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Veisi P, Nikouei M, Cheraghi M, Shahgheibi S, Moradi Y. The association between the multiple birth and breast cancer incidence: an update of a systematic review and meta-analysis from 1983 to 2022. Arch Public Health 2023; 81:76. [PMID: 37106433 PMCID: PMC10142199 DOI: 10.1186/s13690-023-01089-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND It has been assumed that perinatal factors such as multiple pregnancies may affect subsequent breast cancer risk in the mother. Considering the inconsistencies in the results of case-control and cohort studies published in the world, this meta-analysis was conducted in order to determine the exact association between multiple pregnancies (twins or more) and the breast cancer incidence. METHODS This study was performed as a meta-analysis based on PRISMA guidelines by searching the international databases of PubMed (Medline), Scopus, and Web of Science as well as by screening selected articles based on their subject, abstract and full text. The search time was from January 1983 to November 2022. Then the NOS checklist was used to evaluate the quality of the final selected articles. The indicators considered for the meta-analysis included the odds ratio (OR) and the risk ratio (RR) along with the confidence interval reported in the selected primary studies. The desired analyzes were performed with STATA software version 17 to be reported. RESULTS In this meta-analysis, 19 studies were finally selected for analysis, which fully met the inclusion criteria. Of these, 11 were case-control studies and 8 were cohort ones. Their sample size was 263,956 women (48,696 with breast cancer and 215,260 healthy) and 1,658,378 (63,328 twin or multiple pregnancies and 1,595,050 singleton pregnancies), respectively. After combining the results of cohort and case-control studies, the effect of multiple pregnancies on the breast cancer incidence was equal to 1.01 (95% CI: 0.89-1.14; I2: 44.88%, P: 0.06) and 0.89 (95% CI: 0.83-0.95; I2: 41.73%, P: 0.07), respectively. CONCLUSION The present meta-analysis results showed, in general, multiple pregnancies were one of the preventive factors of breast cancer.
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Affiliation(s)
- Pedram Veisi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Nikouei
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mojtaba Cheraghi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Sholeh Shahgheibi
- Department of Obstetrics and Gynecology, School of Medicine, Besat Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Samadder NJ, Neklason D, Snow A, Samowitz W, Cessna MH, Rowe K, Sandhu I, Boucher K, Pappas L, Smith KR, Wong J, Curtin K, Provenzale D, Burt RW. Clinical and Molecular Features of Post-Colonoscopy Colorectal Cancers. Clin Gastroenterol Hepatol 2019; 17:2731-2739.e2. [PMID: 30930275 DOI: 10.1016/j.cgh.2019.02.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/15/2019] [Accepted: 02/25/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Post-colonoscopy colorectal cancers (PCCRCs) may arise from missed lesions or due to molecular features of tumors that allow them to grow rapidly. We aimed to compare clinical, pathology, and molecular features of PCCRCs (those detected within 6-60 months of colonoscopy) and detected CRCs (those detected within 6 months of a colonoscopy). METHODS Within a population-based cross-sectional study of incident CRC cases in Utah (from 1995 through 2009), we identified PCCRCs (those cancers that developed within 5 years of a colonoscopy) and matched the patients by age, sex, and hospital site to patients with detected CRC. Archived specimens were retrieved and tested for microsatellite instability (MSI), CpG island methylation, and mutations in KRAS and BRAF. There were 2659 cases of CRC diagnosed within the study window; 6% of these (n = 159) were defined as PCCRCs; 84 of these cases had tissue available and were matched to 84 subjects with detected CRC. RESULTS Higher proportions of PCCRCs than detected CRCs formed in the proximal colon (64% vs 44%; P = .016) and were of an early stage (86% vs 69%; P = .040). MSI was observed in 32% of PCCRCs compared with 13% of detected CRCs (P = .005). The other molecular features were found in similar proportions of PCCRCs and detected CRCs. In a multivariable logistic regression, MSI (odds ratio, 4.20; 95% CI, 1.58-11.14) was associated with PCCRC. There was no difference in 5-year survival between patients with PCCRCs vs detected CRCs. CONCLUSION In this population-based cross-sectional study of incident CRC cases in Utah, we found PCCRCs to be more likely to arise in the proximal colon and demonstrate MSI, so PCCRCs and detected CRC appear to have different features or processes of tumorigenesis. Additional studies are needed to determine if post-colonoscopy cancers arise through a specific genetic pathway.
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Affiliation(s)
- N Jewel Samadder
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Medicine (Gastroenterology), University of Utah, Salt Lake City, Utah; Department of Medicine (Gastroenterology), Mayo Clinic, Phoenix, Arizona.
| | - Deb Neklason
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Medicine (Genetic Epidemiology), University of Utah, Salt Lake City, Utah
| | - Angela Snow
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Wade Samowitz
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Pathology, University of Utah, Salt Lake City, Utah
| | - Melissa H Cessna
- Department of Pathology and Biorepository, Intermountain Healthcare, Salt Lake City, Utah
| | - Kerry Rowe
- Department of Medicine, Intermountain Healthcare, Salt Lake City, Utah
| | - Iqbal Sandhu
- Department of Bioinformatics, Intermountain Healthcare, Salt Lake City, Utah
| | - Kenneth Boucher
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Lisa Pappas
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Ken Robert Smith
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jathine Wong
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Karen Curtin
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Medicine (Genetic Epidemiology), University of Utah, Salt Lake City, Utah
| | - Dawn Provenzale
- Department of Medicine (Gastroenterology), Duke University, Durham, North Carolina; VA Cooperative Studies Program Epidemiology Center, Departments of Medicine (Gastroenterology) and Clinical Genomics, Mayo Clinic, Phoenix, Arizona
| | - Randall W Burt
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Medicine (Gastroenterology), University of Utah, Salt Lake City, Utah; Department of Oncological Sciences, University of Utah, Salt Lake City, Utah
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Lambert MP, Arulselvan A, Schott A, Markham SJ, Crowley TB, Zackai EH, McDonald-McGinn DM. The 22q11.2 deletion syndrome: Cancer predisposition, platelet abnormalities and cytopenias. Am J Med Genet A 2017; 176:2121-2127. [PMID: 28940864 DOI: 10.1002/ajmg.a.38474] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/08/2017] [Accepted: 08/21/2017] [Indexed: 01/10/2023]
Abstract
The 22q11.2 deletion syndrome (DS) is associated with variable phenotypic expression as findings range from severely affected individuals with the classical triad of DiGeorge and velocardiofacial syndromes, including congenital heart disease, immunodeficiency, hypocalcemia, and palatal abnormalities, to subtly affected adults who only come to attention following the diagnosis of a more severely affected child. The multiple manifestations can affect all organ systems, including the hematologic system resulting in baseline lower platelet counts for individuals with 22q11.2DS and increased platelet size. In addition, there may be an associated increased risk of bleeding. Individuals with 22q11.2DS are also at increased risk of autoimmune cytopenias that can complicate the evaluation or management of other manifestations. Finally, there may be an increased risk of malignancy, although the mechanism for this risk is not fully understood. This review summarizes the currently available data on hematologic/oncologic manifestations of 22q11.2DS and reports on our findings within a large cohort of individuals with the deletion.
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Affiliation(s)
- Michele P Lambert
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Abinaya Arulselvan
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Amanda Schott
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Arcadia University, Glenside, Pennsylvania
| | - Stephen J Markham
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Terrance B Crowley
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Elaine H Zackai
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Donna M McDonald-McGinn
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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Bishop KS, Han DY, Karunasinghe N, Goudie M, Masters JG, Ferguson LR. An examination of clinical differences between carriers and non-carriers of chromosome 8q24 risk alleles in a New Zealand Caucasian population with prostate cancer. PeerJ 2016; 4:e1731. [PMID: 26966665 PMCID: PMC4782686 DOI: 10.7717/peerj.1731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 02/02/2016] [Indexed: 11/20/2022] Open
Abstract
Background. Prostate cancer makes up approximately 15% of all cancers diagnosed in men in developed nations and approximately 4% of cases in developing nations. Although it is clear that prostate cancer has a genetic component and single nucleotide polymorphisms (SNPs) can contribute to prostate cancer risk, detecting associations is difficult in multi-factorial diseases, as environmental and lifestyle factors also play a role. In this study, specific clinical characteristics, environmental factors and genetic risk factors were assessed for interaction with prostate cancer. Methods. A total of 489 prostate cancer cases and 427 healthy controls were genotyped for SNPs found on chromosome 8q24 and a genetic risk score was calculated. In addition the SNPs were tested for an association with a number of clinical and environmental factors. Results. Age and tobacco use were positively associated, whilst alcohol consumption was negatively associated with prostate cancer risk. The following SNPs found on chromosome 8q24 were statistically significantly associated with prostate cancer: rs10086908, rs16901979; rs1447295and rs4242382. No association between Gleason score and smoking status, or between Gleason score and genotype were detected. Conclusion. A genetic risk score was calculated based on the 15 SNPs tested and found to be significantly associated with prostate cancer risk. Smoking significantly contributed to the risk of developing prostate cancer, and this risk was further increased by the presence of four SNPs in the 8q24 chromosomal region.
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Affiliation(s)
- Karen S Bishop
- Auckland Cancer Society Research Centre, Faculty of Medical and Health Sciences, University of Auckland , Auckland , New Zealand
| | - Dug Yeo Han
- Nutrigenomics New Zealand, University of Auckland, Auckland, New Zealand; Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Nishi Karunasinghe
- Auckland Cancer Society Research Centre, Faculty of Medical and Health Sciences, University of Auckland , Auckland , New Zealand
| | - Megan Goudie
- Urology Department, Auckland District Health Board , Auckland , New Zealand
| | - Jonathan G Masters
- Urology Department, Auckland District Health Board , Auckland , New Zealand
| | - Lynnette R Ferguson
- Auckland Cancer Society Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Nutrigenomics New Zealand, University of Auckland, Auckland, New Zealand; Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Ahrenfeldt LJ, Skytthe A, Möller S, Czene K, Adami HO, Mucci LA, Kaprio J, Petersen I, Christensen K, Lindahl-Jacobsen R. Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden. Cancer Epidemiol Biomarkers Prev 2015; 24:1622-8. [PMID: 26282631 DOI: 10.1158/1055-9965.epi-15-0317] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/29/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Increasing evidence shows that some cancers originate in utero. It is hypothesized that elevated exposure to some steroid hormones might increase cancer risk and that hormone transfer between twin fetuses could result in different prenatal exposure to testosterone. METHODS This large-scale prospective twin study compared opposite-sex (OS) and same-sex (SS) twins to test the impact of intrauterine exposures on cancer risk. On the basis of the Danish and Swedish twin and cancer registries, we calculated incidence rate ratios for OS and SS twins, whereas standardized incidence ratios (SIR) with 95% confidence intervals (CI) were calculated for OS/SS twins compared with the general population. RESULTS A total of 18,001 cancers were identified during 1943-2009. No significant differences were observed between OS and SS twins, neither for the sex-specific cancers nor for cancer at all sites. All-cause cancer was slightly reduced for OS and SS twins compared with the general population, significant for OS males (SIR, 0.95; 95% CI, 0.92-0.98) and for SS males and females (SIR, 0.97; 95% CI, 0.94-0.99). CONCLUSIONS Our data suggest that having a male co-twin-which may entail higher exposure to prenatal testosterone-does not increase the risk of sex-specific cancers in OS females. Furthermore, the study supports that twinning per se is not a risk factor of cancer. IMPACT Findings are reassuring, as they fail to provide evidence for the hypothesis that endocrine or other difference in the in utero milieu affects the risk of sex-specific cancers.
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Affiliation(s)
- Linda J Ahrenfeldt
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense C, Denmark.
| | - Axel Skytthe
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Sören Möller
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jaakko Kaprio
- Department of Public Health and Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland. Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Inge Petersen
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Kaare Christensen
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense C, Denmark. Department of Clinical Biochemistry and Pharmacology and Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Rune Lindahl-Jacobsen
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense C, Denmark. Max-Planck Odense Center on the Biodemography of Aging, University of Southern Denmark, Odense C, Denmark
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Samadder NJ, Curtin K, Tuohy TMF, Rowe KG, Mineau GP, Smith KR, Pimentel R, Wong J, Boucher K, Burt RW. Increased risk of colorectal neoplasia among family members of patients with colorectal cancer: a population-based study in Utah. Gastroenterology 2014; 147:814-821.e5; quiz e15-6. [PMID: 25042087 DOI: 10.1053/j.gastro.2014.07.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 07/09/2014] [Accepted: 07/11/2014] [Indexed: 01/18/2023]
Abstract
BACKGROUND & AIMS Colorectal cancer (CRC) frequently develops in multiple members of the same families, but more data are needed to prepare effective screening guidelines. We quantified the risk of CRC and adenomas in first-degree relatives (FDRs) and second-degree relatives and first cousins of individuals with CRC, and stratified risk based on age at cancer diagnosis. METHODS We performed a case-control study of Utah residents, 50-80 years old, who underwent colonoscopy from 1995 through 2009. Index cases (exposed to colonoscopy) were colonoscopy patients with a CRC diagnosis. Age- and sex-matched individuals, unexposed to colonoscopy (controls) were selected to form the comparison groups for determining risk in relatives. Colonoscopy results were linked to cancer and pedigree information from the Utah Population Database to investigate familial aggregation of colorectal neoplasia using Cox regression analysis. RESULTS Of 126,936 patients who underwent a colonoscopy, 3804 were diagnosed with CRC and defined the index cases. FDRs had an increased risk of CRC (hazard rate ratio [HRR], 1.79; 95% confidence interval [CI],1.59-2.03), as did second-degree relatives (HRR, 1.32; 95% CI, 1.19-1.47) and first cousins (HRR, 1.15; 95% CI, 1.07-1.25), compared with relatives of controls. This risk was greater for FDRs when index patients developed CRC at younger than age 60 years (HRR, 2.11; 95% CI, 1.70-2.63), compared with older than age 60 years (HRR, 1.77; 95% CI, 1.58-1.99). The risk of adenomas (HRR, 1.82; 95% CI, 1.66-2.00) and adenomas with villous histology (HRR, 2.43; 95% CI, 1.96-3.01) also were increased in FDRs. Three percent of CRCs in FDRs would have been missed if the current guidelines, which stratify screening recommendations by the age of the proband, were strictly followed. CONCLUSIONS FDRs, second-degree relatives, and first cousins of patients who undergo colonoscopy and are found to have CRC have a significant increase in the risk of colorectal neoplasia. These data should be considered when establishing CRC screening guidelines for individuals and families.
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Affiliation(s)
- N Jewel Samadder
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Division of Gastroenterology, University of Utah, Salt Lake City, Utah.
| | - Karen Curtin
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Division of Genetic Epidemiology, Department of Medicine, University of Utah, Salt Lake City, Utah
| | | | - Kerry G Rowe
- Department of Oncology, Intermountain Healthcare, Salt Lake City, Utah
| | - Geraldine P Mineau
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Oncological Sciences, University of Utah, Salt Lake City, Utah
| | - Ken R Smith
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Richard Pimentel
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jathine Wong
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Ken Boucher
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Randall W Burt
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Division of Gastroenterology, University of Utah, Salt Lake City, Utah; Department of Oncological Sciences, University of Utah, Salt Lake City, Utah
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Crump C, Sundquist K, Sieh W, Winkleby MA, Sundquist J. Season of birth and other perinatal risk factors for melanoma. Int J Epidemiol 2014; 43:793-801. [PMID: 24453238 PMCID: PMC4052134 DOI: 10.1093/ije/dyt277] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Ultraviolet radiation (UVR) exposure is the main risk factor for cutaneous malignant melanoma (CMM), but its specific effect in infancy is unknown. We examined whether season of birth, a proxy for solar UVR exposure in the first few months of life, is associated with CMM in childhood through young adulthood. METHODS National cohort study of 3,571,574 persons born in Sweden in 1973-2008, followed up for CMM incidence through 2009 (maximum age 37 years) to examine season of birth and other perinatal factors. RESULTS There were 1595 CMM cases in 63.9 million person-years of follow-up. We found a sinusoidal pattern in CMM risk by season of birth (P=0.006), with peak risk corresponding to birthdates in spring (March-May). Adjusted odds ratios for CMM by season of birth were 1.21 [95% confidence interval (CI), 1.05-1.39; P=0.008] for spring, 1.07 (95% CI, 0.92-1.24; P=0.40) for summer and 1.12 (95% CI, 0.96-1.29; P=0.14) for winter, relative to fall. Spring birth was associated with superficial spreading subtype of CMM (P=0.02), whereas there was no seasonal association with nodular subtype (P=0.26). Other CMM risk factors included family history of CMM in a sibling (>6-fold) or parent (>3-fold), female gender, high fetal growth and high paternal education level. CONCLUSIONS In this large cohort study, persons born in spring had increased risk of CMM in childhood through young adulthood, suggesting that the first few months of life may be a critical period of UVR susceptibility. Sun avoidance in early infancy may play an important role in the prevention of CMM in high-risk populations.
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Affiliation(s)
- Casey Crump
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Kristina Sundquist
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USADepartment of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Weiva Sieh
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Marilyn A Winkleby
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Jan Sundquist
- Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USADepartment of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA
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Samadder NJ, Curtin K, Tuohy TMF, Pappas L, Boucher K, Provenzale D, Rowe KG, Mineau GP, Smith K, Pimentel R, Kirchhoff AC, Burt RW. Characteristics of missed or interval colorectal cancer and patient survival: a population-based study. Gastroenterology 2014; 146:950-60. [PMID: 24417818 DOI: 10.1053/j.gastro.2014.01.013] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 01/06/2014] [Accepted: 01/07/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Colorectal cancers (CRCs) diagnosed within a few years after an index colonoscopy can arise from missed lesions or the development of a new tumor. We investigated the proportion, characteristics, and factors that predict interval CRCs that develop within 6-60 months of colonoscopy. METHODS We performed a population-based cohort study of Utah residents who underwent colonoscopy examinations from 1995 through 2009 at Intermountain Healthcare or the University of Utah Health System, which provide care to more than 85% of state residents. Colonoscopy results were linked with cancer histories from the Utah Population Database to identify patients who underwent colonoscopy 6-60 months before a diagnosis of CRC (interval cancer). Logistic regression was performed to identify risk factors associated with interval cancers. RESULTS Of 126,851 patients who underwent colonoscopies, 2659 were diagnosed with CRC; 6% of these CRCs (159 of 2659) developed within 6 to 60 months of a colonoscopy. Sex and age were not associated with interval CRCs. A higher percentage of patients with interval CRC were found to have adenomas at their index colonoscopy (57.2%), compared with patients found to have CRC detected at colonoscopy (36%) or patients who did not develop cancer (26%) (P < .001). Interval CRCs tended to be earlier-stage tumors than those detected at index colonoscopy, and to be proximally located (odds ratio, 2.24; P < .001). Patients with interval CRC were more likely to have a family history of CRC (odds ratio, 2.27; P = .008) and had a lower risk of death than patients found to have CRC at their index colonoscopy (hazard ratio, 0.63; P < .001). CONCLUSIONS In a population-based study in Utah, 6% of all patients with CRC had interval cancers (cancer that developed within 6 to 60 months of a colonoscopy). Interval CRCs were associated with the proximal colon, earlier-stage cancer, lower risk of death, higher rate of adenoma, and family history of CRC. These findings indicate that interval colorectal tumors may arise as the result of distinct biologic features and/or suboptimal management of polyps at colonoscopy.
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Affiliation(s)
- N Jewel Samadder
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Medicine (Gastroenterology), University of Utah, Salt Lake City, Utah.
| | - Karen Curtin
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Medicine (Genetic Epidemiology), University of Utah, Salt Lake City, Utah
| | | | - Lisa Pappas
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Ken Boucher
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Dawn Provenzale
- VA Cooperative Studies Epidemiology Center-Durham, Durham VAMC, Durham, North Carolina; Department of Medicine (Gastroenterology), Duke University, Durham, North Carolina
| | - Kerry G Rowe
- Department of Oncology, Intermountain Healthcare, Salt Lake City, Utah
| | - Geraldine P Mineau
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Oncological Sciences, University of Utah, Salt Lake City, Utah
| | - Ken Smith
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Oncological Sciences, University of Utah, Salt Lake City, Utah
| | - Richard Pimentel
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Pediatrics at University of Utah, Salt Lake City, Utah
| | - Randall W Burt
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah; Department of Medicine (Gastroenterology), University of Utah, Salt Lake City, Utah; Department of Oncological Sciences, University of Utah, Salt Lake City, Utah
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9
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Tuohy TMF, Rowe KG, Mineau GP, Pimentel R, Burt RW, Samadder NJ. Risk of colorectal cancer and adenomas in the families of patients with adenomas: a population-based study in Utah. Cancer 2013; 120:35-42. [PMID: 24150925 DOI: 10.1002/cncr.28227] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 02/05/2013] [Accepted: 02/26/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Guidelines recommend that individuals with a first-degree relative (FDR) diagnosed with colorectal cancer (CRC) or advanced adenoma before age 60 years should undergo colonoscopy starting at age 40 years. The authors quantified the risk of adenomas and CRC in FDRs, second-degree relatives (SDRs), and third-degree relatives (TDRs) of patients diagnosed with adenomas and advanced adenomas. METHODS A population-based, retrospective, case-control study was performed of residents of the state of Utah aged 50 years to 80 years who underwent colonoscopy between 1995 and 2009 at Intermountain Healthcare or the University of Utah. Controls were selected from the population of colonoscopy patients who were free of adenomas or CRC and matched to each case based on sex and birth year. Colonoscopy results were linked with cancer and pedigree information from the Utah Population Database to investigate the familial aggregation of adenomas and CRC using Cox regression analysis. The unit of analysis was the relatives of cases and controls. RESULTS Of 126,936 patients who underwent colonoscopy, 43,189 had adenomas and 5563 had advanced adenomas and defined the case population. An elevated risk of CRC was found in FDRs (relative risk [RR], 1.35; 95% confidence interval [95% CI], 1.25-1.46), SDRs (RR, 1.15; 95% CI, 1.07-1.23) of adenoma cases, and in FDRs of advanced adenoma cases (RR, 1.68; 95% CI, 1.29-2.18) compared with controls. Approximately 10% of CRCs diagnosed in relatives would have been missed if the current screening guidelines were strictly adhered to. CONCLUSIONS Relatives of colonoscopy patients with adenomas and advanced adenomas appear to have a significantly elevated risk of developing colorectal neoplasia. These data should be considered when establishing CRC screening guidelines for individuals and their families.
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Affiliation(s)
- Thérèse M F Tuohy
- Hereditary Gastrointestinal Cancer Registry, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
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Xu J, Sun J, Zheng SL. Prostate cancer risk-associated genetic markers and their potential clinical utility. Asian J Androl 2013; 15:314-22. [PMID: 23564047 PMCID: PMC3739659 DOI: 10.1038/aja.2013.42] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 03/16/2013] [Accepted: 03/18/2013] [Indexed: 02/02/2023] Open
Abstract
Prostate cancer (PCa) is one of the most common cancers among men in Western developed countries and its incidence has increased considerably in many other parts of the world, including China. The etiology of PCa is largely unknown but is thought to be multifactorial, where inherited genetics plays an important role. In this article, we first briefly review results from studies of familial aggregation and genetic susceptibility to PCa. We then recap key findings of rare and high-penetrance PCa susceptibility genes from linkage studies in PCa families. We devote a significant portion of this article to summarizing discoveries of common and low-penetrance PCa risk-associated single-nucleotide polymorphisms (SNPs) from genetic association studies in PCa cases and controls, especially those from genome-wide association studies (GWASs). A strong focus of this article is to review the literature on the potential clinical utility of these implicated genetic markers. Most of these published studies described PCa risk estimation using a genetic score derived from multiple risk-associated SNPs and its utility in determining the need for prostate biopsy. Finally, we comment on the newly proposed concept of genetic score; the notion is to treat it as a marker for genetic predisposition, similar to family history, rather than a diagnostic marker to discriminate PCa patients from non-cancer patients. Available evidence to date suggests that genetic score is an objective and better measurement of inherited risk of PCa than family history. Another unique feature of this article is the inclusion of genetic association studies of PCa in Chinese and Japanese populations.
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Affiliation(s)
- Jianfeng Xu
- Fudan Institute of Urology, Huashan Hospital, Fudan UniversityFudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Petridou ET, Sergentanis TN, Panagopoulou P, Moschovi M, Polychronopoulou S, Baka M, Pourtsidis A, Athanassiadou F, Kalmanti M, Sidi V, Dessypris N, Frangakis C, Matsoukis IL, Stefanadis C, Skalkidou A, Stephansson O, Adami HO, Kieler H. In vitro fertilization and risk of childhood leukemia in Greece and Sweden. Pediatr Blood Cancer 2012; 58:930-6. [PMID: 21618418 DOI: 10.1002/pbc.23194] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 04/14/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cancer risk in children born after in vitro fertilization (IVF) remains largely unknown. We aimed to investigate risk of leukemia and lymphoma following IVF using two nationwide datasets. METHODS The hospital-based case-control study in Greece derived from the National Registry for Childhood Hematological Malignancies (1996-2008, 814 leukemia and 277 lymphoma incident cases with their 1:1 matched controls). The Swedish case-control study was nested in the Swedish Medical Birth Register (MBR) (1995-2007, 520 leukemia and 71 lymphoma cases with their 5,200 and 710 matched controls) with ascertainment of incident cancer cases in the National Cancer Register. Study-specific and combined odds ratios (OR) were estimated using conditional logistic regression, with adjustment for possible risk factors. RESULTS Nationwide studies pointed to similar size excess risk of leukemia following IVF, but to a null association between IVF and lymphoma. The proportion of leukemia cases conceived through IVF was 3% in Greece and 2.7% in Sweden; prevalence of IVF in matched controls was 1.8% and 1.6%, respectively. In combined multivariable analyses, the increased risk of leukemia was confined to age below 3.8 years (OR = 2.21; 95% confidence interval, CI: 1.27-3.85) and to acute lymphoblastic leukemia (ALL) (OR = 1.77; 95% CI: 1.06-2.95) with no sufficient evidence of excess risk for other leukemias (OR = 1.34; 95% CI: 0.38-4.69). Following IVF, OR for ALL was 2.58 (95% CI: 1.37-4.84) before age 3.8 and 4.29 (95% CI: 1.49-12.37) before age 2 years. CONCLUSIONS IVF seems to be associated with increased risk of early onset ALL in the offspring.
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Affiliation(s)
- Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece.
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12
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Linet MS, Slovis TL, Miller DL, Kleinerman R, Lee C, Rajaraman P, Berrington de Gonzalez A. Cancer risks associated with external radiation from diagnostic imaging procedures. CA Cancer J Clin 2012; 62:75-100. [PMID: 22307864 PMCID: PMC3548988 DOI: 10.3322/caac.21132] [Citation(s) in RCA: 220] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The 600% increase in medical radiation exposure to the US population since 1980 has provided immense benefit, but increased potential future cancer risks to patients. Most of the increase is from diagnostic radiologic procedures. The objectives of this review are to summarize epidemiologic data on cancer risks associated with diagnostic procedures, describe how exposures from recent diagnostic procedures relate to radiation levels linked with cancer occurrence, and propose a framework of strategies to reduce radiation from diagnostic imaging in patients. We briefly review radiation dose definitions, mechanisms of radiation carcinogenesis, key epidemiologic studies of medical and other radiation sources and cancer risks, and dose trends from diagnostic procedures. We describe cancer risks from experimental studies, future projected risks from current imaging procedures, and the potential for higher risks in genetically susceptible populations. To reduce future projected cancers from diagnostic procedures, we advocate the widespread use of evidence-based appropriateness criteria for decisions about imaging procedures; oversight of equipment to deliver reliably the minimum radiation required to attain clinical objectives; development of electronic lifetime records of imaging procedures for patients and their physicians; and commitment by medical training programs, professional societies, and radiation protection organizations to educate all stakeholders in reducing radiation from diagnostic procedures.
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Affiliation(s)
- Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-7238, USA.
| | - Thomas L Slovis
- Chief, Pediatric Radiology, Department of Radiology, Children's Hospital of Michigan, Detroit, MI
| | - Donald L Miller
- Acting Chief, Diagnostic Devices Branch, Division of Mammography Quality and Radiation Program Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD
| | - Ruth Kleinerman
- Epidemiologist, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Choonsik Lee
- Investigator, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Preetha Rajaraman
- Investigator, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Amy Berrington de Gonzalez
- Senior Investigator, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Incidence of testicular malignancies and correlation to risk factors in a TESE population of subfertile men. Arch Gynecol Obstet 2011; 285:247-53. [DOI: 10.1007/s00404-011-1938-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 05/20/2011] [Indexed: 10/18/2022]
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14
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Cook MB, Akre O, Forman D, Madigan MP, Richiardi L, McGlynn KA. A systematic review and meta-analysis of perinatal variables in relation to the risk of testicular cancer--experiences of the son. Int J Epidemiol 2010; 39:1605-18. [PMID: 20660640 DOI: 10.1093/ije/dyq120] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We undertook a systematic review and meta-analysis of perinatal variables in relation to testicular cancer risk, with a specific focus upon characteristics of the son. METHODS Literature databases Scopus, EMBASE, PubMed and Web of Science were searched using highly sensitive search strategies. Of 5865 references retrieved, 67 articles met the inclusion criteria, each of which was included in at least one perinatal analysis. RESULTS Random effects meta-analysis produced the following results for association with testicular cancer risk: birth weight [per kilogram, odds ratio (OR) = 0.94, 95% confidence interval (CI) 0.88-1.01, I(2)= 12%], low birth weight (OR = 1.34, 95% CI 1.08-1.67, I(2)= 51%), high birth weight (OR = 1.05, 95% CI 0.96-1.14, I(2)= 0%), gestational age (per week, OR = 0.95, 95% CI 0.92-0.98, I(2)= 38%; low vs not, OR = 1.31, 95% CI 1.07-1.59, I(2)= 49%), cryptorchidism (OR = 4.30, 95% CI 3.62-5.11, I(2)= 44%), inguinal hernia (OR = 1.63, 95% CI 1.37-1.94, I(2)= 38%) and twinning (OR = 1.22, 95% CI 1.03-1.44, I(2)= 22%). Meta-analyses of the variables birth length, breastfeeding and neonatal jaundice did not provide evidence for an association with testicular cancer risk. When low birth weight was stratified by data ascertainment (record/registry vs self-report), only the category of self-report was indicative of an association. Meta-regression of data ascertainment (record/registry vs self-report) inferred that record-/registry-based studies were less supportive of an association with gestational age (per week = 0.97, 95% CI 0.94-1.00, I(2)( )= 29%; low vs not = 1.08, 95% CI 0.91-1.28, I(2)= 32%). CONCLUSION In conclusion, this systematic review and meta-analysis finds evidence that cryptorchidism, inguinal hernia and twinning, and tentative evidence that birth weight and gestational age, are associated with risk of testicular cancer.
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Affiliation(s)
- Michael B Cook
- Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20852-7234, USA.
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Olesen AV, Parner ET, Mortensen PB, Sørensen HT, Olsen J. Prenatal Risk Factors for Cutaneous Malignant Melanoma: Follow-up of 2,594,783 Danes Born from 1950 to 2002. Cancer Epidemiol Biomarkers Prev 2009; 18:155-61. [DOI: 10.1158/1055-9965.epi-08-0294] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Puumala SE, Carozza SE, Chow EJ, Fox EE, Horel S, Johnson KJ, McLaughlin C, Mueller BA, Reynolds P, Von Behren J, Spector LG. Childhood cancer among twins and higher order multiples. Cancer Epidemiol Biomarkers Prev 2009; 18:162-8. [PMID: 19124494 PMCID: PMC2705199 DOI: 10.1158/1055-9965.epi-08-0660] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Although several studies have found no change or a decreased risk of childhood cancer in twins, few have controlled for potential confounders such as birth weight. We examined the association of birth plurality and childhood cancer in pooled data from five U.S. states (California, Minnesota, New York, Texas, and Washington) using linked birth-cancer registry data. The data, excluding children with Down syndrome or who died before 28 days of life, included 17,672 cases diagnosed from 1980 to 2004 at ages 28 days to 14 years and 57,966 controls with all cases and controls born from 1970 to 2004. Analyses were restricted to children weighing
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Affiliation(s)
- Susan E. Puumala
- Division of Epidemiology/Clinical Research, Department of Pediatrics, University of Minnesota
| | - Susan E. Carozza
- Department of Epidemiology and Biostatistics, Texas A&M University
| | | | - Erin E. Fox
- Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services
| | - Scott Horel
- Department of Epidemiology and Biostatistics, Texas A&M University
| | - Kimberly J. Johnson
- Division of Epidemiology/Clinical Research, Department of Pediatrics, University of Minnesota
| | | | | | | | | | - Logan G. Spector
- Division of Epidemiology/Clinical Research, Department of Pediatrics, University of Minnesota
- Masonic Cancer Center, University of Minnesota
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Murphy MFG, Bunch KJ, Chen B, Hemminki K. Reduced occurrence of childhood cancer in twins compared to singletons: protection but by what mechanism? Pediatr Blood Cancer 2008; 51:62-5. [PMID: 18300317 DOI: 10.1002/pbc.21479] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Several small studies combined have suggested that twins develop fewer childhood cancers than singletons. The national Swedish Family-Cancer Database contains information on a large population of multiple births providing an unbiased dataset for the estimation of cancer risk in twins. Lifelong cancer incidence in these twins has already been reported as similar to that in singleton births. In contrast, the present paper presents robust estimates of a significantly reduced childhood cancer risk in twins to age 15. METHODS Standardised incidence ratios (SIR) were used to measure cancer risk for twins, taking the corresponding rates for singletons as reference. Rates were adjusted for age, sex, period of birth, and residential area. Follow up data cover the period 1958-2002. RESULTS Overall childhood cancer risk was significantly reduced in all twins (SIR 0.81 [95% CI: 0.69-0.94]) as was the risk for Wilms tumour (SIR 0.34 [95% CI: 0.09-0.88]). These significant reductions in risk were both driven by effects in same sex twins (overall cancer SIR 0.77 [95% CI: 0.64-0.93], Wilms tumour 0.12 [95% CI: 0.00-0.71]). Leukaemia risk was also significantly reduced for same sex twins (SIR 0.69 [95% CI: 0.47-0.97]). CONCLUSIONS Our study provides the evidence that twins experience less childhood cancer than singletons. The risk reduction is most marked for Wilms tumour but may, to a varying extent, be true for a number of childhood neoplasms.
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Affiliation(s)
- M F G Murphy
- Childhood Cancer Research Group, University of Oxford, Oxford, UK.
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Franco-Lie I, Iversen T, Robsahm TE, Abdelnoor M. Birth weight and melanoma risk: a population-based case-control study. Br J Cancer 2007; 98:179-82. [PMID: 18087270 PMCID: PMC2359697 DOI: 10.1038/sj.bjc.6604159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We investigated whether lower birth weight was associated with lower risk of melanoma later in life. This population-based case–control study included all incident cases of histologically verified invasive melanoma diagnosed until 31 December 2003 in the Norwegian population born between 1967 and 1986 (n=709). The control group without malignant disease was established by random sampling from the same source population as the cases (n=108 209). Data on birth weight, gender, mother's residence and parental age at the time of birth were collected from the Medical Birth Registry of Norway and data on cancer from the Cancer Registry of Norway. The Mantel–Haenszel test of linear trend showed no trend in risk across the birth weight categories: individuals in the highest quartile of birth weight (⩾3860 g) had an odds ratio (OR) of 1.19 (95% confidence interval, CI: 0.77–1.84) compared to individuals with birth weight <2500 g. The adjusted OR was 0.81 (95% CI: 0.52–1.26) for birth weight below 2500 g (exposed). Though not statistically significant, the results suggest that low birth weight might influence the risk of melanoma later in life.
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Affiliation(s)
- I Franco-Lie
- Department for Research and Education, Center for Clinical Research, Ullevaal University Hospital, Oslo 0407, Norway.
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Neale RE, Carrière P, Murphy MFG, Baade PD. Testicular cancer in twins: a meta-analysis. Br J Cancer 2007; 98:171-3. [PMID: 18071360 PMCID: PMC2359686 DOI: 10.1038/sj.bjc.6604136] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In a meta-analysis of testicular cancer in twins, twins had a 30% increased risk (estimate 1.31, 95% CI 1.1–1.6), providing indirect support for the hypothesis that in utero hormone variations influence risk of testicular cancer. The summary-estimate for dizygotic twins was 1.3 (1.0–1.7) and for monozygotic or same sex twins 1.4 (1.2–1.8).
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Affiliation(s)
- R E Neale
- Division of Population and Clinical Sciences, Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Queensland 4029, Australia.
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