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Simon MS, Lamerato L, Krajenta R, Booza J, Ruterbusch J, Kunz S, Schwartz K. P2-14-05: Racial Differences in the Use of Adjuvant Chemotherapy for Breast Cancer in a Large Urban Integrated Health System. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p2-14-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Despite improvements in breast cancer treatment, there continues to be a gap in survival between African American (AA) and White women with breast cancer, which may be due at least in part to racial differences in the patterns of care. In order to better understand breast cancer survival disparities, we evaluated racial differences in the receipt of adjuvant chemotherapy among women treated at a large integrated health care system in Southeastern Michigan. Materials and Methods: The study population included 2,234 women (33 % AA) with stage I through III breast cancer treated at the Henry Ford Health System (HFHS) from 1996 through 2005. Linked datasets from the HFHS, the Metropolitan Detroit Cancer Surveillance System (MDCSS) and the U.S. Census Bureau were used to obtain sociodemographic and clinical information. Co-morbidity was assessed by the Charlson co-morbidity index (CCI), and economic deprivation was categorized using a neighborhood deprivation index (DI). Results: AA women were significantly more likely than Whites to have larger tumors (40% vs. 31% > 2 cm), as well as more aggressive tumors (29% vs 19% estrogen and progesterone negative). AA women were also significantly more likely than Whites to have other co-morbid conditions (15 % vs. 8% with a CCI of 2+) and to reside in a more economically deprived area (45% vs. 5% reside in the most deprived area). While AA women were more likely to receive adjuvant chemotherapy (47% vs. 43%, p=0.0278), they were also more likely to have a delay in initiation of treatment (57% vs 45% delayed beyond 60 days from diagnosis, p=0.0004). After multivariable adjustment for age, DI, CCI, insurance and surgery, there were no racial differences in treatment delay (Odds Ratio 1.20, 95% confidence interval, 0.82−1.77). Discussion: In a large urban integrated health care system, racial differences in the delay in receipt of adjuvant chemotherapy for breast cancer can be explained by clinical and socioeconomic characteristics.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-14-05.
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Colt JS, Schwartz K, Graubard BI, Davis F, Ruterbusch J, DiGaetano R, Purdue M, Rothman N, Wacholder S, Chow WH. Hypertension and risk of renal cell carcinoma among white and black Americans. Epidemiology 2011; 22:797-804. [PMID: 21881515 PMCID: PMC3188386 DOI: 10.1097/ede.0b013e3182300720] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Renal cell carcinoma and hypertension (a well-established renal cancer risk factor) are both more frequent among blacks than whites in the United States. The association between hypertension and renal cell carcinoma has not been examined in black Americans. We investigated the hypertension-renal cancer association by race, and we assessed the role of hypertension in the racial disparity of renal cancer incidence. METHODS Participants were enrolled in a population-based case-control study in Detroit and Chicago during 2002-2007 (number of cases: 843 whites, 358 blacks; number of controls: 707 whites, 519 blacks). Participants reported their history of hypertension and antihypertensive drug use. We used unconditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for demographic characteristics, smoking, body mass index, and family history of cancer. RESULTS Hypertension doubled renal cancer risk (OR = 2.0 [CI = 1.7-2.5]) overall. For whites, the OR was 1.9 (CI = 1.5-2.4), whereas for blacks it was 2.8 (2.1-3.8) (P for interaction = 0.11). ORs increased with time after hypertension diagnosis (P for trend <0.001), reaching 4.1 (CI = 2.3-7.4) for blacks and 2.6 (CI = 1.7-4.1) for whites after 25 years. ORs for poorly controlled hypertension were 4.5 (CI = 2.3-8.8) for blacks and 2.1 (CI = 1.2-3.8) for whites. If these estimates correctly represent causal effects and if, hypothetically, hypertension could be prevented entirely among persons aged 50-79 years, the black/white disparity in renal cancer could be reversed among women and reduced by two-thirds among men. CONCLUSIONS Hypertension is a risk factor for renal cancer among both blacks and whites, and might explain a substantial portion of the racial disparity in renal cancer incidence. Preventing and controlling hypertension might reduce renal cancer incidence, adding to the known benefits of blood pressure control for heart disease and stroke reduction, particularly among blacks.
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Hofmann JN, Baccarelli A, Schwartz K, Davis FG, Ruterbusch JJ, Hoxha M, McCarthy BJ, Savage SA, Wacholder S, Rothman N, Graubard BI, Colt JS, Chow WH, Purdue MP. Risk of renal cell carcinoma in relation to blood telomere length in a population-based case-control study. Br J Cancer 2011; 105:1772-5. [PMID: 22033273 PMCID: PMC3242602 DOI: 10.1038/bjc.2011.444] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: There are few known risk factors for renal cell carcinoma (RCC). Two small hospital-based case–control studies suggested an association between short blood telomere length (TL) and increased RCC risk. Methods: We conducted a large population-based case–control study in two metropolitan regions of the United States comparing relative TL in DNA derived from peripheral blood samples from 891 RCC cases and 894 controls. Odds ratios and 95% confidence intervals were estimated using unconditional logistic regression in both unadjusted and adjusted models. Results: Median TL was 0.85 for both cases and controls (P=0.40), and no differences in RCC risk by quartiles of TL were observed. Results of analyses stratified by age, sex, race, tumour stage, and time from RCC diagnosis to blood collection were similarly null. In multivariate analyses among controls, increasing age and history of hypertension were associated with shorter TL (P<0.001 and P=0.07, respectively), and African Americans had longer TL than Caucasians (P<0.001). Conclusion: These data do not support the hypothesis that blood TL is associated with RCC. This population-based case–control study is, to our knowledge, the largest investigation to date of TL and RCC.
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Hofmann JN, Schwartz K, Chow WH, Ruterbusch JJ, Rothman N, Wacholder S, Colt JS, Purdue MP. Abstract A75: Preexisting kidney disorders and risk of renal cell carcinoma: Results from a population-based case-control study of Caucasians and African Americans. Cancer Epidemiol Biomarkers Prev 2011. [DOI: 10.1158/1055-9965.disp-11-a75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: In the United States, the incidence of renal cell carcinoma (RCC) is higher among African Americans (AA) than among Caucasians. However, few studies have investigated potential risk factors that may contribute to racial disparities in RCC incidence. Established risk factors for RCC include smoking, obesity, and hypertension. Beyond these factors the etiology of RCC remains largely unknown, though previous observations suggest that patients with end-stage renal disease on long-term dialysis may be at increased risk of developing RCC.
Methods: We conducted an investigation of RCC risk in relation to pre-existing kidney disorders in a population-based case-control study of AAs and Caucasians in the metropolitan regions of Chicago and Detroit. Personal interviews were conducted to obtain information on history of kidney disorders and other covariates from 1,217 RCC cases (361 AAs and 856 Caucasians) and 1,235 controls (523 AAs and 712 Caucasians). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using sample weighted unconditional logistic regression models adjusted for age, sex, race, level of education, smoking status, body mass index, history of hypertension, family history of cancer, and study center. Analyses stratified by race and time since kidney disease diagnosis were also performed.
Results: A statistically significant increased risk of RCC was observed among subjects who had been previously diagnosed with chronic renal failure (OR 4.7, 95% CI 2.2–10.1) or were on dialysis (OR 18.0, 95% CI 3.6–91.1). Stronger associations were observed among subjects who had renal failure or were on dialysis 10 or more years prior to RCC diagnosis. The association between chronic renal failure and RCC was considerably stronger among AAs than among Caucasians (ORs of 8.7 and 2.0, respectively; P-interaction=0.03). Among AAs, history of kidney stones, kidney cysts, and nephrotic syndrome were all associated with an elevated risk of RCC (OR≥2.0), though these findings were not statistically significant.
Conclusions: The results of this large population-based study suggest that chronic renal failure and dialysis may be important risk factors for RCC development in both AAs and Caucasians. Our findings of differences in risk estimates by race, to our knowledge the first such report, require replication.
Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A75.
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Purdue MP, Colt JS, Graubard B, Davis F, Ruterbusch JJ, Digaetano R, Karami S, Wacholder S, Schwartz K, Chow WH. A case-control study of reproductive factors and renal cell carcinoma among black and white women in the United States. Cancer Causes Control 2011; 22:1537-44. [PMID: 21866373 DOI: 10.1007/s10552-011-9830-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 08/05/2011] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Renal cell carcinoma (RCC) incidence is higher among blacks than whites in the United States and has been associated with the frequency and timing of childbirth among women in some epidemiologic studies. We investigated whether reproductive factors are associated with RCC, overall and by race, within a population-based case-control study. METHODS Between 2002 and 2007, 497 female cases of incident RCC (136 black, 361 white) and 546 female controls (273 black, 273 white) within the Detroit and Chicago metropolitan areas were enrolled. Information on reproductive history and other factors was collected through in-person interviews. Multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) were computed using unconditional logistic regression. RESULTS Reduced RCC risk was observed among women aged ≥30 years at first live birth, relative to an age of <20 years (OR 0.5, 95% CI 0.3-0.9). This association was present among both white (OR 0.4, 95% CI 0.2-0.9) and, though not statistically significant, black women (OR 0.6, 95% CI 0.2-1.8). In analyses restricted to clear cell adenocarcinoma, the most common RCC histological subtype, the association was particularly strong (OR 0.3, 95% CI 0.2-0.8). We did not observe clear evidence of association with RCC for other reproductive factors. CONCLUSIONS Our findings further support an association between late maternal age at first birth and reduced RCC risk, and suggest that the association may be particularly strong for clear cell adenocarcinoma.
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Young RF, Schwartz K, Booza J. Medical barriers to mammography screening of African American women in a high cancer mortality area: implications for cancer educators and health providers. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2011; 26:262-269. [PMID: 21210272 DOI: 10.1007/s13187-010-0184-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
African American women have a higher breast cancer mortality rate than whites even when cancer subtype is considered, are more likely to be diagnosed at a later stage, and are less likely to have mammography screening. Structural barriers limit screening but may be less important than clinical care and personal barriers among minority and lower income women. A random sample of 178 African American females aged >40 years from a high cancer risk area was surveyed to associate mammography screening with clinical, structural, and personal barriers. Clinical barriers including patient education and communication were significantly associated with lack of screening in previous 2 years. Personal barriers (lack of trust and knowledge) and structural barriers (lack of insurance, facilities, and providers) also reduced screening. Results reveal that medical practitioners should be more pro-active in reducing clinical barriers to mammography screening among lower income African American women. Improved patient physician communication, education about breast cancer to build knowledge and reduce fears, referral for mammography, and building trust are indicated.
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Isunju JB, Schwartz K, Schouten MA, Johnson WP, van Dijk MP. Socio-economic aspects of improved sanitation in slums: a review. Public Health 2011; 125:368-76. [PMID: 21616514 DOI: 10.1016/j.puhe.2011.03.008] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 01/22/2011] [Accepted: 03/17/2011] [Indexed: 11/25/2022]
Abstract
This socio-economic review provides an overview of the sanitation crisis in slum areas, and re-emphasizes the importance of sanitation. It highlights a lack of recognition of actual drivers for sanitation improvements, and the complexities in the provision of sanitation services in the context of urban slums with a mix of tenants and landlords. It elaborates how the drivers of demand for sanitation outlined in contemporary research are not universal but are rather context specific. The authors point out specific knowledge gaps for future research; for example, the need to establish a scientific basis for context-specific drivers of demand for sanitation improvements in slums, and a better understanding of associated complexities in order to set boundary conditions for achieving desired improvements.
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Maghout Juratli S, Janisse J, Schwartz K, Arnetz BB. Demographic and lifestyle factors associated with perceived stress in the primary care setting: a MetroNet study. Fam Pract 2011; 28:156-62. [PMID: 21068192 DOI: 10.1093/fampra/cmq091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Stress and stress-related disorders are common in primary care. The stress-related needs for patients are often unmet partially due to the time and resource constraints inherent to many primary care settings. We examined the relative significance of key demographic and lifestyle factors related to stress among primary care patients. This information is unknown and needed to strategize these increasingly limited resources. METHODS We distributed surveys to 100 consecutive adult patients in each of four family medicine centres in metropolitan Detroit between 2006 and 2007. Hierarchical multivariable regression analyses were used to assess the relative significance of the demographic and lifestyle factors related to stress. RESULTS Of the 400 distributed surveys, 315 (78.7%) answered a minimum of 70% of the questions and were included in the analysis. The lifestyle factors [exercise, body mass index (BMI), sleep, social support, recovery or self-care skills (such as the ability to rest, relax and recuperate)] explained 39% (P < 0.001) of the variance in stress compared to 10% (P < 0.001) by the demographic factors (age, gender, race, employment, education and marital status). Stress was inversely related to sleep (P < 0.001), recovery (P < 0.001) and social support (P = 0.02) and positively to education (P < 0.001). CONCLUSIONS The modifiable lifestyle factors explained significantly more of perceived stress among primary care patients than the demographic factors. Sleep and recovery had the biggest inverse relationship with stress, which suggests that they should be the primary target for assessment and intervention in patients who report stress or stress-related disorders.
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Vestergaard P, Schwartz K, Pinholt EM, Rejnmark L, Mosekilde L. Stroke in relation to use of raloxifene and other drugs against osteoporosis. Osteoporos Int 2011; 22:1037-45. [PMID: 20449570 DOI: 10.1007/s00198-010-1276-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Accepted: 04/08/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED Prior studies have associated fatal stroke with raloxifene. In a cohort study, we found no excess risk of stroke with raloxifene; whereas, an excess risk of stroke and fatal stroke was seen with alendronate and etidronate. However, the excess risks were small. PURPOSE We aim to study the association between use of raloxifene and other drugs against osteoporosis and risk of stroke. METHODS This is a nationwide cohort study from Denmark. All users of bisphosphonates and other drugs against osteoporosis between 1996 and 2006 (n = 103,562) as exposed group and three age- and gender-matched controls from the general population (n = 310,683). RESULTS Before the drugs were started, patients later initiating alendronate or raloxifene had fewer strokes than the controls. In contrast, patients who later did start clodronate have more strokes. Among the later users of other bisphosphonates, strontium ranelate or parathyroid hormone, no change in the risk of stroke was present. Patients who started raloxifene neither had an excess risk of strokes nor of fatal strokes. No dose-response relationship was present. Among users of alendronate, a decreasing overall risk of stroke was seen with increasing dose. However, for fatal strokes, the risk increased with increasing dose of alendronate. Among users of etidronate, no trend with dose was present for overall stroke risk; whereas for fatal strokes, an increasing risk was seen with increasing dose of etidronate. CONCLUSIONS Raloxifene does not seem associated with an excess risk of strokes. The increase seen for alendronate did not seem to be causal as no classical dose-response relationship was present. The dose-response relationship for fatal strokes with alendronate and etidronate needs further examination. However, the excess risks were small and may be due to the underlying disease.
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Trautmann C, Costantini JM, Meftah A, Schwartz K, Stoquert JP, Toulemonde M. Swelling of SiO2 Quartz Induced by Energetic Heavy Ions. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-504-123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTA pronounced swelling effect occurs when irradiating SiO2 quartz with heavy ions (F, S, Cu, Kr, Xe, Ta, and Pb) in the electronic energy loss regime. Using a profilometer, the out-of-plane swelling was measured by scanning over the border line between an irradiated and a virgin area of the sample surface. The step height varied between 20 and 300 nm depending on the fluence, the electronic energy loss and the total range of the ions. From complementary Rutherford backscattering experiments under channelling condition (RBS-C), the damage fraction and corresponding track radii were extracted. Normalising the step height per incoming ion and by the projected range, a critical energy loss of 1.8 ± 0.5 keV/nm was found which is in good agreement with the threshold observed by RBS-C. Swelling can be explained by the amorphisation induced along the ion trajectories. The experimental results in quartz are compared to swelling data obtained under similar irradiation conditions in LiNbO3
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Miller DC, Ruterbusch J, Colt JS, Davis FG, Linehan WM, Chow WH, Schwartz K. Contemporary clinical epidemiology of renal cell carcinoma: insight from a population based case-control study. J Urol 2010; 184:2254-8. [PMID: 20952033 DOI: 10.1016/j.juro.2010.08.018] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Indexed: 01/20/2023]
Abstract
PURPOSE To clarify the contemporary clinical epidemiology of renal cell carcinoma we present trends in clinical presentation and treatment in patients enrolled in a population based case-control study. MATERIALS AND METHODS The National Cancer Institute performed a population based case-control study in metropolitan Detroit and Chicago from 2002 through 2007. In 1,136 patients with renal cell carcinoma who consented to an epidemiological interview and medical record review we ascertained detailed information on social and medical history, methods of renal cell carcinoma detection and diagnosis, cancer severity and treatment(s) received. From these data we assessed the demographic and cancer specific characteristics of study cases, and trends in clinical presentation, diagnosis and treatment. RESULTS Most patients with renal cell carcinoma had localized or regional tumors, including 52% with tumors 4 cm or less. The proportion of asymptomatic cases increased from 35% in 2002 to 50% in 2007 (p<0.001). Hypertension and diabetes were common in patients (58% and 17%, respectively) and 24% had at least 2 significant comorbid conditions at cancer diagnosis. While the use of laparoscopic surgery increased with time (p<0.001), fewer than 1/5 patients underwent nephron sparing surgery. CONCLUSIONS The proportion of patients presenting with small, asymptomatic renal cell carcinoma continues to increase. Most of these cases are still treated with radical nephrectomy, although increasingly via a laparoscopic approach. Since most patients with small renal cell carcinomas have 1 or more renal function relevant comorbidities, there is an imperative to increase the use of nephron sparing surgery.
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Lompre AM, Mercadier JJ, Wisnewsky C, Bouveret P, Pantaloni C, D'Albis A, Schwartz K. Species- and age-dependent changes in the relative amounts of cardiac myosin isoenzymes in mammals. Dev Biol 2010; 84:286-90. [PMID: 20737866 DOI: 10.1016/0012-1606(81)90396-1] [Citation(s) in RCA: 238] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In mice, rabbits, and pigs, two basic types of cardiac myosin isoenzymes were found by electrophoresis of native molecules: a fast-migrating form with high Ca(2+)-dependent ATPase activity and a slow-migrating form with low activity. According to the nomenclature of J. F. Y. Hoh, P. A. McGrath, and P. T. Hale (1978, J. Mol. Cell. Cardiol. 10, 1053-1076) these forms are called, respectively, V1 and V3. In all species, myosin was essentially V3 during fetal life, while V1 appeared around the time of birth. There were species differences in adults: mice remained V1, while rabbits and pigs returned to V3 after 3 weeks of age. Adult dog, beef, and human myosins were also composed of the V3 form only.
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Vestergaard P, Schwartz K, Pinholt EM, Rejnmark L, Mosekilde L. Use of bisphosphonates and raloxifene and risk of deep venous thromboembolism and pulmonary embolism. Osteoporos Int 2010; 21:1591-7. [PMID: 19859641 DOI: 10.1007/s00198-009-1091-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Accepted: 10/02/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY Prior studies have associated raloxifene and strontium ranelate with deep venous thromboembolism and pulmonary embolism. In a cohort study, we observed an increased risk also with the bisphosphonates. However, the increase was present already before the start of bisphosphonates pointing at an effect of the underlying condition. INTRODUCTION We seek to study the association between use of drugs against osteoporosis and risk of deep venous thromboembolism (DVT) and pulmonary embolism (PE). METHODS Nationwide register-based cohort study from Denmark with all users of bisphosphonates and other drugs against osteoporosis between 1996 and 2006 (n = 103,562) as cases and three age- and gender-matched controls from the general population (n = 310,683). RESULTS Before start of a drug against osteoporosis, an increased risk of DVT/PE was present in the crude analysis for alendronate, etidronate, and risedronate. However, upon adjustment, this increase in risk disappeared. Before start of raloxifene, a decreased risk of DVT/PE was present (odds ratio (OR) = 0.53, 95% confidence interval (CI), 0.39-0.71). After start of a drug, alendronate (HR = 1.20, 95% CI, 1.00-1.43), clodronate (HR = 4.06, 95% CI, 1.47-11.2), and etidronate (HR = 1-37, 95% CI, 1.23-1.51) were all associated with an increased risk of DVT/PE, while raloxifene was only borderline, significantly associated with risk of DVT/PE (HR = 1.64, 95% CI, 0.97-2.77). No dose-response relationship was present except for alendronate, where the risk was inversely associated with dose, i.e., the risk of DVT/PE decreased with increasing average daily dose. The HR for DVT/PE was higher with clodronate and etidronate than with alendronate. Alendronate and raloxifene carried the same risk for DVT/PE. CONCLUSION Bisphosphonates seem associated with an increased risk of DVT/PE. However, the association does not seem to be causal.
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Stork H, Dinse KP, Ditter M, Fujara F, Masierak W, Neumann R, Schuster B, Schwartz K, Trautmann C. Spatially resolved nuclear spin relaxation, electron spin relaxation and light absorption in swift heavy ion irradiated LiF crystals. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2010; 22:185402. [PMID: 21393683 DOI: 10.1088/0953-8984/22/18/185402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Spatially resolved (19)F and (7)Li spin-lattice relaxation rates are measured for LiF single crystals after irradiation with two kinds of swift heavy ions ((12)C of 133 MeV and (208)Pb of 1.78 GeV incident energy). Like in earlier studies on (130)Xe and (238)U irradiated LiF crystals, we found a strong enhancement of the nuclear spin-lattice relaxation rate within the ion penetration depth and a slight--but still significant--enhancement beyond. By evaluating the nuclear relaxation rate enhancement within the ion range after irradiation with different projectiles, a universal relationship between the spin-lattice relaxation rate and the dose is deduced. The results of accompanying X-band electron paramagnetic resonance relaxation measurements and optical absorption spectroscopy are included in a physical interpretation of this relationship. Also the reason for the enhanced relaxation rate beyond the ion range is further discussed.
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Filson C, Miller D, Ruterbusch J, Colt J, Chow WH, Schwartz K. 1481 UTILIZATION OF NEPHRON-SPARING SURGERY AMONG RENAL CELL CARCINOMA PATIENTS WITH DIABETES OR HYPERTENSION. J Urol 2010. [DOI: 10.1016/j.juro.2010.02.1197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Filson C, Miller D, Ruterbusch J, Colt J, Chow WH, Schwartz K. 721 SURGICAL APPROACH AND THE USE OF LYMPHADENECTOMY AND ADRENALECTOMY FOR PATIENTS WITH RENAL CELL CARCINOMA. J Urol 2010. [DOI: 10.1016/j.juro.2010.02.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Beebe-Dimmer JL, Cetin K, Fryzek JP, Schuetze SM, Schwartz K. The epidemiology of malignant giant cell tumors of bone: an analysis of data from the Surveillance, Epidemiology and End Results Program (1975-2004). Rare Tumors 2009; 1:e52. [PMID: 21139931 PMCID: PMC2994468 DOI: 10.4081/rt.2009.e52] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Revised: 11/04/2009] [Accepted: 11/05/2009] [Indexed: 11/23/2022] Open
Abstract
Malignant giant cell tumor (GCT) of bone is a rare tumor with debilitating consequences. Patients with GCT of bone typically present with mechanical difficulty and pain as a result of bone destruction and are at an increased risk for fracture. Because of its unusual occurrence, little is known about the epidemiology of malignant GCT of bone. This report offers the first reliable population-based estimates of incidence, patient demographics, treatment course and survival for malignancy in GCT of bone in the United States. Using data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program, we estimated the overall incidence and determinants of survival among patients diagnosed with malignant GCT of bone from 1975–2004. Cox proportional hazards regression was used to evaluate demographic and clinical determinants of survival among malignant GCT cases. Based on analyses of 117 malignant GCT cases, the estimated annual incidence in the United States was 1.6 per 10,000,000 persons per year. Incidence was highest among adults aged 20 to 44 years (2.4 per 10,000,000 per year) and most patients were diagnosed with localized (31.6%) or regional (29.9%) disease compared to distant disease (16.2%). Approximately 85% of patients survived at least 5 years, with survival poorest among older patients and those with evidence of distant metastases at time of diagnosis. The current study represents the largest systematic investigation examining the occurrence and distribution of malignancy in GCT of bone in the general U.S. population. We confirm its rare occurrence and suggest that age and stage at diagnosis are strongly associated with long-term survival.
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Moore LE, Brennan P, Karami S, Menashe I, Berndt SI, Dong LM, Meisner A, Yeager M, Chanock S, Colt J, Schwartz K, Davis F, Zaridze D, Mattveev V, Janout V, Kollarova H, Bencko V, Navratilova M, Szeszenia-Dabrowska N, Mates D, Holcatova I, Boffetta P, Chow WH, Rosenberg PS, Rothman N. Apolipoprotein E/C1 locus variants modify renal cell carcinoma risk. Cancer Res 2009; 69:8001-8. [PMID: 19808960 DOI: 10.1158/0008-5472.can-09-1734] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Lipid peroxidation is considered a unifying mechanistic pathway through which known risk factors induce renal cell carcinoma (RCC). We hypothesized that genes selected a priori for their role in lipid peroxidation would modify cancer risk. We genotyped 635 single nucleotide polymorphisms (SNP) in 38candidate genes in 777 Caucasian RCC cases and 1,035 controls enrolled in a large European case-control study. Top candidate SNPs were confirmed among 718 Caucasian cases and 615 controls in a second study in the United States. Two of the three SNPs (rs8106822 and rs405509) that replicated in the U.S. study were within a regulatory region of the APOE promoter. The OR for rs8106822 A>G variant was 1.22(AG) and 1.41(GG) (P(trend) = 0.01) in the European study, 1.05(AG) and 1.51(GG) (P(trend) = 0.03) in the U.S. study, and 1.15(AG) and 1.44(GG) (P(trend) = 0.001) among 1,485 cases and 1,639 controls combined. The rs405509 G>T variant was associated with risk in the European (OR, 0.87(TG); OR, 0.71(TT); P(trend) = 0.02), the U.S. (OR, 0.68(TG); OR, 0.71(TT); P(trend) = 0.02), and both studies combined (OR(TG), 0.79; OR(TT), 0.71; P(trend) = 0.001), as was the G-G haplotype (r(2) = 0.64; P= 4.7 x 10(-4)). This association is biologically plausible as SNP rs405509 was shown to modify protein binding and transcriptional activity of the APOE protein in vitro and is in linkage disequilibrium with key known variants defining the e2, e3, and e4 alleles that modify risk of atherosclerosis, Alzheimer's disease risk, and progression to AIDS. In two large case-control studies, our findings further define a functional region of interest at the APOE locus that increases RCC susceptibility.
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94
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Yan B, Noone AM, Yee C, Banerjee M, Schwartz K, Simon MS. Racial differences in colorectal cancer survival in the Detroit Metropolitan Area. Cancer 2009; 115:3791-800. [PMID: 19598220 DOI: 10.1002/cncr.24408] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Colorectal carcinoma is the second most common cause of cancer death with African Americans having lower survival compared with White Americans. The purpose of this study was to investigate the effect of demographics, clinical factors, and socioeconomic status (SES) on racial disparities in colorectal cancer survival in the Detroit Metropolitan Area. METHODS The study population included 9078 individuals with primary invasive colorectal cancer identified between 1988 and 1992 through the Surveillance, Epidemiology, and End Results (SEER) program. Demographics, clinical information, and survival were obtained through SEER. SES was categorized using occupation, educational level, and poverty status at the census tract level. Kaplan-Meier survival curves and Cox proportional hazards regression were used to compare overall survival by race. RESULTS African Americans were more likely to be diagnosed with stage IV disease (P < .001), and to reside within poor census tracts (P < .001) compared with White Americans. Unadjusted analysis showed that African Americans had a significantly higher risk of death compared with their White American counterparts (hazards ratio [HR], 1.13; 95% confidence interval [CI], 1.07-1.20). After adjusting for age, marital status, sex, SES group, TNM stage, and treatment, race was no longer significantly associated with overall survival (HR, 1.00; 95% CI, 0.92-1.09). Similar results were seen with colorectal cancer-specific survival. CONCLUSIONS Racial disparities in colorectal cancer survival dissipate after adjusting for other demographic and clinical factors. These results can potentially affect medical guidelines regarding screening and treatment, and possibly influence public health policies that can have a positive impact on equalizing racial differences in access to care.
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95
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Schwartz K. Interest, attitudes, and participation in clinical trials among lymphoma patients with online access. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e19514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19514 Background: There is an increasing number of investigational agents for lymphomas and a limited patient pool, approximately 5% of available patients. Thus, identifying and addressing obstacles to study enrollment is vital to making progress. Methods: This analysis was made from a non-random population of 251 lymphoma patients with online access to our survey. Results: In this cohort, 43% reported High Interest in clinical trials, 50% have Considered Trials, and 27% Have Participated. Patients who considered studies (126) ranked the following reasons for declining as significant: Randomization (70), Insurance (49), Study Risks / Toxicities (42), Travel and Lodging (30), Eligibility (28), Tests and Procedures (12), and a perception that Regular Treatment is superior (6). See Table 1 for associations with consideration of clinical trials and participation. Conclusions: In this cohort, interest in clinical trials and participation rates were much higher than generally cited. As expected, the discussion of clinical trials with the patient's oncologist was associated with the highest consideration (85%) and participation (53%) rates, suggesting a need to increase awareness of study protocols among treating physicians so that this discussion can become more routine. Patient issues and perceptions regarding randomization, study risk, eligibility, and tests and procedures suggest an opportunity to improve enrollment in clinical trials by focusing on these aspects of study design, specifically, attending to the rationale of the protocol as a treatment decision. [Table: see text] No significant financial relationships to disclose.
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96
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Jagsi R, Abrahamse P, Morrow M, Griggs JJ, Schwartz K, Katz SJ. Postmastectomy radiotherapy for breast cancer: patterns, correlates, communication, and insights into the decision process. Cancer 2009; 115:1185-93. [PMID: 19180636 DOI: 10.1002/cncr.24164] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Given accumulating evidence supporting postmastectomy radiotherapy (PMRT) in selected patients, it is important to evaluate patterns and correlates of PMRT utilization, including communication and attitudinal factors. METHODS The authors surveyed 2382 patients diagnosed with breast cancer in 2002 and reported to the Los Angeles and Detroit Surveillance, Epidemiology, and End Results registries (n=1844, 77.4% response rate). Analyses were restricted to patients with nonmetastatic invasive breast cancer treated by mastectomy who had decided whether or not to undergo PMRT (n=396). The authors assessed rates of explanation, recommendation, and receipt of radiation by indication grouping, defined primarily by the 2001 American Society of Clinical Oncology guidelines. They evaluated correlates of PMRT receipt, including tumor and sociodemographic characteristics. They also explored patients' self-reported reasons for nonreceipt of PMRT. RESULTS The adjusted proportion in each indication group reporting that a provider had explained radiation was high (77% of those in whom PMRT was indicated, 76% of those in whom medical opinion was divided, and 73% of those in whom PMRT was not indicated; P=.10). The adjusted proportions reporting recommendations for radiation (86%, 35%, and 17%, respectively) and receipt (81%, 34%, and 10%, respectively) varied significantly by indication grouping (P<.001). On multivariate analysis, tumor size (P<.001), lymph node status (P<.001), comorbidity (P=.02), and chemotherapy receipt (P=.003) were found to be independent significant correlates of PMRT receipt. The most common reasons cited for not pursuing PMRT were lack of physician recommendation and perceived lack of need. CONCLUSIONS PMRT receipt is strongly correlated with clinical indication. The authors found no sociodemographic disparities in utilization. However, approximately one-fifth of patients with strong indications did not receive treatment.
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97
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Friedrich FW, Bausero P, Sun Y, Treszl A, Kramer E, Juhr D, Richard P, Wegscheider K, Schwartz K, Brito D, Arbustini E, Waldenstrom A, Isnard R, Komajda M, Eschenhagen T, Carrier L. A new polymorphism in human calmodulin III gene promoter is a potential modifier gene for familial hypertrophic cardiomyopathy. Eur Heart J 2009; 30:1648-55. [DOI: 10.1093/eurheartj/ehp153] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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98
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Dong LM, Brennan P, Karami S, Hung RJ, Menashe I, Berndt SI, Yeager M, Chanock S, Zaridze D, Matveev V, Janout V, Kollarova H, Bencko V, Schwartz K, Davis F, Navratilova M, Szeszenia-Dabrowska N, Mates D, Colt JS, Holcatova I, Boffetta P, Rothman N, Chow WH, Rosenberg PS, Moore LE. An analysis of growth, differentiation and apoptosis genes with risk of renal cancer. PLoS One 2009; 4:e4895. [PMID: 19603096 PMCID: PMC2656573 DOI: 10.1371/journal.pone.0004895] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Accepted: 02/19/2009] [Indexed: 11/23/2022] Open
Abstract
We conducted a case-control study of renal cancer (987 cases and 1298 controls) in Central and Eastern Europe and analyzed genomic DNA for 319 tagging single-nucleotide polymorphisms (SNPs) in 21 genes involved in cellular growth, differentiation and apoptosis using an Illumina Oligo Pool All (OPA). A haplotype-based method (sliding window analysis of consecutive SNPs) was used to identify chromosome regions of interest that remained significant at a false discovery rate of 10%. Subsequently, risk estimates were generated for regions with a high level of signal and individual SNPs by unconditional logistic regression adjusting for age, gender and study center. Three regions containing genes associated with renal cancer were identified: caspase 1/5/4/12(CASP 1/5/4/12), epidermal growth factor receptor (EGFR), and insulin-like growth factor binding protein-3 (IGFBP3). We observed that individuals with CASP1/5/4/12 haplotype (spanning area upstream of CASP1 through exon 2 of CASP5) GGGCTCAGT were at higher risk of renal cancer compared to individuals with the most common haplotype (OR:1.40, 95% CI:1.10–1.78, p-value = 0.007). Analysis of EGFR revealed three strong signals within intron 1, particularly a region centered around rs759158 with a global p = 0.006 (GGG: OR:1.26, 95% CI:1.04–1.53 and ATG: OR:1.55, 95% CI:1.14–2.11). A region in IGFBP3 was also associated with increased risk (global p = 0.04). In addition, the number of statistically significant (p-value<0.05) SNP associations observed within these three genes was higher than would be expected by chance on a gene level. To our knowledge, this is the first study to evaluate these genes in relation to renal cancer and there is need to replicate and extend our findings. The specific regions associated with risk may have particular relevance for gene function and/or carcinogenesis. In conclusion, our evaluation has identified common genetic variants in CASP1, CASP5, EGFR, and IGFBP3 that could be associated with renal cancer risk.
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99
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Alford SH, Schwartz K, Soliman A, Johnson CC, Gruber SB, Merajver SD. Breast cancer characteristics at diagnosis and survival among Arab-American women compared to European- and African-American women. Breast Cancer Res Treat 2009; 114:339-46. [PMID: 18415013 PMCID: PMC2804102 DOI: 10.1007/s10549-008-9999-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Accepted: 03/28/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND Data from Arab world studies suggest that Arab women may experience a more aggressive breast cancer phenotype. To investigate this finding, we focused on one of the largest settlements of Arabs and Iraqi Christians (Chaldeans) in the US, metropolitan Detroit- a SEER reporting site since 1973. MATERIALS AND METHODS We identified a cohort of primary breast cancer cases diagnosed 1973-2003. Using a validated name algorithm, women were identified as being of Arab/Chaldean descent if they had an Arab last or maiden name. We compared characteristics at diagnosis (age, grade, histology, SEER stage, and marker status) and overall survival between Arab-, European-, and African-Americans. RESULTS The cohort included 1,652 (2%) women of Arab descent, 13,855 (18%) African-American women, and 63,615 (80%) European-American women. There were statistically significant differences between the racial groups for all characteristics at diagnosis. Survival analyses overall and for each SEER stage showed that Arab-American women had the best survival, followed by European-American women. African-American women had the poorest overall survival and were 1.37 (95% confidence interval: 1.23-1.52) times more likely to be diagnosed with an aggressive tumor (adjusting for age, grade, marker status, and year of diagnosis). CONCLUSION Overall, Arab-American women have a distribution of breast cancer histology similar to European-American women. In contrast, the stage, age, and hormone receptor status at diagnosis among Arab-Americans was more similar to African-American women. However, Arab-American women have a better overall survival than even European-American women.
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MESH Headings
- Black or African American
- Arabs
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/diagnosis
- Breast Neoplasms/epidemiology
- Breast Neoplasms/mortality
- Carcinoma in Situ/diagnosis
- Carcinoma in Situ/epidemiology
- Carcinoma in Situ/mortality
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Lobular/diagnosis
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/mortality
- Carcinoma, Medullary/diagnosis
- Carcinoma, Medullary/epidemiology
- Carcinoma, Medullary/mortality
- Cohort Studies
- Female
- Humans
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local
- Neoplasm Staging
- Risk Factors
- SEER Program
- Survival Rate
- White People
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100
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Kato I, Yee CL, Ruterbusch J, Schwartz K. Patterns of cancer in first generation immigrants from the Arab League and other countries. JOURNAL OF REGISTRY MANAGEMENT 2009; 36:71-102. [PMID: 19999650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Arabic immigrants are a relatively new group of immigrants and one of the fastest growing populations in the United States. Yet, information about their disease patterns is limited because Arabic is not a recognized minority group in population statistics. We tested whether population-based cancer registry data were useful to describe cancer patterns of the first generation of Arabic immigrants, compared with non-immigrants as well as the first generation of other immigrants. Information on invasive cancer cases with only one primary and known age was extracted from Surveillance, Epidemiology, and End Results (SEER) public use data (1973-2004) and software. Immigrants were divided by place of birth; Arabic: born in the Arab League countries, and other immigrants: born in countries other than the United States or Arab League, whereas US-born were used as a reference population. Information on place of birth was frequently absent for non-deceased cases, therefore data were limited to deceased cases. Age- and gender-standardized proportional ratios (SPR) were calculated for 24 aggregated cancer sites. Significantly high or low SPRs were observed for Arabic immigrants for the following cancer sites: liver (3.15), gallbladder & other biliary (1.87), thyroid (1.74), stomach (1.54), leukemia (1.41), lymphoma (1.36), pancreas (1.36), ovary (1.29), brain and other nervous system (1.23), lung (0.80), prostate (0.72), oral cavity and pharynx (0.64), esophagus (0.39), and skin melanoma (0.33). These patterns were similar for the other immigrants; however, ovary and brain were Arabic-specific, and thus may deserve further investigation for specific environmental or genetic exposures among Arabic immigrants.
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