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Jiang R, Shen J, Wang X, Chen S, Wu S, Cai H. Association between body mass index combined with high-sensitivity C-reactive protein and the risk of postmenopausal breast cancer: A prospective cohort study. Mol Clin Oncol 2024; 21:64. [PMID: 39071977 PMCID: PMC11273258 DOI: 10.3892/mco.2024.2762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/20/2024] [Indexed: 07/30/2024] Open
Abstract
The present study aimed to assess the risk of postmenopausal breast cancer in women based on a combination of body mass index (BMI) and high-sensitivity C-reactive protein (hs-CRP) levels. A total of 20,400 participants were investigated as part of the 'Kailuan Study' clinical trial. Participants were classified into four groups based on BMI (BMI ≥24 or <24 kg/m2) and hs-CRP level (hs-CRP ≥3 or <3 mg/l). Cox proportional hazards models were used to evaluate the association between the combination of BMI and hs-CRP and the risk of postmenopausal breast cancer. A total of 19,540 participants met the inclusion criteria. The median follow-up time was 14.97 years, with a cumulative follow-up period of 283,599.43 person-years. Among the participants, 269 individuals were diagnosed with postmenopausal breast cancer. Individuals with a high BMI (BMI ≥24 kg/m2) and a high hs-CRP level (hs-CRP ≥3 mg/) had a greater risk of postmenopausal breast cancer compared with individuals with a low BMI (BMI <24 kg/m2) and a low hs-CRP level (<3 mg/l) (hazard ratio, 1.75; 95% confidence interval, 1.25-2.47). The sensitivity analysis showed findings consistent with the primary results. In conclusion, the combination of high BMI and high hs-CRP level is associated with an increased risk of postmenopausal breast cancer. The present study is part of the Kailuan Study. Trial registration number: ChiCTRTNCR11001489 (Chinese Clinical Trial Registry, https://www.chictr.org.cn/showproj.html?proj=8050). Date of registration: 19/07/2015.
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Affiliation(s)
- Runxue Jiang
- Department of Oncology Surgery, Tangshan People's Hospital, Tangshan, Hebei 063000, P.R. China
| | - Jianglun Shen
- Department of Oncology Surgery, Tangshan People's Hospital, Tangshan, Hebei 063000, P.R. China
| | - Xia Wang
- Department of Gynaecology, Tangshan Hongci Hospital, Tangshan, Hebei 063000, P.R. China
| | - Shuohua Chen
- Health Department of Kailuan (Group), Kailuan General Hospital, Tangshan, Hebei 063000, P.R. China
| | - Shouling Wu
- Health Department of Kailuan (Group), Kailuan General Hospital, Tangshan, Hebei 063000, P.R. China
| | - Haifeng Cai
- Department of Oncology Surgery, Tangshan People's Hospital, Tangshan, Hebei 063000, P.R. China
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Perry AS, Farber-Eger E, Gonzales T, Tanaka T, Robbins JM, Murthy VL, Stolze LK, Zhao S, Huang S, Colangelo LA, Deng S, Hou L, Lloyd-Jones DM, Walker KA, Ferrucci L, Watts EL, Barber JL, Rao P, Mi MY, Gabriel KP, Hornikel B, Sidney S, Houstis N, Lewis GD, Liu GY, Thyagarajan B, Khan SS, Choi B, Washko G, Kalhan R, Wareham N, Bouchard C, Sarzynski MA, Gerszten RE, Brage S, Wells QS, Nayor M, Shah RV. Proteomic analysis of cardiorespiratory fitness for prediction of mortality and multisystem disease risks. Nat Med 2024; 30:1711-1721. [PMID: 38834850 PMCID: PMC11186767 DOI: 10.1038/s41591-024-03039-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/30/2024] [Indexed: 06/06/2024]
Abstract
Despite the wide effects of cardiorespiratory fitness (CRF) on metabolic, cardiovascular, pulmonary and neurological health, challenges in the feasibility and reproducibility of CRF measurements have impeded its use for clinical decision-making. Here we link proteomic profiles to CRF in 14,145 individuals across four international cohorts with diverse CRF ascertainment methods to establish, validate and characterize a proteomic CRF score. In a cohort of around 22,000 individuals in the UK Biobank, a proteomic CRF score was associated with a reduced risk of all-cause mortality (unadjusted hazard ratio 0.50 (95% confidence interval 0.48-0.52) per 1 s.d. increase). The proteomic CRF score was also associated with multisystem disease risk and provided risk reclassification and discrimination beyond clinical risk factors, as well as modulating high polygenic risk of certain diseases. Finally, we observed dynamicity of the proteomic CRF score in individuals who undertook a 20-week exercise training program and an association of the score with the degree of the effect of training on CRF, suggesting potential use of the score for personalization of exercise recommendations. These results indicate that population-based proteomics provides biologically relevant molecular readouts of CRF that are additive to genetic risk, potentially modifiable and clinically translatable.
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Affiliation(s)
- Andrew S Perry
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Eric Farber-Eger
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Tomas Gonzales
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Toshiko Tanaka
- Longtidudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Jeremy M Robbins
- Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Lindsey K Stolze
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shilin Zhao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shi Huang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Laura A Colangelo
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Shuliang Deng
- Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Keenan A Walker
- Multimodal Imaging of Neurodegenerative Disease (MIND) Unit, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longtidudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Eleanor L Watts
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Jacob L Barber
- Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Prashant Rao
- Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Michael Y Mi
- Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bjoern Hornikel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Nicholas Houstis
- Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| | - Gregory D Lewis
- Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| | - Gabrielle Y Liu
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of California Davis, Sacramento, CA, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minnesota, MN, USA
| | - Sadiya S Khan
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bina Choi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - George Washko
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ravi Kalhan
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Claude Bouchard
- Human Genomic Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Mark A Sarzynski
- Department of Exercise Science, University of South Carolina Columbia, Columbia, SC, USA
| | - Robert E Gerszten
- Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Quinn S Wells
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Matthew Nayor
- Sections of Cardiovascular Medicine and Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Ravi V Shah
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
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3
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Jiang R, Wang X, Sun Z, Wu S, Chen S, Cai H. Association of education level with the risk of female breast cancer: a prospective cohort study. BMC Womens Health 2023; 23:91. [PMID: 36882777 PMCID: PMC9993575 DOI: 10.1186/s12905-023-02245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/24/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Breast cancer is a serious threat to female health, and its incidence varies with education level (EL). In the present study, the association between EL and the risk of developing female breast cancer was investigated. METHODS From May 2006 to December 2007, 20,400 observation subjects in Kailuan Cohort received questionnaires and were subjected to clinical examinations for data collection on baseline population characteristics, height, weight, lifestyle and past disease history. Then, these participants were followed up with from the date of recruitment to December 31, 2019. Cox proportional risk regression models were used to analyse the association between EL and the risk of developing female breast cancer. RESULTS The cumulative follow-up period of 20,129 observation subjects that meet the inclusion criteria of this study was 254,386.72 person-years, and the median follow-up time was 12.96 years. During the follow-up period, 279 cases of breast cancer were diagnosed. In comparison with the low EL group, the risk of developing breast cancer was significantly higher in the medium (hazard ratio [HR] (95% confidence interval [CI]) = 2.23 (1.12-4.64)] and high [HRs (95% CI) = 2.52 (1.12-5.70)] EL group. CONCLUSION An increased risk of breast cancer was associated with a higher EL, and some certain factors, such as alcohol use and hormone therapy, may play a mediating role.
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Affiliation(s)
- Runxue Jiang
- Department of Oncology Surgery, Tangshan People's Hospital, Tangshan, 063000, China
| | - Xia Wang
- Department of Gynaecology, Tangshan Hongci Hospital, Tangshan, 063000, China
| | - Zhiguo Sun
- Department of Oncology Surgery, Tangshan People's Hospital, Tangshan, 063000, China
| | - Shouling Wu
- Health Department of Kailuan(Group), Tangshan, 063000, China
| | - Shuohua Chen
- Health Department of Kailuan(Group), Tangshan, 063000, China
| | - Haifeng Cai
- Department of Oncology Surgery, Tangshan People's Hospital, Tangshan, 063000, China.
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Byrne S, Boyle T, Ahmed M, Lee SH, Benyamin B, Hyppönen E. Lifestyle, genetic risk and incidence of cancer: a prospective cohort study of 13 cancer types. Int J Epidemiol 2023:6990971. [PMID: 36651198 DOI: 10.1093/ije/dyac238] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/20/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Genetic and lifestyle factors are associated with cancer risk. We investigated the benefits of adhering to lifestyle advice by the World Cancer Research Fund (WCRF) with the risk of 13 types of cancer and whether these associations differ according to genetic risk using data from the UK Biobank. METHODS In 2006-2010, participants aged 37-73 years had their lifestyle assessed and were followed up for incident cancers until 2015-2019. Analyses were restricted to those of White European ancestry with no prior history of malignant cancer (n = 195 822). Polygenic risk scores (PRSs) were computed for 13 cancer types and these cancers combined ('overall cancer'), and a lifestyle index was calculated from WCRF recommendations. Associations with cancer incidence were estimated using Cox regression, adjusting for relevant confounders. Additive and multiplicative interactions between lifestyle index and PRSs were assessed. RESULTS There were 15 240 incident cancers during the 1 926 987 person-years of follow-up (median follow-up = 10.2 years). After adjusting for confounders, the lifestyle index was associated with a lower risk of overall cancer [hazard ratio per standard deviation increase (95% CI) = 0.89 (0.87, 0.90)] and of eight specific cancer types. There was no evidence of interactions on the multiplicative scale. There was evidence of additive interactions in risks for colorectal, breast, pancreatic, lung and bladder cancers, such that the recommended lifestyle was associated with greater change in absolute risk for persons at higher genetic risk (P < 0.0003 for all). CONCLUSIONS The recommended lifestyle has beneficial associations with most cancers. In terms of absolute risk, the protective association is greater for higher genetic risk groups for some cancers. These findings have important implications for persons most genetically predisposed to those cancers and for targeted strategies for cancer prevention.
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Affiliation(s)
- Stephanie Byrne
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Muktar Ahmed
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
- Department of Epidemiology, Faculty of Public Health, Jimma University Institute of Health, Jimma, Ethiopia
| | - Sang Hong Lee
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Beben Benyamin
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Elina Hyppönen
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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5
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Lima SM, Nazareth M, Schmitt KM, Reyes A, Fleck E, Schwartz GK, Terry MB, Hillyer GC. Interest in genetic testing and risk-reducing behavioral changes: results from a community health assessment in New York City. J Community Genet 2022; 13:605-617. [PMID: 36227532 DOI: 10.1007/s12687-022-00610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 09/29/2022] [Indexed: 11/25/2022] Open
Abstract
Risk-based genetic tests are often used to determine cancer risk, when to initiate screening, and frequency of screening, but rely on interest in genetic testing. We examined overall interest in genetic testing for cancer risk assessment and willingness to change behavior, and whether these are affected by demographic or socioeconomic factors.We conducted a community needs health survey in 2019 among primary care and cancer patients, family members and community members in New York City. We used univariable analysis and relative risk regression to examine interest in genetic cancer risk testing and willingness to modify lifestyle behaviors in response to an informative genetic test.Of the 1225 participants, 74.0% (n = 906) expressed interest in having a genetic test to assess cancer risk. Interest in genetic testing was high across all demographic and socioeconomic groups; reported interest in genetic testing by group ranged from 65.0 (participants aged 65 years and older) to 83.6% (participants below federal poverty level). Among the 906 participants that reported interest in genetic testing, 79.6% were willing to change eating habits, 66.5% to change exercise habits, and 49.5% to lose weight in response to an informative genetic test result.Our study reveals that interest in genetic testing for cancer risk is high among patients and community members and is high across demographic and socioeconomic groups, as is the reported willingness to change behavior. Based on these results, we recommend that population-based genetic testing may result in greater reduction cancer risk, particularly among minoritized groups.
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Affiliation(s)
- Sarah M Lima
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY, USA
| | - Meaghan Nazareth
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY, USA
| | - Karen M Schmitt
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
- Division of Community and Population Health, New York Presbyterian Hospital, New York, NY, USA
| | - Andria Reyes
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Elaine Fleck
- Division of Community and Population Health, New York Presbyterian Hospital, New York, NY, USA
| | - Gary K Schwartz
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
- Department of Hematology and Oncology, Columbia University Irving Medical Center, New York, NY, USA
| | - Mary Beth Terry
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Grace C Hillyer
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY, USA.
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.
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6
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Fakhri N, Chad MA, Lahkim M, Houari A, Dehbi H, Belmouden A, El Kadmiri N. Risk factors for breast cancer in women: an update review. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2022; 39:197. [PMID: 36071255 DOI: 10.1007/s12032-022-01804-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/18/2022] [Indexed: 10/14/2022]
Abstract
Breast Cancer remains, according to the World Health Organization, the most complex disease cancer in 2021 in the world and the most common cause of death among women. Based on unequivocal scientific data, the establishment of an operative program for prevention could save lives of millions women suffering from breast cancer. In this update review, we highlight the major risk factors related to breast cancer investigated in women over the last 5 years. Thus, we clarify the involvement of these risk factors in the occurrence and growth of breast cancer. Investigations of 15 studies (n = 1,254,418; six case-control studies, five cohort studies, three prospective studies, and one meta-analysis) revealed that age, family history, obesity, use of oral contraceptives, status menopausal, smoking, alcohol consumption, lifestyle, and genetics factors are significantly linked to breast cancer. Additional studies are needed to corroborate these outcomes and initiate new practices aimed at preventing breast cancer.
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Affiliation(s)
- Nada Fakhri
- Molecular Engineering, Biotechnology and Innovation Team, Geo-Bio -Environment Engineering and Innovation Laboratory, Polydisciplinary Faculty of Taroudant, IBN ZOHR University, Hay El Mohammadi (Lastah) B.P: 271, 83000, Taroudannt City, Morocco
| | - Mohamed Amine Chad
- Molecular Engineering, Biotechnology and Innovation Team, Geo-Bio -Environment Engineering and Innovation Laboratory, Polydisciplinary Faculty of Taroudant, IBN ZOHR University, Hay El Mohammadi (Lastah) B.P: 271, 83000, Taroudannt City, Morocco.,Regional Oncology Center, Souss Massa Region, Agadir city, Morocco
| | - Mohamed Lahkim
- Molecular Engineering, Biotechnology and Innovation Team, Geo-Bio -Environment Engineering and Innovation Laboratory, Polydisciplinary Faculty of Taroudant, IBN ZOHR University, Hay El Mohammadi (Lastah) B.P: 271, 83000, Taroudannt City, Morocco.,Military Hospital of Rabat, Rabat City, Morocco
| | - Abdellah Houari
- Molecular Engineering, Biotechnology and Innovation Team, Geo-Bio -Environment Engineering and Innovation Laboratory, Polydisciplinary Faculty of Taroudant, IBN ZOHR University, Hay El Mohammadi (Lastah) B.P: 271, 83000, Taroudannt City, Morocco
| | - Hind Dehbi
- Medical Genetics Laboratory, Ibn Rochd University Hospital of Casablanca, Casablanca City, Morocco.,Laboratory of Cellular and Molecular Pathologies, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca City, Morocco
| | - Ahmed Belmouden
- Laboratory of Cellular Biology and Molecular Genetics, Faculty of Sciences, IBN ZOHR University, Agadir City, Morocco
| | - Nadia El Kadmiri
- Molecular Engineering, Biotechnology and Innovation Team, Geo-Bio -Environment Engineering and Innovation Laboratory, Polydisciplinary Faculty of Taroudant, IBN ZOHR University, Hay El Mohammadi (Lastah) B.P: 271, 83000, Taroudannt City, Morocco.
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7
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Sebastian AT, Rajkumar E, John R, Daniel M, George AJ, Greeshma R, James T. Emotional Self-Care: Exploring the Influencing Factors Among Individuals With Cancer. Front Psychol 2022; 13:898345. [PMID: 35734454 PMCID: PMC9207817 DOI: 10.3389/fpsyg.2022.898345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Cancer is a leading source of distress and fatality worldwide. Cancer-related aberrant cell proliferation causes excruciating pain and impairment. To cope with pain and manage symptoms and illness, pharmaceutical and non-pharmacological options are available. Self-care behaviors are recognized as a key source in symptom management and improving quality adherence to treatment among the current non-pharmacological strategies. The intervention measures to improve self-care were hardly impacted because of the narrow focus on physical self-care. Bringing in emotional self-care and addressing the individual's emotional health can enhance the effectiveness of interventions on a holistic level. Hence, this study has attempted to explore the factors that influence emotional self-care among individuals with cancer. Following an exploratory research design, the data were collected from 15 participants (4 men and 11 women) using purposive sampling and semi-structured interviews. Through thematic analysis, eight major themes were identified: physiological factors, social factors, family factors, psychological factors, individual factors, socioeconomic factors, cultural factors, and spiritual factors. The findings explained the emotional self-care among patients with cancer and how different identified factors influence their emotional self-care practices.
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Affiliation(s)
| | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Gulbarga, India
- *Correspondence: Eslavath Rajkumar
| | - Romate John
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | - Monica Daniel
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | - Allen Joshua George
- Humanities and Applied Sciences, Indian Institute of Management Ranchi, Ranchi, India
| | - Rajgopal Greeshma
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | - Treasa James
- Department of Medicine, KMCT Medical College, Kozhikode, India
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Liu H, Wang Z, Zou L, Gu S, Zhang M, Hukportie DN, Zheng J, Zhou R, Yuan Z, Wu K, Huang Z, Zhong Q, Huang Y, Wu X. Favourable Lifestyle Protects Cognitive Function in Older Adults With High Genetic Risk of Obesity: A Prospective Cohort Study. Front Mol Neurosci 2022; 15:808209. [PMID: 35677584 PMCID: PMC9169719 DOI: 10.3389/fnmol.2022.808209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
The relationship between body mass index (BMI) and cognitive impairment remains controversial, especially in older people. This study aims to confirm the association of phenotypic and genetic obesity with cognitive impairment and the benefits of adhering to a healthy lifestyle. This prospective study included 10,798 participants (aged ≥ 50 years) with normal cognitive function from the Health and Retirement Study in the United States. Participants were divided into low (lowest quintile), intermediate (quintiles 2–4), and high (highest quintile) groups according to their polygenic risk score (PRS) for BMI. The risk of cognitive impairment was estimated using Cox proportional hazard models. Higher PRS for BMI was associated with an increased risk, whereas phenotypic obesity was related to a decreased risk of cognitive impairment. Never smoking, moderate drinking, and active physical activity were considered favourable and associated with a lower risk of cognitive impairment compared with current smoking, never drinking, and inactive, respectively. A favourable lifestyle was associated with a low risk of cognitive impairment, even in subjects with low BMI and high PRS for BMI. This study suggest that regardless of obesity status, including phenotypic and genetic, adhering to a favourable lifestyle is beneficial to cognitive function.
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Affiliation(s)
- Huamin Liu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhenghe Wang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Lianwu Zou
- Baiyun Jingkang Hospital, Guangzhou, China
| | | | - Minyi Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Daniel Nyarko Hukportie
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jiazhen Zheng
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Rui Zhou
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zelin Yuan
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Keyi Wu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhiwei Huang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qi Zhong
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yining Huang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xianbo Wu
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- *Correspondence: Xianbo Wu,
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9
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Yang PJ, Hou MF, Ou-Yang F, Tsai EM, Wang TN. Association of early-onset breast cancer with body mass index, menarche, and menopause in Taiwan. BMC Cancer 2022; 22:259. [PMID: 35277131 PMCID: PMC8917681 DOI: 10.1186/s12885-022-09361-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/28/2022] [Indexed: 12/20/2022] Open
Abstract
Background The trend of women suffering from early-onset breast cancer is increasing in Taiwan. The association of early-onset breast cancer with body mass index (BMI), menarche, and menopausal status has focused interest on the field of cancer epidemiology; however, few studies have explored the interaction of these factors on early-onset risk. This study aimed to estimate the interaction effects of BMI, menarche, and menopausal status on 40-year-old early-onset breast cancer. Methods Breast cancer patients were recruited from Kaohsiung Medical University Chung-Ho Memorial Hospital from 2013 to 2020. Multivariable logistic regression was used to estimate odds ratios (ORs) for early-onset breast cancer risk associated with menarcheal age stratified by sociodemographic factors and for the interaction between BMI and menopausal status on early-onset risk. Results A total of 775 participants were divided into 131 early-onset cases (≤ 40 years) and 644 late-onset cases (> 40 years). Compared to the age of 13 years at menarche, the age ≤ 11 years was significantly positively associated (OR: 2.62, 95% CI: 1.38–4.97) and ≥ 16 years was negatively associated (OR: 0.13, 95% CI: 0.03–0.53) with 40-year-old early-onset breast cancer respectively. In an adjusted model, the status of BMI < 24 and premenopause had 1.76- and 4.59-fold risk of early-onset breast cancer respectively. Especially in BMI < 24 status, premenopause also had a 6.47-fold early-onset risk and the early-onset risk increased by a significant amount per one year younger at menarche (aOR: 1.26, 95% CI: 1.03–1.55). There was also a positive interaction effect on an additive scale between BMI and menopausal status on early-onset breast cancer (RERIOR = 4.62, Pinteraction = 0.057). Compared to both BMI ≥ 24 and peri-/postmenopausal status, both the status of BMI < 24 and premenopause were associated with early-onset breast cancer (aOR: 7.16, 95% CI: 3.87–13.25). Conclusions This study suggests that the status of BMI < 24 and premenopause were associated with an increased risk of early-onset breast cancer and there was a positive interaction on an additive scale. Understanding how obesity and menopausal status affect early-onset breast cancer is important for drafting preventive measures for early-onset breast cancer in Taiwan.
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Peila R, Arthur RS, Dannenberg AJ, Rohan TE. Association of a Healthy Lifestyle Index with Risk of Breast Cancer among Women with Normal Body Mass Index in the UK Biobank. Cancer Epidemiol Biomarkers Prev 2022; 31:554-560. [PMID: 34933955 DOI: 10.1158/1055-9965.epi-21-0765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/01/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND A high healthy lifestyle index (HLI), a composite score based on good diet quality, low alcohol consumption, no smoking, moderate to high physical activity, and waist circumference <80 cm, has been consistently associated with a reduced risk of breast cancer. Recently, high levels of body fat were found to be associated with an elevated risk of breast cancer in postmenopausal women with a normal body mass index (BMI; 18.5-<25 kg/m2). Whether the HLI is associated with breast cancer risk in women with normal BMI is unknown. METHODS We studied 102,572 women aged 40 to 69 years with a normal BMI at enrollment into the UK Biobank cohort study. The HLI was created by assigning to each component higher scores for healthier behaviors and then summing the scores. The HLI was categorized by tertiles and age- and multivariable-adjusted HRs for the association of the HLI with breast cancer risk by menopausal status were estimated using Cox proportional hazards models. RESULTS In postmenopausal women, compared with a low HLI, higher scores were associated with a reduced risk of breast cancer [HRHLI-3rd tertile = 0.76; 95% confidence interval (CI), 0.64-0.91]. Findings were similar for premenopausal women, although they did not reach statistical significance, except when smoking status was excluded from the HLI score (HLIwithout smoking: HR3rd tertile = 0.71; 95% CI, 0.56-0.90). CONCLUSIONS In normal BMI postmenopausal women, a high HLI score was associated with a reduced risk of breast cancer. IMPACT Following a healthy lifestyle may reduce the risk of breast cancer among normal weight postmenopausal women.
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Affiliation(s)
- Rita Peila
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York
| | - Rhonda S Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York
| | - Andrew J Dannenberg
- Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York
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11
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Hassanin E, May P, Aldisi R, Spier I, Forstner AJ, Nöthen MM, Aretz S, Krawitz P, Bobbili DR, Maj C. Breast and prostate cancer risk: The interplay of polygenic risk, rare pathogenic germline variants, and family history. Genet Med 2022; 24:576-585. [PMID: 34906469 DOI: 10.1016/j.gim.2021.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/12/2021] [Accepted: 11/12/2021] [Indexed: 12/22/2022] Open
Abstract
PURPOSE We aimed to investigate to what extent polygenic risk scores (PRS), rare pathogenic germline variants (PVs), and family history jointly influence breast cancer and prostate cancer risk. METHODS A total of 200,643 individuals from the UK Biobank were categorized as follows: (1) heterozygotes or nonheterozygotes for PVs in moderate to high-risk cancer genes, (2) PRS strata, and (3) with or without a family history of cancer. Multivariable logistic regression and Cox proportional hazards models were used to compute the odds ratio across groups and the cumulative incidence through life. RESULTS Cumulative incidence by age 70 years among the nonheterozygotes across PRS strata ranged from 9% to 32% and from 9% to 35% for breast cancer and prostate cancer, respectively. Among the PV heterozygotes it ranged from 20% to 48% in moderate-risk genes and from 51% to 74% in high-risk genes for breast cancer, and it ranged from 30% to 59% in prostate cancer risk genes. Family history was always associated with an increased cancer odds ratio. CONCLUSION PRS alone provides a meaningful risk gradient leading to a cancer risk stratification comparable to PVs in moderate risk genes, whereas acts as a risk modifier when considering high-risk genes. Including family history along with PV and PRS further improves cancer risk stratification.
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Affiliation(s)
- Emadeldin Hassanin
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Patrick May
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Rana Aldisi
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Isabel Spier
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany; National Center for Hereditary Tumor Syndromes, University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany; Centre for Human Genetics, Philipps-University Marburg, Marburg, Germany; Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Stefan Aretz
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany; National Center for Hereditary Tumor Syndromes, University Hospital Bonn, Bonn, Germany
| | - Peter Krawitz
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Dheeraj Reddy Bobbili
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Carlo Maj
- Institute for Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany.
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Huang KL, Liu YL, Hsu YY, Kuo WL. Retrospective Analysis of Clinicopathological Features and Familial Cancer History of Synchronous Bilateral Breast Cancer. Healthcare (Basel) 2021; 9:healthcare9091203. [PMID: 34574977 PMCID: PMC8470905 DOI: 10.3390/healthcare9091203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/20/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022] Open
Abstract
Bilateral breast cancer is a strong predictor of BRCA 1/2 mutation and hence one criterion indicated for hereditary genetic testing. The purpose of this study is to assess the characteristics of synchronous bilateral breast cancer (SBBC) and its association with personal and familial cancer traits. Patients diagnosed with SBBC in our institute between 1992 and 2018 were retrospectively reviewed, and the information of clinicopathological features, personal and family cancer history were analyzed. Of the 307 SBBCs enrolled, the growing case number generally aligned with the regional breast cancer incidence after the era of population-based mammography screening. SBBC patients had similar cancer stages but worse survival outcomes than those in the standard scenario. A total of 42.0% had mixed pathological diagnoses, and 22.8% had discordant immunohistochemistry (IHC) subtypes from both sides, which contributed to treatment challenges. The correlation of SBBC with hereditary breast and ovarian cancer (HBOC) syndrome was strongly implied, as 20.7% of our SBBC patients with known familial cancer histories had HOBC-related familial cancers (breast, ovarian, or prostate cancers). These findings highlight the need for genetic counseling and germline mutation testing in patients with SBBC. Early PARP inhibitor treatment should also be considered in high-risk cases for outcome improvement.
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Affiliation(s)
- Kai-Ling Huang
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou and Taipei Medical Center, Chang Gung Medical Foundation, Taoyuan 33305, Taiwan;
- Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Yu-Ling Liu
- Breast Surgery Division, General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou and Taipei Medical Center, Chang Gung Medical Foundation, Taipei 33305, Taiwan;
| | - Ya-Ying Hsu
- Chang Gung University, Taoyuan 33302, Taiwan;
| | - Wen-Ling Kuo
- Breast Surgery Division, General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou and Taipei Medical Center, Chang Gung Medical Foundation, Taipei 33305, Taiwan;
- Chang Gung University, Taoyuan 33302, Taiwan;
- Correspondence: ; Tel.: +886-3281200 (ext. 3636)
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Changes of intestinal microflora of breast cancer in premenopausal women. Eur J Clin Microbiol Infect Dis 2020; 40:503-513. [PMID: 32936397 DOI: 10.1007/s10096-020-04036-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022]
Abstract
Breast cancer is one of the most common malignant tumors in women. More than half of breast cancer patients are not menopausal at the time of diagnosis. The occurrence and development of premenopausal breast cancer are affected by many factors. Intestinal flora, especially SCFA-producing bacteria, participates in the development of various tumors, and there is a lack of in-depth research in premenopausal breast cancer patients. We used 16S rRNA gene sequencing, targeted metabolomics, and cell culture methods to analyze the changes in the intestinal flora and metabolites of premenopausal breast cancer patients. In addition, we treated breast cancer cells with significantly altered propionate and butyrate in vitro to examine their effects on cell activity. This study followed STROBE guidelines. We found that compared with healthy premenopausal women, the composition and symbiosis of intestinal flora in patients with premenopausal breast cancer changed significantly. The abundance of short-chain fatty acid (SCFA)-producing bacteria was significantly reduced, and the key SCFA-producing enzymes were also significantly reduced. Pediococcus and Desulfovibrio could distinguish premenopausal breast cancer patients from normal premenopausal women. The related propionate and butyrate had a certain ability to inhibit breast cancer cell viability in vitro. As SCFA-producing bacteria, Pediococcus and Desulfovibrio showed potential reference value for the diagnosis of premenopausal breast cancer. The ability of propionate and butyrate to inhibit breast cancer cell lines in vitro suggests that the relevant SCFA receptor may be a new target for the treatment of premenopausal breast cancer.
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