1
|
Kim HJ, Jung S, Eliassen AH, Chen WY, Willett WC, Cho E. Alcohol Consumption and Breast Cancer Risk in Younger Women According to Family History of Breast Cancer and Folate Intake. Am J Epidemiol 2017; 186:524-531. [PMID: 28520842 DOI: 10.1093/aje/kwx137] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 10/17/2016] [Indexed: 12/14/2022] Open
Abstract
To evaluate the association between alcohol consumption and breast cancer risk in younger women, overall and by family history of breast cancer and folate intake, we prospectively followed 93,835 US women aged 27-44 years in Nurses' Health Study II who had alcohol consumption data in 1991. Alcohol consumption and folate intake were measured by food frequency questionnaire every 4 years. We documented 2,866 incident cases of invasive breast cancer between 1991 and 2011. Alcohol consumption was not associated with breast cancer risk overall (for intake of ≥10 g/day vs. nondrinking, multivariate hazard ratio = 1.07, 95% confidence interval: 0.94, 1.22). When the association was stratified by family history and folate intake, a positive association between alcohol consumption and breast cancer was found among women with a family history and folate intake less than 400 μg/day (multivariate hazard ratio = 1.82, 95% confidence interval: 1.06, 3.12; P-trend = 0.08). Alcohol consumption was not associated with breast cancer in other categories of family history and folate intake (P-interaction = 0.55). In conclusion, in this population of younger women, higher alcohol consumption was associated with increased risk of breast cancer among those with both a family history of breast cancer and lower folate intake.
Collapse
|
2
|
Terry MB, Phillips KA, Daly MB, John EM, Andrulis IL, Buys SS, Goldgar DE, Knight JA, Whittemore AS, Chung WK, Apicella C, Hopper JL. Cohort Profile: The Breast Cancer Prospective Family Study Cohort (ProF-SC). Int J Epidemiol 2016; 45:683-92. [PMID: 26174520 PMCID: PMC5005937 DOI: 10.1093/ije/dyv118] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mary Beth Terry
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA,
| | - Kelly-Anne Phillips
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, School of Population and Global Health, St Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA, USA, Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Irene L Andrulis
- Lunenfeld-Tanenbaum Research Institute, University of Toronto, Toronto, ON, Canada
| | | | - David E Goldgar
- Department of Dermatology, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Julia A Knight
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada and
| | - Alice S Whittemore
- Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | | | | |
Collapse
|
3
|
McDonald JA, Goyal A, Terry MB. Alcohol Intake and Breast Cancer Risk: Weighing the Overall Evidence. CURRENT BREAST CANCER REPORTS 2013; 5:10.1007/s12609-013-0114-z. [PMID: 24265860 PMCID: PMC3832299 DOI: 10.1007/s12609-013-0114-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Moderate alcohol consumption has been linked to an approximate 30-50% increased risk in breast cancer. Case-control and cohort studies have consistently observed this modest increase. We highlight recent evidence from molecular epidemiologic studies and studies of intermediate markers like mammographic density that provide additional evidence that this association is real and not solely explained by factors/correlates of the exposure and outcome present in non-randomized studies. We also review evidence from studies of higher risk women including BRCA1 and BRCA2 mutation carriers. Given the incidence of heart disease is higher than breast cancer and modest alcohol consumption is associated with reduced risk of heart disease, we examine the latest evidence to evaluate if alcohol reduction should be targeted to women at high risk for breast cancer. We also review the most recent evidence on the effect of alcohol use on tumor recurrence and survival for those diagnosed with breast cancer.
Collapse
Affiliation(s)
- Jasmine A. McDonald
- 722W 168St, R719 Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032 Phone: 212-305-9114 Fax: 212-305-9413
| | - Abhishek Goyal
- 722W 168St, R723 Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032 Phone: 212-305-3586 Fax: 212-305-9413
| | - Mary Beth Terry
- 722W 168St, R724A Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032; Herbert Irving Comprehensive Cancer Center 1130 St. Nicholas Ave. Columbia University New York, NY 10032
| |
Collapse
|
4
|
Hartz AJ, He T. Cohort study of risk factors for breast cancer in post menopausal women. Epidemiol Health 2013; 35:e2013003. [PMID: 23682336 PMCID: PMC3654090 DOI: 10.4178/epih/e2013003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 04/17/2013] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The present study assessed more than 800 potential risk factors to identify new predictors of breast cancer and compare the independence and relative importance of established risk factors. METHODS Data were collected by the Women's Health Initiative and included 147,202 women ages 50 to 79 who were enrolled from 1993 to 1998 and followed for 8 years. Analyses performed in 2011 and 2012 used the Cox proportional hazard regression to test the association between more than 800 baseline risk factors and incident breast cancer. RESULTS Baseline factors independently associated with subsequent breast cancer at the p<0.001 level (in decreasing order of statistical significance) were breast aspiration, family history, age, weight, history of breast biopsies, estrogen and progestin use, fewer live births, greater age at menopause, history of thyroid cancer, breast tenderness, digitalis use, alcohol intake, white race, not restless, no vaginal dryness, relative with prostate cancer, colon polyps, smoking, no breast augmentation, and no osteoporosis. Risk factors previously reported that were not independently associated with breast cancer in the present study included socioeconomic status, months of breast feeding, age at first birth, adiposity measures, adult weight gain, timing of initiation of hormone therapy, and several dietary, psychological, and exercise variables. Family history was not found to alter the risk associated with other factors. CONCLUSIONS These results suggest that some risk factors not commonly studied may be important for breast cancer and some frequently cited risk factors may be relatively unimportant or secondary.
Collapse
Affiliation(s)
- Arthur J Hartz
- Health Services Research, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | |
Collapse
|
5
|
de Guzman AB, Jimenez BCB, Jocson KP, Junio AR, Junio DE, Jurado JBN, Justiniano ABF. This Too Shall Pass. J Holist Nurs 2012; 31:35-46. [DOI: 10.1177/0898010112462066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Considering the paucity of studies dealing with the holistic aspect of the cancer experience, this grounded theory study seeks to conceptualize the process of cancer survivorship among Filipinos. Twenty-seven Filipino cancer survivors were purposively selected, and a two-part instrument, specifically robotfoto and focus group interviews, was used to gather data. The Glaserian method of grounded theory analysis was used, and extended texts were analyzed inductively via a dendrogram. Member checking and correspondence were observed to validate the surfacing stages, leading to the conceptualization of a theoretical model termed as the Ribbon of Cancer Survivorship. The said model describes the trifling (living before), transfusing (accepting the reality), transforming (being strong), and transcending (living beyond) phases of cancer survivorship. Ten interesting substages were also identified, namely: tainting, desolating, disrupting, and embracing for the transfusing phase; tormenting, distressing, awakening, and transfiguring for the transforming phase, and trembling and enlivening for the transcending phase. The resulting theoretical model has clearly and successfully described the entire process of cancer survivorship among Filipinos. It is hoped that the model be used as a reference for future studies about cancer survivorship and as a guide for nurses in providing a more empathetic care among cancer patients.
Collapse
|
6
|
McLeish L, Reis MM, Stewart C, Goudie DR, Berg JN, Harvie M, Hanning KA, Vysny H, Steel CM. Lifestyle Changes in Women at Genetic Risk of Breast Cancer: an Observational Study. Int J Behav Med 2012; 20:514-21. [DOI: 10.1007/s12529-012-9263-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
7
|
Spector D, Deroo LA, Sandler DP. Lifestyle behaviors in black and white women with a family history of breast cancer. Prev Med 2011; 52:394-7. [PMID: 21396953 PMCID: PMC3096469 DOI: 10.1016/j.ypmed.2011.03.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 02/18/2011] [Accepted: 03/01/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine lifestyle behaviors among non-Hispanic black and white women with a family history of breast cancer and determine the extent to which they meet American Cancer Society (ACS) Nutrition and Physical Activity Recommendations for Breast Cancer Prevention. METHOD Cross-sectional data from 44,364 women enrolled in the Sister Study (2009), a study of sisters of women with breast cancer within the U.S., were analyzed. Descriptive statistics and chi-square analyses were used to examine body mass index and lifestyle behaviors (e.g., exercise, diet, and smoking) and to determine percentages of women meeting ACS recommendations. RESULTS Black women consumed a lower percentage of calories from fat (mean 36.90% vs. 37.17%) and were more likely to meet ACS alcohol recommendations than whites. White women consumed more fruits and vegetables/day (mean 4.81 vs. 4.41) than black women and were more likely to meet ACS guidelines for physical activity (26.4% vs. 18.2%) and body mass index (42.5% vs. 16.7%). CONCLUSION Despite an elevated risk for breast cancer due to a family history of breast cancer, the majority of women were no more likely than women in the general population to engage in healthy lifestyle behaviors. These women may benefit from lifestyle behavior risk-reduction counseling.
Collapse
Affiliation(s)
- Denise Spector
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | | | | |
Collapse
|
8
|
Breast cancer risk perception and lifestyle behaviors among White and Black women with a family history of the disease. Cancer Nurs 2009; 32:299-308. [PMID: 19444084 DOI: 10.1097/ncc.0b013e31819deab0] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although researchers have investigated the relationships between perceived risk and behavioral risk factors for breast cancer, few qualitative studies have addressed the meaning of risk and its impact on decision making regarding lifestyle behaviors. This qualitative study explored factors involved in the formulation of perceived breast cancer risk and associations between risk perception and lifestyle behaviors in white and black women with a family history of breast cancer. Eligible participants were North Carolina residents in the Sister Study, a nationwide study of risk factors for breast cancer among women who have at least 1 sister diagnosed with breast cancer. Personal interviews were conducted with 32 women. Although most had heightened perceived risk, almost 20% considered themselves below-to-average risk. Participants with moderate-to-high perceived risk were more likely to report an affected sister and mother, a first-degree relative's diagnosis within 4 years, and death of a first-degree relative from breast cancer. Many women were unaware of associations between lifestyle behaviors and breast cancer risk. Only one-third of the women reported healthy lifestyle changes because of family history; dietary change was most frequently reported. Findings may be important for cancer nurses involved in developing breast cancer education programs for women with a family history of breast cancer.
Collapse
|
9
|
Rees G, Gaff C, Young MA, Martin PR. Health beliefs and behaviors of women who have received genetic counseling for breast cancer. J Genet Couns 2007; 16:457-68. [PMID: 17619128 DOI: 10.1007/s10897-006-9079-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Accepted: 11/29/2006] [Indexed: 11/25/2022]
Abstract
There are both genetic and behavioral risk factors for breast cancer, but the interaction between these factors is not clear. Little is known about the impact of receiving genetic risk information for breast cancer on behaviors such as diet and physical activity. Seven focus groups were conducted with 23 women who had recently received genetic counseling for breast cancer, in order to explore health beliefs and behaviors following genetic counseling. Findings revealed that there was much confusion and uncertainty about the associations between health behaviors and breast cancer risk, and participants reported that receiving genetic counseling had little impact on health protective behaviors. Further research is required to understand variation in response to genetic risk information, and to assess the impact of providing additional information regarding lifestyle factors.
Collapse
Affiliation(s)
- Gwyneth Rees
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
| | | | | | | |
Collapse
|
10
|
Abstract
Lifestyle behaviors have not been adequately addressed as potential cancer risk-reduction strategies in women with BRCA1 or BRCA2 genetic mutations. The aims of this qualitative pilot study were to explore current lifestyle practices among these women and to assess perceptions regarding risk as well as perceived benefits and perceived barriers to engage in healthy behaviors. Qualitative descriptive methodology was used with research questions derived from key Health Belief Model concepts. Interviews were conducted with 10 women recruited through a cancer genetics clinic. Interviews were tape-recorded and transcribed for content analysis of common themes and patterns. All of the participants expressed that they were at high risk for cancer; however, 5 of the women had prophylactic surgery, which decreased their sense of risk. Most women made some healthy behavior change as a result of their elevated risk awareness. Perceived benefits to healthy lifestyles included increased energy and improved mood. Perceived barriers were related to the expense and inconvenience of preparing healthy meals and lack of time to exercise. The findings reveal that there is a need for nursing interventions that may improve education and enhance motivation regarding potential lifestyle risk-reduction behaviors in women with a genetic predisposition for breast and ovarian cancer.
Collapse
Affiliation(s)
- Denise Spector
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
| |
Collapse
|
11
|
Rees G, Young MA, Gaff C, Martin PR. A qualitative study of health professionals' views regarding provision of information about health-protective behaviors during genetic consultation for breast cancer. J Genet Couns 2006; 15:95-104. [PMID: 16541332 DOI: 10.1007/s10897-005-9009-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study aimed to explore health professionals' views and practice regarding the provision of information about health-protective behaviors (e.g., exercise, alcohol consumption, diet) during genetic consultation for breast cancer. Ten genetic counselors participated in three focus groups, and seven medical specialists were interviewed in a focus group or individually. Data was analyzed using the constant comparative method. Findings suggested that health professionals held differing, often opposing, views about the value of health-protective behaviors for women at increased risk of breast cancer. The content and extent of information provided about health-protective behaviors varied widely, and participants expressed a need to form consensus regarding information provision both within and across clinics. The main barriers to providing information regarding health-protective behaviors included the lack of research evidence regarding the impact of these factors and higher priority of other information need to be provided in the limited consultation time. Participants generally did not consider it their role to promote health-protective behaviors, and were concerned about the psychological impact of providing information about behavioral risk factors during genetic consultations.
Collapse
Affiliation(s)
- Gwyneth Rees
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Vic 3002, Australia.
| | | | | | | |
Collapse
|
12
|
Mancinelli R, Binetti R, Ceccanti M. Woman, alcohol and environment: Emerging risks for health. Neurosci Biobehav Rev 2006; 31:246-53. [PMID: 16908064 DOI: 10.1016/j.neubiorev.2006.06.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2006] [Accepted: 06/12/2006] [Indexed: 01/22/2023]
Abstract
Alcohol drinking is one of the most relevant problems in Western Countries but the negative effects of alcohol misuse are often neglected or underestimated with serious consequences for public health. Over the last few years a rapid growth in the number of drinking females and the decrease of their age of first use, have increased the health risk for women and their offspring. Moreover, modern environments facilitate pollutants exposure, further escalating the health risks due to lifestyle habits. This review takes into account the peculiarities of alcohol effects on female health and the risks of teratogenic effects. The possible interaction between alcohol and pollutants exposure is also discussed. The role of biomarkers against alcohol-related damage is presented as an invaluable clinical tool, including early intervention, treatment monitoring and, above all, prevention of prenatal non-reversible damage. Recent alcohol studies show the greater severity of alcohol damage in female subjects and the need of gender-targeted intervention.
Collapse
Affiliation(s)
- Rosanna Mancinelli
- Dipartimento Ambiente e Connessa Prevenzione Primaria, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Roma.
| | | | | |
Collapse
|
13
|
Gunzerath L, Faden V, Zakhari S, Warren K. National Institute on Alcohol Abuse and Alcoholism Report on Moderate Drinking. Alcohol Clin Exp Res 2006; 28:829-47. [PMID: 15201626 DOI: 10.1097/01.alc.0000128382.79375.b6] [Citation(s) in RCA: 185] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In support of the 2005 update of the U.S. Department of Agriculture/U.S. Department of Health and Human Services Dietary Guidelines, the National Institute on Alcohol Abuse and Alcoholism was asked to assess the strength of the evidence related to health risks and potential benefits of moderate alcohol consumption, with particular focus on the areas of cardiovascular disease, breast cancer, obesity, birth defects, breastfeeding, and aging. The findings were reviewed by external researchers with extensive research backgrounds on the consequences and benefits of alcohol consumption. This report now serves as the National Institutes of Health's formal position paper on the health risks and potential benefits of moderate alcohol use.
Collapse
Affiliation(s)
- Lorraine Gunzerath
- Strategic Research Planning Branch , Division of Metabolism & Health Effects, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20892-9304, USA.
| | | | | | | |
Collapse
|
14
|
Chase V, Neild R, Sadler CW, Batey RG. The medical complications of alcohol use: understanding mechanisms to improve management. Drug Alcohol Rev 2006; 24:253-65. [PMID: 16096129 DOI: 10.1080/09595230500167510] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The use of alcohol in a dependent or even a regular heavy pattern predisposes the drinker to a range of adverse consequences. These include a risk of direct harm from alcohol, including organ damage, mental health disorders and a range of social and legal problems associated with behaviours due to alcohol's effects. The range of organ damage associated with regular heavy alcohol consumption is well described. Much new information on the mechanisms by which damage occurs is available and is reviewed in this paper. New knowledge can assist in the development of more appropriate management strategies for those affected by the medical complications of alcohol use. Genetic susceptibility to tissue injury is explored and the reasons why many heavy drinkers do not appear to experience organ damage are considered. Approaches to the management of certain alcohol-related disorders are outlined.
Collapse
Affiliation(s)
- Vicki Chase
- Drug and Alcohol Clinical Services, Hunter/New England Area Health Service, Faculty of Health, University of Newcastle, NSW, Australia
| | | | | | | |
Collapse
|
15
|
Madlensky L, Vierkant RA, Vachon CM, Pankratz VS, Cerhan JR, Vadaparampil ST, Sellers TA. Preventive health behaviors and familial breast cancer. Cancer Epidemiol Biomarkers Prev 2005; 14:2340-5. [PMID: 16214914 DOI: 10.1158/1055-9965.epi-05-0254] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIM To examine medical and lifestyle preventive behaviors among women with varying levels of familial breast cancer risk. METHODS Using cross-sectional data from the Minnesota Breast Cancer Family Study, a historical cohort of 426 families, we compared medical (mammography adherence, antiestrogen use, and prophylactic surgery) and lifestyle (physical activity, smoking, alcohol, and diet) behaviors across three groups of cancer-free women ages 18 to 95 defined by their family history of breast cancer. Family history was classified as high-risk, moderate-risk, or average to low-risk depending on the number and degree of relationship of family members with breast cancer. RESULTS After adjusting for age and education, high-risk women were twice as likely to have ever used an antiestrogenic agent (9.0% versus 4.6% among moderate-risk and 4.1% among average to low-risk; P = 0.002). Among women ages <40, the high-risk group were more likely to have ever had a mammogram (82% versus 47% among moderate-risk and 35% among average to low-risk; P < 0.001). Average to low-risk women were the least likely to be current smokers and high-risk women may consume slightly fewer fruits and vegetables compared with the other groups, but there were no other differences in lifestyle behaviors, including physical activity and alcohol use. CONCLUSIONS Women with strong family histories of breast cancer are more likely to undertake medical but not lifestyle preventive behaviors.
Collapse
Affiliation(s)
- Lisa Madlensky
- University of California San Diego Cancer Center, 9500 Gilman Drive, La Jolla, CA 92093-0901, USA.
| | | | | | | | | | | | | |
Collapse
|
16
|
Abstract
Designs that involve families (the traditional strength of genetic epidemiology) and population-based sampling (the traditional strength of environmental epidemiology) allow investigation of both genes and environment, separately or together, and allow valid inference to the population. These case-control-family designs (including those involving twin pairs), can be regarded as retrospective cohort studies of relatives, and can be used for: determining familial risks and genetic models; estimating risk (penetrance) for measured genotypes; genetic association studies; stratifying risks by family history and known mutation status; and studying modifiers of risk in genetically susceptible individuals. Follow-up of families allows genetic and environmental risks to be studied prospectively. We discuss statistical methods, theoretical and practical strengths, limitations, and other issues. Given their versatility, population-based family studies could become a principal framework in epidemiology, and move genetics from its traditional focus on high-risk families to give it a wider clinical and population health relevance.
Collapse
Affiliation(s)
- John L Hopper
- University of Melbourne, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, 723 Swanston Street, Carlton, Victoria 3053, Australia.
| | | | | |
Collapse
|
17
|
Madlensky L, Flatt SW, Bardwell WA, Rock CL, Pierce JP. Is family history related to preventive health behaviors and medical management in breast cancer patients? Breast Cancer Res Treat 2005; 90:47-54. [PMID: 15770526 DOI: 10.1007/s10549-004-2626-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Women diagnosed with breast cancer who also have a family history of the disease are at increased risk of developing additional primary breast or ovarian cancers. We investigated whether a relationship exists between family history and health behaviors in a cross-sectional study of breast cancer survivors. METHODS Participants in the Women's Healthy Eating and Living (WHEL) Study (a randomized trial designed to test the effect of a plant-based diet on breast cancer recurrence) completed baseline questionnaires about their family history and health behaviors. Medical records and self-reports provided treatment data. Participants were defined as having a family history (FH+) if they met specific family history criteria (n=195), and were compared with women having no family history (FH-) of breast cancer (n=1736). RESULTS The mean age of breast cancer diagnosis was 51.2 years for both groups, but FH+ women were more likely to be diagnosed before age 40. FH+ and FH- women had similar dietary patterns, alcohol intake, exercise patterns, body mass index and smoking histories. However, FH+ women were more likely to have undergone prophylactic contralateral mastectomy (OR=3.6, 95% CI=2.2 - 6.2) and bilateral oophorectomy (OR=1.6; 95% CI=1.0 - 2.3) following diagnosis, adjusted for age and time since diagnosis. The FH+ and FH- groups had similar patterns of use of anti-estrogen medications and frequency of medical follow-up. CONCLUSIONS Breast cancer survivors with a strong family history of breast cancer are more likely to undergo surgical preventive measures to reduce their risk of additional cancer, but do not report undertaking more preventive lifestyle behaviors compared to breast cancer survivors without a family history.
Collapse
Affiliation(s)
- Lisa Madlensky
- Cancer Prevention and Control, Rebecca and John Moores UCSD Cancer Center, University of California, SanDiego, 95000 Gilman Drive, San Diego, California 92093-0901, USA.
| | | | | | | | | |
Collapse
|
18
|
Leslie NS, Deiriggi P, Gross S, DuRant E, Smith C, Veshnesky JG. Knowledge, attitudes, and practices surrounding breast cancer screening in educated Appalachian women. Oncol Nurs Forum 2003; 30:659-67. [PMID: 12861325 DOI: 10.1188/03.onf.659-667] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To determine how and what women learn about breast cancer and screening practices and which factors influence women's breast cancer screening practices. DESIGN Descriptive analysis of questionnaire data collected at the time of enrollment in a clinical trial. SETTING Breast care center of a mid-Atlantic academic health sciences center. SAMPLE 185 women in a predominantly Appalachian, entirely rural state. METHODS Participants completed the Modified Toronto Breast Self-Examination Inventory and questions related to personal mammography practices at the time of enrollment before randomization in a longitudinal clinical intervention study. MAIN RESEARCH VARIABLES Women's demographics, knowledge of breast cancer screening practices, adherence to breast cancer screening guidelines, and motivation, knowledge, and practice proficiency surrounding breast cancer screening. FINDINGS These educated women had knowledge deficits about breast cancer, breast cancer risk factors, and screening guidelines, particularly the timing and practice behaviors of breast self-examination. Women who had received healthcare and cancer-screening instruction by healthcare providers, including advanced practice nurses, had greater knowledge of breast cancer and detection practices. CONCLUSIONS Women still have knowledge deficits about breast cancer, breast cancer detection, and personal risk factors. In addition, some educated women in this study failed to practice breast cancer screening according to current guidelines. IMPLICATIONS FOR NURSING Practitioners must continue to remind and update women about breast disease, and women's cancer-screening practices must be reinforced. All levels of providers should improve their rates of performing clinical breast examinations with physical examinations. Nurses, who greatly influence women's health care, must remain current in their knowledge of breast disease, screening, and treatment.
Collapse
Affiliation(s)
- Nan S Leslie
- School of Nursing, West Virginia University, Morgantown, WV, USA.
| | | | | | | | | | | |
Collapse
|
19
|
Abstract
OBJECTIVE To update and summarize evidence of risk factors for breast cancer. SUMMARY BACKGROUND DATA Women who are at high risk for breast cancer have a variety of options available to them, including watchful waiting, prophylactic surgery, and chemoprevention. It is increasingly important to accurately assess a patient's risk profile to ensure that the cost/benefit ratio of the selected treatment is favorable. METHODS Estimates of relative risk for documented risk factors were obtained from seminal papers identified in previous reviews. These estimates were updated where appropriate with data from more recent reports using large sample sizes or presenting meta-analyses of previous studies. These reports were identified from a review of the Medline database from 1992 to 2002. RESULTS Risk factors that have received a great deal of publicity (hormone use, alcohol consumption, obesity, nulliparity) present a relatively modest relative risk for breast cancer (<2). Factors associated with a prior history of neoplastic disease or atypical hyperplasia and factors associated with a genetic predisposition significantly affect the risk of breast cancer, with relative risks ranging from 3 (for some cases of positive family history) to 200 (for premenopausal women positive for a BRCA mutation). CONCLUSIONS More precise tools, based on techniques of molecular biology such as microarray analysis, will be needed to assess individual risk for breast cancer.
Collapse
Affiliation(s)
- S Eva Singletary
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 444, Houston, TX 77030-4095, USA.
| |
Collapse
|
20
|
Martinic M. Alcohol and ‘special populations’: Biological vulnerability. DRUGS AND ALCOHOL TODAY 2002. [DOI: 10.1108/17459265200200013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
21
|
Loud JT, Peters JA, Fraser M, Jenkins J. Applications of advances in molecular biology and genomics to clinical cancer care. Cancer Nurs 2002; 25:110-22; quiz 123-4. [PMID: 11984099 DOI: 10.1097/00002820-200204000-00007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Genetics technologies, methods, and discoveries are being integrated rapidly into medical and nursing practices in a variety of ways. The purpose of this article is to familiarize nurses with how new genetic technologies and discoveries are being incorporated into various phases of clinical oncology practice. The scope of this article is broad to provide an overview of the of ways in which cancer prevention, surveillance, diagnosis, prognosis, monitoring, treatment, and gene therapy are evolving due to advances in the molecular biology of cancer. We use specific examples to demonstrate the use of genetic information to achieve these objectives and to illustrate principles and strategies that may be applied to a variety of cancers.
Collapse
Affiliation(s)
- Jennifer T Loud
- Clinical Genetics Branch (CGB), National Cancer Institute, National Institutes of Health, Rockville, Md 20852, USA.
| | | | | | | |
Collapse
|
22
|
Owens J, Ramster B, Milburn J, Baderman N, Berry S. News in brief. Drug Discov Today 2001. [DOI: 10.1016/s1359-6446(01)02012-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|