1
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Song M, Jayasekara H, Pelucchi C, Rabkin CS, Johnson KC, Hu J, Palli D, Ferraroni M, Liao LM, Bonzi R, Zaridze D, Maximovitch D, Aragonés N, Martin V, Castaño-Vinyals G, Guevara M, Tsugane S, Hamada GS, Hidaka A, Negri E, Ward MH, Sinha R, Lagiou A, Lagiou P, Boffetta P, Curado MP, Lunet N, Vioque J, Zhang ZF, La Vecchia C, Camargo MC. Reproductive factors, hormonal interventions, and gastric cancer risk in the Stomach cancer Pooling (StoP) Project. Cancer Causes Control 2024; 35:727-737. [PMID: 38123742 DOI: 10.1007/s10552-023-01829-1] [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] [Received: 09/28/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Gastric cancer incidence is higher in men, and a protective hormone-related effect in women is postulated. We aimed to investigate and quantify the relationship in the Stomach cancer Pooling (StoP) Project consortium. METHODS A total of 2,084 cases and 7,102 controls from 11 studies in seven countries were included. Summary odds ratios (ORs) and 95% confidence intervals (CIs) assessing associations of key reproductive factors and menopausal hormone therapy (MHT) with gastric cancer were estimated by pooling study-specific ORs using random-effects meta-analysis. RESULTS A duration of fertility of ≥ 40 years (vs. < 20), was associated with a 25% lower risk of gastric cancer (OR = 0.75; 95% CI: 0.58-0.96). Compared with never use, ever, 5-9 years and ≥ 10 years use of MHT in postmenopausal women, showed ORs of 0.73 (95% CI: 0.58-0.92), 0.53 (95% CI: 0.34-0.84) and 0.71 (95% CI: 0.50-1.00), respectively. The associations were generally similar for anatomical and histologic subtypes. CONCLUSION Our results support the hypothesis that reproductive factors and MHT use may lower the risk of gastric cancer in women, regardless of anatomical or histologic subtypes. Given the variation in hormones over the lifespan, studies should address their effects in premenopausal and postmenopausal women. Furthermore, mechanistic studies may inform potential biological processes.
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Affiliation(s)
- Minkyo Song
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Harindra Jayasekara
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Claudio Pelucchi
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Charles S Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Kenneth C Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rossella Bonzi
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - David Zaridze
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Registration and Surveillance Unit, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Vicente Martin
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Barcelona Institute for Global Health-ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Salud Pública y Laboral de Navarra, 31003, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Carlo La Vecchia
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
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Kocakavuk E, Varn FS, Johnson KC, Verhaak RGW. JS08.7.A Integrative analysis of longitudinal genomic and non-genetic mechanisms of radiotherapy-resistance in glioma. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.026] [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: 11/13/2022] Open
Abstract
Abstract
Background
Radiotherapy (RT) is a mainstay in the treatment of glioma patients, but RT-resistance is common. We have recently identified RT-associated genomic small deletion signatures, marking tumors that have developed resistance. Here, we used longitudinal molecular profiles to explore non-genetic mechanisms of RT-resistance.
Material and Methods
We have analyzed the multi-omic Glioma Longitudinal Analysis (GLASS) dataset, integrating DNA and RNA sequencing datasets from primary and post-treatment gliomas.
Results
We classified tumors as harboring temozolomide-associated hypermutation based on mutational burden increase (HM), and RT-associated signature based on small deletion burden increase (RTscars). By deconvoluting RNA profiles into cell state fractions, we observed an increase of a proliferating stem-like (PSL) cell state in 50% of patients with a RTscars+ signature which was significantly higher than RTscars-/HM- patients (P=8e-04, Fisher’s exact). PSL cell state increase associated with worse overall survival outcomes (P=1.5e-03, log-rank). We observed a significant correlation between the expression change of E2F cell cycle regulator genes (R=0.91, P=6.7e-04, Pearson) and EZH2 (R=0.81, P=8.3e-03) with the increase in the PSL cell state, nominating the E2F/EZH2-pathway as regulator of the PSL cell state. Furthermore, the RTscars signature was associated with an increase in frameshift neoantigens and significantly higher neoantigen burden at recurrence (P=2.4e-02, Kruskal-Wallis). This was accompanied by a significantly higher post-treatment T-cell fraction in RTscars+ tumors (P=8.2e-04, Wilcox), suggesting an increased T-cell infiltration in these patients.
Conclusion
Our analyses revealed a longitudinal increase in the proliferating stem-like cell state associated with RT-resistance and nominates the cell cycle pathway as an actionable target. The RT-associated deletion signature (RTscars) correlated with increased frameshift-neoantigens and T-cell fractions at recurrence, suggesting a potential benefit of a combinatorial immune-targeted therapy in this specific patient population.
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Affiliation(s)
- E Kocakavuk
- The Jackson Laboratory for Genomic Medicine , Farmington, CT , United States
- University Hospital Essen , Essen , Germany
| | - F S Varn
- The Jackson Laboratory for Genomic Medicine , Farmington, CT , United States
| | - K C Johnson
- The Jackson Laboratory for Genomic Medicine , Farmington, CT , United States
| | - R G W Verhaak
- The Jackson Laboratory for Genomic Medicine , Farmington, CT , United States
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Johnson KC, Daviss BA. Birth certificate study comparing United States birth centers to hospitals: conclusions exceed the evidence. Am J Obstet Gynecol 2022; 226:597-598. [PMID: 34838798 DOI: 10.1016/j.ajog.2021.11.1361] [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] [Received: 10/22/2021] [Accepted: 11/23/2021] [Indexed: 11/01/2022]
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4
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Affiliation(s)
| | - Kenneth C Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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5
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Kocakavuk E, Anderson KJ, Varn FS, Johnson KC, Amin SB, Sulman EP, Lolkema MP, Barthel FP, Verhaak RGW. PL03.2.A Radiotherapy is associated with a deletion signature that contributes to poor outcomes in glioma patients. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.004] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Diffuse gliomas are highly aggressive brain tumors that invariably relapse despite treatment with chemo- and radiotherapy. Treatment with alkylating chemotherapy can drive tumors to develop a hypermutator phenotype. In contrast, the genomic effects of radiation therapy (RT) remain largely unknown.
MATERIAL AND METHODS
We analyzed the mutational spectra following treatment with RT in whole genome or exome sequencing data from 190 paired primary-recurrent gliomas from the Glioma Longitudinal Analysis (GLASS) dataset and 3693 post-treatment metastatic tumors from the Hartwig Medical Foundation (HMF).
RESULTS
We identified a significant increase in the burden of small deletions following radiation therapy that was independent of other factors (P = 3e-03, multivariable log-linear regression). These novel deletions demonstrated distinct characteristics when compared to pre-existing deletions present prior to RT-treatment and deletions in RT-untreated tumors. Radiation therapy-acquired deletions were characterized by a larger deletion size (GLASS and HMF, P = 1.5e-04 and P = 6e-16, respectively; Mann-Whitney U test), an increased distance to repetitive DNA elements (P < 2.2e-16, Kolmogorov-Smirnov test) and a lack of microhomology at breakpoints (P = 6.6e-05, paired Wilcoxon signed-rank test). Furthermore, mutational signature analysis confirmed the distinct genomic characteristics of RT-associated deletions when compared to deletions arising via homologous recombination deficiency or microsatellite instability.
These observations suggested that canonical non-homologous end joining (c-NHEJ) was the preferred pathway for DNA double strand break repair of RT-induced DNA damage. Furthermore, RT resulted in frequent chromosomal deletions and significantly increased frequencies of CDKN2A homozygous deletions in IDHmut glioma (P= 1.9e-05, Fisher’s exact test). Finally, a high burden of RT-associated deletions was associated with worse clinical outcomes (GLASS and HMF, P = 3.4e-02 and P < 1e-04, respectively; log-rank test).
CONCLUSION
Our results collectively suggest that effective repair of RT-induced DNA damage is detrimental to patient survival and that inhibiting c-NHEJ may be a viable strategy for improving the cancer-killing effect of radiotherapy. Furthermore, CDKN2A homozygous deletion at recurrence may be leveraged as a promising clinical biomarker of RT-resistance in IDHmut glioma. Taken together, the identified genomic scars as a result of RT reflect a more aggressive tumor with increased levels of resistance to follow up treatments.
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Affiliation(s)
- E Kocakavuk
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, United States
| | - K J Anderson
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, United States
| | - F S Varn
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, United States
| | - K C Johnson
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, United States
| | - S B Amin
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, United States
| | - E P Sulman
- NYU Langone Health, New York, NY, United States
| | - M P Lolkema
- Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - F P Barthel
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, United States
| | - R G W Verhaak
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, United States
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6
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Daviss BA, Anderson DA, Johnson KC. Pivoting to Childbirth at Home or in Freestanding Birth Centers in the US During COVID-19: Safety, Economics and Logistics. Front Sociol 2021; 6:618210. [PMID: 33869572 PMCID: PMC8022486 DOI: 10.3389/fsoc.2021.618210] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/19/2021] [Indexed: 05/23/2023]
Abstract
Birth-related decisions principally center on safety; giving birth during a pandemic brings safety challenges to a new level, especially when choosing the birth setting. Amid the COVID-19 crisis, the concurrent work furloughs, business failures, and mounting public and private debt have made prudent expenditures an inescapable second concern. This article examines the intersections of safety, economic efficiency, insurance, liability and birthing persons' needs that have become critical as the pandemic has ravaged bodies and economies around the world. Those interests, and the challenges and solutions discussed in this article, remain important even in less troubled times. Our economic analysis suggests that having an additional 10% of deliveries take place in private homes or freestanding birth centers could save almost $11 billion per year in the United States without compromising safety.
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Affiliation(s)
- Betty-Anne Daviss
- The Pauline Jewett Institute of Women’s and Gender Studies, Faculty of Arts and Social Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Kenneth C. Johnson
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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7
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Ferro A, Costa AR, Morais S, Bertuccio P, Rota M, Pelucchi C, Hu J, Johnson KC, Zhang ZF, Palli D, Ferraroni M, Yu GP, Bonzi R, Peleteiro B, López-Carrillo L, Tsugane S, Hamada GS, Hidaka A, Malekzadeh R, Zaridze D, Maximovitch D, Vioque J, Navarrete-Munoz EM, Alguacil J, Castaño-Vinyals G, Wolk A, Håkansson N, Hernández-Ramírez RU, Pakseresht M, Ward MH, Pourfarzi F, Mu L, López-Cervantes M, Persiani R, Kurtz RC, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, Camargo MC, Curado MP, La Vecchia C, Lunet N. Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project. Int J Cancer 2020; 147:3090-3101. [PMID: 32525569 PMCID: PMC8545605 DOI: 10.1002/ijc.33134] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 10/19/2019] [Revised: 03/20/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022]
Abstract
A low intake of fruits and vegetables is a risk factor for gastric cancer, although there is uncertainty regarding the magnitude of the associations. In our study, the relationship between fruits and vegetables intake and gastric cancer was assessed, complementing a previous work on the association betweenconsumption of citrus fruits and gastric cancer. Data from 25 studies (8456 cases and 21 133 controls) with information on fruits and/or vegetables intake were used. A two-stage approach based on random-effects models was used to pool study-specific adjusted (sex, age and the main known risk factors for gastric cancer) odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Exposure-response relations, including linear and nonlinear associations, were modeled using one- and two-order fractional polynomials. Gastric cancer risk was lower for a higher intake of fruits (OR: 0.76, 95% CI: 0.64-0.90), noncitrus fruits (OR: 0.86, 95% CI: 0.73-1.02), vegetables (OR: 0.68, 95% CI: 0.56-0.84), and fruits and vegetables (OR: 0.61, 95% CI: 0.49-0.75); results were consistent across sociodemographic and lifestyles categories, as well as study characteristics. Exposure-response analyses showed an increasingly protective effect of portions/day of fruits (OR: 0.64, 95% CI: 0.57-0.73 for six portions), noncitrus fruits (OR: 0.71, 95% CI: 0.61-0.83 for six portions) and vegetables (OR: 0.51, 95% CI: 0.43-0.60 for 10 portions). A protective effect of all fruits, noncitrus fruits and vegetables was confirmed, supporting further dietary recommendations to decrease the burden of gastric cancer.
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Affiliation(s)
- Ana Ferro
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Ana Rute Costa
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Samantha Morais
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Matteo Rota
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Kenneth C. Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson, Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network – ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Bárbara Peleteiro
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Eva M. Navarrete-Munoz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona,Spain
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
- Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
| | - Mary H. Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | | | - Roberto Persiani
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Roma, Italia
- Università Cattolica del Sacro Cuore, Dipartimento di Chirurgia, Roma, Italia
| | - Robert C. Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stefania Boccia
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - M. Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brasil
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Nuno Lunet
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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8
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Yu EY, Wesselius A, Sinhart C, Wolk A, Stern MC, Jiang X, Tang L, Marshall J, Kellen E, van den Brandt P, Lu CM, Pohlabeln H, Steineck G, Allam MF, Karagas MR, La Vecchia C, Porru S, Carta A, Golka K, Johnson KC, Benhamou S, Zhang ZF, Bosetti C, Taylor JA, Weiderpass E, Grant EJ, White E, Polesel J, Zeegers MP. A data mining approach to investigate food groups related to incidence of bladder cancer in the BLadder cancer Epidemiology and Nutritional Determinants International Study. Br J Nutr 2020; 124:611-619. [PMID: 32321598 PMCID: PMC9429981 DOI: 10.1017/s0007114520001439] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
At present, analysis of diet and bladder cancer (BC) is mostly based on the intake of individual foods. The examination of food combinations provides a scope to deal with the complexity and unpredictability of the diet and aims to overcome the limitations of the study of nutrients and foods in isolation. This article aims to demonstrate the usability of supervised data mining methods to extract the food groups related to BC. In order to derive key food groups associated with BC risk, we applied the data mining technique C5.0 with 10-fold cross-validation in the BLadder cancer Epidemiology and Nutritional Determinants study, including data from eighteen case-control and one nested case-cohort study, compromising 8320 BC cases out of 31 551 participants. Dietary data, on the eleven main food groups of the Eurocode 2 Core classification codebook, and relevant non-diet data (i.e. sex, age and smoking status) were available. Primarily, five key food groups were extracted; in order of importance, beverages (non-milk); grains and grain products; vegetables and vegetable products; fats, oils and their products; meats and meat products were associated with BC risk. Since these food groups are corresponded with previously proposed BC-related dietary factors, data mining seems to be a promising technique in the field of nutritional epidemiology and deserves further examination.
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Affiliation(s)
- Evan Y.W. Yu
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Anke Wesselius
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Christoph Sinhart
- DKE Scientific staff, Data Science & Knowledge Engineering, Faculty of Science and Engineering
| | - Alicja Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Mariana Carla Stern
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Xuejuan Jiang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Li Tang
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - James Marshall
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Eliane Kellen
- Leuven University Centre for Cancer Prevention (LUCK), Leuven, Belgium
| | - Piet van den Brandt
- Department of Epidemiology, Schools for Oncology and Developmental Biology and Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Chih-Ming Lu
- Department of Urology, Buddhist Dalin Tzu Chi General Hospital, Dalin Township 62247, Chiayi County, Taiwan
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Gunnar Steineck
- Department of Oncology and Pathology, Division of Clinical Cancer Epidemiology, Karolinska Hospital, Stockholm, Sweden
| | - Mohamed Farouk Allam
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Cordoba, Cordoba, Spain
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Carlo La Vecchia
- Department of Clinical Medicine and Community Health, University of Milan, Milan, Italy
| | - Stefano Porru
- Department of Diagnostics and Public Health, Section of Occupational Health, University of Verona, Italy
- University Research Center “Integrated Models for Prevention and Protection in Environmental and Occupational Health” MISTRAL, University of Verona, Milano Bicocca and Brescia, Italy
| | - Angela Carta
- University Research Center “Integrated Models for Prevention and Protection in Environmental and Occupational Health” MISTRAL, University of Verona, Milano Bicocca and Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy
| | - Klaus Golka
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund, Dortmund, Germany
| | - Kenneth C. Johnson
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Simone Benhamou
- INSERM U946, Variabilite Genetique et Maladies Humaines, Fondation Jean Dausset/CEPH, Paris, France
| | - Zuo-Feng Zhang
- Departments of Epidemiology, UCLA Center for Environmental Genomics, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri-IRCCS, Milan, Italy
| | - Jack A. Taylor
- Epidemiology Branch, and Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Eric J. Grant
- Department of Epidemiology Radiation Effects Research Foundation, Hiroshima, Japan
| | - Emily White
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Maurice P.A. Zeegers
- CAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands
- School of Cancer Sciences, University of Birmingham, Birmingham, UK
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9
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Shah SC, Boffetta P, Johnson KC, Hu J, Palli D, Ferraroni M, Tsugane S, Hamada GS, Hidaka A, Zaridze D, Maximovich D, Vioque J, Navarrete-Munoz EM, Zhang ZF, Mu L, Boccia S, Pastorino R, Kurtz RC, Rota M, Bonzi R, Negri E, La Vecchia C, Pelucchi C, Hashim D. Occupational exposures and odds of gastric cancer: a StoP project consortium pooled analysis. Int J Epidemiol 2020; 49:422-434. [PMID: 31965145 PMCID: PMC10507679 DOI: 10.1093/ije/dyz263] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 11/21/2019] [Accepted: 12/02/2019] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Gastric cancer pathogenesis represents a complex interaction of host genetic determinants, microbial virulence factors and environmental exposures. Our primary aim was to determine the association between occupations/occupational exposures and odds of gastric cancer. METHODS We conducted a pooled-analysis of individual-level data harmonized from 11 studies in the Stomach cancer Pooling Project. Multivariable logistic regression was used to estimate the odds ratio (OR) of gastric cancer adjusted for relevant confounders. RESULTS A total of 5279 gastric cancer cases and 12 297 controls were analysed. There were higher odds of gastric cancer among labour-related occupations, including: agricultural and animal husbandry workers [odds ratio (OR) 1.33, 95% confidence interval (CI): 1.06-1.68]; miners, quarrymen, well-drillers and related workers (OR 1.70, 95% CI: 1.01-2.88); blacksmiths, toolmakers and machine-tool operators (OR 1.41, 95% CI: 1.05-1.89); bricklayers, carpenters and construction workers (OR 1.30, 95% CI: 1.06-1.60); and stationary engine and related equipment operators (OR 6.53, 95% CI: 1.41-30.19). The ORs for wood-dust exposure were 1.51 (95% CI: 1.01-2.26) for intestinal-type and 2.52 (95% CI: 1.46-4.33) for diffuse-type gastric cancer. Corresponding values for aromatic amine exposure were 1.83 (95% CI: 1.09-3.06) and 2.92 (95% CI: 1.36-6.26). Exposure to coal derivatives, pesticides/herbicides, chromium, radiation and magnetic fields were associated with higher odds of diffuse-type, but not intestinal-type gastric cancer. CONCLUSIONS Based on a large pooled analysis, we identified several occupations and related exposures that are associated with elevated odds of gastric cancer. These findings have potential implications for risk attenuation and could be used to direct investigations evaluating the impact of targeted gastric cancer prevention/early detection programmes based on occupation.
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Affiliation(s)
- Shailja C Shah
- Gastroenterology, Hepatology and Nutrition, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Paolo Boffetta
- Tisch Cancer Institute, Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth C Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovich
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Jesus Vioque
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Campus San Juan, Alicante, Spain
| | - Eva M Navarrete-Munoz
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Campus San Juan, Alicante, Spain
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Stefania Boccia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Roberta Pastorino
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Matteo Rota
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Dana Hashim
- Tisch Cancer Institute, Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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10
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Ferro A, Rosato V, Rota M, Costa AR, Morais S, Pelucchi C, Johnson KC, Hu J, Palli D, Ferraroni M, Zhang ZF, Bonzi R, Yu GP, Peleteiro B, López-Carrillo L, Tsugane S, Hamada GS, Hidaka A, Zaridze D, Maximovitch D, Vioque J, Navarrete-Munoz EM, Aragonés N, Martín V, Hernández-Ramírez RU, Bertuccio P, Ward MH, Malekzadeh R, Pourfarzi F, Mu L, López-Cervantes M, Persiani R, Kurtz RC, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, Camargo MC, Curado MP, La Vecchia C, Lunet N. Meat intake and risk of gastric cancer in the Stomach cancer Pooling (StoP) project. Int J Cancer 2019; 147:45-55. [PMID: 31584199 DOI: 10.1002/ijc.32707] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [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: 03/19/2019] [Revised: 07/17/2019] [Accepted: 07/23/2019] [Indexed: 12/12/2022]
Abstract
The consumption of processed meat has been associated with noncardia gastric cancer, but evidence regarding a possible role of red meat is more limited. Our study aims to quantify the association between meat consumption, namely white, red and processed meat, and the risk of gastric cancer, through individual participant data meta-analysis of studies participating in the "Stomach cancer Pooling (StoP) Project". Data from 22 studies, including 11,443 cases and 28,029 controls, were used. Study-specific odds ratios (ORs) were pooled through a two-stage approach based on random-effects models. An exposure-response relationship was modeled, using one and two-order fractional polynomials, to evaluate the possible nonlinear association between meat intake and gastric cancer. An increased risk of gastric cancer was observed for the consumption of all types of meat (highest vs. lowest tertile), which was statistically significant for red (OR: 1.24; 95% CI: 1.00-1.53), processed (OR: 1.23; 95% CI: 1.06-1.43) and total meat (OR: 1.30; 95% CI: 1.09-1.55). Exposure-response analyses showed an increasing risk of gastric cancer with increasing consumption of both processed and red meat, with the highest OR being observed for an intake of 150 g/day of red meat (OR: 1.85; 95% CI: 1.56-2.20). This work provides robust evidence on the relation between the consumption of different types of meat and gastric cancer. Adherence to dietary recommendations to reduce meat consumption may contribute to a reduction in the burden of gastric cancer.
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Affiliation(s)
- Ana Ferro
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Valentina Rosato
- Unit of Medical Statistics, Biometry and Bioinformatics, National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - Matteo Rota
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Ana Rute Costa
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Kenneth C Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Zuo-Feng Zhang
- Department of Epidemiology, Comprehensive Cancer Center, UCLA Fielding School of Public Health and Jonsson, Los Angeles, CA
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Bárbara Peleteiro
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Eva M Navarrete-Munoz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Vicente Martín
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Research Group in Gene-Environment Interactions and Health, University of León, León, Spain
| | - Raúl Ulisses Hernández-Ramírez
- Mexico National Institute of Public Health, Morelos, Mexico.,Department of Biostatistics, Yale School of Medicine, Yale School of Public Health, New Haven, CT
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.,Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | | | - Roberto Persiani
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Rome, Italy.,Dipartimento di Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY
| | - Areti Lagiou
- Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Paolo Boffetta
- Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stefania Boccia
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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11
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Tao MH, Chen S, Freudenheim JL, Cauley JA, Johnson KC, Mai X, Sarto GE, Wakelee H, Boffetta P, Wactawski-Wende J. Oral bisphosphonate use and lung cancer incidence among postmenopausal women. Ann Oncol 2019; 29:1476-1485. [PMID: 29617712 PMCID: PMC6005043 DOI: 10.1093/annonc/mdy097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Bisphosphonates are common medications for the treatment of osteoporosis in older populations. Several studies, including the Women’s Health Initiative (WHI), have found inverse associations of bisphosphonate use with risk of breast and endometrial cancer, but little is known about its association with other common malignancies. The objective of this study was to evaluate the association of bisphosphonate use on the incidence of lung cancer in the WHI. Patients and methods The association between oral bisphosphonate use and lung cancer risk was examined in 151 432 postmenopausal women enrolled into the WHI in 1993–1998. At baseline and during follow-up, participants completed an inventory of regularly used medications including bisphosphonates. Results After a mean follow-up of 13.3 years, 2511 women were diagnosed with incident lung cancer. There was no evidence of a difference in lung cancer incidence between oral bisphosphonate users and never users (adjusted hazard ratio = 0.91; 95% confidence intervals, 0.80–1.04; P = 0.16). However, an inverse association was observed among those who were never smokers (hazard ratio = 0.57, 95% confidence interval, 0.39–0.84; P < 0.01). Conclusion In this large prospective cohort of postmenopausal women, oral bisphosphonate use was associated with significantly lower lung cancer risk among never smokers, suggesting bisphosphonates may have a protective effect against lung cancer. Additional studies are needed to confirm our findings.
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Affiliation(s)
- M H Tao
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, USA.
| | - S Chen
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, USA
| | - J L Freudenheim
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, USA
| | - J A Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, USA
| | - K C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - X Mai
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, USA
| | - G E Sarto
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, USA
| | - H Wakelee
- Division of Oncology, Department of Medicine, Stanford University and Stanford Cancer Institute, Stanford, USA
| | - P Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - J Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, USA
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12
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Carbone LD, Vasan S, Prentice RL, Harshfield G, Haring B, Cauley JA, Johnson KC. The renin-angiotensin aldosterone system and osteoporosis: findings from the Women's Health Initiative. Osteoporos Int 2019; 30:2039-2056. [PMID: 31209511 DOI: 10.1007/s00198-019-05041-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/30/2019] [Indexed: 01/30/2023]
Abstract
UNLABELLED New users of RAAS inhibitors, including ACE inhibitors and ARBs, have a small increased risk for fracture in the first 3 years of use, with a reduced risk of fracture with longer duration of use. INTRODUCTION Pharmacological inhibitors of the renin-angiotensin aldosterone system (RAAS) are used to treat hypertension. However, the relationship of these medications to osteoporosis is inconsistent, and no study has included simultaneous measurements of both incident fractures and bone mineral density (BMD). METHODS The association of RAAS inhibitor use (n = 131,793) with incident fractures in new users of these medications in women in the Women's Health Initiative over a minimum median follow-up of 6.5 years was assessed by Cox proportional hazard models. The association of incident fractures by a cumulative duration of use of these medications (< 3 years.) and (> 3 years.) was also estimated. Subgroup analysis of fracture risk by RAAS inhibitor use confined to women with hypertension was also performed (n = 33,820). The association of RAAS inhibitor use with changes in BMD of the hip was estimated by linear regression in 8940 women with dual energy X-ray absorptiometry measurements. RESULTS There was no significant association between RAAS inhibitor use and all fractures in the final adjusted multivariable models including hip BMD (HR 0.86 (0.59, 1.24)). However, among users of RAAS inhibitors, including ACE inhibitors and angiotensin receptor blockers (ARBs), hazard ratios for all incident fracture sites in final multivariable models including hip BMD showed dramatic differences by duration of use, with short duration of use (3 years or less) associated with a marked increased risk for fracture (HR 3.28 (1.66, 6.48)) to (HR 6.23 (3.11, 12.46)) and use for more than 3 years associated with a reduced fracture risk (HR 0.40 (0.24, 0.68) to (HR 0.44 (0.20, 0.97)) . Findings were similar in the subgroup of women with a history of hypertension. There was no significant change in BMD of the hip by RAAS inhibitor use. CONCLUSIONS In postmenopausal women, use of RAAS inhibitors, including ACE inhibitors and ARBs, is associated with an increased risk for fracture among new users of these medications in the first 3 years of use. However, long-term use (> 3 years) is associated with a reduced risk. Consideration for fracture risk may be part of the decision-making process for initiation of these medications for other disease states.
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Affiliation(s)
- L D Carbone
- Department of Medicine, Division of Rheumatology, J. Harold Harrison MD, Distinguished University Chair in Rheumatology, Medical College of Georgia at Augusta University, Augusta, GA, USA.
- Charlie Norwood Veterans Affairs Medical Center, Augusta, GA, USA.
| | - S Vasan
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - R L Prentice
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - G Harshfield
- Georgia Prevention Institute, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - B Haring
- Department of Medicine, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Bavaria, Germany
| | - J A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - K C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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13
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Rota M, Alicandro G, Pelucchi C, Bonzi R, Bertuccio P, Hu J, Zhang ZF, Johnson KC, Palli D, Ferraroni M, Yu GP, Galeone C, López-Carrillo L, Muscat J, Lunet N, Ferro A, Ye W, Plymoth A, Malekzadeh R, Zaridze D, Maximovitch D, Kogevinas M, Fernández de Larrea N, Vioque J, Navarrete-Muñoz EM, Tsugane S, Hamada GS, Hidaka A, Pakseresht M, Wolk A, Håkansson N, Hernández-Ramírez RU, López-Cervantes M, Ward M, Pourfarzi F, Mu L, Kurtz RC, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, La Vecchia C. Education and gastric cancer risk-An individual participant data meta-analysis in the StoP project consortium. Int J Cancer 2019; 146:671-681. [PMID: 30919464 DOI: 10.1002/ijc.32298] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 09/07/2018] [Revised: 01/30/2019] [Accepted: 02/14/2019] [Indexed: 01/11/2023]
Abstract
Low socioeconomic position (SEP) is a strong risk factor for incidence and premature mortality from several cancers. Our study aimed at quantifying the association between SEP and gastric cancer (GC) risk through an individual participant data meta-analysis within the "Stomach cancer Pooling (StoP) Project". Educational level and household income were used as proxies for the SEP. We estimated pooled odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) across levels of education and household income by pooling study-specific ORs through random-effects meta-analytic models. The relative index of inequality (RII) was also computed. A total of 9,773 GC cases and 24,373 controls from 25 studies from Europe, Asia and America were included. The pooled OR for the highest compared to the lowest level of education was 0.60 (95% CI, 0.44-0.84), while the pooled RII was 0.45 (95% CI, 0.29-0.69). A strong inverse association was observed both for noncardia (OR 0.39, 95% CI, 0.22-0.70) and cardia GC (OR 0.47, 95% CI, 0.22-0.99). The relation was stronger among H. pylori negative subjects (RII 0.14, 95% CI, 0.04-0.48) as compared to H. pylori positive ones (RII 0.29, 95% CI, 0.10-0.84), in the absence of a significant interaction (p = 0.28). The highest household income category showed a pooled OR of 0.65 (95% CI, 0.48-0.89), while the corresponding RII was 0.40 (95% CI, 0.22-0.72). Our collaborative pooled-analysis showed a strong inverse relationship between SEP indicators and GC risk. Our data call for public health interventions to reduce GC risk among the more vulnerable groups of the population.
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Affiliation(s)
- Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gianfranco Alicandro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Italian National Institute of Statistics, Rome, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Kenneth C Johnson
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Carlotta Galeone
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Joshua Muscat
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Penn Sylvania State University College of Medicine, Hershey, PA, USA
| | - Nuno Lunet
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Ana Ferro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amelie Plymoth
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Nerea Fernández de Larrea
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Jesus Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Eva M Navarrete-Muñoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada.,Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Raúl Ulises Hernández-Ramírez
- Mexico National Institute of Public Health, Morelos, Mexico.,Department of Biostatistics, Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA
| | | | - Mary Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Stefania Boccia
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italia
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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14
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Bertuccio P, Alicandro G, Rota M, Pelucchi C, Bonzi R, Galeone C, Bravi F, Johnson KC, Hu J, Palli D, Ferraroni M, López‐Carrillo L, Lunet N, Ferro A, Malekzadeh R, Zaridze D, Maximovitch D, Vioque J, Navarrete‐Munoz EM, Pakseresht M, Hernández‐Ramírez RU, López‐Cervantes M, Ward M, Pourfarzi F, Tsugane S, Hidaka A, Zhang Z, Kurtz RC, Lagiou P, Lagiou A, Boffetta P, Boccia S, Negri E, La Vecchia C. Citrus fruit intake and gastric cancer: The stomach cancer pooling (StoP) project consortium. Int J Cancer 2019; 144:2936-2944. [PMID: 30521095 DOI: 10.1002/ijc.32046] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/14/2018] [Accepted: 11/21/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Paola Bertuccio
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Gianfranco Alicandro
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Matteo Rota
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Carlotta Galeone
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Francesca Bravi
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Kenneth C. Johnson
- School of Epidemiology, Public Health and Preventive MedicineUniversity of Ottawa Ottawa ON Canada
| | - Jinfu Hu
- Harbin Medical University Harbin China
| | - Domenico Palli
- Cancer Risk Factors and Life‐Style Epidemiology UnitInstitute for Cancer Research, Prevention and Clinical Network ‐ ISPRO Florence Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | | | - Nuno Lunet
- Departamento de Ciências da Saúde Pública e Forenses e Educação MédicaFaculdade de Medicina da Universidade do Porto Porto Portugal
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto Porto Portugal
| | - Ana Ferro
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto Porto Portugal
| | - Reza Malekzadeh
- Digestive Oncology Research CenterDigestive Disease Research Institute, Tehran University of Medical Sciences Tehran Iran
| | - David Zaridze
- Department of Epidemiology and PreventionRussian N.N. Blokhin Cancer Research Center Moscow Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and PreventionRussian N.N. Blokhin Cancer Research Center Moscow Russia
| | - Jesus Vioque
- CIBER Epidemiologia y Salud Publica (CIBERESP) Madrid Spain
- Department of Public HealthMiguel Hernandez University, FISABIO‐ISABIAL Alicante Spain
| | - Eva M. Navarrete‐Munoz
- CIBER Epidemiologia y Salud Publica (CIBERESP) Madrid Spain
- Department of Public HealthMiguel Hernandez University, FISABIO‐ISABIAL Alicante Spain
| | - Mohammadreza Pakseresht
- Digestive Oncology Research CenterDigestive Disease Research Institute, Tehran University of Medical Sciences Tehran Iran
- Department of Agricultural, Food and Nutritional SciencesUniversity of Alberta Edmonton AB Canada
- Nutritional Epidemiology Group, Centre for Epidemiology and BiostatisticsUniversity of Leeds Leeds United Kingdom
| | - Raúl U. Hernández‐Ramírez
- Mexico National Institute of Public Health Morelos Mexico
- Department of BiostatisticsYale School of Public Health, Yale School of Medicine New Haven CT USA
| | - Malaquias López‐Cervantes
- Dirección General de Planeación y Desarrollo en SaludSecretaría de Salud. Coyoacán 1501 Ciudad de México Mexico
| | - Mary Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer Institute Rockville MD USA
| | - Farhad Pourfarzi
- Digestive Oncology Research CenterDigestive Disease Research Institute, Tehran University of Medical Sciences Tehran Iran
- Digestive Disease Research CenterArdabil University of Medical Sciences Ardabil Iran
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health SciencesNational Cancer Center Tokyo Japan
| | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health SciencesNational Cancer Center Tokyo Japan
| | - Zuo‐Feng Zhang
- Department of EpidemiologyUCLA Fielding School of Public Health and Jonsson, Comprehensive Cancer Center CA Los Angeles USA
| | - Robert C. Kurtz
- Department of MedicineMemorial Sloan Kettering Cancer Centre New York NY USA
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical StatisticsSchool of Medicine, National and Kapodistrian University of Athens Athens Greece
- Department of EpidemiologyHarvard T.H. Chan School of Public Health Boston MA USA
| | - Areti Lagiou
- Department of Public and Community HealthSchool of Health Sciences, University of West Attica Egaleo Greece
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai New York NY USA
| | - Stefania Boccia
- Università Cattolica del Sacro CuoreSezione di Igiene, Istituto di Sanità Pubblica Rome Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCSUOC Igiene Ospedaliera Rome Italia
| | - Eva Negri
- Department of Biomedical and Clinical SciencesUniversità degli Studi di Milano Milan Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
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15
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Ferro A, Morais S, Rota M, Pelucchi C, Bertuccio P, Bonzi R, Galeone C, Zhang ZF, Matsuo K, Ito H, Hu J, Johnson KC, Yu GP, Palli D, Ferraroni M, Muscat J, Malekzadeh R, Ye W, Song H, Zaridze D, Maximovitch D, Fernández de Larrea N, Kogevinas M, Vioque J, Navarrete-Muñoz EM, Pakseresht M, Pourfarzi F, Wolk A, Orsini N, Bellavia A, Håkansson N, Mu L, Pastorino R, Kurtz RC, Derakhshan MH, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, La Vecchia C, Peleteiro B, Lunet N. Alcohol intake and gastric cancer: Meta-analyses of published data versus individual participant data pooled analyses (StoP Project). Cancer Epidemiol 2018; 54:125-132. [PMID: 29727805 DOI: 10.1016/j.canep.2018.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 08/21/2017] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Individual participant data pooled analyses allow access to non-published data and statistical reanalyses based on more homogeneous criteria than meta-analyses based on systematic reviews. We quantified the impact of publication-related biases and heterogeneity in data analysis and presentation in summary estimates of the association between alcohol drinking and gastric cancer. METHODS We compared estimates obtained from conventional meta-analyses, using only data available in published reports from studies that take part in the Stomach Cancer Pooling (StoP) Project, with individual participant data pooled analyses including the same studies. RESULTS A total of 22 studies from the StoP Project assessed the relation between alcohol intake and gastric cancer, 19 had specific data for levels of consumption and 18 according to cancer location; published reports addressing these associations were available from 18, 5 and 5 studies, respectively. The summary odds ratios [OR, (95%CI)] estimate obtained with published data for drinkers vs. non-drinkers was 10% higher than the one obtained with individual StoP data [18 vs. 22 studies: 1.21 (1.07-1.36) vs. 1.10 (0.99-1.23)] and more heterogeneous (I2: 63.6% vs 54.4%). In general, published data yielded less precise summary estimates (standard errors up to 2.6 times higher). Funnel plot analysis suggested publication bias. CONCLUSION Meta-analyses of the association between alcohol drinking and gastric cancer tended to overestimate the magnitude of the effects, possibly due to publication bias. Additionally, individual participant data pooled analyses yielded more precise estimates for different levels of exposure or cancer subtypes.
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Affiliation(s)
- Ana Ferro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal
| | - Matteo Rota
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Carlotta Galeone
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Jinfu Hu
- Department of Epidemiology, Harbin Medical University, Harbin, China
| | - Kenneth C Johnson
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Joshua Muscat
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Huan Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Nerea Fernández de Larrea
- Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jesus Vioque
- Miguel Hernandez University and ISABIAL-FISABIO Foundation, Campus San Juan, Alicante, Spain
| | - Eva M Navarrete-Muñoz
- Miguel Hernandez University and ISABIAL-FISABIO Foundation, Campus San Juan, Alicante, Spain
| | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada; Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala Sweden
| | - Nicola Orsini
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Bellavia
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Roberta Pastorino
- Section of Hygiene - Institute of Public Health; Università Cattolica del Sacro Cuore, IRCCS Fondazione Policlinico "Agostino Gemelli", L.go F. Vito, 1 - 00168, Rome, Italy
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Mohammad H Derakhshan
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, United Kingdom; Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Areti Lagiou
- Department of Public Health and Community Health, School of Health Professions, Athens Technological Educational Institute, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefania Boccia
- Section of Hygiene - Institute of Public Health; Università Cattolica del Sacro Cuore, IRCCS Fondazione Policlinico "Agostino Gemelli", L.go F. Vito, 1 - 00168, Rome, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Bárbara Peleteiro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
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16
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Affiliation(s)
- Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Kenneth C Johnson
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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17
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Abstract
Our primary objective was to compare neonatal and maternal outcomes in women with twin pregnancies, beyond 32 weeks, having a planned vaginal birth or a planned caesarean section (CS). This was a retrospective cohort study from a single tertiary centre over nine years. 534 sets of twins ≥32 + 0 weeks of gestation were included. 401 sets were planned vaginally and 133 sets were planned by CS. We compared a composite adverse perinatal outcome (perinatal mortality or serious neonatal morbidity; five minute APGAR score ≤4, neurological abnormality and need for intubation) and a composite maternal adverse outcome (major haemorrhage, trauma or infection) between the groups. There were no significant differences. Given the similarity of these results with several other larger studies of twin birth, we sought to look at reasons why there is still a rising rate of CS for twin births. We further make suggestions for keeping this rate to a sensible minimum. Impact statement What is already known on this subject? The largest randomised controlled study comparing planned vaginal birth with planned CSs for lower risk twins between 32 and 39 weeks of gestation, showed no added safety from planned CS. However, in most of the Western countries this conclusion has failed to increase the number of planned vaginal births for lower risk twins. What do the results of this study add? This observational study from a single tertiary centre provides external validation of the twin trial results in a practical day-to-day setting. It also provides insights as to how planned vaginal birth can be developed and maintained, with a key focus on safety and maternal participation in decision making. It does focus on consent and providing accurate data. What are the implications of these findings for clinical practice and/or further research? There are good grounds to encourage vaginal birth for low-risk twin pregnancies. The trend of rising caesarean rates in low-risk twin pregnancies worldwide will erode important skills for the conduct of vaginal births without any clear benefit for mothers or babies. The current situation demands careful thought about implementing innovative training opportunities for younger obstetricians. Finally, we need intelligent responses to many non-evidence-based factors which can drive clinical practice.
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Affiliation(s)
- A Reitter
- a Department of Obstetrics and Gynaecology , University Hospital Frankfurt, Goethe-University , Frankfurt , Germany
| | - B A Daviss
- b Department of Obstetrics and Gynaecology, Midwifery Division , Montfort Hospital , Ottawa , Canada
| | - M J Krimphove
- a Department of Obstetrics and Gynaecology , University Hospital Frankfurt, Goethe-University , Frankfurt , Germany
| | - K C Johnson
- c Department of Epidemiology and Community Medicine , University of Ottawa , Ottawa , Canada
| | - R Schlößer
- d Department of Pediatrics, Division Neonatology , University Hospital Frankfurt, Goethe-University , Frankfurt , Germany
| | - F Louwen
- a Department of Obstetrics and Gynaecology , University Hospital Frankfurt, Goethe-University , Frankfurt , Germany
| | - A Bisits
- e Department of Obstetrics and Gynecology, Royal Hospital for Women , University of New South Wales , Randwick , Australia
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18
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Affiliation(s)
- Kenneth C Johnson
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
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19
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Rota M, Pelucchi C, Bertuccio P, Matsuo K, Zhang ZF, Ito H, Hu J, Johnson KC, Palli D, Ferraroni M, Yu GP, Muscat J, Lunet N, Peleteiro B, Ye W, Song H, Zaridze D, Maximovitch D, Guevara M, Fernández-Villa T, Vioque J, Navarrete-Muñoz EM, Wolk A, Orsini N, Bellavia A, Håkansson N, Mu L, Persiani R, Kurtz RC, Lagiou A, Lagiou P, Galeone C, Bonzi R, Boffetta P, Boccia S, Negri E, La Vecchia C. Alcohol consumption and gastric cancer risk-A pooled analysis within the StoP project consortium. Int J Cancer 2017; 141:1950-1962. [PMID: 28718913 DOI: 10.1002/ijc.30891] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [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: 01/25/2017] [Revised: 05/22/2017] [Accepted: 05/29/2017] [Indexed: 01/11/2023]
Abstract
An association between heavy alcohol drinking and gastric cancer risk has been recently reported, but the issue is still open to discussion and quantification. We investigated the role of alcohol drinking on gastric cancer risk in the "Stomach cancer Pooling (StoP) Project," a consortium of epidemiological studies. A total of 9,669 cases and 25,336 controls from 20 studies from Europe, Asia and North America were included. We estimated summary odds-ratios (ORs) and the corresponding 95% confidence intervals (CIs) by pooling study-specific ORs using random-effects meta-regression models. Compared with abstainers, drinkers of up to 4 drinks/day of alcohol had no increase in gastric cancer risk, while the ORs were 1.26 (95% CI, 1.08-1.48) for heavy (>4 to 6 drinks/day) and 1.48 (95% CI 1.29-1.70) for very heavy (>6 drinks/day) drinkers. The risk for drinkers of >4 drinks/day was higher in never smokers (OR 1.87, 95% CI 1.35-2.58) as compared with current smokers (OR 1.14, 95% CI 0.93-1.40). Somewhat stronger associations emerged with heavy drinking in cardia (OR 1.61, 95% CI 1.11-2.34) than in non-cardia (OR 1.28, 95% CI 1.13-1.45) gastric cancers, and in intestinal-type (OR 1.54, 95% CI 1.20-1.97) than in diffuse-type (OR 1.29, 95% CI 1.05-1.58) cancers. The association was similar in strata of H. pylori infected (OR = 1.52, 95% CI 1.16-2.00) and noninfected subjects (OR = 1.69, 95% CI 0.95-3.01). Our collaborative pooled-analysis provides definite, more precise quantitative evidence than previously available of an association between heavy alcohol drinking and gastric cancer risk.
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Affiliation(s)
- Matteo Rota
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Claudio Pelucchi
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA
| | - Hidemi Ito
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Jinfu Hu
- Department of Epidemiology, Harbin Medical University, Harbin, China
| | - Kenneth C Johnson
- School of Epidemiology, Public Health and Preventive Medicine (SEPHPM), University of Ottawa, ON, Canada
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Joshua Muscat
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Penn Sylvania State University College of Medicine, Hershey, PA
| | - Nuno Lunet
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal.,Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Bárbara Peleteiro
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal.,Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Huan Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Marcela Guevara
- Public Health Institute of Navarra, IdiSNA, Pamplona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain
| | - Tania Fernández-Villa
- Research Group on Gene-Environment Interactions (GIGAS), University of Leòn, Leòn, Spain
| | - Jesus Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain.,Department of Public Health, Miguel Hernandez University, Campus San Juan, Alicante, Spain
| | - Eva M Navarrete-Muñoz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain.,Department of Public Health, Miguel Hernandez University, Campus San Juan, Alicante, Spain
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nicola Orsini
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Bellavia
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, NY
| | - Roberto Persiani
- Department of Surgical Sciences, Division of General Surgery, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli", Rome, Italy
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, NY
| | - Areti Lagiou
- Department of Public Health and Community Health, School of Health Professions, Athens Technological Educational Institute, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Carlotta Galeone
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, NY
| | - Stefania Boccia
- Section of Hygiene - Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli,", Rome, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Italy
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Fabian ID, Stacey AW, Johnson KC, Chowdhury T, Duncan C, Reddy MA, Sagoo MS. Primary enucleation for group D retinoblastoma in the era of systemic and targeted chemotherapy: the price of retaining an eye. Br J Ophthalmol 2017; 102:265-271. [PMID: 28659391 DOI: 10.1136/bjophthalmol-2017-310624] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 04/19/2017] [Revised: 05/24/2017] [Accepted: 05/25/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Chemotherapy is increasingly used as primary treatment for group D retinoblastoma, whereas primary enucleation is considered to have a diminishing role. This study aimed to compare the management course, including number of examinations under anaesthesia (EUAs), of group D patients treated by enucleation versus chemotherapy. METHODS A retrospective analysis of 92 group D patients, of which 40 (37 unilateral) underwent primary enucleation and 52 (17 unilateral) were treated with intravenous chemotherapy. Number of EUAs was compared between the treatment groups with respect to the whole cohort, using univariate and multivariate analysis, and to unilateral cases only. RESULTS Patients were followed up for a median of 61 months (mean: 66, range: 14-156), in which time primary enucleated patients had on average seven EUAs and chemotherapy-treated patients 21 EUAs (p<0.001). Chemotherapy, young age, bilateral disease, multifocal tumours, familial and germline retinoblastoma were found on univariate analysis to correlate with increased number of EUAs (p≤0.019). On multivariate analysis, however, only treatment type and presentation age were found significant (p≤0.001). On subanalysis of the unilateral cases, patients undergoing primary enucleation had in average seven EUAs, as compared with 16 in the chemotherapy group (p<0.001). Of the 55 unilateral-presenting patients, a new tumour developed in the fellow eye only in a single familial case. CONCLUSION Group D patients' families should be counselled regarding the significant difference in number of EUAs following primary enucleation versus chemotherapy when deciding on a treatment strategy. In this regard, primary enucleation would be most beneficial for older patients with unilateral disease.
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Affiliation(s)
- Ido D Fabian
- Ocular Oncology Service, Moorfields Eye Hospital, London, UK.,Retinoblastoma Service, Royal London Hospital, London, UK.,Ocular Oncology Service, Goldschleger Eye Institute, Sheba Medical Center, Tel-Aviv University, Tel Aviv, Israel
| | - Andrew W Stacey
- Ocular Oncology Service, Moorfields Eye Hospital, London, UK.,Retinoblastoma Service, Royal London Hospital, London, UK.,Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | | | - Tanzina Chowdhury
- Retinoblastoma Service, Royal London Hospital, London, UK.,Department of Paediatric Oncology, Great Ormond Street Hospital, London, UK
| | - Catriona Duncan
- Retinoblastoma Service, Royal London Hospital, London, UK.,Department of Paediatric Oncology, Great Ormond Street Hospital, London, UK
| | - M Ashwin Reddy
- Retinoblastoma Service, Royal London Hospital, London, UK
| | - Mandeep S Sagoo
- Ocular Oncology Service, Moorfields Eye Hospital, London, UK.,Retinoblastoma Service, Royal London Hospital, London, UK.,University College London, Institute of Ophthalmology, London, UK
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21
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Bottorff JL, Haines-Saah R, Oliffe JL, Struik LL, Bissell LJL, Richardson CP, Gotay C, Johnson KC, Hutchinson P. Designing Tailored Messages about Smoking and Breast Cancer: A Focus Group Study with Youth. Can J Nurs Res 2017; 46:66-86. [DOI: 10.1177/084456211404600106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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22
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Lavigne É, Bélair MA, Do MT, Stieb DM, Hystad P, van Donkelaar A, Martin RV, Crouse DL, Crighton E, Chen H, Brook JR, Burnett RT, Weichenthal S, Villeneuve PJ, To T, Cakmak S, Johnson M, Yasseen AS, Johnson KC, Ofner M, Xie L, Walker M. Maternal exposure to ambient air pollution and risk of early childhood cancers: A population-based study in Ontario, Canada. Environ Int 2017; 100:139-147. [PMID: 28108116 DOI: 10.1016/j.envint.2017.01.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 12/15/2016] [Accepted: 01/06/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND There are increasing concerns regarding the role of exposure to ambient air pollution during pregnancy in the development of early childhood cancers. OBJECTIVE This population based study examined whether prenatal and early life (<1year of age) exposures to ambient air pollutants, including nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters ≤2.5μm (PM2.5), were associated with selected common early childhood cancers in Canada. METHODS 2,350,898 singleton live births occurring between 1988 and 2012 were identified in the province of Ontario, Canada. We assigned temporally varying satellite-derived estimates of PM2.5 and land-use regression model estimates of NO2 to maternal residences during pregnancy. Incident cases of 13 subtypes of pediatric cancers among children up to age 6 until 2013 were ascertained through administrative health data linkages. Associations of trimester-specific, overall pregnancy and first year of life exposures were evaluated using Cox proportional hazards models, adjusting for potential confounders. RESULTS A total of 2044 childhood cancers were identified. Exposure to PM2.5, per interquartile range increase, over the entire pregnancy, and during the first trimester was associated with an increased risk of astrocytoma (hazard ratio (HR) per 3.9μg/m3=1.38 (95% CI: 1.01, 1.88) and, HR per 4.0μg/m3=1.40 (95% CI: 1.05-1.86), respectively). We also found a positive association between first trimester NO2 and acute lymphoblastic leukemia (ALL) (HR=1.20 (95% CI: 1.02-1.41) per IQR (13.3ppb)). CONCLUSIONS In this population-based study in the largest province of Canada, results suggest an association between exposure to ambient air pollution during pregnancy, especially in the first trimester and an increased risk of astrocytoma and ALL. Further studies are required to replicate the findings of this study with adjustment for important individual-level confounders.
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Affiliation(s)
- Éric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | | | - Minh T Do
- Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - David M Stieb
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada; Population Studies Division, Health Canada, Vancouver, British Columbia, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel L Crouse
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Eric Crighton
- Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada; Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
| | - Hong Chen
- Public Health Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Air Quality Research Division, Environment Canada, Downsview, Ontario, Canada
| | | | - Scott Weichenthal
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Teresa To
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sabit Cakmak
- Population Studies Division, Health Canada, Ottawa, Ontario, Canada
| | - Markey Johnson
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
| | - Abdool S Yasseen
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kenneth C Johnson
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Marianna Ofner
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Global Health and Guideline Division, Public Health Agency of Canada, Toronto, Ontario, Canada
| | - Lin Xie
- Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Mark Walker
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
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23
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Louwen F, Daviss BA, Johnson KC, Reitter A. Does breech delivery in an upright position instead of on the back improve outcomes and avoid cesareans? Int J Gynaecol Obstet 2017; 136:151-161. [DOI: 10.1002/ijgo.12033] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/26/2016] [Accepted: 11/02/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Frank Louwen
- Department of Obstetrics and Gynaecology; Johann Goethe-University Klinikum; Frankfurt Germany
| | - Betty-Anne Daviss
- Department of Obstetrics and Gynaecology; The Montfort Hospital and The Ottawa Hospital; Ottawa ON Canada
| | - Kenneth C. Johnson
- School of Epidemiology; Public Health and Preventive Medicine; Faculty of Medicine; University of Ottawa; Ottawa ON Canada
| | - Anke Reitter
- Department of Obstetrics and Gynaecology; Johann Goethe-University Klinikum; Frankfurt Germany
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24
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Goossens ME, Isa F, Brinkman M, Mak D, Reulen R, Wesselius A, Benhamou S, Bosetti C, Bueno-de-Mesquita B, Carta A, Allam MF, Golka K, Grant EJ, Jiang X, Johnson KC, Karagas MR, Kellen E, La Vecchia C, Lu CM, Marshall J, Moysich K, Pohlabeln H, Porru S, Steineck G, Stern MC, Tang L, Taylor JA, van den Brandt P, Villeneuve PJ, Wakai K, Weiderpass E, White E, Wolk A, Zhang ZF, Buntinx F, Zeegers MP. International pooled study on diet and bladder cancer: the bladder cancer, epidemiology and nutritional determinants (BLEND) study: design and baseline characteristics. ACTA ACUST UNITED AC 2016; 74:30. [PMID: 27386115 PMCID: PMC4933992 DOI: 10.1186/s13690-016-0140-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 03/10/2016] [Accepted: 05/18/2016] [Indexed: 01/10/2023]
Abstract
Background In 2012, more than 400,000 urinary bladder cancer cases occurred worldwide, making it the 7th most common type of cancer. Although many previous studies focused on the relationship between diet and bladder cancer, the evidence related to specific food items or nutrients that could be involved in the development of bladder cancer remains inconclusive. Dietary components can either be, or be activated into, potential carcinogens through metabolism, or act to prevent carcinogen damage. Methods/design The BLadder cancer, Epidemiology and Nutritional Determinants (BLEND) study was set up with the purpose of collecting individual patient data from observational studies on diet and bladder cancer. In total, data from 11,261 bladder cancer cases and 675,532 non-cases from 18 case–control and 6 cohort studies from all over the world were included with the aim to investigate the association between individual food items, nutrients and dietary patterns and risk of developing bladder cancer. Discussion The substantial number of cases included in this study will enable us to provide evidence with large statistical power, for dietary recommendations on the prevention of bladder cancer.
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Affiliation(s)
- Maria E Goossens
- Department of General Practice, Katholieke Universiteit Leuven, ACHG-KU Leuven, Kapucijnenvoer 33, Blok J, bus 7001, 3000 Leuven, Belgium
| | - Fatima Isa
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | | | - David Mak
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Raoul Reulen
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Anke Wesselius
- NUTRIM School for Nutrition and Translational Research in Metabolism, University of Maastricht, Maastricht, The Netherlands
| | - Simone Benhamou
- INSERM U946, Variabilite Genetique et Maladies Humaines, Fondation Jean Dausset / CEPH, Paris, France
| | - Cristina Bosetti
- Laboratory of General Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Bas Bueno-de-Mesquita
- Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands ; Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands ; Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK ; Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Angela Carta
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Brescia, Italy
| | - Md Farouk Allam
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Cordoba, Cordoba, Spain
| | - Klaus Golka
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund, Dortmund, Germany
| | - Eric J Grant
- Department of Epidemiology Radiation Effects Research Foundation, Hiroshima, Japan
| | - Xuejuan Jiang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
| | - Kenneth C Johnson
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON Canada
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH USA
| | - Eliane Kellen
- Leuven University Centre for Cancer Prevention (LUCK), Leuven, Belgium
| | - Carlo La Vecchia
- Department of Clinical Medicine and Community Health, University of Milan, Milan, Italy
| | - Chih-Ming Lu
- Department of Urology, Buddhist Dalin Tzu Chi General Hospital, Dalin Township, 62247 Chiayi County Taiwan
| | - James Marshall
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY USA
| | - Kirsten Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY USA
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Stefano Porru
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Brescia, Italy
| | - Gunnar Steineck
- Department of Oncology and Pathology, Division of Clinical Cancer Epidemiology, Karolinska Hospital, Stockholm, Sweden
| | - Marianne C Stern
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA
| | - Li Tang
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY USA
| | - Jack A Taylor
- Epidemiology Branch, and Epigenetic and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC USA
| | - Piet van den Brandt
- Department of Epidemiology, Schools for Oncology and Developmental Biology and Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Kenji Wakai
- Department of Preventive medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden ; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway ; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland ; Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Emily White
- Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Alicja Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Zuo-Feng Zhang
- Departments of Epidemiology, UCLA Center for Environmental Genomics, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA USA
| | - Frank Buntinx
- Department of General Practice, Katholieke Universiteit Leuven, ACHG-KU Leuven, Kapucijnenvoer 33, Blok J, bus 7001, 3000 Leuven, Belgium ; CAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands
| | - Maurice P Zeegers
- NUTRIM School for Nutrition and Translational Research in Metabolism, University of Maastricht, Maastricht, The Netherlands ; CAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands ; School of Cancer Sciences, University of Birmingham, Birmingham, UK
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25
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Van Ryswyk K, Villeneuve PJ, Johnson KC. Dietary patterns and the risk of female breast cancer among participants of the Canadian National Enhanced Cancer Surveillance System. Can J Public Health 2016; 107:e49-e55. [PMID: 27348110 PMCID: PMC6972247 DOI: 10.17269/cjph.107.5230] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 03/30/2016] [Accepted: 01/17/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The role of diet in the etiology of breast cancer is not well understood despite extensive research. In the majority of this work, a single nutrient-based approach has been used which does not take into account combinations of food that are consumed. An alternative to the single nutrient approach is to identify patterns in the dietary intake information and relate these patterns to disease incidence. This investigation characterized dietary patterns among participants of a Canadian case-control study and related these dietary patterns to the incidence of breast cancer. METHODS Dietary and other risk factor data from cases and controls of the Canadian National Enhanced Cancer Surveillance System were collected using self-administered questionnaires. Principal component factor analysis was used to classify individuals based on their dietary patterns. The relationship between these dietary patterns and breast cancer was evaluated using logistic regression. The derived odds ratios and their 95% confidence limits were adjusted for several factors, such as smoking, alcohol intake, environmental tobacco smoke exposure and obesity. RESULTS In the 2,009 cases and 2,086 controls, three dietary patterns were identified: western, healthy and vitamin. The highest quartile of the "healthy" dietary pattern was related to a 22% decrease in breast cancer risk (95% CI: 0.61-1.00), relative to the lowest quartile. The fourth quartile of the "vitamin" dietary pattern was associated with a 14% decrease in breast cancer risk (95% CI: 0.70-1.04) relative to the first. No statistically significant associations between the "western" dietary pattern and breast cancer were found. These associations were neither confounded nor modified by menopausal status. CONCLUSION Our analyses reveal that individual dietary items tend to cluster together in such a way that there are three distinct dietary patterns in this sample of Canadian women. Some of these patterns, in turn, were associated with the risk of breast cancer.
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Affiliation(s)
- Keith Van Ryswyk
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.
| | - Kenneth C Johnson
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
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26
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Grundy A, Harris SA, Demers PA, Johnson KC, Agnew DA, Villeneuve PJ. Occupational exposure to magnetic fields and breast cancer among Canadian men. Cancer Med 2016; 5:586-96. [PMID: 26792203 PMCID: PMC4799956 DOI: 10.1002/cam4.581] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 10/01/2015] [Accepted: 10/15/2015] [Indexed: 01/13/2023] Open
Abstract
Occupational magnetic field (MF) exposure has been suggested as a risk factor for breast cancer in both men and women. Due to the rarity of this disease in men, most epidemiologic studies investigating this relationship have been limited by small sample sizes. Herein, associations of several measures of occupational MF exposure with breast cancer in men were investigated using data from the population-based case-control component of the Canadian National Enhanced Cancer Surveillance System. Lifetime job histories were provided by 115 cases and 570 controls. Average MF exposure of individual jobs was classified into three categories (<0.3, 0.3 to <0.6, or ≥0.6 μT) through expert blinded review of participant's lifetime occupational histories. The impact of highest average and cumulative MF exposure, as well as exposure duration and specific exposure-time windows, on cancer risk was examined using logistic regression. The proportion of cases (25%) with a highest average exposure of ≥0.3 μT was higher than among controls (22%). We found an elevated risk of breast cancer in men who were exposed to ≥0.6 μT (odds ratio [OR] = 1.80, 95% CI = 0.82-3.95) when compared to those with exposures <0.3 μT. Those exposed to occupational MF fields for at least 30 years had a nearly threefold increase in risk of breast cancer (OR = 2.77, 95% CI = 0.98-7.82) when compared to those with background levels of exposure. Findings for the other time-related MF variables were inconsistent. Our analysis, in one of the largest case-control studies of breast cancer in men conducted to date, provides limited support for the hypothesis that exposure to MF increases the risk breast cancer in men.
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Affiliation(s)
- Anne Grundy
- Department of Cancer Epidemiology and Prevention ResearchAlberta Health Services – Cancer Control AlbertaCalgaryAlbertaCanada
| | - Shelley A. Harris
- Prevention and Cancer ControlCancer Care OntarioTorontoOntarioCanada
- Occupational Cancer Research CenterCancer Care OntarioTorontoOntarioCanada
- Division of Occupational and Environmental HealthDalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Division of EpidemiologyDalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Paul A. Demers
- Occupational Cancer Research CenterCancer Care OntarioTorontoOntarioCanada
- Division of Occupational and Environmental HealthDalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Kenneth C. Johnson
- Department of Epidemiology and Community MedicineUniversity of OttawaOttawaOntarioCanada
| | - David A. Agnew
- University of Ontario Institute of TechnologyOshawaOntarioCanada
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27
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Kachuri L, Villeneuve PJ, Parent MÉ, Johnson KC, Harris SA. Workplace exposure to diesel and gasoline engine exhausts and the risk of colorectal cancer in Canadian men. Environ Health 2016; 15:4. [PMID: 26762540 PMCID: PMC4712563 DOI: 10.1186/s12940-016-0088-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 07/10/2015] [Accepted: 01/10/2016] [Indexed: 05/26/2023]
Abstract
BACKGROUND The International Agency for Research on Cancer (IARC) classified diesel exhaust as carcinogenic to humans (Group 1) and gasoline exhaust as a possible carcinogen (Group 2B) based studies of lung cancer, however the evidence for other sites is limited. We addressed this question by investigating exposure to diesel and gasoline emissions with respect to risk of colorectal cancer in men. METHODS We used data from a population-based case-control study with incident cases of colon (n = 931) and rectal (n = 840) cancer and 1360 controls from 7 Canadian provinces conducted in 1994-1997. Lifetime occupational history and information on other risk factors was collected. Occupational hygienists, blinded to case-control status, assigned exposures to each job for 3 dimensions: concentration, frequency, and reliability. Logistic regression was used to estimate odds ratios (OR) and their 95 % confidence intervals (CI), adjusted for age, province, use of proxy respondents, smoking, body-mass index, physical activity, intake of alcohol, processed meats, and occupational exposure to asbestos and aromatic amines. RESULTS Among CRC cases, 638 (36 %) were exposed to diesel and 814 (46 %) were exposed to gasoline emissions. Relative to the unexposed, elevated risks were observed among subjects ever exposed to high concentration levels of diesel emissions for colorectal cancer (OR = 1.65, 95 % CI = 0.98-2.80) and rectal cancer (OR = 1.98, 95 % CI = 1.09-3.60), but not colon cancer. Prolonged (>10 years) exposure at high concentrations was also associated with high risks of rectal cancer (OR = 2.33 95 % CI = 0.94-5.78; p-trend = 0.02). No statistically significant associations were observed for gasoline emissions. CONCLUSIONS Our findings suggest that sustained high-level exposure diesel emissions may increase the risk of rectal cancer.
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Affiliation(s)
- Linda Kachuri
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3 M7, Canada.
- Occupational Cancer Research Centre, Cancer Care Ontario, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 2 L3, Canada.
- Prevention and Cancer Control, Cancer Care Ontario, 620 University Ave, Toronto, ON, M5G 2 L7, Canada.
| | - Paul J Villeneuve
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3 M7, Canada.
- Occupational Cancer Research Centre, Cancer Care Ontario, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 2 L3, Canada.
- CHAIM Research Centre, Carleton University, 5435 Herzberg Laboratories, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.
| | - Marie-Élise Parent
- INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, University of Quebec, 531 boul. des Prairies, Édifice 12, Laval, QC, H7V 1B7, Canada.
| | - Kenneth C Johnson
- Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8 M5, Canada.
| | - Shelley A Harris
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3 M7, Canada.
- Occupational Cancer Research Centre, Cancer Care Ontario, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 2 L3, Canada.
- Prevention and Cancer Control, Cancer Care Ontario, 620 University Ave, Toronto, ON, M5G 2 L7, Canada.
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Latifovic L, Villeneuve PJ, Parent MÉ, Johnson KC, Kachuri L, Harris SA. Bladder cancer and occupational exposure to diesel and gasoline engine emissions among Canadian men. Cancer Med 2015; 4:1948-62. [PMID: 26511593 PMCID: PMC5123782 DOI: 10.1002/cam4.544] [Citation(s) in RCA: 27] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 08/21/2015] [Accepted: 08/24/2015] [Indexed: 11/17/2022] Open
Abstract
The International Agency for Research on Cancer has classified diesel exhaust as a carcinogen based on lung cancer evidence; however, few studies have investigated the effect of engine emissions on bladder cancer. The purpose of this study was to investigate the association between occupational exposure to diesel and gasoline emissions and bladder cancer in men using data from the Canadian National Enhanced Cancer Surveillance System; a population‐based case–control study. This analysis included 658 bladder cancer cases and 1360 controls with information on lifetime occupational histories and a large number of possible cancer risk factors. A job‐exposure matrix for engine emissions was supplemented by expert review to assign values for each job across three dimensions of exposure: concentration, frequency, and reliability. Odds ratios (OR) and their corresponding 95% confidence intervals were estimated using logistic regression. Relative to unexposed, men ever exposed to high concentrations of diesel emissions were at an increased risk of bladder cancer (OR = 1.64, 0.87–3.08), but this result was not significant, and those with >10 years of exposure to diesel emissions at high concentrations had a greater than twofold increase in risk (OR = 2.45, 1.04–5.74). Increased risk of bladder cancer was also observed with >30% of work time exposed to gasoline engine emissions (OR = 1.59, 1.04–2.43) relative to the unexposed, but only among men that had never been exposed to diesel emissions. Taken together, our findings support the hypothesis that exposure to high concentrations of diesel engine emissions may increase the risk of bladder cancer.
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Affiliation(s)
- Lidija Latifovic
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Paul J Villeneuve
- CHAIM Research Centre, Carleton University, Ottawa, Ontario, Canada.,Occupational Cancer Research Center, Toronto, Ontario, Canada.,Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Marie-Élise Parent
- INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, University of Quebec, Laval, Quebec, Canada
| | - Kenneth C Johnson
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Linda Kachuri
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada.,Occupational Cancer Research Center, Toronto, Ontario, Canada.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Shelley A Harris
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada.,Occupational Cancer Research Center, Toronto, Ontario, Canada.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Division of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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29
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Winters N, Goldberg MS, Hystad P, Villeneuve PJ, Johnson KC. Exposure to ambient air pollution in Canada and the risk of adult leukemia. Sci Total Environ 2015; 526:153-176. [PMID: 25955692 DOI: 10.1016/j.scitotenv.2015.03.149] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/13/2015] [Accepted: 03/23/2015] [Indexed: 06/04/2023]
Abstract
There is a paucity of studies investigating adult leukemia and air pollution. To address this gap, we analyzed data from a Canadian population-based case-control study conducted in 1994-1997. Cases were 1064 adults with incident leukemia and controls were 5039 healthy adults. We used data from satellites and fixed-site monitoring stations to estimate residential concentrations of NO2 and fine particulate matter (PM2.5) for the period prior to diagnosis, starting in 1975 and ending in 1994. We modeled the average annual exposure of each subject. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated using logistic regression, adjusted for age, gender, province, smoking, education, body mass index, income, and self-reported exposures to ionizing radiation and benzene. We found an 'n-shaped' response function between exposure to NO2 and all forms of leukemia: from the tenth percentile to the median (4.51 to 14.66 ppb), the OR was 1.20; 95% CI: 0.97-1.48 and from the 75th percentile to the 90th (22.75 to 29.7 ppb), the OR was 0.79; 95% CI 0.68-0.93. For PM2.5 we found a response function consistent with a linear model, with an OR per 10 μg/m(3) of 0.97 (95% CI 0.75-1.26). For chronic lymphocytic leukemia we found response functions that were consistent with a simple linear model, with an OR per 5 ppb of NO2 of 0.93 (95% CI 0.86-1.00) and an OR per 10 μg/m(3) of PM2.5 of 0.62 (95% CI 0.42-0.93). In summary, for chronic lymphocytic leukemia we found no evidence of an association with air pollution and with all forms of leukemia we found weak evidence of an association only at low concentrations of NO2. It is possible that these inconsistent results may have arisen because of unaccounted urban/rural differences or possibly from a selection effect, especially among controls.
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Affiliation(s)
- Nicholas Winters
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Ave. W., R4.29, Montreal, Quebec H3A 1A1, Canada.
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Kenneth C Johnson
- Science Integration Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Choi BCK, Wigle DT, Johansen H, Losos J, Fair ME, Napke E, Anderson LJ, Davies JW, White K, Miller AB, Li FCK, Stachenko S, Lindsay J, Gaudette LA, Nair C, Levy I, Morrison H, Silins J, Bouchard F, Tonmyr L, Villeneuve PJ, McRae L, Johnson KC, Lane RS, Probert A. Status Report--Retracing the history of the early development of national chronic disease surveillance in Canada and the major role of the Laboratory Centre for Disease Control (LCDC) from 1972 to 2000. Health Promot Chronic Dis Prev Can 2015; 35:35-44. [PMID: 25915119 PMCID: PMC4910431 DOI: 10.24095/hpcdp.35.2.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Health surveillance is the ongoing, systematic
use of routinely collected health
data to guide public health action in a
timely fashion.
This paper describes the creation and
growth of national surveillance systems
in Canada and their impact on chronic
disease and injury prevention.
In 2008, the authors started a review process
to retrace the history of the early development
of national chronic disease surveillance
in Canada from 1960 to 2000. A 1967
publication describes the history of the
development of the Laboratory of Hygiene
from 1921 to 1967. This review is a sequel
to that paper and describes the history of the
development of national chronic disease
surveillance in Canada before and after the
formation of the Laboratory Centre for
Disease Control (LCDC).
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Affiliation(s)
- B C K Choi
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- Health Canada, Ottawa, Ontario, Canada
| | - D T Wigle
- Health Canada, Ottawa, Ontario, Canada
| | - H Johansen
- Health Canada, Ottawa, Ontario, Canada
- Statistics Canada, Ottawa, Ontario, Canada
| | - J Losos
- Health Canada, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - M E Fair
- Statistics Canada, Ottawa, Ontario, Canada
| | - E Napke
- Health Canada, Ottawa, Ontario, Canada
| | - L J Anderson
- Health Canada, Ottawa, Ontario, Canada
- Health and Social Policy Editing Consultant, Ottawa, Ontario, Canada
| | - J W Davies
- Health Canada, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - K White
- Health Canada, Ottawa, Ontario, Canada
- Statistics Canada, Ottawa, Ontario, Canada
| | - A B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - F C K Li
- Health Canada, Ottawa, Ontario, Canada
- Embassy of Canada, Beijing, China
| | - S Stachenko
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - J Lindsay
- Health Canada, Ottawa, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - L A Gaudette
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- Statistics Canada, Ottawa, Ontario, Canada
| | - C Nair
- Statistics Canada, Ottawa, Ontario, Canada
- Health Information Solutions, Ottawa, Ontario, Canada
| | - I Levy
- Health Canada, Ottawa, Ontario, Canada
- Ottawa Public Health, Ottawa, Ontario, Canada
| | - H Morrison
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- Health Canada, Ottawa, Ontario, Canada
| | - J Silins
- Health Canada, Ottawa, Ontario, Canada
- Statistics Canada, Ottawa, Ontario, Canada
| | - F Bouchard
- Health Canada, Ottawa, Ontario, Canada
- Nunavik Regional Board of Health and Social Services, Kuujjuaq, Quebec, Canada
| | - L Tonmyr
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- Health Canada, Ottawa, Ontario, Canada
| | - P J Villeneuve
- Health Canada, Ottawa, Ontario, Canada
- Carleton University, Ottawa, Ontario, Canada
| | - L McRae
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- Health Canada, Ottawa, Ontario, Canada
| | - K C Johnson
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- Health Canada, Ottawa, Ontario, Canada
| | - R S Lane
- Health Canada, Ottawa, Ontario, Canada
- Canadian Nuclear Safety Commission, Ottawa, Ontario, Canada
| | - A Probert
- Health Canada, Ottawa, Ontario, Canada
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Johnson KC. Nodal line-scanning method for maskless optical lithography. Appl Opt 2014; 53:J7-J18. [PMID: 25607977 DOI: 10.1364/ao.53.0000j7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Maskless optical lithography can improve the economics and performance of multi-patterning by eliminating photomasks and by simplifying the lithography exposure technology. It could also potentially eliminate the need for multi-patterning by enabling dual-wavelength, nonlinear optical recording methods. High-resolution, maskless patterning can be achieved with a scanned-spot-array system in which modulated, diffraction-limited focus spots write the exposure pattern. Each spot has a central zero-intensity interference null along a line parallel to the scan direction for printing sub-resolution line patterns. High throughput can be achieved at the comparatively low repetition rate of excimer lasers (e.g., 6 kHz). The low repetition rate simplifies the optical modulation technology, enabling the use of supplemental modulation controls including dynamic gray-level and beam-centration controls for resolution enhancement.
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Schwartz J, Bottorff JL, Ratner PA, Gotay C, Johnson KC, Memetovic J, Richardson CG. Effect of web-based messages on girls' knowledge and risk perceptions related to cigarette smoke and breast cancer: 6-month follow-up of a randomized controlled trial. JMIR Res Protoc 2014; 3:e53. [PMID: 25271096 PMCID: PMC4210946 DOI: 10.2196/resprot.3282] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 07/01/2014] [Accepted: 08/18/2014] [Indexed: 02/05/2023] Open
Abstract
Background Evidence indicating an association between cigarette smoke exposure and an increase in breast cancer risk highlights the need for health messages that aim to prevent smoking initiation and reduce secondhand smoke (SHS) exposure among adolescent girls. Objective This study aimed to evaluate the efficacy of targeted gender-sensitive, breast cancer-specific, Web-based messages about the increased risk of breast cancer associated with cigarette smoke exposure. Outcomes assessed 6 months postmessage delivery included nonsmoking adolescent girls’ knowledge of the link between cigarette smoke exposure and breast cancer, perceptions of breast cancer risk associated with cigarette smoke, smoking behavior and intentions, and stage of change related to avoidance of secondhand smoke. Methods A prospective randomized controlled trial was used to compare standard (control) messages with targeted gender- and Aboriginal status-sensitive, breast cancer-specific (intervention) messages. Messages were delivered online to 618 nonsmoking girls, aged 13 to 15 years, clustered in 74 Canadian secondary schools. Results Compared with the control group, girls in the intervention group were significantly more likely to report that breast cancer is an illness caused by cigarette smoke (adjusted relative risk [ARR] 1.33, 95% CI 1.05-1.68) and to agree that exposure to SHS increases their risk of breast cancer (ARR 1.10, 95% CI 1.02-1.20). No significant effects were observed for a change in smoking status, intention to try smoking, or stage of change related to avoidance of SHS. Conclusions Compared with standard messages, targeted gender-sensitive, breast cancer-specific messages had a stronger influence on girls’ knowledge and perceived risk of cigarette smoke exposure as a risk factor for breast cancer. Brief information-based interventions delivered over the Internet have the potential to provide effective health promotion that could be broadly disseminated and lead to long-term effects on girls’ knowledge and risk perceptions about cigarette exposure and breast cancer.
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Affiliation(s)
- Jennifer Schwartz
- Yale University, School of Medicine, Center for Outcomes Research & Evaluation (CORE), New Haven, CT, United States.
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Johnson KC. Projection operator method for biperiodic diffraction gratings with anisotropic/bianisotropic generalizations. J Opt Soc Am A Opt Image Sci Vis 2014; 31:1698-1709. [PMID: 25121524 DOI: 10.1364/josaa.31.001698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The "projection operator" method is a variation of the normal-vector method for simulating optical diffraction from biperiodic gratings. A projection operator defined by the normal vector is interpolated over the grating volume rather than interpolating the vector itself. This approach circumvents difficulties associated with sign reversals and discontinuities encountered with the normal-vector method, and it facilitates implementation for general grating geometries. The method is readily extensible to anisotropic and bianisotropic materials. Several numerical examples of the new method are presented, including comparisons to previously published test cases.
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Brinton LA, Cook MB, McCormack V, Johnson KC, Olsson H, Casagrande JT, Cooke R, Falk RT, Gapstur SM, Gaudet MM, Gaziano JM, Gkiokas G, Guénel P, Henderson BE, Hollenbeck A, Hsing AW, Kolonel LN, Isaacs C, Lubin JH, Michels KB, Negri E, Parisi D, Petridou ET, Pike MC, Riboli E, Sesso HD, Snyder K, Swerdlow AJ, Trichopoulos D, Ursin G, van den Brandt PA, Van Den Eeden SK, Weiderpass E, Willett WC, Ewertz M, Thomas DB. Anthropometric and hormonal risk factors for male breast cancer: male breast cancer pooling project results. J Natl Cancer Inst 2014; 106:djt465. [PMID: 24552677 DOI: 10.1093/jnci/djt465] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The etiology of male breast cancer is poorly understood, partly because of its relative rarity. Although genetic factors are involved, less is known regarding the role of anthropometric and hormonally related risk factors. METHODS In the Male Breast Cancer Pooling Project, a consortium of 11 case-control and 10 cohort investigations involving 2405 case patients (n = 1190 from case-control and n = 1215 from cohort studies) and 52013 control subjects, individual participant data were harmonized and pooled. Unconditional logistic regression generated study design-specific (case-control/cohort) odds ratios (ORs) and 95% confidence intervals (CIs), with exposure estimates combined using fixed effects meta-analysis. All statistical tests were two-sided. RESULTS Risk was statistically significantly associated with weight (highest/lowest tertile: OR = 1.36; 95% CI = 1.18 to 1.57), height (OR = 1.18; 95% CI = 1.01 to 1.38), and body mass index (BMI; OR = 1.30; 95% CI = 1.12 to 1.51), with evidence that recent rather than distant BMI was the strongest predictor. Klinefelter syndrome (OR = 24.7; 95% CI = 8.94 to 68.4) and gynecomastia (OR = 9.78; 95% CI = 7.52 to 12.7) were also statistically significantly associated with risk, relations that were independent of BMI. Diabetes also emerged as an independent risk factor (OR = 1.19; 95% CI = 1.04 to 1.37). There were also suggestive relations with cryptorchidism (OR = 2.18; 95% CI = 0.96 to 4.94) and orchitis (OR = 1.43; 95% CI = 1.02 to 1.99). Although age at onset of puberty and histories of infertility were unrelated to risk, never having had children was statistically significantly related (OR = 1.29; 95% CI = 1.01 to 1.66). Among individuals diagnosed at older ages, a history of fractures was statistically significantly related (OR = 1.41; 95% CI = 1.07 to 1.86). CONCLUSIONS Consistent findings across case-control and cohort investigations, complemented by pooled analyses, indicated important roles for anthropometric and hormonal risk factors in the etiology of male breast cancer. Further investigation should focus on potential roles of endogenous hormones.
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Affiliation(s)
- Louise A Brinton
- Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (LAB, MBC, RTF, JHL); Section on Environment and Radiation, International Agency for Research on Cancer, Lyon, France (VM); Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada (KCJ); Department of Oncology, Lund University, Lund, Sweden (HO); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (JTC, BEH, MCP, GU); Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK (RC, AJS); Epidemiology Research Program, American Cancer Society, Atlanta, GA (SMG, MMG); Department of Medicine (JMG), Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology (KBM), and Divisions of Preventive Medicine and Aging (HDS), Brigham and Women's Hospital, Boston, MA; MAVERIC, VA Boston Healthcare System, Boston, MA (JMG); Department of Surgery, Aretaieion University Hospital, Athens, Greece (GG); Center for Research in Epidemiology and Population Health, INSERM Unit 1018, Paris-Sud University, Villejuif, France (PG); AARP Research, AARP, Washington, DC (AH); Cancer Prevention Institute of California, Freemont, CA (AWH); Division of Epidemiology, Department of Health Research and Policy, and Stanford Cancer Institute, Stanford School of Medicine, Stanford University, Palo Alto, CA (AWH); Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI (LNK); Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC (CI); Department of Epidemiology (KBM) and Department of Nutrition (WCW), Harvard School of Public Health, Boston, MA (KBM); Istituto di Richerche Farmacologiche, Milan, Italy (EN, DT); IMS, Inc, Rockville, MD (DP, KS); Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece (ETP); School of Public Health, Imperial C
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Glantz SA, Johnson KC. The Surgeon General Report on Smoking and Health 50 Years Later: Breast Cancer and the Cost of Increasing Caution. Cancer Epidemiol Biomarkers Prev 2014; 23:37-46. [DOI: 10.1158/1055-9965.epi-13-1081] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hystad P, Brauer M, Demers PA, Johnson KC, Setton E, Cervantes-Larios A, Poplawski K, McFarlane A, Whitehead A, Nicol AM. Geographic variation in radon and associated lung cancer risk in Canada. Can J Public Health 2014; 105:e4-e10. [PMID: 24735695 PMCID: PMC6972071 DOI: 10.17269/cjph.105.4002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 01/06/2014] [Accepted: 11/28/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Radon is an important risk factor for lung cancer. Here we use maps of the geographic variation in radon to estimate the lung cancer risk associated with living in high radon areas of Canada. METHODS Geographic variation in radon was estimated using two mapping methods. The first used a Health Canada survey of 14,000 residential radon measurements aggregated to health regions, and the second, radon risk areas previously estimated from geology, sediment geochemistry and aerial gamma-ray spectrometry. Lung cancer risk associated with living in these radon areas was examined using a population-based case-control study of 2,390 lung cancer cases and 3,507 controls collected from 1994-1997 in eight Canadian provinces. Residential histories over a 20-year period were used in combination with the two mapping methods to estimate ecological radon exposures. Hierarchical logistic regression analyses were used to estimate odds ratios for lung cancer incidence, after adjusting for a comprehensive set of individual and geographic covariates. RESULTS Across health regions in Canada, significant variation in average residential radon concentrations (range: 16-386 Bq/m3) and in high geological-based radon areas (range: 0-100%) is present. In multivariate models, a 50 Bq/m3 increase in average health region radon was associated with a 7% (95% CI: -6-21%) increase in the odds of lung cancer. For every 10 years that individuals lived in high radon geological areas, the odds of lung cancer increased by 11% (95% CI: 1-23%). CONCLUSIONS These findings provide further evidence that radon is an important risk factor for lung cancer and that risks are unevenly distributed across Canada.
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Chlebowski RT, Haque R, Col N, Paskett E, Manson JE, Kubo JT, Johnson KC, Wactawski-Wende J, Anderson G. Abstract P1-13-02: Benefit/risk of invasive breast cancer adjuvant tamoxifen or aromatase inhibitor use by age, race/ethnicity, and co-morbidity. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-13-02] [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: Older age, minority race/ethnicity, and co-morbidities adversely influence early stage IBC outcome. Further, as AI compared to tamoxifen use has different effects on IBC recurrence and other health outcomes including hip fracture, endometrial cancer, stroke, pulmonary embolism and, perhaps especially, coronary heart disease (CHD), an approach to summarize relative benefit/risk of these agents is needed.
Methods: Incidence rates for health outcomes by age and race/ethnicity, absent AI or tamoxifen use, were obtained from the placebo arms of the three primary Women's Health Initiative clinical prevention trials (n = 33,072). AI and tamoxifen effects on IBC distant recurrence (relative risk [PR] 0.82) were estimated from a meta-analysis of the ATAC and Big-1-98 trial results (n = 14,149) and on other health outcomes from published meta-analysis of side effects in seven AI vs tamoxifen trials (n = 30,023); RR of 1.47 for hip fracture, 0.34 for endometrial cancer, 0.84 for stroke, 0.55 for pulmonary embolism, 1.26 for CHD (Amir et al JNCI 2011;103:1299). Following the methodology of Freedman et al (JCO 2011;29:2327), mortality weights were assigned health outcomes (5 year mortality risk of 0.2 for MI, 0.8 for IBC distant recurrence, etc) to assess net all cause mortality benefit/risk for AI compared to tamoxifen by recurrence risk, age (decade), race/ethnicity, hysterectomy (yes/no) and, in separate analyses, in women with diabetes and in women with cardiovascular disease [CVD] history.
Results: In these analyses, clinical outcome of women with early stage IBC was unfavorable (more deaths per 1000 women/years) with tamoxifen compared to AI adjuvant use regardless of age, race/ethnicity, diabetes or CVD history even with 10-year distant recurrence risk of only 10%. AI superiority was substantially greater in women with a uterus and, in exploratory analyses, when assuming a CVD relative risk for AI use of 1.0, rather than a CHD relative risk of 1.26 used in all other analyses, as the AI CHDrisk elevation is controversial. The net benefit of AI compared to tamoxifen influence on clinical outcomes are described in a series of tables to be presented which quantify benefit/risk in particular women groups. The example below illustrates the excess number of deaths/1000 woman years for tamoxifen vs. AI by recurrence risk, age, and hysterectomy status.
Excess Number of Deaths per 1000 women/year for Tamoxifen Compared to AI Tamoxifen vs. AI (with uterus)Tamoxifen vs. AI (without uterus)10-year Distant Recurrence (%)Age GroupAge Group 50-59y60-69y70-79y50-59y60-69y70-79y1015120620010211111030326382375278287286
For a 60-69 year old woman with a uterus at 30% 10 year recurrence risk, there would be 382 more deaths per 1000 women/yr for tamoxifen vs. AI use. With prior hysterectomy, there would still be 287 more deaths for tamoxifen use.
Conclusion: We developed an index to quantify the benefit risk for adjuvant AI vs. tamoxifen use. Even assessing a RR of 1.26 for CHD for AI use, tamoxifen compared to AI use had unfavorable outcome in all examined groups. This index can complement clinical evaluation in comparing use of these two adjuvant therapy approaches in women of different ages and racial/ethnic groups.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-13-02.
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Affiliation(s)
- RT Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Kaiser Foundation Research Institute, Pasadena, CA; University of New England, Portland, ME; Ohio State University, Columbus, OH; Harvard Medical School, Boston, MA; Stanford School of Medicine, Palo Alto, CA; University of Tennessee, Memphis, TN; University of Buffalo, Buffalo, NY; Fred Hutchinson Cancer Research Center, Seattle, WA
| | - R Haque
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Kaiser Foundation Research Institute, Pasadena, CA; University of New England, Portland, ME; Ohio State University, Columbus, OH; Harvard Medical School, Boston, MA; Stanford School of Medicine, Palo Alto, CA; University of Tennessee, Memphis, TN; University of Buffalo, Buffalo, NY; Fred Hutchinson Cancer Research Center, Seattle, WA
| | - N Col
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Kaiser Foundation Research Institute, Pasadena, CA; University of New England, Portland, ME; Ohio State University, Columbus, OH; Harvard Medical School, Boston, MA; Stanford School of Medicine, Palo Alto, CA; University of Tennessee, Memphis, TN; University of Buffalo, Buffalo, NY; Fred Hutchinson Cancer Research Center, Seattle, WA
| | - E Paskett
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Kaiser Foundation Research Institute, Pasadena, CA; University of New England, Portland, ME; Ohio State University, Columbus, OH; Harvard Medical School, Boston, MA; Stanford School of Medicine, Palo Alto, CA; University of Tennessee, Memphis, TN; University of Buffalo, Buffalo, NY; Fred Hutchinson Cancer Research Center, Seattle, WA
| | - JE Manson
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Kaiser Foundation Research Institute, Pasadena, CA; University of New England, Portland, ME; Ohio State University, Columbus, OH; Harvard Medical School, Boston, MA; Stanford School of Medicine, Palo Alto, CA; University of Tennessee, Memphis, TN; University of Buffalo, Buffalo, NY; Fred Hutchinson Cancer Research Center, Seattle, WA
| | - JT Kubo
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Kaiser Foundation Research Institute, Pasadena, CA; University of New England, Portland, ME; Ohio State University, Columbus, OH; Harvard Medical School, Boston, MA; Stanford School of Medicine, Palo Alto, CA; University of Tennessee, Memphis, TN; University of Buffalo, Buffalo, NY; Fred Hutchinson Cancer Research Center, Seattle, WA
| | - KC Johnson
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Kaiser Foundation Research Institute, Pasadena, CA; University of New England, Portland, ME; Ohio State University, Columbus, OH; Harvard Medical School, Boston, MA; Stanford School of Medicine, Palo Alto, CA; University of Tennessee, Memphis, TN; University of Buffalo, Buffalo, NY; Fred Hutchinson Cancer Research Center, Seattle, WA
| | - J Wactawski-Wende
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Kaiser Foundation Research Institute, Pasadena, CA; University of New England, Portland, ME; Ohio State University, Columbus, OH; Harvard Medical School, Boston, MA; Stanford School of Medicine, Palo Alto, CA; University of Tennessee, Memphis, TN; University of Buffalo, Buffalo, NY; Fred Hutchinson Cancer Research Center, Seattle, WA
| | - G Anderson
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Kaiser Foundation Research Institute, Pasadena, CA; University of New England, Portland, ME; Ohio State University, Columbus, OH; Harvard Medical School, Boston, MA; Stanford School of Medicine, Palo Alto, CA; University of Tennessee, Memphis, TN; University of Buffalo, Buffalo, NY; Fred Hutchinson Cancer Research Center, Seattle, WA
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Richardson CG, Struik LL, Johnson KC, Ratner PA, Gotay C, Memetovic J, Okoli CT, Bottorff JL. Initial impact of tailored web-based messages about cigarette smoke and breast cancer risk on boys' and girls' risk perceptions and information seeking: randomized controlled trial. JMIR Res Protoc 2013; 2:e53. [PMID: 24326101 PMCID: PMC3868973 DOI: 10.2196/resprot.2858] [Citation(s) in RCA: 8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/28/2013] [Accepted: 10/31/2013] [Indexed: 12/02/2022] Open
Abstract
Background Recent evidence indicates a causal link between both active smoking and secondhand smoke (SHS) exposure and breast cancer (BC). Objective The objective of the present study was to evaluate the initial reactions of girls and boys to tailored Web-based messages that describe the relationship between SHS and BC, using a parallel, single-blinded cluster randomized controlled trial. Methods This trial was nested within a cycle of an ongoing longitudinal study of 1498 students from 74 secondary schools. Self-reported assessments were used to evaluate the impact of study messages on participants’ risk perception and interest in obtaining additional information after participants were randomized by schools to control or intervention groups. The intervention group received a tailored visual message (based on gender and Aboriginal status) about BC and tobacco smoke. The control group received a standard visual message about smoking and cancer. Results SHS exposure was identified as a BC risk factor by 380/1488 (25.54%) participants, during the preintervention analysis. Compared to the female participants in the control group (491/839, 58.5%), girls who received the intervention (339/649, 52.2%) were 14% more likely to agree that exposure to SHS increased their BC risk (relative risk [RR] 1.14, 95% CI 1.07-1.21). Nonsmoking girls who received the intervention were 14% more likely to agree that starting smoking would increase their BC risk (RR 1.14, 95% CI 1.07-1.21). Compared to the male participants in control group (348/839, 41.5%), boys who received the intervention (310/649, 47.8%) were 10% more likely to agree that girls’ exposure to SHS increased their BC risk (RR 1.10, 95% CI 1.02-1.18). Compared to controls, girls who received the intervention were 52% more likely to request additional information about SHS and BC (RR 1.52, 95% CI 1.12-2.06). Conclusions Brief gender-sensitive messages delivered via the Internet have the potential to increase awareness and to stimulate information seeking about the risk for BC associated with SHS.
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Affiliation(s)
- Chris G Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
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Kachuri L, Villeneuve PJ, Parent MÉ, Johnson KC, Harris SA. Occupational exposure to crystalline silica and the risk of lung cancer in Canadian men. Int J Cancer 2013; 135:138-48. [PMID: 24272527 DOI: 10.1002/ijc.28629] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [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: 06/13/2013] [Accepted: 11/07/2013] [Indexed: 01/08/2023]
Abstract
Crystalline silica is a recognized carcinogen, but the association with lung cancer at lower levels of exposure has not been well characterized. This study investigated the relationship between occupational silica exposure and lung cancer and the combined effects of cigarette smoking and silica exposure on lung cancer risk. A population-based case-control study was conducted in eight Canadian provinces between 1994 and 1997. Self-reported questionnaires were used to obtain a lifetime occupational history and information on other risk factors. Occupational hygienists assigned silica exposures to each job based on concentration, frequency and reliability. Data from 1681 incident lung cancer cases and 2053 controls were analyzed using logistic regression to estimate odds ratios (OR) and their 95% confidence intervals (CI). Models included adjustments for cigarette smoking, lifetime residential second-hand smoke and occupational exposure to diesel and gasoline engine emissions. Relative to the unexposed, increasing duration of silica exposure at any concentration was associated with a significant trend in lung cancer risk (OR ≥ 30 years: 1.67, 1.21-2.24; ptrend = 0.002). The highest tertile of cumulative silica exposure was associated with lung cancer (OR = 1.81, 1.34-2.42; ptrend = 0.004) relative to the lowest. Men exposed to silica for ≥30 years with ≥40 cigarette pack-years had the highest risk relative to those unexposed with <10 pack-years (OR = 42.53, 23.54-76.83). The joint relationship with smoking was consistent with a multiplicative model. Our findings suggest that occupational exposure to silica is a risk factor for lung cancer, independently from active and passive smoking, as well as from exposure to other lung carcinogens.
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Affiliation(s)
- Linda Kachuri
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, ON; Occupational Cancer Research Centre, Toronto, ON; Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON
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Hystad P, Carpiano RM, Demers PA, Johnson KC, Brauer M. Neighbourhood socioeconomic status and individual lung cancer risk: Evaluating long-term exposure measures and mediating mechanisms. Soc Sci Med 2013; 97:95-103. [DOI: 10.1016/j.socscimed.2013.08.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 08/04/2013] [Accepted: 08/08/2013] [Indexed: 12/12/2022]
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Graff M, Fernández-Rhodes L, Liu S, Carlson C, Wassertheil-Smoller S, Neuhouser M, Reiner A, Kooperberg C, Rampersaud E, Manson JE, Kuller LH, Howard BV, Ochs-Balcom HM, Johnson KC, Vitolins MZ, Sucheston L, Monda K, North KE. Generalization of adiposity genetic loci to US Hispanic women. Nutr Diabetes 2013; 3:e85. [PMID: 23978819 PMCID: PMC3759132 DOI: 10.1038/nutd.2013.26] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 06/28/2013] [Accepted: 07/22/2013] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND: Obesity is a public health concern. Yet the identification of adiposity-related genetic variants among United States (US) Hispanics, which is the largest US minority group, remains largely unknown. OBJECTIVE: To interrogate an a priori list of 47 (32 overall body mass and 15 central adiposity) index single-nucleotide polymorphisms (SNPs) previously studied in individuals of European descent among 3494 US Hispanic women in the Women's Health Initiative SNP Health Association Resource (WHI SHARe). DESIGN: Cross-sectional analysis of measured body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) were inverse normally transformed after adjusting for age, smoking, center and global ancestry. WC and WHR models were also adjusted for BMI. Genotyping was performed using the Affymetrix 6.0 array. In the absence of an a priori selected SNP, a proxy was selected (r2⩾0.8 in CEU). RESULTS: Six BMI loci (TMEM18, NUDT3/HMGA1, FAIM2, FTO, MC4R and KCTD15) and two WC/WHR loci (VEGFA and ITPR2-SSPN) were nominally significant (P<0.05) at the index or proxy SNP in the corresponding BMI and WC/WHR models. To account for distinct linkage disequilibrium patterns in Hispanics and further assess generalization of genetic effects at each locus, we interrogated the evidence for association at the 47 surrounding loci within 1 Mb region of the index or proxy SNP. Three additional BMI loci (FANCL, TFAP2B and ETV5) and five WC/WHR loci (DNM3-PIGC, GRB14, ADAMTS9, LY86 and MSRA) displayed Bonferroni-corrected significant associations with BMI and WC/WHR. Conditional analyses of each index SNP (or its proxy) and the most significant SNP within the 1 Mb region supported the possible presence of index-independent signals at each of these eight loci as well as at KCTD15. CONCLUSION: This study provides evidence for the generalization of nine BMI and seven central adiposity loci in Hispanic women. This study expands the current knowledge of common adiposity-related genetic loci to Hispanic women.
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Affiliation(s)
- M Graff
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Lavigne E, Holowaty EJ, Pan SY, Villeneuve PJ, Johnson KC, Fergusson DA, Morrison H, Brisson J. Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. BMJ 2013; 346:f2399. [PMID: 23637132 DOI: 10.1136/bmj.f2399] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate whether the stage distribution among women diagnosed as having breast cancer differs between those who have received breast implants for cosmetic purposes and those with no implants and to evaluate whether cosmetic breast augmentation before the detection of breast cancer is a predictor of post-diagnosis survival. DESIGN Systematic review of observational studies with two meta-analyses. DATA SOURCES Systematic search of the literature published before September 2012 conducted in Medline, Embase, Global health, CINAHL, IPAB, and PsycINFO. STUDY SELECTION Eligible publications were those that included women diagnosed as having breast cancer and who had had augmentation mammaplasty for cosmetic purposes. RESULTS The overall odds ratio of the first meta-analysis based on 12 studies was 1.26 (95% confidence interval 0.99 to 1.60; P=0.058; I(2)=35.6%) for a non-localized stage of breast cancer at diagnosis comparing women with implants who had breast cancer and women without implants who had breast cancer. The second meta-analysis, based on five studies, evaluated the relation between cosmetic breast implantation and survival. This meta-analysis showed reduced survival after breast cancer among women who had implants compared with those who did not (overall hazard ratio for breast cancer specific mortality 1.38, 95% confidence interval 1.08 to 1.75). CONCLUSIONS The research published to date suggests that cosmetic breast augmentation adversely affects the survival of women who are subsequently diagnosed as having breast cancer. These findings should be interpreted with caution, as some studies included in the meta-analysis on survival did not adjust for potential confounders. Further investigations are warranted regarding diagnosis and prognosis of breast cancer among women with breast implants.
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Affiliation(s)
- Eric Lavigne
- Centre de Recherche du CHU de Québec, Faculté de Médecine, Université Laval, Quebec, QC, Canada.
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Villeneuve PJ, Parent MÉ, Harris SA, Johnson KC. Occupational exposure to asbestos and lung cancer in men: evidence from a population-based case-control study in eight Canadian provinces. BMC Cancer 2012; 12:595. [PMID: 23234401 PMCID: PMC3534484 DOI: 10.1186/1471-2407-12-595] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [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: 09/19/2012] [Accepted: 12/10/2012] [Indexed: 11/17/2022] Open
Abstract
Background Asbestos is classified as a human carcinogen, and studies have consistently demonstrated that workplace exposure to it increases the risk of developing lung cancer. Few studies have evaluated risks in population-based settings where there is a greater variety in the types of occupations, and exposures. Methods This was a population based case–control study with 1,681 incident cases of lung cancer, and 2,053 controls recruited from 8 Canadian provinces between 1994 and 1997. Self-reported questionnaires were used to elicit a lifetime occupational history, including general tasks, and information for other risk factors. Occupational hygienists, who were blinded to case–control status, assigned asbestos exposures to each job on the basis of (i) concentration (low, medium, high), (ii) frequency (<5%, 5-30%, and >30% of the time in a normal work week), and (iii) reliability (possible, probable, definite). Logistic regression was used to estimate odds ratios (ORs) and their corresponding 95% confidence intervals (CI). Results Those occupationally exposed to (i) low, and (ii) medium or high concentrations of asbestos had ORs for lung cancer of 1.17 (95% CI=0.92 – 1.50) and 2.16 (95% CI=1.21-3.88), respectively, relative to those who were unexposed. Medium or high exposure to asbestos roughly doubled the risk for lung cancer across all three smoking pack-year categories. The joint relationship between smoking and asbestos was consistent with a multiplicative risk model. Conclusions Our findings provide further evidence that exposure to asbestos has contributed to an increased risk of lung cancer in Canadian workplaces, and suggests that nearly 3% of lung cancers among Canadian men are caused by occupational exposure to asbestos.
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Affiliation(s)
- Paul J Villeneuve
- Population Studies Division, Health Canada, Ottawa, Ontario, Canada.
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Hystad P, Demers PA, Johnson KC, Brook J, van Donkelaar A, Lamsal L, Martin R, Brauer M. Spatiotemporal air pollution exposure assessment for a Canadian population-based lung cancer case-control study. Environ Health 2012; 11:22. [PMID: 22475580 PMCID: PMC3372423 DOI: 10.1186/1476-069x-11-22] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [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: 12/06/2011] [Accepted: 04/04/2012] [Indexed: 05/17/2023]
Abstract
BACKGROUND Few epidemiological studies of air pollution have used residential histories to develop long-term retrospective exposure estimates for multiple ambient air pollutants and vehicle and industrial emissions. We present such an exposure assessment for a Canadian population-based lung cancer case-control study of 8353 individuals using self-reported residential histories from 1975 to 1994. We also examine the implications of disregarding and/or improperly accounting for residential mobility in long-term exposure assessments. METHODS National spatial surfaces of ambient air pollution were compiled from recent satellite-based estimates (for PM2.5 and NO2) and a chemical transport model (for O3). The surfaces were adjusted with historical annual air pollution monitoring data, using either spatiotemporal interpolation or linear regression. Model evaluation was conducted using an independent ten percent subset of monitoring data per year. Proximity to major roads, incorporating a temporal weighting factor based on Canadian mobile-source emission estimates, was used to estimate exposure to vehicle emissions. A comprehensive inventory of geocoded industries was used to estimate proximity to major and minor industrial emissions. RESULTS Calibration of the national PM2.5 surface using annual spatiotemporal interpolation predicted historical PM2.5 measurement data best (R2 = 0.51), while linear regression incorporating the national surfaces, a time-trend and population density best predicted historical concentrations of NO2 (R2 = 0.38) and O3 (R2 = 0.56). Applying the models to study participants residential histories between 1975 and 1994 resulted in mean PM2.5, NO2 and O3 exposures of 11.3 μg/m3 (SD = 2.6), 17.7 ppb (4.1), and 26.4 ppb (3.4) respectively. On average, individuals lived within 300 m of a highway for 2.9 years (15% of exposure-years) and within 3 km of a major industrial emitter for 6.4 years (32% of exposure-years). Approximately 50% of individuals were classified into a different PM2.5, NO2 and O3 exposure quintile when using study entry postal codes and spatial pollution surfaces, in comparison to exposures derived from residential histories and spatiotemporal air pollution models. Recall bias was also present for self-reported residential histories prior to 1975, with cases recalling older residences more often than controls. CONCLUSIONS We demonstrate a flexible exposure assessment approach for estimating historical air pollution concentrations over large geographical areas and time-periods. In addition, we highlight the importance of including residential histories in long-term exposure assessments. For submission to: Environmental Health.
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Affiliation(s)
- Perry Hystad
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Ontario, Canada
| | - Kenneth C Johnson
- Science Integration Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ontario, Canada
| | - Jeff Brook
- Air Quality Research Division, Environment, Ontario, Canada
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Ontario, Canada
| | - Lok Lamsal
- Atmospheric Chemistry and Dynamics Branch, NASA Goddard Space Flight Center, Greenbelt, USA
| | - Randall Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Canada; Harvard-Smithsonian Center for Astrophysics, Cambridge, USA
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Villeneuve PJ, Parent MÉ, Sahni V, Johnson KC. Occupational exposure to diesel and gasoline emissions and lung cancer in Canadian men. Environ Res 2011; 111:727-35. [PMID: 21536265 DOI: 10.1016/j.envres.2011.04.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 03/28/2011] [Accepted: 04/04/2011] [Indexed: 05/03/2023]
Abstract
The International Agency for Research on Cancer classifies diesel exhaust as a probable human carcinogen; this decision is based largely from lung cancer evidence. Gasoline exhaust is classified as a possible carcinogen. Epidemiological studies are needed that improve upon some of the limitations of previous research with respect to the characterization of exposure, and the control for the potential confounding influence of smoking and other occupational exposures. Our objective was to investigate associations between occupational exposure to diesel and gasoline engine emissions and lung cancer. We used a case-control study design that involved men 40 years of age and older at the time of interview. Analyses are based on 1681 incident cases of lung cancer and 2,053 population controls. A self-reported questionnaire elicited a lifetime occupational history, including general tasks, and information on other potential risk factors. Occupational exposures to diesel and gasoline emissions, crystalline silica, and asbestos were assigned to each job held by study subjects by industrial hygienists who were blind to case-control status. Exposure metrics for diesel and gasoline emissions that were modeled included: ever exposure, cumulative exposure, and concentration of exposure. We found a dose-response relationship between cumulative occupational exposure to diesel engine emissions and lung cancer. This association was more pronounced for the squamous and large cell subtypes with adjusted odds ratios across the three increasing tertiles of cumulative lifetime exposure relative to those with no exposure of 0.99, 1.25, and 1.32 (p=0.04) for squamous cell carcinoma, and 1.06, 1.19, 1.68 (p=0.02) for large cell carcinoma. While the association with cumulative exposure to gasoline was weakly positive, it was not statistically significant. Our findings suggest that exposure to diesel engine emissions increases the risk of lung cancer particularly for squamous and large cell carcinoma subtypes.
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Affiliation(s)
- Paul J Villeneuve
- Population Studies Division, Health Canada, Ottawa, Ontario, Canada.
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Johnson KC, Daviss BA. International data demonstrate home birth safety. Am J Obstet Gynecol 2011; 204:e16-7; author reply e18-20, discussion e20. [PMID: 21458614 DOI: 10.1016/j.ajog.2011.01.034] [Citation(s) in RCA: 6] [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] [Received: 09/24/2010] [Accepted: 01/19/2011] [Indexed: 11/25/2022]
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Johnson KC, Miller AB, Collishaw NE, Palmer JR, Hammond SK, Salmon AG, Cantor KP, Miller MD, Boyd NF, Millar J, Turcotte F. Active smoking and secondhand smoke increase breast cancer risk: the report of the Canadian Expert Panel on Tobacco Smoke and Breast Cancer Risk (2009). Tob Control 2010; 20:e2. [PMID: 21148114 DOI: 10.1136/tc.2010.035931] [Citation(s) in RCA: 149] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Four authoritative reviews of active smoking and breast cancer have been published since 2000, but only one considered data after 2002 and conclusions varied. Three reviews of secondhand smoke (SHS) and breast cancer (2004-2006) each came to different conclusions. With 30 new studies since 2002, further review was deemed desirable. An Expert Panel was convened by four Canadian agencies, the Ontario Tobacco Research Unit, the Public Health Agency of Canada, Physicians for a Smoke-Free Canada and the Canadian Partnership Against Cancer to comprehensively examine the weight of evidence from epidemiological and toxicological studies and understanding of biological mechanisms regarding the relationship between tobacco smoke and breast cancer. This article summarises the panel's full report (http://www.otru.org/pdf/special/expert_panel_tobacco_breast_cancer.pdf). There are 20 known or suspected mammary carcinogens in tobacco smoke, and recognised biological mechanisms that explain how exposure to these carcinogens could lead to breast cancer. Results from the nine cohort studies reporting exposure metrics more detailed than ever/never and ex/current smoker show that early age of smoking commencement, higher pack-years and longer duration of smoking increase breast cancer risk 15% to 40%. Three meta-analyses report 35% to 50% increases in breast cancer risk for long-term smokers with N-acetyltransferase 2 gene (NAT2) slow acetylation genotypes. The active smoking evidence bolsters support for three meta-analyses that each reported about a 65% increase in premenopausal breast cancer risk among never smokers exposed to SHS. The Panel concluded that: 1) the association between active smoking and breast cancer is consistent with causality and 2) the association between SHS and breast cancer among younger, primarily premenopausal women who have never smoked is consistent with causality.
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Affiliation(s)
- Kenneth C Johnson
- Science Integration Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, 785 Carling Avenue, Ottawa K1A0K9, Canada.
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Bottorff JL, McKeown SB, Carey J, Haines R, Okoli C, Johnson KC, Easley J, Ferrence R, Baillie L, Ptolemy E. Young women's responses to smoking and breast cancer risk information. Health Educ Res 2010; 25:668-77. [PMID: 20080807 PMCID: PMC2905920 DOI: 10.1093/her/cyp067] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Accepted: 12/07/2009] [Indexed: 05/28/2023]
Abstract
Current evidence confirms that young women who smoke or who have regular long-term exposure to secondhand smoke (SHS) have an increased risk of developing premenopausal breast cancer. The aim of this research was to examine the responses of young women to health information about the links between active smoking and SHS exposure and breast cancer and obtain their advice about messaging approaches. Data were collected in focus groups with 46 women, divided in three age cohorts: 15-17, 18-19 and 20-24 and organized according to smoking status (smoking, non-smoking and mixed smoking status groups). The discussion questions were preceded by information about passive and active smoking and its associated breast cancer risk. The study findings show young women's interest in this risk factor for breast cancer. Three themes were drawn from the analysis: making sense of the information on smoking and breast cancer, personal susceptibility and tobacco exposure and suggestions for increasing awareness about tobacco exposure and breast cancer. There was general consensus on framing public awareness messages about this risk factor on 'protecting others' from breast cancer to catch smokers' attention, providing young women with the facts and personal stories of breast cancer to help establish a personal connection with this information and overcome desensitization related to tobacco messages, and targeting all smokers who may place young women at risk. Cautions were also raised about the potential for stigmatization. Implications for raising awareness about this modifiable risk factor for breast cancer are discussed.
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Affiliation(s)
- Joan L Bottorff
- Institute for Healthy Living.hronic Disease Prevention, University of British Columbia Okanagan, Kelowna, BC, Canada.
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