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Kanadys W, Barańska A, Malm M, Błaszczuk A, Polz-Dacewicz M, Janiszewska M, Jędrych M. Use of Oral Contraceptives as a Potential Risk Factor for Breast Cancer: A Systematic Review and Meta-Analysis of Case-Control Studies Up to 2010. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4638. [PMID: 33925599 PMCID: PMC8123798 DOI: 10.3390/ijerph18094638] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 01/11/2023]
Abstract
Despite numerous studies evaluating the risk of breast cancer among oral contraception users, the effect of oral contraceptive on developing breast cancer remains inconclusive. Therefore, we conducted a systematic review of literature with meta-analysis in order to quantitative estimate this association. The bibliographic database MEDLINE and EMBASE, and reference lists of identified articles were searched, with no language restrictions, from the start of publication to August 2010. We performed a reanalysis and overall estimate of 79 case-control studies conducted between 1960-2010, including a total of 72,030 incidents, histologically confirmed cases of breast cancer and 123,650 population/hospital controls. A decrease was observed in cancer risk in OC users before age 25 years (0.91, 0.83-1.00). However, the use of OCs before the first full-term pregnancy had a significant increased risk of breast cancer (OR, 1.14, 1.01-1.28, p = 0.04), as did OC use longer than 5 years (1.09, 1.01-1.18, p = 0.02). Pooled crude odds ratios of breast cancer in ever-users of oral contraceptives was 1.01 [95% confidence interval (CI), 0.95-1.07], compared with never-users. There was no significant increase in risk among premenopausal women (1.06, 0.92-1.22), postmenopausal women (0.99, 0.89-1.10), or nulliparous women (1.02, 0.82-1.26). Oral contraceptives do not appear to increase the risk of breast cancer among users. However, OC use before a first full-term pregnancy or using them longer than 5 years can modify the development of the breast cancer.
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Affiliation(s)
- Wiesław Kanadys
- Specialistic Medical Center “Czechów” in Lublin, 20-848 Lublin, Poland;
| | - Agnieszka Barańska
- Department of Medical Informatics and Statistics with E-learning Lab, Medical University, 20-090 Lublin, Poland; (A.B.); (M.J.); (M.J.)
| | - Maria Malm
- Department of Medical Informatics and Statistics with E-learning Lab, Medical University, 20-090 Lublin, Poland; (A.B.); (M.J.); (M.J.)
| | - Agata Błaszczuk
- Department of Virology with SARS Laboratory, Medical University, 20-093 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Małgorzata Polz-Dacewicz
- Department of Virology with SARS Laboratory, Medical University, 20-093 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Mariola Janiszewska
- Department of Medical Informatics and Statistics with E-learning Lab, Medical University, 20-090 Lublin, Poland; (A.B.); (M.J.); (M.J.)
| | - Marian Jędrych
- Department of Medical Informatics and Statistics with E-learning Lab, Medical University, 20-090 Lublin, Poland; (A.B.); (M.J.); (M.J.)
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Brenner DR, Ruan Y, Shaw E, O'Sullivan D, Poirier AE, Heer E, Villeneuve PJ, Walter SD, Friedenreich CM, Smith L, De P. Age-standardized cancer-incidence trends in Canada, 1971-2015. CMAJ 2020; 191:E1262-E1273. [PMID: 31740536 DOI: 10.1503/cmaj.190355] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2019] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Although cancer incidence over time is well documented in Canada, trends by birth cohort and age group are less well known. We analyzed age- and sex-standardized incidence trends in Canada for 16 major cancer sites and all cancers combined. METHODS We obtained nationally representative population-based cancer incidence data in Canada between 1971 and 2015 from the National Cancer Incidence Reporting System (1969-1992) and the Canadian Cancer Registry (1992-2015). We analyzed cancer-incidence trends, reported as annual percent change (APC) for each 10-year group from age 20 to 89 years. We also estimated age-adjusted incidence rate ratios from fitted birth cohort models. RESULTS Across most age categories, the most recent trends show significant decreases in the incidence of cervical (APC -8.8% to -0.33%), lung (men: -7.42% to -0.36%; women: -6.27% to 1.07%), bladder (women: -4.12% to -0.07%; men: -5.13% to -0.38%) and prostate cancer (-11.11% to -1.11%). Significant increasing trends were observed for kidney, thyroid and uterine cancers. Overall incidence has increased among both sexes younger than 50 years of age, with recent increases in pancreatic cancer among men, breast cancer among women and colorectal cancer among both sexes. From the birth cohort analysis, we observed increasing trends in colorectal, liver and prostate cancers among men; kidney cancer and melanoma among women; and thyroid cancer among both sexes. We observed decreasing trends in cervical and ovarian cancers, and in bladder and lung cancers among men. INTERPRETATION Cancer incidence is decreasing at many sites targeted by primary-prevention efforts, such as smoking cessation and screening programs. Substantial increases in incidence among younger populations are driven by cancers possibly associated with obesity.
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Affiliation(s)
- Darren R Brenner
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont.
| | - Yibing Ruan
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Eileen Shaw
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Dylan O'Sullivan
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Abbey E Poirier
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Emily Heer
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Paul J Villeneuve
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Stephen D Walter
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Christine M Friedenreich
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Leah Smith
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Prithwish De
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
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Harnod T, Tsai IJ, Chen W, Wang JH, Lin SZ, Sung FC, Ding DC. Hysterectomy and unilateral salpingectomy associate with a higher risk of subsequent ovarian cancer: A population-based cohort study in Taiwan. Medicine (Baltimore) 2019; 98:e18058. [PMID: 31770221 PMCID: PMC6890306 DOI: 10.1097/md.0000000000018058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Studies on the relationship between gynecologic surgery and subsequent ovarian cancer have been carried out in limited Western ethnic groups. We aim to evaluate whether receiving hysterectomy and/or salpingectomy associated with ovarian cancer risk in Taiwan.From the Taiwan National Health Insurance Research Database, we identified a gynecologic surgery cohort consisting of women who had newly received hysterectomy (N = 181,151), salpingectomy (N = 45,410) or both hysterectomy and salpingectomy (N = 11,875) in 2000 to 2013. A comparison cohort of 953,744 women was randomly selected from women without the surgeries, frequency-matched by age and index date of the surgery case. They were followed up to identify subsequent ovarian cancer by the end of 2013.The overall ovarian cancer incidence was 4.4-fold greater in the gynecologic surgery cohort than in the comparison cohort (41.5 vs 9.43 per 10 person-years) with an adjusted hazard ratio of 3.86 (95% confidence interval = 2.56-5.84). Women with both hysterectomy and salpingectomy had the highest incidence and followed by women with hysterectomy or salpingectomy (52.5, 45.5, or 23.3 per 10 person-years, respectively). No ovarian cancer was noted in the subgroup with bilateral salpingectomies.We conclude that women with gynecologic surgery of hysterectomy and/or salpingectomy are at an increased risk of developing ovarian cancer, particularly among women who have had other gynecologic comorbidity. Women with gynecologic surgery and comorbidity deserve greater attention to prevent and screen for ovarian cancer.
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Affiliation(s)
- Tomor Harnod
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University, Taichung
| | - Weishan Chen
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University, Taichung
| | - Jen-Hung Wang
- Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien
| | - Shinn-Zong Lin
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital
- Department of Health Services Administration, China Medical University College of Public Health, Taichung
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
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Parity, Age at First Birth, and Risk of Death from Bladder Cancer: A Population-Based Cohort Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121197. [PMID: 27918463 PMCID: PMC5201338 DOI: 10.3390/ijerph13121197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/23/2016] [Accepted: 11/23/2016] [Indexed: 11/30/2022]
Abstract
The evidence is limited on the relationship between reproductive factors and bladder cancer (BC). We studied 1,292,462 women who had a first and singleton delivery between 1 January 1978 and 31 December 1987. Each woman in the study cohort was tracked from their first childbirth to 31 December 2009. Vital status of the women was determined by crosswalking records with a computerized mortality database. We used Cox proportional hazard regression models to estimate the hazard ratios (HRs) of death from BC associated with maternal age at first birth and parity. The data showed 63 BC deaths during 34,980,246 person-years of follow-up. BC mortality rate was 0.90 cases for every 100,000 person-years. Compared with women who gave birth under the age of 23, the adjusted HR was 1.24 (95% confidence interval (CI) = 0.66–2.35) for women who gave birth between age 23 and 26 and 2.30 (95% CI = 1.21–4.39) for women who gave birth over the age of 26. Increasing age at first birth (p for trend = 0.01) is associated with a trend in increasing risk of BC mortality. Relative to women who had a single childbirth, the adjusted HRs were 1.17 (95% CI = 0.51–2.69) for women who gave birth to two children, and 1.31 (95% CI = 0.56–3.10) for women with three or more childbirths, respectively. These results were not statistically significant. Study results suggests that giving birth at an early age may confer a protective effect on the risk of death from BC.
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Yu FS, Yu CS, Chen JC, Yang JL, Lu HF, Chang SJ, Lin MW, Chung JG. Tetrandrine induces apoptosis Via caspase-8, -9, and -3 and poly (ADP ribose) polymerase dependent pathways and autophagy through beclin-1/ LC3-I, II signaling pathways in human oral cancer HSC-3 cells. ENVIRONMENTAL TOXICOLOGY 2016; 31:395-406. [PMID: 25266202 DOI: 10.1002/tox.22053] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 09/05/2014] [Accepted: 09/10/2014] [Indexed: 06/03/2023]
Abstract
Tetrandrine is a bisbenzylisoquinoline alkaloid that was found in the Radix Stephania tetrandra S Moore. It had been reported to induce cytotoxic effects on many human cancer cells. In this study, we investigated the cytotoxic effects of tetrandrine on human oral cancer HSC-3 cells in vitro. Treatments of HSC-3 cells with tetrandrine significantly decreased the percentage of viable cells through the induction of autophagy and apoptosis and these effects are in concentration-dependent manner. To define the mechanism underlying the cytotoxic effects of tetrandrine, we investigated the critical molecular events known to regulate the apoptotic and autophagic machinery. Tetrandrine induced chromatin condensation, internucleosomal DNA fragmentation, activation of caspases-3, -8, and -9, and cleavage of poly (ADP ribose) polymerase (PARP) that were associated with apoptosis, and it also enhanced the expression of LC3-I and -II that were associated with the induction of autophagy in human squamous carcinoma cell line (HSC-3) cells. Tetrandrine induced autophagy in HSC-3 cells was significantly attenuated by bafilomycin A1 (inhibitor of autophagy) pre-treatment that confirmed tetrandrine induced cell death may be associated with the autophagy. In conclusion, we suggest that tetrandrine induced cell death may be through the induction of apoptosis as well as autophagy in human oral cancer HSC-3 cells via PARP, caspases/Becline I/LC3-I/II signaling pathways.
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Affiliation(s)
- Fu-Shun Yu
- Department of Dentist, China Medical University, Taichung, 404, Taiwan
| | - Chun-Shu Yu
- School of Pharmacy, China Medical University, Taichung, 404, Taiwan
| | - Jaw-Chyun Chen
- Department of Medicinal Botany and Health Applications, Da-Yeh University, Changhua, Taiwan
| | - Jiun-Long Yang
- Department of Chinese Medicine Resources, China Medical University, Taichung, 404, Taiwan
| | - Hsu-Feng Lu
- Clinical Pathology, Cheng Hsin General Hospital, Taipei, Taiwan
- School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Shu-Jen Chang
- School of Pharmacy, China Medical University, Taichung, 404, Taiwan
| | - Meng-Wei Lin
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan, Taiwan
| | - Jing-Gung Chung
- Department of Biological Science and Technology, China Medical University, Taichung, 404, Taiwan
- Department of Biotechnology, Asia University, Taichung, 413, Taiwan
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Parity, Age at First Birth, and Risk of Death from Non-Hodgkin's Lymphoma: A Population-Based Cohort Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:9131-40. [PMID: 26251917 PMCID: PMC4555269 DOI: 10.3390/ijerph120809131] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/27/2015] [Accepted: 07/29/2015] [Indexed: 11/16/2022]
Abstract
We undertook this study to examine whether there exists an association between parity and age at first birth and risk of death from non-Hodgkin’s lymphoma (NHL). Our sample included a total of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We followed each subject from their first childbirth to 31 December 2009, and determined their vital status by merging natality data with Taiwan’s national death certificate database. Hazard ratios (HR) of death from NHL associated with parity and age at first birth were estimated using Cox proportional hazard regression models. In all, 412 NHL deaths were recorded during 34,980,246 person-years of follow-up. NHL mortality rate was 1.18 cases per 100,000 person-years. Older age at first birth (>23 vs. ≤23 years) was linked to an increased risk of death from NHL (adjusted HR = 1.41; 95% CI = 1.13–1.75). Controlling for age at first birth, the adjusted HR were 0.74 (95% CI = 0.55–0.98) for women with 2 births, and 0.71 (95% CI = 0.53–0.95) for women with 3 births or more, respectively, when compared with women with only 1 birth. A statistically significant downward trend in the adjusted HR for NHL death was detected with increasing parity (p for trend = 0.05). The HR of death from NHL was decreased by 7% (HR = 0.93; 95% CI = 0.87–0.99) for each additional parity. Our findings are consistent with reproductive factors (parity and early age at first birth) conferring a protective effect against the risk of NHL death.
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Kim Y, Yoo KY, Goodman MT. Differences in Incidence, Mortality and Survival of Breast Cancer by Regions and Countries in Asia and Contributing Factors. Asian Pac J Cancer Prev 2015; 16:2857-70. [DOI: 10.7314/apjcp.2015.16.7.2857] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Chan TF, Wu CH, Chiu HF, Yang CY. Parity and risk of death from gallbladder cancer among a cohort of premenopausal parous women in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:1864-73. [PMID: 25664696 PMCID: PMC4344698 DOI: 10.3390/ijerph120201864] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 01/04/2015] [Accepted: 01/30/2015] [Indexed: 12/21/2022]
Abstract
Little epidemiologic research has been done on the etiology of gallbladder cancer (GC). This cohort study was undertaken to examine whether there is an association between parity and risk of death from GC. The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We tracked each woman from the time of their first childbirth to 31 December 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) of death from GC associated with parity. There were 257 GC deaths during 34,980,246 person-years of follow-up. The mortality rate of GC was 0.73 cases per 100,000 person-years. As compared with women who had given birth to only one child, the adjusted HR was 1.20 (95% CI = 0.79–1.83) for women who had two children, 1.47 (95% CI = 0.95–2.29) for women who had three children, and 1.68 (95% CI = 0.99–2.85) for women with four or more births. There was a significant increasing trend in the adjusted HRs for GC with increasing parity. The findings suggested that premenopausal women of higher parity may increase the risk of death from GC.
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Affiliation(s)
- Te-Fu Chan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih Chuan 1st RD, Kaohsiung 807, Taiwan.
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, 100 Shih‑Chuan 1st RD, Kaohsiung 807, Taiwan.
| | - Chen-Hsuan Wu
- Department of Obstetrics and Gynecology, Kaohsiung Chang-Gung Memorial Hospital, No.123, DA-PI Rd. Niaosng Dist., Kaohsiung 833, Taiwan.
- College of Medicine, Chang-Gung University, No.123, DA-PI Rd. Niaosng Dist., Kaohsiung 833, Taiwan.
| | - Hui-Fen Chiu
- Department of Pharmacology, College of Medicine, Kaohsiung Medical University, 100 Shih Chuan 1st RD, Kaohsiung 807, Taiwan.
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, 100 Shih Chuan 1st RD, Kaohsiung 807, Taiwan.
- Division of Environmental Health and Occupational Medicine, National Health Research Institute, 35 Keyan Road, Zhunan, Miaoli 350, Taiwan.
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Parity, age at first birth, and risk of death from asthma: evidence from a cohort in taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:6147-55. [PMID: 24921463 PMCID: PMC4078571 DOI: 10.3390/ijerph110606147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 05/30/2014] [Accepted: 06/03/2014] [Indexed: 11/20/2022]
Abstract
This study was undertaken to examine whether there is an association between age at first birth and parity and risk of asthma death. The study cohort consisted of 1,292,462 women in Taiwan who had a first live birth between 1 January 1978 and 31 December 1987. We tracked each woman from the date of their first childbirth to 31 December 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate hazard ratios of death from asthma associated with parity and age at first birth. A trend of increasing risk of asthma death was seen with increasing age at first birth. The adjusted hazard ratio was 0.75 (95% confidence interval (CI) = 0.53–1.08) among women with two live births and 0.53 (95% CI = 0.36–0.78) among those with three or more births, compared with women who had one live birth. There was a significant decreasing trend in adjusted hazard ratios of asthma death with increasing parity. This study is the first to provide evidences to support an association between reproductive factors (parity and early age at first birth) and the risk of asthma death.
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Anothaisintawee T, Wiratkapun C, Lerdsitthichai P, Kasamesup V, Wongwaisayawan S, Srinakarin J, Hirunpat S, Woodtichartpreecha P, Boonlikit S, Teerawattananon Y, Thakkinstian A. Risk factors of breast cancer: a systematic review and meta-analysis. Asia Pac J Public Health 2013; 25:368-87. [PMID: 23709491 DOI: 10.1177/1010539513488795] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The etiology of breast cancer might be explained by 2 mechanisms, namely, differentiation and proliferation of breast epithelial cells mediated by hormonal factors. We performed a systematic review and meta-analysis to update effects of risk factors for both mechanisms. MEDLINE and EMBASE were searched up to January 2011. Studies that assessed association between oral contraceptives (OC), hormonal replacement therapy (HRT), diabetes mellitus (DM), or breastfeeding and breast cancer were eligible. Relative risks with their confidence intervals (CIs) were extracted. A random-effects method was applied for pooling the effect size. The pooled odds ratios of OC, HRT, and DM were 1.10 (95% CI = 1.03-1.18), 1.23 (95% CI = 1.21-1.25), and 1.14 (95% CI = 1.09-1.19), respectively, whereas the pooled odds ratio of ever-breastfeeding was 0.72 (95% CI = 0.58-0.89). Our study suggests that OC, HRT, and DM might increase risks, whereas breastfeeding might lower risks of breast cancer.
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HUANG ANCHENG, LIEN JINCHERNG, LIN MENGWEI, YANG JAISING, WU PINGPING, CHANG SHUJEN, LAI TUNGYUAN. Tetrandrine induces cell death in SAS human oral cancer cells through caspase activation-dependent apoptosis and LC3-I and LC3-II activation-dependent autophagy. Int J Oncol 2013; 43:485-94. [DOI: 10.3892/ijo.2013.1952] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 04/08/2013] [Indexed: 11/05/2022] Open
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Chiu HF, Chen CC, Tsai SS, Ho SC, Yang CY. Parity, age at first birth, and risk of death from brain cancer: a population-based cohort study in Taiwan. BMC Public Health 2012; 12:857. [PMID: 23046716 PMCID: PMC3487843 DOI: 10.1186/1471-2458-12-857] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 10/02/2012] [Indexed: 11/10/2022] Open
Abstract
Background This study was undertaken to examine whether there is an association between parity and age at first birth and risk of death from brain cancer. Methods The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between Jan. 1, 1978 and Dec. 31, 1987. We tracked each woman from the time of their first childbirth to December 31, 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) of death from brain cancer associated with parity and age at first birth. Results There were 316 brain cancer deaths during 34,980,246 person-years of follow-up. The mortality rate of brain cancer was 0.90 cases per 100,000 person-years. The adjusted HR was 1.35 (95% CI= 0.91-2.01) for women who gave birth between 21 and 25, 1.61 (95% CI=1.05-2.45) for women who gave birth after 25 years of age, respectively, when compared with women who gave birth less than 20 years. A trend of increasing risk of brain cancer was seen with increasing age at first birth. The adjusted HR were 0.73 (95% CI= 0.53-0.99) for women who had 2 children, and 0.60 (95% CI =0.43-0.83) for women with 3 or more births, respectively, when compared with women who had given birth to only 1 child. There was a significant decreasing trend in the HRs of brain cancer with increasing parity. Conclusions This study provides evidence that reproductive factors (parity and early age at first birth) may confer a protective effect on the risk of death from brain cancer.
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Affiliation(s)
- Hui-Fen Chiu
- Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Kuo CH, Kuo CC, Wu HY, Wu DC, Yang CY. Higher parity and earlier age at first birth are associated with lower risk of death from colon cancer. Cancer Sci 2012; 103:1553-7. [PMID: 22594578 DOI: 10.1111/j.1349-7006.2012.02336.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 05/07/2012] [Accepted: 05/09/2012] [Indexed: 12/17/2022] Open
Abstract
This study was undertaken to examine whether there is an association between parity and age at first birth and risk of colon cancer. The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between 1978 and 1987. We tracked each woman from the time of their first childbirth to December 31, 2009, and their vital status was ascertained by linking records with the computerized mortality database. We used the Cox proportional hazards model with time-dependent covariates to estimate the hazard ratios (HR) of death from colon cancer associated with parity and age at first birth. We limited eligible colon cancer deaths to those who were 45 years old or more to exclude possible heredity colon cancer cases, which usually occur at an early age. There were 670 colon cancer deaths during 34,980,246 person-years of follow-up. The colon cancer death rate was 1.96 cases per 100,000 person-years. The adjusted HR was 2.76 (95% CI = 1.60-4.75) for women who gave birth between 20 and 24 years and 7.35 (95% CI = 4.28-12.62) for women who gave birth after 24 years of age when compared with women who gave birth at younger than 20 years. A rising risk of colon cancer was seen with increasing age at first birth. The adjusted HR were 0.81 (95% CI = 0.65-1.02) among women with two live births, 0.93 (95% CI = 0.74-1.18) among women with three live births and 0.72 (95% CI = 0.51-1.00) for women with four or more births when compared with women who had given birth to only one child. The present study provides evidence that reproductive factors (parity and early age at first birth) may confer a protective effect on the risk of colon cancer.
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Affiliation(s)
- Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Cheng MH, Tsai SS, Chen CC, Ho SC, Chiu HF, Wu TN, Yang CY. Parity and risk of death from lung cancer among a cohort of premenopausal parous women in Taiwan. J Epidemiol 2012; 22:364-9. [PMID: 22522149 PMCID: PMC3798656 DOI: 10.2188/jea.je20110123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background We examined the association between parity and risk of lung cancer. Methods The study cohort consisted of all women with a record of a first singleton birth in the Taiwanese Birth Register between 1978 and 1987. We tracked each woman from the time of their first childbirth to 31 December 2009. Follow-up was terminated when the mother died, when she reached age 50 years, or on 31 December 2009, whichever occurred first. The vital status of mothers was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) for death from lung cancer associated with parity. Results There were 1375 lung cancer deaths during 32 243 637.08 person-years of follow-up. The mortality rate of lung cancer was 4.26 cases per 100 000 person-years. As compared with women who had given birth to only 1 child, the adjusted HR was 1.13 (95% CI, 0.94–1.35) for women who had 2 children, 1.10 (0.91–1.33) for those who had 3 children, and 1.22 (0.96–1.54) for those who had 4 or more children. Conclusions The findings suggest that premenopausal women of higher parity tended to have an increased risk of lung cancer, although the trend was not statistically significant.
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Affiliation(s)
- Meng-Hsuan Cheng
- Division of Pulmonary and Critical Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Chung SD, Chen YK, Chen YH, Lin HC. Hyperthyroidism and female urinary incontinence: a population-based cohort study. Clin Endocrinol (Oxf) 2011; 75:704-8. [PMID: 21623855 DOI: 10.1111/j.1365-2265.2011.04126.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The imbalanced autonomic nervous system present in hyperthyroidism may cause lower urinary tract symptoms. Urinary incontinence (UI) is the most bothersome lower urinary tract symptom; however, in the literature, reports regarding urinary dysfunction and/or incontinence among hyperthyroid patients are scarce. This population-based cohort study aimed to examine the relationship between hyperthyroidism in women and the risk of developing UI in Taiwan. DESIGN This study used data from the Longitudinal Health Insurance Database. For this study, 10,817 female patients diagnosed with hyperthyroidism from 2001 to 2005 were recruited together with a comparison cohort of 54,085 matched enrollees who did not have a history of hyperthyroidism. All patients were tracked for a 3-year period from their index date to identify those who had a subsequent UI. The stratified Cox proportional hazards models were used to compute the risk of UI between study and comparison cohorts. RESULTS During the follow-up period, of 64,169 patients, 173 (1·60%) from the hyperthyroidism group and 560 (1·04%) from the comparison group, had a diagnosis of UI. The regression analysis showed that, after adjusting for monthly income, geographic region, urbanization level of the community in which the patient resided, obesity and hysterectomy, patients with hyperthyroidism were more likely to have UI during the 3-year follow-up period than the comparison patients (hazard ratio = 1·54; 95% CI = 1·30-1·83; P < 0·001). CONCLUSION Our results suggest an increased risk of UI in patients with hyperthyroidism at the 3-year follow-up.
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Affiliation(s)
- Shiu-Dong Chung
- Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taiwan
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Wu CH, Chan TF, Changchien CC, Yang CY. Parity, age at first birth, and risk of death from liver cancer: Evidence from a cohort in Taiwan. J Gastroenterol Hepatol 2011; 26:334-9. [PMID: 21261724 DOI: 10.1111/j.1440-1746.2010.06365.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM The present study was undertaken to examine whether there is an association between parity and age at first birth and risk of liver cancer. METHODS The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We tracked each woman from the time of their first childbirth to 31 December 2007, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the relative risks (RR) of death from liver cancer associated with parity and age at first birth. RESULTS There were 826 liver cancer deaths during 32,464,186.58 person-years of follow-up. The mortality rate of liver cancer was 2.54 cases per 100,000 person-years. The adjusted RR was 1.59 (95% confidence interval [CI] = 1.36-1.86) for women who gave birth between 26 and 30, 2.41 (95% CI = 1.81-3.20) for women who gave birth between 31 and 35, and 6.26 (95% CI = 4.27-9.19) for women who gave birth after 35 years of age, respectively, when compared with women who gave birth at less than 25 years of age. The adjusted RR was 0.72 (95% CI = 0.59-0.87) for women who had two to three children, and 0.63 (95% CI = 0.47-0.84) for women with four or more births, respectively, when compared with women who had given birth to only one child. CONCLUSIONS The present study suggests that reproductive factors (parity and early age at first birth) may confer a protective effect on the risk of liver cancer.
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Affiliation(s)
- Chen-Hsuan Wu
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital- Kaohsiung Medical Center, College of Medicine, Chang Gung University, Kaohsiung, Taiwan
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Abstract
OBJECTIVES This study was undertaken to examine whether there is an association between parity and age at first birth and risk of pancreatic cancer. METHODS The study cohort consisted of all women with a record of a first and singleton childbirth in the Birth Registration System between 1978 and 1987. We tracked each woman from the time of their first childbirth and linked their vital status with mortality database. Cox proportional hazard regression models were used to estimate the relative risks (RRs) of death from pancreatic cancer associated with parity and age at first birth. RESULTS A trend of increasing risk of pancreatic cancer was seen with increasing age at first birth. The adjusted RR was 0.69 (95% confidence interval, 0.49-0.98) for women who born 2 children and 0.64 (95% confidence interval, 0.44-0.93) for women with 3 or more births, respectively, when compared with women who had given birth to only 1 child. There was a significant decreasing trend in the RR of pancreatic cancer with increasing parity. CONCLUSIONS This study provides evidence that reproductive factors (parity and early age at first birth) may confer a protective effect on the risk of pancreatic cancer.
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Fwu CW, Chien YC, Kirk GD, Nelson KE, You SL, Kuo HS, Feinleib M, Chen CJ. Hepatitis B Virus Infection and Hepatocellular Carcinoma Among Parous Taiwanese Women: Nationwide Cohort Study. J Natl Cancer Inst 2009; 101:1019-27. [DOI: 10.1093/jnci/djp146] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Kuo YH, Wang JH, Lu SN, Hung CH, Wei YC, Hu TH, Chen CH, Yen YH, Lee CM, Eng HL. Natural course of hepatic focal nodular hyperplasia: a long-term follow-up study with sonography. JOURNAL OF CLINICAL ULTRASOUND : JCU 2009; 37:132-137. [PMID: 18855931 DOI: 10.1002/jcu.20533] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE We aimed to investigate the natural course of hepatic focal nodular hyperplasia (FNH) in a long-term follow-up study with sonography. METHOD This study comprised 30 patients (24 women and 6 men) with 34 FNHs. Diagnosis of FNH was made using color Doppler sonography, contrast-enhanced CT, or MRI in combination with needle biopsy. Patients were followed every 3 to 6 months with sonography. Regression or progression of tumor was defined as a change of over 30% in maximal diameter. Disappearance was defined as no vizualization of the tumor on at least 3 follow-up sonographic examinations. RESULTS Thirty-four FNHs were followed over a mean period of 42 months (range, 7-95 months). Twenty-four lesions (70.6%) were stable in size, 1 (2.9%) progressed, and 9 (26.5%) regressed. Of those that regressed, 6 (17.6%) disappeared over a mean period of 59 +/- 30 months (range, 20-95 months). Older age (OR 1.26, 95% CI 1.02-1.56; p < 0.05) and longer follow-up time (OR 1.11, 95% CI 1.01-1.21; p < 0.05) were the independent factors associated with complete regression of FNH. CONCLUSION Most FNHs were stable or regressed/disappeared after a long follow-up period. Based on the benign course, conservative treatment for asymptomatic FNH should be advocated.
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Affiliation(s)
- Yuan-Hung Kuo
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung 833 Kaohsiung, Taiwan
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Sun YF, Leu JD, Chen SM, Lin IF, Lee YJ. Results based on 124 cases of breast cancer and 97 controls from Taiwan suggest that the single nucleotide polymorphism (SNP309) in the MDM2 gene promoter is associated with earlier onset and increased risk of breast cancer. BMC Cancer 2009; 9:13. [PMID: 19144119 PMCID: PMC2649157 DOI: 10.1186/1471-2407-9-13] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 01/13/2009] [Indexed: 12/24/2022] Open
Abstract
Background It has been suggested that the single nucleotide polymorphism 309 (SNP309, T -> G) in the promoter region of the MDM2 gene is important for tumor development; however, with regards to breast cancer, inconsistent associations have been reported worldwide. It is speculated that these conflicting results may have arisen due to different patient subgroups and ethnicities studied. For the first time, this study explores the effect of the MDM2 SNP309 genotype on Taiwanese breast cancer patients. Methods Genomic DNA was obtained from the whole blood of 124 breast cancer patients and 97 cancer-free healthy women living in Taiwan. MDM2 SNP309 genotyping was carried out by restriction fragment length polymorphism (RFLP) assay. The multivariate logistic regression and the Kaplan-Meier method were used for analyzing the risk association and significance of age at diagnosis among different MDM2 SNP309 genotypes, respectively. Results Compared to the TT genotype, an increased risk association with breast cancer was apparent for the GG genotype (OR = 3.05, 95% CI = 1.04 to 8.95), and for the TG genotype (OR = 2.12, 95% CI = 0.90 to 5.00) after adjusting for age, cardiovascular disease/diabetes, oral contraceptive usage, and body mass index, which exhibits significant difference between cases and controls. Furthermore, the average ages at diagnosis for breast cancer patients were 53.6, 52 and 47 years for those harboring TT, TG and GG genotypes, respectively. A significant difference in median age of onset for breast cancer between GG and TT+TG genotypes was obtained by the log-rank test (p = 0.0067). Conclusion Findings based on the current sample size suggest that the MDM2 SNP309 GG genotype may be associated with both the risk of breast cancer and an earlier age of onset in Taiwanese women.
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Affiliation(s)
- Ying-Fang Sun
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
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Kuo HW, Chou SY, Hu TW, Wu FY, Chen DJ. Urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) and genetic polymorphisms in breast cancer patients. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2007; 631:62-8. [PMID: 17512776 DOI: 10.1016/j.mrgentox.2007.04.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Revised: 04/10/2007] [Accepted: 04/17/2007] [Indexed: 11/29/2022]
Abstract
Reactive oxygen species (ROS) causes damage to DNA, but the role of ROS in breast carcinoma is still not clear. The objective of this study was to measure the urinary 8-OHdG levels of breast cancer patients at each stage of carcinogenesis and assess its association with the development of breast cancer. Sixty patients with malignant breast tumors were matched with 60 control subjects of the same ages in this case control study. Urinary 8-OHdG levels were significantly higher among breast cancer patients than among the control subjects, after making adjustments for confounders such as smoking, coffee consumption and use of oral contraceptives. The breast cancer patients were divided into three groups based on the stages of their cancer; urinary 8-OHdG levels decreased with each stage of breast carcinoma. Using multiple regression and logistic models adjusted for other covariates, urinary 8-OHdG levels significantly correlated with the development of breast cancer. However, it was found that breast cancer was not significantly influenced by CYP1A1, CYP1M1 or NAT2 polymorphisms. In conclusion, it was found that oxygen radical generation occurred within carcinoma cells, but the role of polymorphism of specific genes in the development of breast cancer should be evaluated.
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Affiliation(s)
- Hsien-Wen Kuo
- Institute of Environmental Health, China Medical University, No. 91, Hsueh-Shin Road, Taichung, Taiwan.
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Folger SG, Marchbanks PA, McDonald JA, Bernstein L, Ursin G, Berlin JA, Daling JR, Norman SA, Strom BL, Weiss LK, Simon MS, Burkman RT, Malone KE, Spirtas R. Risk of breast cancer associated with short-term use of oral contraceptives. Cancer Causes Control 2007; 18:189-98. [PMID: 17216547 DOI: 10.1007/s10552-006-0086-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2006] [Accepted: 10/22/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To estimate breast cancer risk associated with short-term (<6 months) oral contraceptive use, and explore variation in estimates by use characteristics and medical, menstrual, and reproductive history. METHODS We analyzed data from the Women's Contraceptive and Reproductive Experiences Study. Case subjects were white women and black women, 35-64 years old, diagnosed with invasive breast cancer in July 1994-April 1998. Control subjects identified by random-digit dialing were matched to case subjects by age, race, and study site. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Overall, short-term oral contraceptive use was not associated with breast cancer risk (OR = 1.0; 95% CI = 0.8-1.1). However, significant interaction between short-term use and menopausal status led to an observed increased breast cancer risk in pre-menopausal women (OR = 1.3; 95% CI = 1.0-1.7) and a reduced risk in post-menopausal women (OR = 0.8; 95% CI = 0.6-1.0) associated with short-term use. The association was more pronounced in women with non-contraceptive reasons for use and underlying risk factors for breast cancer. CONCLUSIONS These associations may result from underlying characteristics of users or unmeasured factors influencing duration of use and breast cancer risk.
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Affiliation(s)
- Suzanne G Folger
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Yang CY, Kuo HW, Chiu HF. Age at first birth, parity, and risk of death from ovarian cancer in Taiwan: a country of low incidence of ovarian cancer. Int J Gynecol Cancer 2007; 17:32-6. [PMID: 17291228 DOI: 10.1111/j.1525-1438.2007.00804.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
This study was undertaken to examine whether there is an association between parity and age at first birth and risk of ovarian cancer. The study cohort consisted of all women with a record of a first and singleton childbirth in the Birth Register between 1978 and 1984. We tracked women from the time of their first childbirth to December 31, 2003, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the relative risks (RR) of death from ovarian cancer associated with parity and age at first birth. There were 322 ovarian cancer deaths during 27,402,995.5 person-years of follow-up. The mortality rate of ovarian cancer was 1.18 cases per 100,000 person-years. A trend of increasing risk of ovarian cancer was seen with increasing age at first birth. The adjusted RR was 0.69 (95% CI = 0.52–0.90) for women who bore two children, and 0.30 (95% CI = 0.21–0.42) for women with three or more births, respectively, when compared with women who had given birth to only one child. There was a significant decreasing trend in the adjusted RR of ovarian cancer with increasing parity. This study provides evidence that parity may confer a protective effect on the risk of ovarian cancer
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Affiliation(s)
- C-Y Yang
- Institute of Public Health, College of Health Sciences, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan.
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Kahlenborn C, Modugno F, Potter DM, Severs WB. Oral contraceptive use as a risk factor for premenopausal breast cancer: a meta-analysis. Mayo Clin Proc 2006; 81:1290-302. [PMID: 17036554 DOI: 10.4065/81.10.1290] [Citation(s) in RCA: 152] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To perform a meta-analysis of case-control studies that addressed whether prior oral contraceptive (OC) use is associated with premenopausal breast cancer. METHODS We searched the MEDLINE and PubMed databases and bibliography reviews to identify case-control studies of OCs and premenopausal breast cancer published in or after 1980. Search terms used included breast neoplasms, oral contraceptives, contraceptive agents, and case-control studies. Studies reported in all languages were included. Thirty-four studies were identified that met inclusion criteria. Two reviewers extracted data from original research articles or additional data provided by study authors. We used the DerSimonian-Laird method to compute pooled odds ratios (ORs) and confidence intervals (CIs) and the Mantel-Haenszel test to assess association between OC use and cancer. RESULTS Use of OCs was associated with an increased risk of premenopausal breast cancer in general (OR, 1.19; 95% CI, 1.09-1.29) and across various patterns of OC use. Among studies that provided data on nulliparous and parous women separately, OC use was associated with breast cancer risk in both parous (OR, 1.29; 95% CI, 1.20-1.40) and nulliparous (OR, 1.24; 95% CI, 0.92-1.67) women. Longer duration of use did not substantially alter risk in nulliparous women (OR, 1.29; 95% CI, 0.85-1.96). Among parous women, the association was stronger when OCs were used before first full-term pregnancy (FFTP) (OR, 1.44; 95% CI, 1.28-1.62) than after FFTP (OR, 1.15; 95% CI, 1.06-1.26). The association between OC use and breast cancer risk was greatest for parous women who used OCs 4 or more years before FFTP (OR, 1.52; 95% CI, 1.26-1.82). CONCLUSION Use of OCs is associated with an increased risk of premenopausal breast cancer, especially with use before FFTP in parous women.
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Affiliation(s)
- Chris Kahlenborn
- Department of Internal Medicine, Altoona Hospital, Altoona, PA, USA.
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Lee MM, Chang IYH, Horng CF, Chang JS, Cheng SH, Huang A. Breast cancer and dietary factors in Taiwanese women. Cancer Causes Control 2006; 16:929-37. [PMID: 16132802 DOI: 10.1007/s10552-005-4932-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2004] [Accepted: 04/05/2005] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To examine the effect of the consumption of dietary factors on the risk of breast cancer in a case-control study in Taiwan. METHODS Two-hundred-and-fifty cases and 219 age-matched controls between the ages of 25 and 74 were interviewed in person between 1996 and 1999. Usual consumption of dietary habits including 100 foods was assessed using a food frequency questionnaire and a nutrient database developed and validated in Taiwanese populations. RESULTS Cases consumed significantly more fat than controls. Cases also consumed statistically significant less supplements such as vitamins and mineral than controls. Food group analyses showed that highest quartile of beef and pork intake significantly increased risk in younger women (OR = 2.5, 95% CI = 1.0-6.0) and all women (OR = 2.5, 95% CI = 1.1-3.3). The age- education- and total calorie-adjusted odds ratio (OR) of breast cancer risk comparing the highest and second highest quartile of fat intake to the lowest quartile was 5.1, 95% confidence interval (CI): 2.1-13 and 3.5, 95% CI: 1.4-8.7 among those younger cases (< or =40). A multiple regression model indicates a protective effect of supplements (OR: 0.40, 95% CI: 0.3-07) and a harmful effect of dietary fat (OR: 2.6, 95% CI: 1.4-5.0) for the highest versus lowest quartile in all women. CONCLUSIONS Our results indicate a strong protective effect of dietary supplements and a harmful effect of dietary fats on the risk of breast cancer among women in Taiwan. These findings should be confirmed in future follow-up studies. Specific amount of dietary supplements and dietary fats should be quantified for a more accurate evaluation on the risk for breast cancer in this population.
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Affiliation(s)
- Marion M Lee
- Department of Epidemiology and Biostatistics, University of California at San Francisco, MU 420 West, San Francisco, CA 94143-0560, USA.
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Dumeaux V, Fournier A, Lund E, Clavel-Chapelon F. Previous oral contraceptive use and breast cancer risk according to hormone replacement therapy use among postmenopausal women. Cancer Causes Control 2005; 16:537-44. [PMID: 15986108 PMCID: PMC1976329 DOI: 10.1007/s10552-004-8024-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2004] [Accepted: 12/22/2004] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess postmenopausal breast cancer risk in relation to particular patterns of oral contraceptive (OC) use according to hormone replacement therapy (HRT) exposure. METHODS Time-dependent Cox regression models were used to analyse information on postmenopausal women from a large-scale French cohort. Among a total of 68,670 women born between 1925 and 1950, 1405 primary invasive postmenopausal breast cancer cases were identified from 1992 to 2000. RESULTS A non-significant decrease in risk of around 10% was associated with ever OC use as compared to never OC use in postmenopausal women. No significant interaction was found between OC and HRT use on postmenopausal breast cancer risk. Breast cancer risk decreased significantly with increasing time since first OC use (test for trend: p=0.01); this was consistent after adjustment for duration of use or for time since last use. CONCLUSION No increase in breast cancer risk was associated with previous OC exposure among postmenopausal women, probably because the induction window had closed. Some women may develop breast cancer soon after exposure to OCs, leading to a deficit of cases of older women. Further investigation is therefore required to identify young women at high risk.
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Affiliation(s)
- Vanessa Dumeaux
- Nutrition, hormones et cancer: épidémiologie et prévention
INSERM : ERI20 IFR69Université Paris Sud - Paris XI EA4045Institut Gustave-Roussy
39 rue Camille Desmoulins
94805 Villejuif CEDEX,FR
- Institute of Community Medicine
University of TromsoTromso,NO
| | - Agnès Fournier
- Nutrition, hormones et cancer: épidémiologie et prévention
INSERM : ERI20 IFR69Université Paris Sud - Paris XI EA4045Institut Gustave-Roussy
39 rue Camille Desmoulins
94805 Villejuif CEDEX,FR
| | - Eiliv Lund
- Institute of Community Medicine
University of TromsoTromso,NO
| | - Françoise Clavel-Chapelon
- Nutrition, hormones et cancer: épidémiologie et prévention
INSERM : ERI20 IFR69Université Paris Sud - Paris XI EA4045Institut Gustave-Roussy
39 rue Camille Desmoulins
94805 Villejuif CEDEX,FR
- * Correspondence should be adressed to: Françoise Clavel-Chapelon
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Fowke JH, Shu XO, Dai Q, Jin F, Cai Q, Gao YT, Zheng W. Oral Contraceptive Use and Breast Cancer Risk: Modification by NAD(P)H:Quinone Oxoreductase ( NQO1) Genetic Polymorphisms. Cancer Epidemiol Biomarkers Prev 2004. [DOI: 10.1158/1055-9965.1308.13.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Despite intensive study, the relationship between oral contraception (OC) and breast cancer remains unclear. OCs contain a potent synthetic estrogen (ethinyl estradiol) but lower endogenous estradiol levels, and ethinyl estradiol is a weak progenitor of semiquinones, catechol estrogens capable of damaging DNA. NAD(P)H:quinone oxoreductase (NQO1) stabilizes semiquinones, thus potentially preventing genetic damage from catechol estrogens, and the NQO1 C609T polymorphism seems functionally relevant. Using data from the Shanghai Breast Cancer Study, a population-based case-control study, we investigated the relationships between OC use (20% ever using), breast cancer, and NQO1 (C/C 31% and C/T + T/T 69%) among 1,039 cases and 1,121 controls. Breast cancer was not significantly associated with NQO1 genotype. There was a significant protective association between OC after age 30 years and premenopausal breast cancer [odds ratio (OR) 0.51, 95% confidence interval (95% CI) 0.29-0.89] primarily with the NQO1 T allele (C/C OR 0.76, 95% CI 0.31-1.82; C/T + T/T OR 0.38, 95% CI 0.18-0.80; P for interaction = 0.19). The association between premenopausal breast cancer and OCs significantly differed with NQO1 genotype when using OCs for >18 months (C/C OR 2.34, 95% CI 0.92-5.99; C/T + T/T OR 0.69, 95% CI 0.38-1.25; P for interaction = 0.02). Among women with the C/C genotype, postmenopausal breast cancer was significantly associated with ever-using OCs (C/C OR 2.01, 95% CI 1.08-3.74; C/T + T/T OR 0.72, 95% CI 0.49-1.05; P for interaction < 0.01). This crossover was stronger with OC use prior to age 30 years (C/C OR 3.00, 95% CI 1.43-6.25; C/T or T/T OR 0.49, 95% CI 0.29-0.81; P for interaction < 0.01). Our results require confirmation but suggest that the OC and breast cancer association depends on the ability to invoke protection from catechol estrogens.
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Affiliation(s)
- Jay H. Fowke
- 1Vanderbilt University Medical Center, Nashville, Tennessee and
| | - Xiao-Ou Shu
- 1Vanderbilt University Medical Center, Nashville, Tennessee and
| | - Qi Dai
- 1Vanderbilt University Medical Center, Nashville, Tennessee and
| | - Fan Jin
- 2Shanghai Cancer Center, Shanghai, China
| | - Qiuyin Cai
- 1Vanderbilt University Medical Center, Nashville, Tennessee and
| | | | - Wei Zheng
- 1Vanderbilt University Medical Center, Nashville, Tennessee and
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Hemminki E, Luostarinen T, Pukkala E, Apter D, Hakulinen T. Oral contraceptive use before first birth and risk of breast cancer: a case control study. BMC Womens Health 2002; 2:9. [PMID: 12160467 PMCID: PMC122097 DOI: 10.1186/1472-6874-2-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2002] [Accepted: 08/05/2002] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: The aim of this study was first, to investigate whether women starting oral contraceptive (OC) use at a young age and before first birth have an increased risk for breast cancer and second, to report difficulties encountered in studying long-term health impacts of medical technologies. METHODS: Breast cancers occurring up until 1997 among 37153 Helsinki students born between 1946 and 1960 were identified by record linkage from the Finnish Cancer Registry; for each cancer case, five age-matched random controls were picked from the same student population. Those who had used the Helsinki Student Health Service (HSHS) at least three times (150 cases and 316 controls) form the final study subjects. Data on OC use and background characteristics were collected from patient records, and data on live births were derived from the population register. Odds ratios (OR) were adjusted for number of births, smoking and sports activity. RESULTS: Compared to the few non-users, OC users had a higher risk of breast cancer: the adjusted OR was 2.1 (95% confidence interval 1.1-4.2). Among OC users, no statistically significant differences in risk of breast cancer were found in regard to starting age or first birth, but small numbers made confidence intervals wide. Even though we had chosen students to be our study group, the population turned out to be unsuitable to answer our research question: most women had started their OC use old (at the age of 20 or later) and there were very few unexposed (almost all had used OC and before their first birth). CONCLUSIONS: Because adoption of the modern pattern of OC use was not common among students, it is unlikely that the impact of early and extended OC use can be studied before 2010, when women born in the 1960s are 40 to 50 years old.
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Affiliation(s)
- Elina Hemminki
- National Research and Development Center for Welfare and Health, Health Services Research, Helsinki, Finland
| | - Tapio Luostarinen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Dan Apter
- Finnish Student Health Service and Family Federation of Finland, Helsinki, Finland
| | - Timo Hakulinen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- Department of Public Health, University of Helsinki, Finland
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