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Tanaka C, Otani K, Tamoto M, Yoshida H, Nadatani Y, Ominami M, Fukunaga S, Hosomi S, Kamata N, Tanaka F, Taira K, Kimura T, Fukumoto S, Watanabe T, Fujiwara Y. Efficacy evaluation of upper gastrointestinal endoscopy screening for secondary prevention of gastric cancer using the standardized detection ratio during a medical check-up in Japan. J Clin Biochem Nutr 2024; 74:253-260. [PMID: 38799136 PMCID: PMC11111473 DOI: 10.3164/jcbn.24-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/11/2024] [Indexed: 05/29/2024] Open
Abstract
We used standardized detection ratio to evaluate the quality of nasal upper gastrointestinal endoscopy screening for the secondary prevention of gastric cancer, and examined the gastric cancer risk in the era of total Helicobacter pylori (H. pylori) eradication. We performed 21,931 upper gastrointestinal endoscopies, 77 subjects were diagnosed with gastric cancer. Of these, 28 had gastric cancer after H. pylori eradication, 47 had gastric cancer with H. pylori-positive or others, and 2 had H. pylori-negative gastric cancer. The Standardized detection ratios for men and women were 5.33 and 4.82, respectively. Multivariable logistic regression analyses performed exclusively on first endoscopy subjects, excluding H. pylori-negative gastric cancer, revealed that smoking was a risk factor for developing gastric cancer (adjusted odds ratio, 3.31; 95% confidence interval, 1.65-6.64; p = 0.001). A statistically significant interaction was found between daily alcohol consumpption and H. pylori eradication on gastric cancer development (p = 0.005). In conclusion, relatively high standardized detection ratio values suggest that an appropriate endoscopic diagnosis of gastric cancer should be performed during a medical check-up. Smoking is a risk factor for developing gastric cancer, and continued alcohol consumption suggests a possible risk for developing gastric cancer after H. pylori eradication.
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Affiliation(s)
- Chieko Tanaka
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Koji Otani
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Mitsuhiro Tamoto
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Yuji Nadatani
- Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Masaki Ominami
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Shusei Fukunaga
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Shuhei Hosomi
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Noriko Kamata
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Fumio Tanaka
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Koichi Taira
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Tatsuo Kimura
- Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Shinya Fukumoto
- Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Toshio Watanabe
- Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Yasuhiro Fujiwara
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
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Cavalieri S, Bruno E, Serafini MS, Lenoci D, Canevari S, Lopez-Perez L, Hernandez L, Mariani L, Miceli R, Gavazzi C, Pasanisi P, Rosso E, Cordero F, Bossi P, Golusinski W, Dietz A, Strojan P, Fuereder T, De Cecco L, Licitra L. Dietary intervention for tertiary prevention in head and neck squamous cell carcinoma survivors: clinical and translational results of a randomized phase II trial. Front Oncol 2024; 13:1321174. [PMID: 38239654 PMCID: PMC10794719 DOI: 10.3389/fonc.2023.1321174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/04/2023] [Indexed: 01/22/2024] Open
Abstract
Background There is a strong need for preventive approaches to reduce the incidence of recurrence, second cancers, and late toxicities in head and neck squamous cell carcinoma (HNSCC) survivors. We conducted a randomized controlled trial (RCT) to assess a dietary intervention as a non-expensive and non-toxic method of tertiary prevention in HNSCC survivors. Methods Eligible participants were disease-free patients with HNSCC in follow-up after curative treatments. Subjects were randomized 1:1 to receive a highly monitored dietary intervention plus the Word Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention (intervention arm) or standard-of-care recommendations (control arm). The planned sample size for the event-free survival evaluation (primary endpoint) was not reached, and the protocol was amended in order to investigate the clinical (nutritional and quality-of-life questionnaires) and translational study [plasma-circulating food-related microRNAs (miRNAs)] as main endpoints, the results of which are reported herein. Results One hundred patients were screened, 94 were randomized, and 89 were eligible for intention-to-treat analysis. Median event-free survival was not reached in both arms. After 18 months, nutritional questionnaires showed a significant increase in Recommended Food Score (p = 0.04) in the intervention arm vs. control arm. The frequency of patients with and without a clinically meaningful deterioration or improvement of the C30 global health status in the two study arms was similar. Food-derived circulating miRNAs were identified in plasma samples at baseline, with a significant difference among countries. Conclusion This RCT represented the first proof-of-principle study, indicating the feasibility of a clinical study based on nutritional and lifestyle interventions in HNSCC survivors. Subjects receiving specific counseling increased the consumption of the recommended foods, but no relevant changes in quality of life were recorded between the two study arms. Food-derived plasma miRNA might be considered promising circulating dietary biomarkers.
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Affiliation(s)
- Stefano Cavalieri
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Eleonora Bruno
- Nutrition Research and Metabolomics, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Mara Serena Serafini
- Integrated Biology of Rare Tumors Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Deborah Lenoci
- Integrated Biology of Rare Tumors Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Laura Lopez-Perez
- Universidad Politecnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Madrid, Spain
| | - Liss Hernandez
- Universidad Politecnica de Madrid-Life Supporting Technologies Research Group, ETSIT, Madrid, Spain
| | - Luigi Mariani
- Biostatistics for Clinical Research Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Rosalba Miceli
- Biostatistics for Clinical Research Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Cecilia Gavazzi
- Clinical Nutrition Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Patrizia Pasanisi
- Nutrition Research and Metabolomics, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elena Rosso
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Computer Science, University of Torino, Torino, Italy
| | | | - Paolo Bossi
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Andreas Dietz
- Department of Otolaryngology, Head and Neck Surgery, Universitätsklinikum, Leipzig, Germany
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Thorsten Fuereder
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Loris De Cecco
- Integrated Biology of Rare Tumors Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lisa Licitra
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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In Silico Prospects and Therapeutic Applications of Ouabagenin and Hydroxylated Corticosteroid Analogues in the Treatment of Lung Cancer. Appl Biochem Biotechnol 2022; 194:6106-6125. [PMID: 35895251 DOI: 10.1007/s12010-022-04083-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/02/2022]
Abstract
Lung cancer is the second most prevalent carcinoma around the world, and about 80% of patients are of non-small cell lung cancer (NS-CLC). Epidermal growth factor receptor (EGFR) is the most expressed protein kinases in lung cancer and hence can be used in target-related anti-cancer therapy. Here, computational approach is used for the exploration of the anti-cancer potential of new steroid derivatives as previously no in vitro data was available for them. Initially, DFT calculations of all compounds were determined to analyze the electronic density of optimized structures. The HOMO and LUMO orbital analysis of all derivatives was analyzed, to investigate the reactivity of compounds. Afterwards, optimized structures were used for molecular docking studies in which all ouabagenin derivatives were docked within the EGFR active site using MOE software. Moreover, anti-cancer potential of selected derivatives was evaluated on the basis of binding interactions with three anti-cancer proteins. The binding scores of these compounds were compared with the FDA-approved drug, i.e., gefitinib. The findings of current study suggested that selected derivatives exhibited significant inhibiting potential of anti-cancer proteins and EGFR. Particularly, compound OD3 is the potent inhibitor of anti-cancer and EGFR protein with the highest binding energies. These novel steroidal derivatives are subjected to in silico analysis for the first time against lung cancer. These compounds possess potential anti-cancerous properties and can be explored further for in vitro and in vivo studies.
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Kuwabara Y, Fujii M, Kinjo A, Osaki Y. Abstaining from annual health check-ups is a predictor of advanced cancer diagnosis: a retrospective cohort study. Environ Health Prev Med 2022; 27:1. [PMID: 35289320 PMCID: PMC9093613 DOI: 10.1265/ehpm.21-00292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Cancer prevention is a crucial challenge in preventive medicine. Several studies have suggested that voluntary health check-ups and recommendations from health professionals are associated with increased participation in cancer screening. In Japan, it is recommended that individuals aged 40–74 years should undergo annual health check-ups; however, the compliance to this recommendation is approximately <50%. According to the national survey, individuals who do not undergo annual health check-ups are at a higher risk for cancer. However, to the best of our knowledge, no previous study has investigated the association between the use of health check-ups and the incidence rate of cancer. We hypothesised that not undergoing periodic health check-ups and/or less use of outpatient medical services are predictors for advanced cancer. Methods To explore the relationship between health check-up or outpatient service utilisation and cancer incidence, this retrospective cohort study used data at two time points—baseline in 2014 and endpoint in 2017—from the National Health Insurance (NHI) claims and cancer registry. A multivariable logistic regression analysis was performed to investigate whether cancer diagnosis was associated with health check-up or outpatient service utilisation. Results A total of 72,171 participants were included in the analysis. The results of the multivariable logistic regression showed that individuals who skipped health check-ups had a higher risk of cancer diagnosis (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04–1.40). Moreover, not undergoing health check-ups increased the risk of advanced-stage cancer (OR, 1.78; 95% CI, 1.29–2.44). Furthermore, increased rate of outpatient service utilisation was negatively associated with advanced cancer diagnosis. Conclusions This is the first study reporting that not undergoing health check-ups is a predictor of cancer diagnosis and advanced cancer stage. Primary prevention strategies for NHI members who do not undergo health check-ups must be reassessed. Moreover, future research should examine secondary prevention strategies, such as health education and recommendations from health professionals to facilitate adequate utilisation of preventive health services. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.21-00292.
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Affiliation(s)
- Yuki Kuwabara
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University
| | - Maya Fujii
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University
| | - Aya Kinjo
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University
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Trajectories and individual determinants of regular cancer screening use over a long period based on data from the French E3N cohort. Soc Sci Med 2021; 294:114663. [PMID: 34974385 DOI: 10.1016/j.socscimed.2021.114663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 11/23/2022]
Abstract
Despite several incentive policies for cancer screenings over the last two decades, the overall and regular use of cancer screenings remains insufficient in France. While the individual determinants of cancer screening uptake have been fairly well studied, the literature has rarely focused on the regularity of screening uptake, which is key to early cancer detection. We aimed to address this issue by studying cancer screening behaviors over 15 years, emphasizing the regularity and diversity of use. Using data from 40,021 women in the French E3N cohort, we studied the individual trajectories of screenings for breast, colorectal and cervical cancer between 2000 and 2014. We employed optimal matching methods to identify typical behaviors of use for each cancer screening. Then, we determined the associations between the identified behavior screening patterns for the different cancer screenings and, finally, assessed the associated individual determinants with logistical and multinomial models. We found that screening behaviors were fairly stable over time, with few typical screening patterns for each cancer. Overall, once a woman starts screening, she continues, and once she stops, she no longer returns. Cancer screening behaviors appear consistent; in particular, insufficient use of mammography appears to be associated with long-term nonuse of other cancer screenings. Factors associated with low or nonuse of screening are overall common between cancer screenings and are similar to those identified in the literature of screening use at a single point in time. Ultimately, these barriers prevent some women from entering a screening process in the long run, ultimately reinforcing social inequalities in health. Targeting women with insufficient mammography uptake may reach women outside of cancer screening settings more generally and, thus, both increase the overall uptake of cancer screening and reduce social inequalities in cancer screening.
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Liu J, Yin L, Chandler JH, Chen X, Valdastri P, Zuo S. A dual‐bending endoscope with shape‐lockable hydraulic actuation and water‐jet propulsion for gastrointestinal tract screening. Int J Med Robot 2020; 17:1-13. [DOI: 10.1002/rcs.2197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Jianbin Liu
- Key Laboratory of Mechanism Theory and Equipment Design Ministry of Education Tianjin University Tianjin China
| | - Linkun Yin
- Key Laboratory of Mechanism Theory and Equipment Design Ministry of Education Tianjin University Tianjin China
| | - James H. Chandler
- Institute of Robotics, Autonomous Systems and Sensing School of Electronic and Electrical Engineering University of Leeds Leeds UK
| | - Xin Chen
- Tianjin Medical University General Hospital Tianjin China
| | - Pietro Valdastri
- Institute of Robotics, Autonomous Systems and Sensing School of Electronic and Electrical Engineering University of Leeds Leeds UK
| | - Siyang Zuo
- Key Laboratory of Mechanism Theory and Equipment Design Ministry of Education Tianjin University Tianjin China
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Ebeling M, Meyer AC, Modig K. The rise in the number of long-term survivors from different diseases can slow the increase in life expectancy of the total population. BMC Public Health 2020; 20:1523. [PMID: 33028250 PMCID: PMC7542716 DOI: 10.1186/s12889-020-09631-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/29/2020] [Indexed: 11/23/2022] Open
Abstract
Background Recent improvements in life expectancy in many countries stem from reduced mortality from cardiovascular disease and cancer above the age of 60. This is the combined result of decreased incidence and improved survival among those with disease. The latter has led to a higher proportion in the population of people with a past history of disease. This is a group with higher mortality than the general population. How growing shares of persons with past history of disease and improved survival with disease have affected changes in life expectancy of the total population is the objective of this paper. Methods Using register data for the total Swedish population, we stratified the population based on whether individuals have been diagnosed with myocardial infarction, stroke, hip fracture, colon cancer, or breast cancer. Using a novel decomposition approach, we decomposed the changes in life expectancy at age 60 between 1994 and 2016 into contributions from improved survival with disease and from changes in proportion of people with past history of disease. Results Improvements in survival from disease resulted in gains of life expectancy for the total population. However, while the contributions to life expectancy improvements from myocardial infarction, stroke and breast cancer were substantial, the contributions from the other diseases were minor. These gains were counteracted, to various degrees, by the increasing proportion of people with raised mortality due to a past history of disease. For instance, the impact on life expectancy by improved survival from breast cancer was almost halved by the increasing share of females with a past history of breast cancer. Conclusion Rising numbers of survivors of different diseases can slow the increase in life expectancy. This dynamic may represent the costs associated with successful treatment of diseases, and thus, a potential “failure of success.” This dynamic should be considered when assessing mortality and life expectancy trends. As populations are aging and disease survival continues to improve, this issue is likely to become even more important in the future.
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Affiliation(s)
- Marcus Ebeling
- Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18055, Rostock, Germany. .,University of Rostock, Rostock, Germany.
| | - Anna C Meyer
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Karin Modig
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
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Padash M, Enz C, Carrara S. Microfluidics by Additive Manufacturing for Wearable Biosensors: A Review. SENSORS 2020; 20:s20154236. [PMID: 32751404 PMCID: PMC7435802 DOI: 10.3390/s20154236] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/04/2020] [Accepted: 07/12/2020] [Indexed: 12/14/2022]
Abstract
Wearable devices are nowadays at the edge-front in both academic research as well as in industry, and several wearable devices have been already introduced in the market. One of the most recent advancements in wearable technologies for biosensing is in the area of the remote monitoring of human health by detection on-the-skin. However, almost all the wearable devices present in the market nowadays are still providing information not related to human ‘metabolites and/or disease’ biomarkers, excluding the well-known case of the continuous monitoring of glucose in diabetic patients. Moreover, even in this last case, the glycaemic level is acquired under-the-skin and not on-the-skin. On the other hand, it has been proven that human sweat is very rich in molecules and other biomarkers (e.g., ions), which makes sweat a quite interesting human liquid with regards to gathering medical information at the molecular level in a totally non-invasive manner. Of course, a proper collection of sweat as it is emerging on top of the skin is required to correctly convey such liquid to the molecular biosensors on board of the wearable system. Microfluidic systems have efficiently come to the aid of wearable sensors, in this case. These devices were originally built using methods such as photolithographic and chemical etching techniques with rigid materials. Nowadays, fabrication methods of microfluidic systems are moving towards three-dimensional (3D) printing methods. These methods overcome some of the limitations of the previous method, including expensiveness and non-flexibility. The 3D printing methods have a high speed and according to the application, can control the textures and mechanical properties of an object by using multiple materials in a cheaper way. Therefore, the aim of this paper is to review all the most recent advancements in the methods for 3D printing to fabricate wearable fluidics and provide a critical frame for the future developments of a wearable device for the remote monitoring of the human metabolism directly on-the-skin.
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Affiliation(s)
- Mahshid Padash
- Laboratory of Integrated Circuits, École Polytechnique Fédérale de Lausanne, CH-2002 Neuchâtel, Switzerland or (M.P.); (C.E.)
- Chemistry Department, Shahid Bahonar University of Kerman, Kerman 76169-13439, Iran
| | - Christian Enz
- Laboratory of Integrated Circuits, École Polytechnique Fédérale de Lausanne, CH-2002 Neuchâtel, Switzerland or (M.P.); (C.E.)
| | - Sandro Carrara
- Laboratory of Integrated Circuits, École Polytechnique Fédérale de Lausanne, CH-2002 Neuchâtel, Switzerland or (M.P.); (C.E.)
- Correspondence:
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Abstract
Objectives A federal court ruled tobacco companies violated racketeering laws and ordered them to publish corrective statements. This study assesses effects of exposure to the statements and related court findings on attitudes toward tobacco-related policies and tobacco company influences on policymaking. Methods We conducted a cross-sectional survey of US adults (N = 2010) prior to publication of the statements. Participants were randomly assigned to the "unexposed" group (N = 1004), which answered attitude questions before reading the statements and court findings, or the "exposed" group (N = 1006), which answered attitude questions after reading the statements and court findings. Results The exposed group was less likely to think lawmakers should trust tobacco companies as much as other companies (β = -.24, p < .001) or that lawmakers should trust tobacco company lobbyists to provide accurate information (β = -.17, p = .019), compared to the unexposed group. The exposed group also was more likely to support requiring graphic warning labels (β = .15, p = .014) and point-of-sale quitline signs (β = .13, p = .028). Conclusions Exposure to the statements and court findings may aid tobacco industry denormalization and tobacco-related policy initiatives.
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Conjugated Linoleic Acid Isomers Affect Profile of Lipid Compounds and Intensity of Their Oxidation in Heart of Rats with Chemically-Induced Mammary Tumors-Preliminary Study. Nutrients 2019; 11:nu11092032. [PMID: 31480307 PMCID: PMC6770796 DOI: 10.3390/nu11092032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/22/2019] [Accepted: 08/27/2019] [Indexed: 01/10/2023] Open
Abstract
Breast cancer and cardiovascular diseases (CVD) have shared risk factors and mechanisms of pathogenicity, as proven by increased cardiac risk in breast cancer patients receiving anticancerogenic therapies and in cancer survivors. A growing mammary tumor may cause heart injury in cancer patients who have not yet been treated. This study aimed to evaluate the effect of conjugated linoleic acid (CLA) supplementation of female rats with 7,12-dimethylbenz(a)anthracene (DMBA)-induced cancerogenesis on fatty acids (FAs), conjugated FAs (CFAs), malondialdehyde (MDA), cholesterol and oxysterols content in cardiac tissue. FAs, cholesterol and oxysterols contents were determined by gas chromatography coupled with mass spectrometry, while the contents of CFAs and MDA were determined by high performance liquid chromatography with photodiode detection. Our results indicate that both CLA supplementation and the presence of tumors influence the lipid biomarkers of CVD. A significant interaction of both experimental factors was observed in the content of polyunsaturated FAs (PUFAs), n-6 PUFAs and CFAs. CLA supplementation significantly inhibited PUFA oxidation, as evidenced by the lower content of MDA in rats' hearts, while the cancerous process intensified the oxidation of cholesterol, as confirmed by the elevated levels of 7-ketocholesterol in DMBA-treated rats. These results may significantly expand knowledge about CLA properties in terms of the prevention of co-existing non-communicable diseases.
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Jia S, Li H, Zeng H, Zheng R, Li J, Shi J, Yang Z, Cao M, Chen W. Association of cancer prevention awareness with esophageal cancer screening participation rates: Results from a population-based cancer screening program in rural China. Chin J Cancer Res 2019; 31:601-608. [PMID: 31564803 PMCID: PMC6736664 DOI: 10.21147/j.issn.1000-9604.2019.04.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objective China have implemented population-based esophageal cancer (EC) screening programs, however, the participant rates were relatively low. This study was conducted to examine the association between cancer prevention knowledge and EC screening participation rates (PRs). Methods Data in the analyses were obtained from a population-based cancer screening program in four provinces in China since 2007. In the course of 2007−2016, participants who were evaluated as high risk for EC and subsequently recommended for endoscopy examination were included in the final analysis. One-way analysis of variance test, Chi-square test and logistic regression analysis were applied. Results A total of 28,543 individuals assessed as high-risk population for EC were included in this study, with 13,036 males (45.67%) and 15,507 females (54.33%). The prevalence rates of current smoking and alcohol drinking were higher in males (58.25% and 44.22%, respectively) than in females (5.35% and 4.05%, respectively). Participants of females, and those who had older age, lower income, as well as higher education level and cancer prevention knowledge level were more likely to undergo endoscopy. Multivariable analysis showed that higher cancer prevention knowledge was associated with higher PR for endoscopic screening [adjusted odd ratio (aORQ4/Q1) =1.511, 95% confidence interval (95% CI): 1.398−1.632] among our study subjects. This association between cancer prevention knowledge and compliance with endoscopic screening also tends to be strong within subgroups of males, females, aged below 60 years, aged 60 years and above, and lower level of education (illiterate individuals and those with junior high education or less).
Conclusions Our results displayed a positive relationship between cancer prevention knowledge and PRs for endoscopic screening, implying cancer prevention awareness being an independent influence factor for compliance with EC screening. Promoting public campaigns about comprehensive knowledge of cancer prevention seemed to be a reasonable and effective strategy to improve population PRs for EC screening.
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Affiliation(s)
- Shangchun Jia
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, China
| | - He Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hongmei Zeng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Rongshou Zheng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jiang Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jufang Shi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zhixun Yang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Maomao Cao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wanqing Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Wu W, Haick H. Materials and Wearable Devices for Autonomous Monitoring of Physiological Markers. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2018; 30:e1705024. [PMID: 29498115 DOI: 10.1002/adma.201705024] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 10/20/2017] [Indexed: 05/02/2023]
Abstract
Wearable devices are gaining considerable attention owing to the ease with which they can collect crucial information in real-time, both continuously and noninvasively, regarding a wearer's health. A concise summary is given of the three main elements that enable autonomous detection and monitoring of the likelihood or the existence of a health-risk state in continuous and real-time modes, with an emphasis on emerging materials and fabrication techniques in the relevant fields. The first element is the sensing technology used in the noninvasive detection of physiological markers relevant to the state of health. The second element is self-powered devices for longer periods of use by drawing energy from bodily movement and temperature. The third element is the self-healing properties of the materials used in the wearable devices to extended usage if they become scratched or cut. Promises and challenges of the separately reviewed parts and the combined parts are presented and discussed. Ideas regarding further improvement of skin-based wearable devices are also presented and discussed.
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Affiliation(s)
- Weiwei Wu
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
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Palli D, Berrino F, Vineis P, Tumino R, Panico S, Masala G, Saieva C, Salvini S, Ceroti M, Pala V, Sieri S, Frasca G, Giurdanella MC, Sacerdote C, Fiorini L, Celentano E, Galasso R, Decarli A, Krogh V. A Molecular Epidemiology Project on Diet and Cancer: The Epic-Italy Prospective Study. Design and Baseline Characteristics of Participants. TUMORI JOURNAL 2018; 89:586-93. [PMID: 14870823 DOI: 10.1177/030089160308900602] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
EPIC-Italy is the Italian section of a larger project known as EPIC (European Prospective Investigation into Cancer and Nutrition), a prospective study on diet and cancer carried out in 10 European countries. In the period 1993-1998, EPIC-Italy completed the recruitment of 47,749 volunteers (15,171 men, 32,578 women, aged 35-65 years) in 4 different areas covered by cancer registries: Varese (12,083 volunteers) and Turin (10,604) in the Northern part of the country; Florence (13,597) and Ragusa (6,403) in Central and Southern Italy, respectively. An associate center in Naples enrolled 5,062 women. Detailed information for each individual volunteer about diet and life-style habits, anthropometric measurements and a blood sample was collected, after signing an informed consent form. A food frequency questionnaire specifically developed for the Italian dietary pattern was tested in a pilot phase. A computerized data base with the dietary and lifestyle information of each participant was completed. Blood samples were processed in the same day of collection, aliquoted (RBC, WBC, serum and plasma) and stored in liquid nitrogen containers. Follow-up procedures were validated and implemented for the identification of newly diagnosed cancer cases. Cancer incidence was related to dietary habits and biochemical markers of food consumption and individual susceptibility in order to test the role of diet-related exposure in the etiology of cancer and its interaction with other environmental or genetic determinants. The comparability of information in a prospective study design is much higher than in other studies. The availability of such a large biological bank linked to individual data on dietary and life-style exposures also provides the unique opportunity of evaluating the role of selected genotypes involved in the metabolism of chemical compounds and DNA repair, potentially related to the risk of cancer, in residents of geographic areas of Italy characterized by specific cancer risk and different dietary patterns. Baseline characteristics of participants are briefly described.
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Affiliation(s)
- Domenico Palli
- UO Epidemiologia Molecolare e Nutrizionale, Centro per lo Studio e la Prevenzione Oncologica (CSPO), Istituto Scientifico della Regione Toscana, Florence, Italy.
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Jin H, Abu-Raya YS, Haick H. Advanced Materials for Health Monitoring with Skin-Based Wearable Devices. Adv Healthc Mater 2017; 6. [PMID: 28371294 DOI: 10.1002/adhm.201700024] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/14/2017] [Indexed: 12/16/2022]
Abstract
Skin-based wearable devices have a great potential that could result in a revolutionary approach to health monitoring and diagnosing disease. With continued innovation and intensive attention to the materials and fabrication technologies, development of these healthcare devices is progressively encouraged. This article gives a concise, although admittedly non-exhaustive, didactic review of some of the main concepts and approaches related to recent advances and developments in the scope of skin-based wearable devices (e.g. temperature, strain, biomarker-analysis werable devices, etc.), with an emphasis on emerging materials and fabrication techniques in the relevant fields. To give a comprehensive statement, part of the review presents and discusses different aspects of these advanced materials, such as the sensitivity, biocompatibility and durability as well as the major approaches proposed for enhancing their chemical and physical properties. A complementary section of the review linking these advanced materials with wearable device technologies is particularly specified. Some of the strong and weak points in development of each wearable material/device are highlighted and criticized. Several ideas regarding further improvement of skin-based wearable devices are also discussed.
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Affiliation(s)
- Han Jin
- Department of Chemical Engineering; Technion - Israel Institute of Technology; Haifa 3200003 Israel
- Faculty of Information Science and Engineering; Ningbo University; Ningbo 315211 P. R. China
| | - Yasmin Shibli Abu-Raya
- Department of Chemical Engineering and The Russell Berrie Nanotechnology Institute; Technion - Israel Institute of Technology; Haifa 3200003 Israel
| | - Hossam Haick
- Department of Chemical Engineering and The Russell Berrie Nanotechnology Institute; Technion - Israel Institute of Technology; Haifa 3200003 Israel
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Kang DH, Choi CW, Kim HW, Park SB, Kim SJ, Nam HS, Ryu DG. Location characteristics of early gastric cancer treated with endoscopic submucosal dissection. Surg Endosc 2017; 31:4673-4679. [PMID: 28389793 DOI: 10.1007/s00464-017-5534-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/20/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND STUDY AIMS The timely detection of early gastric cancer (EGC) is important in performing endoscopic submucosal dissection (ESD). We attempted to determine the location characteristics of regions where EGC is frequently detected and analyzed the EGC characteristics associated with that location. METHODS We retrospectively reviewed the medical records of patients with EGC treated by ESD between November 2008 and August 2016. We retrospectively investigated and analyzed 647 EGC lesions. RESULTS The patients' mean age was 66.7 ± 10.8 years. The patient population was predominantly male (77.1%, 499/647). A well-to-moderately differentiated carcinoma was observed in 97.2% of patients. The common site of carcinoma occurrence was the lower part of the stomach (the antrum and lower third of body, 89.6%). Among the stomach hemispheres, the lesser curvature side was the most frequent site of EGC (43.9%). The posterior side of EGC was more frequent than anterior side of EGC (20.4 vs. 15.6%, respectively). Submucosal invasive EGC was more frequent in the mid-to-upper parts of stomach than lower part of stomach (odds ratio 1.919; confidence interval 1.014-3.623; p = 0.045). CONCLUSIONS Most EGCs that are resectable with ESD were found in the lower part and in the lesser curvature of the stomach. The submucosal invasive EGC was more frequent in the mid-to-upper part of stomach.
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Affiliation(s)
- Dae Hwan Kang
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Cheol Woong Choi
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Korea.
| | - Hyung Wook Kim
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Su Bum Park
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Su Jin Kim
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Hyeong Seok Nam
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Dae Gon Ryu
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Korea
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Park YM, Kim JH, Baik SJ, Park JJ, Youn YH, Park H. Clinical risk assessment for gastric cancer in asymptomatic population after a health check-up: An individualized consideration of the risk factors. Medicine (Baltimore) 2016; 95:e5351. [PMID: 27858920 PMCID: PMC5591168 DOI: 10.1097/md.0000000000005351] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
For the prevention of gastric cancer, the detection of risk factors associated with precancerous conditions may be more informative. The aim of this study was to identify the risk factors of gastric cancer, including precancerous conditions: atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia.The clinical and endoscopic findings of 60,261 adults who underwent gastroduodenoscopy as part of a health check-up were reviewed retrospectively. Subgroup analysis was conducted according to age, sex, cancer stage, and histology based on Lauren classification.Gastric cancer was diagnosed in 75 patients (0.12%). Both IM and AG were independent risk factors for gastric cancer in all subgroups. Male, older age, obesity, diabetes mellitus (DM), a salty and spicy diet, and Helicobacter pylori (H. pylori) were significantly associated with precancerous conditions. However, risk factors related to precancerous conditions were different according to age and sex. In <40 years, H. pylori was the only risk factor related to precancerous conditions, whereas DM with a salty and spicy diet were additional risk factors in ≥40 years. In female individuals, obesity was significant risk factor for precancerous conditions as well as H. pylori infection.AG and IM are independent risk factors for gastric cancer. To prevent gastric cancer, H. pylori eradication may be more useful in <40 years, whereas additional factors such as DM, obesity, salty and spicy diet may be important in female or ≥40 years.
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Affiliation(s)
- Yoo Mi Park
- Department of Internal Medicine
- Health Promotion Center, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine
- Correspondence: Jie-Hyun Kim, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, Korea (e-mail: )
| | - Su Jung Baik
- Health Promotion Center, Institute of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Jin H, Huynh TP, Haick H. Self-Healable Sensors Based Nanoparticles for Detecting Physiological Markers via Skin and Breath: Toward Disease Prevention via Wearable Devices. NANO LETTERS 2016; 16:4194-202. [PMID: 27328179 DOI: 10.1021/acs.nanolett.6b01066] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Flexible and wearable electronic sensors are useful for the early diagnosis and monitoring of an individual's health state. Sampling of volatile organic compounds (VOCs) derived from human breath/skin or monitoring abrupt changes in heart-beat/breath rate should allow noninvasive monitoring of disease states at an early stage. Nevertheless, for many reported wearable sensing devices, interaction with the human body leads incidentally to unavoidable scratches and/or mechanical cuts and bring about malfunction of these devices. We now offer proof-of-concept of nanoparticle-based flexible sensor arrays with fascinating self-healing abilities. By integrating a self-healable polymer substrate with 5 kinds of functionalized gold nanoparticle films, a sensor array gives a fast self-healing (<3 h) and attractive healing efficiency in both the substrate and sensing films. The proposed platform was used in sensing pressure variation and 11 kinds of VOCs. The sensor array had satisfactory sensitivity, a low detection limit, and promising discrimination features in monitoring both of VOCs and pressure variation, even after full healing. These results presage a new type of smart sensing device, with a desirable performance in the possible detection and/or clinical application for a number of different purposes.
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Affiliation(s)
- Han Jin
- The Faculty of Information Science and Engineering, Ningbo University , Ningbo 315211, P. R. China
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Rosberger Z, Perez S, Bloom J, Shapiro GK, Fielding R. The missing piece: cancer prevention within psycho-oncology - a commentary. Psychooncology 2015; 24:1330-1337. [DOI: 10.1002/pon.3916] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/25/2015] [Accepted: 06/25/2015] [Indexed: 12/28/2022]
Affiliation(s)
- Zeev Rosberger
- Department of Psychology; McGill University; Montreal QC Canada
- Lady Davis Institute for Medical Research; Jewish General Hospital; Montreal QC Canada
- Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center; Jewish General Hospital; Montreal QC Canada
- Departments of Psychiatry and Oncology; McGill University; Montreal QC Canada
| | - Samara Perez
- Department of Psychology; McGill University; Montreal QC Canada
- Lady Davis Institute for Medical Research; Jewish General Hospital; Montreal QC Canada
- Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center; Jewish General Hospital; Montreal QC Canada
| | - Joan Bloom
- Kaiser-Permanente Professor of Health Policy and Management and Associate Dean of Students; University of California; Berkeley USA
| | - Gilla K. Shapiro
- Department of Psychology; McGill University; Montreal QC Canada
- Lady Davis Institute for Medical Research; Jewish General Hospital; Montreal QC Canada
- Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center; Jewish General Hospital; Montreal QC Canada
| | - Richard Fielding
- School of Public Health, Li Ka Shing Faculty of Medicine; The University of Hong Kong; Hong Kong
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Duan F, Cui S, Song C, Dai L, Zhao X, Zhang X. Systematic evaluation of cancer risk associated with DNMT3B polymorphisms. J Cancer Res Clin Oncol 2015; 141:1205-20. [PMID: 25515408 DOI: 10.1007/s00432-014-1894-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 12/02/2014] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of our study is to provide a precise quantification for the association between DNA methyltransferase 3B (DNMT3B) variations (rs2424913 C/T, rs1569686 G/T, rs6087990 T/C and rs2424908 T/C) and the risk of cancer. METHODS We performed a systematic literature review and assessed the methodological quality of included case-control designed studies based on Newcastle-Ottawa Scale. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were calculated to assess the strengths of the associations. RESULTS We identified 34 studies for pooled analyses. Overall, the results demonstrated that rs2424913 polymorphism was significantly associated with negative cancer risk in the African population (CT vs TT: OR 0.10, 95% CI 0.02-0.63, P = 0.01; CT+CC vs TT: OR 0.14, 95% CI 0.03-0.76, P = 0.02), and the rs1569686 polymorphism was significantly associated with a subtly decreased cancer risk (GT vs TT: OR 0.80, 95% CI 0.72-0.90, P < 0.01; GT+GG vs TT: OR 0.84, 95% CI 0.76-0.94, P < 0.01), particularly in the Asian population (GT vs TT: OR 0.79, 95% CI 0.66-0.96, P < 0.01) and in colorectal cancer subgroup (G vs T: OR 0.69, 95% CI 0.54-0.88, P < 0.01). In addition, the rs6087990 polymorphism was associated with decreased risk in Asian population (T vs C: OR 0.77, 95% CI 0.62-0.96, P = 0.02). Similarly, the rs2424908 polymorphism was observed as a protective factor for cancer in the Asian population (CT+CC vs TT: OR 0.79, 95% CI 0.66-0.95, P = 0.01). CONCLUSIONS DNMT3B polymorphisms might be associated with decreased cancer risk especially in the Asian population and for colorectal cancer. Further multicentric studies are still needed to confirm the results.
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Affiliation(s)
- Fujiao Duan
- Department of Hospital Infection Management, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, Henan, China,
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Leatherdale ST. An examination of the co-occurrence of modifiable risk factors associated with chronic disease among youth in the COMPASS study. Cancer Causes Control 2015; 26:519-28. [PMID: 25673505 DOI: 10.1007/s10552-015-0529-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 02/02/2015] [Indexed: 12/27/2022]
Abstract
PURPOSE To examine the prevalence of major modifiable risk factors for cancer, examine risk factor co-occurrence, and examine how demographic and social factors are associated with risk factor co-occurrence among youth in the COMPASS study. METHODS Data from 23,280 grade 9-12 students in Year 1 (2012-2013) of the COMPASS study were used to examine the prevalence of seven different modifiable risk factors and the co-occurrence of these risk factors by gender and by grade. The between-school variance in the number of risk factors was calculated, and a model was developed to examine how demographic and social factors were associated with the number of co-occurring risk factors. RESULTS Among youth in this sample, 5.5% were current smokers, 22.9% were current binge drinkers, 16.5% were current marijuana users, 20.0% were overweight/obese, 53.1% were physically inactive, 96.7% were highly sedentary, and 95.1% had inadequate fruit and vegetable consumption. The mean number of co-occurring risk factors among students was 3.2 (± 1.1) and only 0.2% (n = 42) reported having none of the risk factors and 0.4% (n = 67) reported having all seven risk factors. Significant between-school random variation in the number of co-occurring risk factors was not identified. The number of risk factors was associated with most of the correlates examined although the effect sizes were generally small. CONCLUSION This research identifies that risk factor co-occurrence is common, most of student characteristics examined are only modestly associated with the likelihood of co-occurrence and that the school environment is not associated with variability in the number of co-occurring risk factors.
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Affiliation(s)
- Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo, ON, N2L 3G1, Canada,
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Štefková G, Veselská ZD, Vargová V, Paľo M. The Association of Education, Employment and Living with a Partner with the Treatment among Patients with Head and Neck Cancer. AIMS Public Health 2015; 2:1-9. [PMID: 29546091 PMCID: PMC5690365 DOI: 10.3934/publichealth.2015.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/21/2015] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to explore possible associations between social and socioeconomic status and ongoing treatment among patients with head and neck cancer. MATERIAL AND METHODS Data from 159 examined patients treated with head and neck cancer during the period from 2011 to 2012 were explored. A logistic regression analysis was used to assess association of social status (living with somebody vs. living alone), socioeconomic status (employed vs. unemployed) and education (primary/secondary/university) with treatment. RESULTS The results from logistic regression showed significant association of employment status and education with both interruption in radiochemotherapy and searching for additional help after surgery. Interruption of radiochemotherapy was almost 3 times more likely in a group of unemployed compared to the employed patients. Lack of searching for help after surgery was almost 4 times more likely in a group of unemployed compared to the employed and 5 times more likely in the group with the lowest education compared with the group with the highest education. CONCLUSIONS The study suggests that special attention needs to be paid, not only during but also after treatment, to the patients from low socioeconomic groups.
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Affiliation(s)
- Gabriela Štefková
- Nursing Department, Medical Faculty, PJ Safarik University in Košice, Slovakia
| | | | - Viola Vargová
- 1st Department of Internal Medicine, Medical Faculty, PJ Safarik University in Košice, Slovakia
| | - Marek Paľo
- Department of Radiology of JA Reiman University hospital in Prešov, Slovakia
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Caprara R, Obstein KL, Scozzarro G, Di Natali C, Beccani M, Morgan DR, Valdastri P. A platform for gastric cancer screening in low- and middle-income countries. IEEE Trans Biomed Eng 2014; 62:1324-32. [PMID: 25561586 DOI: 10.1109/tbme.2014.2386309] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gastric cancer is the second leading cause of cancer death worldwide and screening programs have had a significant impact on reducing mortality. The majority of cases occur in low- and middle-income countries (LMIC), where endoscopy resources are traditionally limited. In this paper, we introduce a platform designed to enable inexpensive gastric screening to take place in remote areas of LMIC. The system consists of a swallowable endoscopic capsule connected to an external water distribution system by a multichannel soft tether. Pressurized water is ejected from the capsule to orient the view of the endoscopic camera. After completion of a cancer screening procedure, the outer shell of the capsule and the soft tether can be disposed, while the endoscopic camera is reclaimed without needing further reprocessing. The capsule, measuring 12 mm in diameter and 28 mm in length, is able to visualize the inside of the gastric cavity by combining waterjet actuation and the adjustment of the tether length. Experimental assessment was accomplished through a set of bench trials, ex vivo analysis, and in vivo feasibility validation. During the ex vivo trials, the platform was able to visualize the main landmarks that are typically observed during a gastric cancer screening procedure in less than 8 min. Given the compact footprint, the minimal cost of the disposable parts, and the possibility of running on relatively available and inexpensive resources, the proposed platform can potentially widen gastric cancer screening programs in LMIC.
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Leatherdale ST, Rynard V. A cross-sectional examination of modifiable risk factors for chronic disease among a nationally representative sample of youth: are Canadian students graduating high school with a failing grade for health? BMC Public Health 2013; 13:569. [PMID: 23758659 PMCID: PMC3751757 DOI: 10.1186/1471-2458-13-569] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 06/05/2013] [Indexed: 11/25/2022] Open
Abstract
Background Substance use and weight gain among youth increase the risk for future disease. As such, the purpose of this study is to examine how many Canadian youth are currently failing to meet substance use and weight gain related public health guidelines. Methods Data from the 2010–11 Youth Smoking Survey were used to examine grade 9 to 12 students meeting seven different guidelines by sex and by grade. Results Among Canadian youth, 8.8% were current smokers, 18.8% were current marijuana users, 25.5% were current binge drinkers, 22.5% were considered overweight or obese, 31.2% did not meet physical activity guidelines, 89.4% exceeded sedentary behaviour guidelines, and 93.6% reported inadequate fruit and vegetable intake. The mean number of risk factors per student was 2.9 (±1.2); only 0.5% of youth reported having none of the risk factors. Conclusion Students rarely met all seven public health guideline examined, and the vast majority of actually reported having two or more modifiable risk factors for disease.
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Affiliation(s)
- Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo ON, N2L 3G1, Canada.
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Leatherdale ST, Laxer RE. Reliability and validity of the weight status and dietary intake measures in the COMPASS questionnaire: are the self-reported measures of body mass index (BMI) and Canada's food guide servings robust? Int J Behav Nutr Phys Act 2013; 10:42. [PMID: 23561578 PMCID: PMC3663698 DOI: 10.1186/1479-5868-10-42] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 03/29/2013] [Indexed: 11/10/2022] Open
Abstract
Background The COMPASS study is designed to follow a cohort of ~30,000 grade 9 to 12 students attending ~60 secondary schools for four years to understand how changes in school characteristics (policies, programs, built environment) are associated with changes in youth health behaviours. Since the student-level questionnaire for COMPASS (Cq) is designed to facilitate multiple large-scale school-based data collections using passive consent procedures, the Cq is only comprised of self-reported measures. The present study assesses the 1-week (1wk) test-retest reliability and the concurrent validity of the Cq measures for weight status and dietary intake. Methods Validation study data were collected from 178 grade 9 students in Ontario (Canada). At time 1 (T1), participants completed the Cq and daily recoding of their dietary intake using the web-based eaTracker tool. After one week, (T2), students completed the Cq again, participants submitted their daily eaTracker logs and staff measured their height and weight. Test-retest reliability of the self-reported (SR) weight status and dietary intake measures at T1 and T2, and the concurrent validity of the objectively measured and SR weight status and dietary intake measures at T2 were examined using intraclass correlation coefficients (ICC). Results Test-retest reliability for SR height (ICC 0.96), weight (ICC 0.99), and BMI (ICC 0.95) are considered substantial. The concurrent validity for SR height (ICC 0.88), weight (ICC 0.95), and BMI (ICC 0.84) are also considered substantial. The test-retest reliability for SR dietary intake for fruits and vegetables (ICC 0.68) and milk and alternatives (ICC 0.69) are considered moderate, whereas meat and alternatives (ICC 0.41), and grain products (ICC 0.56) are considered fair. The concurrent validity for SR dietary intake identified that fruits and vegetables (ICC 0.53), milk and alternatives (ICC 0.60), and grain products (ICC 0.41) are considered fair, whereas meat and alternatives (ICC 0.34) was considered slight. Conclusions While the test-retest reliability of the measures used in this study were all high, the concurrent validity of the measures was considered acceptable. The results support the use of the self-reported COMPASS weight status and dietary intake measures for use in research where objective measures are not possible.
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Affiliation(s)
- Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo, ON N2L 3G1, Canada.
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Espina C, Porta M, Schüz J, Aguado IH, Percival RV, Dora C, Slevin T, Guzman JR, Meredith T, Landrigan PJ, Neira M. Environmental and occupational interventions for primary prevention of cancer: a cross-sectorial policy framework. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:420-6. [PMID: 23384642 PMCID: PMC3620754 DOI: 10.1289/ehp.1205897] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 01/31/2013] [Indexed: 05/10/2023]
Abstract
BACKGROUND Nearly 13 million new cancer cases and 7.6 million cancer deaths occur worldwide each year; 63% of cancer deaths occur in low- and middle-income countries. A substantial proportion of all cancers are attributable to carcinogenic exposures in the environment and the workplace. OBJECTIVE We aimed to develop an evidence-based global vision and strategy for the primary prevention of environmental and occupational cancer. METHODS We identified relevant studies through PubMed by using combinations of the search terms "environmental," "occupational," "exposure," "cancer," "primary prevention," and "interventions." To supplement the literature review, we convened an international conference titled "Environmental and Occupational Determinants of Cancer: Interventions for Primary Prevention" under the auspices of the World Health Organization, in Asturias, Spain, on 17-18 March 2011. DISCUSSION Many cancers of environmental and occupational origin could be prevented. Prevention is most effectively achieved through primary prevention policies that reduce or eliminate involuntary exposures to proven and probable carcinogens. Such strategies can be implemented in a straightforward and cost-effective way based on current knowledge, and they have the added benefit of synergistically reducing risks for other noncommunicable diseases by reducing exposures to shared risk factors. CONCLUSIONS Opportunities exist to revitalize comprehensive global cancer control policies by incorporating primary interventions against environmental and occupational carcinogens.
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Affiliation(s)
- Carolina Espina
- Department of Public Health and Environment, World Health Organization (WHO), Geneva, Switzerland
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Vidrine JI, Shete S, Cao Y, Greisinger A, Harmonson P, Sharp B, Miles L, Zbikowski SM, Wetter DW. Ask-Advise-Connect: a new approach to smoking treatment delivery in health care settings. JAMA Intern Med 2013; 173:458-64. [PMID: 23440173 PMCID: PMC3858085 DOI: 10.1001/jamainternmed.2013.3751] [Citation(s) in RCA: 177] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Several national health care-based smoking cessation initiatives have been recommended to facilitate the delivery of evidence-based treatments, such as quitline (telephone-based tobacco cessation services) assistance. The most notable examples are the 5 As (Ask, Advise, Assess, Assist, Arrange) and Ask. Advise. Refer. (AAR) programs. Unfortunately, rates of primary care referrals to quitlines are low, and most referred smokers fail to call for assistance. OBJECTIVE To evaluate a new approach--Ask-Advise-Connect (AAC)--designed to address barriers to linking smokers with treatment. DESIGN A pair-matched, 2-treatment-arm, group-randomized design in 10 family practice clinics in a single metropolitan area. Five clinics were randomized to the AAC (intervention) and 5 to the AAR (control) conditions. In both conditions, clinic staff were trained to assess and record the smoking status of all patients at all visits in the electronic health record, and smokers were given brief advice to quit. In the AAC clinics, the names and telephone numbers of smokers who agreed to be connected were sent electronically to the quitline daily, and patients were called proactively by the quitline within 48 hours. In the AAR clinics, smokers were offered a quitline referral card and encouraged to call on their own. All data were collected from February 8 through December 27, 2011. SETTING Ten clinics in Houston, Texas. PARTICIPANTS Smoking status assessments were completed for 42,277 patients; 2052 unique smokers were identified at AAC clinics, and 1611 smokers were identified at AAR clinics. INTERVENTIONS Linking smokers with quitline-delivered treatment. MAIN OUTCOME MEASURE Impact was based on the RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) conceptual framework and defined as the proportion of all identified smokers who enrolled in treatment. RESULTS In the AAC clinics, 7.8% of all identified smokers enrolled in treatment vs 0.6% in the AAR clinics (t4 = 9.19 [P < .001]; odds ratio, 11.60 [95% CI, 5.53-24.32]), a 13-fold increase in the proportion of smokers enrolling in treatment. CONCLUSIONS AND RELEVANCE The system changes implemented in the AAC approach could be adopted broadly by other health care systems and have tremendous potential to reduce tobacco-related morbidity and mortality.
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Affiliation(s)
- Jennifer Irvin Vidrine
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1440, Houston, TX 77030, USA.
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Elton-Marshall T, Leatherdale ST, Burkhalter R, Brown KS. Changes in tobacco use, susceptibility to future smoking, and quit attempts among Canadian youth over time: a comparison of off-reserve Aboriginal and non-Aboriginal youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:729-41. [PMID: 23429753 PMCID: PMC3635174 DOI: 10.3390/ijerph10020729] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/17/2013] [Accepted: 01/29/2013] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to determine whether there is a growing inequity in tobacco use, susceptibility to future smoking, and quit attempts among Off-Reserve Aboriginal (ORA) youth in Canada relative to Non-Aboriginal youth. Current smoking, susceptibility to future smoking and quit attempts were examined among a nationally representative sample of ORA and Non-Aboriginal Canadian youth. Data are from cross-sectional surveys of 88,661 respondents in Grades 6 to 9 across the 2004, 2006 and 2008 survey waves of the Youth Smoking Survey (YSS). At each wave, ORA youth were more likely to be current smokers (overall OR = 3.91, 95% CI 3.47 to 4.41), to be susceptible to future smoking (overall OR = 1.37, 95% CI 1.27 to 1.48), and less likely to have ever made a quit attempt compared to Non-Aboriginal youth (overall OR = 0.74, 95% CI 0.57 to 0.96). Although susceptibility to future smoking declined for Non-Aboriginal youth, the prevalence of susceptibility remained stable among ORA youth. The percentage of ORA youth reporting making a quit attempt increased, however, current smoking rates among ORA youth did not decline. These findings suggest that the disparity in susceptibility to future tobacco use among ORA and Non-Aboriginal youth has increased over time. Despite increased rates of quit attempts, current smoking rates remain significantly higher among ORA youth. Tobacco control programs for Aboriginal youth should be a public health priority.
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Affiliation(s)
- Tara Elton-Marshall
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mails: (T.E.-M.); (K.S.B.)
| | - Scott T. Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mails: (T.E.-M.); (K.S.B.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-519-888-4567 (ext. 37812); Fax: +1-519-746-8171
| | - Robin Burkhalter
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mail:
| | - K. Stephen Brown
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mails: (T.E.-M.); (K.S.B.)
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mail:
- Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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Cabibbo G, Maida M, Genco C, Antonucci M, Cammà C. Causes of and prevention strategies for hepatocellular carcinoma. Semin Oncol 2012; 39:374-83. [PMID: 22846856 DOI: 10.1053/j.seminoncol.2012.05.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hepatocellular carcinoma (HCC) is a challenging malignancy of global importance. It is associated with a high rate of mortality and its prevalence in the United States and in Western Europe is increasing. Cirrhosis is the strongest and the most common known risk factor for HCC, usually due to hepatitis C virus (HCV) and hepatitis B virus (HBV) infections. However, different lines of evidence identify in non-alcoholic fatty liver disease (NAFLD) a possible relevant risk factor for occurrence of HCC. Given the continuing increase in the prevalence of obesity and diabetes, the incidence of non-alcoholic steatohepatitis-related HCC may also be expected to increase, and a potential role of behavior treatment and/or insulin-sensitizing drugs can be envisaged. Vaccination against HBV is the most efficient primary prevention measure currently available to reduce the HCC incidence and mortality in high-incidence areas, while data on the role of interferon (IFN) and nucleos(t)ide analogues (NUC) are still controversial. The pooling of data from the literature suggests a slight preventive effect of antiviral therapy on HCC development in patients with HCV-related cirrhosis, but the preventive effect is limited to sustained virological responders.
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Affiliation(s)
- Giuseppe Cabibbo
- Sezione di Gastroenterologia, DIBIMIS, University of Palermo, Palermo, Italy
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Lifetime risk for cancer death by sex and smoking status: the lifetime risk pooling project. Cancer Causes Control 2012; 23:1729-37. [PMID: 22825072 DOI: 10.1007/s10552-012-9959-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 04/06/2012] [Indexed: 01/11/2023]
Abstract
BACKGROUND Understanding how sex and tobacco exposure may modify lifetime risks for cancer mortality is important for effective communication of risk in targeted public health messages. OBJECTIVE To determine lifetime risk estimates for cancer death associated with sex and smoking status in the United States. METHODS A pooled cohort design using ten well-defined epidemiologic cohorts including middle-aged and older individuals was used to estimate the lifetime risk for cancer death at selected index ages, with death from non-cancer causes as the competing risk, by sex and smoking status. RESULTS There were a total of 11,317 cancer-related deaths. At age 45 years, the lifetime risk of cancer death for male smokers is 27.7 % (95 % CI 24.0-31.4 %) compared to 15.8 % (95 % CI 12.7-18.9 %) for male non-smokers. At age 45 years, the lifetime risk of cancer death for female smokers is 21.7 % (95 % CI 18.8-24.6 %) compared to 13.2 % (95 % CI 11.0-15.4 %) for female non-smokers. Remaining lifetime risk for cancer death declined with age, and men have a greater risk for cancer death compared to women. Adjustment for competing risk of death, particularly representing cardiovascular mortality, yielded a greater change in lifetime risk estimates for men and smokers compared to women and non-smokers. CONCLUSIONS At the population level, the lifetime risk for cancer death remains significantly higher for smokers compared to non-smokers, regardless of sex. These estimates may provide clinicians with useful information for counseling individual patients and highlight the need for continued public health efforts related to smoking cessation.
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Grulich AE, Jin F, Poynten IM, Vajdic CM. HIV, cancer, and aging. Sex Health 2012; 8:521-5. [PMID: 22127038 DOI: 10.1071/sh11048] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 06/05/2011] [Indexed: 12/17/2022]
Abstract
As people with HIV age, they will experience increasing rates of all diseases of aging, including cancer. However, the pattern of higher cancer risk in people with HIV is mostly explained by the chronic effects of certain oncogenic infections, and is not consistent with a syndrome of accelerated aging. Many of those cancers that are most closely associated with aging do not occur at increased rates in people with HIV compared with the general population. The risk of many infection-associated cancers in people with HIV is closely related to the degree of immune deficiency, and for some types of cancer, it is also associated with ongoing HIV replication. Thus, if HIV therapy can provide durable HIV suppression and maintain near normal levels of immune function, the excess risk of cancer is likely to be minimised. While avoidance of profound immunity will greatly reduce cancer risk, it is unclear how close to normal immune function must be to minimise HIV-associated cancer risk. People with HIV are also at a high risk of cancer because they have high rates of lifestyle risks for cancer, in particular tobacco and alcohol exposure. For most cancers, it is appropriate to follow general population guidelines on cancer screening. The exception is cervical cancer, for which annual screening is recommended. In addition, active research is required to establish whether anal cancer screening would prevent the unacceptably high levels of morbidity caused by this disease in people with HIV, most particularly in gay men.
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Affiliation(s)
- Andrew E Grulich
- Kirby Institute, University of New South Wales, Sydney, NSW 2010, Australia.
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Inumaru LE, Silveira EAD, Naves MMV. [Risk and protective factors for breast cancer: a systematic review]. CAD SAUDE PUBLICA 2012; 27:1259-70. [PMID: 21808811 DOI: 10.1590/s0102-311x2011000700002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 05/06/2011] [Indexed: 11/21/2022] Open
Abstract
This review aimed to investigate risk and protective factors for breast cancer and to analyze whether scientific evidence from the World Cancer Research Fund and American Institute for Cancer Research, published in 2007, was confirmed by new research. In May 2010 we reviewed cohort and case-control analytical studies from 2007 to 2010 in the PubMed, LILACS, and SciELO databases. We selected 27 articles (14 case-control and 13 cohort studies). Breastfeeding and physical activity were protective factors against breast cancer, and alcohol consumption was a risk factor. A direct proportional relationship was observed between larger waist circumference, weight throughout adulthood, and height and risk of breast cancer in postmenopausal women. The association between body fat and breast cancer is contradictory in both premenopausal and postmenopausal women. According to the accumulated evidence, breastfeeding and healthy lifestyle are the factors most strongly associated with breast cancer prevention.
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Affiliation(s)
- Lívia Emi Inumaru
- Faculdade de Nutrição, Universidade Federal de Goiás, Goiânia, Brasil
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Kang JM, Shin DW, Kwon YM, Park SM, Park MS, Park JH, Son KY, Cho BL. Stomach cancer screening and preventive behaviors in relatives of gastric cancer patients. World J Gastroenterol 2011; 17:3518-25. [PMID: 21941419 PMCID: PMC3163250 DOI: 10.3748/wjg.v17.i30.3518] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Revised: 02/15/2011] [Accepted: 02/22/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate gastric cancer screening and preventive behaviors among the relatives of patients with gastric cancer [i.e., gastric cancer relatives (GCRs)].
METHODS: We examined the Korean National Health and Nutrition Examination Survey 2005 (KNHANES III) database and compared the gastric cancer screening and preventive behaviors of GCRs (n = 261) with those of non-GCRs (n = 454) and controls without a family history of cancer (n = 2842).
RESULTS: The GCRs were more likely to undergo gastric cancer screening compared with the control group (39.2% vs 32.3%, adjusted odds ratio: 1.43, CI: 1.05-1.95), although the absolute screening rate was low. Dietary patterns and smoking rates did not differ significantly between the groups, and a high proportion of GCRs reported inappropriate dietary habits (i.e., approximately 95% consumed excessive sodium, 30% were deficient in vitamin C, and 85% were deficient in dietary fiber).
CONCLUSION: The gastric cancer screening and preventive behaviors of GCRs have yet to be improved. To increase awareness among GCRs, systematic family education programs should be implemented.
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Cancer screening and preventative care among long-term cancer survivors in the United Kingdom. Br J Cancer 2010; 102:1085-90. [PMID: 20234361 PMCID: PMC2853098 DOI: 10.1038/sj.bjc.6605609] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background: Long-term cancer survivors in the United Kingdom are mostly followed up in a primary care setting by their general practitioner; however, there is little research on the use of services. This study examines whether cancer survivors receive adequate screening and preventative care in UK primary care. Patients and methods: We identified a cohort of long-term survivors of breast, colorectal and prostate cancer with at least a 5-year survival using the General Practice Research Database, with controls matched for age, gender and practice. We compared adherence with cancer screening and the use of preventative care between cancer survivors and controls. Results: The cancer survivors’ cohort consisted of 18 612 breast, 5764 colorectal and 4868 prostate cancer survivors. Most cancer survivors receive cancer screening at the same levels as controls, except for breast cancer survivors who were less likely to receive a mammogram than controls (OR=0.78, 95% CI: 0.66–0.92). Long-term cancer survivors received comparable levels of influenza vaccinations and cholesterol tests, but breast (OR 0.81, 95% CI: 0.74–0.87) and prostate cancer survivors (OR=0.70, 95% CI: 0.57–0.87) were less likely to receive a blood pressure test. All survivors were more likely to receive bone densitometry. Conclusion: The provision and uptake of preventive care in a primary care setting in the United Kingdom is comparable between the survivors of three common cancers and those who have not had cancer. However, long-term breast cancer survivors in this cohort were less likely to receive a mammogram.
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LÓPEZ M, LANA A, DÍAZ S, FOLGUERAS M, SÁNCHEZ L, COMENDADOR M, BELYAKOVA E, RODRÍGUEZ J, CUETO A. Multiple primary cancer: an increasing health problem. Strategies for prevention in cancer survivors. Eur J Cancer Care (Engl) 2009; 18:598-605. [DOI: 10.1111/j.1365-2354.2008.00974.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Oh DY, Choi KS, Shin HR, Bang YJ. Public awareness of gastric cancer risk factors and disease screening in a high risk region: a population-based study. Cancer Res Treat 2009; 41:59-66. [PMID: 19707502 DOI: 10.4143/crt.2009.41.2.59] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2009] [Accepted: 05/12/2009] [Indexed: 01/17/2023] Open
Abstract
PURPOSE This study involved a population-based survey to provide evidence of public awareness of risk factors of gastric cancer and to investigate attitudes for the screening of gastric cancer in the South Korean population. MATERIALS AND METHODS Using a nationwide random selection method, 2014 subjects were enrolled in the study between 5 September 2006 and 25 September 2006. RESULTS In terms of the awareness of risk factors, awareness was scored as the percentage of the probability of developing gastric cancer when a subject had a particular risk factor. For the risk factors, stress ranked highest with a score of 73.5%, followed by chronic gastritis (score of 72.1%), gastric ulcer (score of 71.2%) and a previous gastrectomy history (score of 68.7%). Other factors included a diet of charred foods (score of 67.3%), alcohol use (score of 65.3%), salty diet (score of 65.1%), history of smoking (score of 64.3%) and Helicobacter pylori infection (score of 57.5%). Subjects believed that 60.4% of all gastric cancers were preventable by lifestyle modification and the subjects believed that regular screening could prevent 72.1% of all gastric cancers. However, 54% of subjects did not receive regular screening and the most common reason for not undergoing screening was a lack of symptoms. CONCLUSION Public education about the risk factors of gastric cancer and of lifestyle modifications and the importance of regular screening regardless of the presence of symptoms should be emphasized to reduce gastric cancer mortality in South Korea.
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Affiliation(s)
- Do-Youn Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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Tanaka S, Yamamoto S, Inoue M, Iwasaki M, Sasazuki S, Iso H, Tsugane S. Projecting the probability of survival free from cancer and cardiovascular incidence through lifestyle modification in Japan. Prev Med 2009; 48:128-33. [PMID: 19071158 DOI: 10.1016/j.ypmed.2008.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 11/07/2008] [Accepted: 11/07/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To promote prevention strategies aimed at reducing the incidence of cancer or cardiovascular disease (CVD), we present a method to project the probability that a subject with given lifestyle risk factors will survive free from either of cancer or CVD. METHODS Projection models were developed from data from a cohort study conducted in Japan. During 1990-2003, 96,592 subjects were followed and 5797 cancer and 2591 CVD cases and 2395 deaths were identified. Smoking, alcohol intake and body mass index (BMI) were used as common risk factors in projection models. RESULTS According to the projection of individualized probability, avoidance of smoking, excess alcohol intake and high BMI increased 10-year disease-free survival probability from 81.4% to 92.9% and from 88.0% to 94.3% in 50- to 54-year-old men and women, respectively. In terms of population average risk, smoking cessation and avoidance of excess alcohol exerted a large impact, while decreasing BMI had a small impact due to the small at-risk population. CONCLUSIONS Current smoking, excess alcohol intake and obesity were suggested as common risk factors for cancer and CVD. Considering the distribution of risk factors in the Japanese population, smoking prevention/cessation and reduction of excess alcohol intake would prevent a large number of incident cases.
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Affiliation(s)
- Sachiko Tanaka
- Department of Management Science, Tokyo University of Science, Japan.
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Affiliation(s)
- Loraine D Marrett
- From Population Studies and Surveillance, Cancer Care Ontario, Toronto, Ont
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Leatherdale ST, Manske S, Wong SL, Cameron R. Integrating research, policy, and practice in school-based physical activity prevention programming: the School Health Action, Planning, and Evaluation System (SHAPES) Physical Activity Module. Health Promot Pract 2008; 10:254-61. [PMID: 18287582 DOI: 10.1177/1524839906298499] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The School Health Action, Planning, and Evaluation System (SHAPES) is a data collection and feedback system designed to support population-based intervention planning, evaluation, and field research related to youth. The Physical Activity Module of SHAPES consists of: (a) a machine readable questionnaire to collect physical activity data from all students (grades 6 to 12) in a school, (b) a school administrator questionnaire to assess school policies, programs, and resources related to physical activity, and (c) a school-specific feedback report documenting student behavior and school programs and policies. This SHAPES module provides schools with feedback that enables them to take stock of patterns of activity and obesity within their school, recognize what is (and what is not) in place to support physical activity, and how to plan and evaluate their own prevention efforts. SHAPES enables researchers and stakeholders to identify what interventions work, in what contexts, with what students.
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Sciamanna CN. Behavior Modification. Oncology 2007. [DOI: 10.1007/0-387-31056-8_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rosero-Bixby L, Sierra R. X-ray screening seems to reduce gastric cancer mortality by half in a community-controlled trial in Costa Rica. Br J Cancer 2007; 97:837-43. [PMID: 17912238 PMCID: PMC2360405 DOI: 10.1038/sj.bjc.6603729] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
X-ray screening of gastric cancer is broadly used in Japan, although no controlled trial has proved its effectiveness. This study evaluates the impact of an X-ray screening demonstrative intervention to reduce gastric cancer mortality in a Costa Rican region. The evaluation follows a quasi-experimental, community-controlled design, with measures before and after. About 7000 individuals participated by invitation in the two-wave screening programme. X-ray screening was followed by videoendoscopy and gastric biopsies. Treatment included resection with or without lymph node dissection. Comparisons with two control groups estimate that gastric cancer mortality was halved in the period from 2 to 7 years after the first screening visit. Validity of X-rays as used in this intervention had 88% sensitivity, 80% specificity, and 3% predictive value for individuals with two screening visits. Incidence in the screened group increased up to four times. Case survival was 85% in the intervention group after 5 years, compared to 12% among the controls before the intervention and 35% among the controls in the same region after the intervention. Although X-ray mass screening seems able to reduce stomach cancer mortality, its high cost may be an obstacle for scaling up this intervention in a non-rich country like Costa Rica.
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Affiliation(s)
- L Rosero-Bixby
- Centro Centroamericano de Población, Universidad de Costa Rica, San José 2060, Costa Rica.
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Abstract
In this review, issues of causality in epidemiologic research with emphasis on the aetiology of human cancer are considered. Principles of assessing causation in epidemiological studies of cancer are distinguished into those concerning an individual study, several studies and a particular person. Strengths and weaknesses of various approaches of documenting carcinogenicity in humans are examined and lists of major established causes of human cancer are presented. The review concludes with estimates of mortality from cancer around the world that can be attributed to specific factors under the light of the current scientific knowledge.
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Affiliation(s)
- Pagona Lagiou
- Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Goudi, Athens, Greece
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Paustenbach DJ, Fehling K, Scott P, Harris M, Kerger BD. Identifying soil cleanup criteria for dioxins in urban residential soils: how have 20 years of research and risk assessment experience affected the analysis? JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2006; 9:87-145. [PMID: 16613806 DOI: 10.1080/10937400500538482] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This article reviews the scientific evidence and methodologies that have been used to assess the risks posed by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and presents a probabilistic analysis for identifying virtually safe concentrations of TCDD toxicity equivalents (TEQ) in residential soils. Updated data distributions that consider state-of-the-science cancer and noncancer toxicity criteria, child soil ingestion and dermal uptake, bioavailability in soil, and residential exposure duration are incorporated. The probabilistic analysis shows that the most sensitive determinants of dose and risk are childhood soil ingestion, exposure duration, and the selected TCDD cancer potency factor. It also shows that the cancer risk at 1 per 100,000 predicted more conservative (lower) soil criteria values than did the noncancer hazard (e.g., developmental and reproductive effects). In this analysis, acceptable or tolerable soil dioxin concentrations (TCDD TEQ) ranged from 0.4 to 5.5 ppb at the 95th percentile for cancer potency factors from 9600 to 156,000 (mg/kg/d)(-1) with site-specific adjustments not included. Various possible soil guidelines based on cancer and noncancer risks are presented and discussed. In the main, the current toxicology, epidemiology, and exposure assessment data indicate that the historical 1 ppb TEQ soil guidance value remains a reasonable screening value for most residential sites. This analysis provides risk managers with a thorough and transparent methodology, as well as a comprehensive information base, for making informed decisions about selecting soil cleanup values for PCDD/Fs in urban residential settings.
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Nichols HB, Trentham-Dietz A, Newcomb PA, Yanke L, Remington PL, Love RR. What causes cancer? Reports from sixth-grade girls. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2006; 21:142-6. [PMID: 17371178 DOI: 10.1207/s15430154jce2103_11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND We evaluated students' perception of cancer causation among sixth-grade girls living in Wisconsin. METHOD We asked female students to list up to 3 causes of cancer in a cross-sectional health survey. RESULTS A total of 141 answers were given by 53 students. The most frequently listed causes of cancer were cigarette smoking (91%), drugs (32%), an unhealthy diet (25%), and heredity (25%). Less than 10% of students listed other potentially modifiable risk factors such as exercise, sun exposure, or alcohol consumption. CONCLUSION Students in this study appeared to link a range of high-risk behaviors with health consequences, although the specific health risks may not be understood.
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Affiliation(s)
- Hazel B Nichols
- The University of Wisconsin Comprehensive Cancer Center, Madison, USA
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Consedine NS, Magai C, Conway F, Neugut AI. Obesity and awareness of obesity as risk factors for breast cancer in six ethnic groups. ACTA ACUST UNITED AC 2005; 12:1680-9. [PMID: 15536232 DOI: 10.1038/oby.2004.208] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To document BMI and knowledge regarding obesity as a risk factor for breast cancer among subpopulations of African-, Caribbean-, and European-American women and to consider the variables predicting obesity in these diverse groups. RESEARCH METHODS AND PROCEDURES A stratified cluster-sampling plan was used to recruit 1364 older women from Brooklyn, NY, during 2000-2002. Two groups were born in the United States (African Americans and European Americans), whereas others were from the English-speaking Caribbean, Haiti, the Dominican Republic, and Eastern Europe. Participants provided demographics, height and weight measures, and estimates of the risk obesity posed for breast cancer. RESULTS Women from all groups were significantly overweight (BMI > 25 kg/m(2)), although European Americans were lowest, followed by Dominicans and Haitians; African-American and English-speaking Caribbean women fell into the obese range, even when background variables were controlled. Knowledge of obesity as a breast cancer risk factor was also poor across groups, but Dominicans and Haitians had the lowest scores on knowledge. Importantly, knowledge was not associated with BMI in the overall sample, even when controlling for demographics and ethnicity, although logistic regressions comparing normal weight women with overweight and obese groupings suggested some knowledge of breast cancer risk in the overweight, but not the obese, group. DISCUSSION The findings remind health professionals of the need to consider more specific ethnic groupings than has hitherto been the case, as well as consider how ethnic and cultural variables may influence perceptions of obesity and its relation to cancer risk.
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Affiliation(s)
- Nathan S Consedine
- Intercultural Institute on Human Development and Aging, 191 Willoughby Street, Suite 1A, Brooklyn, NY 11201, USA.
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Whitaker ED. The Bicycle Makes the Eyes Smile: Exercise, Aging, and Psychophysical Well-Being in Older Italian Cyclists. Med Anthropol 2005; 24:1-43. [PMID: 15823896 DOI: 10.1080/01459740590905633] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite a cultural and biomedical consensus about the health benefits of physical activity, most adults do not exercise regularly and their activity tends to decline further in older age. This study reports on a group of older-age Italian bicyclists who maintain extraordinary activity levels. It explores the physical and mental health effects of intensive exercise in older people, the meanings and motivations associated with it, and the cultural and social features that support and promote bicycling in Italy. The findings suggest some public health implications for the prevention of chronic diseases caused by inactivity and excessive body weight.
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Affiliation(s)
- Elizabeth D Whitaker
- Social Sciences Department, California Polytechnic State University, San Luis Obispo, CA 93407, USA.
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Petridou E, Alexe DM. Evaluation of community based injury prevention: an epidemiologist's quandary. Eur J Epidemiol 2004; 19:615-6. [PMID: 15461191 DOI: 10.1023/b:ejep.0000036891.65339.e3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Eleni Petridou
- Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece.
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Position of the American Dietetic Association and Dietitians of Canada: Nutrition and Women’s Health. ACTA ACUST UNITED AC 2004; 104:984-1001. [PMID: 15175601 DOI: 10.1016/j.jada.2004.04.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
It is the position of the American Dietetic Association (ADA) and Dietitians of Canada (DC) that women have specific nutritional needs and vulnerabilities and, as such, are at unique risk for various nutrition-related diseases and conditions. Therefore, the ADA and the DC strongly support research, health promotion activities, health services, and advocacy efforts that will enable women to adopt desirable nutrition practices for optimal health. Women are at risk for numerous chronic diseases and conditions that affect the duration and quality of their lives. Although women's health-related issues are multifaceted, nutrition has been shown to influence significantly the risk of chronic disease and to assist in maintaining optimal health status. Dietetics professionals strongly support research, health promotion activities, health services, and advocacy efforts that will enable women to adopt desirable nutrition practices for optimal health.
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Becker N. Epidemiological aspects of cancer screening in Germany. J Cancer Res Clin Oncol 2003; 129:691-702. [PMID: 14557878 DOI: 10.1007/s00432-003-0494-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2003] [Accepted: 07/23/2003] [Indexed: 01/22/2023]
Abstract
PURPOSE Since 1971, a statutory early detection programme has operated in Germany which comprises health-insurance-paid annual examinations of the breast, cervix, prostate, rectum, and the skin. Since the programme is conceptualised as opportunistic screening, the attendance rates have been low and only reached about 50% among females and 13% among males by the end of the 1990s. Based on these figures and present knowledge on the efficacy of screening modalities, we assessed past benefits and the future potential of cancer screening in Germany. METHODS We used published data on the efficacy of screening procedures and German attendance rates, and internationally available data on incidence and mortality in Germany and, for cervical cancer, in other countries. Incidence and mortality rates have been standardised to the world standard, and screening benefit has been given as the population preventable fraction given in percentage. RESULTS The past benefits of the statutory early detection programme ranged around 2.0-6.5%. Since the upper limit was due to generous assumptions regarding efficacy or inclusion of treatment effects, the true value might be closer to the estimates of the effect of cervical cancer screening (2.0-4.7%). The achievable future benefit of exploiting the theoretical potential of more exhaustive screening could provide a further mortality reduction of about 3.4% (50% compliance) or 4.7% (70% compliance). CONCLUSIONS Screening partially requires an expensive medical infrastructure and is not without risks for the participants. The overall benefit is critically dependent upon the quality of the programme and its in-time control. Any benefit may be annulled by poor quality while costs are overflowing. Well-organised high-quality screening may be a sound basis for cancer control. To preserve or increase the impact of screening and control its expenses: (a) further research efforts are needed towards new or better targeted screening tools or modalities; (b) the efficacy of new modalities has to be evaluated carefully in advance; (c) the programme has to be reconceptualised as organised screening; (d) in-time quality control based on the collection of the basic performance data must be an intrinsic part of the programme.
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Affiliation(s)
- Nikolaus Becker
- Deutsches Krebsforschungszentrum, Abteilung Klinische Epidemiologie, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
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Greene JF, Hays S, Paustenbach D. Basis for a proposed reference dose (RfD) for dioxin of 1-10 pg/kg-day: a weight of evidence evaluation of the human and animal studies. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2003; 6:115-159. [PMID: 12554432 DOI: 10.1080/10937400306470] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The dioxins have been perhaps the most studied of all chemicals to which humans are routinely exposed. It has been reported that more than 5,000 scientific papers have been published that have evaluated the toxicology of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Although the cancer hazard posed by this chemical has probably received the bulk of attention over the past 20 years, the U.S. Environmental Protection Agency (EPA) and the recent U.S. EPA Science Advisory Board (SAB) that reviewed the "Reassessment" have suggested that the noncancer hazard may well be more important than the cancer hazard at current background doses to the general public. The World Health Organization (WHO) and U.K. Food Standards Agency (FAO) committee (JECFA) on dioxins has reached similar conclusions. This article reviews the published studies involving laboratory animals and humans that address the noncancer effects. Based on our review, developmental toxicity is the most sensitive effect of TCDD consistently seen in mice and rats. Specifically, of the various studies, a no-observed-adverse-effects level (NOAEL) of 13 ng/kg (maternal body burden) was identified as the most pertinent for deriving a reference dose (RfD) for humans. Although more than a dozen different adverse effects have been reported in various studies of humans over the past 25 years, the most consistent clinically important adverse effect of human exposure appears to be chloracne. Following a review of all published studies, we concluded that the best estimate of a LOAEL for production of chloracne is approximately 160 ng/kg (body burden). Based on our analysis, an RfD of between 1 and 10 pg/kg-d (TCDD TEQ) is consistent with the objectives of this risk criterion. Maintaining a lifetime average daily dose below this concentration, based on what is known today, should prevent noncancer effects in virtually all persons. This value is consistent with the JECFA recommendation of 70 pg/kg-mo.
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A. Khan N. Antioxidants and Cancer. JOURNAL OF MEDICAL SCIENCES 2001. [DOI: 10.3923/jms.2002.38.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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