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Farland LV, Lind KE, Thomson CA, Saquib N, Shadyab AH, Schnatz PF, Robles-Morales R, Qi L, Strickler H, Lane DS, Murugappan G, Roe DJ, Harris HR. Infertility and risk of postmenopausal breast cancer in the women's health initiative. Breast Cancer Res Treat 2024:10.1007/s10549-024-07257-2. [PMID: 38459395 DOI: 10.1007/s10549-024-07257-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/18/2024] [Indexed: 03/10/2024]
Abstract
PURPOSE Although infertility (i.e., failure to conceive after ≥ 12 months of trying) is strongly correlated with established breast cancer risk factors (e.g., nulliparity, number of pregnancies, and age at first pregnancy), its association with breast cancer incidence is not fully understood. Previous studies were primarily small clinic-based or registry studies with short follow-up and predominantly focused on premenopausal breast cancer. The objective of this study was to assess the relationship between infertility and postmenopausal breast cancer risk among participants in the Women's Health Initiative (analytic sample = 131,784; > 25 years of follow-up). METHODS At study entry, participants were asked about their pregnancy history, infertility history, and diagnosed reasons for infertility. Incident breast cancers were self-reported with adjudication by trained physicians reviewing medical records. Cox proportional hazards models were used to estimate risk of incident postmenopausal breast cancer for women with infertility (overall and specific infertility diagnoses) compared to parous women with no history of infertility. We examined mediation of these associations by parity, age at first term pregnancy, postmenopausal hormone therapy use at baseline, age at menopause, breastfeeding, and oophorectomy. RESULTS We observed a modest association between infertility (n = 23,406) and risk of postmenopausal breast cancer (HR = 1.07; 95% CI 1.02-1.13). The association was largely mediated by age at first term pregnancy (natural indirect effect: 46.4% mediated, CI 12.2-84.3%). CONCLUSION These findings suggest that infertility may be modestly associated with future risk of postmenopausal breast cancer due to age at first pregnancy and highlight the importance of incorporating reproductive history across the life course into breast cancer analyses.
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Affiliation(s)
- Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA.
- Department of Obstetrics and Gynecology, College of Medicine - Tucson, University of Arizona, Tucson, AZ, USA.
| | - Kimberly E Lind
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Nazmus Saquib
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah, Kingdom of Saudi Arabia
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA, USA
| | - Peter F Schnatz
- Departments of Obstetrics and Gynecology and Internal Medicine, Reading Hospital and Drexel University, Reading, PA, USA
| | - Rogelio Robles-Morales
- Clinical and Translational Sciences, College of Medicine - Tucson, University of Arizona, Tucson, AZ, USA
| | - Lihong Qi
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Howard Strickler
- Department of Epidemiology and Biostatistics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dorothy S Lane
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | | | - Denise J Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Kelly H, Jaafar I, Chung M, Michelow P, Greene S, Strickler H, Xie X, Schiffman M, Broutet N, Mayaud P, Dalal S, Arbyn M, de Sanjosé S. Diagnostic accuracy of cervical cancer screening strategies for high-grade cervical intraepithelial neoplasia (CIN2+/CIN3+) among women living with HIV: A systematic review and meta-analysis. EClinicalMedicine 2022; 53:101645. [PMID: 36187721 PMCID: PMC9520209 DOI: 10.1016/j.eclinm.2022.101645] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND We systematically reviewed the diagnostic accuracy of cervical cancer screening and triage strategies in women living with HIV (WLHIV). METHODS Cochrane Library, Embase, Global Health and Medline were searched for randomised controlled trials, prospective or cross-sectional studies published from database inception to 15 July 2022 reporting diagnostic accuracy of tests in cervical cancer screening and triage of screen-positive WLHIV. Studies were included if they reported the diagnostic accuracy of any cervical cancer screening or triage strategies for the detection of histologically-confirmed high-grade cervical intraepithelial neoplasia (CIN2+/CIN3+) among WLHIV. Summary data were extracted from published reports. Authors were contacted for missing data where applicable. Sensitivity and specificity estimates for CIN2/3+ were pooled using models for meta-analysis of diagnostic accuracy data. Study quality was assessed using the QUADAS-2 tool for the quality assessment of diagnostic accuracy studies. PROSPERO registration:CRD42020189031. FINDINGS In 38 studies among 18,737 WLHIV, the majority (n=19) were conducted in sub-Saharan Africa. The pooled prevalence was 12.0% (95%CI:9.8-14.1) for CIN2+ and 6.7% (95%CI:5.0-8.4) for CIN3+. The proportion of screen-positive ranged from 3-31% (visual inspection using acetic acid[VIA]); 2-46% (high-grade squamous intraepithelial lesions, and greater [HSIL+] cytology); 20-64% (high-risk[HR]-HPV DNA). In 14 studies, sensitivity and specificity of VIA were variable limiting the reliability of pooled estimates. In 5 studies where majority had histology-confirmed CIN2+, pooled sensitivity was 56.0% (95%CI:45.4-66.1; I2=65%) for CIN2+ and 65.0% (95%CI:52.9-75.4; I2 =42%) for CIN3+; specificity for <CIN2 was 73.8% (95%CI:59.8-84.2, I2=94%). Cytology was similarly variable (sensitivity of ASCUS+ for CIN2+ range: 58-100%; specificity: 9-96%). In 28 studies, sensitivity of tests targeting 14-HR-HPV types was high (91.6%, 95%CI:88.1-94.1; I2=45% for CIN2+ and 92.5%, 95%CI:88.4-95.2; I2=32%) for CIN3+); but specificity for <CIN2 was low (62.2% (95%CI:57.9-66.4;I2=92%). Restriction to 8-HR-HPV increased specificity (65.8%; Relative specificity[RSpec] vs. 14-HR-HPV=1.17; 95%CI:1.10-1.24) with no significant change in sensitivity (CIN2+:85.5%; Relative Sensitivity[RSens]=0.94, 95%CI: 0.89-1.00; CIN3+:90%; RSens=0.96, 95%CI:0.89-1.03). VIA triage of 14-HR-HPV positive women decreased sensitivity for CIN2+ compared to HPV-DNA test alone (64.4% vs. 91.6%; RSens=0.68, 95%CI:0.62-0.75). INTERPRETATION HPV-DNA based approaches consistently showed superior sensitivity for CIN2+/CIN3+ compared to VIA or cytology. The low specificity of HPV-DNA based methods targeting up to 14-HR-HPV could be improved significantly by restricting to 8-HR-HPV with only minor losses in sensitivity, limiting requirement for triage for which optimal approaches are less clear. FUNDING World Health Organisation; National Cancer Institute; European Union's Horizon 2020 and Marie Skłodowska-Curie Actions programme.
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Affiliation(s)
- Helen Kelly
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- National Cancer Institute, National Institutes of Health, Rockville, MD, USA
- Corresponding author at: London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Iman Jaafar
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
| | - Michael Chung
- Department of Global Health, University of Washington, Seattle, USA
| | - Pamela Michelow
- Cytology Unit, Department of Anatomical Pathology, Faculty of Health Science, National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa
| | - Sharon Greene
- Department of Global Health, University of Washington, Seattle, USA
| | - Howard Strickler
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Xianhong Xie
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Mark Schiffman
- National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Nathalie Broutet
- Department of Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
| | - Philippe Mayaud
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shona Dalal
- Department of Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, University Ghent, Ghent, Belgium
| | - Silvia de Sanjosé
- National Cancer Institute, National Institutes of Health, Rockville, MD, USA
- ISGlobal, Barcelona, Spain
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Campbell PT, Newton CC, Jacobs EJ, McCullough ML, Wang Y, Rees-Punia E, Guinter MA, Murphy N, Koshiol J, Dehal AN, Rohan T, Strickler H, Petrick J, Gunter M, Zhang X, McGlynn KA, Pollak M, Patel AV, Gapstur SM. Prospective associations of hemoglobin A 1c and c-peptide with risk of diabetes-related cancers in the Cancer Prevention Study-II Nutrition Cohort. Cancer Res Commun 2022; 2:653-662. [PMID: 36712480 PMCID: PMC9881454 DOI: 10.1158/2767-9764.crc-22-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/05/2022] [Accepted: 06/21/2022] [Indexed: 02/02/2023]
Abstract
Self-reported type 2 diabetes mellitus (T2DM) is a risk factor for many cancers, suggesting its pathology relates to carcinogenesis. We conducted a case-cohort study to examine associations of hemoglobin A1c (HbA1c) and c-peptide with cancers associated with self-reported T2DM. This study was drawn from a prospective cohort of 32,383 women and men who provided blood specimens at baseline: c-peptide and HbA1c were assessed in 3,000 randomly selected participants who were cancer-free-at-baseline and an additional 2,281 participants who were cancer-free-at-baseline and subsequently diagnosed with incident colorectal, liver, pancreatic, female breast, endometrial, ovarian, bladder, or kidney cancers. Weighted-Cox regression models estimated hazards ratios (HRs) and 95% confidence intervals (CI), adjusted for covariates. C-peptide was associated with higher risk of liver cancer (per standard deviation (SD) HR: 1.80; 95%CI: 1.32-2.46). HbA1c was associated with higher risk of pancreatic cancer (per SD HR: 1.21 95%CI 1.05-1.40) and with some suggestion of higher risks for all-cancers-of-interest (per SD HR: 1.05; 95%CI: 0.99-1.11) and colorectal (per SD HR: 1.09; 95%CI: 0.98-1.20), ovarian (per SD HR: 1.18; 95%CI 0.96-1.45) and bladder (per SD HR: 1.08; 95%CI 0.96-1.21) cancers. Compared to no self-reported T2DM and HbA1c <6.5% (reference group), self-reported T2DM and HbA1c <6.5% (i.e., T2DM in good glycemic control) was not associated with risk of colorectal cancer, whereas it was associated with higher risks of all-cancers-of-interest combined (HR: 1.28; 95%CI: 1.01-1.62), especially for breast and endometrial cancers. Additional large, prospective studies are needed to further explore the roles of hyperglycemia, hyperinsulinemia, and related metabolic traits with T2DM-associated cancers to better understand the mechanisms underlying the self-reported T2DM-cancer association and to identify persons at higher cancer risk.
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Affiliation(s)
- Peter T. Campbell
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
- Population Science Department, American Cancer Society (ACS), Atlanta, Georgia
| | - Christina C. Newton
- Population Science Department, American Cancer Society (ACS), Atlanta, Georgia
| | - Eric J. Jacobs
- Population Science Department, American Cancer Society (ACS), Atlanta, Georgia
| | | | - Ying Wang
- Population Science Department, American Cancer Society (ACS), Atlanta, Georgia
| | - Erika Rees-Punia
- Population Science Department, American Cancer Society (ACS), Atlanta, Georgia
| | - Mark A. Guinter
- Population Science Department, American Cancer Society (ACS), Atlanta, Georgia
| | - Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, NIH, NCI, Rockville, Maryland
| | - Ahmed N. Dehal
- Department of Clinical Science, Kaiser Permanente Bernard J Tyson School of Medicine, Panorama City, California
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Howard Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Jessica Petrick
- Slone Epidemiology Center at Boston University, Boston, Massachusetts
| | - Marc Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Michael Pollak
- Depsartment of Medicine and Oncology, McGill University, Montreal, Quebec, Canada
| | - Alpa V. Patel
- Population Science Department, American Cancer Society (ACS), Atlanta, Georgia
| | - Susan M. Gapstur
- Population Science Department, American Cancer Society (ACS), Atlanta, Georgia
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Karra P, Winn M, Haaland B, Anderson G, Thomson CA, Shadyab AH, Luo J, Saquib N, Strickler H, Chlebowski R, Arthur R, Hardikar S, Playdon MC. Abstract 5880: Diabetes incidence after obesity-related cancer diagnosis and survival in the women’s health initiative. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-5880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Obesity-related cancer (ORC) diagnosed individuals are at an elevated risk of new-onset diabetes compared with cancer-free individuals. However, less is known about mortality among those with incident type 2 diabetes after cancer.
Methods: In the Women’s Health Initiative (N=14,455 ORC cases), we measured the association of incident type 2 diabetes diagnosed 0-1 years, >1-3, >3-5, >5-7 and >7-10 years after ORC diagnosis with cancer-specific and overall mortality using stratified Cox proportional hazards regression analysis.
Results: The participants were post-menopausal females with ORC and predominantly white. The number of WHI participants with ORC who developed diabetes after cancer diagnosis were: 0-1 years - 205/12992 (1.58%); 1-3 years - 326/11322 (2.88%); 3-5 years - 276/9784 (2.82%); 5-7 years - 268/8420 (3.18%); and 7-10 years - 510/6419 (7.95%). The median survival after the first year of cancer diagnosis for participants without diabetes was 16.6 years (95% CI: 16.17-17.0 years) and for those with diabetes was 10.3 years (95% CI: 7.97-14.9 years). New-onset diabetes after ORC diagnosis showed elevated overall mortality and cancer-specific mortality when compared with no diabetes diagnosis.
Conclusions: Incident type 2 diabetes is associated with worse cancer-specific and overall survival, particularly in the year after diagnosis, among women with ORC.
Type 2 Diabetes from time since cancer diagnosis Overall mortality HR (95% CI)a Cancer-specific mortality HR (95% CI)a 0-1 years 1.79 (1.41-2.29) 1.56 (1.04-2.34) >1-3 years 1.22 (0.99-1.51) 1.05 (0.72-1.55) >3-5 years 1.21 (0.95-1.55) 1.37 (0.89-2.12) >5-7 years 1.02 (0.78-1.33) 0.80 (0.47-1.36) >7-10 years 1.10 (0.87-1.40) 0.97 (0.59-1.60) aModel adjusted for demographics (age, education, race/ethnicity, marital status), body mass index (BMI)) and cancer characteristics (cancer type, stage, grade). CI = confidence interval; HR = Hazard ratio.
Citation Format: Prasoona Karra, Maci Winn, Benjamin Haaland, Garnet Anderson, Cynthia A. Thomson, Aladdin H. Shadyab, Juhua Luo, Nazmus Saquib, Howard Strickler, Rowan Chlebowski, Rhonda Arthur, Sheetal Hardikar, Mary C. Playdon. Diabetes incidence after obesity-related cancer diagnosis and survival in the women’s health initiative [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5880.
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Affiliation(s)
- Prasoona Karra
- 1University of Utah, Huntsman Cancer Institute, Salt Lake City, UT
| | - Maci Winn
- 1University of Utah, Huntsman Cancer Institute, Salt Lake City, UT
| | - Benjamin Haaland
- 1University of Utah, Huntsman Cancer Institute, Salt Lake City, UT
| | | | | | | | - Juhua Luo
- 5Indiana University, Bloomington, IN
| | - Nazmus Saquib
- 6Sulaiman AlRajhi University, Saudi Arabia, Saudi Arabia
| | | | | | | | - Sheetal Hardikar
- 1University of Utah, Huntsman Cancer Institute, Salt Lake City, UT
| | - Mary C. Playdon
- 1University of Utah, Huntsman Cancer Institute, Salt Lake City, UT
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Caro-Vegas C, Ramirez C, Landis J, Adimora AA, Strickler H, French AL, Ofotokun I, Fischl M, Seaberg EC, Wang CCJ, Spence AB, Dittmer DP. Molecular profiling of breast and lung cancer in women with HIV reveals high tumor mutational burden. AIDS 2022; 36:567-571. [PMID: 34873086 PMCID: PMC8881359 DOI: 10.1097/qad.0000000000003144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study compared the mutation profile and tumor mutational burden (TMB) in women with HIV (WWH) diagnosed with lung adenocarcinoma (n = 8) or breast ductal neoplasm (n = 13) who were enrolled into the Women's Interagency HIV Study (WIHS). DESIGN Previous studies tended to focus on single institutions based on sample availability. This study is based on a representative, multicenter cohort that represents the racial and ethnic composition of women with HIV in the United States. METHODS The study sequenced the complete human exome of n = 26 cancer samples from HIV-positive women, using Ion torrent next-generation sequencing. The study cohort was compared with a HIV-negative cohort obtained from the Genomic Data Commons Data Portal of the NCI. RESULTS There were no differences in known cancer mutations between breast cancer and lung cancer that developed in WWH and those that developed in HIV-negative (HIV-) women; however, WWH presented a significantly higher TMB in comparison to HIV- patients. Seventy-five percent of lung cancers and 61% of breast cancers were defined as TMB-high (more than 10 mutation/mb of DNA). CONCLUSION This study affirms the recommendation that WWH be included in clinical trials of novel treatments for these cancers. Although these data are preliminary, the high TMB in WLHV suggests, paradoxically, that this immune challenged population may benefit greatly from immune checkpoint inhibitor therapies.
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Affiliation(s)
- Carolina Caro-Vegas
- UNC Lineberger Comprehensive Cancer Center and Center for AIDS Research, Chapel Hill, NC
- UNC Department of Microbiology and Immunology, Chapel Hill, NC
| | - Catalina Ramirez
- UNC Lineberger Comprehensive Cancer Center and Center for AIDS Research, Chapel Hill, NC
- UNC Department of Medicine Division of Infectious Diseases, Chapel Hill, NC
| | - Justin Landis
- UNC Lineberger Comprehensive Cancer Center and Center for AIDS Research, Chapel Hill, NC
- UNC Department of Microbiology and Immunology, Chapel Hill, NC
| | - Adaora A. Adimora
- UNC Lineberger Comprehensive Cancer Center and Center for AIDS Research, Chapel Hill, NC
- UNC Department of Medicine Division of Infectious Diseases, Chapel Hill, NC
| | - Howard Strickler
- Albert Einstein College of Medicine, Department of Epidemiology, Bronx, NY
| | - Audrey L. French
- Stronger Hospital of Cook County Health, Division of Infectious Diseases Chicago, IL
| | - Igho Ofotokun
- Emory University School of Medicine, Division of Infectious Diseases, Atlanta, GA
| | - Margaret Fischl
- University of Miami Department of Medicine, Division of Infectious Diseases, Miami, FL
| | - Eric C. Seaberg
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, VA
| | | | - Amanda B. Spence
- Georgetown University Medical Center, Division of Infectious Diseases Washington, DC, VA
| | - Dirk P. Dittmer
- UNC Lineberger Comprehensive Cancer Center and Center for AIDS Research, Chapel Hill, NC
- UNC Department of Microbiology and Immunology, Chapel Hill, NC
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Niu L, Hoyt LT, Salandy A, Nucci-Sack A, Shankar V, Strickler H, Burk RD, Schlecht NF, Diaz A. The interaction between pubertal timing and childhood maltreatment on the risk of human papillomavirus infection among adolescent girls and young women. Prev Med 2020; 138:106126. [PMID: 32389680 PMCID: PMC7808758 DOI: 10.1016/j.ypmed.2020.106126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/20/2020] [Accepted: 05/03/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE The goal of this study was to evaluate the effect of pubertal timing, and its interaction with prior childhood maltreatment, on the risk of cervical human papillomavirus (HPV) among sexually active adolescent minority female adolescents and young adults. METHODS This cross-sectional study includes 842 adolescent girls and young women (aged 12 to 20 years; predominately Black and Hispanic) enrolled in an HPV vaccine surveillance study at a large adolescent health clinic in New York City between 2007 and 2016. Pubertal timing was assessed by self-reported age at menarche at baseline, with "early" and "late" defined as one standard deviation below (<11 years) or above (>13 years) the mean. Childhood exposure to abuse (sexual, physical and emotional) and neglect (physical and emotional) was assessed using the Childhood Trauma Questionnaire. Over 40 types of HPV infection were detected using the polymerase chain reaction in cervical Pap specimens. RESULTS Results from multivariable logistic regression showed that early and late pubertal timing were marginally associated with a higher risk of HPV infection, adjusting for demographic and health covariates. Childhood maltreatment moderated the association between early pubertal timing and HPV infection: early pubertal timing was associated with a higher risk for HPV infection among maltreated girls (OR = 3.32, 95%CI:1.61-6.85), but not among non-maltreated girls (OR = 0.96, 95%CI:0.61-1.50; p-interaction<0.01). CONCLUSIONS Variation in the timing of puberty and history of childhood maltreatment may have implications for adolescent sexual and reproductive health. Findings suggest that clinicians need to assess the biological and psychosocial risks in caring for youth.
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Affiliation(s)
- Li Niu
- Department of Psychology, Fordham University, NY, USA; Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | | | - Anthony Salandy
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA.
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Howard Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert D Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Departments of Pediatrics, Microbiology & Immunology, Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
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7
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D'Souza G, Clemens G, Troy T, Castillo RG, Struijk L, Waterboer T, Bender N, Pierorazio PM, Best SR, Strickler H, Wiley DJ, Haddad RI, Posner M, Fakhry C. Evaluating the Utility and Prevalence of HPV Biomarkers in Oral Rinses and Serology for HPV-related Oropharyngeal Cancer. Cancer Prev Res (Phila) 2019; 12:689-700. [PMID: 31420362 PMCID: PMC7029397 DOI: 10.1158/1940-6207.capr-19-0185] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/23/2019] [Accepted: 08/08/2019] [Indexed: 12/21/2022]
Abstract
Performance of commercially available human papillomavirus (HPV) assays (approved for cervical HPV detection) is unknown for detecting HPV-related oropharyngeal cancer (HPV-OPC). Assays for detection of HPV DNA [ELISA (DEIA) and Cobas], and RNA (Aptima) in oral rinse samples, and serum HPV oncogene antibodies were evaluated. Sensitivity and specificity of each test was explored among HPV-OPC cases and controls. Biomarker prevalence was evaluated among 294 "at-risk" people (screening) and 133 "high-risk" people [known to previously have oral oncogenic HPV (oncHPV) DNA and/or HPV16 E6/E7 antibodies detected]. HPV16 E6 antibodies had the best overall test performance with sensitivity of 88%, compared with oral HPV16 DNA sensitivity of 51% by DEIA and 43% by Cobas (each P < 0.001). Specificity was comparable in each of these tests (≥98%). When positivity for any oncHPV type was compared with HPV16 for the same test, sensitivity was comparable (60% vs. 51%, 40% vs. 43%, and 92% vs. 88% for DEIA, Cobas, and E6 antibodies, respectively), but specificity was reduced (93%-97%). Aptima had poor sensitivity (23%). Sensitivity decreased when cotesting HPV16 oral rinse DNA and E6 antibodies (37%-48%), or multiple E antibodies (69%-72%). HPV16 DNA were detected in ∼2% of the at-risk by either DEIA or Cobas and up to 15% of the high-risk population. HPV16 E6 seroprevalence was 2.3% and 2.4% in the at-risk and high-risk populations, respectively. Oral rinse HPV testing had moderate-to-poor sensitivity for HPV-OPC, suggesting many true positives would be missed in a potential screening scenario. HPV16 E6 serum antibody was the most promising biomarker evaluated.
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Affiliation(s)
- Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Gwendolyn Clemens
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Tanya Troy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rachel G Castillo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Linda Struijk
- DDL Diagnostic Laboratory, Rijswijk, the Netherlands
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Noemi Bender
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Simon R Best
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Howard Strickler
- Department of Epidemiology & Public Health, Albert Einstein College of Medicine, Bronx, New York
| | - Dorothy J Wiley
- University of California, Los Angeles School of Nursing, Los Angeles, California
| | - Robert I Haddad
- Division of Head and Neck Oncology, Dana Farber Cancer Institute, Boston, Massachusetts
| | - Marshall Posner
- Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, New York
| | - Carole Fakhry
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
- Brady Urological Institute, Johns Hopkins Hospital, Baltimore, Maryland
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8
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Arthur RS, Kabat GC, Kim MY, Wild RA, Shadyab AH, Wactawski-Wende J, Ho GYF, Reeves KW, Kuller LH, Luo J, Beebe-Dimmer J, Simon MS, Strickler H, Wassertheil-Smoller S, Rohan TE. Metabolic syndrome and risk of endometrial cancer in postmenopausal women: a prospective study. Cancer Causes Control 2019; 30:355-363. [PMID: 30788634 DOI: 10.1007/s10552-019-01139-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/06/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Obesity is a strong risk factor for endometrial cancer, but it is unclear whether metabolic syndrome (MetS) contributes to endometrial cancer risk over and above the contribution of obesity. METHODS We examined the association of MetS and its components with risk of endometrial cancer in a sub-cohort of 24,210 women enrolled in the Women's Health Initiative cohort study. Two variants of the National Cholesterol Education Program Adult Treatment Panel III definition of the MetS were used: one including and one excluding waist circumference (WC). Cox proportional hazards models were used to estimate the association of the study exposures with disease risk. RESULTS When WC was included in the definition, MetS showed an approximately two-fold increase in endometrial cancer risk (HR 2.20; 95% CI 1.61-3.02); however, when WC was excluded, MetS was no longer associated with risk. We also observed that women with hyperglycemia, dyslipidemia and hypertension, in combination, had almost a twofold increased risk of endometrial cancer, independent of WC (HR 1.94; 95% CI 1.09, 3.46). Glucose, and, in particular, WC and body mass index were also positively associated with risk. CONCLUSIONS Our findings suggest that MetS may predict risk of endometrial cancer independent of obesity among women with the remaining four Mets components.
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Affiliation(s)
- Rhonda S Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
| | | | - Mimi Y Kim
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Robert A Wild
- Department of Obstetrics and Gynecology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, University of California, La Jolla, CA, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Gloria Y F Ho
- Department of Occupational Medicine, Epidemiology and Prevention, Feinstein Institute for Medical Research, Hofstra Northwell School of Medicine, Great Neck, NY, USA
| | - Katherine W Reeves
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, MA, USA
| | - Lewis H Kuller
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Juhua Luo
- Departments of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN, USA
| | | | | | - Howard Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
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9
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Chlebowski RT, Luo J, Anderson GL, Barrington W, Reding K, Simon MS, Manson JE, Rohan TE, Wactawski-Wende J, Lane D, Strickler H, Mosaver-Rahmani Y, Freudenheim JL, Saquib N, Stefanick ML. Weight loss and breast cancer incidence in postmenopausal women. Cancer 2018; 125:205-212. [PMID: 30294816 DOI: 10.1002/cncr.31687] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/22/2018] [Accepted: 06/01/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although obesity is an established risk factor for postmenopausal breast cancer, the results of weight loss and breast cancer studies are inconsistent. Therefore, we evaluated associations between weight change and breast cancer risk in postmenopausal women in the Women's Health Initiative Observational Study. METHODS Postmenopausal women (n = 61,335) who had no prior breast cancer and a normal mammogram had body weight and height measured and body mass index (BMI) calculated at baseline and year 3. Weight change at year 3 was categorized as stable (<5%), loss (≥5%), or gain (≥5%) with further assessment of weight loss intentionality by self-report. Multivariable Cox proportional hazard regression models were used to evaluate relationships between weight change and subsequent breast cancer incidence. RESULTS During a mean follow-up of 11.4 years with 3061 incident breast cancers, women with weight loss (n = 8175) had a significantly lower risk of breast cancer compared with women whose weight remained stable (n = 41,139) (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.78-0.98; P = .02) with no interaction by BMI. Adjustment for mammography did not alter findings (HR, 0.88; 95% CI, 0.78-0.99) with no significant difference by weight loss intentionality. Weight gain (≥5%) (n = 12,021) was not associated with breast cancer risk (HR, 1.02; 95% CI, 0.93-1.11) but was associated with higher triple-negative breast cancer incidence (HR, 1.54; 95% CI, 1.16-2.05). CONCLUSIONS Postmenopausal women who lose weight have lower breast cancer risk than those with stable weight. These findings suggest that postmenopausal women who lose weight may reduce their breast cancer risk.
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Affiliation(s)
- Rowan T Chlebowski
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California
| | - Juhua Luo
- Epidemiology and Biostatistics, Indiana University, Bloomington, Indiana
| | - Garnet L Anderson
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Wendy Barrington
- Psychosocial and Community Health, University of Washington, Seattle, Washington
| | - Kerryn Reding
- Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, Washington
| | - Michael S Simon
- Clinical Arrangements, Karmanos Cancer Institute, Detroit, Michigan
| | - JoAnn E Manson
- Department of Epidemiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Thomas E Rohan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, New York
| | - Dorothy Lane
- Department of Epidemiology & Population Health, Stony Brook University School of Medicine, Stony Brook, New York
| | - Howard Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Yasmin Mosaver-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, New York
| | - Nazmus Saquib
- Department of Research, Sulaimaon Al Rajhi College School of Medicine, Al Bukayri ah, Saudi Arabia
| | - Marcia L Stefanick
- Department of Medicine, Stanford University School of Medicine, Stanford, California
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10
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Chlebowski RT, Luo J, Anderson GL, Simon M, Barrington W, Reding K, Manson JE, Rohan T, Wactawki-Wende J, Lane D, Strickler H, Mossavar-Rahmani Y, Freudenheim J, Saquib ATN, Stefanick M. Abstract GS5-07: Weight change in postmenopausal women and breast cancer risk in the women's health initiative observational study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-gs5-07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose
While obesity is an established breast cancer risk factor, information about the influence of weight loss on breast cancer risk in postmenopausal women is mixed precluding generation of a strong public health message regarding potential benefits of weight loss with respect to cancer risk. Therefore, we evaluated associations between weight change and invasive breast cancer risk in postmenopausal women participating in the Women's Health Initiative (WHI) Observational Study.
Patients and Methods
Postmenopausal women (n=61,335) with no prior breast cancer and normal mammogram who were not underweight (body mass index [BMI] ≥ 18.5 kg/m2), ages 50-79 years at WHI enrollment between 1993 and 1998 at 40 US clinical centers, had body weight and height measured and BMI calculated at the clinical centers at baseline and at year 3. Weight change over 3 years was categorized as: stable (no change ≤ 5%), loss (change ≥ 5%), or gain (change ≥ 5%) with weight lost intentionality determined by self-report response to direct query at year 3. Breast cancers were initially ascertained through annual survey and were centrally confirmed by medical record review. Multi-variable Cox proportional hazards regression models incorporating breast cancer risk factors and baseline BMI were used to evaluate relationships between weight change and breast cancer incidence.
Results
During 11.4 years (mean) of follow-up, 3,061 women developed invasive breast cancer. In multi-variable analyses, compared with women with stable weight (n=41,139), women with weight loss (≥ 5%) (n=8,175) had a significantly lower breast cancer risk (hazard ratio [HR] 0.88 95% confidence interval [CI] 0.78-0.98). Adjustment for mammography did not alter findings (HR 0.88 95% CI 0.78-0.99). There was no significant interaction for breast cancer effect by weight loss intentionality. Women with weight loss ≥ 15% had even lower breast cancer risk (HR 0.63 95% CI 0.45-0.90). While weight gain (≥ 5%) (n=12,021) was not associated with higher overall breast cancer risk, women with weight gain had a significantly higher risk of triple negative breast cancer (HR 1.54 95% CI 1.16-2.05). Weight change association with breast cancer incidence was examined in four subgroups: by tumor subtype (hormone receptor and HER2 status based), baseline BMI (normal, overweight, obese), race/ethnicity, and age group (50, -<70 years). Effects in all subgroups was similar with no evidence of heterogeneity as no interaction term test in these analyses was significant.
Conclusion
Weight loss in postmenopausal women is associated with lower breast cancer risk. These findings suggest that postmenopausal women who lose weight may reduce their breast cancer risk.
Citation Format: Chlebowski RT, Luo J, Anderson GL, Simon M, Barrington W, Reding K, Manson JE, Rohan T, Wactawki-Wende J, Lane D, Strickler H, Mossavar-Rahmani Y, Freudenheim J, Saquib ATN, Stefanick M. Weight change in postmenopausal women and breast cancer risk in the women's health initiative observational study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr GS5-07.
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Affiliation(s)
- RT Chlebowski
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - J Luo
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - GL Anderson
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - M Simon
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - W Barrington
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - K Reding
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - JE Manson
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - T Rohan
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - J Wactawki-Wende
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - D Lane
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - H Strickler
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - Y Mossavar-Rahmani
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - J Freudenheim
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - ATN Saquib
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
| | - M Stefanick
- City of Hope National Medical Center, Duarete, CA; Indiana University, Bloomington, IN; Fred Hutchinson Cancer Research Center, Seattle, WA; Karmanos Cancer Institute, Detroit, MI; University of Washington, Seattle, WA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Albert Einstein College of Medicine, New York, NY; University at Buffalo, SUNY, Buffalo, NY; Stony Brook University School of Medicine, Stony Brook, NY; Sulaiman Al Rajhi College, School of Medicine, Al Bukayriyah, Saudi Arabia; Stanford University School of Medicine, Stanford, CA
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11
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Simon MS, Beebe-Dimmer JL, Hastert TA, Manson JE, Cespedes Feliciano EM, Neuhouser ML, Ho GYF, Freudenheim JL, Strickler H, Ruterbusch J, Barac A, Chlebowski R, Caan B. Cardiometabolic risk factors and survival after breast cancer in the Women's Health Initiative. Cancer 2018; 124:1798-1807. [PMID: 29338086 DOI: 10.1002/cncr.31230] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/01/2017] [Accepted: 12/18/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few studies have examined the relationship between cardiometabolic risk factors linked to metabolic syndrome and mortality among women with breast cancer. METHODS We used the Women's Health Initiative to evaluate the relationship between cardiometabolic risk factors, including waist circumference (WC), blood pressure, cholesterol level, and presence of type 2 diabetes, and their relation with death from breast cancer, cardiovascular disease (CVD), and other causes among 8641 women with local or regional stage invasive breast cancer. Cox proportional hazards models were used to estimate hazard ratios, and 95% confidence intervals, adjusted for important predictors of survival. RESULTS After a median of 11.3 years, there were 2181 total deaths, 619 (28.4%) of which were due to breast cancer. Most participants (55.7%) had at least 2 cardiometabolic risk factors, and 4.9% had 3 or 4. Having a larger number of risk factors was associated with higher risk of CVD and other-cause mortality (P trend < .001 for both), but not with breast cancer mortality (P trend = .86). Increased WC was associated with a higher risk of CVD (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.05-1.57) and other-cause mortality (HR, 1.32; 95% CI, 1.16-1.49) and only with a small and nonsignificant higher risk of breast cancer mortality (HR, 1.19; 95% CI, 0.93-1.52). The results did not differ in analyses stratified by race, hormone receptor status, or after an analysis of cases diagnosed within 5 years after baseline. CONCLUSIONS Among women with early stage breast cancer, cardiometabolic risk factors are significantly associated with cardiovascular and other-cause mortality, but not breast cancer mortality. Cancer 2018;124:1798-807. © 2018 American Cancer Society.
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Affiliation(s)
- Michael S Simon
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - Jennifer L Beebe-Dimmer
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - Theresa A Hastert
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Gloria Y F Ho
- Department of Occupational Medicine, Epidemiology and Prevention, Feinstein Institute for Medical Research, Hofstra Northwell School of Medicine, Great Neck, New York
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York
| | - Howard Strickler
- Department of Epidemiology and Public Health, Albert Einstein, New York, New York
| | - Julie Ruterbusch
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - Ana Barac
- MedStar Heart and Vascular Institute, Washington, DC
| | - Rowan Chlebowski
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California
| | - Bette Caan
- Division of Research, Kaiser Permanente, Oakland, California
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12
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Colón-López V, Shiels MS, Machin M, Ortiz AP, Strickler H, Castle PE, Pfeiffer RM, Engels EA. Anal Cancer Risk Among People With HIV Infection in the United States. J Clin Oncol 2017; 36:68-75. [PMID: 29140774 DOI: 10.1200/jco.2017.74.9291] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose People with HIV infection have an elevated risk of anal cancer. However, recent calendar trends are incompletely described, and which population subgroups might benefit from cancer screening is unknown. Methods We used linked data from HIV and cancer registries in nine US areas (1996 to 2012). We calculated standardized incidence ratios to compare anal cancer incidence in people with HIV infection with the general population, used Poisson regression to evaluate anal cancer incidence among subgroups of people with HIV and to assess temporal trends, and estimated the cumulative incidence of anal cancer to measure absolute risk. Results Among 447,953 people with HIV infection, anal cancer incidence was much higher than in the general population (standardized incidence ratio, 19.1; 95% CI, 18.1 to 20.0). Anal cancer incidence was highest among men who have sex with men (MSM), increased with age, and was higher in people with AIDS than in those without AIDS (ie, HIV only; adjusted incidence rate ratio, 3.82; 95% CI, 3.27 to 4.46). Incidence among people with HIV increased steeply during 1996 to 2000 (annual percentage change, 32.8%; 95% CI, -1.0% to 78.2%), reached a plateau during 2001 to 2008, and declined during 2008 to 2012 (annual percentage change, -7.2%; 95% CI, -14.4% to 0.6%). Cumulative incidence after a 5-year period was high for MSM with HIV only age 45 to 59 or ≥ 60 years (0.32% to 0.33%) and MSM with AIDS age 30 to 44, 45 to 59, or ≥ 60 years (0.29% to 0.65%). Conclusion Anal cancer incidence is markedly elevated among people with HIV infection, especially in MSM, older individuals, and people with AIDS. Recent declines may reflect delayed benefits of HIV treatment. Groups with high cumulative incidence of anal cancer may benefit from screening.
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Affiliation(s)
- Vivian Colón-López
- Vivian Colón-López, Mark Machin, and Ana P. Ortiz, University of Puerto Rico, San Juan, PR; Meredith S. Shiels, Ruth M. Pfeiffer, and Eric A. Engels, National Cancer Institute, Bethesda, MD; and Howard Strickler and Philip E. Castle, Albert Einstein College of Medicine, Bronx, NY
| | - Meredith S Shiels
- Vivian Colón-López, Mark Machin, and Ana P. Ortiz, University of Puerto Rico, San Juan, PR; Meredith S. Shiels, Ruth M. Pfeiffer, and Eric A. Engels, National Cancer Institute, Bethesda, MD; and Howard Strickler and Philip E. Castle, Albert Einstein College of Medicine, Bronx, NY
| | - Mark Machin
- Vivian Colón-López, Mark Machin, and Ana P. Ortiz, University of Puerto Rico, San Juan, PR; Meredith S. Shiels, Ruth M. Pfeiffer, and Eric A. Engels, National Cancer Institute, Bethesda, MD; and Howard Strickler and Philip E. Castle, Albert Einstein College of Medicine, Bronx, NY
| | - Ana P Ortiz
- Vivian Colón-López, Mark Machin, and Ana P. Ortiz, University of Puerto Rico, San Juan, PR; Meredith S. Shiels, Ruth M. Pfeiffer, and Eric A. Engels, National Cancer Institute, Bethesda, MD; and Howard Strickler and Philip E. Castle, Albert Einstein College of Medicine, Bronx, NY
| | - Howard Strickler
- Vivian Colón-López, Mark Machin, and Ana P. Ortiz, University of Puerto Rico, San Juan, PR; Meredith S. Shiels, Ruth M. Pfeiffer, and Eric A. Engels, National Cancer Institute, Bethesda, MD; and Howard Strickler and Philip E. Castle, Albert Einstein College of Medicine, Bronx, NY
| | - Philip E Castle
- Vivian Colón-López, Mark Machin, and Ana P. Ortiz, University of Puerto Rico, San Juan, PR; Meredith S. Shiels, Ruth M. Pfeiffer, and Eric A. Engels, National Cancer Institute, Bethesda, MD; and Howard Strickler and Philip E. Castle, Albert Einstein College of Medicine, Bronx, NY
| | - Ruth M Pfeiffer
- Vivian Colón-López, Mark Machin, and Ana P. Ortiz, University of Puerto Rico, San Juan, PR; Meredith S. Shiels, Ruth M. Pfeiffer, and Eric A. Engels, National Cancer Institute, Bethesda, MD; and Howard Strickler and Philip E. Castle, Albert Einstein College of Medicine, Bronx, NY
| | - Eric A Engels
- Vivian Colón-López, Mark Machin, and Ana P. Ortiz, University of Puerto Rico, San Juan, PR; Meredith S. Shiels, Ruth M. Pfeiffer, and Eric A. Engels, National Cancer Institute, Bethesda, MD; and Howard Strickler and Philip E. Castle, Albert Einstein College of Medicine, Bronx, NY
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13
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Jung SY, Rohan T, Strickler H, Bea J, Zhang ZF, Ho G, Crandall C. Genetic variants and traits related to insulin-like growth factor-I and insulin resistance and their interaction with lifestyles on postmenopausal colorectal cancer risk. PLoS One 2017; 12:e0186296. [PMID: 29023587 PMCID: PMC5638514 DOI: 10.1371/journal.pone.0186296] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 09/28/2017] [Indexed: 02/08/2023] Open
Abstract
Genetic variants and traits in metabolic signaling pathways may interact with lifestyle factors such as obesity, physical activity, and exogenous estrogen (E), influencing postmenopausal colorectal cancer (CRC) risk, but these interrelated pathways are not fully understood. In this case-cohort study, we examined 33 single-nucleotide polymorphisms (SNPs) in genes related to insulin-like growth factor-I (IGF-I)/ insulin resistance (IR) traits and signaling pathways, using data from 704 postmenopausal women in Women’s Health Initiative Observation ancillary studies. Stratifying by the lifestyle modifiers, we assessed the effects of IGF-I/IR traits (fasting total and free IGF-I, IGF binding protein-3, insulin, glucose, and homeostatic model assessment–insulin resistance) on CRC risk as a mediator or influencing factor. Six SNPs in the INS, IGF-I, and IGFBP3 genes were associated with CRC risk, and those associations differed between non-obese/active and obese/inactive women and between E nonusers and users. Roughly 30% of the cancer risk due to the SNP was mediated by IGF-I/IR traits. Likewise, carriers of 11 SNPs in the IRS1 and AKT1/2 genes (signaling pathway–related genetic variants) had different associations with CRC risk between strata, and the proportion of the SNP–cancer association explained by traits varied from 30% to 50%. Our findings suggest that IGF-I/IR genetic variants interact with obesity, physical activity, and exogenous E, altering postmenopausal CRC risk, through IGF-I/IR traits, but also through different pathways. Unraveling gene–phenotype–lifestyle interactions will provide data on potential genetic targets in clinical trials for cancer prevention and intervention strategies to reduce CRC risk.
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Affiliation(s)
- Su Yon Jung
- Translational Sciences Section, Jonsson Comprehensive Cancer Center, School of Nursing, University of California, Los Angeles, Los Angeles, California, United States of America
- * E-mail:
| | - Thomas Rohan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Howard Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Jennifer Bea
- Medicine & Nutritional Sciences, University of Arizona Cancer Center, Tucson, Arizona, United States of America
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Gloria Ho
- Department of Occupational Medicine, Epidemiology and Prevention, Feinstein Institute for Medical Research, Hofstra Northwell School of Medicine, Great Neck, New York, United States of America
| | - Carolyn Crandall
- Division of General Internal Medicine, Department of Internal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America
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14
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Kimura T, Tse K, Miller J, McArdle S, Vassallo M, Wolf D, Baas L, Kobiyama K, Jenkins MK, James EA, Kwok W, Hanna DB, Kaplan RC, Strickler H, Sidney J, Sette A, Ley K. MHC class II tetramers identify apolipoprotein B-specific CD4 T cells in mice and humans. The Journal of Immunology 2017. [DOI: 10.4049/jimmunol.198.supp.199.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
Immunization with atherosclerotic plaque antigens including MHC-II-restricted peptides from apolipoprotein B (ApoB, core protein of low density lipoprotein, LDL) is known to be atheroprotective in animal models. Herein we report a human ApoB peptide whose sequence is identical to mouse ApoB and which binds to both mouse (I-Ab) and human MHC class II. Immunization with this peptide reduced atherosclerotic plaque in the aortas of Apoe−/− mice fed with a Western diet and induced IL-10 producing CD25+FoxP3+ regulatory T cells (Tregs). After peptide restimulation in vivo, responding CD4+ T cells (by Nur77-GFP) were highly enriched in CD25+FoxP3+ Tregs. Using a novel I-Ab tetramer reagent, we further showed that peptide-specific CD4+ T cells expand upon vaccination, ~50% express FoxP3, and were 10-fold enriched for IL-10 producers. In human peripheral blood mononuclear cells (PBMCs) from individuals assessed for subclinical cardiovascular disease, ApoB-specific CD4+ T cells were detected using novel HLA-DR1/ApoB peptide tetramers. Peptide-specific CD4+ T cells from donors with carotid artery plaques showed more RORγt expression and less FoxP3 expression compared to those without. This is the first demonstration of ApoB-specific CD4+ T cells by tetramer in humans and the first animal model evidence of atheroprotective vaccination with a human ApoB peptide.
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Affiliation(s)
| | - Kevin Tse
- 1La Jolla Inst. for Allergy and Immunology
| | | | | | | | | | - Livia Baas
- 1La Jolla Inst. for Allergy and Immunology
| | | | | | | | | | | | | | | | | | | | - Klaus Ley
- 1La Jolla Inst. for Allergy and Immunology
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15
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Kaplan RC, Strizich G, Aneke-Nash C, Dominguez-Islas C, Bužková P, Strickler H, Rohan T, Pollak M, Kuller L, Kizer JR, Cappola A, Li CI, Psaty BM, Newman A. Insulinlike Growth Factor Binding Protein-1 and Ghrelin Predict Health Outcomes Among Older Adults: Cardiovascular Health Study Cohort. J Clin Endocrinol Metab 2017; 102:267-278. [PMID: 27820656 PMCID: PMC5413102 DOI: 10.1210/jc.2016-2779] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/04/2016] [Indexed: 02/04/2023]
Abstract
CONTEXT Multiple diseases may explain the association of the growth hormone/insulinlike growth factor-I (GH/IGF-I) axis with longevity. OBJECTIVE To relate circulating GH/IGF-I system protein levels with major health events. DESIGN AND SETTING This is a cohort study set in 4 US communities. PARTICIPANTS Adults (N = 2268) 65 years and older free of diabetes and cardiovascular disease. MEASUREMENTS We assessed insulinlike growth factor binding protein-1 (IGFBP-1) and ghrelin in fasting and 2-hour oral glucose tolerance test (OGTT) blood samples, as well as fasting IGF-I and IGFBP-3. Hazard ratios for mortality and a composite outcome for first incident myocardial infarction, stroke, heart failure, hip fracture, or death were adjusted for sociodemographic, behavioral, and physiological covariates. RESULTS During 13,930 person-years of follow-up, 48.1% of individuals sustained one or more components of the composite outcome and 31.8% died. Versus the lowest quartiles, the highest quartiles of fasting and 2-hour ghrelin were associated with 27% higher (95% confidence interval [CI]: 6%, 53%) and 39% higher (95% CI: 14%, 71%) risks of the composite outcome, respectively. The highest quartile of 2-hour IGFBP-1 was associated with 35% higher (95% CI: 1%, 52%) risk of the composite end point. Similarly, higher mortality was significantly associated with higher fasting and 2-hour ghrelin levels and with 2-hour IGFBP-1 level. When examined together, 2-hour post-OGTT levels of IGFBP-1 and ghrelin tended to predict outcomes better than fasting levels. CONCLUSIONS Circulating IGFBP-1 and ghrelin measured during an OGTT predicted major health events and death in older adults, which may explain the influence of the GH/IGF-I axis on lifespan and health.
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Affiliation(s)
| | | | | | | | | | | | - Thomas Rohan
- Department of Epidemiology and Population Health and
| | - Michael Pollak
- Department of Medicine and Oncology, McGill University, Montreal, Quebec, Canada H4A 3J1
| | - Lewis Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261
| | - Jorge R Kizer
- Division of Cardiology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461
| | - Anne Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Christopher I Li
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington 98195
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109; and
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Epidemiology and Health Services, University of Washington & Group Health Research Institute, Group Health Cooperative, Seattle, Washington 98101
| | - Anne Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261
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16
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Robbins HA, Massad LS, Pierce CB, Flowers L, Darragh TM, Minkoff H, Rahangdale L, Keller MJ, Milam J, Fischl M, Shrestha S, Colie C, Strickler H, D’Souza G. Abstract 2580: Optimizing cervical cancer screening for HIV-infected women: A risk-based approach. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-2580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Women living with HIV (WLHIV) have increased cervical cancer risk. Guidelines suggest screening WLHIV with negative cervical cytology annually, and managing WLHIV with ASC-US cytology by general population (GP) guidelines (1 year return if HPV testing unavailable).
Methods: We used risk benchmarking to compare cervical precancer risk in WLHIV to the GP. For WLHIV ages 21-65 years in the Women's Interagency HIV Study (WIHS), we evaluated the first cytology result from 2000 or later. We used parametric survival models to calculate HSIL risks after negative or ASC-US cytology, overall and by CD4 cell count. Separately, we synthesized HSIL risk estimates among GP women in 13 published studies using mixed-effects models. We then benchmarked risks in WLHIV to the 3-year GP risks, which for negative cytology represent the threshold for re-screening.
Results: Among 2,653 WLHIV, 1,982 (75%) had negative cytology and 377 (14%) had ASC-US cytology. Most WLHIV with negative (72%) and ASC-US (52%) cytology had CD4≥350 cells/μL. We observed 95 cases of HSIL (CIN2+; 44 were CIN3+ including 1 cancer) within 5 years of cytology. After negative cytology, 3-year GP risk “benchmarks” were 0.83% (CIN2+) and 0.60% (CIN3+). WLHIV with CD4≥350 met both benchmarks by 2 years (1.1% and 0.68% respectively), while WLHIV with CD4<350 exceeded the CIN2+ benchmark at only 1 year (1.1%). After ASC-US cytology, 3-year GP benchmarks were 8.7% (CIN2+) and 4.4% (CIN3+). For WLHIV with CD4≥350, 3-year risks were similar to the benchmarks (9.4% and 4.0%), but WLHIV with CD4<350 approximated these risks at only 1 year (8.8% and 3.9%).
Conclusions: For WLHIV with CD4≥350, these data suggest that the interval for re-screening after negative cervical cytology can be lengthened from 1 to 2 years, and that inclusion in GP guidelines for managing ASC-US cytology is appropriate. In contrast, WLHIV with CD4<350 remain at increased risk and should be screened annually after negative cervical cytology and referred to colposcopy after ASC-US. Cervical precancer risk after normal or ASC-US cytology in WLHIV compared to the general populationHSIL (CIN2+) risk,%HSIL (CIN2+) risk,%HSIL (CIN2+) risk,%HSIL (CIN3+) risk,%HSIL (CIN3+) risk,%HSIL (CIN3+) risk,%1 year2 years3 years1 year2 years3 yearsNEGATIVE CYTOLOGY:General population benchmark0.830.60HIV+, overall (N = 1,982)0.621.32.00.330.681.0HIV+, CD4≥350 (N = 1,393)0.471.11.70.380.680.96HIV+, CD4<350 (N = 542)1.12.02.80.240.651.1ASC-US CYTOLOGY:General population benchmark8.74.4HIV+, overall (N = 377)7.310.112.23.24.35.2HIV+, CD4≥350 (N = 191)5.57.89.42.53.34.0HIV+, CD4<350 (N = 175)8.812.815.93.95.56.8
Citation Format: Hilary A. Robbins, L. Stewart Massad, Christopher B. Pierce, Lisa Flowers, Teresa M. Darragh, Howard Minkoff, Lisa Rahangdale, Marla J. Keller, Joel Milam, Margaret Fischl, Sadeep Shrestha, Christine Colie, Howard Strickler, Gypsyamber D’Souza. Optimizing cervical cancer screening for HIV-infected women: A risk-based approach. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2580.
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Affiliation(s)
| | | | | | - Lisa Flowers
- 3Grady Memorial Hospital and Emory University School of Medicine, Atlanta, GA
| | | | | | - Lisa Rahangdale
- 6University of North Carolina School of Medicine, Chapel Hill, NC
| | | | - Joel Milam
- 8University of Southern California, Los Angeles, CA
| | | | - Sadeep Shrestha
- 10University of Alabama at Birmingham School of Public Health, Birmingham, AL
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17
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Zhang Y, Waterboer T, Pawlita M, Sugar E, Minkoff H, Cranston RD, Wiley D, Burk R, Reddy S, Margolick J, Strickler H, Weber K, Gillison M, D'Souza G. Human Papillomavirus (HPV) 16 E6 seropositivity is elevated in subjects with oral HPV16 infection. Cancer Epidemiol 2016; 43:30-4. [PMID: 27344614 DOI: 10.1016/j.canep.2016.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/13/2016] [Accepted: 06/15/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Human Papillomavirus (HPV) 16 E6 serum antibodies are common in people with HPV-related oropharyngeal cancers (HPV-OPC), but not the general population. We explored HPV16 seroprevalence in people with and without oral HPV16 infection, the cause of HPV-OPC. METHODS Oral rinse samples were collected semiannually and tested for 36 types of HPV DNA by PCR. HPV16 E6 serum antibodies were tested at the visit of first oral HPV detection in participants with prevalent (n=54), or incident (n=39) oral HPV16 DNA; or at baseline in matched participants with no oral HPV16 DNA (n=155) using multiplex serology assay. Predictors of seropositivity were examined using logistic regression. RESULTS HPV16 E6 seropositivity (7.5% vs 0.7%; p=0.005) but not seropositivity to the other HPV16 antigens, was significantly more common in those with than without oral HPV16 infection. There were only 8 HPV16 E6 seropositive participants, but oral HPV16 DNA remained a strong predictor of E6 seropositivity after adjustment for other risk factors (aOR=14.6 95%CI, 1.7-122.5). Seroprevalence was similar in those with prevalent (7.4%; 4/54), and incident (7.7%; 3/39) oral HPV16 infection (p=1.00). E6 seroprevalence was associated with reduced oral HPV16 clearance, but was not statistically significant (HR=0.65 95% CI, 0.16-2.70). Seropositive participants were primarily male (87.5%), HIV-positive (75.0%; median CD4 cell-count of 840) and had oral HPV16 DNA (87.5%). History of an HPV-related cancer (0/8) or HPV-related anogenital dysplasia (1/8) was rare, and 4 participants had recent screening showing no anogenital dysplasia. DISCUSSION HPV16 E6 seropositivity was higher among people with than without oral HPV16 infection, despite no known anogenital disease in these participants.
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Affiliation(s)
- Yuehan Zhang
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, United States
| | - Tim Waterboer
- German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Michael Pawlita
- German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Elizabeth Sugar
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, United States
| | - Howard Minkoff
- Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, United States
| | - Ross D Cranston
- University of Pittsburgh, 3520 Fifth Avenue, Pittsburgh, PA 15213, United States
| | - Dorothy Wiley
- University of California, Los Angeles, 2-256 Factor Bldg., Los Angeles, CA 90095-1702, United States
| | - Robert Burk
- Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461, United States
| | - Susheel Reddy
- Northwestern University, 645 N Michigan Ave., Chicago, IL 60611, United States
| | - Joseph Margolick
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, United States
| | - Howard Strickler
- Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461, United States
| | - Kathleen Weber
- CORE Center at John H. Stroger Jr. Hospital of Cook County, 2225 W Harrison St., Chicago, IL 60612, United States
| | - Maura Gillison
- Ohio State University Comprehensive Cancer Center, 420 W 12th Ave., Columbus, OH 43210, United States
| | - Gypsyamber D'Souza
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, United States.
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18
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Merritt M, Strickler H, Einstein M, Cossio M, Whitney K, Gunter M, Huang G. Endometrial expression of hormonal and insulin/IGF receptors in relation to cancer risk factors. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Kocarnik JM, Chan AT, Slattery ML, Potter JD, Meyerhardt J, Phipps A, Nan H, Harrison T, Rohan TE, Qi L, Hou L, Caan B, Kroenke CH, Strickler H, Hayes RB, Schoen RE, Chong DQ, White E, Berndt SI, Peters U, Newcomb PA. Relationship of prediagnostic body mass index with survival after colorectal cancer: Stage-specific associations. Int J Cancer 2016; 139:1065-72. [PMID: 27121247 DOI: 10.1002/ijc.30163] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 04/11/2016] [Indexed: 12/11/2022]
Abstract
Higher body mass index (BMI) is a well-established risk factor for colorectal cancer (CRC), but is inconsistently associated with CRC survival. In 6 prospective studies participating in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), 2,249 non-Hispanic white CRC cases were followed for a median 4.5 years after diagnosis, during which 777 died, 554 from CRC-related causes. Associations between prediagnosis BMI and survival (overall and CRC-specific) were evaluated using Cox regression models adjusted for age at diagnosis, sex, study and smoking status (current/former/never). The association between BMI category and CRC survival varied by cancer stage at diagnosis (I-IV) for both all-cause (p-interaction = 0.03) and CRC-specific mortality (p-interaction = 0.04). Compared to normal BMI (18.5-24.9 kg/m(2) ), overweight (BMI 25.0-29.9) was associated with increased mortality among those with Stage I disease, and decreased mortality among those with Stages II-IV disease. Similarly, obesity (BMI ≥30) was associated with increased mortality among those with Stages I-II disease, and decreased mortality among those with Stages III-IV disease. These results suggest the relationship between BMI and survival after CRC diagnosis differs by stage at diagnosis, and may emphasize the importance of adequate metabolic reserves for colorectal cancer survival in patients with late-stage disease.
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Affiliation(s)
- Jonathan M Kocarnik
- Department of Epidemiology, University of Washington, Seattle, WA.,Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Andrew T Chan
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA.,Division of Gastroenterology, Massachusetts General Hospital, Boston, MA
| | - Martha L Slattery
- Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT
| | - John D Potter
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jeffrey Meyerhardt
- Dana-Farber Cancer Institute, Boston, MA.,Brigham and Women's Hospital, Boston, MA
| | - Amanda Phipps
- Department of Epidemiology, University of Washington, Seattle, WA.,Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Hongmei Nan
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN.,Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
| | - Tabitha Harrison
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Thomas E Rohan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Lihong Qi
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA
| | - Lifang Hou
- Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Bette Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Howard Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Richard B Hayes
- Division of Epidemiology, New York University School of Medicine, New York, NY
| | - Robert E Schoen
- Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Dawn Q Chong
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA.,Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Emily White
- Department of Epidemiology, University of Washington, Seattle, WA.,Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Sonja I Berndt
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD
| | - Ulrike Peters
- Department of Epidemiology, University of Washington, Seattle, WA.,Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Polly A Newcomb
- Department of Epidemiology, University of Washington, Seattle, WA.,Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
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20
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Wang A, Stefanick ML, Kapphahn K, Hedlin H, Desai M, Manson JAE, Strickler H, Martin L, Wactawski-Wende J, Simon M, Tang JY. Relation of statin use with non-melanoma skin cancer: prospective results from the Women's Health Initiative. Br J Cancer 2016; 114:314-20. [PMID: 26742009 PMCID: PMC4742576 DOI: 10.1038/bjc.2015.376] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/24/2015] [Accepted: 10/08/2015] [Indexed: 12/12/2022] Open
Abstract
Background: The relationship between statin use and non-melanoma skin cancer (NMSC) is unclear with conflicting findings in literature. Data from the Women's Health Initiative (WHI) Observational Study and WHI Clinical Trial were used to investigate the prospective relationship between statin use and NMSC in non-Hispanic white (NHW) postmenopausal women. Methods: The WHI study enrolled women aged 50–79 years at 40 US centres. Among 133 541 NHW participants, 118 357 with no cancer history at baseline and complete medication/covariate data comprised the analytic cohort. The association of statin use (baseline, overall as a time-varying variable, duration, type, potency, lipophilicity) and NMSC incidence was determined using random-effects logistic regression models. Results: Over a mean of 10.5 years of follow-up, we identified 11 555 NMSC cases. Compared with participants with no statin use, use of any statin at baseline was associated with significantly increased NMSC incidence (adjusted odds ratio (ORadj) 1.21; 95% confidence interval (CI): 1.07–1.35)). In particular, lovastatin (OR 1.52; 95% CI: 1.08–2.16), simvastatin (OR 1.38; 95% CI: 1.12–1.69), and lipophilic statins (OR 1.39; 95% CI: 1.18–1.64) were associated with higher NMSC risk. Low and high, but not medium, potency statins were associated with higher NMSC risk. No significant effect modification of the statin–NMSC relationship was found for age, BMI, smoking, solar irradiation, vitamin D use, and skin cancer history. Conclusions: Use of statins, particularly lipophilic statins, was associated with increased NMSC risk in postmenopausal white women in the WHI cohort. The lack of duration–effect relationship points to possible residual confounding. Additional prospective research should further investigate this relationship.
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Affiliation(s)
- Ange Wang
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway Street, Pavilion B, 4th Floor MC 5338, Redwood City, CA 94063, USA
| | - Marcia L Stefanick
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Kristopher Kapphahn
- Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Haley Hedlin
- Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Manisha Desai
- Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Jo Ann E Manson
- Department of Epidemiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Howard Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Lisa Martin
- Department of Medicine, George Washington University, Washington, DC, USA
| | - Jean Wactawski-Wende
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY, USA
| | - Michael Simon
- Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Jean Y Tang
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway Street, Pavilion B, 4th Floor MC 5338, Redwood City, CA 94063, USA
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21
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Chen L, Duan Z, Tinker L, Sangi-Haghpeykar H, Strickler H, Ho G, Rohan T, Gunter M, Logsdon C, White D, Royse K, El-Serag H, Jiao L. Abstract 937: Soluble receptor for advanced glycation end-products is a player in obesity-related colorectal cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Insulin resistance, adiposity, and chronic inflammation contribute to colorectal cancer (CRC) development. Nϵ-(carboxymethyl)-lysine (CML) is a well-characterized type of advanced glycation end product (AGE). It can bind to the receptor for AGEs (RAGE) and trigger insulin resistance and sustained chronic inflammation. Soluble RAGE (sRAGE) mitigates the detrimental effect of RAGE by acting as a decoy receptor for its ligands. In a case-cohort study within the Women's Health Initiative Observational study, we examined the association between CML-AGE, sRAGE and risk of CRC among 447 cases and 802 subcohort controls. Information on lifestyle, anthropometry, medical history, and diet were collected at baseline. Levels of CML-AGE and sRAGE were measured by ELISA using fasting blood collected at baseline. Circulating levels of adipokines, insulin, glucose, estradiol, and C-reactive protein were previously measured for the study subjects. Multivariate Cox proportional hazard regression model accounting for the case-cohort design was used to estimate hazard ratio (HR) and 95% confidence interval (CI) for CRC according to quartile (Q) of biomarkers with adjustment for age, race, waist circumstance, smoking, family history of colorectal cancer, NASID, energy intake, physical activity, alcohol consumption, saturated fat intake, available carbohydrate intake, hypertension, hormone replacement therapy, calcium, folate equivalent, red meat, insulin, and adiponectin. Average participant follow-up was 7.8 years. Among 802 subcohort controls, CML-AGE and sRAGE were both significantly inversely correlated with BMI, waist circumference, serum insulin, glucose, and leptin, but positively correlated with adiponectin (P values < 0.05). sRAGE levels were inversely associated with CRC (HRQ2 vs Q1:0.53; 95% CI: 0.31-0.90; HRQ4 vs Q1: 0.81; 95% CI: 0.46-1.42) (Ptrend = 0.95). This inverse association was evident among women who had BMI ≥ 25 kg/m2 (HRQ2 vs Q1: 0.49; 95% CI: 0.25-0.99; HRQ4 vs Q1: 0.43, 95% CI: 0.19-0.97) (Ptrend = 0.22), but not among women with normal BMI (BMI < 25) (HRQ4 vs Q1: 1.72, 95% CI:0.53-5.55) (P value for interaction was 0.01). CML-AGE was not associated with CRC risk (HRQ4 vs Q1: 0.78, 95% CI: 0.48-1.37) (Ptrend = 0.18). We found pre-diagnostic sRAGE levels were inversely associated with risk of CRC among overweight and obese postmenopausal women. This study identifed the RAGE pathway as a potential etiological factor in obesity-associated CRC.
Citation Format: Liang Chen, Zhigang Duan, Lesley Tinker, Haleh Sangi-Haghpeykar, Howard Strickler, Gloria Ho, Thomas Rohan, Marc Gunter, Craig Logsdon, Donna White, Kathryn Royse, Hashem El-Serag, Li Jiao. Soluble receptor for advanced glycation end-products is a player in obesity-related colorectal cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 937. doi:10.1158/1538-7445.AM2015-937
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Affiliation(s)
- Liang Chen
- 1Baylor College of Medicine, Houston, TX
| | | | | | | | | | - Gloria Ho
- 4Albert Einstein College of Medicine, Bronx, NY
| | | | - Marc Gunter
- 5Imperial College London, London, United Kingdom
| | | | | | | | | | - Li Jiao
- 1Baylor College of Medicine, Houston, TX
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Van Arsdale A, Einstein M, Kaur G, Strickler H, Moadel A, Girda E, Goldberg G, Nevadunsky N. Association between statin use and disease-specific endometrial cancer survival. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sinayobye JD, Sklar M, Hoover DR, Shi Q, Dusingize JC, Cohen M, Mutimura E, Asiimwe-Kateera B, Castle PE, Strickler H, Anastos K. Prevalence and risk factors for High-Risk Human Papillomavirus (hrHPV) infection among HIV-infected and Uninfected Rwandan women: implications for hrHPV-based screening in Rwanda. Infect Agent Cancer 2014; 9:40. [PMID: 25926864 PMCID: PMC4413542 DOI: 10.1186/1750-9378-9-40] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 11/05/2014] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND New World Health Organization guidelines recommend high-risk human papillomavirus (hrHPV) screen-and-treat strategies for cervical cancer prevention. We describe risk of, and risk factors for, testing hrHPV positive in a pilot study of hrHPV screen-and-treat conducted in Rwanda. METHODS A total of 2,964 women, 1,289 HIV-infected (HIV [+]) and 1,675 HIV-uninfected (HIV [-]), aged 30-60 years and living in Rwanda were enrolled in 2010. Cervical specimens were collected and tested by careHPV, a DNA test for a pool of 14 hrHPV types. Prevalence with binomial 95% confidence intervals (95% CI) and determinants of testing hrHPV positive were calculated. RESULTS hrHPV prevalence was higher in HIV [+] (31.8%, 95% CI = 29.2-34.4%) than HIV [-] women (8.2%, 95% CI = 6.7-9.8%; P < 0.0001). Among HIV [+] women, there was a significant trend (ptrend <0.001) of higher hrHPV prevalence with lower CD4 cell count, with the highest hrHPV prevalence among those with <200 CD4 cell counts (45.5%, 95% CI = 34.8-56.4%). In multivariate analysis of HIV [+] women, testing hrHPV positive was positively associated CD4 count of <200 cells/μL, history of 3 or more sexual partners, and history of using hormonal contraception, and negatively associated with older age. In HIV [-] women, testing hrHPV positive was negatively associated only with older age groups of 45-49 and 50-60 years and surprisingly was not associated with lifetime number of sexual partners. CONCLUSION hrHPV prevalence is high in HIV [+], especially in women with the lowest CD4 cell counts, which may have implications for utilizing hrHPV-based screening strategies such as screen-and-treat in these high-risk subgroups.
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Affiliation(s)
| | - Marc Sklar
- Albert Einstein College of Medicine, Bronx, NY USA
| | - Donald R Hoover
- Albert Einstein College of Medicine, Bronx, NY USA ; Rutgers University, New Brunswick, NJ USA
| | - Qiuhu Shi
- NY Medical College, Valhalla, NY USA
| | - Jean Claude Dusingize
- Regional Alliance for Sustainable Development (RASD), P. O. Box 1544, Kigali, Rwanda
| | - Mardge Cohen
- John Stroger (Cook County) Hospital, Chicago, IL USA
| | - Eugene Mutimura
- Regional Alliance for Sustainable Development (RASD), P. O. Box 1544, Kigali, Rwanda
| | | | - Philip E Castle
- Albert Einstein College of Medicine, Bronx, NY USA ; Global Coalition Against Cervical Cancer, Arlington, VA USA
| | - Howard Strickler
- Regional Alliance for Sustainable Development (RASD), P. O. Box 1544, Kigali, Rwanda
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Yavorsky RL, Hollman D, Steever J, Soghomonian C, Diaz A, Strickler H, Schlecht N, Burk RD, Ochner CN. Prevalence of sexually transmitted infections in at-risk adolescent females at a comprehensive, stand-alone adolescent health center in New York City. Clin Pediatr (Phila) 2014; 53:890-5. [PMID: 24807980 PMCID: PMC4239196 DOI: 10.1177/0009922814533816] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sexually transmitted infections (STIs) are common among adolescents, and multiple STIs over one's lifetime can increase health risks. Few studies have assessed lifetime STI prevalence. This study evaluates minority, underserved adolescents' self-reported lifetime STI history and objective STI rates. METHODS Lifetime STI rates of female patients at an urban adolescent health center were obtained from self-administered questionnaires. Additionally, STI test results were retrieved from electronic medical records. RESULTS Patients reported a high lifetime prevalence of STIs. By comparing self-report and objective data, underreporting was identified for chlamydia, gonorrhea, and herpes. CONCLUSIONS STI rates in at-risk adolescent females are higher than in the general population and remain elevated over time. Lifetime STI reports could expand our understanding of sexual health and should be further studied. Underreporting, which may increase health risks and hinder health care delivery, requires further investigation. Improvements in STI screening and prevention targeting at-risk populations are warranted.
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Affiliation(s)
| | | | - John Steever
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Angela Diaz
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Chlebowski RT, McTiernan A, Wactawski-Wende J, Manson JE, Aragaki AK, Rohan T, Ipp E, Kaklamani VG, Vitolins M, Wallace R, Gunter M, Phillips LS, Strickler H, Margolis K, Euhus DM. Diabetes, metformin, and breast cancer in postmenopausal women. J Clin Oncol 2012; 30:2844-52. [PMID: 22689798 DOI: 10.1200/jco.2011.39.7505] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Emerging evidence suggests that metformin may reduce breast cancer incidence, but reports are mixed and few provide information on tumor characteristics. Therefore, we assessed associations among diabetes, metformin use, and breast cancer in postmenopausal women participating in Women's Health Initiative clinical trials. PATIENTS AND METHODS In all, 68,019 postmenopausal women, including 3,401 with diabetes at study entry, were observed over a mean of 11.8 years with 3,273 invasive breast cancers diagnosed. Diabetes incidence status was collected throughout follow-up, with medication information collected at baseline and years 1, 3, 6, and 9. Breast cancers were confirmed by review of central medical records and pathology reports. Cox proportional hazards regression, adjusted for breast cancer risk factors, compared breast cancer incidence in women with diabetes who were metformin users or nonusers with breast cancer incidence in women without diabetes. RESULTS Compared with that in women without diabetes, breast cancer incidence in women with diabetes differed by diabetes medication type (P = .04). Women with diabetes receiving medications other than metformin had a slightly higher incidence of breast cancer (hazard ratio [HR], 1.16; 95% CI, 0.93 to 1.45), and women with diabetes who were given metformin had lower breast cancer incidence (HR, 0.75; 95% CI, 0.57 to 0.99). The association was observed for cancers positive for both estrogen receptor and progesterone receptor and those that were negative for human epidermal growth factor receptor 2. CONCLUSION Metformin use in postmenopausal women with diabetes was associated with lower incidence of invasive breast cancer. These results can inform future studies evaluating metformin use in breast cancer management and prevention.
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Affiliation(s)
- Rowan T Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
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Chlebowski RT, McTiernan A, Aragaki AK, Rohan T, Wactawski-Wende J, Ipp E, Euhus D, Kaklamani VG, Vitolins M, Wallace RB, Liu S, Gunter MJ, Phillips L, Strickler H, Howard B. Metformin and breast cancer incidence in postmenopausal diabetic women in the Women’s Health Initiative (WHI). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1503] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Einstein M, Belbin T, Adrien L, Goldberg G, Strickler H, Burk R, Schlecht N. Prospective identification of epigenetic signatures that predict clinical outcomes in high-risk human papillomavirus-positive early cervical intraepithelial neoplasia. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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D'Souza G, Jing Y, Strickler H, Silverberg M, Engels E, Bosch R, Brooks JT, Dubrow R, Eron J, Gebo K, Gill MJ, Hogg B, Kitahata M, Klein M, Moore R, Rourke S, Abraham AG. Cervical cancer epidemiology among HIV-infected women in North America. Infect Agent Cancer 2010. [PMCID: PMC3002751 DOI: 10.1186/1750-9378-5-s1-a9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Wang T, Ho G, Ye K, Strickler H, Elston RC. A partial least-square approach for modeling gene-gene and gene-environment interactions when multiple markers are genotyped. Genet Epidemiol 2009; 33:6-15. [PMID: 18615621 DOI: 10.1002/gepi.20351] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Genetic association studies achieve an unprecedented level of resolution in mapping disease genes by genotyping dense single nucleotype polymorphisms (SNPs) in a gene region. Meanwhile, these studies require new powerful statistical tools that can optimally handle a large amount of information provided by genotype data. A question that arises is how to model interactions between two genes. Simply modeling all possible interactions between the SNPs in two gene regions is not desirable because a greatly increased number of degrees of freedom can be involved in the test statistic. We introduce an approach to reduce the genotype dimension in modeling interactions. The genotype compression of this approach is built upon the information on both the trait and the cross-locus gametic disequilibrium between SNPs in two interacting genes, in such a way as to parsimoniously model the interactions without loss of useful information in the process of dimension reduction. As a result, it improves power to detect association in the presence of gene-gene interactions. This approach can be similarly applied for modeling gene-environment interactions. We compare this method with other approaches, the corresponding test without modeling any interaction, that based on a saturated interaction model, that based on principal component analysis, and that based on Tukey's one-degree-of-freedom model. Our simulations suggest that this new approach has superior power to that of the other methods. In an application to endometrial cancer case-control data from the Women's Health Initiative, this approach detected AKT1 and AKT2 as being significantly associated with endometrial cancer susceptibility by taking into account their interactions with body mass index.
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Affiliation(s)
- Tao Wang
- Division of Biostatistics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, USA.
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Minkoff H, Shen X, Xian LS, Watts DH, Leighty R, Hershow R, Palefsky J, Tuomala R, Neu N, Zorrilla CD, Paul M, Strickler H. Relationship of Pregnancy to Human Papillomavirus Among Human Immunodeficiency Virus–Infected Women. Obstet Gynecol 2006; 108:953-60. [PMID: 17012459 DOI: 10.1097/01.aog.0000236447.81813.c3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Because parity is a reported risk factor for cervical cancer, we sought to estimate the effects of pregnancy on the prevalence, incident detection, and copy number of human papillomavirus (HPV) among human immunodeficiency virus (HIV)-infected women, patients at high risk for cervical cancer. METHODS Human immunodeficiency virus-infected women who had a pregnancy in the Women's Interagency HIV Study (n = 178) and the Women and Infants Transmission Study (n = 450) underwent serial type-specific HPV DNA testing using MY09/MY11 polymerase chain reaction. During pregnancy and during the prepregnancy and postpregnancy periods, we assessed HPV prevalence, incident detection, and HPV copy number (estimated using hybridization signal strength) of both oncogenic and nononcogenic HPV. All binary-regression analyses incorporated generalized estimating equations to address the repeated observations of the same women over time, and were further adjusted for parity, gestational age, smoking, antiretroviral use, number of lifetime sexual partners, and oral contraceptive use. RESULTS The prevalence and copy number of oncogenic and nononcogenic HPV did not significantly differ between pregnancy and either the prepregnancy or postpregnancy periods. Incident HPV detection was significantly lower for both oncogenic and nononcogenic HPV during pregnancy compared with the postpregnancy period (relative risk 0.534, 95% confidence interval 0.390-0.732, P < .001 and relative risk 0.577, 95% confidence interval 0.428-0.779, P < .001, respectively), but not compared with the prepregnancy period CONCLUSION Among HIV-infected women, the incident detection of HPV is lower during pregnancy compared with postpregnancy, while prevalence and copy number do no differ between pregnancy and either prepregnancy or postpregnancy. LEVEL OF EVIDENCE II-3.
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Affiliation(s)
- Howard Minkoff
- Department of Obstetrics and Gynecology, Maimonides Medical Center and SUNY Downstate, Brooklyn, New York, USA.
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Huang JM, Anastos K, Robison E, Shi R, Freeman K, Strickler H, Steinberg JJ. Evaluation of DNA adduction of AZT in peripheral blood leukocytes of HIV-infected individuals by (32)P-post-labeling thin-layer chromatography: a feasibility study. J Chromatogr B Analyt Technol Biomed Life Sci 2005; 810:1-6. [PMID: 15358301 DOI: 10.1016/j.jchromb.2004.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2003] [Accepted: 06/22/2004] [Indexed: 11/28/2022]
Abstract
3'-Azido-3'-deoxythymidine (AZT, Zidovudine) has been effectively used for HIV infection treatment. It inhibits virus reproduction through viral reverse transcriptase inhibition. However, the side effects of this anti-retroviral drug might be cumulative, particularly in its effects on the patients' DNA. As a nucleoside analogue, AZT might incorporate into hosts' DNA, and then form DNA adducts. This may result in potential long-term risks of mutagenesis in AIDS patients who received therapy. In this feasibility study, a (32)P-post-labeling thin-layer chromatography (TLC) assay is successfully used to measure AZT-DNA analogue and adducts formed in peripheral blood leukocytes of AZT treated patients. There are DNA analogue/adducts measured in all four AZT treated patients' DNA specimens. This assay is reliable with the significant coefficient of correlation in both intra-assay (r = 0.8761, P = 0.0001) and inter-assay (r = 0.8761, P = 0.0001).
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Affiliation(s)
- Jerry M Huang
- Novartis Pharmaceuticals Corporation, One Health Plaza, 122-S337, East Hanover, NJ 07936, USA
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32
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Viscidi RP, Ahdieh-Grant L, Schneider MF, Clayman B, Massad LS, Anastos KM, Burk RD, Minkoff H, Palefsky J, Levine A, Strickler H. Serum Immunoglobulin A Response to Human Papillomavirus Type 16 Virus–Like Particles in Human Immunodeficiency Virus (HIV)–Positive and High‐Risk HIV–Negative Women. J Infect Dis 2003; 188:1834-44. [PMID: 14673762 DOI: 10.1086/379975] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2003] [Accepted: 07/17/2003] [Indexed: 11/04/2022] Open
Abstract
Serum samples from 2008 human immunodeficiency virus (HIV)-positive and 551 HIV-negative women were tested for immunoglobulin A (IgA) to human papillomavirus (HPV) type 16 capsids. IgA seropositivity was lower than previously reported IgG seropositivity (7% vs. 51%), but, like IgG antibodies, HPV 16 IgA was associated with sexual behavior, cervicovaginal HPV 16 DNA, and cytological abnormalities. IgA seropositivity was higher in HIV-positive women than in HIV-negative women (7.7% vs. 4.9%; P=.02), but the association was lost after adjustment for HPV 16 cervicovaginal infection. IgA, but not IgG, seropositivity was associated with progression to high-grade cytological abnormalities (relative hazard [RH], 2.2 [95% confidence interval, 1.2-4.2]), raising the possibility that an IgA response to HPV 16, as described for other DNA viruses, may be a marker of persistent viral replication. The risk of incident infection with non-16-related HPV types was increased in IgA seropositive women (RH, 1.8 [95% confidence interval, 1.3-2.6]), compared with seronegative women (RH, 2.2 [95% confidence interval, 0.9-5.4]), but there was no difference in the risk of incident HPV 16 or HPV 16-related infections. This may be evidence of partial type-specific or clade-specific immunity conferred by seropositivity to HPV 16 capsids.
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Affiliation(s)
- Raphael P Viscidi
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Viscidi RP, Ahdieh-Grant L, Clayman B, Fox K, Massad LS, Cu-Uvin S, Shah KV, Anastos KM, Squires KE, Duerr A, Jamieson DJ, Burk RD, Klein RS, Minkoff H, Palefsky J, Strickler H, Schuman P, Piessens E, Miotti P. Serum immunoglobulin G response to human papillomavirus type 16 virus-like particles in human immunodeficiency virus (HIV)-positive and risk-matched HIV-negative women. J Infect Dis 2003; 187:194-205. [PMID: 12552444 DOI: 10.1086/346052] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2002] [Revised: 09/09/2002] [Indexed: 11/04/2022] Open
Abstract
Baseline serum samples from 2815 human immunodeficiency virus (HIV)-positive and 963 HIV-negative women enrolled in 2 cohort studies were tested for immunoglobulin G antibodies to human papillomavirus type 16 (HPV-16) capsids. HPV-16 seropositivity was associated with lifetime number of sex partners (P<.001) among both HIV-positive and HIV-negative women. Approximately 50%-60% of HPV-16 DNA-positive women were HPV-16 positive. HPV-16 seropositivity was associated with HIV infection; however, after adjustment for baseline cervical HPV infection and disease, the association disappeared. Thus, the high seroprevalence of HPV-16 among HIV-positive women may be explained by a high prevalence of HPV of all types. Approximately 50% of HIV-positive women had serological evidence of prior HPV-16 infection, but only approximately 5% had an HPV-16 cervical infection at baseline. Despite the higher prevalence of HPV infection in this group, most HIV-positive women are able to control HPV-16 replication at the cervix, and reactivation, if it occurs, is not very common.
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Affiliation(s)
- Raphael P Viscidi
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Strickler H, Shah K. Re: Comparison of three management strategies for patients with atypical squamous cells of undetermined significance: baseline results from a randomized trial. J Natl Cancer Inst 2001; 93:951; author reply 951-2. [PMID: 11416120 DOI: 10.1093/jnci/93.12.951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hayes RB, Pottern LM, Strickler H, Rabkin C, Pope V, Swanson GM, Greenberg RS, Schoenberg JB, Liff J, Schwartz AG, Hoover RN, Fraumeni JF. Sexual behaviour, STDs and risks for prostate cancer. Br J Cancer 2000; 82:718-25. [PMID: 10682688 PMCID: PMC2363322 DOI: 10.1054/bjoc.1999.0986] [Citation(s) in RCA: 137] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A population-based case-control study was carried out among 981 men (479 black, 502 white) with pathologically confirmed prostate cancer and 1315 controls (594 black, 721 white). In-person interviews elicited information on sexual behaviour and other potential risk factors for prostate cancer. Blood was drawn for serologic studies in a subset of the cases (n = 276) and controls (n = 295). Prostate cancer risk was increased among men who reported a history of gonorrhoea or syphilis (odds ratio (OR) = 1.6; 95% confidence internal (CI) 1.2-2.1) or showed serological evidence of syphilis (MHA-TP) (OR = 1.8; 95% CI 1.0-3.5). Patterns of risk for gonorrhoea and syphilis were similar for blacks (OR = 1.7; 95% CI 1.2-2.2) and whites (OR = 1.6; 95% CI 0.8-3.2). Risks increased with increasing occurrences of gonorrhoea, rising to OR = 3.3 (95% CI 1.4-7.8) among subjects with three or more events (Ptrend = 0.0005). Frequent sexual encounters with prostitutes and failure to use condoms were also associated with increased risk. Syphilis, gonorrhoea, sex with prostitutes and unprotected sexual intercourse may be indicators of contact with a sexually transmissible factor that increases the risk of prostate cancer.
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Affiliation(s)
- R B Hayes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
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Weiss R, Giordano A, Furth P, DeCaprio J, Pipas J, Ozer H, Strickler H, Procopio A, Garcea R, Carbone M. SV40 as an oncogenic virus and possible human pathogen. Dev Biol Stand 1998; 94:355-60, 369-82. [PMID: 9776256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Abstract
Cytologic screening in combination with ablative therapy has helped reduce cervical cancer mortality in the developed world. Despite the success of this approach, cervical cancer remains a major cause of death, especially among women with limited access to health care. Recognition that human papillomaviruses (HPVs) are the main etiologic agent in cervical cancer suggests that a prophylactic vaccine could reduce the incidence of HPV infection and, therefore, achieve cancer control with reduced reliance on costly screening programs. In this review, the rationale for developing a prophylactic HPV vaccine and the potential impact that vaccination would have on cervical cancer screening are discussed.
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Affiliation(s)
- M E Sherman
- Department of Pathology, George Washington University Medical Center, Washington, D.C., USA
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Strickler H. Correspondence re: F. Martini et al., SV40 early region and large T antigen in human brain tumors, peripheral blood cells, and sperm fluids from healthy individuals. Cancer Res., 56: 4820-4825, 1996. Cancer Res 1997; 57:3319-20. [PMID: 9242467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Abstract
Estimating human immunodeficiency virus (HIV) prevalence from sentinel seroprevalence studies is difficult. We characterize these studies and show that most are investigations of incompletely defined (hypothetical) cohorts and are usually based on nonprobability samples. Prevalence in HIV sentinel serosurveys is also time-averaged and vulnerable to several time-dependent sources of bias (e.g., migration, deaths, and changes in incidence). Assumptions must be made that these time-dependent biases did not meaningfully affect the data, and this can be helped by reducing the period of investigation. Furthermore, we show that "reliability" can not be adequately measured by standard error, that "internal validity" is vulnerable to self-selection bias and laboratory problems, and that "generalizability" is limited. We propose that what is needed is a procedure (like formal metaanalysis methods) incorporating information from several separate HIV sentinel seroprevalence studies, in a manner that is reproducible and can take into consideration the differences between studies.
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Affiliation(s)
- H Strickler
- Viral Epidemiology Branch, Division of Cancer Etiology, National Cancer Institute, National Institutes of Health, Rockville, MD 20852, USA
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Affiliation(s)
- D M Dwyer
- Epidemiology and Disease Control Program, Maryland Department of Health and Mental Hygiene, Baltimore
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Ohloff G, Strickler H, Willhalm B, Borer C, Hinder M. �ber En-synthesen mit Singulett-Sauerstoff [1] II. Die Farbstoff-sensibilisierte Photooxygenierung von (?)-Thujopsen und die Stereochemie der dargestellten Thujopsanole. Helv Chim Acta 1970. [DOI: 10.1002/hlca.19700530321] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Strickler H, Sz. Kováts E. 245. Zur Kenntnis ätherischer Öle 5. Mitteilung [1] Zwei Monoterpenoxide aus dem sog. «destillierten» Limetten-Öl (Citrus medicaL.,var. AcidaBrandis;Citrus aurantifoliaSwingle). Helv Chim Acta 1966. [DOI: 10.1002/hlca.660490712] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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