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Olivos N, Banta JE, Spencer-Hwang R, Ansong D, Beane Freeman LE, Clegg-Lamptey JN, Wiafe-Addai B, Edusei L, Adjei E, Titiloye N, Dedey F, Aitpillah F, Oppong J, Vanderpuye V, Osei-Bonsu E, Ahearn TU, Biritwum R, Yarney J, Awuah B, Nyarko K, Garcia-Closas M, Abubakar M, Brinton LA, Figueroa JD, Wiafe S. Mosquito control exposures and breast cancer risk: analysis of 1071 cases and 2096 controls from the Ghana Breast Health Study. Breast Cancer Res 2023; 25:150. [PMID: 38082317 PMCID: PMC10714652 DOI: 10.1186/s13058-023-01737-x] [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: 06/19/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Epidemiologic data on insecticide exposures and breast cancer risk are inconclusive and mostly from high-income countries. Using data from 1071 invasive pathologically confirmed breast cancer cases and 2096 controls from the Ghana Breast Health Study conducted from 2013 to 2015, we investigated associations with mosquito control products to reduce the spread of mosquito-borne diseases, such as malaria. These mosquito control products were insecticide-treated nets, mosquito coils, repellent room sprays, and skin creams for personal protection against mosquitos. Multivariable and polytomous logistic regression models were used to estimate odds ratios (ORadj) and 95% confidence intervals (CI) with breast cancer risk-adjusted for potential confounders and known risk factors. Among controls, the reported use of mosquito control products were mosquito coils (65%), followed by insecticide-treated nets (56%), repellent room sprays (53%), and repellent skin creams (15%). Compared to a referent group of participants unexposed to mosquito control products, there was no significant association between breast cancer risk and mosquito coils. There was an association in breast cancer risk with reported use of insecticide-treated nets; however, that association was weak and not statistically significant. Participants who reported using repellent sprays were at elevated risks compared to women who did not use any mosquito control products, even after adjustment for all other mosquito control products (OR = 1.42, 95% CI=1.15-1.75). We had limited power to detect an association with repellent skin creams. Although only a few participants reported using repellent room sprays weekly/daily or < month-monthly, no trends were evident with increased frequency of use of repellent sprays, and there was no statistical evidence of heterogeneity by estrogen receptor (ER) status (p-het > 0.25). Our analysis was limited when determining if an association existed with repellent skin creams; therefore, we cannot conclude an association. We found limited evidence of risk associations with widely used mosquito coils and insecticide-treated nets, which are reassuring given their importance for malaria prevention. Our findings regarding specific breast cancer risk associations, specifically those observed between repellent sprays, require further study.
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Affiliation(s)
- Naomie Olivos
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Jim E Banta
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | | | | | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | | | | | | | | | | | | | | | | | | | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | | | | | | | | | - Mustapha Abubakar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jonine D Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
| | - Seth Wiafe
- School of Public Health, Loma Linda University, Loma Linda, CA, USA.
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Wu Z, Pfeiffer RM, Byrd DA, Wan Y, Ansong D, Clegg-Lamptey JN, Wiafe-Addai B, Edusei L, Adjei E, Titiloye N, Dedey F, Aitpillah F, Oppong J, Vanderpuye V, Osei-Bonsu E, Dagnall CL, Jones K, Hutchinson A, Hicks BD, Ahearn TU, Knight R, Biritwum R, Yarney J, Wiafe S, Awuah B, Nyarko K, Garcia-Closas M, Sinha R, Figueroa JD, Brinton LA, Trabert B, Vogtmann E. Associations of Circulating Estrogens and Estrogen Metabolites with Fecal and Oral Microbiome in Postmenopausal Women in the Ghana Breast Health Study. Microbiol Spectr 2023; 11:e0157223. [PMID: 37341612 PMCID: PMC10433996 DOI: 10.1128/spectrum.01572-23] [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: 04/24/2023] [Accepted: 05/26/2023] [Indexed: 06/22/2023] Open
Abstract
The human fecal and oral microbiome may play a role in the etiology of breast cancer through modulation of endogenous estrogen metabolism. This study aimed to investigate associations of circulating estrogens and estrogen metabolites with the fecal and oral microbiome in postmenopausal African women. A total of 117 women with fecal (N = 110) and oral (N = 114) microbiome data measured by 16S rRNA gene sequencing, and estrogens and estrogen metabolites data measured by liquid chromatography tandem mass spectrometry were included. The outcomes were measures of the microbiome and the independent variables were the estrogens and estrogen metabolites. Estrogens and estrogen metabolites were associated with the fecal microbial Shannon index (global P < 0.01). In particular, higher levels of estrone (β = 0.36, P = 0.03), 2-hydroxyestradiol (β = 0.30, P = 0.02), 4-methoxyestrone (β = 0.51, P = 0.01), and estriol (β = 0.36, P = 0.04) were associated with higher levels of the Shannon index, while 16alpha-hydroxyestrone (β = -0.57, P < 0.01) was inversely associated with the Shannon index as indicated by linear regression. Conjugated 2-methoxyestrone was associated with oral microbial unweighted UniFrac as indicated by MiRKAT (P < 0.01) and PERMANOVA, where conjugated 2-methoxyestrone explained 2.67% of the oral microbial variability, but no other estrogens or estrogen metabolites were associated with any other beta diversity measures. The presence and abundance of multiple fecal and oral genera, such as fecal genera from families Lachnospiraceae and Ruminococcaceae, were associated with several estrogens and estrogen metabolites as indicated by zero-inflated negative binomial regression. Overall, we found several associations of specific estrogens and estrogen metabolites and the fecal and oral microbiome. IMPORTANCE Several epidemiologic studies have found associations of urinary estrogens and estrogen metabolites with the fecal microbiome. However, urinary estrogen concentrations are not strongly correlated with serum estrogens, a known risk factor for breast cancer. To better understand whether the human fecal and oral microbiome were associated with breast cancer risk via the regulation of estrogen metabolism, we conducted this study to investigate the associations of circulating estrogens and estrogen metabolites with the fecal and oral microbiome in postmenopausal African women. We found several associations of parent estrogens and several estrogen metabolites with the microbial communities, and multiple individual associations of estrogens and estrogen metabolites with the presence and abundance of multiple fecal and oral genera, such as fecal genera from families Lachnospiraceae and Ruminococcaceae, which have estrogen metabolizing properties. Future large, longitudinal studies to investigate the dynamic changes of the fecal and oral microbiome and estrogen relationship are needed.
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Affiliation(s)
- Zeni Wu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Ruth M. Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Doratha A. Byrd
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Yunhu Wan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Casey L. Dagnall
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Cancer Genomics Research Laboratory, Frederick National Lab for Cancer Research, Frederick, Maryland, USA
| | - Kristine Jones
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Cancer Genomics Research Laboratory, Frederick National Lab for Cancer Research, Frederick, Maryland, USA
| | - Amy Hutchinson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Cancer Genomics Research Laboratory, Frederick National Lab for Cancer Research, Frederick, Maryland, USA
| | - Belynda D. Hicks
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Cancer Genomics Research Laboratory, Frederick National Lab for Cancer Research, Frederick, Maryland, USA
| | - Thomas U. Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | | | | | - Seth Wiafe
- School of Public Health, Loma Linda University, Loma Linda, California, USA
| | | | | | - Montserrat Garcia-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Jonine D. Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Louise A. Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Britton Trabert
- Department of Obstetrics and Gynecology, University of Utah, and Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah, USA
| | - Emily Vogtmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
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Nyarko K, Whale J, Urmee T. Drivers and challenges of off-grid renewable energy-based projects in West Africa: A review. Heliyon 2023; 9:e16710. [PMID: 37292273 PMCID: PMC10245072 DOI: 10.1016/j.heliyon.2023.e16710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/11/2023] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023] Open
Abstract
Off-grid hybrid power systems with renewable energy as the primary resource remain the best option to electrify rural/remote areas in developing countries to help attain universal electricity access by 2030. However, deploying these systems in West Africa faces several challenges and regularly fail to transition from pilot, donor-sponsored projects to sustainable large-scale implementations. The study examined the drivers and challenges by conducting a review of previous studies done in the region and a short survey in Ghana. Using Political, Economic, Social, Technical, Legal and Environmental dimensions, the review and survey showed that economic challenges have the worst impacts on the sustainable development of off-grid renewable energy-based power systems in WA. Further, the analysis revealed patterns and linkages among the challenges that make it detrimental to focus solely on the most pressing challenges.
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Affiliation(s)
- Kofi Nyarko
- Department of Energy Systems Engineering, Faculty of Engineering, Koforidua Technical University, P. O. Box KF 981, Koforidua, Ghana
| | - Jonathan Whale
- Discipline of Engineering and Energy, Murdoch University, Murdoch, WA, 6150, Australia
| | - Tania Urmee
- Discipline of Engineering and Energy, Murdoch University, Murdoch, WA, 6150, Australia
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Abubakar M, Ahearn TU, Duggan MA, Lawrence S, Adjei E, Clegg-Lamptey JN, Yarney J, Wiafe-Addai B, Awuah B, Wiafe S, Nyarko K, Aitpillah F, Ansong D, Hewitt SM, Brinton LA, Figueroa JD, Garcia-Closas M, Edusei L, Titiloye N. Associations of breast cancer etiologic factors with stromal microenvironment of primary invasive breast cancers in the Ghana Breast Health Study. Res Sq 2023:rs.3.rs-2791342. [PMID: 37090574 PMCID: PMC10120782 DOI: 10.21203/rs.3.rs-2791342/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Background Emerging data suggest that beyond the neoplastic parenchyma, the stromal microenvironment (SME) impacts tumor biology, including aggressiveness, metastatic potential, and response to treatment. However, the epidemiological determinants of SME biology remain poorly understood, more so among women of African ancestry who are disproportionately affected by aggressive breast cancer phenotypes. Methods Within the Ghana Breast Health Study, a population-based case-control study in Ghana, we applied high-accuracy machine-learning algorithms to characterize biologically-relevant SME phenotypes, including tumor-stroma ratio (TSR (%); a metric of connective tissue stroma to tumor ratio) and tumor-associated stromal cellular density (Ta-SCD (%); a tissue biomarker that is reminiscent of chronic inflammation and wound repair response in breast cancer), on digitized H&E-stained sections from 792 breast cancer patients aged 17-84 years. Kruskal-Wallis tests and multivariable linear regression models were used to test associations between established breast cancer risk factors, tumor characteristics, and SME phenotypes. Results Decreasing TSR and increasing Ta-SCD were strongly associated with aggressive, mostly high grade tumors (p-value < 0.001). Several etiologic factors were associated with Ta-SCD, but not TSR. Compared with nulliparous women [mean (standard deviation) = 28.9% (7.1%)], parous women [mean (standard deviation) = 31.3% (7.6%)] had statistically significantly higher levels of Ta-SCD (p-value = 0.01). Similarly, women with a positive family history of breast cancer [FHBC; mean (standard deviation) = 33.0% (7.5%)] had higher levels of Ta-SCD than those with no FHBC [mean (standard deviation) = 30.9% (7.6%); p-value = 0.01]. Conversely, increasing body size was associated with decreasing Ta-SCD [mean (standard deviation) = 32.0% (7.4%), 31.3% (7.3%), and 29.0% (8.0%) for slight, moderate, and large body sizes, respectively, p-value = 0.005]. These associations persisted and remained statistically significantly associated with Ta-SCD in mutually-adjusted multivariable linear regression models (p-value < 0.05). With the exception of body size, which was differentially associated with Ta-SCD by grade levels (p-heterogeneity = 0.04), associations between risk factors and Ta-SCD were not modified by tumor characteristics. Conclusions Our findings raise the possibility that epidemiological factors may act via the SME to impact both risk and biology of breast cancers in this population, underscoring the need for more population-based research into the role of SME in multi-state breast carcinogenesis.
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Geczik AM, Falk RT, Xu X, Wiafe-Addai B, Yarney J, Awuah B, Biritwum R, Vanderpuye V, Dedey F, Adjei E, Aitpillah F, Osei-Bonsu E, Oppong J, Titiloye N, Edusei L, Nyarko K, Clegg-Lamptey JN, Wiafe S, Ansong D, Ahearn TU, Figueroa J, Garcia-Closas M, Brinton LA, Trabert B. Relation of circulating estrogens with hair relaxer and skin lightener use among postmenopausal women in Ghana. J Expo Sci Environ Epidemiol 2023; 33:301-310. [PMID: 34992224 PMCID: PMC9256865 DOI: 10.1038/s41370-021-00407-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Hair relaxers and skin lighteners have been commonly used by African women, with suggestions that they may have hormonal activity. OBJECTIVES To investigate the relationship of hair relaxer and skin lightener use to serum estrogen/estrogen metabolite levels. METHODS We utilized the postmenopausal population-based controls of the Ghana Breast Health Study to estimate adjusted geometric means (GM) and 95% confidence intervals of individual circulating estrogen levels by hair relaxer/skin lightener exposure categories. RESULTS Of the 585 postmenopausal women included in our analysis, 80.2% reported hair relaxer use and 29.4% skin lightener use. Ever hair relaxer use was positively associated with estriol (adjusted GM 95.4 pmol/L vs. never 74.5, p value = 0.02) and 16-epiestriol (20.4 vs. 16.8, p value = 0.05) particularly among users of lye-based hair relaxers. Positive associations between scalp burns and unconjugated estrogens were observed (e.g., unconjugated estrone: 5+ scalp burns 76.9 [59.6-99.2] vs. no burns 64.0 [53.7-76.3], p-trend = 0.03). No association was observed between use of skin lighteners and circulating estrogens. SIGNIFICANCE This study presents evidence that circulating 16-pathway estrogens (i.e., estriol and 16-epiestriol) may be increased in users of lye-based hair relaxer products. Among hair relaxer users, unconjugated estrogen levels were elevated in women with a greater number of scalp burns. IMPACT STATEMENT In this population-based study of hair relaxer and skin lightener use among postmenopausal women in Ghana, altered estrogen metabolism was observed with hair relaxer use, particularly among women using lye-based products or with a greater number of scalp burns. In contrast, skin lightener use was not associated with differences in estrogen metabolism in this population. Continued investigation of the potential biological impact on breast cancer risk of hair relaxer use is warranted.
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Affiliation(s)
- Ashley M Geczik
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Xia Xu
- Protein Characterization Laboratory, Leidos-Frederick, Inc, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Seth Wiafe
- Loma Linda University, School of Public Health, Loma Linda, CA, USA
| | - Daniel Ansong
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jonine Figueroa
- The University of Edinburgh, Cancer Research UK Edinburgh Center, Edinburgh, UK
| | - Montserrat Garcia-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Geczik AM, Falk RT, Xu X, Wiafe-Addai B, Yarney J, Awuah B, Biritwum R, Vanderpuye V, Dedey F, Adjei E, Aitpillah F, Osei-Bonsu E, Oppong J, Titiloye N, Edusei L, Nyarko K, Clegg-Lamptey JN, Wiafe S, Ansong D, Ahearn TU, Figueroa J, Garcia-Closas M, Brinton LA, Trabert B. Correction to: Relation of circulating estrogens with hair relaxer and skin lightener use among postmenopausal women in Ghana. J Expo Sci Environ Epidemiol 2023; 33:311. [PMID: 35094015 DOI: 10.1038/s41370-022-00415-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Ashley M Geczik
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Xia Xu
- Protein Characterization Laboratory, Leidos-Frederick, Inc, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Seth Wiafe
- Loma Linda University, School of Public Health, Loma Linda, CA, USA
| | - Daniel Ansong
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jonine Figueroa
- The University of Edinburgh, Cancer Research UK Edinburgh Center, Edinburgh, UK
| | - Montserrat Garcia-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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7
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Wu Z, Byrd DA, Wan Y, Ansong D, Clegg-Lamptey JN, Wiafe-Addai B, Edusei L, Adjei E, Titiloye N, Dedey F, Aitpillah F, Oppong J, Vanderpuye V, Osei-Bonsu E, Dagnall CL, Jones K, Hutchinson A, Hicks BD, Ahearn TU, Shi J, Knight R, Biritwum R, Yarney J, Seth Wiafe, Awuah B, Nyarko K, Figueroa JD, Sinha R, Garcia-Closas M, Brinton LA, Vogtmann E. The oral microbiome and breast cancer and nonmalignant breast disease, and its relationship with the fecal microbiome in the Ghana Breast Health Study. Int J Cancer 2022; 151:1248-1260. [PMID: 35657343 PMCID: PMC9420782 DOI: 10.1002/ijc.34145] [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: 12/07/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 12/24/2022]
Abstract
The oral microbiome, like the fecal microbiome, may be related to breast cancer risk. Therefore, we investigated whether the oral microbiome was associated with breast cancer and nonmalignant breast disease, and its relationship with the fecal microbiome in a case-control study in Ghana. A total of 881 women were included (369 breast cancers, 93 nonmalignant cases and 419 population-based controls). The V4 region of the 16S rRNA gene was sequenced from oral and fecal samples. Alpha-diversity (observed amplicon sequence variants [ASVs], Shannon index and Faith's Phylogenetic Diversity) and beta-diversity (Bray-Curtis, Jaccard and weighted and unweighted UniFrac) metrics were computed. MiRKAT and logistic regression models were used to investigate the case-control associations. Oral sample alpha-diversity was inversely associated with breast cancer and nonmalignant breast disease with odds ratios (95% CIs) per every 10 observed ASVs of 0.86 (0.83-0.89) and 0.79 (0.73-0.85), respectively, compared to controls. Beta-diversity was also associated with breast cancer and nonmalignant breast disease compared to controls (P ≤ .001). The relative abundances of Porphyromonas and Fusobacterium were lower for breast cancer cases compared to controls. Alpha-diversity and presence/relative abundance of specific genera from the oral and fecal microbiome were strongly correlated among breast cancer cases, but weakly correlated among controls. Particularly, the relative abundance of oral Porphyromonas was strongly, inversely correlated with fecal Bacteroides among breast cancer cases (r = -.37, P ≤ .001). Many oral microbial metrics were strongly associated with breast cancer and nonmalignant breast disease, and strongly correlated with fecal microbiome among breast cancer cases, but not controls.
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Affiliation(s)
- Zeni Wu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Doratha A Byrd
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL USA
| | - Yunhu Wan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Casey L. Dagnall
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Cancer Genomics Research Laboratory, Frederick National Lab for Cancer Research, Frederick, MD USA
| | - Kristine Jones
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Cancer Genomics Research Laboratory, Frederick National Lab for Cancer Research, Frederick, MD USA
| | - Amy Hutchinson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Cancer Genomics Research Laboratory, Frederick National Lab for Cancer Research, Frederick, MD USA
| | - Belynda D. Hicks
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Cancer Genomics Research Laboratory, Frederick National Lab for Cancer Research, Frederick, MD USA
| | - Thomas U. Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
| | | | | | - Seth Wiafe
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | | | | | - Jonine D. Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Louise A. Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Emily Vogtmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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Ahearn TU, Choudhury PP, Derkach A, Wiafe-Addai B, Awuah B, Yarney J, Edusei L, Titiloye N, Adjei E, Vanderpuye V, Aitpillah F, Dedey F, Oppong J, Osei-Bonsu EB, Duggan MA, Brinton LA, Allen J, Luccarini C, Baynes C, Carvalho S, Dunning AM, Davis Lynn BC, Chanock SJ, Hicks BD, Yeager M, Chatterjee N, Biritwum R, Clegg-Lamptey JN, Nyarko K, Wiafe S, Ansong D, Easton DF, Figueroa JD, Garcia-Closas M. Breast Cancer Risk in Women from Ghana Carrying Rare Germline Pathogenic Mutations. Cancer Epidemiol Biomarkers Prev 2022; 31:1593-1601. [PMID: 35654374 DOI: 10.1158/1055-9965.epi-21-1397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/16/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Risk estimates for women carrying germline mutations in breast cancer susceptibility genes are mainly based on studies of European ancestry women. METHODS We investigated associations between pathogenic variants (PV) in 34 genes with breast cancer risk in 871 cases [307 estrogen receptor (ER)-positive, 321 ER-negative, and 243 ER-unknown] and 1,563 controls in the Ghana Breast Health Study (GBHS), and estimated lifetime risk for carriers. We compared results with those for European, Asian, and African American ancestry women. RESULTS The frequency of PV in GBHS for nine breast cancer genes was 8.38% in cases and 1.22% in controls. Relative risk estimates for overall breast cancer were: (OR, 13.70; 95% confidence interval (CI), 4.03-46.51) for BRCA1, (OR, 7.02; 95% CI, 3.17-15.54) for BRCA2, (OR, 17.25; 95% CI, 2.15-138.13) for PALB2, 5 cases and no controls carried TP53 PVs, and 2.10, (0.72-6.14) for moderate-risk genes combined (ATM, BARD1, CHEK2, RAD51C, RAD52D). These estimates were similar to those previously reported in other populations and were modified by ER status. No other genes evaluated had mutations associated at P < 0.05 with overall risk. The estimated lifetime risks for mutation carriers in BRCA1, BRCA2, and PALB2 and moderate-risk genes were 18.4%, 9.8%, 22.4%, and 3.1%, respectively, markedly lower than in Western populations with higher baseline risks. CONCLUSIONS We confirmed associations between PV and breast cancer risk in Ghanaian women and provide absolute risk estimates that could inform counseling in Ghana and other West African countries. IMPACT These findings have direct relevance for breast cancer genetic counseling for women in West Africa.
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Affiliation(s)
- Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Parichoy Pal Choudhury
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Andriy Derkach
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | | | | | | | | | | | | | | | | | | | - Máire A Duggan
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Jamie Allen
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Craig Luccarini
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Caroline Baynes
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Sara Carvalho
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Brittny C Davis Lynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Belynda D Hicks
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Meredith Yeager
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Nilanjan Chatterjee
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | | | | | - Seth Wiafe
- Loma Linda University, School of Public Health, Loma Linda, California
| | | | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Jonine D Figueroa
- Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, United Kingdom
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9
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Geczik AM, Falk RT, Xu X, Ansong D, Yarney J, Wiafe-Addai B, Edusei L, Dedey F, Vanderpuye V, Titiloye N, Adjei E, Aitpillah F, Osei-Bonsu E, Oppong J, Biritwum R, Nyarko K, Wiafe S, Awuah B, Clegg-Lamptey JN, Ahearn TU, Figueroa J, Garcia-Closas M, Brinton LA, Trabert B. Measured body size and serum estrogen metabolism in postmenopausal women: the Ghana Breast Health Study. Breast Cancer Res 2022; 24:9. [PMID: 35081987 PMCID: PMC8793253 DOI: 10.1186/s13058-022-01500-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Several anthropometric measures have been associated with hormone-related cancers, and it has been shown that estrogen metabolism in postmenopausal women plays an important role in these relationships. However, little is known about circulating estrogen levels in African women, and the relevance to breast cancer or breast cancer risk factors. To shed further light on the relationship of anthropometric factors and estrogen levels in African women, we examined whether measured body mass index (BMI), waist-to-hip ratio (WHR), height, and self-reported body size were associated with serum estrogens/estrogen metabolites in a cross-sectional analysis among postmenopausal population-based controls of the Ghana Breast Health Study.
Methods
Fifteen estrogens/estrogen metabolites were quantified using liquid chromatography-tandem mass spectrometry in serum samples collected from postmenopausal female controls enrolled in the Ghana Breast Health Study, a population-based case–control study conducted in Accra and Kumasi. Geometric means (GMs) of estrogens/estrogen metabolites were estimated using linear regression, adjusting for potential confounders.
Results
Measured BMI (≥ 30 vs. 18.5–24.9 kg/m2) was positively associated with parent estrogens (multivariable adjusted GM for unconjugated estrone: 78.90 (66.57–93.53) vs. 50.89 (43.47–59.59), p-value < 0.0001; and unconjugated estradiol: 27.83 (21.47–36.07) vs. 13.26 (10.37–16.95), p-value < 0.0001). Independent of unconjugated estradiol, measured BMI was associated with lower levels of 2-pathway metabolites and higher levels of 16-ketoestradriol. Similar patterns of association were found with WHR; however, the associations were not entirely independent of BMI. Height was not associated with postmenopausal estrogens/estrogen metabolite levels in African women.
Conclusions
We observed strong associations between measured BMI and parent estrogens and estrogen metabolite patterns that largely mirrored relations that have previously been associated with higher breast cancer risk in postmenopausal White women. The consistency of the BMI-estrogen metabolism associations in our study with those previously noted among White women suggests that estrogens likely explain part of the BMI-postmenopausal breast cancer risk in both groups. These findings merit evaluation in Black women, including prospective studies.
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10
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Kargbo DK, Nyarko K, Sackey S, Addo-Lartey A, Kenu E, Anto F. Determinants of low birth weight deliveries at five referral hospitals in Western Area Urban district, Sierra Leone. Ital J Pediatr 2021; 47:212. [PMID: 34711248 PMCID: PMC8554995 DOI: 10.1186/s13052-021-01160-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 09/24/2021] [Indexed: 12/02/2022] Open
Abstract
Background Low birth weight (LBW) contributes significantly to infant and child mortality. Each year, about 20 1million deliveries are LBW with 96.5% occurring in developing countries. Whiles the incidence of LBW is reducing in other districts of Sierra Leone, it has been reported to be increasing in the Western Area Urban district. Determining the risk factors in a specific geographic area is important for identifying mothers at risk and thereby for planning and taking appropriate action. The current study sought to identify factors associated with LBW deliveries in the Western Area Urban district of Sierra Leone. Methods A hospital-based unmatched 1:2 case-control study was conducted among mothers who delivered live singleton babies from November, 2019 to February, 2020 in five referral health facilities. Mothers were conveniently sampled and sequentially enrolled into the study after delivery. Their antenatal care cards were reviewed and a pre-tested questionnaire administered to the mothers. Data analysis was done using Stata 15.0 and association between maternal socio-demographic, socio-economic, obstetric and lifestyle factors and LBW assessed using bivariable and multivariable logistic regression analyses. Results A total of 438 mothers (146 cases and 292 controls), mean age: 24.2 (±5.8) and 26.1 (±5.5) years for cases and controls respectively participated in the study. Multivariable analysis revealed that being unemployed (AoR = 2.52, 95% CI 1.16–5.49, p = 0.020), having anaemia during pregnancy (AoR = 3.88, 95% CI 1.90–7.90, p < 0.001), having less than 2 years inter-pregnancy interval (AoR = 2.53, 95% CI 1.11–5.73, p = 0.026), and smoking cigarettes during pregnancy (AoR = 4.36, 95% CI 1.94–9.80, p < 0.001) were significantly associated with having LBW babies. Conclusion Factors associated with LBW identified were unemployment, anaemia during pregnancy, < 2 years inter-pregnancy interval and cigarette smoking during pregnancy. Health care providers should screen and sensitize mothers on the risk factors of LBW during antenatal sessions. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-021-01160-y.
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Affiliation(s)
- David Kabba Kargbo
- Field Epidemiology and Laboratory Training Programme, Accra, Ghana.,Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.,Field Epidemiology Training Program, Free Town, Sierra Leone
| | - Kofi Nyarko
- Field Epidemiology Training Program, Free Town, Sierra Leone
| | - Samuel Sackey
- Field Epidemiology and Laboratory Training Programme, Accra, Ghana.,Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Adolphina Addo-Lartey
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Ernest Kenu
- Field Epidemiology and Laboratory Training Programme, Accra, Ghana.,Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Francis Anto
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.
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11
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Ahuno ST, Doebley AL, Ahearn TU, Yarney J, Titiloye N, Hamel N, Adjei E, Clegg-Lamptey JN, Edusei L, Awuah B, Song X, Vanderpuye V, Abubakar M, Duggan M, Stover DG, Nyarko K, Bartlett JMS, Aitpillah F, Ansong D, Gardner KL, Boateng FA, Bowcock AM, Caldas C, Foulkes WD, Wiafe S, Wiafe-Addai B, Garcia-Closas M, Kwarteng A, Ha G, Figueroa JD, Polak P. Circulating tumor DNA is readily detectable among Ghanaian breast cancer patients supporting non-invasive cancer genomic studies in Africa. NPJ Precis Oncol 2021; 5:83. [PMID: 34535742 PMCID: PMC8448727 DOI: 10.1038/s41698-021-00219-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 07/21/2021] [Indexed: 12/20/2022] Open
Abstract
Circulating tumor DNA (ctDNA) sequencing studies could provide novel insights into the molecular pathology of cancer in sub-Saharan Africa. In 15 patient plasma samples collected at the time of diagnosis as part of the Ghana Breast Health Study and unselected for tumor grade and subtype, ctDNA was detected in a majority of patients based on whole- genome sequencing at high (30×) and low (0.1×) depths. Breast cancer driver copy number alterations were observed in the majority of patients.
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Affiliation(s)
- Samuel Terkper Ahuno
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Anna-Lisa Doebley
- Molecular and Cellular Biology Program, University of Washington, Seattle, WA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | | | - Nancy Hamel
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | | | | | | | | | - Xiaoyu Song
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | | | - Mustapha Abubakar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Maire Duggan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Daniel G Stover
- Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA
- Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | | | - John M S Bartlett
- Ontario Institute for Cancer Research, Toronto, ON, Canada
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Francis Aitpillah
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
- School of Medicine & Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Ansong
- Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kevin L Gardner
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York, USA
| | | | - Anne M Bowcock
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | | | - William D Foulkes
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Lady Davis Institute and Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada
- Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montréal, QC, Canada
| | - Seth Wiafe
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | | | | | - Alexander Kwarteng
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Kumasi Center for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Gavin Ha
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Jonine D Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
- CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, UK.
| | - Paz Polak
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
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12
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Ahuno S, Doebley AL, Ahearn T, Yarney J, Titiloye N, Hamel N, Adjei E, Clegg-Lamptey JN, Edusei L, Awuah B, Song X, Vanderpuye V, Abubakar M, Duggan M, Stover D, Nyarko K, Bartlet J, Aitpillah F, Ansong D, Gardner K, Bowcock A, Caldas C, Foulkes W, Wiafe S, Wiafe-Addai, Garcia-Closas M, Kwarteng A, Ha G, Figueroa J, Polak P. Abstract 81: Studying Ghanian Cancer Genomes Using Cell-free DNA. Cancer Epidemiol Biomarkers Prev 2021. [DOI: 10.1158/1538-7755.asgcr21-81] [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] Open
Abstract
Abstract
Purpose: Analysis of cell free DNA could provide a rapid and non-invasive approach to detect cancer and provide new molecular insights in many African countries where expert pathology is lacking. Hence, we tested whether whole-genome sequencing of cfDNA (WGS-cfDNA) could identify somatic alterations that drive breast cancer.
Methods: We conducted a pilot on 15 Ghanaian women (median age 49.5 years) recruited as part of the Ghana Breast Health Study. cfDNA was extracted and subjected to WGS at 30x and 0.1x. ichorCNA software was used to predict copy number alterations and ctDNA fractions.
Results: We found extensive amplification and deletion of multiple chromosomal regions including those with oncogenes and tumor suppressor genes associated with breast cancer. Similar copy number alterations for selected breast cancer genes were observed with 0.1x and 30x cfDNA-WGS with increasing concordance between the two instruments as the ctDNA fraction increases. We observed a high frequency (>50%) of copy number gain in 3/5 regions and potential target genes for the amplification (chr8p11-12 [ZNF703] n=8, 53.3%; chr8q24.2 [MYC] n=9, 60%; chr19q12 [CCNE1] n=9, 60%), which were in agreement to previous observations among African-American (AA) ancestry compared to European-American (EA) ancestry in TCGA datasets.
Conclusion: Our data provided evidence that ctDNA-based genomic studies are possible and ctDNA analysis could be a tool for future molecular oncology studies in Africa for cancer etiology, surveillance and clinical trials.
Citation Format: Samuel Ahuno, Anna-Lisa Doebley, Thomas Ahearn, Joel Yarney, Nicholas Titiloye, Nancy Hamel, Ernest Adjei, Joe-Nat Clegg-Lamptey, Lawrence Edusei, Baffour Awuah, Xiaoyu Song, Verne Vanderpuye, Mustapha Abubakar, Maire Duggan, Daniel Stover, Kofi Nyarko, John Bartlet, Francis Aitpillah, Daniel Ansong, Kevin Gardner, Anne Bowcock, Carlos Caldas, William Foulkes, Seth Wiafe, Wiafe-Addai, Montserrat Garcia-Closas, Alexander Kwarteng, Gavin Ha, Jonine Figueroa, Paz Polak, On Behalf Of Ghana Breast Health Study Team. Studying Ghanian Cancer Genomes Using Cell-free DNA [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 81.
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Affiliation(s)
- Samuel Ahuno
- 1Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,
| | - Anna-Lisa Doebley
- 2Molecular and Cellular Biology Program, University of Washington, Seattle, WA, USA,
| | - Thomas Ahearn
- 3Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA,
| | | | | | - Nancy Hamel
- 6Research Institute of the McGill University Health Centre, Montréal, QC, Canada,
| | | | | | | | | | - Xiaoyu Song
- 7Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA,
| | | | - Mustapha Abubakar
- 3Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA,
| | - Maire Duggan
- 8Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada,
| | - Daniel Stover
- 9Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH, USA,
| | | | - John Bartlet
- 11Ontario Institute for Cancer Research, Toronto, Ontario, Canada,
| | | | - Daniel Ansong
- 12Department of Child Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,
| | - Kevin Gardner
- 13Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA,
| | - Anne Bowcock
- 14Departments of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York City, New York,
| | - Carlos Caldas
- 15Cancer Research UK Cambridge Centre, Cambridge, UK,
| | - William Foulkes
- 6Research Institute of the McGill University Health Centre, Montréal, QC, Canada,
| | - Seth Wiafe
- 16Loma Linda University, School of Public Health, Loma Linda, CA, USA,
| | | | | | - Alexander Kwarteng
- 1Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,
| | - Gavin Ha
- 18Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA,
| | - Jonine Figueroa
- 19Usher Institute, Edinburgh, United Kingdom,
- 20Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Paz Polak
- 1Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,
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13
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Byrd DA, Vogtmann E, Wu Z, Han Y, Wan Y, Clegg-Lamptey JN, Yarney J, Wiafe-Addai B, Wiafe S, Awuah B, Ansong D, Nyarko K, Hullings AG, Hua X, Ahearn T, Goedert JJ, Shi J, Knight R, Figueroa JD, Brinton LA, Garcia-Closas M, Sinha R. Associations of fecal microbial profiles with breast cancer and nonmalignant breast disease in the Ghana Breast Health Study. Int J Cancer 2021; 148:2712-2723. [PMID: 33460452 PMCID: PMC8386185 DOI: 10.1002/ijc.33473] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 08/03/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 12/11/2022]
Abstract
The gut microbiota may play a role in breast cancer etiology by regulating hormonal, metabolic and immunologic pathways. We investigated associations of fecal bacteria with breast cancer and nonmalignant breast disease in a case-control study conducted in Ghana, a country with rising breast cancer incidence and mortality. To do this, we sequenced the V4 region of the 16S rRNA gene to characterize bacteria in fecal samples collected at the time of breast biopsy (N = 379 breast cancer cases, N = 102 nonmalignant breast disease cases, N = 414 population-based controls). We estimated associations of alpha diversity (observed amplicon sequence variants [ASVs], Shannon index, and Faith's phylogenetic diversity), beta diversity (Bray-Curtis and unweighted/weighted UniFrac distance), and the presence and relative abundance of select taxa with breast cancer and nonmalignant breast disease using multivariable unconditional polytomous logistic regression. All alpha diversity metrics were strongly, inversely associated with odds of breast cancer and for those in the highest relative to lowest tertile of observed ASVs, the odds ratio (95% confidence interval) was 0.21 (0.13-0.36; Ptrend < .001). Alpha diversity associations were similar for nonmalignant breast disease and breast cancer grade/molecular subtype. All beta diversity distance matrices and multiple taxa with possible estrogen-conjugating and immune-related functions were strongly associated with breast cancer (all Ps < .001). There were no statistically significant differences between breast cancer and nonmalignant breast disease cases in any microbiota metric. In conclusion, fecal bacterial characteristics were strongly and similarly associated with breast cancer and nonmalignant breast disease. Our findings provide novel insight into potential microbially-mediated mechanisms of breast disease.
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Affiliation(s)
- Doratha A. Byrd
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Emily Vogtmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Zeni Wu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Yongli Han
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Yunhu Wan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | | | | | - Seth Wiafe
- Loma Linda University, School of Public Health, Loma Linda, CA, USA
| | | | | | | | - Autumn G. Hullings
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Xing Hua
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Thomas Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - James J. Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, California
| | - Jonine D. Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
- Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | - Louise A. Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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14
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Ahuno ST, Edusei L, Titiloye N, Adjei E, Clegg-Lamptey JN, Yarney J, Wiafe-Addai B, Awuah B, Vanderpuye V, Duggan M, Wiafe S, Nyarko K, Aitpillah F, Ansong D, Ahearn T, Kwarteng A, Abubakar M, Garcia-Closas M, Ha G, Figueroa JD, Polak P. Abstract PO-093: Circulating tumor DNA (ctDNA) from peripheral blood is detectable among Ghanaian breast cancer patients. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp20-po-093] [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] Open
Abstract
Abstract
Cancer incidence is rising and mortality rates are high in Africa, where access to molecular pathology is limited. Analysis of cancer-related mutations in circulating tumor DNA (ctDNA) from cell-free DNA (cfDNA) that is shed into the bloodstream by tumor cells could be transformative to the African continent and provide new molecular insights. Using samples collected from the Ghana Breast Health Study we tested whether whole-genome sequencing (WGS) of cfDNA could detect ctDNA and identify somatic alterations that drive breast cancer. We selected 15 breast cancer patients (median age 49.5 years) with duplicated plasma samples. Pathologic grade, age, and immunohistochemical (IHC) stains for estrogen receptor (ER), progesterone receptor (PR) and HER2 were available for the majority of patients (>80%). cfDNA extraction and WGS at 30x and 0.1x was performed. ichorCNA software was used on Next Generation Sequencing (NGS) read counts to estimate the ctDNA fraction and predict copy number alteration profiles. High depth 30x cfDNA-WGS analysis showed that all 15 breast cancer patients had 1% ctDNA or greater (median[IQR] 3.96%[2.22%-8.13%]). There was high concordance between estimated ctDNA fraction using 0.1x and 30x WGS (Pearson r = 0.9). Copy number profiling showed extensive amplification and deletion of multiple chromosomal regions containing important cancer genes (such as MYC, PIK3CA, TERT, and GATA3). Of the four patients classified as HER2 positive based on IHC, two had increased ERBB2 copy number (50 and 3 copies, respectively). Our data provide evidence that ctDNA-based genomic studies are possible and ctDNA analysis could be a tool for future molecular oncology studies in Africa for cancer etiology, surveillance and clinical trials.
Citation Format: Samuel T. Ahuno, Lawrence Edusei, Nicolas Titiloye, Ernest Adjei, Joe-Nat Clegg-Lamptey, Joel Yarney, Beatrice Wiafe-Addai, Baffour Awuah, Verne Vanderpuye, Maire Duggan, Seth Wiafe, Kofi Nyarko, Francis Aitpillah, Daniel Ansong, Thomas Ahearn, Alexander Kwarteng, Mustapha Abubakar, Montserrat Garcia-Closas, Gavin Ha, Jonine D. Figueroa, Paz Polak, on behalf of the Ghana Breast Health Study Team. Circulating tumor DNA (ctDNA) from peripheral blood is detectable among Ghanaian breast cancer patients [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-093.
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Affiliation(s)
- Samuel T. Ahuno
- 1Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana,
| | | | | | - Ernest Adjei
- 3Komfo Anokye Teaching Hospital, Kumasi, Ashanti, Ghana,
| | | | - Joel Yarney
- 4Komfo Anokye Teaching Hospital, Kumasi, Ashanti, Ghana,
| | | | - Baffour Awuah
- 4Komfo Anokye Teaching Hospital, Kumasi, Ashanti, Ghana,
| | | | - Maire Duggan
- 6Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada,
| | - Seth Wiafe
- 7Loma Linda University, School of Public Health, Loma Linda, CA,
| | - Kofi Nyarko
- 8University of Ghana, Accra, Greater Accra, Ghana,
| | | | - Daniel Ansong
- 9Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana,
| | - Thomas Ahearn
- 10Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD,
| | - Alexander Kwarteng
- 11Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana,
| | - Mustapha Abubakar
- 10Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD,
| | | | - Gavin Ha
- 12Division of Public Health Services, Fred Hutchinson Cancer Research Center, Seattle, WA,
| | - Jonine D. Figueroa
- 13Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, United Kingdom,
| | - Paz Polak
- 14Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
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15
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Figueroa JD, Davis Lynn BC, Edusei L, Titiloye N, Adjei E, Clegg-Lamptey JN, Yarney J, Wiafe-Addai B, Awuah B, Duggan MA, Wiafe S, Nyarko K, Aitpillah F, Ansong D, Hewitt SM, Ahearn T, Garcia-Closas M, Brinton LA. Reproductive factors and risk of breast cancer by tumor subtypes among Ghanaian women: A population-based case-control study. Int J Cancer 2020; 147:1535-1547. [PMID: 32068253 DOI: 10.1002/ijc.32929] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/09/2020] [Accepted: 01/29/2020] [Indexed: 02/05/2023]
Abstract
Higher proportions of early-onset and estrogen receptor (ER) negative cancers are observed in women of African ancestry than in women of European ancestry. Differences in risk factor distributions and associations by age at diagnosis and ER status may explain this disparity. We analyzed data from 1,126 cases (aged 18-74 years) with invasive breast cancer and 2,106 controls recruited from a population-based case-control study in Ghana. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for menstrual and reproductive factors using polytomous logistic regression models adjusted for potential confounders. Among controls, medians for age at menarche, parity, age at first birth, and breastfeeding/pregnancy were 15 years, 4 births, 20 years and 18 months, respectively. For women ≥50 years, parity and extended breastfeeding were associated with decreased risks: >5 births vs. nulliparous, OR 0.40 (95% CI 0.20-0.83) and 0.71 (95% CI 0.51-0.98) for ≥19 vs. <13 breastfeeding months/pregnancy, which did not differ by ER. In contrast, for earlier onset cases (<50 years) parity was associated with increased risk for ER-negative tumors (p-heterogeneity by ER = 0.02), which was offset by extended breastfeeding. Similar associations were observed by intrinsic-like subtypes. Less consistent relationships were observed with ages at menarche and first birth. Reproductive risk factor distributions are different from European populations but exhibited etiologic heterogeneity by age at diagnosis and ER status similar to other populations. Differences in reproductive patterns and subtype heterogeneity are consistent with racial disparities in subtype distributions.
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Affiliation(s)
- Jonine D Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.,Usher Institute and CRUK Edinburgh Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Brittny C Davis Lynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | | | | | | | | | | | | | - Maire A Duggan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Seth Wiafe
- Loma Linda University, School of Public Health, Loma Linda, CA
| | | | | | - Daniel Ansong
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephen M Hewitt
- Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Thomas Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | | | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Cossaboom CM, Khaiseb S, Haufiku B, Katjiuanjo P, Kannyinga A, Mbai K, Shuro T, Hausiku J, Likando A, Shikesho R, Nyarko K, Miller LA, Agolory S, Vieira AR, Salzer JS, Bower WA, Campbell L, Kolton CB, Marston C, Gary J, Bollweg BC, Zaki SR, Hoffmaster A, Walke H. Anthrax Epizootic in Wildlife, Bwabwata National Park, Namibia, 2017. Emerg Infect Dis 2019; 25:947-950. [PMID: 31002072 PMCID: PMC6478215 DOI: 10.3201/eid2505.180867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In late September 2017, Bwabwata National Park in Namibia experienced a sudden die-off of hippopotamuses and Cape buffalo. A multiorganizational response was initiated, involving several ministries within Namibia and the US Centers for Disease Control and Prevention. Rapid interventions resulted in zero human or livestock cases associated with this epizootic.
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Nartey Y, Hill P, Amo-Antwi K, Asmah R, Nyarko K, Yarney J, Damale N, Cox B. Recommendations for cervical cancer prevention and control in Ghana: public education and human papillomavirus vaccination. Ghana Med J 2019; 52:94-102. [PMID: 30662082 DOI: 10.4314/gmj.v52i2.6] [Citation(s) in RCA: 10] [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] [Indexed: 01/15/2023] Open
Abstract
Globally, cervical cancer is a major public health issue causing increasing morbidity and mortality especially in low- and middle-income countries where preventive and control measures are lacking. In Ghana, it is the most common cancer among women. Approaches to reduce the incidence and mortality of the disease in Ghana have had little success due to lack of accurate data on the disease among other factors, to inform policies on prevention, early detection, diagnosis and treatment. Additionally, the lack of clear commitment, policy direction and resources has hindered the scale-up of some of the initiatives implemented to curb the cervical cancer situation in Ghana. In this paper, we make recommendations on cervical cancer education and human papillomavirus vaccination. A collaborative approach is needed involving both private and government organizations, health professionals and the general public. Public education on cervical cancer and HPV vaccination needs to be delivered through a mixture of systems including both healthcare facilities and outreach programs, involving teachers, youth groups, community members and professional bodies. The vaccination of adolescents aged 10-14 years using the nonavalent HPV vaccine will be important in reducing the incidence and mortality of cervical cancer in Ghana. The integration of public education on cervical cancer prevention, HPV vaccination and screening programs into both medical and public health services is critical in achieving high coverage of these programs. Funding None.
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Affiliation(s)
- Yvonne Nartey
- Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Philip Hill
- Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Kwabena Amo-Antwi
- Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Richard Asmah
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Legon, Greater Accra, Ghana
| | - Kofi Nyarko
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Greater Accra, Ghana
| | - Joel Yarney
- National Centre for Radiotherapy and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana
| | - Nelson Damale
- Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital Accra, Greater Accra, Ghana
| | - Brian Cox
- Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, Otago, New Zealand
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Nyante SJ, Biritwum R, Figueroa J, Graubard B, Awuah B, Addai BW, Yarney J, Clegg-Lamptey JN, Ansong D, Nyarko K, Wiafe S, Oppong J, Boakye I, Brotzman M, Adjei R, Afriyie LT, Garcia-Closas M, Brinton LA. Recruiting population controls for case-control studies in sub-Saharan Africa: The Ghana Breast Health Study. PLoS One 2019; 14:e0215347. [PMID: 30990841 PMCID: PMC6467449 DOI: 10.1371/journal.pone.0215347] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 04/01/2019] [Indexed: 01/18/2023] Open
Abstract
Background In case-control studies, population controls can help ensure generalizability; however, the selection of population controls can be challenging in environments that lack population registries. We developed a population enumeration and sampling strategy to facilitate use of population controls in a breast cancer case-control study conducted in Ghana. Methods Household enumeration was conducted in 110 census-defined geographic areas within Ghana’s Ashanti, Central, Eastern, and Greater Accra Regions. A pool of potential controls (women aged 18 to 74 years, never diagnosed with breast cancer) was selected from the enumeration using systematic random sampling and frequency-matched to the anticipated distributions of age and residence among cases. Multiple attempts were made to contact potential controls to assess eligibility and arrange for study participation. To increase participation, we implemented a refusal conversion protocol in which initial non-participants were re-approached after several months. Results 2,528 women were sampled from the enumeration listing, 2,261 (89%) were successfully contacted, and 2,106 were enrolled (overall recruitment of 83%). 170 women were enrolled through refusal conversion. Compared with women enrolled after being first approached, refusal conversion enrollees were younger and less likely to complete the study interview in the study hospital (13% vs. 23%). The most common reasons for non-participation were lack of interest and lack of time. Conclusions Using household enumeration and repeated contacts, we were able to recruit population controls with a high participation rate. Our approach may provide a blue-print for others undertaking epidemiologic studies in populations that lack accessible population registries.
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Affiliation(s)
- Sarah J. Nyante
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- * E-mail:
| | | | | | - Barry Graubard
- National Cancer Institute, Rockville, MD, United States of America
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Nartey Y, Hill P, Amo-Antwi K, Nyarko K, Yarney J, Cox B. Clinical Features of Women Diagnosed With Invasive Cervical Cancer in Ghana. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.29000] [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: 11/20/2022] Open
Abstract
Background: The incidence of cervical cancer continues to increase in many low- and middle-income countries. It remains the commonest cancer affecting females in Ghana. However, comprehensive information on the clinical characteristics of women diagnosed with invasive cervical cancer is scarce. Aim: To characterize the clinical features of women with invasive cervical cancer in Ghana. Methods: We conducted a retrospective study in two large referral hospitals in Ghana: the Korle Bu teaching hospital, Accra and Komfo Anokye teaching hospital, Kumasi. Through the review of paper-based, electronic, and pathology medical records, information on women diagnosed with invasive cervical cancer from 1st January 2010 to 31st December 2013 was collected. The information was entered onto a standardized data abstraction sheet and included demographics, comorbid conditions, treatment and follow-up. All analyses were conducted in STATA and described the distribution of key clinical features by the stage at diagnosis. Results: A total of 1,725 women with invasive cervical cancer were included in the analysis. Few had cervical screening before their cervical cancer diagnosis (1.1%). Women who were resident in a metropolitan area ( P = 0.034), or who had any comorbidity ( P < 0.001) were at an increased risk of FIGO stage III-IV disease. The majority of women had at least two diagnostic investigations (75%) with cervical biopsy performed for 95.5% of women. More than half received radiotherapy (55.4%) and only 22.4% receiving chemotherapy. Clinical follow-up after the first consultation was performed for 61%, with 73% of women with clinical follow-up having at least one follow-up investigation. Conclusion: Improvements in access to early diagnosis and optimal treatment of cervical cancer, such as an increased use of chemoradiation would reduce the burden of the disease in Ghana.
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Affiliation(s)
- Y. Nartey
- University of Otago, Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, Dunedin, New Zealand
| | - P. Hill
- University of Otago, Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, Dunedin, New Zealand
| | - K. Amo-Antwi
- University of Otago, Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, Dunedin, New Zealand
| | - K. Nyarko
- University of Otago, Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, Dunedin, New Zealand
| | - J. Yarney
- University of Otago, Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, Dunedin, New Zealand
| | - B. Cox
- University of Otago, Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, Dunedin, New Zealand
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Aku FY, Akweongo P, Nyarko K, Sackey S, Wurapa F, Afari EA, Ameme DK, Kenu E. Bacteriological profile and antibiotic susceptibility pattern of common isolates of neonatal sepsis, Ho Municipality, Ghana-2016. Matern Health Neonatol Perinatol 2018; 4:2. [PMID: 29403648 PMCID: PMC5778684 DOI: 10.1186/s40748-017-0071-z] [Citation(s) in RCA: 20] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 12/28/2017] [Indexed: 12/20/2022] Open
Abstract
Background Globally, 4 million neonates die annually, with one-third of such deaths occurring as a result of infections. In 2011, there were 7.2million deaths in children below 5 years globally, and a proportion of 40% of these deaths occurred in neonates. Sepsis was reported to account for one-third of these deaths. Presently, multidrug antibiotic resistance is rapidly increasing in Neonatal Intensive Care Units (NICUs), particularly in developing countries and poses a threat to public health. The change in these organisms has been reported to vary across regions, between health facilities and even within the same facility. Continuous surveillance is required to inform antibiotic choice for neonatal sepsis management. We identified the common causative organisms of neonatal sepsis and their antibiotic susceptibility pattern in the Ho municipality. Method A cross sectional study was conducted in the Ho municipality from January to May, 2016. A semi-structured questionnaire was used to collect socio-demographic data from mothers of neonates with clinically suspected of sepsis. Clinical data of both mothers and neonates were extracted from case notes. A 2 ml volume of blood was also taken from neonates and dispensed into a 20 ml mixture of thioglycollate fluid broth and tryptone soy broth for culture and antibiotic susceptibility pattern determined. Results Out of the 150 clinically suspected neonatal sepsis cases, 91 (60.7%) were males. The Median gestational week was 38 (IQR: 36-39) and Median birthweight was 3.0 kg (IQR 2.5-3.4). The prevalence of culture positive sepsis was 17.3% of the 150 suspected cases. A total of 26 different pathogens were isolated, of which gram positive organisms had a preponderance of 18 (69%) over gram negative organisms 8 (31%). Staphylococcus epidermidis was the most common 14 (53.8%) isolate identified. There was a single isolate (4%) each of Proteus mirabilis and Escherichia coli identified. All the isolates identified showed 100% resistance to ampicillin. Conclusion The prevalence of culture proven sepsis was 17.3% and Staphylococcus epidermidis was the most common isolate identified. Pathogens isolated were resistant to the first line drugs for management of neonatal sepsis. Hence, the need for a review of first line drug for empirical treatment in neonatal sepsis.
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Affiliation(s)
- Fortress Yayra Aku
- 1Ghana Field Epidemiology and Laboratory Training Programme and Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.,2Ghana Health Service, Volta Regional Health Directorate, Ho, Ghana
| | - Patricia Akweongo
- 1Ghana Field Epidemiology and Laboratory Training Programme and Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Kofi Nyarko
- 1Ghana Field Epidemiology and Laboratory Training Programme and Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Samuel Sackey
- 1Ghana Field Epidemiology and Laboratory Training Programme and Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Fredrick Wurapa
- 1Ghana Field Epidemiology and Laboratory Training Programme and Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Edwin Andrew Afari
- 1Ghana Field Epidemiology and Laboratory Training Programme and Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Donne Kofi Ameme
- 1Ghana Field Epidemiology and Laboratory Training Programme and Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Ernest Kenu
- 1Ghana Field Epidemiology and Laboratory Training Programme and Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
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Damanka S, Lartey B, Agbemabiese C, Dennis FE, Adiku T, Nyarko K, Ofori M, Armah GE. Detection of the first G6P[14] human rotavirus strain in an infant with diarrhoea in Ghana. Virol J 2016; 13:183. [PMID: 27832798 PMCID: PMC5103419 DOI: 10.1186/s12985-016-0643-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/04/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Rotaviruses with G6P[14] specificity are mostly isolated in cattle and have been established as a rare cause of gastroenteritis in humans. This study reports the first detection of G6P[14] rotavirus strain in Ghana from the stool of an infant during a hospital-based rotavirus surveillance study in 2010. METHODS Viral RNA was extracted and rotavirus VP7 and VP4 genes amplified by one step RT-PCR using gene-specific primers. The DNA was purified, sequenced and genotypes determined using BLAST and RotaC v2.0. Phylogenetic tree was constructed using maximum likelihood method in MEGA v6.06 software and statistically supported by bootstrapping with 1000 replicates. Phylogenetic distances were calculated using the Kimura-2 parameter model. RESULTS The study strain, GHA-M0084/2010 was characterised as G6P[14]. The VP7 gene of the Ghanaian strain clustered in G6 lineage-III together with artiodactyl and human rotavirus (HRV) strains. It exhibited the highest nucleotide (88.1 %) and amino acid (86.9 %) sequence identity with Belgian HRV strain, B10925. The VP8* fragment of the VP4 gene was closely related to HRV strains detected in France, Italy, Spain and Belgium. It exhibited the strongest nucleotide sequence identity (87.9 %) with HRV strains, PA169 and PR/1300 (Italy) and the strongest amino acid sequence identity (89.3 %) with HRV strain R2775/FRA/07 (France). CONCLUSION The study reports the first detection of G6P[14] HRV strain in an infant in Ghana. The detection of G6P[14], an unusual strain pre-vaccine introduction in Ghana, suggests a potential compromise of vaccine effectiveness and indicates the necessity for continuous surveillance in the post vaccine era.
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Affiliation(s)
- Susan Damanka
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
| | - Belinda Lartey
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Chantal Agbemabiese
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Francis E Dennis
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Theophilus Adiku
- Department of Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Kofi Nyarko
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Michael Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - George E Armah
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Damanka S, Dennis FE, Agbemabiese C, Lartey B, Adiku T, Nyarko K, Enweronu-Laryea CC, Sagoe KW, Ofori M, Rodrigues O, Armah GE. Identification of OP354-like human rotavirus strains with subtype P[8]b in Ghanaian children with diarrhoea. Virol J 2016; 13:69. [PMID: 27103227 PMCID: PMC4841057 DOI: 10.1186/s12985-016-0523-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 04/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rotaviruses with the P[8] genotype have been associated with majority of infections. Recent improvements in molecular diagnostics have delineated the P[8] genotype into P[8]a and P[8]b subtypes. P[8]a is the previously known P[8] genotype which is common whilst P[8]b subtype also known as OP354-like strain is genetically distinct, rarely detected and reported from a few countries. In a previous study, the P-types could not be determined for 80 RVA-positive samples by conventional RT-PCR genotyping methods with the recommended pool of P-genotype specific primers used in the WHO Regional Rotavirus Reference Laboratory in Ghana. The present study employed sequence-dependent cDNA amplification method to genotype previously non-typeable P-types. METHODS Viral RNAs were extracted and rotavirus VP4 genes amplified by one step RT-PCR using gene specific primers. PCR amplicons were purified, sequenced and sequences aligned with cognate gene sequences available in GenBank using the ClustalW algorithm. Phylogenetic analysis was performed using the Neighbour-Joining method in MEGA v6.06 software. Phylogenetic tree was statistically supported by bootstrapping with 1000 replicates, and distances calculated using the Kimura-2 parameter model. RESULTS Of the 80 RVA-positive samples, 57 were successfully sequenced and characterized. Forty-eight of these were identified as P[8] strains of which 5 were characterized as the rare P[8]b subtype. Phylogenetic analysis of the VP8* fragment of the VP4 genes of these P[8]b strains revealed a close relationship with prototype OP354-like P[8]b strain and P[8]b strains of Russian and South African P[8]b origin. CONCLUSION The study highlights the importance of regularly updating the primers employed for molecular typing of rotaviruses.
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Affiliation(s)
- Susan Damanka
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
| | - Francis E Dennis
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Chantal Agbemabiese
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Belinda Lartey
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Theophilus Adiku
- Department of Microbiology, University of Ghana Medical School, College of Health Sciences, Accra, Ghana
| | - Kofi Nyarko
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Christabel C Enweronu-Laryea
- Department of Child Health, Korle Bu Teaching Hospital, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Kwamena W Sagoe
- Department of Microbiology, University of Ghana Medical School, College of Health Sciences, Accra, Ghana
| | - Michael Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Onike Rodrigues
- Department of Child Health, Korle Bu Teaching Hospital, College of Health Sciences, University of Ghana, Accra, Ghana
| | - George E Armah
- Department of Electron Microscopy and Histopathology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Figueroa JD, Edusei L, Adjei E, Titiloye N, Ylaya K, Addai B, Clegg-Lamptey JN, Awuah B, Nyarko K, Ansong D, Wiafe S, Brinton LA, Hewitt S. Abstract C11: Impact of pathologic specimen quality on classifying molecular subtypes of breast cancer: A pilot study from three hospitals in Ghana, Africa. Cancer Epidemiol Biomarkers Prev 2014. [DOI: 10.1158/1538-7755.disp13-c11] [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] Open
Abstract
Abstract
Background: Breast cancer is a heterogeneous disease with clinically, molecularly and pathologically defined subtypes that have different etiologies, clinical presentations and outcomes. African women reportedly have especially high rates of breast cancers that are estrogen receptor (ER) or progesterone receptor (PR) negative, or triple negative [ER, PR and human epidermal growth factor receptor-2 (HER-2) negative], with the proportion reported for triple negative breast cancers ranging from 28-82%, compared to 11-20% among Caucasian populations. However, it is unclear to what extent pathology and specimen handling affect receptor measurements in Africa. Here we sought to determine pathology specimen quality of breast tumor tissues from three hospitals in Ghana where we are conducting a molecular epidemiologic study of breast cancer.
Methods: We acquired 15 formalin-fixed paraffin-embedded (FFPE) archived breast cancer tissue blocks with specimens obtained at biopsy (N=5) or surgery (N=10) from three hospitals in Ghana. Blocks were re-embedded and four 0.5um whole sections were cut for hematoxylin and eosin stains, and immunohistochemistry (IHC) using previously validated protocols for ER (clone 1D5), PR (clone PgR1294) and HER2 (polyclonal), all obtained from Dako (Carpinteria CA). Specimens were considered ER or PR positive if 10% or more cells stained positive, while HER2 was considered positive if intensity of staining was 3+.
Results: Specimens were noted to be embedded in high-melting temperature paraffin. To perform ER, PR, and HER2 IHC staining, deparaffinization procedures were optimized for hard paraffin. Zonal and gradient staining patterns were noted in surgical specimens, features that are likely due to delayed/prolonged fixation. Zonal/gradient staining issues were not identified in the needle biopsies, which were smaller compared to specimens collected at surgery and generally placed in buffered formalin immediately after collection. IHC assays of the tumor specimens revealed that 67% were ER-positive, 20% PR-positive, and 66% HER2 positive. The proportion negative for all three markers was 13%.
Conclusion: In contrast to previous reports for African breast cancer patients, within our sample of FFPE breast cancers from Ghana we found a higher prevalence of ER positive tumors and a lower prevalence of tumors negative for all three markers. These results suggest that the high rates of hormone receptor negativity previously reported in African populations may be inaccurate due to various sources of error, particularly fixation time and IHC staining protocols. Future studies focusing on proper documentation of sample collection procedures and optimization of IHC methods are required to determine the true prevalence of molecular subtypes of breast cancer among African women. Such efforts are essential for breast cancer surveillance, identifying etiologic factors for prevention efforts and developing more effective treatment programs.
Citation Format: Jonine D. Figueroa, Lawrence Edusei, Ernest Adjei, Nicholas Titiloye, Kris Ylaya, Beatrice Addai, Joe Nat Clegg-Lamptey, Baffour Awuah, Kofi Nyarko, Daniel Ansong, Seth Wiafe, Louise A. Brinton, Stephen Hewitt. Impact of pathologic specimen quality on classifying molecular subtypes of breast cancer: A pilot study from three hospitals in Ghana, Africa. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C11. doi:10.1158/1538-7755.DISP13-C11
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Affiliation(s)
| | | | | | | | - Kris Ylaya
- 1National Cancer Institute, Bethesda, MD,
| | | | | | | | | | | | - Seth Wiafe
- 4Peace and Love Hospital, Kumasi, Ghana,
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Brinton LA, Figueroa JD, Awuah B, Yarney J, Wiafe S, Wood SN, Ansong D, Nyarko K, Wiafe-Addai B, Clegg-Lamptey JN. Breast cancer in Sub-Saharan Africa: opportunities for prevention. Breast Cancer Res Treat 2014; 144:467-78. [PMID: 24604092 DOI: 10.1007/s10549-014-2868-z] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 02/06/2014] [Indexed: 12/12/2022]
Abstract
Although breast cancer is a growing health problem in sub-Saharan Africa, reasons for its increased occurrence remain unclear. We reviewed the published literature to determine the magnitude of the increase in breast cancer, associated risk factors (including for breast cancer subtypes), and ways to reduce incidence and mortality. Some of the increased breast cancer occurrence likely reflects that women are living longer and adopting lifestyles that favor higher incidence rates. However, a greater proportion of breast cancers occur among premenopausal women as compared to elsewhere, which may reflect unique risk factors. Breast cancers diagnosed among African women reportedly include a disproportionate number of poor prognosis tumors, including hormone receptor negative, triple negative, and core basal phenotype tumors. However, it is unclear how lack of standardized methods for tissue collection, fixation, and classification contribute to these rates. Given appropriate classifications, it will be of interest to compare rates with other populations and to identify risk factors that relate to specific tumor subtypes. This includes not only risk factors that have been recognized in other populations but also some that may play unique roles among African women, such as genetic factors, microbiomata, xenoestrogens, hair relaxers, and skin lighteners. With limited opportunities for effective treatment, a focus is needed on identifying etiologic factors that may be amenable to intervention. It will also be essential to understand reasons why women delay seeking care after the onset of symptoms and for there to be educational campaigns about the importance of early detection.
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Affiliation(s)
- Louise A Brinton
- National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rm. 7E-102, MSC 9774, Bethesda, MD, 20892-9774, USA,
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Phillips R, Horsfield C, Mangan J, Laing K, Etuaful S, Awuah P, Nyarko K, Osei-Sarpong F, Butcher P, Lucas S, Wansbrough-Jones M. Cytokine mRNA expression in Mycobacterium ulcerans-infected human skin and correlation with local inflammatory response. Infect Immun 2006; 74:2917-24. [PMID: 16622230 PMCID: PMC1459747 DOI: 10.1128/iai.74.5.2917-2924.2006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cytokine mRNA expression in biopsies of Mycobacterium ulcerans-infected human tissue was investigated using real-time PCR, and the findings were correlated with the clinical stages of disease and histopathologies. A broad range of cytokine mRNAs were detected in 16 early nodules and 28 late-stage ulcers, including those for the Th1 cytokines tumor necrosis factor alpha (TNF-alpha) and gamma interferon (IFN-gamma) and the Th2 cytokine interleukin 10 (IL-10). IFN-gamma was strongly expressed in both nodules and ulcers, suggesting that a Th1 response begins early in the disease. There was a significantly higher expression of IL-8 and other proinflammatory cytokines in results from 32 biopsies with neutrophilia than in those from 12 biopsies without acute inflammation. Ten tissue samples containing granulomas showed high mRNA expression for IFN-gamma, IL-1beta, IL-12p35, IL-12p40, IL-15, and TNF-alpha relative to 34 tissue samples without granulomas. These results suggest that the human immune response to M. ulcerans is similar to that seen with some other mycobacteria despite the presence of the toxin mycolactone in the tissues.
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Affiliation(s)
- R Phillips
- Komfo Anokye Teaching Hospital, KNUST, Kumasi, Ghana.
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