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Johnson KJ, Lee SH. Factors Associated With Volunteering Among Racial/Ethnic Groups: Findings From the California Health Interview Survey. Res Aging 2015; 39:575-596. [DOI: 10.1177/0164027515618243] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study investigated how volunteering was influenced by individual resources and social capital among four racial/ethnic groups of adults aged 50 and older. The data came from the California Health Interview Survey, a statewide sample that includes non-Hispanic Whites ( n = 18,927), non-Hispanic Asians ( n = 2,428), non-Hispanic Blacks ( n = 1,265), and Hispanics ( n = 3,799). Logistic regression models of volunteering were estimated to explore the effects of human and social capital within and across the racial/ethnic groups. Compared to Whites, racial/ethnic minority adults volunteered less. Although education was a significant predictor of volunteering across all groups, the findings indicated group-specific factors related to human and social capital. Results showed similarities and differences associated with volunteer participation among diverse racial/ethnic groups. The findings underscore the importance of understanding ways of creating inclusive opportunities for civic engagement among an increasingly diverse population.
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Abadin SS, Zoellner NL, Schaeffer M, Porcelli B, Gutmann DH, Johnson KJ. Racial/Ethnic Differences in Pediatric Brain Tumor Diagnoses in Patients with Neurofibromatosis Type 1. J Pediatr 2015; 167:613-20.e1-2. [PMID: 26028287 PMCID: PMC4784699 DOI: 10.1016/j.jpeds.2015.04.076] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/06/2015] [Accepted: 04/30/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate evidence for differences in pediatric brain tumor diagnoses by race and ethnicity using a cross-sectional study design in individuals with neurofibromatosis type 1 (NF1). STUDY DESIGN Subjects with NF1 were ascertained from the NF1 Patient Registry Initiative and through a clinical record database of patients at a large academic medical center. Logistic regression was employed to calculate ORs and 95% CIs to analyze differences in the odds of brain tumor diagnosis by race (White, Black, Asian, other/unknown) and ethnic (Hispanic vs non-Hispanic) groups. RESULTS Data from a total of 1546, 629, and 2038 individuals who were ascertained from the NF1 Patient Registry Initiative, clinical records, and pooled datasets were analyzed, respectively. After adjusting for birth year, we observed a significantly reduced odds of brain tumor diagnoses in individuals self-identified or clinically reported as Black (OR = 0.13, 95% CI 0.05-0.31), Asian (OR = 0.15, 95% CI 0.04-0.64), and other/unknown (OR = 0.61, 95% CI 0.41-0.93) race compared with those with reported as White race. There was no significant difference in the odds of pediatric brain tumor diagnosis by Hispanic ethnicity. CONCLUSIONS Consistent with prior smaller studies, these data suggest that pediatric brain tumor diagnoses vary by race in individuals with NF1. Reasons underlying observed differences by race warrant further investigation.
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Liu Q, Zoellner N, Gutmann DH, Johnson KJ. Parental age and Neurofibromatosis Type 1: a report from the NF1 Patient Registry Initiative. Fam Cancer 2014; 14:317-24. [DOI: 10.1007/s10689-014-9774-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Johnson KJ, Cullen J, Barnholtz-Sloan JS, Ostrom QT, Langer CE, Turner MC, McKean-Cowdin R, Fisher JL, Lupo PJ, Partap S, Schwartzbaum JA, Scheurer ME. Childhood brain tumor epidemiology: a brain tumor epidemiology consortium review. Cancer Epidemiol Biomarkers Prev 2014; 23:2716-36. [PMID: 25192704 PMCID: PMC4257885 DOI: 10.1158/1055-9965.epi-14-0207] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Childhood brain tumors are the most common pediatric solid tumor and include several histologic subtypes. Although progress has been made in improving survival rates for some subtypes, understanding of risk factors for childhood brain tumors remains limited to a few genetic syndromes and ionizing radiation to the head and neck. In this report, we review descriptive and analytical epidemiology childhood brain tumor studies from the past decade and highlight priority areas for future epidemiology investigations and methodological work that is needed to advance our understanding of childhood brain tumor causes. Specifically, we summarize the results of a review of studies published since 2004 that have analyzed incidence and survival in different international regions and that have examined potential genetic, immune system, developmental and birth characteristics, and environmental risk factors. Cancer Epidemiol Biomarkers Prev; 23(12); 2716-36. ©2014 AACR.
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Xie M, Lu C, Wang J, McLellan MD, Johnson KJ, Wendl MC, McMichael JF, Schmidt HK, Yellapantula V, Miller CA, Ozenberger BA, Welch JS, Link DC, Walter MJ, Mardis ER, Dipersio JF, Chen F, Wilson RK, Ley TJ, Ding L. Age-related mutations associated with clonal hematopoietic expansion and malignancies. Nat Med 2014; 20:1472-8. [PMID: 25326804 PMCID: PMC4313872 DOI: 10.1038/nm.3733] [Citation(s) in RCA: 1294] [Impact Index Per Article: 129.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 09/21/2014] [Indexed: 12/15/2022]
Abstract
Several genetic alterations characteristic of leukemia and lymphoma have been detected in the blood of individuals without apparent hematological malignancies. The Cancer Genome Atlas (TCGA) provides a unique resource for comprehensive discovery of mutations and genes in blood that may contribute to the clonal expansion of hematopoietic stem/progenitor cells. Here, we analyzed blood-derived sequence data from 2,728 individuals from TCGA and discovered 77 blood-specific mutations in cancer-associated genes, the majority being associated with advanced age. Remarkably, 83% of these mutations were from 19 leukemia and/or lymphoma-associated genes, and nine were recurrently mutated (DNMT3A, TET2, JAK2, ASXL1, TP53, GNAS, PPM1D, BCORL1 and SF3B1). We identified 14 additional mutations in a very small fraction of blood cells, possibly representing the earliest stages of clonal expansion in hematopoietic stem cells. Comparison of these findings to mutations in hematological malignancies identified several recurrently mutated genes that may be disease initiators. Our analyses show that the blood cells of more than 2% of individuals (5-6% of people older than 70 years) contain mutations that may represent premalignant events that cause clonal hematopoietic expansion.
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Johnson KJ, Mueller N, Sharkey E, Liu Q, Gutmann DH. Abstract 1295: The association between asthma and pediatric brain tumors in neurofibromatosis type 1. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-1295] [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. Neurofibromatosis type 1 (NF1) is a common hereditary cancer syndrome, affecting an estimated 1/2,500 people worldwide. NF1 increases the risk of several tumor types, including pediatric brain tumors that affect an estimated 10-20% of individuals. While established risk factors for pediatric brain tumor development in this population have not been elucidated, consistent evidence from non-syndromic populations suggests a strong inverse association between asthma and brain tumors. As such, the objective of this study was to test the hypothesis that asthma is inversely associated with pediatric brain tumors in the NF1 population.
Methods. In this analysis, we employed two data sources. The first dataset was assembled from the international NF1 Patient Registry Initiative (NPRI) (https://nf1registry.wustl.edu/) that enrolled individuals with NF1 over ∼2.5 years. Medical history data were collected through the online registry questionnaire. The second study used private health insurance claims data from 2006-2010 from Thompson Reuters MarketScan to assemble an NF1 group and their claims data on asthma- and brain tumor-related healthcare visits. Diagnoses were determined from ICD-9 codes. The NF1 group was defined by the presence of >2 NF1-related outpatient claims >30 days apart or one NF1-related inpatient claim. Within the NF1 group, individuals were classified as having asthma and/or brain tumors if they had >2 claims for these conditions >30 days apart. The study population for both data sources was limited to subjects who were <18 years old at the time of NPRI or insurance enrollment. Unconditional logistic regression was employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between pediatric brain tumors and asthma for both datasets.
Results. A total of 409 individuals with NF1 were included in the analysis using NPRI data, resulting in 119 pediatric brain tumors. After adjusting for birth year, we observed an inverse association between pediatric brain tumors and asthma (OR=0.6; 95% CI 0.4-1.1). In the analysis using MarketScan data, the NF1 group included a total of 3,871 individuals <18 years at the time of insurance enrollment, of which 397 had >2 pediatric brain tumor-related claims. After controlling for number of months enrolled, birth year, and number of healthcare visits, subjects with brain tumor claims were significantly less likely to have asthma claims than those without brain tumor claims (OR=0.5; 95% CI 0.3-0.8).
Conclusions. Similar to findings from non-syndromic populations, the results from this study provide strong epidemiologic evidence for an inverse association between asthma and pediatric brain tumors in the NF1 population.
Acknowledgements. This work was supported by Alex's Lemonade Stand Foundation and NIH CTSA UL1 TR000448.
Citation Format: Kimberly J. Johnson, Nancy Mueller, Evelyn Sharkey, Qian Liu, David H. Gutmann. The association between asthma and pediatric brain tumors in neurofibromatosis type 1. [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;74(19 Suppl):Abstract nr 1295. doi:10.1158/1538-7445.AM2014-1295
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Wang J, Lu C, Xie M, Tripathi P, McLellan M, Chen F, Johnson KJ, Ding L. Abstract 3438: Integrated analysis of germline and somatic variants in renal clear cell carcinoma. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-3438] [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
Each year in the United States, there are approximately 54,000 new cases of kidney and upper urinary tract cancers and 13,000 deaths. Renal clear cell carcinoma (RCC) is the most common type of kidney cancer comprising more than 75% of cases. It is known that certain genetic syndromes strongly increase risk for renal cell carcinoma including Von Hippel Lindau disease (VHL) that is caused by germline mutations in the VHL tumor suppressor gene. However, there are a large number of cases with familial RCC that are not explained by germline VHL mutations. Publically available data generated through large scale genomic sequencing projects such as The Cancer Genome Atlas (TCGA) provides new opportunities for identifying both known and novel germline cancer susceptibility variants. Moreover, the availability of matched tumor and normal genomic sequencing data from cancer patients (including RCCC) through TCGA allows for integrated analyses of germline and somatic interactions. Toward this end, we analyzed the TCGA exome sequencing data from 499 RCC cases. We employed GATK, VarScan, and Pindel tools to identify germline single nucleotide variants and indels and identified 10,492 candidate germline rare truncation variants (X truncation variants were in cancer genes). All the truncation candidates in commonly mutated cancer driver genes were manually reviewed, resulting in a total of 119 high confidence germline truncation variants in cancer genes. To date, we have identified one nonsense mutation in the VHL gene. In addition, there was one nonsense mutation and a frame-shift deletion in WRN and a nonsense and a splice-site mutation in BAP1, a recently identified RCC predisposition gene. Moreover, we also identified 6,079 candidate missense variants in known cancer driver genes, among a total of 179,066 rare missense variants. Future directions for this project will be to use the burden analysis to determine genes with significant enrichment for deleterious variants. We will also examine loss of heterozygosity patterns to evaluate germline somatic interactions.
Citation Format: Jiayin Wang, Charles Lu, Mingchao Xie, Piyush Tripathi, Michael McLellan, Feng Chen, Kimberly J. Johnson, Li Ding. Integrated analysis of germline and somatic variants in renal clear cell carcinoma. [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;74(19 Suppl):Abstract nr 3438. doi:10.1158/1538-7445.AM2014-3438
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Madubata CC, Olsen MA, Stwalley DL, Gutmann DH, Johnson KJ. Neurofibromatosis type 1 and chronic neurological conditions in the United States: an administrative claims analysis. Genet Med 2014; 17:36-42. [PMID: 24901347 PMCID: PMC4257895 DOI: 10.1038/gim.2014.70] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 05/08/2014] [Indexed: 01/11/2023] Open
Abstract
Purpose Neurofibromatosis Type 1 (NF1) has been linked to several neurological conditions including: epilepsy, Parkinson's disease, headache, multiple sclerosis, and sleep disturbances, predominantly through case reports and series that lack comparison groups. Our objective was to assess whether specific neurological conditions occur more frequently in individuals with NF1 vs. those without NF1. Methods We used the 2006-2010 MarketScan Commercial Claims and Encounters database to examine associations between neurological conditions and NF1. The NF1 group was identified through ≥2 ICD-9-CM NF codes (237.70, 237.71) occurring ≥30 days apart or one inpatient NF code. A non-NF1 comparison group was frequency-matched to the NF1 group on age and enrollment length at a 10:1 ratio. Unconditional logistic regression was employed to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for associations between NF and neurological conditions. Results Compared to the non-NF1 group (n=85,790), the NF1 group (n=8,579) had a significantly higher odds of health insurance claims for epilepsy (OR=7.3; 95% CI 6.4-8.3), Parkinson's disease (OR=3.1; 95% CI 1.3-7.5), headache (OR=2.9, 95% CI 2.6-3.1), multiple sclerosis (OR=1.9, 95% CI 1.2-2.9), and sleep disturbances/disorder (OR=1.4, 95% CI 1.2-3.6). Conclusion This large study provides strong evidence for positive associations between several neurological conditions and NF1.
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Johnson KJ, Mueller NL, Williams K, Gutmann DH. Evaluation of participant recruitment methods to a rare disease online registry. Am J Med Genet A 2014; 164A:1686-94. [DOI: 10.1002/ajmg.a.36530] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 02/14/2014] [Indexed: 11/07/2022]
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Been RA, Ross JA, Nagel CW, Hooten AJ, Langer EK, DeCoursin KJ, Marek CA, Janik CL, Linden MA, Reed RC, Schutten MM, Largaespada DA, Johnson KJ. Perigestational dietary folic acid deficiency protects against medulloblastoma formation in a mouse model of nevoid basal cell carcinoma syndrome. Nutr Cancer 2014; 65:857-65. [PMID: 23909730 DOI: 10.1080/01635581.2013.804940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Hereditary nevoid basal cell carcinoma syndrome (NBCCS) is caused by PTCH1 gene mutations that result in diverse neoplasms including medulloblastoma (MB). Epidemiological studies report reduced pediatric brain tumor risks associated with maternal intake of prenatal vitamins containing folic acid (FA) and FA supplements specifically. We hypothesized that low maternal FA intake during the perigestational period would increase MB incidence in a transgenic NBCCS mouse model, which carries an autosomal dominant mutation in the Ptch1 gene. Female wild-type C57BL/6 mice (n = 126) were randomized to 1 of 3 diets with differing FA amounts: 0.3 mg/kg (low), 2.0 mg/kg (control), and 8.0 mg/kg (high) 1 mo prior to mating with Ptch1 (+/-) C57BL/6 males. Females were maintained on the diet until pup weaning; the pups were then aged for tumor development. Compared to the control group, offspring MB incidence was significantly lower in the low FA group (Hazard Ratio = 0.47; 95% confidence interval 0.27-0.80) at 1 yr. No significant difference in incidence was observed between the control and high FA groups. Low maternal perigestational FA levels may decrease MB incidence in mice genetically predisposed to tumor development. Our results could have implications for prenatal FA intake recommendations in the presence of cancer syndromes.
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Johnson KJ, Mutchler JE. The emergence of a positive gerontology: from disengagement to social involvement. THE GERONTOLOGIST 2013; 54:93-100. [PMID: 24009172 DOI: 10.1093/geront/gnt099] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The latter part of the 20th century was a period characterized by a fundamental transition in scholarship on activity and the aging process. Theory emphasizing the inevitable decline of human capacity was gradually replaced with concepts stressing positive, multidimensional views of aging. In this article, we highlight the key contributors and trace the origins and overlapping themes of successful aging, productive aging, and civic engagement in later life: 3 examples of scholarship representing a "positive" gerontology. Rowe and Kahn's model of successful aging highlights the interplay between social engagement with life, health, and functioning for a positive aging experience. Productive aging, led by Robert Butler, recognizes the previously underappreciated participation of older adults in activities such as volunteering, paid work, and caregiving, and generates interest in the individual and societal barriers to and benefits of participation. Civic engagement in later life raises public awareness about the need to involve older adults in the community, creates opportunities for participation, and generates further interest in the mutual benefit of participation for community beneficiaries and participants. Successful aging, productive aging, and civic engagement represent important contributions to the field of gerontology through applications to policy, advocacy, and theory development.
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Johnson KJ, Williams KS, Ross JA, Krailo MD, Tomlinson GE, Malogolowkin MH, Feusner JH, Spector LG. Parental tobacco and alcohol use and risk of hepatoblastoma in offspring: a report from the children's oncology group. Cancer Epidemiol Biomarkers Prev 2013; 22:1837-43. [PMID: 23950215 DOI: 10.1158/1055-9965.epi-13-0432] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hepatoblastoma is a rare pediatric liver tumor that has significantly increased in incidence over the last several decades. The International Agency for Research on Cancer (IARC) recently classified hepatoblastoma as a tobacco-related cancer. Parental alcohol use has shown no association. We examined associations between parental tobacco and alcohol use around the time of pregnancy and hepatoblastoma in a large case-control study. METHODS Maternal interviews were completed for 383 cases diagnosed in the United States during 2000-2008. Controls (n = 387) were identified through U.S. birth registries and frequency-matched to cases on birth weight, birth year, and region of residence. We used unconditional logistic regression to calculate ORs and 95% confidence intervals (CI) for associations between parental smoking and maternal drinking and offspring hepatoblastoma. RESULTS We found no association between hepatoblastoma and maternal smoking at any time (OR, 1.0; 95% CI, 0.7-1.4), within the year before pregnancy (OR, 1.1; 95% CI, 0.8-1.6), early in pregnancy (OR, 1.0; 95% CI, 0.7-1.6), or throughout pregnancy (OR, 0.9; 95% CI, 0.5-1.6). We observed marginally positive associations between hepatoblastoma and paternal smoking in the year before pregnancy (OR, 1.4; 95% CI, 1.0-2.0) and during pregnancy (OR, 1.4; 95% CI, 0.9-2.0). Maternal alcohol use was not associated with hepatoblastoma. CONCLUSION Our results do not provide evidence for an etiologic relationship between maternal smoking or drinking and hepatoblastoma, and only weak evidence for an association for paternal smoking in the year before pregnancy. IMPACT Our study provides limited support for hepatoblastoma as a tobacco-related cancer; however, it remains wise to counsel prospective parents on the merits of smoking cessation.
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Wick JB, Johnson KJ, O'Brien J, Wick MJ. Second-trimester diagnosis of triploidy: a series of four cases. AJP Rep 2013; 3:37-40. [PMID: 23943708 PMCID: PMC3699153 DOI: 10.1055/s-0032-1331378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Accepted: 07/31/2012] [Indexed: 01/22/2023] Open
Abstract
Triploidy occurs in 2 to 3% of conceptuses and accounts for approximately 20% of chromosomally abnormal first-trimester miscarriages. As such, triploidy is estimated to occur in 1 of 3,500 pregnancies at 12 weeks', 1 in 30,000 at 16 weeks', and 1 in 250,000 at 20 weeks' gestation. We present a series of four cases of second-trimester triploidy diagnosed at our center within a 1-year timeframe. This is remarkable, as the delivery volume at our institution is roughly 2,500/y. All patients were at least 19 weeks' gestation, with multiple abnormalities identified on prenatal ultrasound at 18 to 20 weeks' gestation; all fetuses had lethal anomalies, but anomalies were not consistent between cases. All patients elected for induction of labor before 24 weeks' gestational age. Two of the four cases had amniocentesis and chromosome analysis prior to delivery, and two cases had chromosome analysis performed on fetal tissue after delivery. All fetuses were examined following delivery. This case series demonstrates that the diagnosis of triploidy may not be obvious based on ultrasound and physical examination findings and highlights the importance of routine chromosome analysis on all prenatal diagnoses of multiple congenital anomalies prior to consideration of more complex genetic testing.
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Wong JR, Harris JK, Rodriguez-Galindo C, Johnson KJ. Incidence of childhood and adolescent melanoma in the United States: 1973-2009. Pediatrics 2013; 131:846-54. [PMID: 23589817 PMCID: PMC3639457 DOI: 10.1542/peds.2012-2520] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Childhood and adolescent melanoma is rare but has been increasing. To gain insight into possible reasons underlying this observation, we analyzed trends in melanoma incidence diagnosed between the ages of 0 and 19 years among US whites by gender, stage, age at diagnosis, and primary site. We also investigated incidence trends by UV-B exposure levels. METHODS By using Surveillance, Epidemiology, and End Results (SEER) program data (1973-2009), we calculated age-adjusted incidence rates (IRs), annual percent changes, and 95% confidence intervals for each category of interest. Incidence trends were also evaluated by using joinpoint and local regression models. SEER registries were categorized with respect to low or high UV-B radiation exposure. RESULTS From 1973 through 2009, 1230 children of white race were diagnosed with malignant melanoma. Overall, pediatric melanoma increased by an average of 2% per year (95% confidence interval, 1.4%-2.7%). Girls, 15- to 19-year-olds, and individuals with low UV-B exposure had significantly higher IRs than boys, younger children, and those living in SEER registries categorized as high UV-B. Over the study period, boys experienced increased IRs for melanoma on the face and trunk, and females on the lower limbs and hip. The only decreased incidence trend we observed was among 15- to 19-year-olds in the high UV-B exposure group from 1985 through 2009. Local regression curves indicated similar patterns. CONCLUSIONS These results may help elucidate possible risk factors for adolescent melanoma, but additional individual-level studies will be necessary to determine the reasons for increasing incidence trends.
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Johnson KJ, Fisher MJ, Listernick RL, North KN, Schorry EK, Viskochil D, Weinstein M, Rubin JB, Gutmann DH. Parent-of-origin in individuals with familial neurofibromatosis type 1 and optic pathway gliomas. Fam Cancer 2013; 11:653-6. [PMID: 22829012 DOI: 10.1007/s10689-012-9549-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Neurofibromatosis type 1 (NF1) is one of the most common autosomal dominant cancer syndromes worldwide. Individuals with NF1 have a wide variety of clinical features including a strongly increased risk for pediatric brain tumors. The etiology of pediatric brain tumor development in NF1 is largely unknown. Recent studies have highlighted the contribution of parent-of-origin effects to tumorigenesis in sporadic cancers and cancer predisposition syndromes; however, there is limited data on this effect for cancers arising in NF1. To increase our understanding of brain tumor development in NF1, we conducted a multi-center retrospective chart review of 240 individuals with familial NF1 who were diagnosed with a pediatric brain tumor (optic pathway glioma; OPG) to determine whether a parent-of-origin effect exists overall or by the patient's sex. Overall, 50 % of individuals with familial NF1 and an OPG inherited the NF1 gene from their mother. Similarly, by sex, both males and females were as likely to inherit the NF1 gene from their mother as from their father, with 52 % and 48 % of females and males with OPGs inheriting the NF1 gene from their mother. In conclusion, in contrast to findings from other studies of sporadic cancers and cancer predisposition syndromes, our results indicate no parent-of-origin effect overall or by patient sex for OPGs in NF1.
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Johnson KJ, Mueller NL, Gutmann DH. Abstract 4847: Efficacy of different recruitment methods for a neurofibromatosis type 1 online registry. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-4847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Neurofibromatosis Type 1 (NF1) is a hereditary cancer syndrome caused by a germline NF1 gene mutation. Affecting an estimated 70,000-100,000 Americans, cancer in individuals with NF1 is a leading cause of death. However, the factors that modify cancer risk in NF1 are largely unknown. To facilitate NF1 research aimed at defining epidemiologic and clinical cancer risk factors, we created an online patient registry (https://nf1registry.wustl.edu/). In the current study, we sought to evaluate different recruiting mechanisms and the characteristics of participants recruited by each mechanism.
Methods. Potential participants were alerted to the registry through three main mechanisms: (1) paid online advertising (Facebook and Google ads), (2) posting on government, academic, and advocacy group websites, and (3) healthcare provider-based recruiting through established NF1 Clinical Programs. Referral patterns were tracked through the online questionnaire that included a question about where the participant first heard about the registry. We compared the total number and characteristics of participants recruited through each method for the period of 4/17/2011-10/22/2012. Statistical significance of differences in participant characteristics between recruiting mechanisms were evaluated using ANOVA and chi-square tests.
Results. A total of 693 participants with self-reported NF1 participated in the registry during the study period. The most effective recruitment mechanism was paid online advertising that resulted in over half of the recruits (n=378), of which 75% responded to a Facebook ad. The second most effective method was postings on government, academic, and advocacy group websites (69 participants) followed by healthcare provider referrals (53 participants). The remainder of the participants reported hearing about the registry through a variety of other mechanisms. The mean age of participants was 30.7 years with the majority of participants reporting white race (72%) and female sex (62%). Age and sex were not significantly associated with the specific recruitment mechanism. However, there was a significant difference in referral patterns by race, with a higher percentage of Whites recruited by Facebook ads than other races and a higher percentage of other races reporting referral via a Google ad than Whites.
Conclusions. We found that the internet, especially Facebook advertising, provides a highly effective means for rapidly assembling large numbers of patients with a rare disease to an online registry for clinical research studies. Although participants were similarly recruited by all three recruitment mechanisms with respect to age and sex, referral patterns appear to differ by race.
Supported by: An American Cancer Society Institutional Research Grant, Alex's Lemonade Stand Foundation, and the St. Louis Children's Hospital Foundation
Citation Format: Kimberly J. Johnson, Nancy L. Mueller, David H. Gutmann. Efficacy of different recruitment methods for a neurofibromatosis type 1 online registry. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4847. doi:10.1158/1538-7445.AM2013-4847
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Johnson KJ, Hussain I, Williams K, Santens R, Mueller NL, Gutmann DH. Development of an international internet-based neurofibromatosis Type 1 Patient registry. Contemp Clin Trials 2013; 34:305-11. [DOI: 10.1016/j.cct.2012.12.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 11/08/2012] [Accepted: 12/05/2012] [Indexed: 11/29/2022]
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Douis H, Davies AM, James SL, Kindblom LG, Grimer RJ, Johnson KJ. Can MR imaging challenge the commonly accepted theory of the pathogenesis of solitary enchondroma of long bone? Skeletal Radiol 2012; 41:1537-42. [PMID: 22422023 DOI: 10.1007/s00256-012-1387-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 12/06/2011] [Accepted: 02/26/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE It has been widely postulated that enchondromas arise from cartilage remnants that have been displaced from the growth plate into the metaphysis. However, this theory remains unproven. Based on the common occurrence of enchondromas on routine knee MR imaging (2.9 %), one would expect to find displaced cartilage in the metaphysis of skeletally immature individuals on routine knee MR examinations if the above theory was to be supported. MATERIALS AND METHODS The electronic databases of a specialist orthopedic hospital and children's hospital were searched for skeletally immature patients who underwent MR imaging of the knee for a variety of indications. Individuals with Ollier disease or hereditary multiple exostoses were excluded. The MR images were subsequently reviewed by a musculoskeletal radiologist for evidence of displaced cartilage into the metaphysis. RESULTS We reviewed 240 MR examinations of the knee that were performed in 209 patients. There were 125 MR studies in male and 115 MR examinations in female patients (age range: 5 months-16 years; median age: 13 years). In 97.1 %, the growth plates around the knee demonstrated a regular appearance. Seven cases (2.9 %) in six patients showed cartilage extension from the growth plate into the metaphysis, which remained in continuity with the growth plate. There were no cases of displaced cartilage into the metaphysis on MRI. CONCLUSIONS Our study challenges the widely believed theory that enchondromas arise from displaced growth plate remnants.
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Johnson KJ. Pediatric brain tumors: gene X environment interactions providing new clues? Pediatr Blood Cancer 2012; 59:597-8. [PMID: 22408060 DOI: 10.1002/pbc.24127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 02/10/2012] [Indexed: 11/06/2022]
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Braganza MZ, Kitahara CM, Berrington de González A, Inskip PD, Johnson KJ, Rajaraman P. Ionizing radiation and the risk of brain and central nervous system tumors: a systematic review. Neuro Oncol 2012; 14:1316-24. [PMID: 22952197 DOI: 10.1093/neuonc/nos208] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although exposure to moderate-to-high doses of ionizing radiation is the only established environmental risk factor for brain and CNS tumors, it is not clear whether this relationship differs across tumor subtypes, by sex or age at exposure, or at the low-to-moderate range of exposure. This systematic review summarizes the epidemiologic evidence on the association between ionizing radiation exposure and risk of brain/CNS tumors. Articles included in this review estimated radiation exposure doses to the brain and reported excess relative risk (ERR) estimates for brain/CNS tumors. Eight cohorts were eligible for inclusion in the analysis. Average age at exposure ranged from 8 months to 26 years. Mean dose to the brain ranged from 0.07 to 10 Gy. Elevated risks for brain/CNS tumors were consistently observed in relation to ionizing radiation exposure, but the strength of this association varied across cohorts. Generally, ionizing radiation was more strongly associated with risk for meningioma compared with glioma. The positive association between ionizing radiation exposure and risk for glioma was stronger for younger vs older ages at exposure. We did not observe an effect modification on the risk for meningioma by sex, age at exposure, time since exposure, or attained age. The etiologic role of ionizing radiation in the development of brain/CNS tumors needs to be clarified further through additional studies that quantify the association between ionizing radiation and risk for brain/CNS tumors at low-to-moderate doses, examine risks across tumor subtypes, and account for potential effect modifiers.
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Harris JK, Provan KG, Johnson KJ, Leischow SJ. Drawbacks and benefits associated with inter-organizational collaboration along the discovery-development-delivery continuum: a cancer research network case study. Implement Sci 2012; 7:69. [PMID: 22831463 PMCID: PMC3443066 DOI: 10.1186/1748-5908-7-69] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Accepted: 07/25/2012] [Indexed: 11/10/2022] Open
Abstract
Background The scientific process around cancer research begins with scientific discovery, followed by development of interventions, and finally delivery of needed interventions to people with cancer. Numerous studies have identified substantial gaps between discovery and delivery in health research. Team science has been identified as a possible solution for closing the discovery to delivery gap; however, little is known about effective ways of collaborating within teams and across organizations. The purpose of this study was to determine benefits and drawbacks associated with organizational collaboration across the discovery-development-delivery research continuum. Methods Representatives of organizations working on cancer research across a state answered a survey about how they collaborated with other cancer research organizations in the state and what benefits and drawbacks they experienced while collaborating. We used exponential random graph modeling to determine the association between these benefits and drawbacks and the presence of a collaboration tie between any two network members. Results Different drawbacks and benefits were associated with discovery, development, and delivery collaborations. The only consistent association across all three was with the drawback of difficulty due to geographic differences, which was negatively associated with collaboration, indicating that those organizations that had collaborated were less likely to perceive a barrier related to geography. The benefit, enhanced access to other knowledge, was positive and significant in the development and delivery networks, indicating that collaborating organizations viewed improved knowledge exchange as a benefit of collaboration. ‘Acquisition of additional funding or other resources’ and ‘development of new tools and methods’ were negatively significantly related to collaboration in these networks. So, although improved knowledge access was an outcome of collaboration, more tangible outcomes were not being realized. In the development network, those who collaborated were less likely to see ‘enhanced influence on treatment and policy’ and ‘greater quality or frequency of publications’ as benefits of collaboration. Conclusion With the exception of the positive association between knowledge transfer and collaboration and the negative association between geography and collaboration, the significant relationships identified in this study all reflected challenges associated with inter-organizational collaboration. Understanding network structures and the perceived drawbacks and benefits associated with collaboration will allow researchers to build and funders to support successful collaborative teams and perhaps aid in closing the discovery to delivery gap.
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Linabery AM, Johnson KJ, Ross JA. Childhood cancer incidence trends in association with US folic acid fortification (1986-2008). Pediatrics 2012; 129:1125-33. [PMID: 22614769 PMCID: PMC3362910 DOI: 10.1542/peds.2011-3418] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Epidemiologic evidence indicates that prenatal vitamin supplementation reduces risk for some childhood cancers; however, a systematic evaluation of population-based childhood cancer incidence trends after fortification of enriched grain products with folic acid in the United States in 1996-1998 has not been previously reported. Here we describe temporal trends in childhood cancer incidence in association with US folic acid fortification. METHODS Using Surveillance, Epidemiology, and End Results program data (1986-2008), we calculated incidence rate ratios and 95% confidence intervals to compare pre- and postfortification cancer incidence rates in children aged 0 to 4 years. Incidence trends were also evaluated by using joinpoint and loess regression models. RESULTS From 1986 through 2008, 8829 children aged 0 to 4 years were diagnosed with malignancies, including 3790 and 3299 in utero during the pre- and postfortification periods, respectively. Pre- and postfortification incidence rates were similar for all cancers combined and for most specific cancer types. Rates of Wilms tumor (WT), primitive neuroectodermal tumors (PNETs), and ependymomas were significantly lower postfortification. Joinpoint regression models detected increasing WT incidence from 1986 through 1997 followed by a sizable decline from 1997 through 2008, and increasing PNET incidence from 1986 through 1993 followed by a sharp decrease from 1993 through 2008. Loess curves indicated similar patterns. CONCLUSIONS These results provide support for a decrease in WT and possibly PNET incidence, but not other childhood cancers, after US folic acid fortification.
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Sam TN, Kersey JH, Linabery AM, Johnson KJ, Heerema NA, Hilden JM, Davies SM, Reaman GH, Ross JA. MLL gene rearrangements in infant leukemia vary with age at diagnosis and selected demographic factors: a Children's Oncology Group (COG) study. Pediatr Blood Cancer 2012; 58:836-9. [PMID: 21800415 PMCID: PMC3208122 DOI: 10.1002/pbc.23274] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 06/20/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Infant leukemias have a high frequency of mixed lineage leukemia (MLL) gene rearrangements. PROCEDURE Using data from a large etiologic study, we evaluated the distribution of selected demographic factors among 374 infant leukemia cases by leukemic subtype, MLL status and diagnosis age. RESULTS Overall, 228 cases were MLL+. Compared to white infants, black infants were significantly less likely to have MLL+ leukemia. Further, there was a statistically significantly higher age at diagnosis for infants with t(9;11) translocations compared to all other translocation partners in both acute lymphoblastic leukemia and acute myeloid leukemia cases. CONCLUSION These patterns may provide important etiological insight into the biology of infant leukemia.
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Johnson KJ, Blair CM, Fink JM, Cerhan JR, Roesler MA, Hirsch BA, Nguyen PL, Ross JA. Medical conditions and risk of adult myeloid leukemia. Cancer Causes Control 2012; 23:1083-9. [PMID: 22576581 DOI: 10.1007/s10552-012-9977-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 04/16/2012] [Indexed: 12/12/2022]
Abstract
PURPOSE Although a few previous studies have reported positive associations between adult myeloid leukemia and a history of certain medical conditions, the etiology of most cases remains largely unknown. Our purpose was to examine associations between certain medical conditions and adult myeloid leukemia. METHODS Using logistic regression, we evaluated associations between 16 self-reported medical conditions and myeloid leukemia in a case-control study of 670 cases [including 420 acute myeloid leukemia (AML) and 186 chronic myelogenous leukemia (CML)] and 701 population-based controls. RESULTS We observed significant positive associations between AML and ulcerative colitis (odds ratio (OR) = 3.8; 95 % confidence interval (CI), 1.1-13) and between CML and peptic ulcer (OR = 2.0; 95% CI, 1.1-3.8). A personal cancer history increased both AML (OR = 2.6; 95% CI, 1.7-3.9) and CML (OR = 3.5; 95% CI, 2.0-5.8) risk even after excluding individuals who reported prior radiation and/or chemotherapy treatment. CONCLUSION Certain inflammatory medical conditions and a personal history of cancer, independent from therapy, are associated with an increased risk of myeloid leukemia.
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Linabery AM, Johnson KJ, Ross JA. Abstract 629: Childhood cancer incidence trends in association with folic acid fortification in the United States (1986-2008). Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-629] [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
Folic acid plays a critical role in embryonic development and sufficient maternal prenatal folic acid consumption significantly reduces the incidence of congenital abnormalities in offspring. Epidemiological evidence supports the hypothesis that maternal prenatal folic acid supplementation lowers the risk of childhood cancer in offspring; however a systematic evaluation of population-based childhood cancer incidence trends following fortification of enriched grain products with folic acid in the U.S. in 1996-1998 has not been previously reported. Here we describe temporal trends in childhood cancer incidence in association with U.S. folic acid fortification. Using Surveillance, Epidemiology, and End Results program data (1986-2008) we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) to compare pre- and post-fortification incidence rates in children aged 0-4 years. Using joinpoint and loess regression models, we looked for inflection points during this period where the incidence trend changed in magnitude and/or direction. From 1986-2008, 8,829 children aged 0-4 years were diagnosed with malignancies, including 3,790 and 3,299 in utero during the pre- and post-fortification periods, respectively. Pre- and post-fortification incidence rates were similar for all cancers combined (IRR=1.01, 95% CI: 0.96-1.06) and for most specific cancer types examined. Rates of ependymomas (IRR=0.70, 95% CI: 0.51-0.97), primitive neuroectodermal tumors (PNETs) (IRR=0.56, 95% CI: 0.37-0.84) and Wilms tumor (WT) (IRR=0.80, 95% CI: 0.68-0.95) were significantly lower post-fortification. Notably, a greater reduction in post-fortification incidence was observed for the latter two subtypes upon restricting the analysis to infants, in whom any true effect of folic acid is expected to be greater. Joinpoint regression models detected increasing PNET incidence from 1986-1993 (annual percent change, APC=11.5, 95% CI: -5.0-31.0) followed by a sharp decrease from 1993-2008 (APC=−7.4%, 95% CI: -12.1- -2.4), and increasing WT incidence from 1986-1997 (APC=2.2, 95% CI: -1.2-5.8) followed by a sizable decline from 1997-2008 (APC=−4.0%, 95% CI: -7.3- -0.6). Loess curves indicated similar patterns. These results provide support for decreases in PNET and WT incidence, but not other childhood cancers, following U.S. folic acid fortification. Ten years of data are now available post-fortification and any substantial changes in childhood cancer rates attributable to fortification should be evident. Drawing firm conclusions regarding the isolated effects of folic acid is difficult, however, as other temporal trends occurred during the time period examined. Alternative study designs are required to rule out other explanations and confirm causal relationships. Supported by NIH Grants T32 CA099936 and K05 CA157439, and Children's Cancer Research Fund, Minneapolis, MN. A.M. Linabery and K.J. Johnson contributed equally to this work.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 629. doi:1538-7445.AM2012-629
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