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Zha JM, Zhang M, Wang T, Li HS, Ban QY, Liu M, Jiang XX, Guo SY, Wang J, Zhou YR, Liu YH, He WQ, Xu H. Association of Overweight and Inflammatory Indicators with Breast Cancer: A Cross-Sectional Study in Chinese Women. Int J Womens Health 2024; 16:783-795. [PMID: 38737496 PMCID: PMC11086397 DOI: 10.2147/ijwh.s428696] [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: 07/31/2023] [Accepted: 04/26/2024] [Indexed: 05/14/2024] Open
Abstract
Objective This cross-sectional study aimed to explore the association of overweight and inflammatory indicators with breast cancer risk in Chinese patients. Methods Weight, height, and peripheral blood inflammatory indicators, including white blood cell count (WBC), neutrophil count (NE), lymphocyte count (LY), platelet count (PLT) and the concentration of hypersensitivity C-reactive protein (hsCRP), were collected in 383 patients with benign breast lumps (non-cancer) and 358 patients with malignant breast tumors (cancer) at the First Affiliated Hospital of Soochow University, China, from March 2018 to July 2020. Body mass index (BMI), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) were determined according to the ratio equation. The correlations among overweight, inflammatory indicators, and the proportion of non-cancer or cancer cases were analyzed. Results BMI is associated with an increased breast cancer risk. Compared with non-cancer patients, the average WBC count, NE count, NLR, and level of hsCRP were significantly higher in cancer patients. The level of hsCRP was closely associated with the size of malignant breast tumors. Conclusion We conclude that overweight and high levels of hsCRP may serve as putative risk factors for malignant breast tumors in Chinese women.
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Affiliation(s)
- Juan-Min Zha
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People’s Republic of China
| | - Mei Zhang
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People’s Republic of China
| | - Tao Wang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Cambridge-Suda (CAM-SU) Genomic Resource Center, Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Hua-Shan Li
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People’s Republic of China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Cambridge-Suda (CAM-SU) Genomic Resource Center, Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Quan-Yao Ban
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People’s Republic of China
| | - Mei Liu
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People’s Republic of China
| | - Xue-Xue Jiang
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People’s Republic of China
| | - Shi-Ying Guo
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Cambridge-Suda (CAM-SU) Genomic Resource Center, Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Jing Wang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Cambridge-Suda (CAM-SU) Genomic Resource Center, Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Ya-Ru Zhou
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Cambridge-Suda (CAM-SU) Genomic Resource Center, Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Yu-Hong Liu
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Cambridge-Suda (CAM-SU) Genomic Resource Center, Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Wei-Qi He
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People’s Republic of China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Cambridge-Suda (CAM-SU) Genomic Resource Center, Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Hong Xu
- Department of Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People’s Republic of China
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Wang J, Peng C, Guranich C, Heng YJ, Baker GM, Rubadue CA, Glass K, Eliassen AH, Tamimi RM, Polyak K, Hankinson S. Early-Life Body Adiposity and the Breast Tumor Transcriptome. J Natl Cancer Inst 2020; 113:778-784. [PMID: 33136151 DOI: 10.1093/jnci/djaa169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/21/2020] [Accepted: 10/19/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Cumulative epidemiologic evidence has shown that early-life adiposity is strongly inversely associated with breast cancer risk throughout life, independent of adult obesity. However, the molecular mechanisms remain poorly understood. METHODS We assessed the association of early-life adiposity, defined as self-reported body size during ages 10-20 years from a validated 9-level pictogram, with the transcriptome of breast tumor (N = 835) and tumor-adjacent histologically normal tissue (N = 663) in the Nurses' Health Study. We conducted multivariable linear regression analysis to identify differentially expressed genes in tumor and tumor-adjacent tissue, respectively. Molecular pathway analysis using Hallmark gene sets (N = 50) was further performed to gain biological insights. Analysis was stratified by tumor estrogen receptor (ER) protein expression status (n = 673 for ER+ and 162 for ER- tumors). RESULTS No gene was statistically significantly differentially expressed by early-life body size after multiple comparison adjustment. However, pathway analysis revealed several statistically significantly (false discovery rate < 0.05) upregulated or downregulated gene sets. In stratified analyses by tumor ER status, larger body size during ages 10-20 years was associated with decreased cellular proliferation pathways, including MYC target genes, in both ER+ and ER- tumors. In ER+ tumors, larger body size was also associated with upregulation in genes involved in TNFα/NFkB signaling. In ER- tumors, larger body size was additionally associated with downregulation in genes involved in interferon α and interferon γ immune response and Phosphatidylinositol 3-kinase (PI3K)/AKT/mammalian target of rapamycin (mTOR) signaling; the INFγ response pathway was also downregulated in ER- tumor-adjacent tissue, though at borderline statistical significance (false discovery rate = 0.1). CONCLUSIONS These findings provide new insights into the biological and pathological underpinnings of the early-life adiposity and breast cancer association.
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Affiliation(s)
- Jun Wang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Cheng Peng
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine Guranich
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Yujing J Heng
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, USA
| | - Gabrielle M Baker
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Christopher A Rubadue
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kimberly Glass
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Healthcare Policy and Research, Weill Cornell Medicine, USC, New York, NY, USA
| | - Kornelia Polyak
- Department of Medical Oncology, Dana-Farber Cancer Institute Boston, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Susan Hankinson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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Prevalence, risk factors, and trajectories of sleep disturbance in a cohort of African-American breast cancer survivors. Support Care Cancer 2020; 29:2761-2770. [PMID: 32995999 DOI: 10.1007/s00520-020-05786-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/16/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE Sleep disturbance may be an overlooked modifiable risk factor for health disparities among African-American breast cancer survivors (AABCS). This study aimed to identify the prevalence of and risk factors for sleep disturbance in a cohort of AABCS. METHODS The study was conducted among participants in the Women's Circle of Health Follow-up Study, a longitudinal study of breast cancer in 10 counties in New Jersey. Cases were identified shortly after diagnosis by the New Jersey State Cancer Registry. Self-reported sleep disturbance (Pittsburgh Sleep Quality Index) and other factors (e.g., socioeconomic status, menopausal status) were assessed at pre-diagnosis (n = 637), 10 months post-diagnosis (n = 261), and 24 months post-diagnosis (n = 632). Clinical data were obtained via medical record abstraction, and height and weight were measured by study staff. RESULTS Most AABCS (57%) reported clinically significant sleep disturbance before diagnosis, and this rate remained largely unchanged at 10 months (53%) and 24 months post-diagnosis (61%). Average sleep disturbance scores indicated clinically significant disturbance at all three assessments (M range = 6.67-7.57). Most reported sleeping fewer than the recommended 7 hours per night at each assessment (range 57-65%). Risk factors for sleep disturbance were identified at each assessment, including pre-diagnosis (less education), 10 months post-diagnosis (lack of insurance, treatment with chemotherapy), and 24 months post-diagnosis (younger age, less education, lower income, obesity, and lymphedema). Treatment with endocrine therapy was a protective factor at 10 months post-diagnosis. CONCLUSION Most AABCS report clinically significant sleep disturbance from before diagnosis through 24 months post-diagnosis. These rates appear indicate AABCS experience significant sleep-related disparities.
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The Women's Circle of Health Follow-Up Study: a population-based longitudinal study of Black breast cancer survivors in New Jersey. J Cancer Surviv 2020; 14:331-346. [PMID: 31907766 DOI: 10.1007/s11764-019-00849-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 12/17/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE The Women's Circle of Health Follow-Up Study is an ongoing longitudinal study of African American/Black breast cancer survivors in New Jersey, specifically designed to evaluate the impact of obesity and related comorbidities on breast cancer survival and health-related quality-of-life in this understudied population. Here, we describe our recruitment and data collection methods and compare characteristics of the overall cohort and the subcohort with follow-up data. METHODS Newly diagnosed breast cancer cases have been recruited into the study since 2006. Pre-diagnosis data on relevant factors and a saliva sample are collected during an in-person interview within 12 months from diagnosis. In 2013, we began active follow up by recontacting participants annually, including two home visits at approximately 2 and 3 years post-diagnosis, during which blood samples are collected. Mortality outcomes (all-cause and breast cancer-specific mortality) are ascertained through linkage with New Jersey State Cancer Registry files. We expect to assemble a cohort of over 2000 Black breast cancer survivors with at least 800 of them having detailed post-diagnosis data. RESULTS Distribution of sociodemographic characteristics, body mass index, comorbidities, clinicopathologic characteristics, and treatment modalities were very similar between those in the full cohort and the subset with follow-up data and blood samples. Obesity (> 50%), hypertension (> 58%), and diabetes (22%) were common in this population. CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS This ongoing longitudinal study represents a unique resource to better understand breast cancer outcomes, patient-reported symptoms, and health-related quality of life among Black breast cancer survivors.
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5
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Nindrea RD, Aryandono T, Lazuardi L, Dwiprahasto I. Association of Overweight and Obesity with Breast Cancer During Premenopausal Period in Asia: A Meta-Analysis. Int J Prev Med 2019; 10:192. [PMID: 31772724 PMCID: PMC6868644 DOI: 10.4103/ijpvm.ijpvm_372_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 04/30/2019] [Indexed: 01/07/2023] Open
Abstract
Background: The association of overweight and obesity with breast cancer risk in premenopausal women and in different ethnicities remains in debate, especially among Asian women. The aim of this systematic review and meta-analysis was to determine the association of overweight and obesity with breast cancer during premenopausal period in Asian women. Methods: We performed a meta-analysis of research articles on the association of overweight and obesity with breast cancer during premenopausal period in Asian women published from January 2000 to July 2018 in article databases of EBSCO, PubMed, and ProQuest. Pooled odds ratios (ORs) were calculated by fixed and random-effect models. Publication bias was visually evaluated using funnel plots, and then statistically assessed using Egger's and Begg's tests. Review Manager 5.3 (RevMan 5.3) and Stata version 14.2 (Stata Corporation) were used to process the data. We reviewed 886 articles. Results: We found 15 studies conducted systematic review continued by meta-analysis of relevant data with 22,362 patients. There was significant association of obesity [OR = 1.36 (95% confidence interval (CI) 1.26–1.47, P < 0.00001)] and overweight [OR = 1.17 (95% CI 1.10–1.25, P < 0.00001)] with breast cancer during premenopausal period in Asian women. In this study, there was no significant publication bias for studies included in overweight and obesity with breast cancer during premenopausal in Asian women. Conclusions: This study suggested association of overweight and obesity with breast cancer during premenopausal period in Asian women.
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Affiliation(s)
- Ricvan Dana Nindrea
- Doctoral Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.,Department of Public Health, Faculty of Medicine, Universitas Andalas, Padang City, Indonesia
| | - Teguh Aryandono
- Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia
| | - Lutfan Lazuardi
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia
| | - Iwan Dwiprahasto
- Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia
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Rivera-Núñez Z, Barrett ES, Szamreta EA, Shapses SA, Qin B, Lin Y, Zarbl H, Buckley B, Bandera EV. Urinary mycoestrogens and age and height at menarche in New Jersey girls. Environ Health 2019; 18:24. [PMID: 30902092 PMCID: PMC6431018 DOI: 10.1186/s12940-019-0464-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 03/13/2019] [Indexed: 05/10/2023]
Abstract
BACKGROUND Despite evidence of the endocrine disrupting properties of zearalenone (ZEN) and alpha-zearalanol (zeranol, α-ZAL), they have been minimally studied in human populations. In previous cross-sectional analyses, we demonstrated that 9-10 years old girls with detectable urinary ZEN were of shorter stature and less likely to have reached the onset of breast development than girls with undetectable urinary ZEN. The aim of this study was to examine baseline concentrations of ZEN, (α-ZAL), and their phase-1 metabolites in relation to subsequent growth and timing of menarche using 10 years of longitudinal data. METHODS Urine samples were collected from participants in the Jersey Girl Study at age 9-10 (n = 163). Unconjugated ZEN, (α-ZAL), and their metabolites were analyzed using high performance liquid chromatography and tandem mass spectrometry. Information on height, weight, and pubertal development was collected at a baseline visit with annual follow-up by mail thereafter. Cox regression was used to evaluate time to menarche in relation to baseline ZEN, (α-ZAL), and total mycoestrogen exposure. Z-scores for height and weight were used in mixed models to assess growth. RESULTS Mycoestrogens were detectable in urine in 78.5% of the girls (median ZEN: 1.02 ng/ml, range 0-22.3). Girls with detectable urinary concentrations of (α-ZAL) and total mycoestrogens (sum of ZEN, (α-ZAL) and their metabolites) at baseline were significantly shorter at menarche than girls with levels below detection (p = 0.04). ZEN and total mycoestrogen concentrations were inversely associated with height- and weight-z-scores at menarche (adjusted β = - 0.18, 95% CI: -0.29, - 0.08, and adjusted β = - 0.10, 95% CI: -0.21, 0.01, respectively). CONCLUSION This study supports and extends our previous results suggesting that exposure to ZEN, (α-ZAL), and their metabolites is associated with slower growth and pubertal development in adolescent girls.
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Affiliation(s)
- Zorimar Rivera-Núñez
- Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ 08901 USA
| | - Emily S. Barrett
- Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University, 170 Frelinghuysen Rd, Piscataway, NJ 08854 USA
- Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854 USA
| | - Elizabeth A. Szamreta
- Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ 08901 USA
- Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854 USA
| | - Sue A. Shapses
- Department of Nutritional Sciences, Rutgers University, 65 Dudley Rd, New Brunswick, NJ 08901-8520 USA
| | - Bo Qin
- Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ 08901 USA
| | - Yong Lin
- Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ 08901 USA
- Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854 USA
| | - Helmut Zarbl
- Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ 08901 USA
- Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University, 170 Frelinghuysen Rd, Piscataway, NJ 08854 USA
| | - Brian Buckley
- Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers University, 170 Frelinghuysen Rd, Piscataway, NJ 08854 USA
- Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854 USA
| | - Elisa V. Bandera
- Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ 08901 USA
- Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854 USA
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7
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Hopper JL, Dite GS, MacInnis RJ, Liao Y, Zeinomar N, Knight JA, Southey MC, Milne RL, Chung WK, Giles GG, Genkinger JM, McLachlan SA, Friedlander ML, Antoniou AC, Weideman PC, Glendon G, Nesci S, Andrulis IL, Buys SS, Daly MB, John EM, Phillips KA, Terry MB. Age-specific breast cancer risk by body mass index and familial risk: prospective family study cohort (ProF-SC). Breast Cancer Res 2018; 20:132. [PMID: 30390716 PMCID: PMC6215632 DOI: 10.1186/s13058-018-1056-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 10/02/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The association between body mass index (BMI) and risk of breast cancer depends on time of life, but it is unknown whether this association depends on a woman's familial risk. METHODS We conducted a prospective study of a cohort enriched for familial risk consisting of 16,035 women from 6701 families in the Breast Cancer Family Registry and the Kathleen Cunningham Foundation Consortium for Research into Familial Breast Cancer followed for up to 20 years (mean 10.5 years). There were 896 incident breast cancers (mean age at diagnosis 55.7 years). We used Cox regression to model BMI risk associations as a function of menopausal status, age, and underlying familial risk based on pedigree data using the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA), all measured at baseline. RESULTS The strength and direction of the BMI risk association depended on baseline menopausal status (P < 0.001); after adjusting for menopausal status, the association did not depend on age at baseline (P = 0.6). In terms of absolute risk, the negative association with BMI for premenopausal women has a much smaller influence than the positive association with BMI for postmenopausal women. Women at higher familial risk have a much larger difference in absolute risk depending on their BMI than women at lower familial risk. CONCLUSIONS The greater a woman's familial risk, the greater the influence of BMI on her absolute postmenopausal breast cancer risk. Given that age-adjusted BMI is correlated across adulthood, maintaining a healthy weight throughout adult life is particularly important for women with a family history of breast cancer.
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Affiliation(s)
- John L. Hopper
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
| | - Gillian S. Dite
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
| | - Robert J. MacInnis
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC Australia
| | - Yuyan Liao
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 7th Floor, New York, NY USA
| | - Nur Zeinomar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 7th Floor, New York, NY USA
| | - Julia A. Knight
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Melissa C. Southey
- Department of Pathology, Genetic Epidemiology Laboratory, The University of Melbourne, Parkville, VIC Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, CA VIC 3168 USA
| | - Roger L. Milne
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC Australia
| | - Wendy K. Chung
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY USA
- Departments of Pediatrics and Medicine, Columbia University, New York, NY USA
| | - Graham G. Giles
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC Australia
| | - Jeanine M. Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 7th Floor, New York, NY USA
| | - Sue-Anne McLachlan
- Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Parkville, VIC Australia
- Department of Medical Oncology, St Vincent’s Hospital, Fitzroy, VIC Australia
| | - Michael L. Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW Australia
- Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW Australia
| | - Antonis C. Antoniou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Prue C. Weideman
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
| | - Gord Glendon
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON Canada
| | - Stephanie Nesci
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - kConFab Investigators
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
- The Research Department, The Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Irene L. Andrulis
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON Canada
- Departments of Molecular Genetics and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Saundra S. Buys
- Department of Medicine and Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, UT USA
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA USA
| | - Esther M. John
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
| | - Kelly Anne Phillips
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 7th Floor, New York, NY USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY USA
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8
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Sandvei MS, Vatten LJ, Bjelland EK, Eskild A, Hofvind S, Ursin G, Opdahl S. Menopausal hormone therapy and breast cancer risk: effect modification by body mass through life. Eur J Epidemiol 2018; 34:267-278. [DOI: 10.1007/s10654-018-0431-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 07/27/2018] [Indexed: 12/28/2022]
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9
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Llanos AAM, Rabkin A, Bandera EV, Zirpoli G, Gonzalez BD, Xing CY, Qin B, Lin Y, Hong CC, Demissie K, Ambrosone CB. Hair product use and breast cancer risk among African American and White women. Carcinogenesis 2017; 38:883-892. [PMID: 28605409 DOI: 10.1093/carcin/bgx060] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/06/2017] [Indexed: 11/14/2022] Open
Abstract
Exposures to carcinogens in hair products have been explored as breast cancer risk factors, yielding equivocal findings. We examined hair product use (hair dyes, chemical relaxers and cholesterol or placenta-containing conditioners) among African American (AA) and White women, and explored associations with breast cancer. Multivariable-adjusted models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to describe the associations of interest among 2280 cases (1508 AA and 772 White) and 2005 controls (1290 AA and 715 White). Among controls, hair dye use was more common among Whites than AAs (58 versus 30%), while relaxer (88 versus 5%) and deep conditioner use (59 versus 6%) was more common among AAs. Among AAs, use of dark hair dye shades was associated with increased breast cancer risk (OR = 1.51, 95% CI: 1.20-1.90) and use of dark shades (OR = 1.72, 95% CI: 1.30-2.26) and higher frequency of use (OR = 1.36, 95% CI: 1.01-1.84) were associated with ER+ disease. Among Whites, relaxer use (OR = 1.74, 95% CI: 1.11-2.74) and dual use of relaxers and hair dyes (OR = 2.40, 95% CI: 1.35-4.27) was associated with breast cancer; use of dark hair dyes was associated with increased ER+ disease (OR = 1.54, 95% CI: 1.01-2.33), and relaxer use was associated with increased ER- disease (OR = 2.56, 95% CI: 1.06-6.16). These novel findings provide support a relationship between the use of some hair products and breast cancer. Further examinations of hair products as important exposures contributing to breast cancer carcinogenesis are necessary.
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Affiliation(s)
- Adana A M Llanos
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA.,Cancer Prevention and Control Program, Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Anna Rabkin
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Elisa V Bandera
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA.,Cancer Prevention and Control Program, Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA.,Division of Medical Oncology, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Gary Zirpoli
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Brian D Gonzalez
- Cancer Prevention and Control Program, Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA.,Division of Medical Oncology, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.,Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Cathleen Y Xing
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Bo Qin
- Cancer Prevention and Control Program, Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Yong Lin
- Department of Biostatistics, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Chi-Chen Hong
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Kitaw Demissie
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA.,Cancer Prevention and Control Program, Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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10
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Shawon MSR, Eriksson M, Li J. Body size in early life and risk of breast cancer. Breast Cancer Res 2017; 19:84. [PMID: 28732505 PMCID: PMC5521119 DOI: 10.1186/s13058-017-0875-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 06/28/2017] [Indexed: 11/26/2022] Open
Abstract
Background Body size in early life is inversely associated with adult breast cancer (BC) risk, but it is unclear whether the associations differ by tumor characteristics. Methods In a pooled analysis of two Swedish population-based studies consisting of 6731 invasive BC cases and 28,705 age-matched cancer-free controls, we examined the associations between body size in early life and BC risk. Self-reported body sizes at ages 7 and 18 years were collected by a validated nine-level pictogram (aggregated into three categories: small, medium and large). Odds ratios (OR) and corresponding 95% confidence intervals (CI) were estimated from multivariable logistic regression models in case-control analyses, adjusting for study, age at diagnosis, age at menarche, number of children, hormone replacement therapy, and family history of BC. Body size change between ages 7 and 18 were also examined in relation to BC risk. Case-only analyses were performed to test whether the associations differed by tumor characteristics. Results Medium or large body size at age 7 and 18 was associated with a statistically significant decreased BC risk compared to small body size (pooled OR (95% CI): comparing large to small, 0.78 (0.70–0.86), Ptrend <0.001 and 0.72 (0.64–0.80), Ptrend <0.001, respectively). The majority of the women (~85%) did not change body size categories between age 7 and 18 . Women who remained medium or large between ages 7 and 18 had significantly decreased BC risk compared to those who remained small. A reduction in body size between ages 7 and 18 was also found to be inversely associated with BC risk (0.90 (0.81–1.00)). No significant association was found between body size at age 7 and tumor characteristics. Body size at age 18 was found to be inversely associated with tumor size (Ptrend = 0.006), but not estrogen receptor status and lymph node involvement. For all analyses, the overall inferences did not change appreciably after further adjustment for adult body mass index. Conclusions Our data provide further support for a strong and independent inverse relationship between early life body size and BC risk. The association between body size at age 18 and tumor size could be mediated by mammographic density. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0875-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Md Shajedur Rahman Shawon
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77, Stockholm, Sweden.,Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77, Stockholm, Sweden
| | - Jingmei Li
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77, Stockholm, Sweden. .,Genome Institute of Singapore, 60 Biopolis St, Genome, #02-01, Singapore, 138672, Singapore.
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11
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Florath I, Sarink D, Saunders C, Heyworth J, Fritschi L. Breast cancer risk and the interaction between adolescent body size and weight gain in later life: A case-control study. Cancer Epidemiol 2016; 45:135-144. [DOI: 10.1016/j.canep.2016.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/21/2016] [Accepted: 10/24/2016] [Indexed: 01/21/2023]
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12
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Xue F, Rosner B, Eliassen H, Michels KB. Body fatness throughout the life course and the incidence of premenopausal breast cancer. Int J Epidemiol 2016; 45:1103-1112. [PMID: 27466312 DOI: 10.1093/ije/dyw149] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The role of body fatness in the aetiology of breast cancer is complex. We evaluated the independent and synergistic effects of body fatness, at different stages throughout a woman's life course, on premenopausal breast cancer risk. METHODS Premenopausal participants of the Nurses' Health Study II (NHSII) were followed from 1991 up to 2009. Body fatness factors including birthweight, somatotype (a 9-level pictogram with level 1 being the leanest) at ages 5 and 10 years and body mass index (BMI) at age 18 were collected at baseline. Current BMI was updated biennially. Multivariate Cox regression models were used to evaluate the association between each body fatness factor as well as cross-classification of all factors and the incidence of breast cancer. RESULTS Based on 1574 incident premenopausal breast cancer cases and 1 133 893 person-years of follow-up, a lower incidence was associated with lower birthweight: hazard ratio (HR) [95% confidence interval (CI)] = 0.74 (0.58-0.95) for <2.5kg vs 3.9+kg, P for trend < 0.001; higher somatotype at age 5: HR=0.57 (95% CI 0.44-0.73) for 5-9 vs 1, P fortrend < 0.0001]; and at age 10: HR=0.61 (95% CI 0.49-0.75) for 5-9 vs 1, P for trend < 0.0001]; and BMI at age 18: HR=0.67 (95% 0.47-0.95) for ≥ 27.5 kg/m2 vs < 18.5 kg/m2, P for trend = 0.009], after adjusting for age and body fatness measures earlier in life and other risk factors, respectively. No significant interaction between body fatness measures was found. Women with the lowest birthweight, the highest somatotype at ages 5 and 10 and the highest BMI at age 18 and currently had a 72% (95% CI 54%-83%) lower incidence of invasive premenopausal breast cancer than women with the opposite extreme of each body fatness indicator. CONCLUSION The lowest incidence of premenopausal breast cancer was associated with the lowest birthweight and the highest childhood, adolescent and early adult body fatness.
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Affiliation(s)
- Fei Xue
- Obstetrics and Gynecology Epidemiology Center
| | - Bernard Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology and.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Heather Eliassen
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology and
| | - Karin B Michels
- Obstetrics and Gynecology Epidemiology Center, .,Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology and
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13
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Keinan-Boker L, Levine H, Derazne E, Molina-Hazan V, Kark JD. Measured adolescent body mass index and adult breast cancer in a cohort of 951,480 women. Breast Cancer Res Treat 2016; 158:157-167. [DOI: 10.1007/s10549-016-3860-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 06/07/2016] [Indexed: 01/31/2023]
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14
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Bertrand KA, Baer HJ, Orav EJ, Klifa C, Kumar A, Hylton NM, LeBlanc ES, Snetselaar LG, Van Horn L, Dorgan JF. Early Life Body Fatness, Serum Anti-Müllerian Hormone, and Breast Density in Young Adult Women. Cancer Epidemiol Biomarkers Prev 2016; 25:1151-7. [PMID: 27197299 DOI: 10.1158/1055-9965.epi-16-0185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 04/25/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Emerging evidence suggests positive associations between serum anti-Müllerian hormone (AMH), a marker of ovarian function, and breast cancer risk. Body size at young ages may influence AMH levels, but few studies have examined this. Also, no studies have examined the relation of AMH levels with breast density, a strong predictor of breast cancer risk. METHODS We examined associations of early life body fatness, AMH concentrations, and breast density among 172 women in the Dietary Intervention Study in Children (DISC). Height and weight were measured at baseline (ages 8-10) and throughout adolescence. Serum AMH concentrations and breast density were assessed at ages 25-29 at the DISC 2006 Follow-up visit. We used linear mixed effects models to quantify associations of AMH (dependent variable) with quartiles of age-specific youth body mass index (BMI) Z-scores (independent variable). We assessed cross-sectional associations of breast density (dependent variable) with AMH concentration (independent variable). RESULTS Neither early life BMI nor current adult BMI was associated with AMH concentrations. There were no associations between AMH and percent or absolute dense breast volume. In contrast, women with higher AMH concentrations had significantly lower absolute nondense breast volume (Ptrend < 0.01). CONCLUSIONS We found no evidence that current or early life BMI influences AMH concentrations in later life. Women with higher concentrations of AMH had similar percent and absolute dense breast volume, but lower nondense volume. IMPACT These results suggest that AMH may be associated with lower absolute nondense breast volume; however, future prospective studies are needed to establish temporality. Cancer Epidemiol Biomarkers Prev; 25(7); 1151-7. ©2016 AACR.
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Affiliation(s)
| | - Heather J Baer
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - E John Orav
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | | | - Nola M Hylton
- Department of Radiology, University of California, San Francisco, California
| | - Erin S LeBlanc
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | | | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Joanne F Dorgan
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
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15
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Bandera EV, Maskarinec G, Romieu I, John EM. Racial and ethnic disparities in the impact of obesity on breast cancer risk and survival: a global perspective. Adv Nutr 2015; 6:803-19. [PMID: 26567202 PMCID: PMC4642425 DOI: 10.3945/an.115.009647] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Obesity is a global concern, affecting both developed and developing countries. Although there are large variations in obesity and breast cancer rates worldwide and across racial/ethnic groups, most studies evaluating the impact of obesity on breast cancer risk and survival have been conducted in non-Hispanic white women in the United States or Europe. Given the known racial/ethnic differences in tumor hormone receptor subtype distribution, obesity prevalence, and risk factor profiles, we reviewed published data for women of African, Hispanic, and Asian ancestry in the United States and their countries of origin. Although the data are limited, current evidence suggests a stronger adverse effect of obesity on breast cancer risk and survival in women of Asian ancestry. For African Americans and Hispanics, the strength of the associations appears to be more comparable to that of non-Hispanic whites, particularly when accounting for subtype and menopausal status. Central obesity seems to have a stronger impact in African-American women than general adiposity as measured by body mass index. International data from countries undergoing economic transition offer a unique opportunity to evaluate the impact of rapid weight gain on breast cancer. Such studies should take into account genetic ancestry, which may help elucidate differences in associations between ethnically admixed populations. Overall, additional large studies that use a variety of adiposity measures are needed, because the current evidence is based on few studies, most with limited statistical power. Future investigations of obesity biomarkers will be useful to understand possible racial/ethnic biological differences underlying the complex association between obesity and breast cancer development and progression.
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Affiliation(s)
- Elisa V Bandera
- Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ
| | | | | | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA; and Department of Health Research and Policy (Epidemiology) and Stanford Cancer Institute, Stanford School of Medicine, Stanford, CA
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16
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Oh H, Boeke CE, Tamimi RM, Smith-Warner SA, Wang M, Willett WC, Eliassen AH. The interaction between early-life body size and physical activity on risk of breast cancer. Int J Cancer 2015; 137:571-81. [PMID: 25335465 PMCID: PMC4405425 DOI: 10.1002/ijc.29272] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 10/07/2014] [Indexed: 01/08/2023]
Abstract
While early-life body leanness is associated with increased breast cancer risk, early-life physical activity may protect against breast cancer. We examined whether the excess risk among lean girls is modified by their levels of prior, concurrent, or future physical activity. We conducted an analysis among 74,723 women in the Nurses' Health Study II (follow-up 1997-2011). Participants recalled their body size at ages 5, 10 and 20 years in 1989 using a 9-level pictogram (Level 1 most lean). In 1997, they reported adolescent levels of physical activity (ages 12-13 and 14-17 years). Cox proportional hazards models estimated the overall association of body size with breast cancer risk and assessed interactions of adolescent physical activity with body size at three different age periods (5-10, 10-20 and 20 years), adjusting for early-life and adult risk factors for breast cancer. Regardless of levels of adolescent physical activity, early-life body leanness (level 1-2 vs. 4.5+) was significantly associated with higher breast cancer risk. The association was slightly attenuated among those who were active (60+ MET-hr/wk) during adolescence compared to those who were inactive (<30 MET-hr/wk) (body size at ages 5-10 years: hazard ratio = 1.37, 95% confidence interval = 1.04-1.81 vs. 1.66, 1.29-2.12), but the interaction was not significant (p = 0.72). The results were similar for body size at three different age periods. Being lean during early life is a risk factor for breast cancer among both inactive and active girls. Adolescent physical activity did not significantly modify the association, although some interaction cannot be excluded.
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Affiliation(s)
- Hannah Oh
- Department of Epidemiology, Harvard School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
- Department of Nutrition, Harvard School of Public Health
| | - Caroline E. Boeke
- Department of Epidemiology, Harvard School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
| | - Rulla M. Tamimi
- Department of Epidemiology, Harvard School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
| | - Stephanie A. Smith-Warner
- Department of Epidemiology, Harvard School of Public Health
- Department of Nutrition, Harvard School of Public Health
| | - Molin Wang
- Department of Epidemiology, Harvard School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
- Department of Biostatistics, Harvard School of Public Health
| | - Walter C. Willett
- Department of Epidemiology, Harvard School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
- Department of Nutrition, Harvard School of Public Health
| | - A. Heather Eliassen
- Department of Epidemiology, Harvard School of Public Health
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
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17
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Wu AH, Pearce CL, Tseng CC, Pike MC. African Americans and Hispanics Remain at Lower Risk of Ovarian Cancer Than Non-Hispanic Whites after Considering Nongenetic Risk Factors and Oophorectomy Rates. Cancer Epidemiol Biomarkers Prev 2015; 24:1094-100. [PMID: 25873577 PMCID: PMC4490941 DOI: 10.1158/1055-9965.epi-15-0023] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/08/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Risk factors for invasive epithelial ovarian cancer (IEOC) among Hispanics and African Americans are understudied despite notable differences in incidence relative to non-Hispanic whites. METHODS We used multivariate logistic regression to examine parity, oral contraceptive use, tubal ligation, endometriosis, family history of ovarian cancer, and talc use and risk of IEOC among Hispanics (308 cases and 380 controls), African Americans (128 cases and 143 controls), and non-Hispanic whites (1,265 cases and 1,868 controls) using four case-control studies we conducted in Los Angeles County. We expressed each of these factors in the form of increasing risk and calculated population attributable risk percentage (PAR%) estimates for the six risk factors separately and jointly in the three groups. RESULTS The risk associations with these six well-accepted factors were comparable in the three groups. The significant racial/ethnic differences in the prevalence of these factors and differences in their oophorectomy rates explained 31% of the lower incidence in African Americans compared with non-Hispanic whites, but only 13% of the lower incidence in Hispanics. The PAR%s ranged from 27.5% to 31.0% for no tubal ligation, 15.9% to 22.2% for not using oral contraceptives, and 12.2% to 15.1% for using talc in the three groups. CONCLUSIONS All six risk factors are comparably important in the three groups. Differences in the prevalence of these factors and their oophorectomy rates explained approximately one third of the difference in incidence between African Americans and non-Hispanic whites. IMPACT Devising strategies to lessen the burden of IEOC will be applicable to all three racial/ethnic groups.
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Affiliation(s)
- Anna H Wu
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California.
| | - Celeste L Pearce
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California. Department of Epidemiology, University of Michigan, School of Public Health, Ann Arbor, Michigan
| | - Chiu-Chen Tseng
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California
| | - Malcolm C Pike
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
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18
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Bandera EV, Chandran U, Hong CC, Troester MA, Bethea TN, Adams-Campbell LL, Haiman CA, Park SY, Olshan AF, Ambrosone CB, Palmer JR, Rosenberg L. Obesity, body fat distribution, and risk of breast cancer subtypes in African American women participating in the AMBER Consortium. Breast Cancer Res Treat 2015; 150:655-66. [PMID: 25809092 DOI: 10.1007/s10549-015-3353-z] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 03/17/2015] [Indexed: 11/26/2022]
Abstract
African American (AA) women are more likely than white women to be obese and to be diagnosed with ER- and triple-negative (TN) breast cancer, but few studies have evaluated the impact of obesity and body fat distribution on breast cancer subtypes in AA women. We evaluated these associations in the AMBER Consortium by pooling data from four large studies. Cases were categorized according to hormone receptor status as ER+, ER-, and TN (ER-, PR-, and HER2-) based on pathology data. A total of 2104 ER+ cases, 1070 ER- cases (including 491 TN cases), and 12,060 controls were included. Odds ratios (OR) and 95 % confidence intervals (CI) were computed using logistic regression, taking into account breast cancer risk factors. In postmenopausal women, higher recent (most proximal value to diagnosis/index date) BMI was associated with increased risk of ER+ cancer (OR 1.31; 95 % CI 1.02-1.67 for BMI ≥ 35 vs. <25 kg/m(2)) and with decreased risk of TN tumors (OR 0.60; 95 % CI 0.39-0.93 for BMI ≥ 35 vs. <25). High young adult BMI was associated with decreased premenopausal ER+ cancer and all subtypes of postmenopausal cancer, and high recent waist-to-hip ratio with increased risk of premenopausal ER+ tumors (OR 1.35; 95 % CI 1.01-1.80) and all tumor subtypes combined in postmenopausal women (OR 1.26; 95 % CI 1.02-1.56). The impact of general and central obesity varies by menopausal status and hormone receptor subtype in AA women. Our findings imply different mechanisms for associations of adiposity with TN and ER+ breast cancers.
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Affiliation(s)
- Elisa V Bandera
- Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08903, USA,
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19
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George P, Chandwani S, Gabel M, Ambrosone CB, Rhoads G, Bandera EV, Demissie K. Diagnosis and surgical delays in African American and white women with early-stage breast cancer. J Womens Health (Larchmt) 2015; 24:209-17. [PMID: 25650628 DOI: 10.1089/jwh.2014.4773] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Delays in diagnosis and treatment for breast cancer may contribute to excess deaths among African Americans. We examined racial differences in delays in diagnosis and surgical treatment for early-stage breast cancer and evaluated race-specific predictors associated with delay. METHODS A retrospective cohort study was conducted among 634 African American and white women diagnosed with invasive breast cancer between 2005 and 2010 in New Jersey. Detailed medical-chart abstraction and patient interviews were undertaken. Time intervals were calculated from symptom recognition to diagnosis (diagnosis delay) and from diagnosis to first operation (surgical delay). Binomial regression models were used to examine racial differences in delay and factors associated with ≥2 months delay in the overall population and stratified by race. Reasons responsible for diagnosis delay were also examined by race. RESULTS Compared to white women, African American women experienced significantly higher risk of ≥2 months delay in diagnosis and surgical treatment (adjusted relative risks=1.44 (1.12-1.86) and 3.08 (1.88-5.04), respectively). For the African Americans, predictors of diagnosis delay included mode of detection, insurance, and tumor size; for whites, mode of detection and tumor grade. Surgical delay was associated with operation type and education among African Americans but with operation type and tumor size for whites. Patient-related factors were commonly noted as reasons for diagnosis delay. CONCLUSIONS These findings emphasize the need to raise further awareness, especially among African American patients and their providers, of the importance of prompt evaluation and treatment of breast abnormalities. Research on effective ways to accomplish this is needed.
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Affiliation(s)
- Prethibha George
- 1 Department of Epidemiology, Rutgers School of Public Health , Piscataway, New Jersey
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20
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The association of reproductive and lifestyle factors with a score of multiple endogenous hormones. Discov Oncol 2014; 5:324-35. [PMID: 25048255 DOI: 10.1007/s12672-014-0191-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 07/10/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION We recently reported that high levels of multiple sex and growth hormones were associated with increased postmenopausal breast cancer risk. Limited research has explored the relationship between reproductive, anthropometric, and lifestyle factors and levels of multiple hormones simultaneously. METHODS This cross-sectional analysis included 738 postmenopausal Nurses' Health Study participants who were controls in a breast cancer nested case-control study and had measured levels of estrone, estradiol, estrone sulfate, testosterone, androstenedione, dehydroepiandrosterone sulfate, prolactin, and sex hormone binding globulin (SHBG). A score was created by summing the number of hormones a woman had above (below for SHBG) each hormone's age-adjusted geometric mean. The association between lifestyle, anthropometric, and reproductive exposures and the score was assessed using generalized linear models. RESULTS The hormone score ranged from 0 to 8 with a mean of 4.0 (standard deviation = 2.2). Body mass index (BMI) and alcohol consumption at blood draw were positively associated with the hormone score: a 5 unit increase in BMI was associated with a 0.79 (95%CI: 0.63, 0.95) unit increase in the score (p < 0.0001) and each 15 g/day increase in alcohol consumption was associated with a 0.41 (95%CI: 0.18, 0.63) unit increase in the score (p = 0.0004). Family history of breast cancer, age at menarche, and physical activity were not associated with the score. CONCLUSIONS Reproductive breast cancer risk factors were not associated with elevated levels of multiple endogenous hormones, whereas anthropometric and lifestyle factors, particularly BMI and alcohol consumption, tended to be associated with higher levels of multiple hormones.
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Chandwani S, George PA, Azu M, Bandera EV, Ambrosone CB, Rhoads GG, Demissie K. Role of preoperative magnetic resonance imaging in the surgical management of early-stage breast cancer. Ann Surg Oncol 2014; 21:3473-80. [PMID: 24912611 DOI: 10.1245/s10434-014-3748-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Indexed: 12/21/2022]
Abstract
PURPOSE To examine the role of preoperative magnetic resonance imaging (pMRI) on time to surgery and rates of reoperation and contralateral prophylactic mastectomy (CPM) using a population-based study of New Jersey breast cancer patients. METHODS The study included 289 African-American and 320 white women who participated in the Breast Cancer Treatment Disparity Study and underwent breast surgery for newly diagnosed early-stage breast cancer between 2005 and 2010. Patients were identified through rapid case ascertainment by the New Jersey State Cancer Registry. Association between pMRI and time to surgery was examined by using linear regression and, with reoperation and CPM, by using binomial regression. RESULTS Half (49.9 %) of the study population received pMRI, with higher use for whites compared with African-Americans (62.5 vs. 37.5 %). After adjusting for potential confounders, patients with pMRI versus those without experienced significantly longer time to initial surgery [geometric mean = 38.7 days; 95 % confidence interval (CI) 34.8-43.0; vs. 26.5 days; 95 % CI 24.3-29.0], a significantly higher rate of CPM [relative risk (RR) = 1.82; 95 % CI 1.06-3.12], and a nonsignificantly lower rate of reoperation (RR = 0.76; 95 % CI 0.54-1.08). CONCLUSIONS Preoperative MRI was associated with significantly increased time to surgery and a higher rate of CPM, but it did not affect the rate of reoperation. Physicians and patients should consider these findings when making surgical decisions on the basis of pMRI findings.
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Affiliation(s)
- Sheenu Chandwani
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA,
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22
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Ambrosone CB, Zirpoli GR, Bovbjerg DH, Shankar J, Hong CC, McCann SE, Ruszczyk M, Khoury T, Yao S, Ciupak GL, Jandorf L, Pawlish KS, Bandera EV. Associations between estrogen receptor-negative breast cancer and timing of reproductive events differ between African American and European American women. Cancer Epidemiol Biomarkers Prev 2014; 23:1115-20. [PMID: 24718280 DOI: 10.1158/1055-9965.epi-14-0110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The effects of reproductive factors on breast cancer risk seem to differ by estrogen receptor (ER) status. Menarche and first live birth (FLB) tend to occur at younger ages in African Americans (AA) than European Americans (EA), and could play a role in breast cancer disparities. In the Women's Circle of Health Study, a case-control study of breast cancer in EA and AA women, in-person interviews were conducted to collect epidemiologic data, including reproductive histories. Data on ER status, abstracted from pathology reports, were available for 814 AA and 538 EA breast cancer cases, and were analyzed with 1015 AA and 715 EA controls, to evaluate associations between subgroups and age at menarche, age at FLB, and the interval between those ages. Among AA women, later age at menarche (≥14 years) was associated with reduced risk of both ER(+) and ER(-) breast cancer, with ORs strongest for ER(-) disease [OR = 0.57; 95% confidence interval (CI), 0.37-0.88]; associations were weaker and nonsignificant for EA women. There were no significant associations with age at FLB, but AA women with a FLB within 15 years of menarche had increased risk of ER(-) disease (OR = 2.26; 95% CI, 1.29-3.95), with no significant associations among EAs. In our data, earlier age at menarche and shorter intervals until FLB are associated with ER(-) breast cancer in AA women; differential distributions by race of these and other reproductive risk factors could contribute to the higher prevalence of ER(-) breast cancer in AA women. Cancer Epidemiol Biomarkers Prev; 23(6); 1115-20. ©2014 AACR.
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Affiliation(s)
- Christine B Ambrosone
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Gary R Zirpoli
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Dana Howard Bovbjerg
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Jyoti Shankar
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New JerseyAuthors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Chi-Chen Hong
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Susan E McCann
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Melanie Ruszczyk
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Thaer Khoury
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Song Yao
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Gregory L Ciupak
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Lina Jandorf
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Karen S Pawlish
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
| | - Elisa V Bandera
- Authors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New JerseyAuthors' Affiliations: Departments of Cancer Prevention and Control and Pathology, Roswell Park Cancer Institute, Buffalo; Icahn School of Medicine at Mount Sinai, New York, New York; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; J. Craig Venter Institute, Rockville, Maryland; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton; Rutgers Cancer Institute of New Jersey, New Brunswick; and Rutgers School of Public Health, Piscataway, New Jersey
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