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Hartman YAW, Kenkhuis MF, Stelten S, Brouwer CG, van Lonkhuijzen LRCW, Kenter GG, van Driel WJ, Winkels RM, Bekkers RLM, Ottevanger NPB, Hoedjes M, Buffart LM. Demographic, clinical, and sociocognitive determinants related to physical activity and dietary intake in patients with ovarian cancer: A cross-sectional study. Gynecol Oncol 2024; 183:39-46. [PMID: 38503140 DOI: 10.1016/j.ygyno.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/26/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To study physical activity and dietary intake among patients with ovarian cancer and to examine which demographic, clinical, and sociocognitive determinants are associated with these behaviours. METHODS This cross-sectional study included 139 patients with ovarian cancer scheduled for (neo)adjuvant chemotherapy. Physical activity was measured with the Physical Activity Scale for the Elderly questionnaire (PASE). Dietary intake was measured with a questionnaire assessing energy and protein intake and a questionnaire assessing adherence to the World Cancer Research Fund (WCRF) lifestyle recommendations. Demographic, clinical, and sociocognitive (e.g., self-efficacy) determinants of physical activity and dietary intake were examined using backward linear regression analyses. RESULTS Patients reported a median PASE score of 50 (IQR 24-94), a mean ± SD dietary intake of 1831 ± 604 kcal/day and 76 ± 27 g protein/day. Patients adhered to 3 out of 5 WCRF lifestyle recommendations. The absence of comorbidities, lower physical outcome expectations, and higher cancer specific outcome expectations were independently associated with higher physical activity levels. Higher age, lower cancer specific outcome expectations, and higher diet-related self-efficacy were significantly associated with adhering to more WCRF lifestyle recommendations, whilst no variables associated with total caloric or protein intake were identified. CONCLUSIONS Patients with ovarian cancer have low physical activity levels and a suboptimal diet, particularly low fruit and vegetable consumption and dietary fibre intake. Interventions aiming to improve physical activity and dietary intake could focus on increasing self-efficacy and outcome expectations, and should consider age and comorbidity as factors that may impact behaviour. TRIAL REGISTRATION Netherlands Trial Registry NTR6300.
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Affiliation(s)
- Yvonne A W Hartman
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marlou-Floor Kenkhuis
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Stephanie Stelten
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Calvin G Brouwer
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Gemma G Kenter
- Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Obstetrics and Gynaecology, Cancer Center Amsterdam, Center for Gynaecologic Oncology Amsterdam (CGOA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Gynaecology, Center for Gynaecologic Oncology Amsterdam (CGOA), The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Willemien J van Driel
- Gynaecology, Center for Gynaecologic Oncology Amsterdam (CGOA), The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Renate M Winkels
- Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Ruud L M Bekkers
- Department of Obstetrics and Gynaecology, Grow School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands; Department of Gynecology, Catharina Hospital, Eindhoven, the Netherlands; Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nelleke P B Ottevanger
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Meeke Hoedjes
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Laurien M Buffart
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands.
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Huang X, Du S, Wang Q, Yang C, Liu X, Chen K, Zhao Y, He N, Wang H. Impact of obese patients in ovarian cancer surgery on postoperative wound complications: A meta-analysis. Int Wound J 2024; 21:e14439. [PMID: 38064172 PMCID: PMC10957721 DOI: 10.1111/iwj.14439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 09/23/2023] [Accepted: 10/02/2023] [Indexed: 03/23/2024] Open
Abstract
The effect of obesity on wound-related outcomes in post-ovarian cancer patients is not clear. A number of studies on the association of fat with post-operation injury in ovarian carcinoma have produced contradictory findings. This study aims to conduct a study of the available data to assess the association of obese individuals with significant surgery results in ovarian cancer. We looked up Cochrane Library, Embase, and PubMed for qualifying research on ovarian cancer operations to determine the primary evidence for evaluating the association of obesity with post-surgical wound injury in ovarian cancer. The odds ratio (OR) was analysed with a fixed effect model if the variability of the study was small; otherwise, the analysis of the data was done with a random effect model. Out of 1259 related trials which were reviewed for eligibility, 6 publications were chosen from 2009 to 2019, 3076 patients who had had an operation for ovarian cancer. Obesity has been linked to an increased rate of wound-related complications in ovarian cancer operations compared to those without obesity (OR, 0.50; 95% CI, 0.37, 0.69 p < 0.0001). Non-obesity was significantly less likely to occur with respect to operation time compared to those with obesity (MD, -48.00; 95% CI, -55.33, -40.68 p < 0.00001). There were no statistically significant differences in the rate of haemorrhage after the operation (OR, 0.26; 95% CI, 0.04, 1.57, p = 0.14). Because of the limited number of trials in this meta-analysis, caution should be exercised in their treatment. More high-quality research with a large sample is required in order to confirm the findings.
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Affiliation(s)
- Xianxia Huang
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Shengye Du
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Qun Wang
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Chenchen Yang
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Xueling Liu
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Kai Chen
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Yinghui Zhao
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Ning He
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Hongping Wang
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
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Cui Q, Gong TT, Liu FH, Xu HL, Zheng G, Yan S, Gao S, Tan XL, Wu QJ. Adherence to Sulfur Microbial Diet and Ovarian Cancer Survival: Evidence from a Prospective Cohort Study. Mol Nutr Food Res 2024; 68:e2300165. [PMID: 37891713 DOI: 10.1002/mnfr.202300165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/13/2023] [Indexed: 10/29/2023]
Abstract
SCOPE The study aims to investigate the role of the sulfur microbial diet in the survival of ovarian cancer (OC). METHODS AND RESULTS A prospective cohort study is conducted with 703 patients diagnosed with OC between 2015 and 2020. Diet information is collected using a validated food frequency questionnaire. Deaths are ascertained up to March 31, 2021, via the death registry linkage. During the follow-up period (median: 37.2 months, interquartile range: 24.7-50.2 months), 130 deaths are observed. A higher sulfur microbial diet score is significantly associated with an increased risk of all-cause mortality among OC patients (tertile 3 vs tertile 1: HR = 1.93, 95% CI = 1.11-3.35). Each 1-standard deviation increment in the sulfur microbial diet score increases the all-cause mortality risk by 33% (95% CI = 1.04-1.71). Stratified analysis shows that significant associations are found in OC patients diagnosed over 50 years of age, with body mass index ≥24 kg m-2 , who changed their diet after diagnosis, or without residual lesions. CONCLUSIONS Adherence to the sulfur microbial diet, characterized by high intakes of red meats and processed meats, and low intakes of fruits, vegetables, and whole grains, is associated with poor survival in OC patients.
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Affiliation(s)
- Qi Cui
- Department of Frigidzone Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China
- Key Laboratory of high altitude Medicine, People's Liberation Army, Chongqing, 400038, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - He-Li Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Gang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Shi Yan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Xiao-Ling Tan
- Department of Frigidzone Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China
- Key Laboratory of high altitude Medicine, People's Liberation Army, Chongqing, 400038, China
| | - Qi-Jun Wu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, 110004, China
- NHC Key Laboratory of Advanced Reproductive Medicine and Fertility (China Medical University), National Health Commission, Shenyang, 110004, China
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Liu YY, Gong TT, Li YZ, Xu HL, Zheng G, Liu FH, Qin X, Xiao Q, Wu QJ, Huang DH, Gao S, Zhao YH. Association of pre-diagnosis specific color groups of fruit and vegetable intake with ovarian cancer survival: results from the ovarian cancer follow-up study (OOPS). Food Funct 2023; 14:8442-8452. [PMID: 37622277 DOI: 10.1039/d3fo01443f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Background: The colors of fruits and vegetables (FV) reflect the presence of pigmented bioactive compounds. The evidence of pre-diagnosis specific FV color group intake contributing to ovarian cancer (OC) survival is limited and inconsistent. Methods: A prospective cohort study was conducted between 2015 and 2020 with 700 newly diagnosed OC patients. Pre-diagnosis dietary information was assessed by a validated food frequency questionnaire. We classified FV into five groups based on the color of their edible parts (e.g., green, red/purple, orange/yellow, white, and uncategorized groups). Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of specific color groups of FV before diagnosis with OC survival. Potential multiplicative and additive interactions were assessed. Results: 130 patients died during a median follow-up of 37.57 (interquartile: 24.77-50.20) months. We observed the improved survival with a higher pre-diagnosis intake of total FV (HRtertile 3 vs. tertile 1 = 0.63, 95%CI = 0.40-0.99), total vegetables (HRtertile 3 vs. tertile 1 = 0.57, 95%CI = 0.36-0.90), and red/purple FV (HRtertile 3 vs. tertile 1 = 0.52, 95%CI = 0.33-0.82). In addition, we observed significant dose-response relationships for per standard deviation increment between total vegetable intake (HR = 0.79, 95%CI = 0.65-0.96) and red/purple group intake (HR = 0.77, 95%CI = 0.60-0.99) before diagnosis with OC survival. Additionally, pre-diagnosis green FV intake was borderline associated with better OC survival (HRper standard deviation increment = 0.83; 95%CI = 0.69-1.00). In contrast, we did not observe significant associations between pre-diagnosis intake of total fruits, orange/yellow, white, and uncategorized groups and OC survival. Conclusion: Pre-diagnosis FV intake from various color groups, especially the green and red/purple ones, may improve OC survival. Further studies are needed to validate our findings.
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Affiliation(s)
- Yu-Yang Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
| | - Yi-Zi Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - He-Li Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Gang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xue Qin
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
| | - Qian Xiao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Key Laboratory of Reproductive and Genetic Medicine (China Medical University), National Health Commission, Shenyang, China
| | - Dong-Hui Huang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning, 110001, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
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Johnston EA, Ibiebele TI, Friedlander ML, Grant PT, van der Pols JC, Webb PM. Association of protein intake with recurrence and survival following primary treatment of ovarian cancer. Am J Clin Nutr 2023:S0002-9165(23)48895-8. [PMID: 37146759 DOI: 10.1016/j.ajcnut.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Malnutrition is common during treatment for ovarian cancer and one in three report multiple symptoms affecting food intake after primary treatment. Little is known about diet post-treatment in relation to ovarian cancer survival, however, general recommendations for cancer survivors are to maintain a higher level of protein intake to support recovery and minimize nutritional deficits. OBJECTIVE To investigate whether intake of protein and protein food sources following primary treatment for ovarian cancer is associated with recurrence and survival. DESIGN Intake levels of protein and protein food groups were calculated from dietary data collected about 12 months post-diagnosis using a validated food frequency questionnaire in an Australian cohort of females with invasive epithelial ovarian cancer. Disease recurrence and survival status were abstracted from medical records (median 4.9 years follow-up). Cox proportional hazards regression was used to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for protein intake and progression-free and overall survival. RESULTS Among 591 females who were progression-free at 12-months follow-up, 329 (56%) subsequently experienced cancer recurrence and 231 (39%) died. A higher level of protein intake was associated with better progression-free survival (>1-1.5 vs. ≤1 grams per kilogram body weight (g/kg): HRadjusted=0.69, 95% CI 0.48, 1.00; >1.5 vs. ≤1g/kg: HRadjusted=0.61, 95% CI 0.41, 0.90; >20% vs. ≤20% total energy intake from protein: HRadjusted=0.77, 95% CI 0.61, 0.96). There was no evidence for better progression-free survival with any particular protein food sources. There was a suggestion of better overall survival among those with higher total intakes of animal-based protein foods, particularly dairy products (HR=0.71, 95% CI 0.51, 0.99 for highest vs. lowest tertiles of total dairy intake). CONCLUSIONS After primary treatment for ovarian cancer, a higher level of protein intake may benefit progression-free survival. Ovarian cancer survivors should avoid dietary practices that limit intake of protein-rich foods.
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Affiliation(s)
- Elizabeth A Johnston
- QIMR Berghofer Medical Research Institute, Population Health Program, Herston, Queensland, Australia; Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Kelvin Grove, Queensland, Australia; Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia.
| | - Torukiri I Ibiebele
- QIMR Berghofer Medical Research Institute, Population Health Program, Herston, Queensland, Australia
| | - Michael L Friedlander
- University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, New South Wales, Australia; Department of Medical Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Peter T Grant
- University of Melbourne, Department of Gynaecological Oncology, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Jolieke C van der Pols
- QIMR Berghofer Medical Research Institute, Population Health Program, Herston, Queensland, Australia; Queensland University of Technology (QUT), Faculty of Health, School of Exercise and Nutrition Sciences, Kelvin Grove, Queensland, Australia
| | - Penelope M Webb
- QIMR Berghofer Medical Research Institute, Population Health Program, Herston, Queensland, Australia
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Zheng G, Gong TT, Ma QP, Wei YF, Du ZD, Zhao JQ, Zou BJ, Yan S, Liu FH, Sun ML, Xiao Q, Gao S, Wu QJ, Zhao YH. The association of macronutrient quality and its interactions with energy intake with survival among patients with ovarian cancer: results from a prospective cohort study. Am J Clin Nutr 2023:S0002-9165(23)46306-X. [PMID: 37001589 DOI: 10.1016/j.ajcnut.2023.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Emerging evidence supports shifting the focus from the quantity of macronutrients to quality to obtain greater benefits for the prognosis of ovarian cancer (OC). Additionally, despite the high relevance between macronutrient quality and quantity, the interaction of these parameters on OC survival remains unknown. OBJECTIVE A multidimensional macronutrient quality index (MQI) was applied to investigate the association between overall macronutrient quality and the survival of patients with OC. METHODS A prospective cohort study was conducted with 701 females diagnosed with OC who were enrolled from 2015 to 2020. Dietary intake information was obtained from a validated food frequency questionnaire. The MQI was calculated based on 3 quality indices: carbohydrate quality index (CQI), fat quality index (FQI), and protein quality index (PQI). Cox proportional hazards regression was conducted to calculate HRs and 95% CIs. Furthermore, we evaluated whether energy intake status (total energy intake and energy balance) modified the association between MQI and OC survival. RESULTS During a median follow-up period of 38 (interquartile: 35-40) mo, 130 deaths occurred. The prediagnosis high MQI scores were associated with substantially improved survival among females with OC (HRtertile 3 vs. tertile 1 = 0.50, 95% CI: 0.33, 0.77). For sub-indices of the MQI, higher CQI (HR = 0.60, 95% CI: 0.36, 0.99), higher FQI (HR = 0.55, 95% CI: 0.34, 0.87), and higher PQI (HR = 0.58, 95% CI: 0.35, 0.94) scores were all associated with better survival. Notably, significant interactions were observed for the MQI score with total energy intake and energy balance as well as the quantity and quality of carbohydrates on survival. CONCLUSIONS Intake of high-quality macronutrients before diagnosis was associated with improved survival among females with OC, especially for those with energy imbalance. Am J Clin Nutr 2023;xxx:xx-xx.
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Affiliation(s)
- Gang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Peng Ma
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Zong-Da Du
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Jun-Qi Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Bing-Jie Zou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Shi Yan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Ming-Li Sun
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qian Xiao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China; Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Reproductive and Genetic Medicine (China Medical University), National Health Commission, Shenyang, China.
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China.
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Endometriosis Stem Cells as a Possible Main Target for Carcinogenesis of Endometriosis-Associated Ovarian Cancer (EAOC). Cancers (Basel) 2022; 15:cancers15010111. [PMID: 36612107 PMCID: PMC9817684 DOI: 10.3390/cancers15010111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Endometriosis is a serious recurrent disease impairing the quality of life and fertility, and being a risk for some histologic types of ovarian cancer defined as endometriosis-associated ovarian cancers (EAOC). The presence of stem cells in the endometriotic foci could account for the proliferative, migrative and angiogenic activity of the lesions. Their phenotype and sources have been described. The similarly disturbed expression of several genes, miRNAs, galectins and chaperones has been observed both in endometriotic lesions and in ovarian or endometrial cancer. The importance of stem cells for nascence and sustain of malignant tumors is commonly appreciated. Although the proposed mechanisms promoting carcinogenesis leading from endometriosis into the EAOC are not completely known, they have been discussed in several articles. However, the role of endometriosis stem cells (ESCs) has not been discussed in this context. Here, we postulate that ESCs may be a main target for the carcinogenesis of EAOC and present the possible sequence of events resulting finally in the development of EAOC.
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Pre-diagnosis and post-diagnosis dietary patterns and survival in women with ovarian cancer. Br J Cancer 2022; 127:1097-1105. [DOI: 10.1038/s41416-022-01901-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/08/2022] Open
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9
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Wei YF, Sun ML, Wen ZY, Liu FH, Liu YS, Yan S, Qin X, Gao S, Li XQ, Zhao YH, Gong TT, Wu QJ. Pre-diagnosis meat intake and cooking method and ovarian cancer survival: results from the Ovarian Cancer Follow-Up Study (OOPS). Food Funct 2022; 13:4653-4663. [PMID: 35373791 DOI: 10.1039/d1fo03825g] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objectives: The relationships between pre-diagnosis meat intake and ovarian cancer (OC) survival were limited and controversial. To date, no study has taken account of cooking methods. Thus, we aimed to firstly clarify these associations based on the Ovarian Cancer Follow-Up Study. Methods: This prospective cohort study, including 853 OC patients between 2015 and 2020, was conducted to examine the aforementioned associations. All women completed a food frequency questionnaire. Deaths were ascertained up to March 31, 2021 via medical records and active follow-up. We used the Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During the median follow-up of 37.17 months, 130 women died. Pre-diagnosis fish and seafood intake was associated with better survival (HRT3 vs. T1 = 0.46, 95% CI = 0.26-0.82, p trend <0.05), whereas processed red meat (HR = 1.54, 95% CI = 1.04-2.26) and a high frequency of fried fish intake (HR = 1.49, 95% CI = 1.03-2.16) were associated with worse survival than consuming none. After considering the interaction of cooking methods, we found that compared with the lowest tertile of fish and seafood intake and almost no fried fish cooking, women with the highest tertile of intake and almost no fried fish cooking had better survival (HR = 0.35, 95% CI = 0.13-0.92). Additionally, compared with the lowest tertile of fish and seafood intake and almost no baked fish cooking, women with the lowest tertile of intake and consuming baked fish had worse survival (HR = 3.75, 95% CI = 1.53-9.15). Conclusions: Pre-diagnosis fish and seafood intake was associated with better OC survival, whereas processed red meat intake was associated with worse survival. Cooking methods, especially for fried or baked fish, may play interaction effects with fish intake on OC survival.
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Affiliation(s)
- Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming-Li Sun
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Zhao-Yan Wen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ya-Shu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shi Yan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xue Qin
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Xiu-Qin Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
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10
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Sultana S, Bouyahya A, Rebezov M, Shariati MA, Balahbib A, Khouchlaa A, El Yaagoubi OM, Khaliq A, Omari NE, Bakrim S, Zengin G, Akram M, Khayrullin M, Bogonosova I, Mahmud S, Simal-Gandara J. Impacts of nutritive and bioactive compounds on cancer development and therapy. Crit Rev Food Sci Nutr 2022; 63:9187-9216. [PMID: 35416738 DOI: 10.1080/10408398.2022.2062699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
For persons who survive with progressive cancer, nutritional therapy and exercise may be significant factors to improve the health condition and life quality of cancer patients. Nutritional therapy and medications are essential to managing progressive cancer. Cancer survivors, as well as cancer patients, are mostly extremely encouraged to search for knowledge about the selection of diet, exercise, and dietary supplements to recover as well as maintain their treatment consequences, living quality, and survival of patients. A healthy diet plays an important role in cancer treatment. Different articles are studied to collect information and knowledge about the use of nutrients in cancer treatment as well as cancer prevention. The report deliberates nutrition and exercise strategies during the range of cancer care, emphasizing significant concerns during treatment of cancer and for patients of advanced cancer, but concentrating mostly on the requirements of the population of persons who are healthy or who have constant disease following their repossession from management. It also deliberates choice nutrition and exercise problems such as dietary supplements, food care, food selections, and weight; problems interrelated to designated cancer sites, and common questions about diet, and cancer survival. Decrease the side effects of medicines both during and after treatment.
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Affiliation(s)
- Sabira Sultana
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathology Biology, Faculty of Sciences, and Genomic Center of Human Pathology, Mohammed V University, Rabat, Morocco
| | - Maksim Rebezov
- V M Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Moscow, Russian Federation
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Mohammad Ali Shariati
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Abdelaali Balahbib
- Laboratory of Biodiversity, Ecology, and Genome, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Aya Khouchlaa
- Laboratory of Human Pathology Biology, Faculty of Sciences, and Genomic Center of Human Pathology, Mohammed V University, Rabat, Morocco
| | - Ouadie Mohamed El Yaagoubi
- Laboratory of Biochemistry, Environment and Agri-Food (URAC 36) - Faculty of Sciences and Techniques - Mohammedia, Hassan II University Casablanca - Morocco
| | - Adnan Khaliq
- Department of Food Science and Technology, Khwaja Fareed University of Engineering and Information Technology, Pakistan
| | - Nasreddine El Omari
- Laboratory of Histology, Embryology, and Cytogenetic, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Saad Bakrim
- Molecular Engineering, Valorization and Environment Team, Polydisciplinary Faculty of Taroudant, Ibn Zohr University, Agadir, Morocco
| | - Gokhan Zengin
- Department of Biology, Science Faculty, Selcuk University, Konya, Turkey
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Mars Khayrullin
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Irina Bogonosova
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Shafi Mahmud
- Genetic Engineering and Biotechnology, University of Rajshahi, Rajshahi, Bangladesh
| | - Jesus Simal-Gandara
- Department of Analytical Chemistry and Food Science, Faculty of Science, Universidade de Vigo, Nutrition and Bromatology Group, Ourense, Spain
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11
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Gu JH, Gong TT, Wu QJ, Liu FH, Wen ZY, Gao C, Wei YF, Yang Z. Association Between Pre-diagnostic Dietary Supplements Intake and Ovarian Cancer Survival: Findings From a Prospective Cohort Study in Chinese Women. Front Nutr 2022; 8:758178. [PMID: 34970575 PMCID: PMC8712326 DOI: 10.3389/fnut.2021.758178] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/11/2021] [Indexed: 12/11/2022] Open
Abstract
Background: As a result of a limited number of studies and inconsistent findings, there remains uncertainty in whether pre-diagnostic dietary supplements intake affects survival after ovarian cancer (OC) diagnosis. Methods: The association between pre-diagnostic dietary supplements intake and all-cause OC mortality was examined in the OC follow-up study, which included a hospital-based cohort (n = 703) of Chinese women diagnosed with OC between 2015 and 2020. Pre-diagnostic dietary supplements information was collected using self-administered questionnaires. Deaths were ascertained up to March 31, 2021, via death registry linkage. Cox proportional hazards were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the aforementioned association. Results: A total of 130 women died during the median follow-up of 37.2 months (interquartile: 24.7–50.2 months). We found no evidence that any pre-diagnostic dietary supplements intake compared with never is associated with OC survival (HR = 0.75, 95%CI: 0.47–1.18). Furthermore, our study suggested no association for ever supplements intakes of vitamin A (HR = 0.48, 95%CI: 0.07–3.46), vitamin C (HR = 0.64, 95%CI: 0.27–1.54), vitamin D (HR = 1.19, 95%CI: 0.28–5.03), vitamin E (HR = 0.47, 95%CI: 0.06–3.87), multivitamin (HR = 0.49, 95%CI: 0.14–1.67), calcium (HR = 0.96, 95%CI: 0.53–1.72), and fish oil/DHA (HR = 0.31, 95%CI: 0.04–2.37) with OC survival. Interestingly, we only found a detrimental effect of vitamin B supplementation intake (HR = 3.78, 95%CI: 1.33–0.69) on OC survival. Conclusions: We found no evidence that any pre-diagnostic dietary supplements intake is associated with OC survival. Considering lower exposure of dietary supplements before OC diagnosis in the present study, further studies are warranted to confirm these findings.
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Affiliation(s)
- Jia-Hui Gu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao-Yan Wen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chang Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhuo Yang
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
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12
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Wei YF, Hao YY, Gao S, Li XQ, Liu FH, Wen ZY, Wang HY, Zhang S, Yan S, Luan M, Zhao YH, Gong TT, Wu QJ. Pre-diagnosis Cruciferous Vegetables and Isothiocyanates Intake and Ovarian Cancer Survival: A Prospective Cohort Study. Front Nutr 2021; 8:778031. [PMID: 34901122 PMCID: PMC8654276 DOI: 10.3389/fnut.2021.778031] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/26/2021] [Indexed: 12/14/2022] Open
Abstract
Background: The associations of the consumption of cruciferous vegetables (CVs) and their bioactive components, isothiocyanates (ITCs), with ovarian cancer (OC) mortality have been unclear, owing to limited studies and inconsistent findings. To date, no studies have evaluated these associations among Chinese patients with OC. This study aims to provide more evidence indicating the relationships of pre-diagnosis CVs and ITC intake with OC survival. Methods: We examined the associations of pre-diagnosis CV and ITC intake with OC mortality in a hospital-based cohort (n = 853) of Chinese patients with epithelial OC between 2015 and 2020. Pre-diagnosis dietary information was evaluated with a validated food frequency questionnaire. Deaths were ascertained until March 31, 2021 via medical records and active follow-up. The associations were examined with the Cox proportional hazards model, adjusted for potential confounders, and stratified by menopausal status, residual lesions, histological type, and body mass index (BMI). Results: During a median follow-up of 37.2 months (interquartile: 24.7–50.2 months), we observed 130 deaths. The highest tertile of total CV intake was associated with better survival than the lowest tertile intake [hazard ratio (HR) = 0.57, 95% confidence interval (CI) = 0.33–0.98, p trend < 0.05]. In addition, higher intake of ITCs from CVs was associated with better survival (HRT3VS.T1 = 0.59, 95% CI = 0.36–0.99, p trend = 0.06). Significant inverse associations were also observed for subgroup analyses stratified by menopausal status, residual lesions, histological type, and BMI, although not all associations showed statistical significance. Conclusion: Increasing pre-diagnosis consumption of CVs and ITCs was strongly associated with better survival in patients with OC.
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Affiliation(s)
- Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ying-Ying Hao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiu-Qin Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao-Yan Wen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Han-Yuan Wang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shuang Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shi Yan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Meng Luan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.,Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
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13
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Jiang L, Gong TT, Gao S, Li XQ, Liu FH, Wen ZY, Wei YF, Yan S, Hou R, Wu QJ. Pre-diagnosis Dairy Product Intake and Ovarian Cancer Mortality: Results From the Ovarian Cancer Follow-Up Study (OOPS). Front Nutr 2021; 8:750801. [PMID: 34778342 PMCID: PMC8586538 DOI: 10.3389/fnut.2021.750801] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/05/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Dairy product consumption is associated with ovarian cancer (OC) incidence. However, limited evidence is available on its influence on OC mortality. Methods: The association between pre-diagnostic dairy product intake and OC mortality was investigated in the OC follow-up study, which included a hospital-based cohort (n = 853) of women diagnosed with epithelial OC between 2015 and 2020. Pre-diagnosis diet information was collected using a validated food frequency questionnaire. Deaths were ascertained up to March 31, 2021 via death registry linkage. Cox proportional hazards model was used to estimate the adjusted hazard ratio (HR) and 95% confidence interval (CI) for the aforementioned association. Results: A total of 130 women died during the median follow-up of 37.2 months (interquartile: 24.7–50.2 months). Comparisons of highest to lowest tertile intake showed that pre-diagnosis dairy product use was associated with total OC mortality (HR = 2.03, 95% CI = 1.21–3.40, p trend = 0.06). In addition, short survival was separately associated with protein (HR = 2.09, 95% CI = 1.25–3.49, p trend < 0.05), fat (HR = 2.16, 95% CI = 1.30–3.61, p trend < 0.05), and calcium (HR = 2.03, 95% CI = 1.21–3.4, p trend = 0.06) from dairy intake. Similar positive magnitudes were observed for menopausal status, residual lesions, histological type, and body mass index, although not all of these factors showed statistical significance. Conclusion: Pre-diagnosis dairy product consumption, including protein, fat, and calcium from dairy intake, was associated with higher mortality among OC survivors.
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Affiliation(s)
- Luo Jiang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiu-Qin Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao-Yan Wen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shi Yan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Rui Hou
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.,Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
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14
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Vitamins as Possible Cancer Biomarkers: Significance and Limitations. Nutrients 2021; 13:nu13113914. [PMID: 34836171 PMCID: PMC8622959 DOI: 10.3390/nu13113914] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022] Open
Abstract
The Western-style diet, which is common in developed countries and spreading into developing countries, is unbalanced in many respects. For instance, micronutrients (vitamins A, B complex, C, D, E, and K plus iron, zinc, selenium, and iodine) are generally depleted in Western food (causing what is known as ‘hidden hunger’), whereas some others (such as phosphorus) are added beyond the daily allowance. This imbalance in micronutrients can induce cellular damage that can increase the risk of cancer. Interestingly, there is a large body of evidence suggesting a strong correlation between vitamin intake as well as vitamin blood concentrations with the occurrence of certain types of cancer. The direction of association between the concentration of a given vitamin and cancer risk is tumor specific. The present review summarized the literature regarding vitamins and cancer risk to assess whether these could be used as diagnostic or prognostic markers, thus confirming their potential as biomarkers. Despite many studies that highlight the importance of monitoring vitamin blood or tissue concentrations in cancer patients and demonstrate the link between vitamin intake and cancer risk, there is still an urgent need for more data to assess the effectiveness of vitamins as biomarkers in the context of cancer. Therefore, this review aims to provide a solid basis to support further studies on this promising topic.
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15
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Paepke D, Wiedeck C, Hapfelmeier A, Kiechle M, Brambs C. Lifestyle modifications after the diagnosis of gynecological cancer. BMC WOMENS HEALTH 2021; 21:260. [PMID: 34182983 PMCID: PMC8240378 DOI: 10.1186/s12905-021-01391-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022]
Abstract
Background The influence of lifestyle factors on the quality of life, incidence and tumor recurrence has been evaluated in several studies and is gaining increasing importance in cancer research. However, the extent of the influence of such lifestyle factors on the quality of life of cancer patients remains largely unclear, as does the number of patients actually pursuing these lifestyle changes. The purpose of this study was to examine the prevalence and predictors of lifestyle changes in patients with gynecological cancer.
Methods The survey consisted of a pseudonymous questionnaire that was conducted from January to May 2014 via a telephone interview with 141 patients with a gynaecological malignancy who had undergone surgery at our Department of Gynaecology and Obstetrics. Lifestyle factors (diet, physical activity, stress level, alcohol and nicotine consumption) prior to and after the diagnosis of cancer were evaluated. Results 89% (n = 125) of the patients reported lifestyle changes after being diagnosed with cancer. There was a significant association between the implementation of lifestyle changes and age as well as the use of complementary medicine. Nutrition: 66% of the patients (n = 93) consumed more fruit and vegetables and 65% ate less meat (n = 92). Physical activity: 37% (n = 52) reported no change in their exercise routine, 36% (n = 51) described a decrease, 27% (n = 38) an increase in their physical activity. Subjective feeling of stress: 77% of the patients (n = 108) described a reduction in their perceived level of stress. Nicotine consumption: 63% (n = 12) of the 19 patients who were smokers at the time of the diagnosis quit or reduced smoking thereafter. Alcohol consumption: 47% (n = 61/129) of the patients reduced their alcohol consumption. Conclusions Most of the patients from our study group implemented lifestyle changes after being diagnosed with cancer. Prospective randomized trials are needed in order to determine the benefit of lifestyle changes (physical activity, dietary habits and stress reduction) for cancer survivors. The potential impact of lifestyle on the quality of life and the trajectory of the disease should be discussed with all oncological patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01391-5.
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Affiliation(s)
- Daniela Paepke
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany.
| | - Clea Wiedeck
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of Medical Informatics, Statistics and Epidemiology, School of Medicine, Technical University of Munich, Munich, Germany.,Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marion Kiechle
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany
| | - Christine Brambs
- Department of Gynecology and Obstetrics, Technical University of Munich, Munich, Germany
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16
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Ciebiera M, Esfandyari S, Siblini H, Prince L, Elkafas H, Wojtyła C, Al-Hendy A, Ali M. Nutrition in Gynecological Diseases: Current Perspectives. Nutrients 2021; 13:nu13041178. [PMID: 33918317 PMCID: PMC8065992 DOI: 10.3390/nu13041178] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/11/2022] Open
Abstract
Diet and nutrition are fundamental in maintaining the general health of populations, including women’s health. Health status can be affected by nutrient deficiency and vice versa. Gene–nutrient interactions are important contributors to health management and disease prevention. Nutrition can alter gene expression, as well as the susceptibility to diseases, including cancer, through several mechanisms. Gynecological diseases in general are diseases involving the female reproductive system and include benign and malignant tumors, infections, and endocrine diseases. Benign diseases such as uterine fibroids and endometriosis are common, with a negative impact on women’s quality of life, while malignant tumors are among the most common cause of death in the recent years. In this comprehensive review article, a bibliographic search was performed for retrieving information about nutrients and how their deficiencies can be associated with gynecological diseases, namely polycystic ovary syndrome, infertility, uterine fibroids, endometriosis, dysmenorrhea, and infections, as well as cervical, endometrial, and ovarian cancers. Moreover, we discussed the potential beneficial impact of promising natural compounds and dietary supplements on alleviating these significant diseases.
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Affiliation(s)
- Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-809 Warsaw, Poland;
| | - Sahar Esfandyari
- Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.E.); (H.E.)
| | - Hiba Siblini
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (H.S.); (A.A.-H.)
| | - Lillian Prince
- Biological Sciences Division, Public Health Sciences, University of Chicago, Chicago, IL 60637, USA;
| | - Hoda Elkafas
- Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA; (S.E.); (H.E.)
- Department of Pharmacology and Toxicology, Egyptian Drug Authority (EDA), Cairo 15301, Egypt
| | - Cezary Wojtyła
- International Prevention Research Institute-Collaborating Centre, Calisia University, 62-800 Kalisz, Poland;
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (H.S.); (A.A.-H.)
| | - Mohamed Ali
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo 11566, Egypt
- Correspondence:
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17
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Fong AJ, Lafaro K, Ituarte PHG, Fong Y. Association of Living in Urban Food Deserts with Mortality from Breast and Colorectal Cancer. Ann Surg Oncol 2021; 28:1311-1319. [PMID: 32844294 PMCID: PMC8046424 DOI: 10.1245/s10434-020-09049-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/03/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Food deserts are neighborhoods with low access to healthy foods and are associated with poor health metrics. We investigated association of food desert residence and cancer outcomes. METHODS In this population-based study, data from the 2000-2012 California Cancer Registry was used to identify patients with stage II/III breast or colorectal cancer. Patient residence at time of diagnosis was linked by census tract to food desert using the USDA Food Access Research Atlas. Treatment and outcomes were compared by food desert residential status. RESULTS Among 64,987 female breast cancer patients identified, 66.8% were < 65 years old, and 5.7% resided in food deserts. Five-year survival for food desert residents was 78% compared with 80% for non-desert residents (p < 0.0001). Among 48,666 colorectal cancer patients identified, 50.4% were female, 39% were > 65 years old, and 6.4% resided in food deserts. Five-year survival for food desert residents was 60% compared with 64% for non-desert residents (p < 0.001). Living in food deserts was significantly associated with diabetes, tobacco use, poor insurance coverage, and low socioeconomic status (p < 0.05) for both cancers. There was no significant difference in rates of surgery or chemotherapy by food desert residential status for either diagnosis. Multivariable analyses showed that food desert residence was associated with higher mortality. CONCLUSION Survival, despite treatment for stage II/III breast and colorectal cancers was worse for those living in food deserts. This association remained significant without differences in use of surgery or chemotherapy, suggesting factors other than differential care access may link food desert residence and cancer outcomes.
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Affiliation(s)
- Abigail J Fong
- Department of Surgery, Cedar-Sinai Hospital, Los Angeles, CA, USA
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
| | - Kelly Lafaro
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
- Department of Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Philip H G Ituarte
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
| | - Yuman Fong
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
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18
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Hurtado-Barroso S, Trius-Soler M, Lamuela-Raventós RM, Zamora-Ros R. Vegetable and Fruit Consumption and Prognosis Among Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies. Adv Nutr 2020; 11:1569-1582. [PMID: 32717747 PMCID: PMC7666913 DOI: 10.1093/advances/nmaa082] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/27/2019] [Accepted: 06/17/2020] [Indexed: 12/29/2022] Open
Abstract
The number of cancer survivors is growing rapidly worldwide, especially long-term survivors. Although a healthy diet with a high vegetable and fruit consumption is a key factor in primary cancer prevention, there is a lack of specific dietary recommendations for cancer survivors, except in the case of breast cancer [World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) report]. We have therefore carried out a systematic review and meta-analysis of cohort studies reporting on the associations between vegetable and fruit intake with cancer recurrence and mortality and all-cause mortality in cancer patients. After a comprehensive search of PubMed and Scopus databases, the results of 28 selected articles were analyzed. A high vegetable intake before diagnosis was inversely associated with overall mortality in survivors of head and neck (HR: 0.75; 95% CI: 0.65, 0.87) and ovarian cancer (HR: 0.78; 95% CI: 0.66, 0.91). In ovarian cancer patients, prediagnosis fruit intake was also inversely associated with all-cause mortality (HR: 0.82; 95% CI: 0.70, 0.96). The evidence was insufficient for survivors of other cancers, although these associations generally tended to be protective. Therefore, more studies are needed to clarify the association between vegetable and fruit consumption and the prognosis of these different types of cancer. To date, the general recommendation to consume ≥5 servings of vegetables and fruit per day (∼400 g/d) could underestimate the needs of cancer survivors, particularly those with ovarian tumors, in which the recommendation could increase to ∼600 g/d (i.e., 300 g/d of vegetables and 300 g/d of fruit).
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Affiliation(s)
- Sara Hurtado-Barroso
- Department of Nutrition, Food Sciences and Gastronomy, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Nutrition and Food Safety Research Institute at the University of Barcelona (INSA-UB), Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Marta Trius-Soler
- Department of Nutrition, Food Sciences and Gastronomy, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Nutrition and Food Safety Research Institute at the University of Barcelona (INSA-UB), Barcelona, Spain
| | - Rosa M Lamuela-Raventós
- Department of Nutrition, Food Sciences and Gastronomy, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Nutrition and Food Safety Research Institute at the University of Barcelona (INSA-UB), Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Raul Zamora-Ros
- Nutrition and Food Safety Research Institute at the University of Barcelona (INSA-UB), Barcelona, Spain
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
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19
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El-Sherif A, El-Sherif S, Taylor AH, Ayakannu T. Ovarian Cancer: Lifestyle, Diet and Nutrition. Nutr Cancer 2020; 73:1092-1107. [PMID: 32674720 DOI: 10.1080/01635581.2020.1792948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Ahmed El-Sherif
- Department of Obstetrics and Gynaecology, Arrow Park Hospital, Upton, UK
| | - Sherif El-Sherif
- Department of Obstetrics and Gynaecology, West Cumberland Hospital, Whitehaven, UK
| | - Anthony Henry Taylor
- Department of Molecular and Cellular Biology, University of Leicester, Leicester, UK
| | - Thangesweran Ayakannu
- Gynaecology Oncology Cancer Centre, Liverpool Women’s NHS Foundation Trust, Liverpool Women’s Hospital, Liverpool, UK
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
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20
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Khodavandi A, Alizadeh F, Razis AFA. Association between dietary intake and risk of ovarian cancer: a systematic review and meta-analysis. Eur J Nutr 2020; 60:1707-1736. [PMID: 32661683 DOI: 10.1007/s00394-020-02332-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 07/07/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE It is unclear how dietary intake influences the ovarian cancer. The present paper sets out to systematically review and meta-analyze research on dietary intake to identify cases having high- or low-risk ovarian cancer. METHODS Scopus, PubMed, and Wiley Online Libraries were searched up to the date November 24, 2019. Two reviewers were requested to independently extract study characteristics and to assess the bias and applicability risks with reference to the study inclusion criteria. Meta-analyses were performed to specify the relationship between dietary intake and the risk of ovarian cancer identifying 97 cohort studies. RESULTS No significant association was found between dietary intake and risk of ovarian cancer. The results of subgroup analyses indicated that green leafy vegetables (RR = 0.91, 95%, 0.85-0.98), allium vegetables (RR = 0.79, 95% CI 0.64-0.96), fiber (RR = 0.89, 95% CI 0.81-0.98), flavonoids (RR = 0.83, 95% CI 0.78-0.89) and green tea (RR = 0.61, 95% CI 0.49-0.76) intake could significantly reduce ovarian cancer risk. Total fat (RR = 1.10, 95% CI 1.02-1.18), saturated fat (RR = 1.11, 95% CI 1.01-1.22), saturated fatty acid (RR = 1.19, 95% CI 1.04-1.36), cholesterol (RR = 1.13, 95% CI 1.04-1.22) and retinol (RR = 1.14, 95% CI 1.00-1.30) intake could significantly increase ovarian cancer risk. In addition, acrylamide, nitrate, water disinfectants and polychlorinated biphenyls were significantly associated with an increased risk of ovarian cancer. CONCLUSION These results could support recommendations to green leafy vegetables, allium vegetables, fiber, flavonoids and green tea intake for ovarian cancer prevention.
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Affiliation(s)
- Alireza Khodavandi
- Department of Biology, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| | - Fahimeh Alizadeh
- Department of Microbiology, Yasooj Branch, Islamic Azad University, Yasooj, Iran
| | - Ahmad Faizal Abdull Razis
- Laboratory of Molecular Biomedicine, Institute of Bioscience, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia. .,Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia. .,Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
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21
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Hansen JM, Nagle CM, Ibiebele TI, Grant PT, Obermair A, Friedlander ML, DeFazio A, Webb PM. A healthy lifestyle and survival among women with ovarian cancer. Int J Cancer 2020; 147:3361-3369. [PMID: 32542708 DOI: 10.1002/ijc.33155] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/22/2022]
Abstract
Ovarian cancer has a poor survival rate and, understandably, women often want to know whether there is anything they can do to improve their prognosis. Our goal was to investigate the association between a healthy lifestyle prediagnosis and postdiagnosis and survival in a cohort of Australian women with invasive epithelial ovarian cancer. We calculated a healthy lifestyle index (HLI) based on women's self-reported smoking status, height, weight, physical activity, diet and alcohol consumption before diagnosis (n = 678) and after completing primary treatment (n = 512). Clinical data and vital status for each woman were ascertained through medical records. Cox proportional hazards regression was conducted to calculate hazard ratios (HR) and 95% confidence interval (CI) for all-cause mortality. There was a suggestive association between a more healthy lifestyle before diagnosis and better survival (HR 0.79, 95% CI: 0.59-1.04), however, the association was stronger for lifestyle after diagnosis, with women in the highest tertile having significantly better survival than women in the lowest tertile (HR 0.61, 95% CI: 0.40-0.93; P-trend = .02). Current smoking, particularly postdiagnosis, was associated with higher mortality (HR 1.68, 95% CI: 1.17-2.42; HR 2.82, 95% CI: 1.29-6.14, for prediagnosis and postdiagnosis smoking, respectively), but women who quit after diagnosis had survival outcomes similar to nonsmokers (HR 0.99, 95% CI: 0.57-1.72). Higher physical activity after diagnosis was associated with better survival (HR 0.60, 95% CI: 0.39-0.92; P-trend = .02). A healthy lifestyle after diagnosis, in particular not smoking and being physically active, may help women with ovarian cancer improve their prognosis.
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Affiliation(s)
- Jessy M Hansen
- Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,School of Public Health, University of Queensland, Brisbane, Australia
| | - Christina M Nagle
- Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Torukiri I Ibiebele
- Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Peter T Grant
- Gynaecological Oncology Unit, Mercy Hospital for Women, Melbourne, Australia
| | - Andreas Obermair
- Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Michael L Friedlander
- Prince of Wales Clinical School, University of New South Wales and Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia
| | - Anna DeFazio
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia.,The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia
| | - Penelope M Webb
- Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,School of Public Health, University of Queensland, Brisbane, Australia
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- Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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22
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Peres LC, Hebert JR, Qin B, Guertin KA, Bandera EV, Shivappa N, Camacho TF, Chyn D, Alberg AJ, Barnholtz-Sloan JS, Bondy ML, Cote ML, Funkhouser E, Moorman PG, Peters ES, Schwartz AG, Terry PD, Schildkraut JM. Prediagnostic Proinflammatory Dietary Potential Is Associated with All-Cause Mortality among African-American Women with High-Grade Serous Ovarian Carcinoma. J Nutr 2019; 149:1606-1616. [PMID: 31152675 PMCID: PMC6735701 DOI: 10.1093/jn/nxz098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/21/2019] [Accepted: 04/15/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Chronic inflammation is associated with ovarian carcinogenesis; yet, the impact of inflammatory-related exposures on outcomes has been understudied. OBJECTIVE Given the poor survival of women diagnosed with ovarian cancer, especially African-Americans, we examined whether diet-associated inflammation, a modifiable source of chronic systemic inflammation measured by the dietary inflammatory index (DII), was associated with all-cause mortality among African-American women with ovarian carcinoma. METHODS Data were available from 490 ovarian carcinoma patients enrolled in a population-based case-control study of African-American women with ovarian cancer, the African-American Cancer Epidemiology Study. Energy-adjusted DII (E-DII) scores were calculated based on prediagnostic dietary intake of foods alone or foods and supplements, which was self-reported using the 2005 Block Food Frequency Questionnaire. Cox proportional hazards regression was used to estimate risk of mortality overall and for the most common histotype, high-grade serous carcinoma. Additionally, we assessed interaction by age at diagnosis and smoking status. RESULTS Women included in this study had a median age of 57 y, and the majority of women were obese (58%), had late-stage disease (Stage III or IV, 66%), and had high-grade serous carcinoma (64%). Greater E-DII scores including supplements (indicating greater inflammatory potential) were associated with an increased risk of mortality among women with high-grade serous carcinoma (HR1-unit change: 1.08; 95% CI: 1.01, 1.17). Similar associations were observed for the E-DII excluding supplements, although not statistically significant (HR1-unit change: 1.07; 95% CI: 0.97, 1.17). There was an interaction by smoking status, where the positive association with mortality was present only among ever smokers (HRQuartile 4/Quartile 1: 2.36; 95% CI: 1.21, 4.60) but not among never smokers. CONCLUSIONS Greater inflammatory potential of prediagnostic diet may adversely impact prognosis among African-American women with high-grade serous carcinoma, and specifically among ever smokers.
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Affiliation(s)
- Lauren C Peres
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL,Department of Public Health Sciences, University of Virginia, Charlottesville, VA,Address correspondence to LCP (E-mail: )
| | - James R Hebert
- Cancer Prevention and Control Program,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC,Connecting Health Innovations LLC, Columbia, SC
| | - Bo Qin
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Kristin A Guertin
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA
| | - Elisa V Bandera
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Nitin Shivappa
- Cancer Prevention and Control Program,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC,Connecting Health Innovations LLC, Columbia, SC
| | - Tareq F Camacho
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA
| | - Deanna Chyn
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA
| | - Anthony J Alberg
- Cancer Prevention and Control Program,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Jill S Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Melissa L Bondy
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX
| | - Michele L Cote
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI
| | - Ellen Funkhouser
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Patricia G Moorman
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC
| | - Edward S Peters
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA
| | - Ann G Schwartz
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI
| | - Paul D Terry
- Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN
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23
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Abstract
Dietary patterns, which reflect overall diet and possible nutrient and food interactions, have been reported to be related to ovarian cancer (OC) risk. However, studies on the relationship between dietary patterns and OC risk have been inconsistent. Thus, we carried out a systematic meta-analysis to assess the relationship between dietary patterns and the risk of OC. Relevant studies are identified by searching the Medline and Embase electronic databases up to December 2016. The Cochrane Q statistic and the I statistical were used to evaluate heterogeneity. A total of 22 studies fulfilled the inclusion criteria and were included in this meta-analysis. There was evidence of a decreased risk for OC in the highest versus the lowest categories of healthy dietary pattern [odds ratio (OR)=0.86; 95% confidence interval (CI): 0.74-0.99; P=0.04]. An increased risk of OC was shown for the highest versus the lowest category of a western-style dietary pattern (OR=1.19; 95% CI: 1.01-1.41; P=0.04). No significant association with OC risk was observed in the highest versus the lowest category of a heavy drinking pattern (OR=0.89; 95% CI: 0.67-1.19; P=0.42). The results of this meta-analysis suggest that a healthy dietary pattern is associated with reduced risk for OC and a western-style dietary pattern is associated with an increased risk of OC. Further studies are needed to confirm our results.
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24
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Taha AAA, Koshiyama M, Matsumura N, Abiko K, Yamaguchi K, Hamanishi J, Baba T, Kharma B, Mohamed IH, Ameen MM, Ismail SA, Konishi I, Mandai M. The effect of the type of dietary protein on the development of ovarian cancer. Oncotarget 2018; 9:23987-23999. [PMID: 29844867 PMCID: PMC5963616 DOI: 10.18632/oncotarget.25253] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 04/08/2018] [Indexed: 01/09/2023] Open
Abstract
We evaluated whether different dietary protein qualities (isocaloric diets involving animal (casein) or plant protein (soy protein) could inhibit the ovarian cancer growth in mice and improve their prognosis and whether chemotherapy had different tumor reducing effects on these mice. In the mice of the 20% plant protein group, the ovarian cancer growth at 5 weeks after tumor implantation was clearly reduced in comparison to the mice in the 20% animal protein group (p< 0.001). The serum levels of insulin and IGF-1 levels were both lower in the mice of the 20% plant protein group than in the mice of the 20% animal protein group (p<0.001 and p<0.01, respectively). Immunohistochemistry revealed that the level of eukaryotic initiation factor 4E-binding protein 1 (p-4EBP1) activity―one of the major downstream effectors of the mTOR pathway ―of the plant protein group was significantly weaker than that of the animal protein group (p<0.001). The prognosis of the 20% plant protein group was better than that of the 20% animal protein group (log-rank test, p=0.0062). The ovarian cancer growth in the 20% plant protein plus cisplatin treatment group was not significantly reduced in comparison to the 20% animal protein plus cisplatin treatment group. Our findings suggest that a diet high in plant protein reduces the growth of human ovarian cancer cells in mice compared to a diet high in animal protein, ―possibly through the lack of activation of the IGF/Akt/mTOR pathway, and leads to a better prognosis with or without cisplatin treatment.
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Affiliation(s)
- Ahmed A A Taha
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Gynecology and Obstetrics, Sohag Faculty of Medicine Sohag University, Sohag, Egypt
| | - Masafumi Koshiyama
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Women's Health, Graduate School of Human Nursing, The University of Shiga Prefecture, Shiga, Japan
| | - Noriomi Matsumura
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kaoru Abiko
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ken Yamaguchi
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jyunzo Hamanishi
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsukasa Baba
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Budiman Kharma
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ibrahim Hassanin Mohamed
- Department of Gynecology and Obstetrics, Sohag Faculty of Medicine Sohag University, Sohag, Egypt
| | - Magdy Mohamed Ameen
- Department of Gynecology and Obstetrics, Sohag Faculty of Medicine Sohag University, Sohag, Egypt
| | - Salah Ali Ismail
- Department of Gynecology and Obstetrics, Sohag Faculty of Medicine Sohag University, Sohag, Egypt
| | - Ikuo Konishi
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masaki Mandai
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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25
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Playdon MC, Nagle CM, Ibiebele TI, Ferrucci LM, Protani MM, Carter J, Hyde SE, Neesham D, Nicklin JL, Mayne ST, Webb PM. Pre-diagnosis diet and survival after a diagnosis of ovarian cancer. Br J Cancer 2017; 116:1627-1637. [PMID: 28463959 PMCID: PMC5518850 DOI: 10.1038/bjc.2017.120] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 12/12/2022] Open
Abstract
Background: The relationship between diet and survival after ovarian cancer diagnosis is unclear as a result of a limited number of studies and inconsistent findings. Methods: We examined the association between pre-diagnostic diet and overall survival in a population-based cohort (n=811) of Australian women diagnosed with invasive epithelial ovarian cancer between 2002 and 2005. Diet was measured by validated food frequency questionnaire. Deaths were ascertained up to 31 August 2014 via medical record review and Australian National Death Index linkage. We conducted Cox proportional hazards regression analysis, controlling for diagnosis age, tumour stage, grade and subtype, residual disease, smoking status, body mass index, physical activity, marital status, and energy intake. Results: We observed improved survival with highest compared with lowest quartile of fibre intake (hazard ratio (HR)=0.69, 95% CI: 0.53–0.90, P-trend=0.002). There was a suggestion of better survival for women with highest compared with lowest intake category of green leafy vegetables (HR=0.79, 95% CI: 0.62–0.99), fish (HR=0.74, 95% CI: 0.57–0.95), poly- to mono-unsaturated fat ratio (HR=0.76, 95% CI: 0.59–0.98), and worse survival with higher glycaemic index (HR=1.28, 95% CI: 1.01–1.65, P-trend=0.03). Conclusions: The associations we observed between healthy components of diet pre-diagnosis and ovarian cancer survival raise the possibility that dietary choices after diagnosis may improve survival.
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Affiliation(s)
- Mary C Playdon
- Yale School of Public Health, Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06520, USA
| | - Christina M Nagle
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia
| | - Torukiri I Ibiebele
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia
| | - Leah M Ferrucci
- Yale School of Public Health, Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06520, USA
| | - Melinda M Protani
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia.,School of Public Health, University of Queensland Public Health Building, Herston Road, Queensland 4006, Australia
| | - Jonathan Carter
- Department of Gynaecological Oncology, The University of Sydney, Sydney, New South Wales 2006, Australia.,Lifehouse Gynaecologic Oncology Group, Lifehouse, Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia
| | - Simon E Hyde
- Mercy Hospital for Women, Department of Gynaecological Oncology, Studley Road, Heidelberg, Victoria 3084, Australia
| | - Deborah Neesham
- Oncology/Dysplasia Unit, The Royal Women's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
| | - James L Nicklin
- Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia.,School of Medicine, Department of Obstetrics and Gynaecology, The University of Queensland, Herston, Queensland 4006, Australia
| | - Susan T Mayne
- Yale School of Public Health, Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06520, USA.,Yale Cancer Center, New Haven, CT 06520, USA.,U.S. Food and Drug Administration, College Park, MD, USA
| | - Penelope M Webb
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia.,School of Public Health, University of Queensland Public Health Building, Herston Road, Queensland 4006, Australia
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26
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Poole EM, Konstantinopoulos PA, Terry KL. Prognostic implications of reproductive and lifestyle factors in ovarian cancer. Gynecol Oncol 2016; 142:574-87. [DOI: 10.1016/j.ygyno.2016.05.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 10/21/2022]
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27
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Thomson CA, Crane TE, Miller A, Garcia DO, Basen-Engquist K, Alberts DS. A randomized trial of diet and physical activity in women treated for stage II-IV ovarian cancer: Rationale and design of the Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES): An NRG Oncology/Gynecologic Oncology Group (GOG-225) Study. Contemp Clin Trials 2016; 49:181-9. [PMID: 27394382 PMCID: PMC5108358 DOI: 10.1016/j.cct.2016.07.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 11/21/2022]
Abstract
Ovarian cancer is the most common cause of gynecological cancer death in United States women. Efforts to improve progression free survival (PFS) and quality of life (QoL) after treatment for ovarian cancer are necessary. Observational studies suggest that lifestyle behaviors, including diet and physical activity, are associated with lower mortality in this population. The Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES) NRG 0225 study is a randomized, controlled trial designed to test the hypothesis that a 24month lifestyle intervention will significantly increase PFS after oncological therapy for stage II-IV ovarian cancer. Women are randomized 1:1 to a high vegetable and fiber, low-fat diet with daily physical activity goals or an attention control group. Secondary outcomes to be evaluated include QoL and gastrointestinal health. Moreover an a priori lifestyle adherence score will be used to evaluate relationships between adoption of the diet and activity goals and PFS. Blood specimens are collected at baseline, 6, 12 and 24months for analysis of dietary adherence (carotenoids) in addition to mechanistic biomarkers (lipids, insulin, telomere length). Women are enrolled at NRG clinic sites nationally and the telephone based lifestyle intervention is delivered from The University of Arizona call center by trained health coaches. A study specific multi-modal telephone, email, and SMS behavior change software platform is utilized for information delivery, coaching and data capture. When completed, LIVES will be the largest behavior-based lifestyle intervention trial conducted among ovarian cancer survivors.
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Affiliation(s)
- Cynthia A Thomson
- Mel & Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, University of Arizona, 1295 N. Martin Ave., PO Box 245209, Tucson, AZ 85724-5209, United States.
| | - Tracy E Crane
- Mel & Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, University of Arizona, 1295 N. Martin Ave., PO Box 245209, Tucson, AZ 85724-5209, United States.
| | - Austin Miller
- NRG Oncology/Gynecologic Oncology Group, Statistics and Data Management Center, Elm & Carlton Streets, Buffalo, NY 14263, United States.
| | - David O Garcia
- Mel & Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, University of Arizona, 1295 N. Martin Ave., PO Box 245209, Tucson, AZ 85724-5209, United States.
| | - Karen Basen-Engquist
- Department of Behavioral Science, Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, United States.
| | - David S Alberts
- University of Arizona Cancer Center, 1515 N. Campbell Ave., Tucson, AZ 85721, United States.
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Cantrell LA, Saks E, Grajales V, Duska L. Nutrition in Gynecologic Cancer. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2015. [DOI: 10.1007/s13669-015-0130-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Webb PM. Environmental (nongenetic) factors in gynecological cancers: update and future perspectives. Future Oncol 2015; 11:295-307. [PMID: 25591840 DOI: 10.2217/fon.14.142] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Globally, gynecological cancers comprise three of the seven most common female cancers and are responsible for more than 1,000,000 new cases and 500,000 deaths annually. This review summarizes current knowledge regarding the role of environmental factors in gynecological cancer etiology and survival, focusing on those that are potentially amenable to intervention. Strong associations with use of exogenous hormones are countered by opposing risks of breast cancer, thus current hormonal preparations are not an option for prevention. Weight control would reduce risk of endometrial cancer but this and other lifestyle modifications are unlikely to have a major effect on gynecological cancer mortality rates. There is little information regarding the potential for lifestyle changes to improve outcomes for women with gynecological cancer.
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Brewer KC, Peterson CE, Davis FG, Hoskins K, Pauls H, Joslin CE. The influence of neighborhood socioeconomic status and race on survival from ovarian cancer: a population-based analysis of Cook County, Illinois. Ann Epidemiol 2015; 25:556-63. [PMID: 25986734 DOI: 10.1016/j.annepidem.2015.03.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/27/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Despite significant improvements in treatment for ovarian cancer, survival is poorer for non-Hispanic black (NHB) women compared to non-Hispanic white (NHW) women. Neighborhood socioeconomic status (SES) has been implicated in racial disparities across a variety of health outcomes and may similarly contribute to racial disparities in ovarian cancer survival. The purpose of this analysis is to assess the influence of neighborhood SES on NHB-NHW survival differences after accounting for differences in tumor characteristics and in treatment. METHODS Data were obtained from 2432 women (443 NHB and 1989 NHW) diagnosed with epithelial ovarian cancer in Cook County, Illinois between 1998 and 2007. Neighborhood (i.e., census tract) SES at the time of diagnosis was calculated for each woman using two well-established composite measures of affluence and disadvantage. Cox proportional hazard models measured the association between NHB race and survival after adjusting for age, tumor characteristics, treatment, year of diagnosis, and neighborhood SES. RESULTS There was a strong association between ovarian cancer survival and both measures of neighborhood SES (P < .0001 for both affluence and disadvantage). After adjusting for age, tumor characteristics, treatment, and year of diagnosis, NHB were more likely than NHW to die of ovarian cancer (hazard ratio [HR] = 1.47, 95% confidence interval [CI]: 1.28-1.68). The inclusion of neighborhood affluence and disadvantage into models separately and together attenuated this risk (HRaffluence = 1.37, 95% CI: 1.18-1.58; HRdisadvantage = 1.28, 95% CI: 1.08-1.52; and HRaffluence + disadvantage = 1.28, 95% CI: 1.08-1.52. CONCLUSIONS Neighborhood SES, as measured by composite measures of affluence and disadvantage, is a predictor of survival in women diagnosed with ovarian cancer in Cook County, Illinois and may contribute to the racial disparity in survival.
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Affiliation(s)
- Katherine C Brewer
- Division of Epidemiology and Biostatistics (MC 923), School of Public Health, University of Illinois at Chicago, Chicago
| | - Caryn E Peterson
- Division of Epidemiology and Biostatistics (MC 923), School of Public Health, University of Illinois at Chicago, Chicago; Cancer Control and Population Science Research Program, University of Illinois at Chicago Cancer Center, Chicago
| | - Faith G Davis
- Cancer Control and Population Science Research Program, University of Illinois at Chicago Cancer Center, Chicago; Department of Public Health Sciences, School of Public Health, University of Alberta, 3-317 Edmonton Clinic Health Academy, Alberta, Canada
| | - Kent Hoskins
- Cancer Control and Population Science Research Program, University of Illinois at Chicago Cancer Center, Chicago; Department of Hematology and Oncology, University of Illinois at Chicago, Chicago
| | - Heather Pauls
- Institute for Health Research and Policy (IHRP), University of Illinois at Chicago, Chicago
| | - Charlotte E Joslin
- Division of Epidemiology and Biostatistics (MC 923), School of Public Health, University of Illinois at Chicago, Chicago; Cancer Control and Population Science Research Program, University of Illinois at Chicago Cancer Center, Chicago; Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago.
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Block KI, Block PB, Gyllenhaal C. Integrative therapies in cancer: modulating a broad spectrum of targets for cancer management. Integr Cancer Ther 2015; 14:113-8. [PMID: 25601968 DOI: 10.1177/1534735414567473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Integrative medicine is an approach to health and healing that "makes use of all appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health and healing." A comprehensive integrative medicine intervention for cancer patients typically includes nutritional counseling, biobehavioral strategies, and promotion of physical activity, as well as dietary supplements including herbs, nutraceuticals, and phytochemicals. A broad-spectrum intervention of this type may contribute uniquely to improvement in cancer outcomes through its impact on a wide variety of relevant molecular targets, including effects on multiple cancer hallmarks. Hallmarks that may be particularly affected include genetic instability, tumor-promoting inflammation, deregulated metabolism, and immune system evasion. Because of their susceptibility to manipulation by diet, exercise, and supplementation, these may be characterized as metabolic hallmarks. Research on the use of comprehensive integrative approaches can contribute to the development of systems of multitargeted treatment regimens and would help clarify the combined effect of these approaches on cancer outcomes.
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Affiliation(s)
- Keith I Block
- Block Center for Integrative Cancer Treatment, Skokie, IL, USA
| | - Penny B Block
- Block Center for Integrative Cancer Treatment, Skokie, IL, USA
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Thomson CA, E Crane T, Wertheim BC, Neuhouser ML, Li W, Snetselaar LG, Basen-Engquist KM, Zhou Y, Irwin ML. Diet quality and survival after ovarian cancer: results from the Women's Health Initiative. J Natl Cancer Inst 2014; 106:dju314. [PMID: 25335480 PMCID: PMC4271032 DOI: 10.1093/jnci/dju314] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 05/16/2014] [Accepted: 08/21/2014] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Survival after an ovarian cancer diagnosis is poor. Given the high mortality in these patients, efforts to identify modifiable lifestyle behaviors that could influence survival are needed. Earlier evidence suggests a protective role for vegetables, but no prior studies have evaluated overall dietary quality and ovarian cancer survival. The purpose of this analysis was to evaluate the role of prediagnosis diet quality in ovarian cancer survival. METHODS We identified 636 centrally adjudicated cases of ovarian cancer within the Women's Health Initiative Observational Study or Clinical Trials of 161808 postmenopausal women followed from 1995 to 2012. Dietary quality was assessed for the Healthy Eating Index (2005) using a food frequency questionnaire, covariables were obtained from standardized questionnaires, and adiposity was measured by clinic-based measurements of height, weight, and waist circumference. The association between diet quality and mortality was analyzed using Cox proportional hazards regression, adjusted for potential confounders, and stratified by waist circumference, physical activity level, and diabetes status. Tests of statistical significance were two-sided. RESULTS Overall, higher diet quality was associated with lower all-cause mortality after ovarian cancer (hazard ratio [HR] for highest vs lowest tertile = 0.73; 95% confidence interval [CI] = 0.55 to 0.97, P(trend) = .03). The effect was strongest among women with waist circumference of 88 cm or less and with no history of diabetes (HR = 0.73, 95% CI = 0.54 to 0.98). Physical activity level did not modify the association between diet quality and survival. CONCLUSION Our results suggest that overall higher prediagnosis diet quality may protect against mortality after ovarian cancer.
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Affiliation(s)
- Cynthia A Thomson
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ (CAT); University of Arizona Cancer Center, Tucson, AZ (CAT, TEC, BCW); Department of Nutritional Sciences, University of Arizona, Tucson, AZ (CAT, TEC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MLN); Department of Medicine, University of Massachusetts Medical School, Amherst, MA (WL); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (LGS); Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, TX (KMBE); Department of Epidemiology (Chronic Diseases), Yale School of Public Health, New Haven, CT (YZ, MLI).
| | - Tracy E Crane
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ (CAT); University of Arizona Cancer Center, Tucson, AZ (CAT, TEC, BCW); Department of Nutritional Sciences, University of Arizona, Tucson, AZ (CAT, TEC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MLN); Department of Medicine, University of Massachusetts Medical School, Amherst, MA (WL); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (LGS); Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, TX (KMBE); Department of Epidemiology (Chronic Diseases), Yale School of Public Health, New Haven, CT (YZ, MLI)
| | - Betsy C Wertheim
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ (CAT); University of Arizona Cancer Center, Tucson, AZ (CAT, TEC, BCW); Department of Nutritional Sciences, University of Arizona, Tucson, AZ (CAT, TEC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MLN); Department of Medicine, University of Massachusetts Medical School, Amherst, MA (WL); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (LGS); Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, TX (KMBE); Department of Epidemiology (Chronic Diseases), Yale School of Public Health, New Haven, CT (YZ, MLI)
| | - Marian L Neuhouser
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ (CAT); University of Arizona Cancer Center, Tucson, AZ (CAT, TEC, BCW); Department of Nutritional Sciences, University of Arizona, Tucson, AZ (CAT, TEC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MLN); Department of Medicine, University of Massachusetts Medical School, Amherst, MA (WL); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (LGS); Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, TX (KMBE); Department of Epidemiology (Chronic Diseases), Yale School of Public Health, New Haven, CT (YZ, MLI)
| | - Wenjun Li
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ (CAT); University of Arizona Cancer Center, Tucson, AZ (CAT, TEC, BCW); Department of Nutritional Sciences, University of Arizona, Tucson, AZ (CAT, TEC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MLN); Department of Medicine, University of Massachusetts Medical School, Amherst, MA (WL); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (LGS); Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, TX (KMBE); Department of Epidemiology (Chronic Diseases), Yale School of Public Health, New Haven, CT (YZ, MLI)
| | - Linda G Snetselaar
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ (CAT); University of Arizona Cancer Center, Tucson, AZ (CAT, TEC, BCW); Department of Nutritional Sciences, University of Arizona, Tucson, AZ (CAT, TEC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MLN); Department of Medicine, University of Massachusetts Medical School, Amherst, MA (WL); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (LGS); Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, TX (KMBE); Department of Epidemiology (Chronic Diseases), Yale School of Public Health, New Haven, CT (YZ, MLI)
| | - Karen M Basen-Engquist
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ (CAT); University of Arizona Cancer Center, Tucson, AZ (CAT, TEC, BCW); Department of Nutritional Sciences, University of Arizona, Tucson, AZ (CAT, TEC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MLN); Department of Medicine, University of Massachusetts Medical School, Amherst, MA (WL); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (LGS); Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, TX (KMBE); Department of Epidemiology (Chronic Diseases), Yale School of Public Health, New Haven, CT (YZ, MLI)
| | - Yang Zhou
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ (CAT); University of Arizona Cancer Center, Tucson, AZ (CAT, TEC, BCW); Department of Nutritional Sciences, University of Arizona, Tucson, AZ (CAT, TEC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MLN); Department of Medicine, University of Massachusetts Medical School, Amherst, MA (WL); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (LGS); Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, TX (KMBE); Department of Epidemiology (Chronic Diseases), Yale School of Public Health, New Haven, CT (YZ, MLI)
| | - Melinda L Irwin
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ (CAT); University of Arizona Cancer Center, Tucson, AZ (CAT, TEC, BCW); Department of Nutritional Sciences, University of Arizona, Tucson, AZ (CAT, TEC); Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA (MLN); Department of Medicine, University of Massachusetts Medical School, Amherst, MA (WL); Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA (LGS); Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, TX (KMBE); Department of Epidemiology (Chronic Diseases), Yale School of Public Health, New Haven, CT (YZ, MLI)
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Socioeconomic status and epithelial ovarian cancer survival in Sweden. Cancer Causes Control 2014; 25:1063-73. [PMID: 24906473 DOI: 10.1007/s10552-014-0407-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 05/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate socioeconomic disparities in epithelial ovarian cancer (EOC) survival in Sweden. METHODS A cohort of 635 women with invasive EOC who participated in a nationwide population-based case-control study was included in the present population-based prospective study. Women were diagnosed with EOC between 1993 and 1995. Mortality until 31 December 2007 was determined through linkage with the Swedish Cause of Death Registry. Clinical data (tumor stage and tumor differentiation) and indicators of socioeconomic status (SES, education level, and annual individual disposable income) were retrieved from medical records and a nationwide database, respectively. The Cox proportional hazards regression model and the Laplace regression model were used to estimate the effect of clinical factors and SES on EOC survival. RESULTS The main factors associated with EOC survival were tumor stage and tumor differentiation: women with stage II, III, and IV tumors had a greater mortality risk than those with stage I tumors [hazard ratio (HR) 2.65, 95 % confidence interval (CI) 1.73-4.07; HR 6.69, 95 % CI 4.85-9.22; HR 12.84, 95 % CI 8.90-18.66, respectively]. After adjustment for these tumor characteristics, no clear association remained between our indicators of SES and EOC survival, but better survival was observed among women with stage IV tumors and a higher income level, and among women with poorly differentiated tumors and a higher education level. Nevertheless, there was no evidence of extended survival among women with higher compared to lower SES. CONCLUSIONS Our study provides no convincing evidence of an association between SES and EOC survival in Sweden.
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Abstract
There is increasing evidence that lifestyle after the diagnosis of cancer may affect prognosis. Several studies have shown that a Western dietary pattern, obesity, weight gain, a sedentary lifestyle, metabolic syndrome, high serum levels of insulin, growth factors, and inflammatory cytokines after the diagnosis of cancer are associated with an increased incidence of recurrences. Most studies have been on breast and colon cancer. However, in the clinical management of cancer, little attention is presently paid to improving lifestyle and controlling body weight. Lifestyle intervention trials are needed to corroborate or confute the observational results on cancer recurrences, but, even now, there is no contraindication to promoting moderate physical exercise, moderate calorie restriction (CR), and a Mediterranean dietary pattern. In fact, the AICR/WCRF 2007 systematic literature review recommends cancer patients to adopt the lifestyle recommended for the prevention of cancer. Interestingly, the evidence-based AICR/WCRF recommendations coincide with traditional rules, based on far Eastern philosophy, of avoiding extremely yin food, such as sugared beverages and calorie-dense foods, and extremely yang food, such as processed meat, and relying on the equilibrium of slightly yang food, such as whole-grain unprocessed cereals, eaten with slightly yin food, such as legumes and vegetables.
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Affiliation(s)
- Franco Berrino
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, 20133, Milan, Italy,
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Zhu Y, Wu H, Wang PP, Savas S, Woodrow J, Wish T, Jin R, Green R, Woods M, Roebothan B, Buehler S, Dicks E, Mclaughlin JR, Campbell PT, Parfrey PS. Dietary patterns and colorectal cancer recurrence and survival: a cohort study. BMJ Open 2013; 3:bmjopen-2012-002270. [PMID: 23396503 PMCID: PMC3586110 DOI: 10.1136/bmjopen-2012-002270] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To examine the association between dietary patterns and colorectal cancer (CRC) survival. DESIGN Cohort study. SETTING A familial CRC registry in Newfoundland. PARTICIPANTS 529 newly diagnosed CRC patients from Newfoundland. They were recruited from 1999 to 2003 and followed up until April 2010. OUTCOME MEASURE Participants reported their dietary intake using a food frequency questionnaire. Dietary patterns were identified with factor analysis. Multivariable Cox proportional hazards models were employed to estimate HR and 95% CI for association of dietary patterns with CRC recurrence and death from all causes, after controlling for covariates. RESULTS Disease-free survival (DFS) among CRC patients was significantly worsened among patients with a high processed meat dietary pattern (the highest vs the lowest quartile HR 1.82, 95% CI 1.07 to 3.09). No associations were observed with the prudent vegetable or the high-sugar patterns and DFS. The association between the processed meat pattern and DFS was restricted to patients diagnosed with colon cancer (the highest vs the lowest quartile: HR 2.29, 95% CI 1.19 to 4.40) whereas the relationship between overall survival (OS) and this pattern was observed among patients with colon cancer only (the highest vs the lowest quartile: HR 2.13, 95% CI 1.03 to 4.43). Potential effect modification was noted for sex (p value for interaction 0.04, HR 3.85 for women and 1.22 for men). CONCLUSIONS The processed meat dietary pattern prior to diagnosis is associated with higher risk of tumour recurrence, metastasis and death among patients with CRC.
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Affiliation(s)
- Yun Zhu
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
- Department of Epidemiology, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hao Wu
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Peizhong Peter Wang
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
- Department of Epidemiology, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Sevtap Savas
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
- Discipline of Oncology, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Jennifer Woodrow
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Tyler Wish
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Rong Jin
- Department of Epidemiology, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Roger Green
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Michael Woods
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Barbara Roebothan
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Sharon Buehler
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Elizabeth Dicks
- Clinical Epidemiology Unit, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - John R Mclaughlin
- Prosserman Centre for Health Research, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Peter T Campbell
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia, USA
| | - Patrick S Parfrey
- Clinical Epidemiology Unit, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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Pineda MJ, Singh DK. What is integrative oncology and can it help my patients? Obstet Gynecol Clin North Am 2012; 39:285-312. [PMID: 22640716 DOI: 10.1016/j.ogc.2012.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Integrative oncology lends itself to the comprehensive practice of gynecologic oncology with multiple tools and interventions that can impact on QoL and survival. However, there remains a paucity of well-designed, well-powered randomized control trials on various CAM modalities for gynecologic cancer patients. The reasons for the lack of level 1 evidence include the nascent state of integrative medicine as a science, the limitations on CAM funding, the relative lack of integration of CAM practitioners into the oncology community, and absence of strict regulation of herbs and supplements by the US FDA. The use of CAM as adjunctive therapies will likely continue given the patient-driven trends to date, and given the evidence for at least safety and potentially efficacy, our patients deserve our willingness to use all possible approaches to improving their outcomes. Continued evolution of our ability to specifically measure and describe QoL will further our ability to hone in on domains most important to patients and their survival and allow practitioners to make patient-specific recommendations. Multimodal programs that include physical activity, stress management, and diet have the potential to address demonstrated deficits in PWB and FWB in ovarian cancer patients which suggests a model of collaborative gynecologic oncology care). Integrative oncology represents a holistic approach to patient care whose goal is maximization of patient quantity and quality of life. Patients can achieve this optimal outcome through the synergy of conventional care, integrative modalities, lifestyle modifications, and supportive care. Refer to Table 4 for a listing of integrated medicine Internet resources.
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Affiliation(s)
- Mario Javier Pineda
- Division of Gynecologic Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M, Byers T, Gansler T. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 2012; 62:243-74. [PMID: 22539238 DOI: 10.3322/caac.21142] [Citation(s) in RCA: 1318] [Impact Index Per Article: 109.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Cancer survivors are often highly motivated to seek information about food choices, physical activity, and dietary supplements to improve their treatment outcomes, quality of life, and overall survival. To address these concerns, the American Cancer Society (ACS) convened a group of experts in nutrition, physical activity, and cancer survivorship to evaluate the scientific evidence and best clinical practices related to optimal nutrition and physical activity after the diagnosis of cancer. This report summarizes their findings and is intended to present health care providers with the best possible information with which to help cancer survivors and their families make informed choices related to nutrition and physical activity. The report discusses nutrition and physical activity guidelines during the continuum of cancer care, briefly highlighting important issues during cancer treatment and for patients with advanced cancer, but focusing largely on the needs of the population of individuals who are disease free or who have stable disease following their recovery from treatment. It also discusses select nutrition and physical activity issues such as body weight, food choices, food safety, and dietary supplements; issues related to selected cancer sites; and common questions about diet, physical activity, and cancer survivorship.
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Affiliation(s)
- Cheryl L Rock
- Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, USA
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Protani MM, Nagle CM, Webb PM. Obesity and ovarian cancer survival: a systematic review and meta-analysis. Cancer Prev Res (Phila) 2012; 5:901-10. [PMID: 22609763 DOI: 10.1158/1940-6207.capr-12-0048] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Studies that have examined the association between obesity and ovarian cancer survival have provided conflicting results. We reviewed and quantitatively summarized existing evidence, exploring potentially important sources of variability, such as the timing of body mass index (BMI) assessment and different cutpoints used to categorize BMI. A systematic search of MEDLINE and EMBASE was conducted to identify original data evaluating the association between obesity and survival in women with ovarian cancer. Adjusted hazard ratios (HR) from studies were pooled using a random-effects model. The meta-analysis of 14 studies showed slightly poorer survival among obese than in non-obese women [pooled HR, 1.17; 95% confidence interval (CI), 1.03-1.34]. This estimate did not vary appreciably when BMI was measured before diagnosis (1.13; 0.95-1.35), at the time of diagnosis (1.13; 0.81-1.57) or at the commencement of chemotherapy (1.12; 0.96-1.31). We found a slightly stronger association in studies that only included women with a BMI ≥ 30 in their "obese" group (1.20) than in studies that also included overweight women (BMI ≥ 25; 1.14). Women with ovarian cancer who are obese appear to have slightly worse survival than non-obese women. However, there is a large amount of inter-study variation, which means that no solid conclusions can be drawn.
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Affiliation(s)
- Melinda M Protani
- Gynaecological Cancers Group, Queensland Institute of Medical Research, Locked Bag 2000 Royal Brisbane Hospital, Herston, QLD 4029, Australia.
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Shen GP, Xu FH, He F, Ruan HL, Cui C, Chen LZ, Zeng YX, Jia WH. Pretreatment lifestyle behaviors as survival predictors for patients with nasopharyngeal carcinoma. PLoS One 2012; 7:e36515. [PMID: 22590554 PMCID: PMC3348163 DOI: 10.1371/journal.pone.0036515] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2011] [Accepted: 04/02/2012] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Lifestyle behaviors have been widely reported to influence the survival of patients with head and neck cancer. However, the relationship between pretreatment lifestyle behaviors and survival among patients with nasopharyngeal carcinoma (NPC) is unclear. METHODS A prospective cohort study was designed to determine the relationship between lifestyle behaviors and survival in 1,533 NPC patients recruited from October 2005 to October 2007. Pretreatment lifestyle behaviors (such as body-mass index [BMI], smoking, alcohol, diet) of the patients were investigated. Univariate and multivariate proportional-hazards models were used to assess the impact of lifestyle behaviors on patient survival. RESULTS Smoking was a predictor of survival; both current smokers (hazard ratio [HR] = 1.88; 95% CI, 1.33 to 2.65) and heavy smokers (≥ 25 Pack-years; HR = 1.84; 95% CI, 1.30 to 2.60) showed associations with poor survival. Higher BMI was significantly associated with a lower risk of death (P(trend) = 0.002). Compared with under/normal-weight patients (BMI less than 22.99 kg/m(2)), the multivariate HR for survival was 0.66 (95% CI, 0.48 to 0.90) and 0.47 (95% CI, 0.23 to 0.97) for overweight and obese patients, respectively. No alcohol intake and high fruit intake were associated with favorable survival in the univariate analysis but lost significance in the multivariate model. CONCLUSION Our findings indicate that pretreatment lifestyle behaviors, especially smoking status and BMI, as easily available data, provide prognostic value for survival in NPC patients.
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Affiliation(s)
- Guo-Ping Shen
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
- Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Feng-Hua Xu
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Fen He
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
- Department of Radiation Oncology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Hong-Lian Ruan
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Cui Cui
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Li-Zhen Chen
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Yi-Xin Zeng
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Wei-Hua Jia
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
- * E-mail:
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Piyathilake CJ, Badiga S, Kabagambe EK, Azuero A, Alvarez RD, Johanning GL, Partridge EE. A dietary pattern associated with LINE-1 methylation alters the risk of developing cervical intraepithelial neoplasia. Cancer Prev Res (Phila) 2012; 5:385-92. [PMID: 22262813 DOI: 10.1158/1940-6207.capr-11-0387] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There is a paucity of research examining the relationships between dietary patterns and risk of developing precancerous lesions as well as biomarkers associated with such dietary patterns. The purpose of the current study was to identify dietary patterns that are associated with higher grades of cervical intraepithelial neoplasia (CIN 2+) and to determine whether these dietary patterns are associated with the degree of DNA methylation in the long interspersed nucleotide elements (L1s) of peripheral blood mononuclear cells (PBMCs), a biomarker associated with risk of developing CIN 2+. Study population consisted of 319 child-bearing age women. Dietary patterns were derived by factor analysis. The degree of PBMC L1 methylation was assessed by pyrosequencing. Logistic regression models were used to evaluate the associations between dietary patterns and CIN 2+. Similar models were used to evaluate the associations between dietary patterns and degree of PBMC L1 methylation in women free of CIN 2+. Women with the unhealthiest dietary pattern were 3.5 times more likely to be diagnosed with CIN 2+ than women with the healthiest dietary pattern [OR = 3.5; 95% confidence interval (CI), 1.2-10.1; P = 0.02]. Women at risk for developing CIN 2+ with the healthiest dietary pattern were 3.3 times more likely to have higher PBMC L1 methylation than women with the unhealthiest dietary pattern (OR = 3.3; 95% CI, 1.0-10.6; P = 0.04). Our findings suggest that human papilloma virus associated risk of developing CIN 2+ may be reduced by improving dietary patterns. The degree of PBMC L1 methylation may serve as a biomarker for monitoring the effectiveness of dietary modifications needed for reducing the risk of CIN 2+.
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Affiliation(s)
- Chandrika J Piyathilake
- Department of Nutrition Sciences, University of Alabama at Birmingham, 1675 University Blvd, Webb 326, Birmingham, AL 35294, USA.
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Paxton RJ, Garcia-Prieto C, Berglund M, Hernandez M, Hajek RA, Handy B, Brown J, Jones LA. A randomized parallel-group dietary study for stages II-IV ovarian cancer survivors. Gynecol Oncol 2011; 124:410-6. [PMID: 22119991 DOI: 10.1016/j.ygyno.2011.11.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 11/15/2011] [Accepted: 11/15/2011] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Few studies have examined the dietary habits of ovarian cancer survivors. Therefore, we conducted a study to assess the feasibility and impact of two dietary interventions for ovarian cancer survivors. METHODS In this randomized, parallel-group study, 51 women (mean age, 53 years) diagnosed with stages II-IV ovarian cancer were recruited and randomly assigned to a low fat, high fiber (LFHF) diet or a modified National Cancer Institute diet supplemented with a soy-based beverage and encapsulated fruit and vegetable juice concentrates (FVJCs). Changes in clinical measures, serum carotenoid and tocopherol levels, dietary intake, anthropometry, and health-related quality of life (HRQOL) were assessed with paired t-tests. RESULTS The recruitment rate was 25%, and the retention rate was 75% at 6 months. At baseline, 28% and 45% of women met guidelines for intake of fiber and of fruits and vegetables, respectively. After 6 months, total serum carotenoid levels and α- and β-carotene concentrations were significantly increased in both groups (P<0.01); however, β-carotene concentrations were increased more in the FVJC group. Serum β-cryptoxanthin levels, fiber intake (+5.2g/day), and daily servings of juice (+0.9 servings/day) and vegetables (+1.3 servings/day) were all significantly increased in the LFHF group (all P<0.05). Serum levels of albumin, lutein and zeaxanthin, retinol, and retinyl palmitate were significantly increased in the FVJC group (all P<0.05). No changes in cancer antigen-125, anthropometry, or HRQOL were observed. CONCLUSION Overall, this study supports the feasibility of designing dietary interventions for stages II-IV ovarian cancer survivors and provides preliminary evidence that a low fat high fiber diet and a diet supplemented with encapsulated FVJC may increase phytonutrients in ovarian cancer survivors.
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Affiliation(s)
- Raheem J Paxton
- Dorothy I. Height Center for Health Equity and Evaluation Research, University of Houston and University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
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Navarro SL, Li F, Lampe JW. Mechanisms of action of isothiocyanates in cancer chemoprevention: an update. Food Funct 2011; 2:579-87. [PMID: 21935537 PMCID: PMC3204939 DOI: 10.1039/c1fo10114e] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Isothiocyanates (ITC), derived from glucosinolates, are thought to be responsible for the chemoprotective actions conferred by higher cruciferous vegetable intake. Evidence suggests that isothiocyanates exert their effects through a variety of distinct but interconnected signaling pathways important for inhibiting carcinogenesis, including those involved in detoxification, inflammation, apoptosis, and cell cycle and epigenetic regulation, among others. This article provides an update on the latest research on isothiocyanates and these mechanisms, and points out remaining gaps in our understanding of these events. Given the variety of ITC produced from glucosinolates, and the diverse pathways on which these compounds act, a systems biology approach, in vivo, may help to better characterize their integrated role in cancer prevention. In addition, the effects of dose, duration of exposure, and specificity of different ITC should be considered.
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Affiliation(s)
- Sandi L. Navarro
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, 98109
- Interdisciplinary Graduate Program in Nutritional Sciences, Department of Epidemiology, University of Washington, Seattle, WA 98195
| | - Fei Li
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, 98109
| | - Johanna W. Lampe
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, 98109
- Interdisciplinary Graduate Program in Nutritional Sciences, Department of Epidemiology, University of Washington, Seattle, WA 98195
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Indole-3-carbinol inhibited tobacco smoke carcinogen-induced lung adenocarcinoma in A/J mice when administered during the post-initiation or progression phase of lung tumorigenesis. Cancer Lett 2011; 311:57-65. [PMID: 21767909 DOI: 10.1016/j.canlet.2011.06.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 06/14/2011] [Accepted: 06/16/2011] [Indexed: 12/23/2022]
Abstract
We studied the chemopreventive efficacy of indole-3-carbinol (I3C), a phytochemical found in cruciferous vegetables, to inhibit tobacco carcinogen-induced lung adenocarcinoma in A/J mice when given following post-initiation or progression protocol. Moreover, we assessed the potential mechanisms responsible for the anticancer effects of I3C. Post-initiation administration of I3C decreased the multiplicity of surface tumors as well as all forms of histopathological lesions, including adenocarcinoma, whereas administration of the compound during tumor progression failed to decrease the multiplicity of surface tumors and early forms of microscopic lesions but reduced the frequency of adenocarcinoma. Mechanistic studies in A549 lung adenocarcinoma cells indicated that the lung cancer preventive effects of I3C are mediated, at least in part, via modulation of the receptor tyrosine kinase/PI3K/Akt signaling pathway.
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von Gruenigen VE, Frasure HE, Kavanagh MB, Lerner E, Waggoner SE, Courneya KS. Feasibility of a lifestyle intervention for ovarian cancer patients receiving adjuvant chemotherapy. Gynecol Oncol 2011; 122:328-33. [PMID: 21600635 DOI: 10.1016/j.ygyno.2011.04.043] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 04/18/2011] [Accepted: 04/28/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This study aimed to assess the feasibility of a lifestyle intervention for promoting physical activity (PA) and diet quality during adjuvant chemotherapy for ovarian cancer. METHODS Patients were enrolled post-operatively and received PA and nutrition counseling, at every chemotherapy visit for six cycles. Quality of life (QoL) was measured with the Functional Assessment of Cancer Therapy (FACT-G), PA with the Leisure Score Index (LSI), dietary intake with 3-day food records, and symptom severity/distress by the Memorial Symptom Assessment Scale (MSAS). Pedometer step count was collected during chemotherapy cycles. RESULTS Recruitment was 73% with 27 patients enrolled. Mean [95% confidence interval] change in minutes of PA from cycle #3 to following cycle #6 was 61 min [-3, 120] p=0.063, and from baseline to after cycle #6 was 73 min [-10, 15]; p=0.082. Mean change in total fruit and vegetable consumption between baseline and during chemotherapy was 0.56 [-0.09, 0.64]; p=0.090. FACT-G increased from 75.4 at baseline to 77.6 during chemotherapy and 83.9 following chemotherapy (p=0.001 for change from baseline to post-chemotherapy). Mean total MSAS score was 20.6 at baseline, 26.6 at cycle #3 and decreased to 17.0 following chemotherapy (p=0.01 comparison of cycle #3 and following chemotherapy). Increased moderate to strenuous PA was correlated with higher physical well-being during chemotherapy (r=0.48, p=0.037). CONCLUSIONS Lifestyle counseling during adjuvant chemotherapy for ovarian cancer is feasible and may improve PA and diet quality. Randomized controlled trials examining the effects of lifestyle counseling on quality of life and treatment outcomes in ovarian cancer patients are warranted.
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Thigpen JT, Alberts D, Birrer M, Copeland L, Coleman RL, Markman M, Bast RC, Eisenhauer EL, Fleming G, Fracasso PM, Gershenson DM, Herzog T, Monk BJ, Ozols RF, Rustin G, Brady MF, Shrader M, Ranganathan A. Current Challenges and Future Directions in the Management of Ovarian Cancer: Proceedings of the First Global Workshop on Ovarian Cancer. ACTA ACUST UNITED AC 2010. [DOI: 10.3816/coc.2010.n.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Kim S, Dolecek TA, Davis FG. Racial differences in stage at diagnosis and survival from epithelial ovarian cancer: a fundamental cause of disease approach. Soc Sci Med 2010; 71:274-281. [PMID: 20483517 PMCID: PMC3176671 DOI: 10.1016/j.socscimed.2010.03.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Revised: 03/15/2010] [Accepted: 03/23/2010] [Indexed: 11/17/2022]
Abstract
Associations between race, socioeconomic status (SES) and health outcomes have been well established. One of the ways in which race and SES affect health is by influencing one's access to resources, which confers ability to avoid or mitigate adverse outcomes. The fundamental cause of disease approach argues that when a new screening tool is introduced, individuals with greater resources tend to have better access to the innovation, thus benefiting from early detection and leading to better survival. Conversely, when there is no established screening tool, racial and SES differences in early detection may be less pronounced. Most ovarian cancer is diagnosed at advanced stages, because of the lack of an effective screening tool and few early symptoms. However, once detected, racial differences may still be observed in mortality and survival outcomes. We examined the racial differences in diagnosis and survival among ovarian cancer cases diagnosed during 1994-1998, in Cook County, Illinois (N = 351). There were no racial differences in the stage at diagnosis: 51.7% of white and 52.9% of black women were diagnosed at later stages (III and IV). Only age was associated with the stage at diagnosis. Tumor characteristics also did not differ between white and black women. Compared to white women, black women were less likely to be married, less educated, more frequently used genital powder, had tubal ligation, and resided in higher poverty census tracts. As of December 31, 2005, 44.3% of white and 54.5% of black women had died of ovarian cancer. Controlling for known confounding variables, the hazard ratio for ovarian cancer death between black and white women was 2.2. The findings show that fundamental cause perspective provides a potential framework to explore subtleties in racial disparities, with which broader social causes may be accounted for in explaining post diagnosis racial differences.
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Affiliation(s)
- Seijeoung Kim
- University of Illinois at Chicago, School of Public Health, Division of Health Policy and Administration, Chicago, IL 60612, United States.
| | - Therese A Dolecek
- University of Illinois at Chicago, School of Public Health, Division of Epidemiology and Biostatistics, Chicago, IL 60612, United States
| | - Faith G Davis
- University of Illinois at Chicago, School of Public Health, Division of Epidemiology and Biostatistics, Chicago, IL 60612, United States
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