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Yap S, Luo Q, Wade S, Ngo P, Goldsbury D, Sarich P, Banks E, Weber M, Canfell K, David M, Steinberg J. Impact of weighting on the association between sociodemographic characteristics, health behaviours and cancer, cardiovascular and all-cause mortality in the Australian 45 and Up Study. Cancer Epidemiol 2024; 90:102567. [PMID: 38603997 DOI: 10.1016/j.canep.2024.102567] [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: 01/18/2024] [Revised: 03/11/2024] [Accepted: 03/23/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Weighting can improve study estimate representativeness. We examined the impact of weighting on associations between participants' characteristics and cancer, cardiovascular and all-cause mortality in the Australian 45 and Up Study cohort. METHODS Raking weighted cohort data to the 2006 Australian population for seven sociodemographic characteristics. Deaths were ascertained via linkage to routinely collected data. Cox's proportional hazards regression quantified associations between 11 sociodemographic and health characteristics and cancer, cardiovascular and all-cause mortality. The ratios of hazard ratios (RHRs) compared unweighted and weighted estimates. RESULTS Among 195,052 included participants (median follow-up 11.4 years), there were 7200 cancer, 5912 cardiovascular and 21,840 all-cause deaths. Overall, 102/111 (91.9%) weighted HRs did not differ significantly from unweighted HRs (100%, 86.5% and 89.2% of 37 HRs for cancer, cardiovascular and all-cause mortality, respectively). Significant differences included a somewhat stronger association between single/widowed/divorced (versus married/de-facto) and cardiovascular mortality (unweighted HR=1.25 (95%CI:1.18-1.32), weighted HR=1.33 (95%CI:1.24-1.42), RHR=1.06 (95%CI:1.02-1.11)); and between no school certificate/qualification (versus university degree) and all-cause mortality (unweighted HR=1.21 (95%CI:1.15-1.27), weighted HR=1.28 (95%CI:1.19-1.38), RHR=1.06 (95%CI:1.03-1.10)). CONCLUSION Our results support the generalisability of most estimates of associations in the 45 and Up Study, particularly in relation to cancer mortality. Slight distortion of a few associations with cardiovascular or all-cause mortality were observed.
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Affiliation(s)
- Sarsha Yap
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia.
| | - Qingwei Luo
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Stephen Wade
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Preston Ngo
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - David Goldsbury
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Peter Sarich
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Marianne Weber
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Michael David
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
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Ho C, Ha NT, Youens D, Abhayaratna WP, Bulsara MK, Hughes JD, Mishra G, Pearson SA, Preen DB, Reid CM, Ruiter R, Saunders CM, Stricker BH, van Rooij FJA, Wright C, Moorin R. Association between long-term use of calcium channel blockers (CCB) and the risk of breast cancer: a retrospective longitudinal observational study protocol. BMJ Open 2024; 14:e080982. [PMID: 38458796 DOI: 10.1136/bmjopen-2023-080982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION Calcium channel blockers (CCB), a commonly prescribed antihypertensive (AHT) medicine, may be associated with increased risk of breast cancer. The proposed study aims to examine whether long-term CCB use is associated with the development of breast cancer and to characterise the dose-response nature of any identified association, to inform future hypertension management. METHODS AND ANALYSIS The study will use data from 2 of Australia's largest cohort studies; the Australian Longitudinal Study on Women's Health, and the 45 and Up Study, combined with the Rotterdam Study. Eligible women will be those with diagnosed hypertension, no history of breast cancer and no prior CCB use at start of follow-up (2004-2009). Cumulative dose-duration exposure to CCB and other AHT medicines will be captured at the earliest date of: the outcome (a diagnosis of invasive breast cancer); a competing risk event (eg, bilateral mastectomy without a diagnosis of breast cancer, death prior to any diagnosis of breast cancer) or end of follow-up (censoring event). Fine and Gray competing risks regression will be used to assess the association between CCB use and development of breast cancer using a generalised propensity score to adjust for baseline covariates. Time-varying covariates related to interaction with health services will also be included in the model. Data will be harmonised across cohorts to achieve identical protocols and a two-step random effects individual patient-level meta-analysis will be used. ETHICS AND DISSEMINATION Ethical approval was obtained from the following Human research Ethics Committees: Curtin University (ref No. HRE2022-0335), NSW Population and Health Services Research Ethics Committee (2022/ETH01392/2022.31), ACT Research Ethics and Governance Office approval under National Mutual Acceptance for multijurisdictional data linkage research (2022.STE.00208). Results of the proposed study will be published in high-impact journals and presented at key scientific meetings. TRIAL REGISTRATION NUMBER NCT05972785.
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Affiliation(s)
- Chau Ho
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Ninh Thi Ha
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - David Youens
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Walter P Abhayaratna
- Canberra Health Services, Canberra, Australian Capital Territory, Australia
- School of Medicine and Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Max K Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Jeffery David Hughes
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
- PainChek, Sydney, New South Wales, Australia
| | - Gita Mishra
- School of Public Health, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Sallie-Anne Pearson
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- The NHMRC Medicines Intelligence Centre of Research Excellence, Sydney, New South Wales, Australia
| | - David B Preen
- The NHMRC Medicines Intelligence Centre of Research Excellence, Sydney, New South Wales, Australia
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Christopher M Reid
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, Zuid-Holland, Netherlands
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, Zuid-Holland, Netherlands
| | - Christobel M Saunders
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | - Cameron Wright
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Fiona Stanley Hospital, Perth, Western Australia, Australia
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Rachael Moorin
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
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Butters A, Blanch B, Kemp-Casey A, Do J, Yeates L, Leslie F, Semsarian C, Nedkoff L, Briffa T, Ingles J, Sweeting J. The Australian Genetic Heart Disease Registry: Protocol for a Data Linkage Study. JMIR Res Protoc 2023; 12:e48636. [PMID: 37728963 PMCID: PMC10551791 DOI: 10.2196/48636] [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: 05/01/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Genetic heart diseases such as hypertrophic cardiomyopathy can cause significant morbidity and mortality, ranging from syncope, chest pain, and palpitations to heart failure and sudden cardiac death. These diseases are inherited in an autosomal dominant fashion, meaning family members of affected individuals have a 1 in 2 chance of also inheriting the disease ("at-risk relatives"). The health care use patterns of individuals with a genetic heart disease, including emergency department presentations and hospital admissions, are poorly understood. By linking genetic heart disease registry data to routinely collected health data, we aim to provide a more comprehensive clinical data set to examine the burden of disease on individuals, families, and health care systems. OBJECTIVE The objective of this study is to link the Australian Genetic Heart Disease (AGHD) Registry with routinely collected whole-population health data sets to investigate the health care use of individuals with a genetic heart disease and their at-risk relatives. This linked data set will allow for the investigation of differences in outcomes and health care use due to disease, sex, socioeconomic status, and other factors. METHODS The AGHD Registry is a nationwide data set that began in 2007 and aims to recruit individuals with a genetic heart disease and their family members. In this study, demographic, clinical, and genetic data (available from 2007 to 2019) for AGHD Registry participants and at-risk relatives residing in New South Wales (NSW), Australia, were linked to routinely collected health data. These data included NSW-based data sets covering hospitalizations (2001-2019), emergency department presentations (2005-2019), and both state-wide and national mortality registries (2007-2019). The linkage was performed by the Centre for Health Record Linkage. Investigations stratifying by diagnosis, age, sex, socioeconomic status, and gene status will be undertaken and reported using descriptive statistics. RESULTS NSW AGHD Registry participants were linked to routinely collected health data sets using probabilistic matching (November 2019). Of 1720 AGHD Registry participants, 1384 had linkages with 11,610 hospital records, 7032 emergency department records, and 60 death records. Data assessment and harmonization were performed, and descriptive data analysis is underway. CONCLUSIONS We intend to provide insights into the health care use patterns of individuals with a genetic heart disease and their at-risk relatives, including frequency of hospital admissions and differences due to factors such as disease, sex, and socioeconomic status. Identifying disparities and potential barriers to care may highlight specific health care needs (eg, between sexes) and factors impacting health care access and use. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48636.
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Affiliation(s)
- Alexandra Butters
- Clinical Genomics Laboratory, Centre for Population Genomics, Garvan Institute of Medical Research, Darlinghurst, Australia
- Clinical Genomics Laboratory, Centre for Population Genomics, Murdoch Children's Research Institute, Melbourne, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Bianca Blanch
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Sydney, Australia
| | - Anna Kemp-Casey
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Judy Do
- Clinical Genomics Laboratory, Centre for Population Genomics, Garvan Institute of Medical Research, Darlinghurst, Australia
- Clinical Genomics Laboratory, Centre for Population Genomics, Murdoch Children's Research Institute, Melbourne, Australia
| | - Laura Yeates
- Clinical Genomics Laboratory, Centre for Population Genomics, Garvan Institute of Medical Research, Darlinghurst, Australia
- Clinical Genomics Laboratory, Centre for Population Genomics, Murdoch Children's Research Institute, Melbourne, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Sydney, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Felicity Leslie
- Clinical Genomics Laboratory, Centre for Population Genomics, Garvan Institute of Medical Research, Darlinghurst, Australia
- Clinical Genomics Laboratory, Centre for Population Genomics, Murdoch Children's Research Institute, Melbourne, Australia
| | - Christopher Semsarian
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Sydney, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, Perth, Australia
- Victor Change Cardiac Research Institute, Sydney, Australia
| | - Tom Briffa
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Jodie Ingles
- Clinical Genomics Laboratory, Centre for Population Genomics, Garvan Institute of Medical Research, Darlinghurst, Australia
- Clinical Genomics Laboratory, Centre for Population Genomics, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Joanna Sweeting
- Clinical Genomics Laboratory, Centre for Population Genomics, Garvan Institute of Medical Research, Darlinghurst, Australia
- Clinical Genomics Laboratory, Centre for Population Genomics, Murdoch Children's Research Institute, Melbourne, Australia
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Lian TY, Yan Y, Ding D, Ma YJ, Zhang X, Jing ZC. Building a modern six-dimensional biobank fosters the future of precision medicine. Sci Bull (Beijing) 2022; 67:2490-2493. [PMID: 36604021 DOI: 10.1016/j.scib.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- Tian-Yu Lian
- The Medical Science Research Center, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yi Yan
- Heart Center and Shanghai Institute of Pediatric Congenital Heart Disease, Shanghai Children's Medical Center, National Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Dong Ding
- The Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Yue-Jiao Ma
- The Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xue Zhang
- McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Zhi-Cheng Jing
- The Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
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Pandolfini C, Campi R, Bonati M. European birth cohorts: a consideration of what they have addressed so far. BMC Pediatr 2022; 22:548. [PMID: 36109711 PMCID: PMC9476293 DOI: 10.1186/s12887-022-03599-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/25/2022] [Indexed: 12/04/2022] Open
Abstract
Background Knowing the research issues addressed by other cohorts when setting up new cohorts allows researchers to avoid unnecessary duplication of efforts, while permitting collaborations, including data merging data, to better tackle knowledge gaps. This study describes the topics addressed by European birth cohorts, the interaction between these cohort interests and aims, and describes the scientific publications deriving from the cohorts. Methods A previous study found 66 pregnancy and 45 birth cohorts in Europe. In this study, between August and October 2020, the predominant key areas addressed by the 45 birth cohorts identified in the previous study were evaluated, as were the publications found in PubMed that were associated with the 45 cohorts. A network analysis was performed to show the connections between the 13 key areas identified. A focus on a topic in common between two areas was provided, describing the related publications. Results A total of 1512 references were found in PubMed (148 publications per cohort). Thirteen predominant key areas were identified, the most common of which was “Environmental” (addressed by 20 cohorts). The Environmental, Genes, and Lifestyle exposure areas were the prevalent topics characterizing the network figure. The Environmental area had the largest number of interactions with the other areas, while the Prematurity area (4 cohorts) the least. The focus provided on smoking led to the comparison of 35 publications from the Environmental group of cohorts and 22 from the Prematurity group, but their objectives did not overlap. Conclusions The results of this descriptive study show that the environment is a priority research area for cohorts in Europe and that cohorts with different research areas may have study issues in common, but may approach them from different viewpoints. Birth cohorts have wide-ranging aims and it would be almost impossible, and undesirable, to have perfectly overlapping and comparable objectives, but joining efforts would permit maximum use of available resources. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03599-2.
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Berkey CS, Tamimi RM, Willett WC, Rosner B, Hickey M, Toriola AT, Frazier AL, Colditz GA. Adolescent alcohol, nuts, and fiber: combined effects on benign breast disease risk in young women. NPJ Breast Cancer 2020; 6:61. [PMID: 33298962 PMCID: PMC7683739 DOI: 10.1038/s41523-020-00206-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/21/2020] [Indexed: 12/29/2022] Open
Abstract
Adolescent drinking is associated with higher risks of proliferative benign breast disease (BBD) and invasive breast cancer (BC). Furthermore, adolescent nut and fiber consumptions are associated with lower risks of benign lesions and premenopausal BC. We hypothesize that diet (nuts, fiber) may mitigate the elevated BBD risk associated with alcohol. A prospective cohort of 9031 females, 9-15 years at baseline, completed questionnaires in 1996-2001, 2003, 2005, 2007, 2010, 2013, and 2014. Participants completed food frequency questionnaires in 1996-2001. In 2005, participants (>=18 years) began reporting biopsy-confirmed BBD (N = 173 cases). Multivariable logistic regression estimated associations between BBD and cross-classified intakes (14-17 years) of alcohol and peanut butter/nuts (separately, total dietary fiber). Only 19% of participants drank in high school; drinking was associated with elevated BBD risk (OR = 1.75, 95% CI: 1.20-2.56; p = 0.004) compared to nondrinkers. Participants consuming any nuts/butter had lower BBD risk (OR = 0.64, 95% CI: 0.45-0.90; p = 0.01) compared to those consuming none. Participants in top 75% fiber intake had lower risk (OR = 0.57, 95% CI: 0.40-0.81; p = 0.002) compared to bottom quartile. Testing our hypothesis that consuming nuts/butter mitigates the elevated alcohol risk, analyzing alcohol and nuts combined found that those who consumed both had lower risk (RR = 0.47, 95% CI: 0.24-0.89; p = 0.02) compared to drinkers eating no nuts. Our analysis of alcohol and fiber together did not demonstrate risk mitigation by fiber. For high school females who drink, their BBD risk may be attenuated by consuming nuts. Due to modest numbers, future studies need to replicate our findings in adolescent/adult females. However, high school students may be encouraged to eat nuts and fiber, and to avoid alcohol, to reduce risk of BBD and for general health benefits.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Rulla M Tamimi
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine and Alvin J Siteman Cancer Center, St. Louis, MO, USA
| | - A Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Graham A Colditz
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
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Araujo WRM, Santos IS, Menezes Filho NA, Souza MTCCD, Cunha AJLAD, Matijasevich A. Brazilian cohorts with potential for life-course studies: a scoping review. Rev Saude Publica 2020; 54:48. [PMID: 32491093 PMCID: PMC7234216 DOI: 10.11606/s1518-8787.2020054001825] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/19/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To identify the Brazilian cohorts that started either in the prenatal period or at birth, to describe their characteristics and the explored variables, and to map the cohorts with potential for studies on early determinants on health and the risk of falling ill on later stages of the life cycle. METHODS A scoping review was carried out. The articles were searched in the electronic databases PubMed and Virtual Health Library (VHL). The descriptors used were [((("Child" OR "Child, Preschool" OR "Infant" OR "Infant, Newborn") AND (Cohort Studies" OR "Longitudinal Studies")) AND "Brazil")]. The inclusion criteria were Brazilian cohorts that started the baseline in the prenatal period or at birth and with at least two follow-ups with the participants. In order to meet the concept of LCE, we excluded those cohorts whose follow-ups were restricted to the first year of life, as well as those that did not address biological, behavioral and psychosocial aspects, and cohorts with data collection of a single stage of the life cycle. RESULTS The search step identified 5,010 articles. Eighteen cohorts were selected for descriptive synthesis. The median number of baseline participants was 2,000 individuals and the median age at the last follow-up was 9 years. Sample loss at the last follow-up ranged from 9.2 to 87.5%. Most cohorts monitored two phases of the life cycle (the perinatal period and childhood). The Southern region had the highest number of cohorts. The main variables collected were sociodemographic and environmental aspects of the family, morbidity aspects, nutritional practices and lifestyle. CONCLUSIONS We recommend the continuity of these cohorts, the approach to different social contexts and the performance of follow-ups with participants in different phases of the life cycle for the strengthening and expansion of life course epidemiology analyses in Brazil.
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Affiliation(s)
- Waleska Regina Machado Araujo
- Programa de Pós-Graduação em Saúde Coletiva, Universidade de São Paulo. Faculdade de Medicina, São Paulo, SP, Brasil
| | - Iná S Santos
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Naercio Aquino Menezes Filho
- Departamento de Economia., Faculdade de Economia e Administração, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Maria Thereza Costa Coelho de Souza
- Departamento de Psicologia da aprendizagem, do desenvolvimento e da personalidade, Instituto de Psicologia, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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Methodological quality of cohort study on rheumatic diseases in China: A systematic review. PLoS One 2020; 15:e0232020. [PMID: 32324798 PMCID: PMC7179908 DOI: 10.1371/journal.pone.0232020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 04/06/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate systematically the quality of the cohort studies on rheumatic diseases in China. Methods Relevant databases were searched to find cohort studies on rheumatic diseases in China, and the basic information included in the literature was extracted and analyzed. Chinese and English literature were then compared with regard to methodological quality, according to the Newcastle–Ottawa Scale (NOS). Results In total, we included 46 cohort studies, with 19 studies published in English and 27 studies published in Chinese. With regard to the basic characteristics of the literature, 78.26% of the studies were published in the past four years; 16 studies were associated with hyperuricemia, followed by eight studies involving systemic lupus erythematosus. The sample size of the studies in Chinese was lower than that in English studies (P< 0.05). The English literature was superior to the Chinese literature in terms of informed consent, ethical review and selection of statistical analysis methods. The methodology quality of the 46 included studies showed that the English and Chinese NOS scores were 5.59 ± 1.25 and 6.06 ± 1.11, respectively, and the difference was significant (P< 0.01). The “representativeness of the exposed group”, “demonstration that outcome of interest was not present at start of study”, and the “adequacy of follow up of cohorts” scores were relatively low in Chinese and English studies. The score for “was follow-up long enough for outcomes to occur” item in English was higher than that in the Chinese studies; however, the “study controls for the most important factor” score for Chinese papers was better than that for the English papers. Conclusion The Chinese rheumatic disease cohort studies started late, with a small sample size and fewer types of rheumatism. The quality of Chinese studies was better than English studies, and all reports were insufficient. In particular, “selecting exposed groups”, “controlling the outcomes before study implementation” and “adequacy of follow-up” needed improvement.
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Passey ME, Longman JM, Adams C, Johnston JJ, Simms J, Rolfe M. Factors associated with provision of smoking cessation support to pregnant women - a cross-sectional survey of midwives in New South Wales, Australia. BMC Pregnancy Childbirth 2020; 20:219. [PMID: 32295541 PMCID: PMC7161220 DOI: 10.1186/s12884-020-02912-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 03/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking is the most important preventable cause of adverse pregnancy outcomes, but provision of smoking cessation support (SCS) to pregnant women is poor. We examined the association between midwives' implementation of SCS (5As - Ask, Advise, Assess, Assist, Arrange follow-up) and reported barriers/enablers to implementation. METHODS On-line anonymous survey of midwives providing antenatal care in New South Wales (NSW), Australia, assessing provision of the 5As and barriers/enablers to their implementation, using the Theoretical Domains Framework (TDF). Factor analyses identified constructs underlying the 5As; and barriers/enablers. Multivariate general linear models examined relationships between the barrier/enabler factors and the 5As factors. RESULTS Of 750 midwives invited, 150 (20%) participated. Respondents more commonly reported Asking and Assessing than Advising, Assisting, or Arranging follow-up (e.g. 77% always Ask smoking status; 17% always Arrange follow-up). Three 5As factors were identified- 'Helping', 'Assessing quitting' and 'Assessing dependence'. Responses to barrier/enabler items showed greater knowledge, skills, intentions, and confidence with Assessment than Assisting; endorsement for SCS as a priority and part of midwives' professional role; and gaps in training and organisational support for SCS. Nine barrier/enabler factors were identified. Of these, the factors of 'Capability' (knowledge, skills, confidence); 'Work Environment' (service has resources, capacity, champions and values SCS) and 'Personal priority' (part of role and a priority) predicted 'Helping'. CONCLUSION The TDF enabled systematic identification of barriers to providing SCS, and the multivariate models identified key contributors to poor implementation. Combined with qualitative data, these results have been mapped to intervention components to develop a comprehensive intervention to improve SCS.
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Affiliation(s)
- Megan E Passey
- The University of Sydney, University Centre for Rural Health, PO Box 3074, Lismore, NSW, 2480, Australia.
| | - Jo M Longman
- The University of Sydney, University Centre for Rural Health, PO Box 3074, Lismore, NSW, 2480, Australia
| | - Catherine Adams
- Northern New South Wales Local Health District, Locked Mail Bag 11, Lismore, NSW, 2480, Australia
| | - Jennifer J Johnston
- The University of Sydney, University Centre for Rural Health, PO Box 3074, Lismore, NSW, 2480, Australia
| | - Jessica Simms
- The University of Sydney, University Centre for Rural Health, PO Box 3074, Lismore, NSW, 2480, Australia
| | - Margaret Rolfe
- The University of Sydney, University Centre for Rural Health, PO Box 3074, Lismore, NSW, 2480, Australia
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Matthews V, Longman J, Berry HL, Passey M, Bennett-Levy J, Morgan GG, Pit S, Rolfe M, Bailie RS. Differential Mental Health Impact Six Months After Extensive River Flooding in Rural Australia: A Cross-Sectional Analysis Through an Equity Lens. Front Public Health 2019; 7:367. [PMID: 31867302 PMCID: PMC6909816 DOI: 10.3389/fpubh.2019.00367] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/18/2019] [Indexed: 01/20/2023] Open
Abstract
Background: Northern New South Wales in Australia is a “hotspot” for natural disaster declarations with recent extensive flooding in early 2017. With limited knowledge about how climate change affects mental health and resilience, robust local assessments are required to better understand long-term impact, particularly in communities prone to extreme weather events. Methods: Six months post-flood, a cross-sectional survey of adults living in the region during the flood was conducted to quantify associations between flood impact and psychological morbidity (post-traumatic stress (PTSD), anxiety, depression, suicidal ideation) for different exposure scenarios, and respondent groups. We adopted a community-academic partnership approach and purposive recruitment to increase participation from marginalized groups. Results: Of 2,180 respondents, almost all (91%) were affected by some degree of flood-related exposure at an individual and community level (ranging from suburb damage to home or business inundated). Socio-economically marginalized respondents were more likely to have their homes inundated and to be displaced. Mental health risk was significantly elevated for respondents: whose home/business/farm was inundated [e.g., home inundation: PTSD adjusted odds ratio (AOR) 13.72 (99% CI 4.53–41.56)]; who reported multiple exposures [e.g., three exposures: PTSD AOR 6.43 (99% CI 2.11–19.60)]; and who were still displaced after 6 months [e.g., PTSD AOR 24.43 (99% CI 7.05–84.69)]. Conclusion: The 2017 flood had profound impact, particularly for respondents still displaced and for socio-economically marginalized groups. Our community-academic partnership approach builds community cohesion, informs targeted mental health disaster preparedness and response policies for different sectors of the community and longer-term interventions aimed at improving community adaptability to climate change.
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Affiliation(s)
- Veronica Matthews
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Jo Longman
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Helen L Berry
- Centre for Health Systems and Safety Research, Macquarie University, Sydney, NSW, Australia
| | - Megan Passey
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - James Bennett-Levy
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Geoffrey G Morgan
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Sabrina Pit
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Margaret Rolfe
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Ross S Bailie
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
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Longman JM, Bennett-Levy J, Matthews V, Berry HL, Passey ME, Rolfe M, Morgan GG, Braddon M, Bailie R. Rationale and methods for a cross-sectional study of mental health and wellbeing following river flooding in rural Australia, using a community-academic partnership approach. BMC Public Health 2019; 19:1255. [PMID: 31510969 PMCID: PMC6739930 DOI: 10.1186/s12889-019-7501-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 08/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Climate change is associated with greater frequency, duration, intensity and unpredictability of certain weather-related events, including floods. Floods harm mental health. There is limited understanding of the mental health and well-being effects from river flooding, particularly over the longer term and in rural contexts. This paper describes the rationale, aims, objectives, study design and socio-demographic characteristics of the sample for a study measuring associations between flood experience and mental health and wellbeing of residents (particularly those most likely to be negatively impacted and hard to reach) in rural NSW Australia 6 months following a devastating flood in 2017. To our knowledge, the study is the first of its kind within Australia in a rural community and is an important initiative given the likelihood of an increasing frequency of severe flooding in Australia given climate change. METHODS A conceptual framework (The Flood Impact Framework) drawing on social ecological approaches was developed by the research team. It was based on the literature and feedback from the community. The Framework describes putative relationships between flood exposure and mental health and wellbeing outcomes. Within a community-academic partnership approach, a cross-sectional survey was then undertaken to quantify and further explore these relationships. RESULTS The cross-sectional survey was conducted online (including on mobile phone) and on paper between September and November 2017 and recruited 2530 respondents. Of those, 2180 provided complete demographic data, among whom 69% were women, 91% were aged 25-74, 4% identified as Aboriginal and/or Torres Strait Islander, 9% were farmers and 33% were business owners. CONCLUSIONS The study recruited a wide range of respondents and the partnership facilitated the community's engagement with the design and implementation of the study. The study will provide a basis for a follow-up study, that will aim to improve the understanding of mental health and wellbeing effects over the longer term. It will provide an important and original contribution to understanding river flooding and mental health in rural Australia, a topic that will grow in importance in the context of human-induced climate change, and identify critical opportunities to strengthen services, emergency planning and resilience to future flooding.
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Affiliation(s)
- J M Longman
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, New South Wales, 2480, Australia.
| | - J Bennett-Levy
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, New South Wales, 2480, Australia
| | - V Matthews
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, New South Wales, 2480, Australia
| | - H L Berry
- Sydney School of Public Health, Edward Ford Building, University of Sydney, Sydney, New South Wales, 2006, Australia
| | - M E Passey
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, New South Wales, 2480, Australia
| | - M Rolfe
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, New South Wales, 2480, Australia
| | - G G Morgan
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, New South Wales, 2480, Australia
| | - M Braddon
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, New South Wales, 2480, Australia
| | - R Bailie
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, New South Wales, 2480, Australia
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12
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Berkey CS, Tamimi RM, Willett WC, Rosner B, Hickey M, Toriola AT, Lindsay Frazier A, Colditz GA. Dietary intake from birth through adolescence in relation to risk of benign breast disease in young women. Breast Cancer Res Treat 2019; 177:513-525. [PMID: 31222710 DOI: 10.1007/s10549-019-05323-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/13/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Nutritional factors during different periods in life impact breast cancer risk. Because benign breast disease (BBD) is a well-established risk factor for breast cancer, we investigated childhood nutrition from birth through age 14 year and subsequent BBD. METHODS A prospective cohort study of 9031 females, 9-15 year at baseline, completed questionnaires (including heights, weights) annually from 1996 to 2001, in 2003, 2005, 2007, 2010, 2013 and 2014. In 1996, mothers reported infant feeding practices during their daughters first year of life. Beginning in 1996, participants completed annual food frequency questionnaires. In 2005, participants (18 year +) began reporting whether they had ever been diagnosed with biopsy-confirmed BBD (N = 173 cases). Multivariable logistic regression models estimated associations between childhood nutrition and BBD, adjusted for maternal breast disease and childhood body size factors. RESULTS Although no infant nutrition factors were associated with biopsy-confirmed BBD, certain adolescent dietary factors were. A multivariable model simultaneously included the most important diet and body size factors from different age periods: higher BBD risk was associated with greater age 10 year consumption of animal (non-dairy, energy-adjusted) fat (OR 2.27, p < .02, top vs. bottom quartiles) and with lower 14 year consumption of nuts/peanut butter (OR 0.60, p = .033, top vs. bottom quartiles). CONCLUSION Greater intake of animal (non-dairy) fat at 10 year and lower intake of nuts/peanut butter at 14 year were independently associated with higher BBD risk. These dietary factors appeared to operate on BBD risk independent of childhood growth (gestational weight gain, childhood BMI and height, adolescent height growth velocity), young adult height and BMI, and family history.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, The University of Melbourne and the Royal Women's Hospital, Melbourne, VIC, Australia
| | - Adetunji T Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine and Alvin J Siteman Cancer Center, St. Louis, MO, USA
| | - A Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - Graham A Colditz
- Washington University School of Medicine, Alvin J. Siteman Cancer Center, St. Louis, MO, USA
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13
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Chua SYL, Thomas D, Allen N, Lotery A, Desai P, Patel P, Muthy Z, Sudlow C, Peto T, Khaw PT, Foster PJ. Cohort profile: design and methods in the eye and vision consortium of UK Biobank. BMJ Open 2019; 9:e025077. [PMID: 30796124 PMCID: PMC6398663 DOI: 10.1136/bmjopen-2018-025077] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/01/2018] [Accepted: 12/11/2018] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To describe the rationale, methods and research potential of eye and vision measures available in UK Biobank. PARTICIPANTS UK Biobank is a large, multisite, prospective cohort study. Extensive lifestyle and health questionnaires, a range of physical measures and collection of biological specimens are collected. The scope of UK Biobank was extended midway through data collection to include assessments of other measures of health, including eyes and vision. The eye assessment at baseline included questionnaires detailing past ophthalmic and family history, measurement of visual acuity, refractive error and keratometry, intraocular pressure (IOP), corneal biomechanics, spectral domain optical coherence tomography (OCT) of the macula and a disc-macula fundus photograph. Since recruitment, UK Biobank has collected accelerometer data and begun multimodal imaging data (including brain, heart and abdominal MRI) in 100 000 participants. Dense genotypic data and a panel of 20 biochemistry measures are available, and linkage to medical health records for the full cohort has begun. FINDINGS TO DATE A total of 502 665 people aged between 40 and 69 were recruited to participate in UK Biobank. Of these, 117 175 took part in baseline assessment of vision, IOP, refraction and keratometry. A subgroup of 67 321 underwent OCT and retinal photography. The introduction of eye and vision measures in UK Biobank was accompanied by intensive training, support and a data monitoring quality control process. FUTURE PLANS UK Biobank is one of the largest prospective cohorts worldwide with extensive data on ophthalmic diseases and conditions. Data collection is an ongoing process and a repeat of the baseline assessment including the questionnaires, measurements and sample collection will be performed in subsets of 25 000 participants every 2-3 years. The depth and breadth of this dataset, coupled with its open-access policy, will create a powerful resource for all researchers to investigate the eye diseases in later life.
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Affiliation(s)
- Sharon Yu Lin Chua
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Dhanes Thomas
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Naomi Allen
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Andrew Lotery
- Department of Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Parul Desai
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Praveen Patel
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Zaynah Muthy
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Cathie Sudlow
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tunde Peto
- Institute of Clinical Science, Queen's University Belfast Faculty of Medicine Health and Life Sciences, Belfast, Belfast, UK
| | - Peng Tee Khaw
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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14
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Creighton N, Purdie S, Soeberg M, Walton R, Baker D, Young J. Self-selection in a population-based cohort study: impact on health service use and survival for bowel and lung cancer assessed using data linkage. BMC Med Res Methodol 2018; 18:84. [PMID: 30089467 PMCID: PMC6083588 DOI: 10.1186/s12874-018-0537-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/27/2018] [Indexed: 12/29/2022] Open
Abstract
Background In contrast to aetiological associations, there is little empirical evidence for generalising health service use associations from cohort studies. We compared the health service use of cohort study participants diagnosed with bowel or lung cancer to the source population of people diagnosed with these cancers in New South Wales (NSW), Australia to assess the representativeness of health service use of the cohort study participants. Methods Population-based cancer registry data for NSW residents aged ≥45 years at diagnosis of bowel or lung cancer were linked to the 45 and Up Study, a NSW population-based cohort study (N~ 267,000). We measured hospitalisation, emergency department (ED) attendance and all-cause survival, and risk factor associations with these outcomes using administrative data for cohort study participants and the source population. We assessed bias in prevalence and risk factor associations using ratios of relative frequency (RRF) and relative odds ratios (ROR), respectively. Results People from major cities, non-English speaking countries and with comorbidites were under-represented among cohort study participants diagnosed with bowel (n = 1837) or lung (n = 969) cancer by 20–50%. Cohort study participants had similar hospitalisation and ED attendance compared with the source population. One-year survival after major surgical resection was similar, but cohort study participants had up to 25% higher post-diagnosis survival (lung cancer 3-year survival: RRF = 1.24, 95% confidence interval 1.12,1.37). Except for area-based socioeconomic position, risk factors associations with health service use measures and survival appeared relatively unbiased. Conclusions Absolute measures of health service use and risk factor associations in a non-representative sample showed little evidence of bias. Non-comparability of risk factor measures of cohort study participants and non-participants, such as area-based socioeconomic position, may bias estimates of risk factor associations. Primary and outpatient care outcomes may be more vulnerable to bias. Electronic supplementary material The online version of this article (10.1186/s12874-018-0537-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicola Creighton
- Cancer Institute NSW, PO Box 41, Alexandria, Sydney, NSW, 1435, Australia.
| | - Stuart Purdie
- Cancer Institute NSW, PO Box 41, Alexandria, Sydney, NSW, 1435, Australia
| | | | - Richard Walton
- Cancer Institute NSW, PO Box 41, Alexandria, Sydney, NSW, 1435, Australia
| | - Deborah Baker
- Cancer Institute NSW, PO Box 41, Alexandria, Sydney, NSW, 1435, Australia.,Sax Institute, Sydney, Australia
| | - Jane Young
- School of Public Health, University of Sydney and Sydney Local Health District, Sydney, Australia
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15
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Mayne DJ, Morgan GG, Jalaludin BB, Bauman AE. The contribution of area-level walkability to geographic variation in physical activity: a spatial analysis of 95,837 participants from the 45 and Up Study living in Sydney, Australia. Popul Health Metr 2017; 15:38. [PMID: 28974226 PMCID: PMC5627488 DOI: 10.1186/s12963-017-0149-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 08/25/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Individual-level studies support a positive relation between walkable built environments and participation in moderate-intensity walking. However, the utility of this evidence for population-level planning is less clear as it is derived at much finer spatial scales than those used for regional programming. The aims of this study were to: evaluate if individual-level relations between walkability and walking to improve health manifest at population-level spatial scales; assess the specificity of area-level walkability for walking relative to other moderate and vigorous physical activity (MVPA); describe geographic variation in walking and other MVPA; and quantify the contribution of walkability to this variation. METHODS Data on sufficient walking, sufficient MVPA, and high MVPA to improve health were analyzed for 95,837 Sydney respondents to the baseline survey of the 45 and Up Study between January 2006 and April 2010. We used conditional autoregressive models to create smoothed MVPA "disease maps" and assess relations between sufficient MVPA to improve health and area-level walkability adjusted for individual-level demographic, socioeconomic, and health factors, and area-level relative socioeconomic disadvantage. RESULTS Within-cohort prevalence of meeting recommendations for sufficient walking, sufficient MVPA, and high MVPA were 31.7 (95% CI 31.4-32.0), 69.4 (95% CI 69.1-69.7), and 56.1 (95% CI 55.8-56.4) percent. Prevalence of sufficient walking was increased by 1.20 (95% CrI 1.12-1.29) and 1.07 (95% CrI 1.01-1.13) for high and medium-high versus low walkability postal areas, and for sufficient MVPA by 1.05 (95% CrI 1.01-1.08) for high versus low walkability postal areas. Walkability was not related to high MVPA. Postal area walkability explained 65.8 and 47.4 percent of residual geographic variation in sufficient walking and sufficient MVPA not attributable to individual-level factors. CONCLUSIONS Walkability is associated with area-level prevalence and geographic variation in sufficient walking and sufficient MVPA to improve health in Sydney, Australia. Our study supports the use of walkability indexes at multiple spatial scales for informing population-level action to increase physical activity and the utility of spatial analysis for walkability research and planning.
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Affiliation(s)
- Darren J. Mayne
- Sydney School of Public Health, The University of Sydney, Camperdown, 2006 NSW Australia
- Public Health Unit, Illawarra Shoalhaven Local Health District, Warrawong, 2502 NSW Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, 2500 NSW Australia
- Illawarra Health and Medical Research Institute, Wollongong, 2500 NSW Australia
| | - Geoffrey G. Morgan
- University Centre for Rural Health - North Coast, School of Public Health, The University of Sydney, Camperdown, 2006 NSW Australia
| | - Bin B. Jalaludin
- Ingham Institute, University of New South Wales, Sydney, 2052 NSW Australia
- Epidemiology, Healthy People and Places Unit, Population Health, South Western Sydney Local Health District, Liverpool, 1871 NSW Australia
| | - Adrian E. Bauman
- Sydney School of Public Health, The University of Sydney, Camperdown, 2006 NSW Australia
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16
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Berkey CS, Rosner B, Tamimi RM, Willett WC, Hickey M, Toriola A, Frazier AL, Colditz GA. Body size from birth through adolescence in relation to risk of benign breast disease in young women. Breast Cancer Res Treat 2017; 162:139-149. [PMID: 28062981 PMCID: PMC5290089 DOI: 10.1007/s10549-016-4084-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Body size, from birth throughout adulthood, is associated with breast cancer risk, but few studies have investigated early-life body size and benign breast disease (BBD), a well-established breast cancer risk factor. We consider whether prenatal factors and size at birth, 10, 18 year, and intervening growth, are related to BBD risk. METHODS The Growing Up Today Study includes 9032 females who completed questionnaires annually from 1996 to 2001, then 2003, 2005, 2007, 2010, and 2013. In 1996, their mothers provided pregnancy-related data. From 2005 to 2013, participants (18 year+) reported whether they had ever been diagnosed with biopsy-confirmed BBD (N = 142 cases). RESULTS Girls had greater adiposity (BMI; kg/m2) at 10 year if they were larger at birth, if mother's pre-pregnancy BMI was higher, or if gestational weight gain was greater (all p < .01). Maternal height was (positively) associated (p < .05) with adolescent peak height growth velocity (PHV; in./year). Greater 10 year adiposity was associated with lower PHV and less height growth 10-18 year (both p < .01). Adiposity at 10 year was inversely associated with BBD (OR 0.83/(kg/m2), p < .01) as was increasing adiposity 10-18 year (OR 0.85/(kg/m2), p = .01). In a separate model, 10 year height (OR 1.13/in., p = .02) and height growth 10-18 year (OR 1.19/in.; p < .01) were positively associated. PHV was similarly positively associated (OR 2.58, p = .01, fastest versus slowest growth quartiles). In a multivariable model of BBD risk, gestational weight gain (daughters at highest risk if <20 lb gained), PHV (slowest growing girls at lowest risk), age 10 year height (positive), and BMI (inverse) were the most critical childhood risk factors (each p < .05). CONCLUSIONS Body size factors from pregnancy through adolescence were independently associated with BBD risk in young women.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Australia
| | - Adetunji Toriola
- Division of Public Health Sciences, Department of Surgery, Alvin J Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - A Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Graham A Colditz
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
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17
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Kennedy AE, Khoury MJ, Ioannidis JPA, Brotzman M, Miller A, Lane C, Lai GY, Rogers SD, Harvey C, Elena JW, Seminara D. The Cancer Epidemiology Descriptive Cohort Database: A Tool to Support Population-Based Interdisciplinary Research. Cancer Epidemiol Biomarkers Prev 2016; 25:1392-1401. [PMID: 27439404 DOI: 10.1158/1055-9965.epi-16-0412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 07/14/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We report on the establishment of a web-based Cancer Epidemiology Descriptive Cohort Database (CEDCD). The CEDCD's goals are to enhance awareness of resources, facilitate interdisciplinary research collaborations, and support existing cohorts for the study of cancer-related outcomes. METHODS Comprehensive descriptive data were collected from large cohorts established to study cancer as primary outcome using a newly developed questionnaire. These included an inventory of baseline and follow-up data, biospecimens, genomics, policies, and protocols. Additional descriptive data extracted from publicly available sources were also collected. This information was entered in a searchable and publicly accessible database. We summarized the descriptive data across cohorts and reported the characteristics of this resource. RESULTS As of December 2015, the CEDCD includes data from 46 cohorts representing more than 6.5 million individuals (29% ethnic/racial minorities). Overall, 78% of the cohorts have collected blood at least once, 57% at multiple time points, and 46% collected tissue samples. Genotyping has been performed by 67% of the cohorts, while 46% have performed whole-genome or exome sequencing in subsets of enrolled individuals. Information on medical conditions other than cancer has been collected in more than 50% of the cohorts. More than 600,000 incident cancer cases and more than 40,000 prevalent cases are reported, with 24 cancer sites represented. CONCLUSIONS The CEDCD assembles detailed descriptive information on a large number of cancer cohorts in a searchable database. IMPACT Information from the CEDCD may assist the interdisciplinary research community by facilitating identification of well-established population resources and large-scale collaborative and integrative research. Cancer Epidemiol Biomarkers Prev; 25(10); 1392-401. ©2016 AACR.
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Affiliation(s)
- Amy E Kennedy
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, NCI, NIH, Rockville, Maryland
| | - Muin J Khoury
- Office of Public Health Genomics, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John P A Ioannidis
- Department of Medicine, Stanford University, Stanford, California. Department of Health Research and Policy, Stanford University, Stanford, California. Department of Statistics, Stanford University, Stanford, California. Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California
| | | | | | - Crystal Lane
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland
| | - Gabriel Y Lai
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, NCI, NIH, Rockville, Maryland
| | - Scott D Rogers
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, NCI, NIH, Rockville, Maryland
| | - Chinonye Harvey
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, NCI, NIH, Rockville, Maryland
| | - Joanne W Elena
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, NCI, NIH, Rockville, Maryland
| | - Daniela Seminara
- Division of Cancer Control and Population Sciences, NCI, NIH, Rockville, Maryland.
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18
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Berkey CS, Rosner B, Willett WC, Tamimi RM, Lindsay Frazier A, Colditz GA. Prenatal factors and infant feeding in relation to risk of benign breast disease in young women. Breast Cancer Res Treat 2015; 154:573-82. [PMID: 26582399 DOI: 10.1007/s10549-015-3637-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 11/07/2015] [Indexed: 11/26/2022]
Abstract
Benign breast disease (BBD) is a well-established risk factor for breast cancer, but little work has considered a girl's early life and her risk for BBD in adulthood. We investigated factors, from pre-conception through infant feeding practices, in relation to subsequent BBD risk in young women. The Growing Up Today Study (GUTS) includes 9032 females, born 1980-1987, who completed questionnaires annually from 1996 through 2001, then 2003, 2005, 2007, 2010, and 2013. In 1996, their mothers provided each participant's birth weight and length, gestational age, biological father's height, and infant feeding factors (e.g., breast-fed, type of formula). In 1999, their mothers reported maternal pre-pregnancy weight and weight gain during index pregnancy. Beginning in 2005, daughters (18 years+) reported whether they had ever been diagnosed with biopsy-confirmed BBD (n = 142 cases, through 2013). Logistic regression estimated associations between early life factors and biopsy-confirmed BBD. Girls whose mother's BMI prior to pregnancy was 20-25 kg/m(2) were at lower risk of BBD as young women (OR = 0.66, p = 0.04, vs. maternal pre-pregnancy BMI < 20). Girls whose mothers gained 20 + pounds (vs. <20 pounds) during pregnancy were at lower risk (among full-term singleton births: OR = 0.48, p = 0.007, if mother gained 20-35 pounds). However, neither birth weight nor BMI at birth were associated with subsequent BBD risk. We found no evidence that infant feeding practices were linked to BBD. A healthy maternal BMI before pregnancy and sufficient weight gain during pregnancy may produce daughters at lower risk for BBD as young women. Further examination of these findings is needed.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - A Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - Graham A Colditz
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, USA
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Crawford DC, Goodloe R, Farber-Eger E, Boston J, Pendergrass SA, Haines JL, Ritchie MD, Bush WS. Leveraging Epidemiologic and Clinical Collections for Genomic Studies of Complex Traits. Hum Hered 2015. [PMID: 26201699 DOI: 10.1159/000381805] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND/AIMS Present-day limited resources demand DNA and phenotyping alternatives to the traditional prospective population-based epidemiologic collections. METHODS To accelerate genomic discovery with an emphasis on diverse populations, we--as part of the Epidemiologic Architecture for Genes Linked to Environment (EAGLE) study--accessed all non-European American samples (n = 15,863) available in BioVU, the Vanderbilt University biorepository linked to de-identified electronic medical records, for genomic studies as part of the larger Population Architecture using Genomics and Epidemiology (PAGE) I study. Given previous studies have cautioned against the secondary use of clinically collected data compared with epidemiologically collected data, we present here a characterization of EAGLE BioVU, including the billing and diagnostic (ICD-9) code distributions for adult and pediatric patients as well as comparisons made for select health metrics (body mass index, glucose, HbA1c, HDL-C, LDL-C, and triglycerides) with the population-based National Health and Nutrition Examination Surveys (NHANES) linked to DNA samples (NHANES III, n = 7,159; NHANES 1999-2002, n = 7,839). RESULTS Overall, the distributions of billing and diagnostic codes suggest this clinical sample is a mixture of healthy and sick patients like that expected for a contemporary American population. CONCLUSION Little bias is observed among health metrics, suggesting this clinical collection is suitable for genomic studies along with traditional epidemiologic cohorts.
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Affiliation(s)
- Dana C Crawford
- Department of Epidemiology and Biostatistics, Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio, USA
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20
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Kordas K, Park A. European birth cohorts offer insights on environmental factors affecting human development and health. Int J Epidemiol 2015; 44:731-4. [PMID: 26232419 PMCID: PMC4521136 DOI: 10.1093/ije/dyv132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Katarzyna Kordas
- Avon Longitudinal Study of Parents and Children (ALSPAC), School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Alison Park
- CLOSER, Institute of Education, University College London, London, UK
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21
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Sudlow C, Gallacher J, Allen N, Beral V, Burton P, Danesh J, Downey P, Elliott P, Green J, Landray M, Liu B, Matthews P, Ong G, Pell J, Silman A, Young A, Sprosen T, Peakman T, Collins R. UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS Med 2015; 12:e1001779. [PMID: 25826379 PMCID: PMC4380465 DOI: 10.1371/journal.pmed.1001779] [Citation(s) in RCA: 5579] [Impact Index Per Article: 619.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cathie Sudlow and colleagues describe the UK Biobank, a large population-based prospective study, established to allow investigation of the genetic and non-genetic determinants of the diseases of middle and old age.
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Affiliation(s)
- Cathie Sudlow
- University of Edinburgh, Edinburgh, United Kingdom
- UK Biobank, Stockport, United Kingdom
| | | | - Naomi Allen
- UK Biobank, Stockport, United Kingdom
- University of Oxford, Oxford, United Kingdom
| | | | - Paul Burton
- University of Bristol, Bristol, United Kingdom
| | - John Danesh
- University of Cambridge, Cambridge, United Kingdom
| | | | | | - Jane Green
- University of Oxford, Oxford, United Kingdom
| | | | - Bette Liu
- University of New South Wales, Sydney, Australia
| | | | - Giok Ong
- University of Warwick, Warwick, United Kingdom
| | - Jill Pell
- University of Glasgow, Glasgow, United Kingdom
| | - Alan Silman
- University of Manchester, Manchester, United Kingdom
| | - Alan Young
- University of Oxford, Oxford, United Kingdom
| | - Tim Sprosen
- University of Oxford, Oxford, United Kingdom
| | | | - Rory Collins
- UK Biobank, Stockport, United Kingdom
- University of Oxford, Oxford, United Kingdom
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22
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Berkey CS, Tamimi RM, Willett WC, Rosner B, Lindsay Frazier A, Colditz GA. Adolescent physical activity and inactivity: a prospective study of risk of benign breast disease in young women. Breast Cancer Res Treat 2014; 146:611-8. [PMID: 25034340 DOI: 10.1007/s10549-014-3055-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 07/04/2014] [Indexed: 10/25/2022]
Abstract
In previous investigations of adolescent activity recalled in adulthood, modest reductions in risk of benign breast disease (BBD) and premenopausal breast cancer were seen with moderate-strenuous activity during high school. We therefore investigated physical activity, walking, and recreational inactivity (watching TV-videos, playing computer-videogames) reported by adolescent girls in relation to their subsequent risk for BBD as young women. The Growing Up Today Study includes 9,039 females, 9-15 years at study initiation (1996), who completed questionnaires annually through 2001, then in 2003, 2005, 2007, 2010 and 2013. Annual surveys (1996-2001) obtained data on physical and sedentary activities during the past year. Beginning in 2005, women (≥18 years) reported whether they had ever been diagnosed with BBD confirmed by breast biopsy (n = 133 cases, to 11/01/2013). Logistic regression (adjusted for baseline adiposity and age; additional factors in multivariable-adjusted models) estimated associations between adolescent activities (moderate-vigorous, walking, METS, inactivity) and biopsy-confirmed BBD in young women. Girls who walked the most had significantly lower risk of BBD (multivariable-adjusted OR = 0.61, ≥30 vs ≤15 min/day; p = .049). We observed no evidence that inactivity (≥3 vs <2 h/day OR = 1.02, p = .92) or METS (top vs bottom tertile OR = 1.19, p = .42) were associated with BBD. Accounting for factors including family history, childhood adiposity, and other activities and inactivities, adolescent girls who walked the most were at lower risk for BBD. We found no evidence that high moderate-vigorous activity might reduce risk, nor did we observe any association with inactivity. Continued follow-up will re-evaluate these findings as more BBD cases, and ultimately breast cancer, are diagnosed.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA,
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Crawford DC, Crosslin DR, Tromp G, Kullo IJ, Kuivaniemi H, Hayes MG, Denny JC, Bush WS, Haines JL, Roden DM, McCarty CA, Jarvik GP, Ritchie MD. eMERGEing progress in genomics-the first seven years. Front Genet 2014; 5:184. [PMID: 24987407 PMCID: PMC4060012 DOI: 10.3389/fgene.2014.00184] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 05/30/2014] [Indexed: 12/15/2022] Open
Abstract
The electronic MEdical Records & GEnomics (eMERGE) network was established in 2007 by the National Human Genome Research Institute (NHGRI) of the National Institutes of Health (NIH) in part to explore the utility of electronic medical records (EMRs) in genome science. The initial focus was on discovery primarily using the genome-wide association paradigm, but more recently, the network has begun evaluating mechanisms to implement new genomic information coupled to clinical decision support into EMRs. Herein, we describe this evolution including the development of the individual and merged eMERGE genomic datasets, the contribution the network has made toward genomic discovery and human health, and the steps taken toward the next generation genotype-phenotype association studies and clinical implementation.
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Affiliation(s)
- Dana C Crawford
- Center for Human Genetics Research, Vanderbilt University Nashville, TN, USA ; Department of Molecular Physiology and Biophysics, Vanderbilt University Nashville, TN, USA
| | - David R Crosslin
- Medical Genetics, Department of Medicine, School of Medicine, University of Washington Seattle, WA, USA ; Department of Genome Sciences, University of Washington Seattle, WA, USA
| | - Gerard Tromp
- The Sigfried and Janet Weis Center for Research, Geisinger Health System Danville, PA, USA
| | - Iftikhar J Kullo
- Division of Cardiovascular Diseases and the Gonda Vascular Center, Mayo Clinic Rochester, MN, USA
| | - Helena Kuivaniemi
- The Sigfried and Janet Weis Center for Research, Geisinger Health System Danville, PA, USA
| | - M Geoffrey Hayes
- Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University Chicago, IL, USA
| | - Joshua C Denny
- Department of Biomedical Informatics, Vanderbilt University Nashville, TN, USA ; Department of Medicine, Vanderbilt University Nashville, TN, USA
| | - William S Bush
- Center for Human Genetics Research, Vanderbilt University Nashville, TN, USA ; Department of Biomedical Informatics, Vanderbilt University Nashville, TN, USA
| | - Jonathan L Haines
- Department of Epidemiology and Biostatistics, Case Western Reserve University Cleveland, OH, USA ; Institute for Computational Biology, Case Western Reserve University Cleveland, OH, USA
| | - Dan M Roden
- Department of Medicine, Vanderbilt University Nashville, TN, USA ; Department of Pharmacology, Vanderbilt University Nashville, TN, USA
| | | | - Gail P Jarvik
- Medical Genetics, Department of Medicine, School of Medicine, University of Washington Seattle, WA, USA ; Department of Genome Sciences, University of Washington Seattle, WA, USA
| | - Marylyn D Ritchie
- Department of Biochemistry and Molecular Biology, Pennsylvania State University University Park, PA, USA ; Center for Systems Genomics, Pennsylvania State University University Park, PA, USA
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Berkey CS, Willett WC, Tamimi RM, Rosner B, Frazier AL, Colditz GA. Vegetable protein and vegetable fat intakes in pre-adolescent and adolescent girls, and risk for benign breast disease in young women. Breast Cancer Res Treat 2013; 141:299-306. [PMID: 24043428 DOI: 10.1007/s10549-013-2686-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 08/27/2013] [Indexed: 01/28/2023]
Abstract
Previous investigations, of adolescent diet recalled in adulthood, found lower risk for benign breast disease (BBD) with higher intakes of vegetable fat and nuts during high school. We investigate whether vegetable protein and fat, derived from diets reported during pre-adolescence and adolescence, are associated with subsequent risk for BBD in young women. The Growing Up Today Study includes 9,039 females, 9-15 years in 1996, who completed questionnaires annually through 2001, and then in 2003, 2005, 2007, and 2010. Food frequency questionnaires (1996-2001) obtained intake data on a variety of foods. Beginning in 2005, women (18-30 years) reported whether they had ever been diagnosed with BBD that was confirmed by breast biopsy (n = 112 cases). Logistic regression estimated associations between intakes of vegetable protein and fat and biopsy-confirmed BBD. Those individual foods that were the largest contributors of protein and fat in this cohort were also investigated. In analyses of intakes from 1996 through 1998, when our cohort was youngest, vegetable fat (OR = 0.72/(10 gm/day), 95 % CI 0.53-0.98; p = 0.04) was inversely associated with BBD risk. The greatest sources of vegetable fat and protein in these girls were peanut butter, peanuts, nuts, beans (beans, lentils, and soybeans), and corn. A daily serving of any one of these was associated with lower risk (OR = 0.32/(serv/day), 95 % CI 0.13-0.79; p = 0.01). Peanut butter (and nuts) at age 11 years was inversely associated with risk (p = 0.01). In analyses of intakes at age 14 years, vegetable protein was associated with lower BBD risk (OR = 0.64/(10 gm/day), 95 % CI 0.43-0.95; p = 0.03). A daily serving at 14 years of any one of the foods was associated with lower risk (OR = 0.34, 95 % CI 0.16-0.75; p = 0.01), as was peanut butter (and nuts) (p = 0.02). Girls with a family history of breast cancer had significantly lower risk if they consumed these foods or vegetable fat. In conclusion, consumption of vegetable protein, fat, peanut butter, or nuts by older girls may help reduce their risk of BBD as young women.
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Affiliation(s)
- Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA,
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25
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Harris MF, Islam FM, Jalaludin B, Chen J, Bauman AE, Comino EJ. Preventive care in general practice among healthy older New South Wales residents. BMC FAMILY PRACTICE 2013; 14:83. [PMID: 23767817 PMCID: PMC3691583 DOI: 10.1186/1471-2296-14-83] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 06/10/2013] [Indexed: 11/18/2022]
Abstract
Background Despite being at high risk, disadvantaged patients may be less likely to receive preventive care in general practice. This study aimed to explore self-reported preventive care received from general practitioners and the factors associated with this by healthy New South Wales (NSW) residents aged 45–74 years. Methods A self-completed questionnaire was sent to 100,000 NSW residents in the 45 and Up cohort study. There was a 60% response rate. After exclusions there were 39,964 participants aged 45–74 years who did not report cardiovascular disease or diabetes. Dichotomised outcome variables were participant report of having had a clinical assessment of their blood pressure (BP), blood cholesterol (BC) or blood glucose (BG), or received advice to eat less high fat food, eat more fruit and vegetables or be more physically active from their GP in the last 12 months. Independent variables included socio-demographic, lifestyle risk factors, health status, access to health care and confidence in self-management. Results Most respondents reported having had their BP (90.6%), BC (73.9%) or BG (69.4%) assessed. Fewer reported being given health advice to (a)eat less high fat food (26.6%), (b) eat more fruit and vegetables (15.5%) or (c) do more physical activity (19.9%). The patterns of association were consistent with recognised need: participants who were older, less well educated or overweight were more likely to report clinical assessments; participants who were overseas born, of lower educational attainment, less confident in their own self-management, reported insufficient physical activity or were overweight were more likely to report receiving advice. However current smokers were less likely to report clinical assessments; and rural and older participants were less likely to receive diet or physical activity advice. Conclusions This study demonstrated a gap between reported clinical assessments and preventive advice. There was evidence for inverse care for rural participants and smokers, who despite being at higher risk of health problems, were less likely to report receiving preventive care. This suggests the need for greater effort to promote preventive care for these groups in Australian general practice.
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26
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Weber MF, Cunich M, Smith DP, Salkeld G, Sitas F, O'Connell D. Sociodemographic and health-related predictors of self-reported mammogram, faecal occult blood test and prostate specific antigen test use in a large Australian study. BMC Public Health 2013; 13:429. [PMID: 23641775 PMCID: PMC3663683 DOI: 10.1186/1471-2458-13-429] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 04/19/2013] [Indexed: 11/10/2022] Open
Abstract
Background While several studies have examined factors that influence the use of breast screening mammography, faecal occult blood tests (FOBT) for bowel cancer screening and prostate specific antigen (PSA) tests for prostate disease in Australia, research directly comparing the use of these tests is sparse. We examined sociodemographic and health-related factors associated with the use of these tests in the previous two years either alone or in combination. Methods Cross-sectional analysis of self-reported questionnaire data from 96,711 women and 82,648 men aged 50 or over in The 45 and Up Study in NSW (2006–2010). Results 5.9% of men had a FOBT alone, 44.9% had a PSA test alone, 18.7% had both tests, and 30.6% had neither test. 3.2% of women had a FOBT alone, 56.0% had a mammogram alone, 16.2% had both and 24.7% had neither test. Among men, age and socioeconomic factors were largely associated with having both FOBT and PSA tests. PSA testing alone was largely associated with age, family history of prostate cancer, health insurance status and visiting a doctor. Among women, age, use of hormone replacement therapy (HRT), health insurance status, family history of breast cancer, being retired and not having a disability were associated with both FOBT and mammograms. Mammography use alone was largely associated with age, use of HRT and family history of breast cancer. FOBT use alone among men was associated with high income, living in regional areas and being fully-retired and among women, being fully-retired or sick/disabled. Conclusions These results add to the literature on sociodemographic discrepancies related to cancer screening uptake and highlight the fact that many people are being screened for one cancer when they could be screened for two.
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Affiliation(s)
- Marianne F Weber
- Cancer Research Division, Cancer Council NSW, PO Box 572, Kings Cross, Sydney, NSW 1340, Australia.
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27
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Pendergrass SA, Brown-Gentry K, Dudek S, Frase A, Torstenson ES, Goodloe R, Ambite JL, Avery CL, Buyske S, Bůžková P, Deelman E, Fesinmeyer MD, Haiman CA, Heiss G, Hindorff LA, Hsu CN, Jackson RD, Kooperberg C, Le Marchand L, Lin Y, Matise TC, Monroe KR, Moreland L, Park SL, Reiner A, Wallace R, Wilkens LR, Crawford DC, Ritchie MD. Phenome-wide association study (PheWAS) for detection of pleiotropy within the Population Architecture using Genomics and Epidemiology (PAGE) Network. PLoS Genet 2013; 9:e1003087. [PMID: 23382687 PMCID: PMC3561060 DOI: 10.1371/journal.pgen.1003087] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 09/12/2012] [Indexed: 01/13/2023] Open
Abstract
Using a phenome-wide association study (PheWAS) approach, we comprehensively tested genetic variants for association with phenotypes available for 70,061 study participants in the Population Architecture using Genomics and Epidemiology (PAGE) network. Our aim was to better characterize the genetic architecture of complex traits and identify novel pleiotropic relationships. This PheWAS drew on five population-based studies representing four major racial/ethnic groups (European Americans (EA), African Americans (AA), Hispanics/Mexican-Americans, and Asian/Pacific Islanders) in PAGE, each site with measurements for multiple traits, associated laboratory measures, and intermediate biomarkers. A total of 83 single nucleotide polymorphisms (SNPs) identified by genome-wide association studies (GWAS) were genotyped across two or more PAGE study sites. Comprehensive tests of association, stratified by race/ethnicity, were performed, encompassing 4,706 phenotypes mapped to 105 phenotype-classes, and association results were compared across study sites. A total of 111 PheWAS results had significant associations for two or more PAGE study sites with consistent direction of effect with a significance threshold of p<0.01 for the same racial/ethnic group, SNP, and phenotype-class. Among results identified for SNPs previously associated with phenotypes such as lipid traits, type 2 diabetes, and body mass index, 52 replicated previously published genotype-phenotype associations, 26 represented phenotypes closely related to previously known genotype-phenotype associations, and 33 represented potentially novel genotype-phenotype associations with pleiotropic effects. The majority of the potentially novel results were for single PheWAS phenotype-classes, for example, for CDKN2A/B rs1333049 (previously associated with type 2 diabetes in EA) a PheWAS association was identified for hemoglobin levels in AA. Of note, however, GALNT2 rs2144300 (previously associated with high-density lipoprotein cholesterol levels in EA) had multiple potentially novel PheWAS associations, with hypertension related phenotypes in AA and with serum calcium levels and coronary artery disease phenotypes in EA. PheWAS identifies associations for hypothesis generation and exploration of the genetic architecture of complex traits.
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Affiliation(s)
- Sarah A. Pendergrass
- Center for Systems Genomics, Department of Biochemistry and Molecular Biology, The Pennsylvania State University, Eberly College of Science, The Huck Institutes of the Life Sciences, University Park, Pennsylvania, United States of America
| | - Kristin Brown-Gentry
- Center for Human Genetics Research, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Scott Dudek
- Center for Human Genetics Research, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Alex Frase
- Center for Systems Genomics, Department of Biochemistry and Molecular Biology, The Pennsylvania State University, Eberly College of Science, The Huck Institutes of the Life Sciences, University Park, Pennsylvania, United States of America
| | - Eric S. Torstenson
- Center for Human Genetics Research, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Robert Goodloe
- Center for Human Genetics Research, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Jose Luis Ambite
- Information Sciences Institute, University of Southern California, Marina del Rey, California, United States of America
| | - Christy L. Avery
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Steve Buyske
- Department of Genetics, Rutgers University, Piscataway, New Jersey, United States of America
- Department of Statistics, Rutgers University, Piscataway, New Jersey, United States of America
| | - Petra Bůžková
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Ewa Deelman
- Information Sciences Institute, University of Southern California, Marina del Rey, California, United States of America
| | - Megan D. Fesinmeyer
- Division of Public Health, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Christopher A. Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, California, United States of America
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Lucia A. Hindorff
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Chu-Nan Hsu
- Information Sciences Institute, University of Southern California, Marina del Rey, California, United States of America
| | | | - Charles Kooperberg
- Division of Public Health, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
| | - Yi Lin
- Division of Public Health, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Tara C. Matise
- Department of Genetics, Rutgers University, Piscataway, New Jersey, United States of America
| | - Kristine R. Monroe
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, California, United States of America
| | - Larry Moreland
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Sungshim L. Park
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
| | - Alex Reiner
- Division of Public Health, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Robert Wallace
- Departments of Epidemiology and Internal Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Lynn R. Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
| | - Dana C. Crawford
- Center for Human Genetics Research, Vanderbilt University, Nashville, Tennessee, United States of America
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Marylyn D. Ritchie
- Center for Systems Genomics, Department of Biochemistry and Molecular Biology, The Pennsylvania State University, Eberly College of Science, The Huck Institutes of the Life Sciences, University Park, Pennsylvania, United States of America
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Liu CY, Maity A, Lin X, Wright RO, Christiani DC. Design and analysis issues in gene and environment studies. Environ Health 2012; 11:93. [PMID: 23253229 PMCID: PMC3551668 DOI: 10.1186/1476-069x-11-93] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 10/22/2012] [Indexed: 05/15/2023]
Abstract
Both nurture (environmental) and nature (genetic factors) play an important role in human disease etiology. Traditionally, these effects have been thought of as independent. This perspective is ill informed for non-mendelian complex disorders which result as an interaction between genetics and environment. To understand health and disease we must study how nature and nurture interact. Recent advances in human genomics and high-throughput biotechnology make it possible to study large numbers of genetic markers and gene products simultaneously to explore their interactions with environment. The purpose of this review is to discuss design and analytic issues for gene-environment interaction studies in the "-omics" era, with a focus on environmental and genetic epidemiological studies. We present an expanded environmental genomic disease paradigm. We discuss several study design issues for gene-environmental interaction studies, including confounding and selection bias, measurement of exposures and genotypes. We discuss statistical issues in studying gene-environment interactions in different study designs, such as choices of statistical models, assumptions regarding biological factors, and power and sample size considerations, especially in genome-wide gene-environment studies. Future research directions are also discussed.
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Affiliation(s)
- Chen-yu Liu
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
- Institute of Environmental Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Arnab Maity
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
- Department of Statistics, North Carolina State University, Raleigh, NC, 27695, USA
| | - Xihong Lin
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - Robert O Wright
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
- Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA
| | - David C Christiani
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
- Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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Bornehag CG, Moniruzzaman S, Larsson M, Lindström CB, Hasselgren M, Bodin A, von Kobyletzkic LB, Carlstedt F, Lundin F, Nånberg E, Jönsson BAG, Sigsgaard T, Janson S. The SELMA study: a birth cohort study in Sweden following more than 2000 mother-child pairs. Paediatr Perinat Epidemiol 2012; 26:456-67. [PMID: 22882790 DOI: 10.1111/j.1365-3016.2012.01314.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND This paper describes the background, aim and study design for the Swedish SELMA study that aimed to investigate the importance of early life exposure during pregnancy and infancy to environmental factors with a major focus on endocrine disrupting chemicals for multiple chronic diseases/disorders in offspring. METHODS The cohort was established by recruiting women in the 10th week of pregnancy. Blood and urine from the pregnant women and the child and air and dust from home environment from pregnancy and infancy period have been collected. Questionnaires were used to collect information on life styles, socio-economic status, living conditions, diet and medical history. RESULTS Of the 8394 reported pregnant women, 6658 were invited to participate in the study. Among the invited women, 2582 (39%) agreed to participate. Of the 4076 (61%) non-participants, 2091 women were invited to a non-respondent questionnaire in order to examine possible selection bias. We found a self-selection bias in the established cohort when compared with the non-participant group, e.g. participating families did smoke less (14% vs. 19%), had more frequent asthma and allergy symptoms in the family (58% vs. 38%), as well as higher education among the mothers (51% vs. 36%) and more often lived in single-family houses (67% vs. 60%). CONCLUSIONS These findings indicate that the participating families do not fully represent the study population and thus, the exposure in this population. However, there is no obvious reason that this selection bias will have an impact on identification of environmental risk factors.
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Song M, Rolland B, Potter JD, Kang D. Asia Cohort Consortium: challenges for collaborative research. J Epidemiol 2012; 22:287-90. [PMID: 22672913 PMCID: PMC3798645 DOI: 10.2188/jea.je20120024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
In this era of chronic diseases, large studies are essential in investigating genes, environment, and gene–environment interactions as disease causes, particularly when associations are important but not strong. Moreover, to allow expansion and generalization of the results, studies should be conducted in populations outside Western countries. Here, we briefly describe the Asia Cohort Consortium (ACC), a collaborative cancer cohort research project that was first proposed in 2004 and now involves more than 1 million healthy individuals across Asia. There are approximately 50 active members from Bangladesh, China, India, Japan, Korea, Malaysia, Singapore, Taiwan, Thailand, the United States, and elsewhere. To date, the work of the ACC includes 3 articles published in 2011 on the roles of body mass index, tobacco smoking, and alcohol consumption in mortality, diabetes, and cancer of the small intestine. Many challenges remain, including data harmonization, resolution of ethical and legal issues, establishment of protocols for biologic samples and transfer agreements, and funding procurement.
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Affiliation(s)
- Minkyo Song
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
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Manolio TA, Weis BK, Cowie CC, Hoover RN, Hudson K, Kramer BS, Berg C, Collins R, Ewart W, Gaziano JM, Hirschfeld S, Marcus PM, Masys D, McCarty CA, McLaughlin J, Patel AV, Peakman T, Pedersen NL, Schaefer C, Scott JA, Sprosen T, Walport M, Collins FS. New models for large prospective studies: is there a better way? Am J Epidemiol 2012; 175:859-66. [PMID: 22411865 PMCID: PMC3339313 DOI: 10.1093/aje/kwr453] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Large prospective cohort studies are critical for identifying etiologic factors for disease, but they require substantial long-term research investment. Such studies can be conducted as multisite consortia of academic medical centers, combinations of smaller ongoing studies, or a single large site such as a dominant regional health-care provider. Still another strategy relies upon centralized conduct of most or all aspects, recruiting through multiple temporary assessment centers. This is the approach used by a large-scale national resource in the United Kingdom known as the “UK Biobank,” which completed recruitment/examination of 503,000 participants between 2007 and 2010 within budget and ahead of schedule. A key lesson from UK Biobank and similar studies is that large studies are not simply small studies made large but, rather, require fundamentally different approaches in which “process” expertise is as important as scientific rigor. Embedding recruitment in a structure that facilitates outcome determination, utilizing comprehensive and flexible information technology, automating biospecimen processing, ensuring broad consent, and establishing essentially autonomous leadership with appropriate oversight are all critical to success. Whether and how these approaches may be transportable to the United States remain to be explored, but their success in studies such as UK Biobank makes a compelling case for such explorations to begin.
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Affiliation(s)
- Teri A Manolio
- Office of Population Genomics, National Human Genome Research Institute, Bethesda, Maryland, USA.
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Sorlie PD, Bild DE, Lauer MS. Cardiovascular epidemiology in a changing world--challenges to investigators and the National Heart, Lung, and Blood Institute. Am J Epidemiol 2012; 175:597-601. [PMID: 22415032 PMCID: PMC3390031 DOI: 10.1093/aje/kws138] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 02/14/2012] [Indexed: 01/03/2023] Open
Abstract
Over the past 60 years, revolutionary discoveries made by epidemiologists have contributed to marked declines in cardiovascular disease morbidity and mortality. Now, in an era of increasingly constrained resources, researchers in cardiovascular epidemiology face a number of challenges that call for novel, paradigm-shifting approaches. In this paper, the authors pose to the community 4 critical questions: 1) How can we avoid wasting resources on studies that provide little incremental knowledge? 2) How can we assure that we direct our resources as economically as possible towards innovative science? 3) How can we be nimble, responding quickly to new opportunities? 4) How can we identify prospectively the most meritorious research questions? Senior program staff at the National Heart, Lung, and Blood Institute invite the epidemiology community to join them in an ongoing Web-based blog conversation so that together we might develop novel approaches that will facilitate the next generation of high-impact discoveries.
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Affiliation(s)
| | | | - Michael S. Lauer
- Correspondence to Dr. Michael S. Lauer, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Room 8128, Bethesda, MD 20892 (e-mail: )
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Vrijheid M, Casas M, Bergström A, Carmichael A, Cordier S, Eggesbø M, Eller E, Fantini MP, Fernández MF, Fernández-Somoano A, Gehring U, Grazuleviciene R, Hohmann C, Karvonen AM, Keil T, Kogevinas M, Koppen G, Krämer U, Kuehni CE, Magnus P, Majewska R, Andersen AMN, Patelarou E, Petersen MS, Pierik FH, Polanska K, Porta D, Richiardi L, Santos AC, Slama R, Sram RJ, Thijs C, Tischer C, Toft G, Trnovec T, Vandentorren S, Vrijkotte TGM, Wilhelm M, Wright J, Nieuwenhuijsen M. European birth cohorts for environmental health research. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:29-37. [PMID: 21878421 PMCID: PMC3261945 DOI: 10.1289/ehp.1103823] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 08/29/2011] [Indexed: 05/03/2023]
Abstract
BACKGROUND Many pregnancy and birth cohort studies investigate the health effects of early-life environmental contaminant exposure. An overview of existing studies and their data is needed to improve collaboration, harmonization, and future project planning. OBJECTIVES Our goal was to create a comprehensive overview of European birth cohorts with environmental exposure data. METHODS Birth cohort studies were included if they a) collected data on at least one environmental exposure, b) started enrollment during pregnancy or at birth, c) included at least one follow-up point after birth, d) included at least 200 mother-child pairs, and e) were based in a European country. A questionnaire collected information on basic protocol details and exposure and health outcome assessments, including specific contaminants, methods and samples, timing, and number of subjects. A full inventory can be searched on www.birthcohortsenrieco.net. RESULTS Questionnaires were completed by 37 cohort studies of > 350,000 mother-child pairs in 19 European countries. Only three cohorts did not participate. All cohorts collected biological specimens of children or parents. Many cohorts collected information on passive smoking (n = 36), maternal occupation (n = 33), outdoor air pollution (n = 27), and allergens/biological organisms (n = 27). Fewer cohorts (n = 12-19) collected information on water contamination, ionizing or nonionizing radiation exposures, noise, metals, persistent organic pollutants, or other pollutants. All cohorts have information on birth outcomes; nearly all on asthma, allergies, childhood growth and obesity; and 26 collected information on child neurodevelopment. CONCLUSION Combining forces in this field will yield more efficient and conclusive studies and ultimately improve causal inference. This impressive resource of existing birth cohort data could form the basis for longer-term and worldwide coordination of research on environment and child health.
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Affiliation(s)
- Martine Vrijheid
- Centre for Research in Environmental Epidemiology, Doctor Aiguader 88, Barcelona, Spain.
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Berkey CS, Tamimi RM, Rosner B, Frazier AL, Colditz GA. Young women with family history of breast cancer and their risk factors for benign breast disease. Cancer 2011; 118:2796-803. [PMID: 22083563 DOI: 10.1002/cncr.26519] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 07/18/2011] [Accepted: 08/04/2011] [Indexed: 01/09/2023]
Abstract
BACKGROUND Breast cancer (BC) patients wonder how their daughters might reduce their risk. The authors investigated childhood/adolescent risk factors for benign breast disease (BBD), a well-documented risk factor for BC, among girls with a family history. METHODS GUTS (the Growing Up Today Study) includes females, aged 9 to 15 years in 1996, who completed annual questionnaires during 1996 to 2001, then in 2003, 2005, and 2007. Participants provided information regarding alcohol, menarche, height, and body mass index (BMI; kg/m(2)). Peak height growth velocity (PHV; in./y) was estimated from longitudinal heights. On 2005-2007 surveys, 6888 women (18-27 years old) reported whether they were diagnosed with biopsy-confirmed BBD (n = 67 cases); 6741 women (noncases) reported no BBD. Participants' mothers reported their own biopsy-confirmed BBD and BC, and BC in their sisters and mothers. Stratified by family history, logistic models investigated BBD risk factors. RESULTS Young women whose mothers or aunts had BC were more likely to be diagnosed with BBD (odds ratio [OR], 2.34; P = .01), as were those with maternal BBD (OR, 1.59; P = .095). Adolescents with BC family history (mother, aunt, grandmother) who consumed alcohol (7 drinks/wk) doubled their BBD risk (OR, 2.28; P = .01), similar to those with maternal BBD (OR, 1.96; P = .02). Girls whose mother or aunt had BC saw their BBD risk elevated with higher PHV (OR, 1.82 [inch/yr]; P = .05). Among girls with no family history, BBD risk appeared to be related to other factors: childhood BMI, adolescent waist circumference, and adult height. CONCLUSIONS Adolescents with family history may reduce their risk by avoiding alcohol. Separate risk factors were observed among girls with family history versus girls with no family history, possibly reflecting different causes of BC.
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Affiliation(s)
- Catherine S Berkey
- Channing Laboratory, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
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Berkey CS, Willett WC, Frazier AL, Rosner B, Tamimi RM, Colditz GA. Prospective study of growth and development in older girls and risk of benign breast disease in young women. Cancer 2011; 117:1612-20. [PMID: 21328325 PMCID: PMC3817000 DOI: 10.1002/cncr.25692] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 08/31/2010] [Accepted: 09/02/2010] [Indexed: 11/09/2022]
Abstract
BACKGROUND In adult women with retrospective data, childhood adiposity, pubertal growth and development were associated with benign breast disease (BBD) and/or breast cancer. The authors prospectively evaluated these childhood/adolescent characteristics and BBD risk. METHODS The Growing Up Today Study (GUTS) included females, aged 9-15 years in 1996, who completed annual questionnaires through 2001, then 2003, 2005, and 2007. Participants annually/biennially provided information on menarche, height, and weight, from which the authors derived body mass index (BMI in kg/m(2) ). Peak height growth velocity (PHV in cm/year) was estimated from longitudinal data. On 2005-2007 surveys, 6899 females (18-27 years of age) reported whether a healthcare provider ever diagnosed BBD (n = 147), and whether it was confirmed by biopsy (n = 67). Logistic models investigated risk factors adjusted for age, alcohol, pregnancy, and maternal history. RESULTS More childhood adiposity (odds ratio [OR], 0.91/[kg/m(2) ]; P = .04) and shorter adult height (OR, 0.93/inch shorter; P = .07) were associated with lower risk of biopsy-confirmed BBD. Girls with most rapid height growth were at increased risk (OR, 2.12; P = .09) relative to those with the slowest growth. Age at menarche was not associated (OR, 1.11/year; P = .32) nor was adult BMI (adjusted for childhood BMI: OR, 1.01/[kg/m(2) ]; P = .98); larger BMI increases (childhood to adulthood) were not protective (OR + 1.04/[kg/m(2) ]; P = .37). Among girls with maternal breast cancer, those with more rapid growth had higher risk (OR, 1.47/[cm/year]; P = .02). All estimates were age-adjusted. CONCLUSIONS Increased BBD risk (likely evolving to elevated breast cancer risk) was observed in thinner girls, girls with the most rapid growth, and taller women. Contrary to expectations, later menarche age was not protective against BBD, consistent with studies that found BBD patients are not protected against breast cancer by later menarche.
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Affiliation(s)
- Catherine S Berkey
- Channing Laboratory, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
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Almqvist C, Adami HO, Franks PW, Groop L, Ingelsson E, Kere J, Lissner L, Litton JE, Maeurer M, Michaëlsson K, Palmgren J, Pershagen G, Ploner A, Sullivan PF, Tybring G, Pedersen NL. LifeGene--a large prospective population-based study of global relevance. Eur J Epidemiol 2011; 26:67-77. [PMID: 21104112 PMCID: PMC7087900 DOI: 10.1007/s10654-010-9521-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 11/02/2010] [Indexed: 11/04/2022]
Abstract
Studying gene-environment interactions requires that the amount and quality of the lifestyle data is comparable to what is available for the corresponding genomic data. Sweden has several crucial prerequisites for comprehensive longitudinal biomedical research, such as the personal identity number, the universally available national health care system, continuously updated population and health registries and a scientifically motivated population. LifeGene builds on these strengths to bridge the gap between basic research and clinical applications with particular attention to populations, through a unique design in a research-friendly setting. LifeGene is designed both as a prospective cohort study and an infrastructure with repeated contacts of study participants approximately every 5 years. Index persons aged 18-45 years old will be recruited and invited to include their household members (partner and any children). A comprehensive questionnaire addressing cutting-edge research questions will be administered through the web with short follow-ups annually. Biosamples and physical measurements will also be collected at baseline, and re-administered every 5 years thereafter. Event-based sampling will be a key feature of LifeGene. The household-based design will give the opportunity to involve young couples prior to and during pregnancy, allowing for the first study of children born into cohort with complete pre-and perinatal data from both the mother and father. Questions and sampling schemes will be tailored to the participants' age and life events. The target of LifeGene is to enroll 500,000 Swedes and follow them longitudinally for at least 20 years.
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Affiliation(s)
- Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE-171 77 Stockholm, Sweden.
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WEBER MARIANNEF, BANKS EMILY, SITAS FREDDY. Smoking in migrants in New South Wales, Australia: Report on data from over 100 000 participants in the 45 and Up Study. Drug Alcohol Rev 2010; 30:597-605. [DOI: 10.1111/j.1465-3362.2010.00247.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rautenstrauss B, Mardin C. Targeting glaucoma beyond intraocular pressure. EXPERT REVIEW OF OPHTHALMOLOGY 2010. [DOI: 10.1586/eop.10.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Health problems and retirement due to ill-health among Australian retirees aged 45–64 years. Health Policy 2010; 94:175-81. [DOI: 10.1016/j.healthpol.2009.09.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Revised: 08/20/2009] [Accepted: 09/07/2009] [Indexed: 11/22/2022]
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Colditz GA. Ensuring long-term sustainability of existing cohorts remains the highest priority to inform cancer prevention and control. Cancer Causes Control 2010; 21:649-56. [PMID: 20063074 PMCID: PMC2855811 DOI: 10.1007/s10552-009-9498-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Accepted: 12/23/2009] [Indexed: 11/28/2022]
Abstract
The case for continued follow-up of existing cohorts arises from the key attributes of cohorts that are already meeting the goals proposed by Potter for the creation of a new cohort. These attributes include the basic nature of ongoing cohorts in that they are, by design, hypothesis-driven and must adapt to emerging technologies over time. Importantly, cohort investigators must identify and address gaps in knowledge that will inform public health strategies and clinical practices. Above all, cohorts must capitalize on their unique features to address public health priorities and inform our prevention strategies. Continued follow-up adds substantial return on investment to guide cancer prevention.
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Affiliation(s)
- Graham A. Colditz
- Institute For Public Health, Washington University In St Louis, St. Louis, MO 63110 USA
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Pereira TV, Patsopoulos NA, Salanti G, Ioannidis JPA. Discovery properties of genome-wide association signals from cumulatively combined data sets. Am J Epidemiol 2009; 170:1197-206. [PMID: 19808636 DOI: 10.1093/aje/kwp262] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Genetic effects for common variants affecting complex disease risk are subtle. Single genome-wide association (GWA) studies are typically underpowered to detect these effects, and combination of several GWA data sets is needed to enhance discovery. The authors investigated the properties of the discovery process in simulated cumulative meta-analyses of GWA study-derived signals allowing for potential genetic model misspecification and between-study heterogeneity. Variants with null effects on average (but also between-data set heterogeneity) could yield false-positive associations with seemingly homogeneous effects. Random effects had higher than appropriate false-positive rates when there were few data sets. The log-additive model had the lowest false-positive rate. Under heterogeneity, random-effects meta-analyses of 2-10 data sets averaging 1,000 cases/1,000 controls each did not increase power, or the meta-analysis was even less powerful than a single study (power desert). Upward bias in effect estimates and underestimation of between-study heterogeneity were common. Fixed-effects calculations avoided power deserts and maximized discovery of association signals at the expense of much higher false-positive rates. Therefore, random- and fixed-effects models are preferable for different purposes (fixed effects for initial screenings, random effects for generalizability applications). These results may have broader implications for the design and interpretation of large-scale multiteam collaborative studies discovering common gene variants.
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Affiliation(s)
- Tiago V Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
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O'Brien SJ. Stewardship of human biospecimens, DNA, genotype, and clinical data in the GWAS era. Annu Rev Genomics Hum Genet 2009; 10:193-209. [PMID: 19630558 DOI: 10.1146/annurev-genom-082908-150133] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An ethical quandary is emerging over custodianship of and access to DNA specimens and attached data, clinical and genetic, held in large disease cohort collections. The balance of patients' rights and science/society's quest for broad open access must be resolved in order to realize the promise of gene association studies of complex human disease. A way forward may be to convene a colloquium of international medical and science organizations charged with developing global consensus guidance and ethical principles for access to and use of genomic biobanks.
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Affiliation(s)
- Stephen J O'Brien
- Laboratory of Genomic Diversity, National Cancer Institute, Frederick, Maryland 21702-1201, USA.
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Wadhwa PD, Buss C, Entringer S, Swanson JM. Developmental origins of health and disease: brief history of the approach and current focus on epigenetic mechanisms. Semin Reprod Med 2009; 27:358-68. [PMID: 19711246 DOI: 10.1055/s-0029-1237424] [Citation(s) in RCA: 594] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
"Barker's hypothesis" emerged almost 25 years ago from epidemiological studies of birth and death records that revealed a high geographic correlation between rates of infant mortality and certain classes of later adult deaths as well as an association between birthweight and rates of adult death from ischemic heart disease. These observations led to a theory that undernutrition during gestation was an important early origin of adult cardiac and metabolic disorders due to fetal programming that permanently shaped the body's structure, function, and metabolism and contributed to adult disease. This theory stimulated interest in the fetal origins of adult disorders, which expanded and coalesced approximately 5 years ago with the formation of an international society for developmental origins of health and disease (DOHaD). Here we review a few examples of the many emergent themes of the DOHaD approach, including theoretical advances related to predictive adaptive responses of the fetus to a broad range of environmental cues, empirical observations of effects of overnutrition and stress during pregnancy on outcomes in childhood and adulthood, and potential epigenetic mechanisms that may underlie these observations and theory. Next, we discuss the relevance of the DOHaD approach to reproductive medicine. Finally, we consider the next steps that might be taken to apply, evaluate, and extend the DOHaD approach.
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Affiliation(s)
- Pathik D Wadhwa
- Department of Pediatrics, University of California, Irvine, School of Medicine, 3117 GillespieNeuroscience Research Facility, Irvine, CA 92697-4260, USA.
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Banks E, Jorm L, Lujic S, Rogers K. Health, ageing and private health insurance: baseline results from the 45 and Up Study cohort. AUSTRALIA AND NEW ZEALAND HEALTH POLICY 2009; 6:16. [PMID: 19594895 PMCID: PMC2719656 DOI: 10.1186/1743-8462-6-16] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 07/13/2009] [Indexed: 11/12/2022]
Abstract
Background This study investigates the relationships between health and lifestyle factors, age and private health insurance (PHI) in a large Australian population-based cohort study of people aged 45 years and over; the 45 and Up Study. Unlike previous Australian analyses of relationships between health, lifestyle and PHI, it incorporates adjustment for multiple confounding socioeconomic and demographic factors. Recruitment into the 45 and Up Study began in February 2006 and these analyses relate to the first 103,042 participants who joined the study prior to July 2008. Results The proportion with PHI decreased with increasing age. The factors independently and most strongly associated with having PHI were: higher income; higher educational attainment; not holding a health care concession card; not being of Aboriginal/Torres Strait Islander origin; being a non-smoker; high levels of self-rated health and functional capacity; and low levels of psychological distress. These factors increased the probability of having PHI by 16% to 125%, compared to individuals without these characteristics. PHI coverage was significantly but only marginally higher in people reporting non-melanoma skin cancer (adjusted RR 1.04, 95%CI 1.03–1.05), prostate cancer (1.09, 1.06–1.11) or an enlarged prostate (1.07, 1.06–1.09), those reporting a family history of a range of conditions (e.g. 1.02, 1.01–1.03 for a family history of heart disease; 1.03, 1.02–1.04 for a family history of prostate cancer) and lower in people reporting diabetes (0.92, 0.91–0.94) or stroke (0.91, 0.88–0.94), compared to people who did not have these medical or family histories. PHI was higher in those reporting certain surgical procedures with RRs (95%CI) of 1.12 (1.09–1.15) for hip replacement, 1.10 (1.08–1.13) for knee replacement and 1.12 (1.09–1.15) for prostatectomy, compared to those not reporting these interventions. Conclusion Compared to the rest of the study population, those with PHI are richer, better educated, more health conscious, in better health and more likely to use certain discretionary health services. Hence, PHI use is generally highest among those with the least need for health care. Whether or not people have PHI is more strongly associated with demographic and lifestyle factors than with health status.
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Affiliation(s)
- Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, ACT 0200, Australia.,The Sax Institute, PO Box 123, Broadway NSW 2007, Australia
| | - Louisa Jorm
- School of Medicine, University of Western Sydney, Campbelltown Campus, Locked Bag 1797, Penrith South DC NSW 1797, Australia.,The Sax Institute, PO Box 123, Broadway NSW 2007, Australia
| | - Sanja Lujic
- School of Medicine, University of Western Sydney, Campbelltown Campus, Locked Bag 1797, Penrith South DC NSW 1797, Australia
| | - Kris Rogers
- The Sax Institute, PO Box 123, Broadway NSW 2007, Australia
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Weber MF, Banks E, Smith DP, O'Connell D, Sitas F. Cancer screening among migrants in an Australian cohort; cross-sectional analyses from the 45 and Up Study. BMC Public Health 2009; 9:144. [PMID: 19442312 PMCID: PMC2693134 DOI: 10.1186/1471-2458-9-144] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 05/15/2009] [Indexed: 11/14/2022] Open
Abstract
Background Limited evidence suggests that people from non-English speaking backgrounds in Australia have lower than average rates of participation in cancer screening programs. The objective of this study was to examine the distribution of bowel, breast and prostate cancer test use by place of birth and years since migration in a large population-based cohort study in Australia. Methods In 2006, screening status, country of birth and other demographic and health related factors were ascertained by self-completed questionnaire among 31,401 (16,126 women and 15,275 men) participants aged 50 or over from the 45 and Up Study in New South Wales. Results 35% of women and 39% of men reported having a bowel cancer test and 57% of men reported having a prostate specific antigen (PSA) test, in the previous 5 years. 72% of women reported having screening mammography in the previous 2 years. Compared to Australian-born women, women from East Asia, Southeast Asia, Continental Western Europe, and North Africa/Middle East had significantly lower rates of bowel testing, with odds ratios (OR; 95%CI) ranging from 0.5 (0.4–0.7) to 0.7 (0.6–0.9); migrants from East Asia (0.5, 0.3–0.7) and North Africa/Middle East (0.5, 0.3–0.9) had significantly lower rates of mammography. Compared to Australian-born men, bowel cancer testing was significantly lower among men from all regions of Asia (OR, 95%CI ranging from 0.4, 0.3–0.6 to 0.6, 0.5–0.9) and Continental Europe (OR, 95%CI ranging from 0.4, 0.3–0.7 to 0.7, 0.6–0.9). Only men from East Asia had significantly lower PSA testing rates than Australian-born men (0.4, 0.3–0.6). As the number of years lived in Australia increased, cancer test use among migrants approached Australian-born rates. Conclusion Certain migrant groups within the population may require targeted intervention to improve their uptake of cancer screening, particularly screening for bowel cancer.
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Affiliation(s)
- Marianne F Weber
- Cancer Epidemiology Research Unit, Cancer Council NSW, PO Box 572, Kings Cross 1340, NSW, Australia.
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Naidoo N, Chia KS. Discovering Gene-Environment Interactions in the Post-Genomic Era. J Prev Med Public Health 2009; 42:356-9. [DOI: 10.3961/jpmph.2009.42.6.356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Nirinjini Naidoo
- Centre for Molecular Epidemiology, Department of Epidemiology and Public Health, National University of Singapore, Singapore
| | - Kee Seng Chia
- Centre for Molecular Epidemiology, Department of Epidemiology and Public Health, National University of Singapore, Singapore
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Allingham RR, Liu Y, Rhee DJ. The genetics of primary open-angle glaucoma: a review. Exp Eye Res 2008; 88:837-44. [PMID: 19061886 DOI: 10.1016/j.exer.2008.11.003] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 09/26/2008] [Accepted: 11/04/2008] [Indexed: 12/24/2022]
Abstract
Glaucoma is the major cause of irreversible blindness worldwide. Primary open-angle glaucoma (POAG), as the most prevalent form of glaucoma, is a complex inherited disorder and affects more than 2 million individuals in the United States. It has become increasingly clear that a host of genetic as well as environmental factors are likely to contribute to the phenotype. A number of chromosomal and genetic associations have been reported for POAG. This review examines what is currently known about the underlying genetic structure, what remains to be learned, and how this may affect our medical management of this major blinding disease.
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Affiliation(s)
- R Rand Allingham
- Duke University Eye Center, Duke University, Durham, NC 27710, USA.
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