequency ventilation (HFV) in acutely lung-injured patients, to critically assess clinical trial data in this area, and discuss why a metasummary is not feasible and a large-scale clinical trial is needed. We searched a computerized database (MEDLINE) from 1976 to January 1997 using the text words "high-frequency ventilation" and "acute respiratory distress syndrome" to retrieve all relevant candidate articles. We retrieved all English language clinical studies conducted in tertiary care centers that employed HFV in adult acute respiratory distress syndrome (ARDS) patients. Only prospective, randomized trials, cohort/case-control studies, and case series evaluating HFV vs. conventional mechanical ventilation in adult ARDS patients were included. We independently screened 3,166 articles on ARDS and 494 papers on HFV in our computer search. We checked reference lists and contacted experts in the field of mechanical ventilation in ARDS to ensure that no relevant studies had been missed. Only four articles met our inclusion criteria and were evaluated in detail. Current clinical studies are statistically under-powered and a metasummary is not feasible because of study quality, as well as lack of similar clinical end points and measures of magnitude of benefit. A large, multicenter trial should be initiated to define the role of HFV in the treatment of adult ARDS.
Publisher: American Medical Association (AMA)
Date: 1987
DOI: 10.1001/ARCHINTE.147.1.157
Abstract: We reviewed the human epidemiologic studies of the possible protective effect against lung cancer of various dietary constituents, including preformed vitamin A, carotene, vitamin E, selenium, and vitamin C. Beta carotene has strong potential as a protective agent, though constituents of green and yellow vegetables other than carotene may account for the reduced cancer incidence observed in many studies. Selenium also deserves attention as a potential chemopreventive nutrient, though data are limited. Data on vitamin E are sparse and inconclusive, and there is little evidence that vitamin C provides protection against human lung cancer. It is likely that cessation of cigarette smoking would have a far greater influence on reducing lung cancer incidence than any known dietary modification.
Publisher: Wiley
Date: 29-11-2006
DOI: 10.1002/IJC.21407
Abstract: Events before puberty may affect adult risk of breast cancer. We examined whether diet during preschool age may affect a woman's risk of breast cancer later in life. We conducted a case-control study including 582 women with breast cancer and 1,569 controls free of breast cancer selected from participants in the Nurses' Health Study and the Nurses' Health Study II. Information concerning childhood diet of the nurses at ages 3-5 years was obtained from the mothers of the participants with a 30-item food-frequency questionnaire. An increased risk of breast cancer was observed among woman who had frequently consumed French fries at preschool age. For one additional serving of French fries per week, the odds ratio (OR) for breast cancer adjusted for adult life breast cancer risk factors was 1.27 (95% confidence interval [CI] = 1.12-1.44). Consumption of whole milk was associated with a slightly decreased risk of breast cancer (covariate-adjusted OR for every additional glass of milk per day = 0.90 95% CI = 0.82-0.99). Intake of none of the nutrients calculated was related to the risk of breast cancer risk in this study. These data suggest a possible association between diet before puberty and the subsequent risk of breast cancer. Differential recall of preschool diet by the mothers of cases and controls has to be considered as a possible explanation for the observed associations. Further studies are needed to evaluate whether the association between preschool diet and breast cancer is reproducible in prospective data not subject to recall bias.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-1998
Publisher: American College of Physicians
Date: 19-12-2000
DOI: 10.7326/0003-4819-133-12-200012190-00008
Abstract: Most primary prevention studies have found that long-term users of postmenopausal hormone therapy are at lower risk for coronary events, but numerous questions remain. An adverse influence of hormone therapy on cardiovascular risk has been suggested during the initial year of use however, few data are available on short-term hormone therapy. In addition, the cardiovascular effects of daily doses of oral conjugated estrogen lower than 0.625 mg are unknown, and few studies have examined estrogen plus progestin in this regard. To investigate duration, dose, and type of postmenopausal hormone therapy and primary prevention of cardiovascular disease. Prospective, observational cohort study. Nurses' Health Study, with follow-up from 1976 to 1996. 70 533 postmenopausal women, in whom 1258 major coronary events (nonfatal myocardial infarction or fatal coronary disease) and 767 strokes were identified. Details of postmenopausal hormone use were ascertained by using biennial questionnaires. Cardiovascular disease was established by using a questionnaire and was confirmed by medical record review. Logistic regression models were used to calculate relative risks and 95% CIs, adjusted for confounders. When all cardiovascular risk factors were considered, the risk for major coronary events was lower among current users of hormone therapy, including short-term users, compared with never-users (relative risk, 0.61 [95% CI, 0.52 to 0.71]). Among women taking oral conjugated estrogen, the risk for coronary events was similarly reduced in those currently taking 0.625 mg daily (relative risk, 0.54 [CI, 0.44 to 0.67]) and those taking 0.3 mg daily (relative risk, 0.58 [CI, 0. 37 to 0.92]) compared with never-users. However, the risk for stroke was statistically significantly increased among women taking 0.625 mg or more of oral conjugated estrogen daily (relative risk, 1.35 [CI, 1.08 to 1.68] for 0.625 mg/d and 1.63 [CI, 1.18 to 2.26] for >/=1.25 mg/d) and those taking estrogen plus progestin (relative risk, 1.45 [CI, 1.10 to 1.92]). Overall, little relation was observed between combination hormone therapy and risk for cardiovascular disease (major coronary heart disease plus stroke) (relative risk, 0.91 [CI, 0.75 to 1.11]). Postmenopausal hormone use appears to decrease risk for major coronary events in women without previous heart disease. Furthermore, 0.3 mg of oral conjugated estrogen daily is associated with a reduction similar to that seen with the standard dose of 0.625 mg. However, estrogen at daily doses of 0.625 mg or greater and in combination with progestin may increase risk for stroke.
Publisher: Wiley
Date: 2003
DOI: 10.1002/EAT.10220
Abstract: To compare self-report to interview assessment of bulimic behaviors among adolescents. A s le of children in an ongoing study were recruited to complete in-depth telephone interviews in 1998 on bulimic behaviors (i.e., binge eating and purging). The s le comprised 449 girls and 50 boys. There was some over-reporting of bulimic behaviors on the 1998 questionnaire (asking about 1997-1998) compared with the interview that may have been due to the shorter and nonoverlapping time frame in the interview compared with the questionnaire. Despite the overestimation, the questionnaire did an excellent job at classifying girls who did not purge (negative predictive values [NPV]: 0.99) or binge eat (NPV = 0.98). When purging on the interview was compared with purging on either the 1998 or 1999 questionnaires, the sensitivity increased substantially from 0.73 to 0.93. These findings suggest that a short self-report assessment can be used to screen children engaging in, or at risk of beginning to engage in, binge eating and purging.
Publisher: Springer Science and Business Media LLC
Date: 10-2004
Publisher: Springer Science and Business Media LLC
Date: 27-05-2007
DOI: 10.1038/NG2075
Publisher: American Association for Cancer Research (AACR)
Date: 2022
DOI: 10.1158/1538-7755.DISP21-IA-03
Abstract: Breast cancer deaths in Missouri are among the highest in the Nation. In St Louis City and North County late-stage diagnosis and mortality have remained high. Cancer disparities can be driven by behavioral risk factors, by health systems, and by biology. Research on all these aspects must be rewarded in academic promotion and tenure review. Siteman created the Program for the Elimination of Cancer Disparities (PECaD) to build community partnerships and develop outreach and education conduct quality improvement and research in breast health services and train community members in public health research principles. We developed a breast cancer community partnership in 2007 and identified priorities for the community and the partnership. These included improve awareness of prevention and breast health services, build trust, develop strategies to help patients keep appointments, support adherence to routine screening. We partnered with the African American newspaper (The St Louis American), public library, and federally qualified health centers. In collaboration with FQHCs, we evaluated referral patterns and identified strategies to improve communication between providers. Using the collective impact model to sustain change, for over a decade PECaD supports the St Louis Regional Breast Navigator workgroup. Diagnoses of breast cancer among Black women were 32% stage III/IV in 2000. By 2019, Siteman had expanded services and partnerships to reduce late-stage diagnosis to 16.4% of incident cancers among Black women, still higher than 9.8% observed among white women. To ensure access to clinical trials we implemented system changes for monitoring trial protocols, defining eligibility targets by race, and monitored accruals by race, integrating the process into PRMC and Siteman leadership review. We reported breast cacner outcomes from SEER and Missouri cancer registries by race and engaged bench researchers to study pathways that may drive disparities. They now study pathways that may drive triple negative breast cancer in African American women and DNA repair pathways that may modify response to treatment. This includes research by Dr. Weber (breast program) on adenosine deaminase acting on RNA (ADAR1, encoded by ADAR) and by Dr. Shao on repair of double strand DNA breaks that may counteract therapy for TNBC. We have expanded community service aspects of promotion review traditionally framed as service to medical center, university, and community. We now specifically call out service to Siteman through our Research Programs or Community Outreach and Engagement activities. Thus, faculty can make explicit their contributions to ersity, equity, and inclusion, and their disparities focused research. By working at multiple levels, we have improved access to screening and breast health services, improving stage at diagnosis among African American women. We have engaged bench scientists to address excess risk of TNBC in African American women, and have used the promotion criteria to reward disparities and community engaged research. Citation Format: Graham A. Colditz. Making progress, together: An inclusive, broad-based approach to reducing excess burden of breast cancer among African American women in St Louis - with lessons for national implementation [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved 2021 Oct 6-8. Philadelphia (PA): AACR Cancer Epidemiol Biomarkers Prev 2022 (1 Suppl):Abstract nr IA-03.
Publisher: American Association for Cancer Research (AACR)
Date: 14-11-2011
DOI: 10.1158/1078-0432.CCR-11-1862
Abstract: Evaluation of new technologies requires rigorous methods to provide unbiased estimates of the performance and so inform future clinical practice. We review evidence on DNA cytometry reported earlier in this journal and point to the standards for reporting of diagnostic accuracy as a metric against which this article can be evaluated. The cross-sectional nature of the data and incomplete reporting limit the clinical utility of the study. With application of improved reporting standards for diagnostic tests and improved design and evaluation of new technologies for screening, we may better inform practices to improve clinical outcomes and population health. Clin Cancer Res 17(22) 6971–2. ©2011 AACR.
Publisher: Oxford University Press (OUP)
Date: 15-02-1995
Abstract: Methylation of DNA, which may have a role in the regulation of gene expression, depends on dietary folate and methionine. Because aberrant DNA methylation may contribute to the initiation or progression of colon cancer, we hypothesized that deficient intakes of folate or methionine and high consumption of alcohol, an antagonist of methyl-group metabolism, increase risk of colon neoplasia. Previously, a high-alcohol and low-methionine--low-folate (methyl-deficient) diet was shown to be related to a higher risk of colon adenomas, precursors of cancer. Our goal was to determine if ingestion of a high-alcohol, methyl-deficient diet is related directly to risk of colon cancer. We assessed dietary intake for a 1-year period for a cohort of 47,931 U.S. male health professionals, 40-75 years old and free of diagnosed cancer in 1986. We assessed diet by using a validated, semiquantitative food-frequency questionnaire. During 6 years of follow-up, we documented 205 new cases of colon cancer in this cohort. Current alcohol intake was directly related to risk of colon cancer (multivariate relative risk [RR] = 2.07 95% confidence interval [CI] = 1.29-3.32, for > 2 drinks versus 2 drinks daily were not associated with risk of colon cancer. The increased risk of colon cancer associated with alcohol and methyl-deficient diets was not confounded by smoking intakes of fat, red meat, and fiber level of physical activity multivitamin or aspirin use and body mass index. These findings support the hypothesis that substantial consumption of alcohol, when combined with inadequate intakes of folate and methionine, may increase risk of colon cancer and confirm similar findings in adenomas. These data provide further support of recommendations to avoid excess alcohol consumption and to increase dietary folate to lower the risk of colon cancer.
Publisher: Wiley
Date: 04-1989
Abstract: We analysed the results of 221 comparisons of an innovation with a standard treatment in surgery published in six leading surgery journals in 1983 to relate features of study design to the magnitude of gain. For each comparison we measured the gain attributed to the innovation over the standard therapy by the Mann-Whitney statistic and the difference in proportion of treatment successes. For primary treatments (aimed at curing or ameliorating a patient's principal disease), an average gain of 0.56 was produced by 20 randomized controlled trials. This was less than the 0.62 average for four non-randomized controlled trials, 0.63 for 19 externally controlled trials, and 0.57 for 73 record reviews (0.50 represents a toss-up between innovation and standard). For secondary therapies (used to prevent or treat complications of therapy), the average gain was 0.53 for 61 randomized controlled trials, 0.58 for eleven non-randomized controlled trials, 0.54 for eight externally controlled trials, and 0.55 for 18 record reviews. Readers of studies evaluating new treatments, particularly for primary treatments, may consider adjustment of the gain according to the study type.
Publisher: Wiley
Date: 04-1989
Abstract: We analysed 113 reports published in 1980 in a s le of medical journals to relate features of study design to the magnitude of gains attributed to new therapies over old. Overall we rated 87 per cent of new therapies as improvements over standard therapies. The mean gain (measured by the Mann-Whitney statistic) was relatively constant across study designs, except for non-randomized controlled trials with sequential assignment to therapy, which showed a significantly higher likelihood that a patient would do better on the innovation than on standard therapy (p = 0.004). Randomized controlled trials that did not use a double-blind design had a higher likelihood of showing a gain for the innovation than did double-blind trials (p = 0.02). Any evaluation of an innovation may include both bias and the true efficacy of the new therapy, therefore we may consider making adjustments for the average bias associated with a study design. When interpreting an evaluation of a new therapy, readers should consider the impact of the following average adjustments to the Mann-Whitney statistic: for trials with non-random sequential assignment a decrease of 0.15, for non-double-blind randomized controlled trials a decrease of 0.11.
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929325.V1
Abstract: Supplementary Table S5: Hazards ratio (95% Confidence Interval) for association inure-menopausal women between baseline risk factors and breast cancer risk utilizing MLOL-VPD
Publisher: Elsevier
Date: 2017
DOI: 10.1016/BS.ACR.2017.07.001
Abstract: The relation between selenium and cancer has been one of the most hotly debated topics in human health over the last decades. Early observational studies reported an inverse relation between selenium exposure and cancer risk. Subsequently, randomized controlled trials showed that selenium supplementation does not reduce the risk of cancer and may even increase it for some types, including advanced prostate cancer and skin cancer. An increased risk of diabetes has also been reported. These findings have been consistent in the most methodologically sound trials, suggesting that the early observational studies were misleading. Other studies have investigated selenium compounds as adjuvant therapy for cancer. Though there is currently insufficient evidence regarding the utility and safety of selenium compounds for such treatments, this issue is worthy of further investigation. The study of selenium and cancer is complicated by the existence of a erse array of organic and inorganic selenium compounds, each with distinct biological properties, and this must be taken into consideration in the interpretation of both observational and experimental human studies.
Publisher: Springer Science and Business Media LLC
Date: 24-06-2003
Publisher: American Association for Cancer Research (AACR)
Date: 09-2009
DOI: 10.1158/1055-9965.EPI-09-0080
Abstract: Between 2001 and 2005, Blacks from the United States experienced a 32% higher pancreatic cancer death rate than Whites. Smoking, diabetes, and family history might explain some of this disparity, but prospective analyses are warranted. From 1984 to 2004, there were 6,243 pancreatic cancer deaths among Blacks (n = 48,525) and Whites (n = 1,011,864) in the Cancer Prevention Study II cohort. Multivariate Cox proportional hazards models yielded hazards ratios (HR) for known and suspected risk factors. Population attributable risks were computed and their effect on age-standardized mortality rates were evaluated. Blacks in this cohort had a 42% increased risk of pancreatic cancer mortality compared with Whites (HR, 1.42 95% confidence intervals (CI), 1.28-1.58). Current smoking increased risk by & % in both races although Blacks smoked less intensely, risks were similar to Whites (HRBlack, 1.67 95% CI, 1.28-2.18 HRWhite, 1.82 95% CI, 1.7-1.95). Obesity was significantly associated with pancreatic cancer mortality in Black men (HR, 1.66 95% CI, 1.05-2.63), White men (HR, 1.42 95% CI, 1.25-1.60), and White women (HR, 1.37 95% CI, 1.22-1.54) results were null in Black women. The population attributable risk due to smoking, family history, diabetes, cholecystectomy, and overweight/obesity was 24.3% in Whites and 21.8% in Blacks. Smoking and overweight/obesity play a substantial a role in pancreatic cancer. Variation in the effect of these factors underscores the need to evaluate disease on the race-sex level. The inability to attribute excess disease in Blacks to currently known risk factors, even when combined with suspected risks, points to yet undetermined factors that play a role in the disease process. (Cancer Epidemiol Biomarkers Prev 2009 (9):2397–405)
Publisher: American Association for Cancer Research (AACR)
Date: 03-2016
DOI: 10.1158/1538-7755.DISP15-C10
Abstract: Introduction: Colorectal cancer (CRC) is a leading cause of cancer-related death in the United States. While CRC-specific mortality has been decreasing, significant disparities by race/ethnicity and socioeconomic factors persist. Unfortunately, despite evidence that CRC screening and early detection are cost effective and reduce incidence and mortality, less than 2/3 of age-eligible adults meet screening guidelines. Research has consistently shown that patients who are insured by Medicaid or are uninsured are even less likely to be screened than those who are privately insured. However, while much research treats insurance status as a stable factor, many low income people cycle on and off insurance. Thus, studies may oversimplify the association between insurance status and preventive care. Our goal in this analysis is to describe how patient demographic characteristics, specifically the varied experience of insurance, are associated with CRC screening rates in “real world” settings. Methods: We analyzed baseline data from patients in four urban federally qualified health centers participating in a randomized controlled trial to promote CRC screening. These in-person interviewer-administered surveys included items on socioeconomic factors, healthcare, and screening utilization. We examined bivariate associations to determine differences in past screening utilization. Patients were defined as screening “up-to-date” if they had received a fecal occult blood test in the past year and/or a flexible sigmoidoscopy or colonoscopy within the past 5 years. Based on current screening guidelines, we excluded people under the age of 50 from our analysis. Of the 329 patients surveyed across the 4 centers, 289 (87.8%) were age ≥50 and were included in this analysis. Results: Of these 289 patients, 115 (39.8%) met the criteria for being screening up-to-date. The s le had slightly more females than males (54.3% vs. 45.7%) and was primarily African-American (84.4%). Initial results show statistically significant demographic differences by screening status (p& .05). The up-to-date patients were older (mean age, 57 vs. 55), and more likely to be female (64.1% vs. 46.9%), have a personal healthcare provider (95.7% vs. 67.2%) and feel “very” or “extremely” comfortable discussing CRC screenings with a primary care doctor (92.3% vs. 75.6%) than patients who were not up-to-date. Additionally, up-to-date patients were less likely to have been homeless in the past 12 months (12.8% vs 31.1%) and less likely to have put off healthcare needs in the past 12 months due to cost concerns (24.8% vs 41.2%) or lack of transportation (17.9% vs. 28.8%). We saw no significant differences in screening status by education level or race. Up-to-date patients were significantly more likely to be currently insured (86.3% vs. 61.9%) than not up-to-date patients. Among those insured (n=210 71.4%), up-to-date patients were less likely to have had a period without insurance in the past 12 months (19.8% vs. 33.9%) and had different distributions of insurance type than not up-to-date patients. Discussion: Less than 40% of age-eligible patients were screening up-to-date in our study. Examining differences between up-to-date and not up-to-date patient populations can provide insight into what factors might be important in promoting CRC screening in medically underserved populations. Our preliminary findings indicate that insurance stability might play a positive role in CRC screening adherence. Statistical modeling might better characterize the role of insurance in screening. Researchers might consider the nuances of measuring insurance and the stability of insurance when studying the association between insurance status and healthcare utilization. In addition to guiding future research, these findings could drive future politico-structural improvements to health care policy. Citation Format: Kunal M. Mathur, Meera Muthukrishnan, Graham A. Colditz, Aimee S. James. Insurance “instability” and colorectal cancer screening utilization. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved Nov 13-16, 2015 Atlanta, GA. Philadelphia (PA): AACR Cancer Epidemiol Biomarkers Prev 2016 (3 Suppl):Abstract nr C10.
Publisher: Springer Science and Business Media LLC
Date: 22-10-2022
DOI: 10.1038/S41375-022-01711-0
Abstract: Lymphoma risk is elevated for relatives with common non-Hodgkin lymphoma (NHL) subtypes, suggesting shared genetic susceptibility across subtypes. To evaluate the extent of mutual heritability among NHL subtypes and discover novel loci shared among subtypes, we analyzed data from eight genome-wide association studies within the InterLymph Consortium, including 10,629 cases and 9505 controls. We utilized Association analysis based on SubSETs (ASSET) to discover loci for subsets of NHL subtypes and evaluated shared heritability across the genome using Genome-wide Complex Trait Analysis (GCTA) and polygenic risk scores. We discovered 17 genome-wide significant loci (P < 5 × 10
Publisher: American Medical Association (AMA)
Date: 09-1999
DOI: 10.1001/ARCHPEDI.153.9.975
Abstract: To evaluate the impact of a school-based interdisciplinary health behavior intervention on diet and physical activity among children in grades 4 and 5. A quasiexperimental field trial with 6 intervention and 8 matched control schools. Outcomes were assessed longitudinally using preintervention (fall 1995) and follow-up (spring 1997) student survey food frequency and activity measures and follow-up 24-hour recall measures of diet and activity. Change was also assessed using yearly repeated cross-sectional surveys of all grade 5 students from 1995 through 1997. Longitudinal data were collected from 479 students initially in grade 4 in Baltimore, Md, public schools 91% were African American. Repeated 24-hour recall measures in 1997 were collected for a random subs le of 336 students. Cross-sectional survey data were collected from all grade 5 students in 1995,1996, and 1997 (n = 2103). The Eat Well and Keep Moving Program was taught by classroom teachers over 2 years in math, science, language arts, and social studies classes. Materials provided links to school food services and families and provided training and wellness programs for teachers and other staff members. Intervention materials focused on decreasing consumption of foods high in total and saturated fat and increasing fruit and vegetable intake, as well as reducing television viewing and increasing physical activity. Dietary intake and physical activity measured via repeated 24-hour recall were primary end points, with additional food frequency and activity measures. The 24-hour recall measures indicated that, after controlling for baseline covariates, the percentages of total energy from fat and saturated fat were reduced among students in intervention compared with control schools (-1.4% 95% confidence interval [CI], -2.8 to -0.04 P = .04 and -0.60% 95% CI, -1.2 to -0.01 P = .05). There was an increase in fruit and vegetable intake (0.36 servings/4184 kJ 95% CI, 0.10-0.62 P=.01), in vitamin C intake (8.8 mg/4184 kJ 95% CI, 2.0-16 P=.01), and in fiber consumption (0.7 g/4184 kJ 95% CI, 0.0-1.4 P=.05). Television viewing was marginally reduced (-0.55 h/d 95% CI, -1.04 to 0.04 P=.06). Analysis of longitudinal and repeated cross-sectional food frequency data indicated similar significant decreases in the percentages of total energy from fat and saturated fat. Evaluation of the Eat Well and Keep Moving Program indicates effectiveness in improving dietary intake of students and reducing television viewing.
Publisher: American Medical Association (AMA)
Date: 17-02-2022
Publisher: Elsevier BV
Date: 06-2012
Publisher: Springer Science and Business Media LLC
Date: 09-01-2010
Publisher: American Psychological Association (APA)
Date: 09-2019
DOI: 10.1037/HEA0000726
Publisher: Springer Science and Business Media LLC
Date: 20-07-2012
Publisher: American Astronomical Society
Date: 25-05-2022
Abstract: Multiplanet systems are valuable arenas for investigating exoplanet architectures and comparing planetary siblings. TOI-1246 is one such system, with a moderately bright K dwarf ( V = 11.6, K = 9.9) and four transiting sub-Neptunes identified by TESS with orbital periods of 4.31, 5.90, 18.66, and 37.92 days. We collected 130 radial velocity observations with Keck/HIRES and TNG/HARPS-N to measure planet masses. We refit the 14 sectors of TESS photometry to refine planet radii (2.97 ± 0.06 R ⊕ , 2.47 ± 0.08 R ⊕ , 3.46 ± 0.09 R ⊕ , and 3.72 ± 0.16 R ⊕ ) and confirm the four planets. We find that TOI-1246 e is substantially more massive than the three inner planets (8.1 ± 1.1 M ⊕ , 8.8 ± 1.2 M ⊕ , 5.3 ± 1.7 M ⊕ , and 14.8 ± 2.3 M ⊕ ). The two outer planets, TOI-1246 d and TOI-1246 e, lie near to the 2:1 resonance ( P e / P d = 2.03) and exhibit transit-timing variations. TOI-1246 is one of the brightest four-planet systems, making it amenable for continued observations. It is one of only five systems with measured masses and radii for all four transiting planets. The planet densities range from 0.70 ± 0.24 to 3.21 ± 0.44 g cm −3 , implying a range of bulk and atmospheric compositions. We also report a fifth planet candidate found in the RV data with a minimum mass of 25.6 ± 3.6 M ⊕ . This planet candidate is exterior to TOI-1246 e, with a candidate period of 93.8 days, and we discuss the implications if it is confirmed to be planetary in nature.
Publisher: SAGE Publications
Date: 11-2020
Abstract: Prearthritic hip disorders (PAHD), such as femoroacetabular impingement (FAI), acetabular dysplasia, and acetabular labral tears, are a common cause of pain and dysfunction in adolescent and young adult athletes, and optimal patient-specific treatment has not been defined. Operative management is often recommended, but conservative management may be a reasonable approach for some athletes. To identify (1) the relative rate of progression to surgery in self-reported competitive athletes versus nonathletes with PAHD and (2) baseline demographic, pain, and functional differences between athletes who proceeded versus those who did not proceed to surgery within 1 year of evaluation. Cohort study Level of evidence, 3. An electronic medical record review was performed of middle school, high school, and college patients who were evaluated for PAHD at a single tertiary-care academic medical center between June 22, 2015, and May 1, 2018. Extracted variables included patients’ self-reported athlete status, decision to choose surgery within 1 year of evaluation, and baseline self-reported pain and functional scores on Patient-Reported Outcomes Measurement Information System (PROMIS) domains, the Hip disability and Osteoarthritis Outcome Score (HOOS), and the modified Harris Hip Score. Of 260 eligible patients (289 hips), 203 patients (78% 227 hips) were athletes. Athletes were no more likely to choose surgery than nonathletes (130/227 hips [57%] vs 36/62 hips [58%] relative risk [RR], 0.99 [95% CI, 0.78-1.25]). Among athletes, those who proceeded to surgery over conservative care were more likely to be female (81% vs 69% RR, 1.34 [95% CI, 0.98-1.83]) and had more known imaging abnormalities (FAI: 82% vs 69%, RR, 1.47 [95% CI, 1.09-1.99] dysplasia: 48% vs 27%, RR, 1.44 [95% CI, 1.16-1.79] mixed deformity: 30% vs 10%, RR, 2.91 [95% CI, 1.53-5.54] known labral tear: 84% vs 40%, RR, 2.79 [95% CI, 2.06-3.76]). Athletes who chose surgery also reported worse baseline hip-specific symptoms on all HOOS subscales (mean difference, 10.8-17.7 P .01 for all). Similar to nonathletes, just over half of athletes with PAHD chose surgical management within 1 year of evaluation. Many competitive athletes with PAHD continued with conservative management and deferred surgery, but more structural hip pathology and worse hip-related baseline physical impairment were associated with the choice to pursue surgery.
Publisher: American Medical Association (AMA)
Date: 21-10-1992
Publisher: American Academy of Pediatrics (AAP)
Date: 07-2016
Abstract: The human papillomavirus (HPV) vaccine is a safe, effective cancer prevention method that is underutilized in the United States. Despite increased understanding of barriers to vaccination, rates remain low. Globally, developed and developing nations have achieved high rates of vaccination. Identification of effective strategies is necessary to optimize uptake of the HPV vaccine. We systematically reviewed the literature for national and international interventions that have successfully increased HPV vaccine uptake. We used a standardized protocol to search for articles published between January 1, 2006, and April 30, 2015, in 3 electronic databases: PubMed, Scopus, and Embase. We identified interventions designed to increase HPV vaccine uptake among adolescents and young adults aged 11 to 26 years. All study designs were acceptable. Only articles that included postintervention vaccination rates were included. Two authors independently reviewed each article for data extraction and quality assessment. Interventions were classified according to the Community Preventive Service Task Force guide. Results were reported according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Fifty-one articles met eligibility criteria: 2 informational interventions, 18 behavioral interventions, and 31 environmental interventions. Factors associated with HPV vaccine uptake were increased vaccine availability, decreased financial barriers, and interventions targeting both providers and patients. Lack of consistent RE-AIM metric reporting, limiting our ability to assess intervention validity and quality. Population-based vaccination strategies that increased vaccine availability reached the greatest number of adolescents and were most successful in achieving high rates of vaccination.
Publisher: Wiley
Date: 11-2009
DOI: 10.3322/CAAC.20042
Publisher: American Medical Association (AMA)
Date: 22-01-1988
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2002
DOI: 10.1097/00008571-200211000-00003
Abstract: A principal hypothesized mechanism underlying breast carcinogenesis involves oestrogen-induced cell proliferation. In addition to its well-established role in the transcriptional regulation of genes required for adipocyte differentiation, the peroxisome proliferator-activated receptor gamma (PPARgamma) may be involved in transcriptional down-regulation of aromatase, a key enzyme in oestrogen biosynthesis. Furthermore, specific agonists for PPARgamma induce differentiation and suppress markers of malignancy in breast cancer cells in vitro. We investigated the association of the Pro12Ala PPARgamma polymorphism with breast cancer in a case-control study nested within the prospective Nurses' Health Study. Included were 725 incident cases of breast cancer diagnosed after blood collection through 1996 and 953 matched controls. In addition to breast cancer, the association of the PPARgamma Pro12Ala polymorphism with breast cancer risk factors, body mass index (BMI), weight gain since age 18 years, plasma hormones [oestrone sulphate, oestrone, oestradiol, androstenedione, testosterone, dehydroepiandrosterone (DHEA) and DHEA sulphate] and plasma lipids (total cholesterol and high density lipoprotein) was analysed. No significant association was observed between PPARgamma Pro12Ala polymorphism and either incident breast cancer (odds ratio = 1.08, 95% confidence interval = 0.85-1.38 for Ala allele carriers compared to non-carriers), plasma hormones, plasma cholesterol, BMI, weight gain since age 18 years or waist-to-hip ratio. To our knowledge, this is the first study to investigate the role of the Pro12Ala PPARgamma polymorphism in cancer. We did not find evidence to support a role for this polymorphism in breast cancer susceptibility. Furthermore, similar to others, we did not find evidence to suggest that Pro12Ala PPARgamma polymorphism is directly associated with body mass or weight gain.
Publisher: Wiley
Date: 15-06-2007
DOI: 10.1002/CNCR.22711
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.23929337.V1
Abstract: Supplementary Table S1: Hazards ratio for association between baseline risk factors and breast cancer risk among postmenopausal women using CC-VPD only.
Publisher: Wiley
Date: 07-1990
Abstract: The use of exogenous sex hormones in relation to the risk of rheumatoid arthritis (RA) was examined in a cohort of married nurses 30-55 years of age followed since 1976 in the Nurses' Health Study. Baseline information on the use of oral contraceptives, replacement estrogens, and other potential risk factors was obtained in 1976 and updated every 2 years. During 8 years of followup, 217 incident cases of polyarthritis were ascertained (115 RA and 102 undifferentiated polyarthritis). When compared with women who had never used oral contraceptives, the age-adjusted relative risk was 1.0 (95% confidence interval [CI] 0.7-1.3) for past users however, too few women were currently using oral contraceptives for a reliable estimate of its effect. Among postmenopausal women, 123 cases of RA were reported. Compared with postmenopausal women who never used replacement estrogens, current users had an age-adjusted relative risk of 1.3 (95% CI 0.9-2.0), past users had an age-adjusted relative risk of 0.7 (95% CI 0.5-1.2), and ever users had a relative risk of 1.0 (95% CI 0.7-1.4). These data do not show a protective effect of past use of oral contraceptives or replacement estrogens for RA however, a modest protective effect of current oral contraceptive use cannot be excluded.
Publisher: American Society of Hematology
Date: 15-11-2013
DOI: 10.1182/BLOOD.V122.21.3111.3111
Abstract: The 2-3 fold excess risk of multiple myeloma (MM) among family members of cases suggests a heritable contribution to risk. Recently, a genome-wide association study (GWAS) identified two genome-wide significant and one promising novel loci associated with multiple myeloma risk. To confirm these associations and identify additional novel risk loci, we performed a four-center, genome-wide association meta-analysis. A fixed effects model was used for the meta-analysis which included a total of 1248 cases and 1485 controls, all of European descent, genotyped and analyzed at four separate centers with s les contributed by 10 studies. After quality control and imputation using the 1000 Genomes Project, the analysis included ∼9.5 million variants (λ=1.024). Associations between (single nucleotide polymorphisms) SNP genotypes and MM risk were evaluated under a log-additive model of inheritance, with each study adjusting for age, sex, and up to 10 principal components to control for population stratification. Promising results were replicated in an independent set of 1587 cases and 1770 controls using TaqMan, for a total of 2835 and 3255 cases and controls, respectively, in a combined meta-analysis. The discovery meta-analysis did not reveal any genome-wide significant associations (defined as p x 10-8). We used a novel pruning algorithm to identify the top 35 most promising single nucleotide polymorphisms (SNPs) to advance to replication. We successfully genotyped 22 SNPs in the replication set. In the combined discovery and replication meta-analysis, rs1345359 at 12q23.1 was the most strongly associated SNP (P=9 x 10-8, Table 1). The variant allele C was associated with reduced risk (odds ratio discovery set [OR]= 0.69, OR replication set = 0.78, OR combined = 0.74). A second locus at 20q13.2 (rs150220835), was associated with a two-fold increased risk (P=1.22 x 10-6), a borderline increased risk (P=0.0900) and 45% increased risk (P=2.44 X 10-5) in the discovery, replication, and combined analysis sets respectively (Table 1). We also confirmed the association between MM risk and two previously published SNPs (rs4487645, p=0.0007and rs105251, p=0.0044) (Broderick et al., Nat. Genet., 2011). The third previously suggested SNP (rs6746082) was of nominal significance (p=0.0517) in the meta-analysis. We confirmed the association between MM risk and two previously published SNPs and identified a possible association with a novel SNP in chromosome 12q23.1 (rs1345359). This SNP is not located in a gene nor associated with biofeatures in ENCODE, thus further examination of correlated SNPs is necessary to identify a functional SNP linked to this locus. We also found suggestive evidence for a second locus at 20q13.2 requiring additional replication. Larger studies would improve risk variant discovery for this rare hematologic malignancy. Wolf: Celgene: Honoraria, Research Funding Millenium: Honoraria Onyx: Honoraria. Anderson:Celgene, Millennium, BMS, Onyx: Membership on an entity’s Board of Directors or advisory committees Acetylon, Oncopep: Scientific Founder , Scientific Founder Other.
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22534882
Abstract: Table S1. Differences in Volumetric Percent Density by Tertiles of Circulating RANK and sRANKL. Table S2. Least Square Means of Non-Dense Volume by Tertiles of Circulating RANK and sRANKL. Table S3. Least Square Means of Volumetric Percent Density, Dense Volume, and Non Dense Volume by Tertiles of Circulating RANK, Excluding Women whose Circulating RANK Values were reported as pg/mL.T
Publisher: Springer Science and Business Media LLC
Date: 02-2007
DOI: 10.1007/S10552-006-0079-6
Abstract: We assessed whether the functional V16A polymorphism in the MnSOD gene is associated with skin cancer risk. We conducted a nested case-control study (219 melanoma, 286 squamous cell carcinoma (SCC), and 300 basal cell carcinoma (BCC) cases, and 873 matched controls) within the Nurses' Health Study. Genotyping was performed by the 5' nuclease assay (TaqMan). We used logistic regression to model the association between the genotype and skin cancer risk. Overall, there was no significant association between this polymorphism and the risk of each type of skin cancer. No significant interaction was observed between this polymorphism and sunburn history and constitutional susceptibility on skin cancer risk. For interactions between intakes of alpha-carotene and beta-carotene and the MnSOD polymorphism on SCC, the inverse association of intake of either carotene with SCC risk was limited to the Val carriers, whereas no association was observed among women with the AA genotype. We observed an interaction between total vitamin C intake and the MnSOD polymorphism on melanoma risk. No interaction was observed for the intakes of other carotenoids, vitamin E, and vitamin A. Further research is needed to confirm these possible associations.
Publisher: Wiley
Date: 11-1980
DOI: 10.1111/J.1365-2923.1980.TB02392.X
Abstract: This study was undertaken to clarify the goals of the clinical general practitioner attachment scheme at the University of Queensland. Emphasis was placed on comparing the aims of the academics, the general practitioner preceptors and the students. Prior to the 2-week attachments students selected a different set of goals from those selected by academics and preceptors as most important. However, after the apprenticeship the students changed the goals in the direction of the preceptors'. Students' rating of the perceived level of achievement of the goals showed that the degree of correspondence between goals set by University teachers, preceptors and students was a good predictor of a successful learning experience. This study further suggests that teaching of Community Practice should not rest solely on apprenticeship schemes since preceptors' aims will largely determine the material learnt in the placement to the exclusion of more innovative academic goals.
Publisher: American College of Physicians
Date: 19-11-2002
DOI: 10.7326/0003-4819-137-10-200211190-00008
Abstract: Physiologic evidence suggests that use of alcohol increases the risk for breast cancer through a hormonal mechanism, but the relationship among breast cancer, alcohol, and postmenopausal hormones (PMH) remains unclear. To examine the relation between concurrent use of alcohol and PMH and invasive breast cancer. Prospective cohort study Nurses' Health Study. 44 187 postmenopausal women. Self-reported data on PMH use and breast cancer obtained from biennial questionnaires completed from 1980 to 1994 and average alcohol consumption in 1980, 1984, 1986, and 1990. 1722 women developed invasive breast cancer. Risk for breast cancer was elevated in women who currently used PMH for 5 or more years and did not drink alcohol (relative risk, 1.32 [95% CI, 1.05 to 1.66]) and those who never used PMH but drank 20 or more g (1.5 to 2 drinks) of alcohol daily (relative risk, 1.28 [CI, 0.97 to 1.69]). Current users of PMH for 5 or more years who consumed 20 or more g of alcohol daily had a relative risk for breast cancer nearly twice (1.99 [CI, 1.42 to 2.79]) that of nondrinking nonusers of PMH. A hypothetical postmenopausal woman whose lifetime risk for breast cancer is 4% could increase her risk to 8% with 5 or more years of current PMH use and consumption of more than one alcoholic drink daily. Both alcohol consumption and PMH use were associated with an increased incidence of breast cancer. Women who are currently taking PMH may want to consider the added risks of regular alcohol consumption.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2006
DOI: 10.1097/01.EDE.0000181629.59452.95
Abstract: Previous reports have found associations between having been breast-fed and a reduced risk of being overweight. These associations may be confounded by sociocultural determinants of both breast-feeding and obesity. We addressed this possibility by assessing the association of breast-feeding duration with adolescent obesity within sibling sets. We surveyed 5,614 siblings age 9 to 14 years and their mothers. These children were a subset of participants in the Growing Up Today Study, in which we had previously reported an inverse association of breast-feeding duration with overweight. We compared the prevalence of overweight (body mass index exceeding the age-sex-specific 85th percentile) in siblings who were breast-fed longer than the mean duration of their sibship with those who were breast-fed for a shorter period. Then we compared odds ratios from this within-family analysis with odds ratios from an overall (ie, not within-family) analysis. Mean +/- standard deviation breast-feeding duration was 6.4 +/- 4.0 months, and crude prevalence of overweight was 19%. On average, siblings who were breast-fed longer than their family mean had breast-feeding duration 3.7 months longer than their shorter-duration siblings. The adjusted odds ratio (OR) for overweight among siblings with longer breast-feeding duration, compared with shorter duration, was 0.92 (95% confidence interval = 0.76-1.11). In overall analyses, the adjusted OR was 0.94 (0.88-1.00) for each 3.7-month increment in breast-feeding duration. The estimated OR for the within-family analysis was close to the overall estimate, suggesting that the apparent protective effect of breast-feeding on later obesity was not highly confounded by unmeasured sociocultural factors. A larger study of siblings, however, would be needed to confirm this conclusion.
Publisher: Georg Thieme Verlag KG
Date: 16-07-2020
Abstract: Objective This study aimed to determine the feasibility and effectiveness of Diabetes Group Prenatal Care to increase patient engagement in diabetes self-care activities. Study Design A pilot randomized controlled trial was conducted at two sites. Inclusion criteria were English or Spanish speaking, type 2 or gestational diabetes, 22 to 34 weeks of gestational age at first study visit, ability to attend group care at specified times, and willingness to be randomized. Exclusion criteria included type 1 diabetes, multiple gestation, major fetal anomaly, serious medical comorbidity, and serious psychiatric illness. Women were randomized to Diabetes Group Prenatal Care or in idual prenatal care. The primary outcome was completion of diabetes self-care activities, including diet, exercise, blood sugar testing, and medication adherence. Secondary outcomes included antenatal care characteristics, and maternal, neonatal, and diabetes management outcomes. Analysis followed the intention-to-treat principle. Results Of 159 eligible women, 84 (53%) consented to participate in the study and were randomized to group (n = 42) or in idual (n = 42) prenatal care. Demographic characteristics were similar between study arms. Completion of diabetes self-care activities was similar overall, but women in group care ate the recommended amount of fruits and vegetables on more days per week (5.1 days/week ± 2.0 standard deviation [SD] in group care vs. 3.4 days ± 2.6 SD in in idual care p 0.01) and gained less weight per week during the study period (0.2 lbs/week [interquartile range: 0–0.7] vs. 0.5 lbs/week [interquartile range: 0.2–0.9] p = 0.03) than women in in idual care. Women with gestational diabetes randomized to group care were 3.5 times more likely to have postpartum glucose tolerance testing than those in in idual care (70 vs. 21% relative risk: 3.5 95% confidence interval: 1.4–8.8). Other maternal, neonatal, and pregnancy outcomes were similar between study arms. Conclusion Diabetes group care is feasible and shows promise for decreasing gestational weight gain, improving diet, and increasing postpartum diabetes testing among women with pregnancies complicated by diabetes. Key Points
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814311
Abstract: Supplementary Figure 1 shows the s le selection process
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-03-2003
DOI: 10.1212/01.WNL.0000046523.05125.87
Abstract: Men who regularly consume caffeinated drinks have a lower risk of PD than do nondrinkers, but this relation has not been found in women. Because this sex difference could be due to hormonal effects, the authors examined prospectively the risk of PD according to use of postmenopausal hormones and caffeine intake among participants in the Nurses' Health Study. The study population comprised 77,713 women free of PD, stroke, or cancer at baseline, who were postmenopausal at baseline or reached menopause before the end of the study. During 18 years of follow-up the authors documented 154 cases of PD. Overall, the risk of PD was similar in women using hormones and women who never used hormones (relative risk 1.02, 95% CI 0.69 to 1.52). Use of hormones, however, was associated with a reduced risk of PD among women with low caffeine consumption (RR 0.39, 95% CI 0.13 to 1.17), and with increased risk among women with high caffeine consumption (RR 2.44, 95% CI 0.75 to 7.86 p for interaction = 0.01). Among hormone users, women consuming six or more cups of coffee per day had a fourfold higher risk of PD (RR 3.92, 95% CI 1.49 to 10.34 p = 0.006) than did women who never drink coffee. These results suggest that caffeine reduces the risk of PD among women who do not use postmenopausal hormones, but increases risk among hormone users. Clinical trials of caffeine or estrogens in women should avoid the combined use of these agents.
Publisher: American Association for Cancer Research (AACR)
Date: 15-08-2020
DOI: 10.1158/1538-7445.AM2020-4632
Abstract: Background Terminal duct lobular units (TDLUs) involute with age. Prior studies using qualitative or semi-quantitative measures of TDLU involution found inverse associations with breast cancer (BC) risk. We applied our validated deep learning computational method to yield quantitative measures of TDLU involution in normal breast tissue and then assessed their association with established BC risk factors and BC risk. Materials and Methods This study used a nested case-control design within the Nurses' Health Study cohorts. Cases and controls were diagnosed with benign breast disease (BBD) and cases subsequently developed BC (median 7.75 years later). Cases and controls were matched on year of BBD diagnosis, age at BC diagnosis (or index date for controls), and years between BBD and BC diagnosis (or index date). We applied our computational method to 3951 whole slide images of normal breast tissue from BBD biopsies (287 cases and 1083 controls median 3 images per woman). Quantitative estimates of TDLU involution were derived for 3 standardized measures (median TDLU span, TDLU count per non-adipose tissue area, median acini count) and 5 novel measures (median TDLU area, TDLU area as a percentage of total tissue area, TDLU area as a percentage of total non-adipose tissue area, acini count per non-adipose tissue area, median acini density). TDLU involution was also manually categorized in 177 cases and 857 controls. Associations between TDLU involution measures and risk factors were evaluated among controls using Spearman's rho or Chi-squared tests. The relationship between each measure and BC risk was evaluated using logistic regression models controlling for the matching factors and BBD histological subtypes. Results All 8 TDLU measures were significantly inversely correlated with age at BBD biopsy (range: rho -0.07 to -0.42 p& .05) and menopausal status (p& .05). Parity was positively associated with 6 metrics (p& .05) birth index was inversely associated with another 6 metrics (p& .05). Select TDLU measures were also significantly associated with BBD histological subtype, BMI, age at first birth, and/or length of total breastfeeding (p& .05). No metric was significantly correlated with body size at ages 5-10 years or age of menarche. No quantitative TDLU involution measure was associated with subsequent BC risk results remained null within strata of parity and menopausal status. Qualitative categorizations of TDLU involution were also not associated with BC risk (predominant lobule type 1 no type 3 versus no type 1, adjusted OR=0.95, 95%CI 0.54-1.71). Conclusion Quantitative measures of TDLU involution were associated with age and reproductive BC risk factors. However, automated and manual assessments of TDLU involution in normal tissue were not associated with BC risk. Further work will include applying our method to assess TDLU involution and BC risk in other cohorts. Citation Format: Kevin H. Kensler, Emily Z. Liu, Suzanne C. Wetstein, Allison M. Onken, Christina I. Luffman, Gabrielle M. Baker, Laura C. Collins, Stuart J. Schnitt, Vanessa C. Bret-Mounet, Mitko Veta, Josien P. Pluim, Ying Liu, Graham A. Colditz, Rulla M. Tamimi, Yu Jing Jan Heng. Automated quantitative measures of terminal duct lobular unit involution and breast cancer risk [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR Cancer Res 2020 (16 Suppl):Abstract nr 4632.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-06-2006
Abstract: The incidence of ductal carcinoma-in-situ (DCIS) of the breast has been increasing. However, uncertainties exist about its prognosis, optimal treatment, and effect on women's health-related quality-of-life (HRQoL). Our study assessed the prospective changes in HRQoL in women diagnosed with DCIS. Between 1992 and 2000, HRQoL was assessed at three 4-year intervals among women enrolled in two Nurses' Health Study cohorts using the Medical Outcomes Survey Short-Form 36 health survey. Using mixed effects and logistic regression modeling, we compared the prospective changes in HRQoL scores among women with and without DCIS. The study included 114,728 women 510 were diagnosed with DCIS during the study period. During 4 years, women with DCIS had small, but statistically significantly greater declines in the domains of role limitations due to physical problems (−6.74 SE, 1.69), vitality (−2.06 SE, 0.78), and social functioning (−2.40 SE, 0.93) than women without DCIS. Among those with DCIS, clinically significant declines were more often observed within 6 months of the diagnosis in the domains of social functioning (odds ratio, 1.78 95% CI, 1.03 to 3.07) and mental health (odds ratio, 2.03 95% CI, 1.09 to 3.79) than after 6 months after diagnosis. Women with DCIS experienced small long-term declines in HRQoL, although these declines did not seem to be clinically important. Short-term clinically significant declines in the psychosocial domains were noted. In counseling women with DCIS, clinicians should provide reassurance but prepare them to deal with the short-term sequelae.
Publisher: Mary Ann Liebert Inc
Date: 1999
Abstract: Chronic alcohol abuse is associated with low bone density and high risk of fracture. However, moderate alcohol consumption may help to maintain bone density in postmenopausal women by increasing endogenous estrogens or by promoting secretion of calcitonin. We conducted a prospective study among a s le of 188 white postmenopausal women (ages 50-74) from the Nurses' Health Study who participated in a health examination between 1993 and 1995 that included bone density assessments of the lumbar spine and proximal femur. Long-term alcohol intake was calculated as the average of the 1980 and 1990 measures from a food frequency questionnaire. Women who consumed 75 g or more of alcohol per week had significantly higher bone densities at the lumbar spine compared with non-drinking women (0.951 vs. 0.849 g/cm2, p = 0.002) after adjusting for age, body mass index (kg/m2), age at menopause, use of postmenopausal estrogens, and smoking status. Further adjustment for physical activity and daily intakes of calcium, vitamin D, protein, and caffeine did not alter the results. We also observed a linear increase in spinal bone density over increasing categories of alcohol intake (p = 0.002), suggesting that alcohol intakes of less than 75 g/week may also be of benefit. This positive association was observed among both current users and never users of postmenopausal estrogens. In contrast to the lumbar spine, femoral bone density was not higher among drinkers compared with nondrinkers, although density did increase among drinkers with increasing level of alcohol consumption. Further research is needed to determine whether moderate alcohol consumption can help to protect against spinal fractures in postmenopausal women. This finding must also be evaluated within a larger scope of the risks and benefits of alcohol on heart disease, breast cancer, and hip fractures.
Publisher: American Association for Cancer Research (AACR)
Date: 08-0002
DOI: 10.1158/1055-9965.23814305
Abstract: Supplementary Table 2 shows the weights used to construct the weighted sleep score
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814308
Abstract: Supplementary Table 1 shows the associations between SNPs and EAC risk
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814302
Abstract: Supplementary Table 3 shows the sensitivity analyses for the association between sleep and EAC and ESCC by excluding cancer cases diagnosed within 2 years of enrollment
Publisher: American Association for Cancer Research (AACR)
Date: 06-2013
DOI: 10.1158/1055-9965.EPI-13-0169
Abstract: Background: Few studies have shown that the association between mammographic breast density and breast cancer persists for up to 10 years after the mammogram. We investigated associations of percent density, absolute dense, and nondense areas with breast cancer risk according to the time since the mammogram. Methods: This study included 1,028 incident breast cancer cases diagnosed within the Nurses' Health Study and 1,780 matched controls. Breast density was measured from digitized film images with computerized techniques. Information on breast cancer risk factors was obtained prospectively from the biennial questionnaires before the date of cancer diagnosis for cases and their matched controls. The data were analyzed with logistic regression. Results: Breast cancer risk increased with increasing percent density and increasing absolute dense area and decreased with increasing nondense area. In multivariate analysis, the magnitude of the association between percent density and breast cancer was similar when the time since the mammogram was & , 2 to & , and 5 to & years [density ≥50% vs.& %: ORs, 3.12 95% confidence interval (CI): 1.55–6.25, 5.35 (95% CI: 2.93–9.76), and 3.91 (95%CI: 2.22–6.88), respectively]. Similarly, the magnitude of association between quartiles of dense and nondense areas and breast cancer risk were similar across the time strata. We found no interactions between the time since the mammogram and breast density measures (Pinteraction & 0.05). Conclusions: Patterns of the associations between percent density, absolute dense, and nondense area with breast cancer risk persist for up to 10 years after the mammogram. Impact: A one-time density measure can be used for long-term breast cancer risk prediction. Cancer Epidemiol Biomarkers Prev 22(6) 1110–7. ©2013 AACR.
Publisher: Massachusetts Medical Society
Date: 07-09-1995
Publisher: American Public Health Association
Date: 08-2002
Abstract: 0bjectives. This study examined the association between caregiving for disabled or ill family members, estimated to occur in more than 22 million US households, and change in mental health. Methods. We assessed 4-year change in mental health among 37 742 Nurses’ Health Study participants with the Medical Outcomes Study Short-Form 36. Results. Women who provided 36 or more weekly hours of care to a disabled spouse were almost 6 times more likely than noncaregivers to experience depressive or anxious symptoms (multivariate odds ratio [OR] = 5.6 95% confidence interval [CI] = 3.8, 8.3). Caring for a disabled or ill parent (≥ 36 weekly hours) was associated with a less dramatic elevation in depressive or anxious symptoms (multivariate OR = 2.0 95% CI = 0.9, 4.3). Conclusions. In this population, caregiving was associated with increased risk of depressive or anxious symptoms.
Publisher: Springer Science and Business Media LLC
Date: 09-2015
DOI: 10.1038/BJC.2015.315
Publisher: Oxford University Press (OUP)
Date: 07-09-1994
Publisher: Springer Science and Business Media LLC
Date: 2000
Publisher: American Medical Association (AMA)
Date: 04-2008
DOI: 10.1001/ARCHOPHT.126.4.519
Abstract: To investigate whether estrogen exposures are associated with lower risks of age-related macular degeneration (AMD). Postmenopausal hormone (PMH) use, past use of oral contraceptives (OCs), ages at menarche and menopause, and parity were assessed among 74,996 postmenopausal women. Over 22 years, cases of early (n = 554) and neovascular (n = 334) AMD with a visual acuity of 20/30 or worse were identified. Cox models were used to calculate the relative risk for each exposure, adjusted for smoking and other factors. Current PMH users had a notable 48% lower risk of neovascular AMD compared with those who had never used PMH, although risk did not decline linearly with longer durations of use. Risk was lowest for PMH users who had used OCs in the past (P value for interaction, .03). In contrast, risk of early AMD was a notable 34% higher among current PMH users and OC use was unassociated with risk. The only remarkable finding for the endogenous estrogenic factors was a 26% lower risk of early AMD for parous women. Although PMH and OC use were associated with a lower risk of neovascular AMD, no benefit was observed for early AMD. Factors influencing lifetime exposure to estrogens were not consistently associated with the disease.
Publisher: Springer Science and Business Media LLC
Date: 12-04-2013
DOI: 10.1038/NRC3520
Publisher: Elsevier BV
Date: 11-2004
DOI: 10.1016/J.JADOHEALTH.2004.02.010
Abstract: To develop a scale to measure adolescent beliefs and attitudes about postponing sexual initiation (PSI). A theory-based, 12-item scale measuring beliefs about PSI was developed and administered via a mailed questionnaire to those participants in an ongoing longitudinal cohort study of adolescents who had not yet initiated sexual intercourse. Internal consistency reliability, content validity, factorial validity, and construct validity were assessed using cross-sectional data. Mean age for boys was 14.4 (+/- 1.6) years and for girls 14.3 (+/-1.6) years (range 11 to 19 years), and 93% of respondents were white. The beliefs about PSI rated as most important by both girls and boys were concern about pregnancy and sexually transmitted infection. Cronbach alpha for the scale was 0.83 for girls and 0.88 for boys. Exploratory factor analysis demonstrated that the items loaded on four factors consistent with the theoretical basis of the model and confirmatory factor analysis demonstrated good fit of the overall model. The PSI scale score was associated with hypothesized sociodemographic, psychological, and behavioral variables, supporting construct validity of the scale. A higher score was associated with female gender age < or = 14 years higher global and social self-esteem more frequent attendance at religious services less peer pressure to have sexual intercourse nonuse of alcohol, illicit drugs, and cigarettes and no intention to initiate sexual intercourse in the next year. The PSI scale demonstrated satisfactory psychometric properties. Future research is needed to evaluate the utility of this scale in predicting sexual initiation and in interventions aimed at postponing sexual initiation.
Publisher: Elsevier BV
Date: 12-2015
Publisher: Wiley
Date: 30-03-2005
DOI: 10.1002/IJC.21041
Abstract: Endogenous estrogen exposure is an important determinant of endometrial cancer risk. Aromatase, encoded by CYP19, catalyzes the aromatization of androstenedione and testosterone to estrone and estradiol, respectively. Several common genetic polymorphisms in CYP19 have been identified, including a TCT insertion/deletion and a (TTTA)(n) repeat polymorphism in intron IV as well as a 3'UTR C/T polymorphism. We evaluated these 3 polymorphisms plus an additional 9 noncoding polymorphisms as in idual genotypes and predicted haplotypes as risk factors for endometrial cancer using a nested case-control study design. Invasive endometrial cancer cases (n = 222) and matched controls (n = 666) were identified among participants in the Nurses' Health Study who had provided a blood s le in 1989-1990 (n = 32,826). We estimated haplotypes from unphased genotype data spanning > 123 kb of CYP19. Six haplotypes constructed from 10 SNPs were estimated with a frequency > or = 5%. The highest prevalence haplotype (33% among cases, 28% among controls) was significantly associated with endometrial cancer risk (p = 0.03). Loci with variant alleles that comprise the risk haplotype were independently associated with endometrial cancer, with relative risk estimates ranging from 1.68 (95% CI 1.13-2.48) to 2.07 (95% CI 1.33-3.23), comparing variant allele carriers to wild-type homozygotes. We observed significant interactions between menopausal status and 2 of the high-risk loci (p = 0.03 and p 2-fold increased risk for variant allele carriers who were postmenopausal but no association between genotype and endometrial cancer among premenopausal women. We evaluated associations between CYP19 haplotypes and plasma steroid hormone levels. The haplotype associated with endometrial cancer risk is also significantly associated with the ratios of estrone to androstenedione and estradiol to testosterone, the products and substrates of the enzyme aromatase, encoded by CYP19. Our data suggest that there is a high-frequency CYP19 haplotype related to higher estrogen to androgen ratios and increased risk of endometrial cancer and that this association may primarily pertain to postmenopausal women.
Publisher: Massachusetts Medical Society
Date: 26-08-1999
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2017
DOI: 10.1097/CCM.0000000000002285
Abstract: This meta-analysis aimed to examine the impact of antipyretic therapy on mortality in critically ill septic adults. Literature searches were implemented in Ovid Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, and ClinicalTrials.gov through February 2016. Inclusion criteria were observational or randomized studies of septic patients, evaluation of antipyretic treatment, mortality reported, and English-language version available. Studies were excluded if they enrolled pediatric patients, patients with neurologic injury, or healthy volunteers. Criteria were applied by two independent reviewers. Two reviewers independently extracted data and evaluated methodologic quality. Outcomes included mortality, frequency of shock reversal, acquisition of nosocomial infections, and changes in body temperature, heart rate, and minute ventilation. Randomized and observational studies were analyzed separately. Eight randomized studies (1,507 patients) and eight observational studies (17,432 patients) were analyzed. Antipyretic therapy did not reduce 28-day/hospital mortality in the randomized studies (relative risk, 0.93 95% CI, 0.77–1.13 I 2 = 0.0%) or observational studies (odds ratio, 0.90 95% CI, 0.54–1.51 I 2 = 76.1%). Shock reversal (relative risk, 1.13 95% CI, 0.68–1.90 I 2 = 51.6%) and acquisition of nosocomial infections (relative risk, 1.13 95% CI, 0.61–2.09 I 2 = 61.0%) were also unchanged. Antipyretic therapy decreased body temperature (mean difference, –0.38°C 95% CI, –0.63 to –0.13 I 2 = 84.0%), but not heart rate or minute ventilation. Antipyretic treatment does not significantly improve 28-day/hospital mortality in adult patients with sepsis.
Publisher: American Diabetes Association
Date: 10-1993
DOI: 10.2337/DIACARE.16.10.1356
Abstract: To assess the dietary habits of diabetic women. Participants in the Nurses Health Study, a cohort of 121,700 registered female nurses, were followed since 1976. We compared the usual dietary intakes of women who had been diagnosed with diabetes mellitus by 1980 and age-matched nondiabetic control women diets of these women were assessed in 1980 and 1984 by a semiquantitative food frequency questionnaire. The study examined 162 IDDM women and 738 NIDDM women. Similar comparisons were made for 429 women who developed NIDDM between 1980 and 1984. Although differences were small, women with IDDM in 1984 and women with NIDDM in 1980 and 1984 consumed less energy from carbohydrates, especially from sucrose, and more energy from protein and fat than did control women. Similar results were also found in 1984 for the 429 women who developed NIDDM between 1980 and 1984. In 1980, energy from nonsucrose carbohydrate was slightly higher in both IDDM and NIDDM women than in the control women. However, in 1984, using a dietary questionnaire designed to assess more complete dietary intake, less consistent results were obtained. Diabetic women tended to avoid desserts and sweets, sugar-containing beverages, and alcoholic beverages but consumed more meat and meat products. Intakes of foods high in complex carbohydrates (e.g., bread, rice, pasta, and potatoes) were similar between diabetic and control women. The results suggest that these diabetic women did not consume the high-carbohydrate, low-fat diets that the American Diabetes Association has been recommending over the past decade.
Publisher: Springer Science and Business Media LLC
Date: 11-1995
DOI: 10.1007/BF00054157
Publisher: Springer Science and Business Media LLC
Date: 31-01-2013
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Publisher: Elsevier BV
Date: 05-1992
Abstract: To determine the relations of diet with risk of clinical noninsulin-dependent diabetes, we analyzed data from a prospective cohort of 84360 US women. During 6 y of follow-up we identified 702 definite incident cases. Because body mass index (BMI) is a powerful risk factor for diabetes, we examined the relations of fat (including type), fiber, sucrose, and other components of diet to risk of diabetes, among women with BMIs (in kg/m2) less than 29 kg/m2. After controlling for body mass index, previous weight change, and alcohol intake, we observed no associations between intakes of energy, protein, sucrose, carbohydrate, or fiber and risk of diabetes. Compared with women in the lowest quintile of energy-adjusted intake, and relative risks (and tests for trend) for those in the highest quintile were 0.61 (P trend = 0.03) for vegetable fat, 0.62 (P trend = 0.008) for potassium, 0.70 (P trend = 0.005) for calcium, and 0.68 (P trend = 0.02) for magnesium. These inverse associations were attenuated among obese women (BMIs greater than or equal to 29).
Publisher: Massachusetts Medical Society
Date: 26-08-1999
Publisher: American Medical Association (AMA)
Date: 28-10-1996
Publisher: American Association for Cancer Research (AACR)
Date: 03-04-2023
DOI: 10.1158/1940-6207.22534882.V1
Abstract: Table S1. Differences in Volumetric Percent Density by Tertiles of Circulating RANK and sRANKL. Table S2. Least Square Means of Non-Dense Volume by Tertiles of Circulating RANK and sRANKL. Table S3. Least Square Means of Volumetric Percent Density, Dense Volume, and Non Dense Volume by Tertiles of Circulating RANK, Excluding Women whose Circulating RANK Values were reported as pg/mL.T
Publisher: Oxford University Press (OUP)
Date: 1987
DOI: 10.1093/IJE/16.3.392
Abstract: To evaluate factors that affect the reproducibility of a semi-quantitative food frequency questionnaire used in a large prospective study we compared an extended 99-item questionnaire with a shorter, 61-item form completed by 1497 women with an interval of nine months between. Correlation coefficients for in idual items assessed by the two questionnaires were highest for beverages (Spearman r = 0.70). For other foods, coefficients ranged from 0.60 to 0.70 for items eaten frequently (or habitually), to values between 0.34 and 0.45 for foods, such as sweet potatoes and ready made pie, that were eaten less frequently. For food items, the correlation between mean frequency of consumption and the reproducibility coefficient (Spearman r) was 0.51 (p less than 0.01), formally confirming that the reproducibility of measurements was positively associated with frequency of use. Pearson correlation coefficients for calorie-adjusted intakes of nutrients between the two questionnaires ranged from 0.40 for trans-fatty acids to 0.71 for vitamin E (including supplements). These correlation coefficients did not vary materially between subjects in different categories of smoking status or tertiles of age or relative weight. Moderate alcohol use had minimal effect on correlation coefficients, but reproducibility was slightly reduced among heavier drinkers. These data indicate that this self-administered dietary questionnaire can provide reproducible information about in idual food and nutrient intakes which is not altered materially by age and a number of important health habits.
Publisher: Springer Science and Business Media LLC
Date: 09-1996
Publisher: American Diabetes Association
Date: 02-2007
DOI: 10.2337/DC06-2336
Publisher: American Society of Hematology
Date: 13-11-2019
DOI: 10.1182/BLOOD-2019-129298
Abstract: Multiple myeloma (MM) is a neoplasm thought to arise from a damaged germinal center B-cell that progresses to a plasma cell clone arising in bone marrow. MM comprises 20% of all hematologic cancer deaths. Persons of African ancestry (AA) have a 1.5 to 2-fold higher risk compared to in iduals of European ancestry (EA). Genetically driven differences in hematopoiesis may lead to variation in the levels white blood cell (WBC) subsets which could, in turn, be associated with MM etiology. There are differences in genetic determinants of WBC traits between EA and AA populations, with possible implications for the racial disparity in risk. We tested the above hypothesis using Mendelian randomization (MR), an approach that leverages genetic determinants of specific traits (i.e. WBC counts) to estimate their effects on the risk of an outcome and a transcriptome-wide association study (TWAS), which utilizes genetic predictors of gene expression to identify susceptibility genes. These analytic approaches were applied to data from the African American Multiple Myeloma Study (AAMMS) consisting of 1813 cases and 8871 AA cancer-free controls to examine how differences in heritable WBC gene expression profiles influence MM risk. Genetic determinants of variation in WBC subsets in AA were obtained from the literature and supplemented with new genome-wide association findings in AA subjects from the UK Biobank cohort (n=6108). Odds ratios (OR) for MM per 1 standard deviation (SD) increase in each WBC phenotype were estimated using independent (linkage disequilibrium (LD) r2 .10) variants with P -6 as genetic instruments. Analyses based on variants associated with WBC traits in AA populations did not identify any statistically-significant associations between MM risk and WBC overall (p=0.81, using 15 SNPs) or subsets (lymphocytes, monocytes, eosinophils, neutrophils and basophils, p .05 for each). However, when we applied genetic determinants of WBC identified in 330,000 cancer-free EA UK Biobank participants (P -8, replication P .05, LD r2 .05), a statistically significant inverse relationship emerged between increasing lymphocyte counts and MM risk (OR=0.80, 95% CI: 0.66-0.97, p=0.02, using 385 SNPs), as well as increasing basophil counts (OR=0.63, 95% CI: 0.41-0.96, p=0.03, using 140 SNPs). Next, we examined the association between WBC gene expression profiles and MM risk in AAMMS data. We applied published and validated ancestry-specific models developed using the PrediXcan approach, which leverage germline genetic and transcriptomic data from the Multi-Ethnic Study of Atherosclerosis (MESA) (Mogil et al. PMID: 30096133). The primary TWAS used gene expression models trained in AA subjects (n=233), with sensitivity analyses using models developed in AA and Hispanic subjects (n=585). The TWAS significance threshold was based on the number of genes with significant germline prediction models (p .05 and R2 ≥0.05) in AA, corresponding to P 0.05/2700 = 1.85×10-5. The expression of two genes was significantly associated with MM risk: KANK1at 9p24.3 (P = 1.01×10-5) and DNAJC27at 2p23.3 (P = 1.56×10-5). KANK1is a candidate tumor suppressor gene for renal cell carcinoma and has recently been associated with MM risk in AA [Du, Blood 2017 130:3058]. Here we provide additional evidence for its role in MM etiology via gene expression-mediated mechanisms. DNAJC27 (previously known as RBJ) is a novel MM risk gene linked to constitutive activation of ERK in solid tumors. We also identified two suggestively associated genes: PRR14 (P = 1.34×10-4 combined AA-Hispanic s le: P = 1.56×10-6), which has been linked to MM risk in EA populations, and PARP16 (P = 9.46×10-5). To our knowledge this is the first study to comprehensively examine variation in WBC traits and gene expression profiles with respect to MM risk in AA. Our TWAS analysis leveraged data from the largest collection of genetic and gene expression data in AA, enabling ancestry-matched inference and identification of two novel risk genes. Although the limited availability of genetic instruments for WBC limited the power of MR analysis, findings using variants identified in European populations may offer some insight into trans-ethnic etiologic pathways and contribute to risk stratification strategies using genetic and blood cell count biomarkers. Future studies, particularly with MGUS-free controls, are needed to validate these results. Song: Millennium Pharmaceuticals Inc: Employment. Rand:Ancestry.com: Employment. Ailawadhi:Cellectar: Research Funding Janssen: Consultancy, Research Funding Celgene: Consultancy Pharmacyclics: Research Funding Amgen: Consultancy, Research Funding Takeda: Consultancy. Nooka:Takeda: Honoraria, Other: advisory board participation Janssen: Honoraria, Other: advisory board participation GSK: Honoraria, Other: advisory board participation Spectrum pharmaceuticals: Honoraria, Other: advisory board participation Adaptive technologies: Honoraria, Other: advisory board participation Amgen: Honoraria, Other: advisory board participation Celgene: Honoraria, Other: advisory board participation BMS: Honoraria, Other: advisory board participation. Singhal:Bureau of Millennium/Takeda, Celgene, Janssen, Celgene, Bristol-Myers Squibb and Bluebird: Speakers Bureau. van Rhee:Takeda: Consultancy Sanofi Genzyme: Consultancy Castleman Disease Collaborative Network: Consultancy EUSA: Consultancy Adicet Bio: Consultancy Kite Pharma: Consultancy Karyopharm Therapeutics: Consultancy. Mehta:Millennium/Takeda, Celgene stock in Celgene, Bristol-Myers Squibb and Bluebird: Speakers Bureau. Wolf:Takeda: Consultancy Celgene: Consultancy Novartis: Consultancy Janssen: Consultancy Amgen: Consultancy. Martin:Roche and Juno: Consultancy Amgen, Sanofi, Seattle Genetics: Research Funding. Fiala:Incyte: Research Funding. Terebelo:Jannsen: Speakers Bureau Celgene: Honoraria Newland Medical Asociates: Employment. Anderson:Bristol-Myers Squibb: Other: Scientific Founder Oncopep: Other: Scientific Founder Amgen: Consultancy, Speakers Bureau Janssen: Consultancy, Speakers Bureau Takeda: Consultancy, Speakers Bureau Celgene: Consultancy, Speakers Bureau Sanofi-Aventis: Other: Advisory Board. Vij:Bristol-Myers Squibb: Honoraria, Research Funding Celgene: Honoraria, Research Funding Genentech: Honoraria Janssen: Honoraria Karyopharm: Honoraria Sanofi: Honoraria Takeda: Honoraria, Research Funding. Bernal-Mizrachi:TAKEDA: Research Funding Kodikas Therapeutic Solutions, Inc: Equity Ownership Winship Cancer Institute: Employment, Patents & Royalties. Morgan:Amgen, Roche, Abbvie, Takeda, Celgene, Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees Celgene: Other: research grant, Research Funding. Zonder:Celgene Corporation: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding Takeda: Membership on an entity's Board of Directors or advisory committees Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees Intellia: Consultancy, Membership on an entity's Board of Directors or advisory committees Caelum: Consultancy, Membership on an entity's Board of Directors or advisory committees Alnylam: Consultancy, Membership on an entity's Board of Directors or advisory committees BMS: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees Oncopeptides: Consultancy, Membership on an entity's Board of Directors or advisory committees. Huff:Member of Safety Monitoring Board for Johnson and Johnson: Membership on an entity's Board of Directors or advisory committees Karyopharm, Sanofi, MiDiagnostics: Consultancy. Lonial:Karyopharm: Consultancy Takeda: Consultancy, Research Funding Amgen: Consultancy BMS: Consultancy Janssen: Consultancy, Research Funding GSK: Consultancy Celgene Corporation: Consultancy, Research Funding Genentech: Consultancy. Orlowski:Poseida Therapeutics, Inc.: Research Funding.
Publisher: Cambridge University Press (CUP)
Date: 03-1999
DOI: 10.1017/S1368980099000397
Abstract: To assess the reproducibility and validity of a semiquantitative food frequency questionnaire (FFQ) to classify children and adolescents in terms of daily servings of fruits and vegetables and intake of calories, protein, fat, carbohydrate, dietary fibre, vitamin C, phosphorous, calcium and iron. FFQs were collected in the autumn of 1993 and 1994. Four 24-hour diet recalls were collected during the same 1-year period and their mean was compared to the FFQ diet estimates. Low income, inner-city state schools. A s le of 109 inner-city fourth to seventh grade students. The 1-year reproducibility of the FFQ, assessed with Spearman correlations, was lower among the fourth and fifth (range: r = −0.26 to 0.40) than the sixth and seventh grade students (range: r = 0.18–0.47). After adjusting for day-to-day variation in dietary intake, for most nutrients and foods the correlations between the FFQ and the 24-hour recalls remained greater among the junior high school students (fourth to fifth grade range: r = 0.0–0.42 sixth to seventh grade range: = 0.07–0.76). Inner-city sixth and seventh grade students demonstrated the ability to provide valid estimates of intake of calories, carbohydrate, calcium, phosphorous, iron and vitamin C over the past year. However, children in the fourth and fifth grades experienced some difficulty in completing the FFQ. Our results suggest that, before using this instrument with fourth and fifth grade children, investigators should assess whether study participants can think abstractly and are familiar with the concept of ‘average intake’.
Publisher: Wiley
Date: 12-1990
DOI: 10.1002/1097-0142(19901201)66:11<2253::AID-CNCR2820661102>3.0.CO;2-G
Abstract: To evaluate the relation between use of oral contraceptives and the incidence of breast cancer, the authors reviewed the epidemiologic literature and used quantitative methods to summarize the data. Study results for any use of oral contraceptives were pooled using a model that accounted for both interstudy and intrastudy variability. The authors also explored interstudy variability and modeled a duration-effect relation between oral contraceptive use and breast cancer. Case-control and follow-up studies were considered separately. Overall, the authors observed no increase in the risk of breast cancer for women who had ever used oral contraceptives, even after a long duration of use. These results were consistent across study design. However, data combined from case-control studies revealed a statistically significant positive trend (P = 0.001) in the risk of premenopausal breast cancer for women exposed to oral contraceptives for longer duration. This risk was predominant among women who used oral contraceptives for at least 4 years before their first term pregnancy (relative risk = 1.72 95% confidence interval = 1.36 to 2.19). Additional study is required to determine whether this finding in a subgroup of exposed women is confirmed and whether the risk remains increased with advancing age.
Publisher: Springer Science and Business Media LLC
Date: 21-09-2018
Publisher: Oxford University Press (OUP)
Date: 23-05-2013
DOI: 10.1093/JNCI/DJT147
Publisher: Wiley
Date: 2001
DOI: 10.1002/1097-0215(200002)9999:9999<::AID-IJC1081>3.0.CO;2-W
Abstract: The environmental organochlorines 2,2-bis(p-chlorophenyl)1,1,1,trichloroethane (DDT) and polychlorinated biphenyls (PCBs) have been implicated as potential causes of female breast cancer. We continued follow-up of our 1997 case-control study nested in the Nurses' Health Study cohort, adding 143 postmenopausal cases and controls to the original 238 pairs, and examining specific PCB congeners for the first time. We measured plasma levels of 2,2-bis(p-chlorophenyl)ethylene (DDE), the major metabolite of DDT, and PCBs prospectively, comparing women who were diagnosed with breast cancer between 1 month and 4 years after blood collection with control women in whom breast cancer did not develop. Median concentrations of lipid-adjusted DDE, total PCBs, and PCB numbers 118, 138, 153 and 180, assessed in idually, were similar among the cases and controls. The multivariate relative risk of breast cancer for women in the highest quintile of exposure as compared with women in the lowest quintile was 0.82 for DDE (95% confidence interval [CI]: 0.49-1.37) and 0.84 for total PCBs (95% CI: 0.47-1.52), 0.69 for PCB 118 (95% CI: 0.39-1.22), 0.87 for PCB 138 (95% CI: 0.50-1.50), 0.83 for PCB 153 (95% CI: 0.47-1.48), and 0.98 for PCB 180 (95% CI: 0.55-1.75). Sub-group analyses were also performed. Overall, our results do not support the hypothesis that exposure to DDT and PCBs increases the risk of breast cancer.
Publisher: Oxford University Press (OUP)
Date: 2002
DOI: 10.1093/AJE/155.1.72
Abstract: Although the observational evidence linking cigarette smoking with risk of senile cataract is well-established, it is unclear whether any benefit is obtained from quitting smoking. Therefore, in this study, the authors examined the association between time since quitting smoking and incidence of cataract extraction in women and men enrolled in the Nurses' Health Study and the Health Professionals Follow-up Study, respectively. There were 4,281 incident physician-confirmed cases of cataract and 1,038,493 accumulated person-years of follow-up. Compared with current smokers, former smokers who had quit smoking 25 or more years previously had a 20% lower risk of cataract extraction after adjustment for age, average number of cigarettes smoked per day, and other potential risk factors (relative risk (RR) = 0.80, 95% confidence interval (CI): 0.71, 0.91). However, risk among past smokers did not decrease to the level seen among never smokers (for never smokers, RR = 0.64, 95% CI: 0.52, 0.79). The observed relation was similar when data were examined by cataract subtype (>25 years since quitting vs. current smoking: primarily nuclear cataract, RR = 0.82, 95% CI: 0.68, 0.97 primarily posterior subcapsular cataract, RR = 0.90, 95% CI: 0.71, 1.13). These findings suggest that any healing from damage due to cigarette smoking occurs at a very modest pace, and they emphasize the importance of never starting to smoke or quitting early in life.
Publisher: Wiley
Date: 04-1996
Abstract: To investigate the role of hair dye use in the etiology of systemic lupus erythematosus (SLE). Participants included 106,391 women enrolled in the Nurses' Health Study, a prospective cohort study. The subjects were ages 30-55 years in 1976, and were free from SLE and any other connective tissue disease at the time of enrollment. In 1976, 1978, 1980, and 1982, subjects were classified as never-users or ever-users of permanent hair dye, based on self-report. Incidence rates of SLE meeting American College of Rheumatology classification criteria were ascertained and confirmed by chart review. Compared with never-users of permanent hair dye, the age-adjusted relative risks (RR) for the development of SLE among ever-users (n = 85 cases) was 0.96 (95% confidence interval [95% CI] 0.63-1.47). Duration of hair dye use was not related to risk of SLE. Women with 15 or more years of use had no increased risk (RR = 0.92, 95% CI 0.46-1.83). There was no relationship between frequency of use or time since first use and risk of SLE. The results were similar when less stringent criteria for SLE were used. We found no evidence that permanent hair dye use, age at first use, frequency of use, or duration of use is associated with the development of SLE.
Publisher: American Association for Cancer Research (AACR)
Date: 08-2023
DOI: 10.1158/1055-9965.23814290.V1
Abstract: Supplementary Table 6 shows the association between composite sleep score and EAC risk with deaths as competing events
Publisher: Springer Science and Business Media LLC
Date: 26-02-2012
Publisher: American Diabetes Association
Date: 10-2004
DOI: 10.2337/DIACARE.27.10.2478
Abstract: OBJECTIVE—Inflammation plays a key role in chronic obstructive pulmonary disease (COPD) and asthma. Increasing evidence points toward a role of inflammation in the pathogenesis of type 2 diabetes. We wanted to determine the relation of COPD and asthma with the development of type 2 diabetes. RESEARCH DESIGN AND METHODS—The Nurses’ Health Study is a prospective cohort study. From 1988–1996, 103,614 female nurses were asked biennially about a physician diagnosis of emphysema, chronic bronchitis, asthma, and diabetes. RESULTS—During 8 years of follow-up, we documented a total of 2,959 new cases of type 2 diabetes. The risk of type 2 diabetes was significantly higher for patients with COPD than those without (multivariate relative risk 1.8, 95% CI 1.1–2.8). By contrast, the risk of type 2 diabetes among asthmatic patients was not increased (1.0, 0.8–1.2). The asthma results remained nonsignificant even when we evaluated diabetes risk by duration of asthma exposure. CONCLUSIONS—Our findings suggest that COPD may be a risk factor for developing type 2 diabetes. Differences in the inflammation and cytokine profile between COPD and asthma might explain why COPD, but not asthma, is associated with increased risk of type 2 diabetes.
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Publisher: Springer Science and Business Media LLC
Date: 06-01-2017
Publisher: Oxford University Press (OUP)
Date: 10-1996
DOI: 10.1093/OXFORDJOURNALS.AJE.A008977
Abstract: The associations between toenail levels of five trace elements and breast cancer risk were studied among a cohort of 62,641 US women who provided toenail clippings and were free from diagnosed breast cancer in 1982. Among 433 cases of breast cancer identified during 4 years of follow-up and their matched controls, the odds ratios comparing the highest with the lowest quintiles and adjusted for established breast cancer risk factors were as follows: for arsenic, 1.12 (95% confidence interval (CI) 0.66-1.91) for copper, 0.91 (95% CI 0.59-1.42) for chromium, 0.96 (95% CI 0.61-1.52) for iron, 0.89 (95% CI 0.56-1.40) and for zinc, 1.09 (95% CI 0.70-1.70). Among postmenopausal women, a marginally significant positive association was observed between toenail chromium levels and breast cancer risk (odds ratio = 1.71, 95% CI 0.87-3.35) (p for trend = 0.07). However, the association between chromium and breast cancer risk was inverse among premenopausal women. Although data on the validity of toenail levels of certain of these elements are limited, these results do not provide evidence for an important effect of arsenic, copper, chromium, iron, or zinc on breast cancer risk.
Publisher: American Association for Cancer Research (AACR)
Date: 03-2007
DOI: 10.1158/0008-5472.CAN-06-4123
Abstract: The CYP19A1 gene encodes the enzyme aromatase, which is responsible for the final step in the biosynthesis of estrogens. In this study, we used a systematic two-step approach that included gene resequencing and a haplotype-based analysis to comprehensively survey common genetic variation across the CYP19A1 locus in relation to circulating postmenopausal steroid hormone levels and breast cancer risk. This study was conducted among 5,356 invasive breast cancer cases and 7,129 controls comprised primarily of White women of European descent drawn from five large prospective cohorts within the National Cancer Institute Breast and Prostate Cancer Cohort Consortium. A high-density single-nucleotide polymorphism (SNP) map of 103 common SNPs (≥5% frequency) was used to identify the linkage disequilibrium and haplotype patterns across the CYP19A1 locus, and 19 haplotype-tagging SNPs were selected to provide high predictability of the common haplotype patterns. We found haplotype-tagging SNPs and common haplotypes spanning the coding and proximal 5′ region of CYP19A1 to be significantly associated with a 10% to 20% increase in endogenous estrogen levels in postmenopausal women [effect per copy of the two-SNP haplotype rs749292-rs727479 (A-A) versus noncarriers P = 4.4 × 10−15]. No significant associations were observed, however, with these SNPs or common haplotypes and breast cancer risk. Thus, although genetic variation in CYP19A1 produces measurable differences in estrogen levels among postmenopausal women, the magnitude of the change was insufficient to contribute detectably to breast cancer. [Cancer Res 2007 (5):1893–7]
Publisher: Wiley
Date: 04-2007
DOI: 10.1038/OBY.2007.616
Abstract: To assess the association of dietary fat and weight gain among adult women and to investigate whether offspring of overweight parents have a greater predisposition to weight gain due to intake of dietary fat. This was an 8-year follow-up of 41,518 women in the Nurses' Health Study (NHS), a population-based, prospective cohort. The women were 41 to 68 years of age, free of cardiovascular disease, cancer, and diabetes in 1986 when "baseline" weight and diet were assessed. Eight years later (1994), changes in weight and dietary intake were assessed. Linear regression models were used to relate change in weight to fat intake and change in fat intake, using the percentage of energy from carbohydrate as the comparison, adjusted for age, BMI in 1986, leisure time physical activity, time spent sitting, percent of calories from protein, and change in percentage of calories from protein. Overall, there was a weak positive association between total fat intake (beta=0.11) and weight gain. Increases in monosaturated and polyunsaturated fat were not associated with weight gain, but increases in animal fat, saturated fat, and trans fat had a positive association with weight change. There was not strong evidence of effect modification by parental weight status (p=0.7 to 0.8 for percentage of calories from total fat, animal fat, and vegetable fat) however, the associations were stronger among the overweight compared with leaner women (p<0.05 for percentage of calories from each type of fat). Among overweight women, for every one percentage increase in percentage of calories from trans fat, women gained an additional 2.3 lb (95% confidence interval, 1.80 to 2.86). Our results show that, overall, percent of calories from fat has only a weak positive association with weight gain however, percentage of calories from animal, saturated, and trans fat has stronger associations. There was no clear evidence that the diet-weight gain association was stronger among offspring of overweight parents, but dietary fat was associated with greater weight gain among overweight women.
Publisher: Springer Science and Business Media LLC
Date: 22-12-2006
DOI: 10.1038/NRC1784
Abstract: It has been almost 25 years since Doll and Peto performed their landmark analysis of epidemiological data to identify the causes of cancers and possible modes of cancer prevention. Since then, there have been many additional studies of cancer incidence using various epidemiological techniques. These studies revealed expanded opportunities for cancer prevention through approaches that include vaccination, increased physical activity, weight control and avoidance of post-menopausal hormone therapy.
Publisher: Oxford University Press (OUP)
Date: 11-1997
DOI: 10.1093/CARCIN/18.11.2127
Abstract: Polymorphisms in the N-acetyltransferase 2 (NAT2) gene are determinants of the rate of metabolic activation of carcinogenic compounds such as aryl aromatic amines. Homozygosity for any combination of three variant alleles in Caucasians defines 'slow' acetylators presence of one or two wild-type alleles characterizes 'rapid' acetylators. Although most previous studies have not observed an overall elevation in risk of breast cancer among slow acetylators, a recent study observed that cigarette smoking was associated with a large increase in risk of breast cancer among slow acetylators. We assessed the relation between NAT2 acetylation status and breast cancer risk, and its interaction with smoking, in a prospective study of mainly Caucasian US women. Four hundred and sixty-six incident cases who were diagnosed with breast cancer after giving a blood specimen in 1989-90 were matched to 466 controls in a nested case-control study. NAT2 genotype was determined using PCR-RFLP assays. The multivariate relative risk (RR) comparing slow with rapid acetylators was 0.9 (95% CI 0.7-1.2). Among slow acetylators, current smoking immediately prior to diagnosis was not associated with a significant elevation in risk compared with never smoking rapid acetylators (RR = 1.4, 95% CI 0.7-2.6). No significant association was seen between pack-years of smoking and risk of breast cancer among either slow or fast acetylators. A non-significant elevation in risk was observed among women who smoked for > or = 5 years prior to first pregnancy and were rapid acetylators, compared with never smoking rapid acetylators (RR = 1.5, 95% CI 0.9-2.6). In analyses limited to 706 post-menopausal women, the elevated risks for current smokers immediately prior to diagnosis who were slow acetylators compared with never smokers who were fast acetylators were slightly stronger but still not statistically significant. In summary, we observed little evidence of an association between NAT2 genotype and breast cancer. In this prospective study, cigarette smoking was not appreciably associated with breast cancer among either slow or fast NAT2 acetylators.
Publisher: Springer Science and Business Media LLC
Date: 07-11-2014
Publisher: JMIR Publications Inc.
Date: 25-07-2022
DOI: 10.2196/35736
Abstract: Metastatic breast cancer (MBC) remains incurable despite significant treatment advances. Coordinating care for patients with MBC can be challenging given the various treatment options, available clinical trials, and frequent need for ancillary services. To optimize MBC care, we designed a project for adapting and developing an academic and community practice collaborative care model for MBC care (Project ADAPT), based on the Ending Metastatic Breast Cancer for Everyone (EMBRACE) program developed at Dana Farber Cancer Institute. We aim to describe the implementation science–based study design and innovative components of Project ADAPT. Project ADAPT uses the Dynamic Adaptation Process informed by the Exploration, Preparation, Implementation, Sustainment framework. Washington University School of Medicine (WUSM) partnered with 3 community hospitals in the St. Louis region covering rural and urban settings. The exploration and preparation phases provide patient and provider feedback on current referral practices to finalize the approach for the implementation phase. At the implementation phase, we will enroll patients with MBC at these 3 community sites to evaluate potential collaborative care at WUSM and assess the impact of this collaborative care model on referral satisfaction and acceptability for patients with MBC and their providers. Patients may then return to their community site for care or continue to receive part of their care at WUSM. We are incorporating virtual and digital health strategies to improve MBC care coordination in order to minimize patient burden. The exploration phase is ongoing. As of August 2021, we have recruited 21 patient and provider participants to complete surveys of the current collaborative care process at WUSM. Using a 2-tailed paired t test, 44 patients (including 10 patients from the exploration phase) and 32 oncologists are required to detect an effect size of 0.5 with 80% power at a level of significance of .05. Throughout this phase and in preparation for the implementation phase, we have iteratively updated and refined our surveys for the implementation phase based on testing of our data collection instruments. Our partner sites are in various stages of the single institutional review board (IRB) approval process. We have ongoing engagement with all partner sites, which has helped solidify our participant recruitment strategies and design patient-friendly recruitment materials. In addition, we have included a patient advocate on the research team. Members of the research team have launched a single IRB Support Network at WUSM to create a repository of the single IRB procedures in order to streamline the partner site onboarding process and facilitate enhanced collaboration across institutions. With this robust model, we expect that patients with MBC will receive optimal care regardless of geographical location and the model will improve patient and provider experiences when navigating the health system. DERR1-10.2196/35736
Publisher: Elsevier BV
Date: 06-2008
Publisher: American Association for Cancer Research (AACR)
Date: 31-03-2011
DOI: 10.1158/1078-0432.CCR-10-2021
Abstract: Purpose: Androgen receptor (AR) is commonly expressed in breast cancers. However, the association between tumor AR status and breast cancer survival is uncertain. Hence, we examined the association between AR status and breast cancer survival in the Nurses' Health Study (NHS). Experimental Design: It was a prospective study of postmenopausal women enrolled in the Nurses' Health Study with stage I to III breast cancer diagnosed between 1976 and 1997 and followed from the date of diagnosis until January 1, 2008 or death. Analyses were conducted using Kaplan–Meier methods and Cox proportional hazard models, to determine the association of AR status with survival outcomes adjusting for covariates. Results: Among 1467 breast cancers, 78.7% were AR-positive (AR+). Among 1,164 estrogen receptor (ER)-positive cases, 88.0% were AR+. AR positivity was associated with a significant reduction in breast cancer mortality (HR, 0.68 95% CI, 0.47–0.99) and overall mortality (HR, 0.70 95% CI, 0.53–0.91) after adjustment for covariates. In contrast, among women with ER-negative tumors (303 cases), 42.9% were AR+. There was a nonsignificant association between AR status and breast cancer death (HR, 1.59 95% CI, 0.94–2.68). Conclusions: The association of AR status and breast cancer survival is dependent on ER status. In particular, AR expression was associated with a more favorable prognosis among women with ER-positive tumors. Thus, determination of AR status may provide additional information on prognosis for postmenopausal women with breast cancer, and provide novel opportunities for targeted therapy. Clin Cancer Res 17(7) 1867–74. ©2011 AACR.
Publisher: Elsevier BV
Date: 06-2001
Abstract: The long-term relations between specific types of dietary fat and risk of type 2 diabetes remain unclear. Our objective was to examine the relations between dietary fat intakes and the risk of type 2 diabetes. We prospectively followed 84204 women aged 34-59 y with no diabetes, cardiovascular disease, or cancer in 1980. Detailed dietary information was assessed at baseline and updated in 1984, 1986, and 1990 by using validated questionnaires. Relative risks of type 2 diabetes were obtained from pooled logistic models adjusted for nondietary and dietary covariates. During 14 y of follow-up, 2507 incident cases of type 2 diabetes were documented. Total fat intake, compared with equivalent energy intake from carbohydrates, was not associated with risk of type 2 diabetes for a 5% increase in total energy from fat, the relative risk (RR) was 0.98 (95% CI: 0.94, 1.02). Intakes of saturated or monounsaturated fatty acids were also not significantly associated with the risk of diabetes. However, for a 5% increase in energy from polyunsaturated fat, the RR was 0.63 (0.53, 0.76 P < 0.0001) and for a 2% increase in energy from trans fatty acids the RR was 1.39 (1.15, 1.67 P = 0.0006). We estimated that replacing 2% of energy from trans fatty acids isoenergetically with polyunsaturated fat would lead to a 40% lower risk (RR: 0.60 95% CI: 0.48, 0.75). These data suggest that total fat and saturated and monounsaturated fatty acid intakes are not associated with risk of type 2 diabetes in women, but that trans fatty acids increase and polyunsaturated fatty acids reduce risk. Substituting nonhydrogenated polyunsaturated fatty acids for trans fatty acids would likely reduce the risk of type 2 diabetes substantially.
Publisher: American Association for Cancer Research (AACR)
Date: 15-08-2020
DOI: 10.1158/1538-7445.AM2020-3393
Abstract: Introduction: Tooth loss increases the risk of cardiovascular disease (CVD). However, its association with overall and cancer mortality, especially according to social gradient and smoking status, remains underexplored. Dental caries has recently emerged as a risk factor for CVD, but its association with mortality has not been well studied. This study aims to evaluate the associations between untreated caries, tooth count, and all-cause and cause-specific mortality in the US population. Methods: A prospective cohort of nationally representative s les from the National Health and Nutrition Examination Survey (NHANES) 1999-2010 containing 15,242 adults 30 years or older without heart disease, stroke, and cancer at baseline was included in analyses. Exposures were the total number of permanent teeth (including the third molar) and untreated caries assessed by trained and standardized dentists or health technologists. All-cause and cause-specific (CVD and cancer) mortality were ascertained via linkage to the National Death Index (NDI) through December 31, 2015. A series of weighted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During up to 16 years of follow-up (1,818,040 person-years), 1,850 total deaths were identified (388 from CVD and 428 from cancer). Significant inverse associations between the number of permanent teeth and all-cause, CVD, and cancer mortality were observed. Compared to in iduals with 25-32 teeth, the multivariable-adjusted HRs (95% CIs) for participants with 17-24, 1-16, and 0 teeth and all-cause mortality were 1.22 (1.04-1.43), 1.37 (1.13-1.66), and 1.62 (1.37-1.90) (P for trend & .001). For CVD mortality, the corresponding HRs were 1.17 (0.85-1.59), 1.22 (0.82-1.82), and 1.69 (1.16-2.48) (P for trend =.012), and 1.12 (0.77-1.62), 1.23 (0.81-1.86), and 2.09 (1.40-3.11) (P for trend & .001) for cancer mortality. After adjusting for socioeconomic status, healthcare access, lifestyle factors, as well as tooth count, untreated caries were significantly associated with increased risk of all-cause (HR = 1.27, 95%CI = 1.11-1.46) and CVD mortality (HR = 1.67, 95%CI = 1.23-2.28) but not cancer mortality. These findings were robust while restricted to in iduals without diabetes at baseline, and also similar according to baseline age (& /≥70), sex, family income poverty ratio (≤1.3/& .3), and smoking status (never/ever). Conclusions: Lower number of permanent teeth was associated with increased all-cause, CVD, and cancer mortality. Untreated caries is linked with an increased risk of all-cause and CVD mortality. Citation Format: Jie Liu, Zitong Li, Emily Vogtmann, Chao Cao, Xiaoyu Zong, Andrew Chan, Eric Rimm, Richard Hayes, Graham Colditz, Dominique Michaud, Kaumudi Joshipura, Christian Abnet, Yin Cao. Tooth count, untreated caries, and all-cause and cause-specific mortality [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR Cancer Res 2020 (16 Suppl):Abstract nr 3393.
Publisher: Springer Science and Business Media LLC
Date: 1999
Abstract: Although substantial evidence suggests that higher intake of fruits and vegetables can reduce the adverse impact of smoking on lung cancer risk, great uncertainty exists regarding the specific foods and their constituents that are protective. We therefore examine prospectively the relation between cigarette smoking and lung cancer incidence among women, and quantify the associations between dietary antioxidants, other nutrients, and lung cancer risk. In a 16-year prospective cohort study (the Nurses' Health Study), 593 cases of lung cancer were confirmed during 1,793,327 person-years of follow-up. Dietary data, including vitamin supplement use and food intake, were collected in 1980 using a validated semiquantitative food frequency questionnaire. The risk of lung cancer increased with the number of cigarettes smoked and with early onset of cigarette smoking. The risk decreased rapidly with the discontinuation of smoking but took 15 years to fall to about the level of risk for women who had never smoked. Dietary intake of fat was not related to the risk of lung cancer. Although beta-carotene intake was not related to risk, intake of carrots showed a strong inverse relation: women who reported consuming five or more carrots per week had a relative risk of 0.4 (95% CI = 0.2-0.8) compared with the risk for women who never ate carrots. Smoking is the most important risk factor for lung cancer in women, as it is in men. Higher vegetable consumption, particularly of carrots, may significantly reduce the risk of lung cancer, but dietary modification cannot be considered a substitute for smoking prevention and cessation.
Publisher: Springer Science and Business Media LLC
Date: 2011
Publisher: American Association for Cancer Research (AACR)
Date: 08-2012
DOI: 10.1158/1940-6207.CAPR-12-0014
Abstract: Tailoring the use of screening colonoscopy based on the risk of advanced colorectal neoplasia (ACN) could optimize the cost-effectiveness of colorectal cancer (CRC) screening. Our goal was to assess the accuracy of the Your Disease Risk (YDR) CRC risk index for stratifying average risk patients into low- versus intermediate/high-risk categories for ACN. The YDR risk assessment tool was administered to 3,317 asymptomatic average risk patients 50 to 79 years of age just before their screening colonoscopy. Associations between YDR-derived relative risk (RR) scores and ACN prevalence were examined using logistic regression and χ2 analyses. ACN was defined as a tubular adenoma ≥1 cm, tubulovillous or villous adenoma of any size, and the presence of high-grade dysplasia or cancer. The overall prevalence of ACN was 5.6%. Although YDR-derived RR scores were linearly associated with ACN after adjusting for age and gender (P = 0.033), the index was unable to discriminate “below average” from “above/average” risk patients [OR, 1.01 95% confidence interval (CI), 0.75–1.37]. Considerable overlap in rates of ACN was also observed between the different YDR risk categories in our age- and gender-stratified analyses. The YDR index lacks accuracy for stratifying average risk patients into low- versus intermediate/high-risk categories for ACN. Cancer Prev Res 5(8) 1044–52. ©2012 AACR.
Publisher: MDPI AG
Date: 06-03-2020
Abstract: Rural populations face significant smoking-related health disparities, such as a higher prevalence of lung cancer and cancer mortality, higher prevalence of smoking, and lower likelihood of receiving cessation treatment than urban counterparts. A significant proportion of health disparities in rural populations could be eliminated with low-barrier, easy-access treatment delivery methods for smoking cessation. In this study, we assessed treatment engagement among patients in rural and urban settings. Then, we examined the effect of an electronic health record-based smoking cessation module on patient receipt of evidence-based cessation care. As part of a quality improvement project, we retrospectively observed 479,798 unique patients accounting for 1,426,089 outpatient clinical encounters from June 2018–March 2019 across 766 clinics in the greater St. Louis, southern Illinois, and mid-Missouri regions. Smoking prevalence was higher in rural versus urban clinics (20.7% vs. 13.9%, 6.7% [6.3, 7.1], odds ratio = 1.6 [1.6, 1.6], p 0.0001), and yet rural smokers were nearly three times less likely than their urban counterparts to receive any smoking cessation treatment after adjusting for patients clustering within clinics (9.6% vs. 25.8%, −16.2% [−16.9, −15.5], odds ratio = 0.304 [0.28, 0.33], p 0.0001). Although not yet scaled up in the rural setting, we examined the effects of a low-burden, point-of-care smoking module currently implemented in cancer clinics. After adjusting for patient clustering within clinics, patients were more likely to receive smoking treatment in clinics that implemented the module versus clinics that did not implement the module (31.2% vs. 17.5%, 13.7% [10.8, 16.6], odds ratio = 2.1 [1.8, 2.6], p 0.0001). The point-of-care treatment approach offers a promising solution for rural settings, both in and outside the context of cancer care.
Publisher: Oxford University Press (OUP)
Date: 02-11-2004
DOI: 10.1093/JNCI/DJH296
Abstract: Studies of fruit and vegetable consumption in relation to overall health are limited. We evaluated the relationship between fruit and vegetable intake and the incidence of cardiovascular disease and cancer and of deaths from other causes in two prospective cohorts. A total of 71 910 female participants in the Nurses' Health study and 37,725 male participants in the Health Professionals' Follow-up Study who were free of major chronic disease completed baseline semiquantitative food-frequency questionnaires in 1984 and 1986, respectively. Dietary information was updated in 1986, 1990, and 1994 for women and in 1990 and 1994 for men. Participants were followed up for incidence of cardiovascular disease, cancer, or death through May 1998 (women) and January 1998 (men). Multivariable-adjusted relative risks were calculated with Cox proportional hazards analysis. We ascertained 9329 events (1964 cardiovascular, 6584 cancer, and 781 other deaths) in women and 4957 events (1670 cardiovascular diseases, 2500 cancers, and 787 other deaths) in men during follow-up. For men and women combined, participants in the highest quintile of total fruit and vegetable intake had a relative risk for major chronic disease of 0.95 (95% confidence interval [CI] = 0.89 to 1.01) times that of those in the lowest. Total fruit and vegetable intake was inversely associated with risk of cardiovascular disease but not with overall cancer incidence, with relative risk for an increment of five servings daily of 0.88 (95% CI = 0.81 to 0.95) for cardiovascular disease and 1.00 (95% CI = 0.95 to 1.05) for cancer. Of the food groups analyzed, green leafy vegetable intake showed the strongest inverse association with major chronic disease and cardiovascular disease. For an increment of one serving per day of green leafy vegetables, relative risks were 0.95 (95% CI = 0.92 to 0.99) for major chronic disease and 0.89 (95% CI = 0.83 to 0.96) for cardiovascular disease. Increased fruit and vegetable consumption was associated with a modest although not statistically significant reduction in the development of major chronic disease. The benefits appeared to be primarily for cardiovascular disease and not for cancer.
Publisher: American Medical Association (AMA)
Date: 11-09-1991
Publisher: Massachusetts Medical Society
Date: 14-09-1995
Publisher: Wiley
Date: 15-02-1993
Abstract: The epidemiology of breast cancer was reviewed in the context of hormonal, hereditary, histologic, and dietary risk factors. Literature review. Late age at menarche and early age at first birth decrease the risk of breast cancer as does an early age at menopause. These risk factors relate to the lifetime exposure of the breast tissue to ovarian hormones. Although an early first birth is associated with a transient increase in the risk of breast cancer, perhaps as a result of the breast's exposure to high levels of hormones before terminal differentiation, in older women, parity is associated with a decreased risk of breast cancer. Among postmenopausal women, obesity is associated with higher levels of estrogens and an increased risk of breast cancer. Within the strata of breast cancer stages at diagnosis, obesity is associated with increased mortality, again supporting the influence of endogenous estrogens on this disease's incidence, recurrence, and survival rates. Consistent with these relationships, current use of estrogen therapy among postmenopausal women is associated with an increased risk of breast cancer. A family history of breast cancer is associated with approximately a two-fold increase in the risk of breast cancer, and this risk is greater if the diagnosis was made when the woman's mother was young, although even a diagnosis in an older mother is associated with an increased risk in her daughters. The follow-up of women with a history of benign breast biopsy results shows that atypical hyperplasia is associated with a fourfold increase in risk compared with a biopsy specimen without proliferative changes. Atypia doubles the risk. These data support the concept of atypia as a precursor lesion for breast cancer and may warrant its use as a marker in further studies. Consistent data from retrospective and prospective studies show a positive association between moderate alcohol intake and the risk of breast cancer. This may reflect the increase in estrogen levels observed among women who consume alcohol. Data from prospective studies do not support a relationship between dietary fat intake and the risk of breast cancer either in premenopausal or postmenopausal women. Few of these associations offer the potential for intervention to reduce the breast cancer risk.
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Publisher: Wiley
Date: 10-01-2018
DOI: 10.1002/IJC.31229
Abstract: The decades before prostate cancer diagnosis represent an etiologically relevant time period for prostate cancer carcinogenesis. However, the association of weight gain in young adulthood with subsequent biochemical recurrence among men with prostate cancer is not well studied, particularly among smokers. We conducted a prospective cohort study of 1,082 men with prostate cancer and treated with either radical prostatectomy or radiation between 2003 and 2010. The association of weight at age 20, weight at age 50 and weight change from age 20 to age 50 with biochemical recurrence was assessed using Cox Proportional Hazards with adjustment for confounders. Stratum‐specific hazard ratio (HR) estimates by smoking status were evaluated. In the overall cohort, weight at age 20 (HR per 30 kg: 1.56, 95% confidence interval (CI): 1.02, 2.38, p ‐trend: 0.039), weight at age 50 (HR per 30 kg: 1.80, 95% CI: 1.32, 2.47, p‐ trend: .001) and weight change from age 20 to age 50 (HR per 30 kg: 1.84, 95% CI: 1.24, 2.74, p‐ trend: 0.003) were associated with biochemical recurrence. In stratified analyses, weight change from age 20 to age 50 was significantly associated with biochemical recurrence only in former smokers (HR per 30 kg: 3.87, 95% CI: 1.88, 8.00, p ‐trend: .001) and ever smokers (HR per 30 kg: 2.38, 95% CI: 1.27, 4.45, p ‐trend: 0.007). No significant association was observed between weight gain in young adulthood and biochemical recurrence in never smokers. Our study adds further evidence that weight gain during early adult years conveys long‐term risk for adverse cancer outcomes.
Publisher: Massachusetts Medical Society
Date: 23-12-2004
DOI: 10.1056/NEJMOA042135
Publisher: Springer Science and Business Media LLC
Date: 04-09-2023
Publisher: American Association for Cancer Research (AACR)
Date: 10-08-2023
DOI: 10.1158/1940-6207.C.6784856.V1
Abstract: Abstract Mammographic percentage of volumetric density is an important risk factor for breast cancer. Epidemiology studies historically used film images often limited to craniocaudal (CC) views to estimate area-based breast density. More recent studies using digital mammography images typically use the averaged density between craniocaudal (CC) and mediolateral oblique (MLO) view mammography for 5- and 10-year risk prediction. The performance in using either and both mammogram views has not been well-investigated. We use 3,804 full-field digital mammograms from the Joanne Knight Breast Health Cohort (294 incident cases and 657 controls), to quantity the association between volumetric percentage of density extracted from either and both mammography views and to assess the 5 and 10-year breast cancer risk prediction performance. Our results show that the association between percent volumetric density from CC, MLO, and the average between the two, retain essentially the same association with breast cancer risk. The 5- and 10-year risk prediction also shows similar prediction accuracy. Thus, one view is sufficient to assess association and predict future risk of breast cancer over a 5 or 10-year interval. Prevention Relevance: Expanding use of digital mammography and repeated screening provides opportunities for risk assessment. To use these images for risk estimates and guide risk management in real time requires efficient processing. Evaluating the contribution of different views to prediction performance can guide future applications for risk management in routine care. /
Publisher: American Medical Association (AMA)
Date: 25-06-2001
DOI: 10.1001/ARCHINTE.161.12.1542
Abstract: Television (TV) watching, a major sedentary behavior in the United States, has been associated with obesity. We hypothesized that prolonged TV watching may increase risk for type 2 diabetes. In 1986, 37 918 men aged 40 to 75 years and free of diabetes, cardiovascular disease, and cancer completed a detailed physical activity questionnaire. Starting from 1988, participants reported their average weekly time spent watching TV on biennial questionnaires. A total of 1058 cases of type 2 diabetes were diagnosed during 10 years (347 040 person-years) of follow-up. After adjustment for age, smoking, alcohol use, and other covariates, the relative risks (RRs) for type 2 diabetes across increasing quintiles of metabolic equivalent hours (MET-hours) per week were 1.00, 0.78, 0.65, 0.58, and 0.51 (P for trend, 40) were 1.00, 1.66, 1.64, 2.16, and 2.87, respectively (P for trend, <.001). This association was somewhat attenuated after adjustment for body mass index, but a significant positive gradient persisted (RR comparing extreme categories, 2.31 P for trend,.01). Increasing physical activity is associated with a significant reduction in risk for diabetes, whereas a sedentary lifestyle indicated by prolonged TV watching is directly related to risk. Our findings suggest the importance of reducing sedentary behavior in the prevention of type 2 diabetes.
Publisher: Springer Science and Business Media LLC
Date: 05-09-2010
Publisher: Elsevier BV
Date: 05-1998
Publisher: Wiley
Date: 1998
DOI: 10.1002/J.1550-8528.1998.TB00309.X
Abstract: Available epidemiological information on the associations between body anthropometry and the incidence of fractures in men is limited. We therefore prospectively investigated the association between body anthropometry and the incidence of hip and wrist fractures from low and moderate trauma among 43,053 men who were 40 years to 75 years of age in 1986 when they first enrolled in the Health Professionals Follow-Up Study. After 8 years of follow-up, 201 wrist fracture cases and 56 hip fracture cases were reported. Greater height was associated with significant elevations in both hip and wrist fractures, whereas nonsignificant inverse associations were observed with weight and body mass index. Men in the highest quintile of waist circumference had a relative risk (RR) of 2.57 (95% confidence interval [CI] 0.64 to 10.3) for hip fracture and 2.05 (95% CI 1.06 to 3.96) for wrist fracture when compared with men in the lowest quintile. Waist-to-hip ratio was also positively related to fracture incidence comparing highest with lowest quintile, the RRs were 3.92 (95% CI 1.07 to 14.3) for hip fracture and 1.50 (95% CI 0.85 to 2.66) for wrist fracture. These anthropometric indicators, in particular waist-to-hip ratio, may be useful for the prediction of hip fracture in adult men.
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2003
Abstract: Objective. To assess whether dieting to control weight was associated with weight change among children and adolescents. Methods. A prospective study was conducted of 8203 girls and 6769 boys who were 9 to 14 years of age in 1996, were in an ongoing cohort study, and completed at least 2 annual questionnaires between 1996 and 1999. Dieting to control weight, binge eating, and dietary intake were assessed annually from 1996 through 1998 with instruments designed specifically for children and adolescents. The outcome measure was age- and sex-specific z score of body mass index (BMI). Results. In 1996, 25.0% of the girls and 13.8% of the boys were infrequent dieters and 4.5% of the girls and 2.2% of the boys were frequent dieters. Among the girls, the percentage of dieters increased over the following 2 years. Binge eating was more common among the girls, but in both sexes, it was associated with dieting to control weight (girls: infrequent dieters, odds ratio [OR]: 5.10 frequent dieters, OR: 12.4 boys: infrequent dieters, OR: 3.49 frequent dieters, OR: 7.30). During 3 years of follow-up, dieters gained more weight than nondieters. Among the girls, frequency of dieting was positively associated with increases in age- and sex-specific z scores of BMI (β = 0.05 and β = 0.04 for frequent and infrequent dieters vs nondieters). Among the boys, both frequent and infrequent dieters gained 0.07 z scores of BMI more than nondieters. In addition, boys who engaged in binge eating gained significantly more weight than nondieters. Conclusions. Although medically supervised weight control may be beneficial for overweight youths, our data suggest that for many adolescents, dieting to control weight is not only ineffective, it may actually promote weight gain.
Publisher: Springer Science and Business Media LLC
Date: 04-06-2004
DOI: 10.1186/BCR809
Publisher: Springer Science and Business Media LLC
Date: 12-08-2015
Publisher: American Association for Cancer Research (AACR)
Date: 12-04-2018
Publisher: Oxford University Press (OUP)
Date: 05-04-1995
Abstract: Inverse associations between selenium status and cancer risk have been observed in animal studies, ecologic studies, and some case-control and prospective studies. Whereas results of some prospective studies have suggested an overall inverse relationship between selenium levels and cancer, other prospective studies have failed to confirm this finding. Prospective data on women are particularly limited because fewer women than men have been studied prospectively. The aim of this study was to prospectively examine the relationship between selenium levels in toenails (previously shown to reflect selenium intake) and incidence of cancer among women. The Nurses' Health Study cohort began in 1976 with 121,700 female nurses aged 30-55 years living in 11 U.S. states. In 1982, we requested toenail clippings from the members of the cohort, and 62,641 participants with no history of cancer returned these clippings. During 41 months of follow-up, 503 cases of cancer other than breast cancer (results previously reported) or nonmelanoma skin cancer were analyzed. For each case patient, a control subject was chosen from women who remained free of diagnosed cancer, matched by age and by date of nail return. No inverse association was observed between selenium levels in toenails and cancer risk. The age- and smoking-adjusted relative risk (RR), comparing the highest with the lowest quintile of toenail selenium level, was 1.44 (95% confidence interval [CI] = 0.97-2.13), and the trend across quintiles was marginally significant (two-sided P = .06). Comparing the highest with the lowest decile, the RR (age- and smoking-adjusted) was 1.77 (95% CI = 1.04-3.02). When these data were combined with the data from 434 breast cancer case patients and their matched control subjects identified in parallel from this same cohort, the RR comparing the highest with the lowest quintile was 1.24 (95% CI = 0.93-1.65). Toenail selenium level was not inversely associated with cancer at any major site, including uterine cancer, colorectal cancer, melanoma, ovarian cancer, or lung cancer (after adjusting for smoking) in fact, nonsignificant positive associations were observed at several sites. Toenail selenium levels were not inversely associated with cancer risk in this study. These data, in conjunction with previous findings of no association between toenail selenium status and breast cancer risk, strongly suggest that higher selenium intake within the range consumed by most U.S. women (as reflected by toenail selenium levels) is not protective against overall cancer incidence in women.
Publisher: Wiley
Date: 20-11-2022
DOI: 10.1002/CAM4.5439
Abstract: To determine if the COVID‐19 pandemic has further exacerbated racial disparities in late‐stage presentation of breast, colorectal, lung, and prostate cancers. We conducted a registry‐based retrospective study of patients with newly reported diagnoses of breast, colorectal, lung, and prostate cancers between March 2019–June 2019 (pre‐COVID‐19) and March 2020–June 2020 (early‐COVID‐19). We compared the volume of new diagnoses and stage at presentation according to race between both periods. During the study period, a total of 3528 patients had newly diagnosed cancer 3304 of which had known disease stages and were included in the formal analyses. 467 (14.1%) were Blacks, and 2743 were (83%) Whites. 1216 (36.8%) had breast, 415 (12.6%) had colorectal, 827 (25%) had lung, and 846 (25.6%) had prostate cancers, respectively. The pre‐COVID‐19 period included 2120 (64.2%), and the early‐COVID‐19 period included 1184 (35.8%), representing a proportional 44.2% decline in the volume of new cases of breast, colorectal, lung, and prostate cancers, p 0.0001. Pre‐COVID‐19, 16.8% were diagnosed with metastatic disease, versus 20.4% early‐COVID‐19, representing a proportional increase of 21.4% in the numbers of new cases with metastatic disease, p = 0.01. There was a non‐significant proportional decline of 1.9% in Black patients diagnosed with non‐metastatic breast, colorectal, lung, and prostate cancers early‐COVID‐19 ( p = 0.71) and a non‐significant proportional increase of 7% in Black patients diagnosed with metastatic disease ( p = 0.71). Difference‐in‐difference analyses showed no statistically significant differences in metastatic presentation comparing Black to White patients. While we identified substantial reductions in the volume of new cancer diagnoses and increases in metastatic presentations due to the COVID‐19 pandemic, the impact was similar for White and Black patients.
Publisher: American Medical Association (AMA)
Date: 04-2020
Publisher: Springer Science and Business Media LLC
Date: 22-08-2013
Publisher: Oxford University Press (OUP)
Date: 1998
Publisher: Public Library of Science (PLoS)
Date: 04-09-2018
Publisher: Springer Science and Business Media LLC
Date: 11-1996
DOI: 10.1007/BF02352719
Abstract: Identifying the brain bases for phenotypic heterogeneity in Autism Spectrum Disorder (ASD) will advance understanding of its pathogenesis and improve its clinical management. We compared Diffusion Tensor Imaging (DTI) indices and connectome measures between 77 ASD and 88 Typically Developing (TD) control participants. We also assessed voxel-wise associations of DTI indices with measures of regional cerebral blood flow (rCBF) and N-acetylaspartate (NAA) to understand how tissue microstructure associates with cellular metabolism and neuronal density, respectively. Autism Spectrum Disorder participants had significantly lower fractional anisotropy (FA) and higher diffusivity values in deep white matter tracts, likely representing ether reduced myelination by oligodendrocytes or a reduced density of myelinated axons. Greater abnormalities in these measures and regions were associated with higher ASD symptom scores. Participant age, sex and IQ significantly moderated these group differences. Path analyses showed that reduced NAA levels accounted significantly for higher diffusivity and higher rCBF values in ASD compared with TD participants. Reduced neuronal density (reduced NAA) likely underlies abnormalities in DTI indices of white matter microstructure in ASD, which in turn are major determinants of elevated blood flow. Together, these findings suggest the presence of reduced axonal density and axonal pathology in ASD white matter. Greater pathology in turn accounts for more severe symptoms, lower intellectual ability, and reduced global efficiency for measures of white matter connectivity in ASD.
Publisher: Springer Science and Business Media LLC
Date: 14-09-2020
Publisher: Springer Science and Business Media LLC
Date: 18-10-2013
Publisher: Cold Spring Harbor Laboratory
Date: 24-01-2022
DOI: 10.1101/2022.01.23.22269728
Abstract: Esophageal cancer is among the most lethal type of cancers worldwide. However, risk factors contributing to more than tenfold increase in esophageal cancer in the last 50 years remain underexplored. This study aimed to examine the associations between sleep behaviors and esophageal cancer overall, by histology, and according to genetic predispositions. A prospective cohort study. A population-based study. A total of 410,428 participants aged 37-73 years at enrollment between 2006 and 2010 in the UK Biobank were followed up until March 31st, 2016 for England and Wales and October 31st, 2015 for Scotland. The risk of incident esophageal cancer. During 2,799,342 person-years of follow-up, 410 incident esophageal cancer cases (294 adenocarcinomas) were diagnosed. Evening chronotype, sleep or h/day, daytime napping, and daytime sleepiness were significantly associated with increased risk of esophageal cancer in age-adjusted models and had a P likelihood ratio test ≤0.20 after multivariable adjustment. Compared with the group without these high-risk behaviors, participants with one high-risk behavior had a 41% (HR=1.41, 95%CI: 1.13, 1.77) increased risk of esophageal cancer, and those with two or more behaviors showed a 79% higher risk (HR=1.79, 95%CI: 1.32, 2.42) ( P trend .001). These associations were largely driven by esophageal adenocarcinoma ( P trend .001) but not squamous cell carcinoma ( P trend =0.340). The elevated risks for esophageal adenocarcinoma were similar within strata of PRS quintiles ( P interaction =0.791). Unhealthy sleep behaviors were associated with an increased risk of esophageal cancer, primarily adenocarcinoma, independent of genetic risk. Sleep behaviors may serve as modifiable factors for the prevention of esophageal cancer, particularly esophageal adenocarcinomas. Are sleep behaviors associated with the risk of esophageal cancer? In this prospective cohort study that included 410,428 participants in the UK Biobank, evening chronotype, sleep or h/day, daytime napping, and sleepiness were associated with increased risk of esophageal cancer. A greater number of these unhealthy sleep behaviors was associated with a higher risk of esophageal cancer. The elevated risks were primarily observed for esophageal adenocarcinoma and were independent of genetic risk. Sleep behaviors may serve as modifiable factors for the esophageal cancer prevention, particularly esophageal adenocarcinoma, independent of genetic risk.
Publisher: Oxford University Press (OUP)
Date: 18-05-2005
DOI: 10.1093/JNCI/DJI128
Abstract: Cancer researchers, clinicians, and the public are increasingly interested in statistical models designed to predict the occurrence of cancer. As the number and sophistication of cancer risk prediction models have grown, so too has interest in ensuring that they are appropriately applied, correctly developed, and rigorously evaluated. On May 20-21, 2004, the National Cancer Institute sponsored a workshop in which experts identified strengths and limitations of cancer and genetic susceptibility prediction models that were currently in use and under development and explored methodologic issues related to their development, evaluation, and validation. Participants also identified research priorities and resources in the areas of 1) revising existing breast cancer risk assessment models and developing new models, 2) encouraging the development of new risk models, 3) obtaining data to develop more accurate risk models, 4) supporting validation mechanisms and resources, 5) strengthening model development efforts and encouraging coordination, and 6) promoting effective cancer risk communication and decision-making.
Publisher: Springer Science and Business Media LLC
Date: 21-02-2006
Location: No location found
Location: United States of America
Location: United States of America
Location: United States of America
Start Date: 1992
End Date: 1997
Funder: Agency for Healthcare Research and Quality
View Funded ActivityStart Date: 2021
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Funder: National Cancer Institute
View Funded ActivityStart Date: 1988
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Funder: National Cancer Institute
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Funder: National Cancer Institute
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End Date: 2017
Funder: National Cancer Institute
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End Date: 2012
Funder: National Heart Lung and Blood Institute
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Funder: National Cancer Institute
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Funder: National Cancer Institute
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Funder: National Cancer Institute
View Funded ActivityStart Date: 2016
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Funder: National Cancer Institute
View Funded ActivityStart Date: 2019
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Funder: National Cancer Institute
View Funded ActivityStart Date: 2001
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Funder: National Cancer Institute
View Funded ActivityStart Date: 2000
End Date: 2001
Funder: Robert Wood Johnson Foundation
View Funded ActivityStart Date: 1997
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Funder: Robert Wood Johnson Foundation
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Funder: National Cancer Institute
View Funded ActivityStart Date: 2006
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Funder: Council for International Exchange of Scholars
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Funder: National Institute on Aging
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Funder: National Cancer Institute
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Funder: National Institute of Diabetes and Digestive and Kidney Diseases
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Funder: National Institute of Child Health and Human Development
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Funder: National Institute of Diabetes and Digestive and Kidney Diseases
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Funder: National Cancer Institute
View Funded ActivityStart Date: 1978
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Funder: National Cancer Institute
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Funder: National Institute of Child Health and Human Development
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Funder: Fogarty International Center
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Funder: National Institute of Diabetes and Digestive and Kidney Diseases
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Funder: National Cancer Institute
View Funded ActivityStart Date: 1992
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Funder: National Institute of Diabetes and Digestive and Kidney Diseases
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Funder: National Institute of Arthritis and Musculoskeletal and Skin Diseases
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Funder: National Cancer Institute
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Funder: National Institute on Aging
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Funder: National Cancer Institute
View Funded ActivityStart Date: 1998
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Funder: National Institute on Aging
View Funded ActivityStart Date: 2013
End Date: 2018
Funder: National Cancer Institute
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