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Gaba AG, Cao L, Renfrew RJ, Witte D, Wernisch JM, Sahmoun AE, Goel S, Egland KA, Crosby RD. The Impact of Medicaid Expansion Under the Affordable Care Act on the Gap Between American Indians and Whites in Breast Cancer Management and Prognosis. Clin Breast Cancer 2024; 24:142-155. [PMID: 38171945 PMCID: PMC10984638 DOI: 10.1016/j.clbc.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/26/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Breast cancer (BC) death rates in the USA have not significantly declined for American Indians (AIs) in comparison to Whites. Our objective was to determine whether Medicaid Expansion as part of the Affordable Care Act led to improved BC outcomes for AIs relative to Whites. PATIENTS AND METHODS Using the National Cancer Database, we conducted a retrospective cohort study. Included were BC patients who were AI and White; 40 to 64 years of age; diagnosed in 2009 to 2016; lived in states that expanded Medicaid in January 2014, and states that did not expand Medicaid. Our outcomes were stage at diagnosis, insurance status, timely treatment, and 3-year mortality. RESULTS There were 359,484 newly diagnosed BC patients, 99.49% White, 0.51% AI. Uninsured rates declined more in the expansion states than in the nonexpansion states (OR = 0.44, 95% CI: 0.15-0.97, P < 0.001). Lower rates of Stage I BC diagnosis was found in AIs compared to Whites (46.58% vs. 55.33%, P < .001); these differential rates did not change after Medicaid expansion. Rates of definitive treatment initiation within 30 days of diagnosis declined after Medicaid expansion (P < .001); there was a smaller decline in the expansion states (OR 1.118, 95% CI: 1.09, 1.15, P < .001). Three year mortality was not different between expansion and nonexpansion states post Medicaid expansion. CONCLUSIONS In newly diagnosed BCs, uninsured rates declined more in the states that expanded Medicaid in January 2014. Timely treatment post Medicaid expansion declined less in states that expanded Medicaid. There was no differential benefit of Medicaid expansion in the 2 races.
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Affiliation(s)
- Anu G Gaba
- Department of Medicine, Sanford Roger Maris Cancer Center, University of North Dakota, Fargo, ND.
| | - Li Cao
- Sanford Center for Biobehavioral Research, Fargo, ND
| | | | | | | | - Abe E Sahmoun
- Department of Internal Medicine, University of North Dakota School of Medicine, Fargo, ND
| | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | | | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, ND
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Sii S, Polyakov A, Rozen G, Agresta F, Stern K. Controlled ovarian hyperstimulation in breast cancer patients: Does oestrogen receptor status make a difference? Aust N Z J Obstet Gynaecol 2023; 63:774-779. [PMID: 37317583 DOI: 10.1111/ajo.13721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/01/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND The presence of different breast cancer receptor status may impact ovarian stimulation outcomes. AIM To study the association between oestrogen receptor (ER) status in breast cancer patients and fertility preservation outcomes in a major tertiary referral centre. MATERIALS AND METHODS Women who underwent fertility preservation following the diagnosis of breast cancer from 2008 to 2018 were included in the study. Patient age, ovarian stimulation parameters and laboratory outcomes were recorded and compared between the ER positive and negative groups. The primary outcome was total number of oocytes frozen. Secondary outcomes included total number of oocytes collected, mature oocytes, and embryos frozen. RESULTS The women included in the study (n = 214) were analysed in the following groups based on their fertility preservation method: oocyte freezing (n = 131), embryo freezing (n = 70), and both embryo and oocyte freezing (n = 13). There was an increase in the mean (but not mature) number of oocytes frozen (12.4 and 9.2, P-value = 0.03) favouring the ER positive group, even though the women in this group were older (35.0 and 33.4, P-value of 0.03). There is no difference in the starting follicle-stimulating hormone dose, duration of stimulation, mature oocytes collected, and embryos frozen in both groups. CONCLUSION Patients with ER positive breast cancer may have more positive ovarian stimulation outcomes.
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Affiliation(s)
| | - Alex Polyakov
- Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Genia Rozen
- Royal Women's Hospital, Melbourne, Victoria, Australia
| | | | - Kate Stern
- Royal Women's Hospital, Melbourne, Victoria, Australia
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Gaba AG, Cao L, Renfrew RJ, Witte D, Wernisch JM, Sahmoun AE, Goel S, Egland KA, Crosby RD. Differences in Breast Cancers Among American Indian/Alaska Native and non-Hispanic Whites in the USA. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01704-4. [PMID: 37432561 DOI: 10.1007/s40615-023-01704-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/03/2023] [Accepted: 06/27/2023] [Indexed: 07/12/2023]
Abstract
IMPORTANCE Breast cancer (BC) death rates have not improved for American Indian/Alaska Native (AI/AN) women, whereas, it has significantly decreased for non-Hispanic White (White) women. OBJECTIVE Delineate the differences in patient and tumor characteristics among AI/AN and Whites with BC, and its impact on age and stage at diagnosis as well as overall survival (OS). METHODS Hospital-based, cohort study using the National Cancer Database to identify female AI/AN and Whites diagnosed with BC between the years 2004 and 2016. RESULTS BC in 6866 AI/AN (0.3%) and 1,987,324 Whites (99.7%) were studied. The median age at diagnosis was 58 for AI/AN and 62 for Whites. AI BC patients traveled double the distance for treatment, lived in lower median income zip codes, had a higher percentage of uninsured, higher comorbidities, lower percentage of Stage 0/I, larger tumor size, greater number of positive lymph nodes, higher proportion of triple negative and HER2-positive BC than Whites. All the above comparisons were significant, p<0.001. Association between patient/tumor characteristics with age and stage at diagnosis was not significantly different between AI/AN and Whites. Unadjusted OS was worse for AI/AN as compared to Whites (HR=1.07, 95% CI=1.01-1.14, p=0.023). After adjustment of all covariates, OS was not different (HR=1.038, 95%CI=0.902-1.195, p=0.601). CONCLUSION There were significant differences in patient/tumor characteristics among AI/AN and White BC which adversely impacted OS in AI/AN. However, when adjusted for various covariates, the survival was similar, suggesting that the worse survival in AI/AN is mostly the impact of known biological, socio-economic, and environmental determinants of health.
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Affiliation(s)
- Anu G Gaba
- Sanford Roger Maris Cancer Center, Department of Medicine, University of North Dakota, 820 4th Street N, Fargo, ND, 58102, USA.
| | - Li Cao
- Sanford Center for Biobehavioral Research, Fargo, ND, USA
| | | | | | | | | | - Sanjay Goel
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, ND, USA
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Alkhaifi S, Padela AI, Hodge F, Brecht ML. Breast cancer screening among immigrant Muslim arab women in the United States: Analyzing relationships between beliefs, knowledge, spousal support and mammogram utilization. J Natl Med Assoc 2023; 115:302-313. [PMID: 36967269 DOI: 10.1016/j.jnma.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/14/2022] [Accepted: 03/06/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Regular mammogram screenings contribute to a decreased breast cancer (BC) mortality rate. Women from ethnic minorities in the United States, however, often underutilize mammogram screenings; in particular, immigrant Muslim Arab (IMAW) women have low mammogram screening rates. OBJECTIVE To explore the associations between mammogram utilization and (a) health and religious beliefs, (b) level of knowledge about mammograms, (c) health care provider (HCP) recommendations, and (d) spousal support. METHODS A cross-sectional study employed online data collection. An Arabic or English survey was completed by women who were 45 or older and married, had immigrated from Arab countries, and had no history of breast cancer. Logistic regression was conducted for data analyses. RESULTS Of the 184 Immigrant Muslim Arab survey participants, 86.6% reported having had at least one mammogram in their lifetime, and 32.6% adhered to mammograms. Ever having obtained a mammogram and adherence to mammograms were negatively associated with perceived mammogram barriers and positively associated with (a) spousal support, (b) level of mammogram knowledge, and (c) perceived self-confidence. Receiving (HCP) recommendation increased the likelihood of ever having obtained a mammogram. Finally, participants who reported higher levels of perceived mammogram benefits were more likely to have obtained a mammogram within the last 2 years compared to their counterparts. CONCLUSIONS IMAW have demonstrated low mammogram adherence rate. IMPLICATIONS Nursing clinicians and scholars must play a role in designing and implementing interventions to promote women adherence to mammograms. Involving husbands in these interventions may improve immigrant Muslim Arab women's mammogram adherence rates.
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Affiliation(s)
- Sarah Alkhaifi
- King Abdulaziz University, School of Nursing, Department of Maternity and Childhood, Nursing, Jeddah, Saudi Arabia; University of California Los Angeles, Schools of Nursing.
| | - Aasim I Padela
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee WI, USA; Initiative on Islam and Medicine, Brookfield, Wisconsin, USA
| | - Felicia Hodge
- University of California Los Angeles, Schools of Public Health
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Association between Breast Cancer Knowledge and Mammogram Utilization among Immigrant Muslim Arab Women in California: Cross-Sectional Design. Healthcare (Basel) 2022; 10:healthcare10122526. [PMID: 36554050 PMCID: PMC9778312 DOI: 10.3390/healthcare10122526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Regular mammogram screenings have contributed to early breast cancer (BC) diagnoses and lowered the mortality rate by 40% in the United States of America (USA). Nonetheless, ethnic women living in developed countries, such as immigrant Muslim Arab women (IMAW), are less likely to get mammograms. AIM OF THE STUDY In our study, we aimed to understand health behaviors among IMAWs as understudied populations in the USA. METHODS We conducted a cross-sectional study on a convenience sample of IMAW living in southern California. We used logistic regression and multivariate logistic regressions to analyze the data. RESULTS The total number of participants who completed the survey was 184 IMAW. Participants who had a higher level of knowledge about BC signs and symptoms and mammogram knowledge were more likely to have obtained a mammogram at some point compared with their counterparts (OR = 1.23, p = 0.03, CI: 1.07-1.42; OR = 2.23, p = 0.23, CI: 1.11-4.46, respectively). CONCLUSIONS Our results provide more evidence emphasizing the important influence of BC and mammogram knowledge on immigrant women's behavior regarding mammogram utilization. The average level of knowledge in all three domains (BC risk factors, BC signs and symptoms, and mammogram use) reported in this study is considered low.
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Moon PK, Ma Y, Megwalu UC. Head and Neck Cancer Stage at Presentation and Survival Outcomes Among Native Hawaiian and Other Pacific Islander Patients Compared With Asian and White Patients. JAMA Otolaryngol Head Neck Surg 2022; 148:636-645. [PMID: 35616952 PMCID: PMC9136676 DOI: 10.1001/jamaoto.2022.1086] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Research studies often group Native Hawaiian and Other Pacific Islander individuals together with Asian individuals despite being consistently identified as having worse health outcomes and higher rates of comorbidities and mortality. Native Hawaiian and Other Pacific Islander individuals also have high incidence rates of oral cavity and pharyngeal cancer compared with the general population; however, disparities in clinical presentation and survival outcomes of head and neck cancer squamous cell carcinoma (HNSCC) among this population have not been investigated nor compared with those of other races. Objective To determine the association of race with cancer stage at diagnosis and survival outcomes among Native Hawaiian and Other Pacific Islander patients with HNSCC compared with Asian and non-Hispanic White patients. Design, Setting, and Participants This was a retrospective population-based cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) 18 database. Asian, Native Hawaiian or Other Pacific Islander, and non-Hispanic White adult patients diagnosed in 1988 through 2015 with HNSCC of the oral cavity, oropharynx, nasopharynx, larynx, and hypopharynx were included; any patient whose record was missing data on disease or demographic information was excluded. Main Outcomes and Measures Cancer stage at presentation was compared among Asian, Native Hawaiian and Other Pacific Islander, and non-Hispanic White patients using a multivariable logistic regression model. Survival outcomes were compared among these racial groups using Cox regression models. Data analyses were performed from July 1, 2021, to March 20, 2022. Results The total study population comprised 76 473 patients: 4894 Asian (mean [SD] age at presentation, 60.7 [14.6] years), 469 Native Hawaiian and Other Pacific Islander (57.8 [12.3] years), and 71 110 non-Hispanic White (62.2 [12.1] years) individuals. Native Hawaiian and Other Pacific Islander patients were more likely to present with advanced-stage HNSCC (odds ratio [OR], 1.38; 95% CI, 1.12 -1.72) compared with non-Hispanic White patients. Asian patients presented with similar stage disease (OR, 1.04; 95% CI, 0.97-1.11) compared with non-Hispanic White patients. Native Hawaiian and Other Pacific Islander patients had worse disease-specific survival (HR, 1.18; 95% CI, 1.02-1.36) compared with non-Hispanic White patients after adjusting for clinical and demographic factors. In contrast, Asian patients had improved disease-specific survival (HR, 0.93; 95% CI, 0.88-0.98) compared with non-Hispanic White patients. Conclusions and Relevance This retrospective population-based cohort study suggests that Native Hawaiian and Other Pacific Islander race was associated with more advanced HNSCC, and worse disease-specific survival compared with non-Hispanic White race, while Asian race was associated with improved survival. This study highlights the importance of disaggregating Asian from Pacific Islander data when assessing health disparities, and the need for culturally sensitive interventions to promote earlier detection of head and neck cancer and improved survival among the Native Hawaiian and Other Pacific Islander population.
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Affiliation(s)
- Peter Kim Moon
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
| | - Yifei Ma
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
| | - Uchechukwu C. Megwalu
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
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Mutation Profiles of Ovarian Seromucinous Borderline Tumors in Japanese Patients. Curr Oncol 2022; 29:3658-3667. [PMID: 35621684 PMCID: PMC9139622 DOI: 10.3390/curroncol29050294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/22/2022] [Accepted: 04/29/2022] [Indexed: 11/17/2022] Open
Abstract
Ovarian seromucinous tumors (SMBTs) are relatively rare, and their carcinogenesis is largely unknown. In this study, the molecular features of SMBTs in Japan are assessed. DNA was extracted from microdissected paraffin-embedded sections from 23 SMBT cases. Genetic mutations (KRAS, BRAF, PIK3CA, and ERBB2) were evaluated using Sanger sequencing. Immunohistochemistry for p53, ARID1A, and PTEN was also performed as a surrogate for the loss of functional mutations in these tumor suppressor genes. The prevalence of KRAS, BRAF, PIK3CA, and ERBB2 mutations was 4.3% (1/23), 8.6% (2/23), 8.6% (2/23), and 17.3% (4/23), respectively. Overexpression or loss of p53 expression occurred in 26% (6/23), loss of ARID1A expression in 4.3% (1/23), and none of the cases showed expression of PTEN loss. These findings suggest that KRAS/BRAF/PIK3CA and PTEN mutations are rare carcinogenic events in SMBTs. The high frequency of positive p53 staining and a low frequency of loss of ARID1A staining suggests that SMBT carcinogenesis may be related to the alteration of p53 rather than that of ARID1A. ERBB2 oncogenic mutations may play an important role in the tumorigenesis of Japanese SMBTs.
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8
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Design and Synthesis of a Novel Antimicrobial Peptide Targeting β-catenin in Human Breast Cancer Cell lines. Int J Pept Res Ther 2021. [DOI: 10.1007/s10989-021-10215-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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9
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Zhou L, Pi W, Hao M, Li Y, An H, Li Q, Zhang P, Wen Y. An injectable and biodegradable nano-photothermal DNA hydrogel enhances penetration and efficacy of tumor therapy. Biomater Sci 2021; 9:4904-4921. [PMID: 34047319 DOI: 10.1039/d1bm00568e] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The biological barrier of solid tumors hinders deep penetration of nanomedicine, constraining anticancer treatment. Moreover, the inherent multidrug resistance (MDR) of cancer tissues may further limit the efficacy of anti-tumor nanomedicine. We synthesized highly permeable, photothermal, injectable, and positively charged biodegradable nucleic acid hydrogel (DNA-gel) nanoparticles to deliver cancer drugs. The nanoparticles are derived from photothermal materials containing black phosphorus quantum dots (BPQDs). The intra-tumoral BPQDs improve the sensitivity of tumor cells to photothermal therapy (PTT) and photodynamic treatment (PDT). Tumor cells take up the positively charged and controllable size DNA-gel nanoparticles, facilitating easy penetration and translocation of the particles across and within the cells. Mouse models demonstrated the anti-tumor activity of the DNA gel nanoparticles in vivo. In particular, the DNA gel nanoparticles enhanced clearance of both small and large tumor masses. Just 20 days after treatment, the tumor masses had been cleared. Compared to DOX chemotherapy alone, the DNA-gel treatment also significantly reduced drug resistance and improved the overall survival of mice with orthotopic breast tumors (83.3%, 78 d). Therefore, DNA gel nanoparticles are safe and efficient supplements for cancer therapy.
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Affiliation(s)
- Liping Zhou
- Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China.
| | - Wei Pi
- Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, 100044 China.
| | - Mingda Hao
- Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China.
| | - Yansheng Li
- Beijing Key Laboratory for Sensors, Beijing Information Science & Technology University, Beijing 100192, China
| | - Heng An
- Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China.
| | - Qicheng Li
- Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, 100044 China.
| | - Peixun Zhang
- Department of Orthopaedics and Trauma, Peking University People's Hospital, Beijing, 100044 China.
| | - Yongqiang Wen
- Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China.
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Orafaie A, Bahrami AR, Matin MM. Use of anticancer peptides as an alternative approach for targeted therapy in breast cancer: a review. Nanomedicine (Lond) 2021; 16:415-433. [PMID: 33615876 DOI: 10.2217/nnm-2020-0352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Breast cancer is the most common cancer in women worldwide. Traditional therapies are expensive and cause severe side effects. Targeted therapy is a powerful method to circumvent the problems of other therapies. It also allows drugs to localize at predefined targets in a selective manner. Currently, there are several monoclonal antibodies which target breast cancer cell surface markers. However, using antibodies has some limitations. In the last two decades, many investigators have discovered peptides that may be useful to target breast cancer cells. In this article, we provide an overview on anti-breast cancer peptides, their sources and biological activities. We further discuss the pros and cons of using anticancer peptides with further emphasis on how to improve their effectiveness in cancer therapy.
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Affiliation(s)
- Ala Orafaie
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Ahmad Reza Bahrami
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran.,Industrial Biotechnology Research Group, Institute of Biotechnology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Maryam M Matin
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran.,Novel Diagnostics & Therapeutics Research Group, Institute of Biotechnology, Ferdowsi University of Mashhad, Mashhad, Iran
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11
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Li X, Gao B, Su X. Anticancer bioactive peptide combined with docetaxel and its mechanism in the treatment of breast cancer. Exp Ther Med 2020; 20:1917-1924. [PMID: 32782500 PMCID: PMC7401194 DOI: 10.3892/etm.2020.8902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 02/07/2020] [Indexed: 01/26/2023] Open
Abstract
Breast cancer remains a worldwide public-health issue. Novel drugs that increase the sensitivity and reduce the toxic side effects of chemotherapeutic agents are urgently required. The present study investigated the effect and mechanism of the short-term intermittent administration of an anticancer bioactive peptide (ACBP), docetaxel (DTX), ACBP combined with DTX (MIX) and ACBP combined with low dose DTX (L-MIX) to nude mice bearing human breast cancer tumors. The body weight, tumor length, tumor diameter, diet and water consumption of the tumor-bearing nude mice were calculated. The protein and mRNA expression levels of p53, p21 and Ki67 were detected via immunohistochemistry and reverse transcription-quantitative PCR, respectively. The results revealed that the activity level of each group of mice was consistent. However, the food and water consumption of the ACBP group was significantly increased compared with the NS group. Compared with the normal saline group, the tumor weights and volumes of the treatment groups were significantly decreased, indicating an inhibitory effect of the treatment. However, the MIX group exhibited lower tumor weights and volumes compared with the ACBP and DTX groups. Furthermore, no significant cell necrosis, edema or inflammatory cell infiltration was observed upon hematoxylin & eosin staining of the liver and spleen in all groups. The results also revealed that the p21, p53 and Ki67 protein and mRNA levels were decreased in the ACBP, DTX and MIX groups compared with the control group. Additionally, when compared with those in the MIX and L-MIX groups, the p21 and Ki67 protein, and p53 and Ki67 mRNA levels in the ACBP and DTX groups were significantly increased. The results suggested that the short-term intermittent use of ACBP alone had an inhibitory effect on tumor growth and improved the food and water consumption of tumor-bearing nude mice. Furthermore, the combination of ACBP and DTX reduced toxic side effects and the dosage requirement of drugs to achieve therapeutic effects on the tumor-bearing nude mice. Therefore, the antitumor effect of ACBP may be associated with the improvement of immune function in tumor-bearing nude mice and ACBP may serve an antitumor role via the p53-p21 signaling pathway in breast cancer.
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Affiliation(s)
- Xian Li
- Clinical Medicine Research Center, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010050, P.R. China
| | - Beibei Gao
- Clinical Medicine Research Center, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010050, P.R. China
| | - Xiulan Su
- Clinical Medicine Research Center, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 010050, P.R. China
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Collins TK, Houghten S. A centrality based multi-objective approach to disease gene association. Biosystems 2020; 193-194:104133. [PMID: 32243908 DOI: 10.1016/j.biosystems.2020.104133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/27/2020] [Accepted: 03/23/2020] [Indexed: 01/11/2023]
Abstract
Disease Gene Association finds genes that are involved in the presentation of a given genetic disease. We present a hybrid approach which implements a multi-objective genetic algorithm, where input consists of centrality measures based on various relational biological evidence types merged into a complex network. Multiple objective settings and parameters are studied including the development of a new exchange methodology, safe dealer-based crossover. Successful results with respect to breast cancer and Parkinson's disease compared to previous techniques and popular known databases are shown. In addition, the newly developed methodology is also successfully applied to Alzheimer's disease, further demonstrating its flexibility. Across all three case studies the strongest results were produced by the shortest path-based measures stress and betweenness, either in a single objective parameter setting or when used in conjunction in a multi-objective environment. The new crossover technique achieved the best results when applied to Alzheimer's disease.
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Affiliation(s)
- Tyler K Collins
- Computer Science Department, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, Ontario L2S 3A1, Canada
| | - Sheridan Houghten
- Computer Science Department, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, Ontario L2S 3A1, Canada.
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13
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Johnson D, Hughes D, Pirmohamed M, Jorgensen A. Evidence to Support Inclusion of Pharmacogenetic Biomarkers in Randomised Controlled Trials. J Pers Med 2019; 9:jpm9030042. [PMID: 31480618 PMCID: PMC6789450 DOI: 10.3390/jpm9030042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 01/01/2023] Open
Abstract
Pharmacogenetics and biomarkers are becoming normalised as important technologies to improve drug efficacy rates, reduce the incidence of adverse drug reactions, and make informed choices for targeted therapies. However, their wider clinical implementation has been limited by a lack of robust evidence. Suitable evidence is required before a biomarker’s clinical use, and also before its use in a clinical trial. We have undertaken a review of five pharmacogenetic biomarker-guided randomised controlled trials (RCTs) and evaluated the evidence used by these trials to justify biomarker inclusion. We assessed and quantified the evidence cited in published rationale papers, or where these were not available, obtained protocols from trial authors. Very different levels of evidence were provided by the trials. We used these observations to write recommendations for future justifications of biomarker use in RCTs and encourage regulatory authorities to write clear guidelines.
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Affiliation(s)
- Danielle Johnson
- Institute of Translational Medicine, Department of Biostatistics, University of Liverpool, Waterhouse Building, 1-5 Brownlow Street, Liverpool L69 3GL, UK.
| | - Dyfrig Hughes
- Centre for Health Economics and Medicines Evaluation, Bangor University, Ardudwy, Normal Site, Bangor LL57 2PZ, UK
| | - Munir Pirmohamed
- MRC Centre for Drug Safety Science and Wolfson Centre for Personalised Medicine, Institute of Translational Medicine, Waterhouse Building, 1-5 Brownlow Street, Liverpool L69 3GL, UK
| | - Andrea Jorgensen
- Institute of Translational Medicine, Department of Biostatistics, University of Liverpool, Waterhouse Building, 1-5 Brownlow Street, Liverpool L69 3GL, UK
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Li Y, Carlson E, Hernández DA, Green B, Calle T, Kumaresan T, Madondo K, Martinez M, Villarreal R, Meraz L, Pagán JA. Patient Perception and Cost-Effectiveness of a Patient Navigation Program to Improve Breast Cancer Screening for Hispanic Women. Health Equity 2019; 3:280-286. [PMID: 31236527 PMCID: PMC6588102 DOI: 10.1089/heq.2018.0089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose: Hispanic women are less likely to be screened for breast cancer than non-Hispanic women, which contributes to the disproportionate prevalence of advanced-stage breast cancer in this population group. Patient navigation may be a promising approach to help women overcome the complexity of accessing multiple health care services related to breast cancer screening and treatment. The goal of this study is to assess patient perception and cost-effectiveness of a multilevel, community-based patient navigation program to improve breast cancer screening among Hispanic women in South Texas. Methods: We used mixed methods—including focus groups of program participants and a microsimulation model of breast cancer—to evaluate the effectiveness and cost-effectiveness of the program on the target population. Program data from 2013 to 2016 were collected and used to conduct the analyses. Results: Focus groups showed that the patient navigation program improved patient knowledge, attitudes, and behaviors regarding breast health and increased the mammography screening rate from 60% to 80%. Cost-effectiveness analysis showed that the program could increase life expectancy by 0.71 years and yield an incremental cost-effectiveness ratio of $3120 per quality-adjusted life year compared to no intervention. Conclusion: The 3-year multilevel, community-based patient navigation program effectively increased mammography screening uptake and adherence and improved knowledge and behaviors on breast health among program participants. Future research is needed to translate and disseminate the program to other socioeconomic and demographic groups to test its robustness and design.
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Affiliation(s)
- Yan Li
- Center for Health Innovation, The New York Academy of Medicine, New York, New York.,Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Erin Carlson
- College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas
| | - Denise A Hernández
- College of Architecture, Planning and Public Affairs, The University of Texas at Arlington, Arlington, Texas
| | - Brandie Green
- College of Architecture, Planning and Public Affairs, The University of Texas at Arlington, Arlington, Texas
| | - Tania Calle
- Williams College, Williamstown, Massachusetts
| | | | - Kumbirai Madondo
- Center for Health Innovation, The New York Academy of Medicine, New York, New York.,Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mariluz Martinez
- Research and Information Management, University Health System, San Antonio, Texas
| | - Roberto Villarreal
- Research and Information Management, University Health System, San Antonio, Texas
| | - Leah Meraz
- Research and Information Management, University Health System, San Antonio, Texas
| | - José A Pagán
- Center for Health Innovation, The New York Academy of Medicine, New York, New York.,Department of Public Health Policy and Management, College of Global Public Health, New York University, New York, New York.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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15
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Hannouf MB, Zaric GS, Blanchette P, Brezden-Masley C, Paulden M, McCabe C, Raphael J, Brackstone M. Cost-effectiveness analysis of multigene expression profiling assays to guide adjuvant therapy decisions in women with invasive early-stage breast cancer. THE PHARMACOGENOMICS JOURNAL 2019; 20:27-46. [PMID: 31130722 DOI: 10.1038/s41397-019-0089-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/07/2018] [Accepted: 03/27/2019] [Indexed: 12/22/2022]
Abstract
Gene expression profiling (GEP) testing using 12-gene recurrence score (RS) assay (EndoPredict®), 58-gene RS assay (Prosigna®), and 21-gene RS assay (Oncotype DX®) is available to aid in chemotherapy decision-making when traditional clinicopathological predictors are insufficient to accurately determine recurrence risk in women with axillary lymph node-negative, hormone receptor-positive, and human epidermal growth factor-receptor 2-negative early-stage breast cancer. We examined the cost-effectiveness of incorporating these assays into standard practice. A decision model was built to project lifetime clinical and economic consequences of different adjuvant treatment-guiding strategies. The model was parameterized using follow-up data from a secondary analysis of the Anastrozole or Tamoxifen Alone or Combined randomized trial, cost data (2017 Canadian dollars) from the London Regional Cancer Program (Canada) and secondary Canadian sources. The 12-gene, 58-gene, and 21-gene RS assays were associated with cost-effectiveness ratios of $36,274, $48,525, and $74,911/quality-adjusted life year (QALY) gained and resulted in total gains of 379, 284.3, and 189.5 QALYs/year and total budgets of $12.9, $14.2, and $16.6 million/year, respectively. The total expected-value of perfect information about GEP assays' utility was $10.4 million/year. GEP testing using any of these assays is likely clinically and economically attractive. The 12-gene and 58-gene RS assays may improve the cost-effectiveness of GEP testing and offer higher value for money, although prospective evidence is still needed. Comparative field evaluations of GEP assays in real-world practice are associated with a large societal benefit and warranted to determine the optimal and most cost-effective assay for routine use.
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Affiliation(s)
- Malek B Hannouf
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Gregory S Zaric
- Ivey School of Business, Western University, London, ON, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Phillip Blanchette
- London Regional Cancer Program, Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Christine Brezden-Masley
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Hematology and Oncology, St. Michael's Hospital, Toronto, ON, Canada
| | - Mike Paulden
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Christopher McCabe
- The Institute of Health Economics, Edmonton, AB, Canada.,Faculty of Medicine, Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jacques Raphael
- London Regional Cancer Program, Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Muriel Brackstone
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. .,London Regional Cancer Program, Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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16
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Dhumal ST, Deshmukh AR, Kharat KR, Sathe BR, Chavan SS, Mane RA. Copper fluorapatite assisted synthesis of new 1,2,3-triazoles bearing a benzothiazolyl moiety and their antibacterial and anticancer activities. NEW J CHEM 2019. [DOI: 10.1039/c9nj00377k] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
New 1,2,3-triazoles with a benzothiazolyl scaffold have been synthesized for the first time using copper fluorapatite as a catalyst and their antibacterial and anticancer activities are reported.
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Affiliation(s)
- Sambhaji T. Dhumal
- Department of Chemistry
- Dr. Babasaheb Ambedkar Marathwada University
- Aurangabad
- India
| | - Amarsinh R. Deshmukh
- Department of Chemistry
- Dr. Babasaheb Ambedkar Marathwada University
- Aurangabad
- India
| | - Kiran R. Kharat
- Centre for Advanced Life Sciences
- Deogiri College
- Aurangabad-431005
- India
| | - Bhaskar R. Sathe
- Department of Chemistry
- Dr. Babasaheb Ambedkar Marathwada University
- Aurangabad
- India
| | - Santosh S. Chavan
- Chemistry and Chemical Bioengineering Unit
- Okinawa Institute of Science and Technology Graduate University
- Onna
- Japan
| | - Ramrao A. Mane
- Department of Chemistry
- Dr. Babasaheb Ambedkar Marathwada University
- Aurangabad
- India
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17
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Hamel LM, Moulder R, Albrecht TL, Boker S, Eggly S, Penner LA. Nonverbal synchrony as a behavioural marker of patient and physician race-related attitudes and a predictor of outcomes in oncology interactions: protocol for a secondary analysis of video-recorded cancer treatment discussions. BMJ Open 2018; 8:e023648. [PMID: 30518586 PMCID: PMC6286484 DOI: 10.1136/bmjopen-2018-023648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Racial disparities in cancer treatment contribute to racial disparities in mortality rates. The quality of patient-physician communication during clinical interactions with black patients and non-black physicians (racially discordant) is poorer than communication quality with white patients (racially concordant). Patient and physician race-related attitudes affect the quality of this communication. These attitudes are likely expressed through subtle non-verbal behaviours, but prior research has not examined these behaviours. Nonverbal synchrony, the coordination of physical movement, reflects the preinteraction attitudes of participants in interactions and predicts their postinteraction perceptions of and affect towards one another. In this study, peer reviewed and funded by the National Institute of Minority Health and Health Disparities (R21MD011766), we will investigate non-verbal synchrony in racially concordant and discordant interactions to better understand racial disparities in clinical communication. METHODS AND ANALYSIS This secondary analysis includes racially concordant (n=163) and racially discordant (n=68) video-recorded oncology interactions, patient and oncologist self-reported race-related attitudes, perceptions of the interaction and observer ratings of physician patient-centred communication and patient and physician affect and rapport. In aim 1, we will assess and compare non-verbal synchrony between physicians and patients in racially concordant and discordant interactions. In aim 2, we will determine the influence of non-verbal synchrony on patient and physician affect and communication. In aim 3, we will examine possible causes (ie, race-related attitudes) and consequences (ie, negative perceptions) of non-verbal synchrony in racially discordant interactions. In aim 4, we will develop and test a mediational model linking physician and patient race-related attitudes to non-verbal synchrony and, in turn, interaction outcomes. ETHICS AND DISSEMINATION The parent and current studies were approved by the Wayne State University Institutional Review Board. Since only archival data will be used, ethical or safety risks are low. We will disseminate our findings to relevant conferences and journals.
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Affiliation(s)
- Lauren M Hamel
- Department of Oncology, School of Medicine, Wayne State University/Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Robert Moulder
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Terrance L Albrecht
- Department of Oncology, School of Medicine, Wayne State University/Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Steven Boker
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Susan Eggly
- Department of Oncology, School of Medicine, Wayne State University/Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Louis A Penner
- Department of Oncology, School of Medicine, Wayne State University/Karmanos Cancer Institute, Detroit, Michigan, USA
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18
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Nikkhoo A, Rostami N, Hojjat-Farsangi M, Azizi G, Yousefi B, Ghalamfarsa G, Jadidi-Niaragh F. Smac mimetics as novel promising modulators of apoptosis in the treatment of breast cancer. J Cell Biochem 2018; 120:9300-9314. [PMID: 30506843 DOI: 10.1002/jcb.28205] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/15/2018] [Indexed: 12/11/2022]
Abstract
Breast cancer is the most prevalent cancer in women. Despite improvements in treatment, the rate of breast cancer-related deaths is still high, and this issue needs further, accurate investigations. Although several treatment options are available, none of them are efficient for complete remission, particularly in advanced stages of the disease. It is known that cancerous cells have dysregulated apoptosis-related pathways, by which they can remain alive for a long time, expand freely, and escape from apoptosis-inducing drugs or antitumor immune responses. Therefore, modulation of apoptosis resistance in cancer cells may be an efficient strategy to overcome current problems faced in the development of immunotherapeutic approaches for the treatment of breast cancer. The inhibitors of apoptosis protein (IAPs) are important targets for cancer therapy because it has been shown that these molecules are overexpressed and highly active in various cancer cells and suppress apoptosis process in malignant cells by blockage of caspase proteins. There is evidence of Smac mimetics efficacy as a single agent; however, recent studies have indicated the efficacy of current anticancer immunotherapeutic approaches when combined with Smac mimetics, which are potent inhibitors of IAPs and synthesized mimicking Smac/Diablo molecules. In this review, we are going to discuss the efficacy of treatment of breast cancer by Smac mimetics alone or in combination with other therapeutics.
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Affiliation(s)
- Afshin Nikkhoo
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Narges Rostami
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hojjat-Farsangi
- Department of Oncology-Pathology, Immune and Gene therapy Lab, Cancer Center Karolinska (CCK), Karolinska University Hospital Solna and Karolinska Institute, Stockholm, Sweden.,Department of Immunology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Gholamreza Azizi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Bahman Yousefi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ghasem Ghalamfarsa
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Farhad Jadidi-Niaragh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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19
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Lamb EP, Pritchard FE, Nouer SS, Tolley EA, Boyd BS, Davidson JT, Munene G, Fleming MD. Understanding Disparities in Breast Cancer Care in Memphis, Tennessee. Am Surg 2018. [DOI: 10.1177/000313481808400510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although significant progress has been made in improving breast cancer survival, disparities among racial, ethnic, and underserved groups still exist. The goal of this investigation is to quantify racial disparities in the context of breast cancer care, examining the outcomes of recurrence and mortality in the city of Memphis. Patients with a biopsy-proven diagnosis of breast cancer from January 1, 2002, through December 31, 2012, were obtained from the tumor registry. Black patients were more likely to have advanced (II, III, or IV) clinical stage of breast cancer at diagnosis versus white patients. Black breast cancer patients had a two times higher odds of recurrence (95% confidence interval: 1.4, 3.0) after adjusting for race and clinical stage. Black breast cancer patients were 1.5 times more likely to die (95% confidence interval: 1.2, 1.8), after adjusting for race; age at diagnosis; clinical stage; ER, PR, HER2 status; and recurrence. Black women with stages 0, I, II, and III breast cancer all had a statistically significant longer median time from diagnosis to surgery than white women. Black patients were more likely to have advanced clinical stages of breast cancer at diagnosis versus white patients on a citywide level in Memphis. Black breast cancer patients have higher odds of recurrence and mortality when compared with white breast cancer patients, after adjusting for appropriate demographic and clinical attributes. More work is needed to develop, evaluate, and disseminate interventions to decrease inequities in timeliness of care for breast cancer patients.
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Affiliation(s)
- Elena P. Lamb
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - F. Elizabeth Pritchard
- Division of Surgical Oncology, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Simonne S. Nouer
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Elizabeth A. Tolley
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Brandon S. Boyd
- Department of Orthopedic Surgery, The University of Tennessee Chattanooga, Chattanooga, Tennessee
| | - Jesse T. Davidson
- Department of Surgery, Washington University in St. Louis, St. Louis, Missouri
| | | | - Martin D. Fleming
- Division of Surgical Oncology, The University of Tennessee Health Science Center, Memphis, Tennessee
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20
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Bianco A, Larosa E, Pileggi C, Nobile CGA, Pavia M. Cervical and breast cancer screening participation and utilisation of maternal health services: a cross-sectional study among immigrant women in Southern Italy. BMJ Open 2017; 7:e016306. [PMID: 29038177 PMCID: PMC5652469 DOI: 10.1136/bmjopen-2017-016306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 07/18/2017] [Accepted: 07/26/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Women make up approximately half of the world's one billion migrants. Immigrant women tend to be one of the most vulnerable population groups with respect to healthcare. Cancer screening (CS) and maternal and reproductive health have been included among the 10 main issues pertinent to women's health. The aim of this study is to explore breast and cervical CS participation and to acquire information regarding access to healthcare services during pregnancy, childbirth and the postpartum period among age eligible immigrant women in Southern Italy. METHODS A structured questionnaire was used to collect data from each participant. Women aged 25-64 years who had not had a hysterectomy and women aged 50-69 years without history of breast cancer were considered eligible for the evaluation of cervical and breast CS participation, respectively. Moreover, women who had delivered at least once in Italy were enrolled to describe antenatal and postpartum care services use. All women were recruited through the third sector and non-profit organisations (NPOs). RESULTS Rate of cervical CS among the 419 eligible women was low (39.1%), and about one-third had had a Pap test for screening purposes within a 3-year period from interview (32.8%). Regarding breast CS practices, of the 125 eligible women 45.6% had had a mammography for control purposes and less than a quarter (26, 20.8%) had their mammography within the recommended time interval of 2 years. About 80% of the respondents did not report difficulties of access and use of antenatal and postpartum services. CONCLUSION This study provides currently unavailable information about adherence to CS and maternal and child health that could encourage future research to develop and test culturally appropriate, women-centred strategies for promoting timely and regular CS among immigrant women in Italy.
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Affiliation(s)
- Aida Bianco
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Campus of Germaneto, Catanzaro, Italy
| | - Elisabetta Larosa
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Campus of Germaneto, Catanzaro, Italy
| | - Claudia Pileggi
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Campus of Germaneto, Catanzaro, Italy
| | - Carmelo G A Nobile
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Campus of Germaneto, Catanzaro, Italy
| | - Maria Pavia
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Campus of Germaneto, Catanzaro, Italy
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21
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Hunter CM, Figueiro MG. Measuring Light at Night and Melatonin Levels in Shift Workers: A Review of the Literature. Biol Res Nurs 2017; 19:365-374. [PMID: 28627309 PMCID: PMC5862149 DOI: 10.1177/1099800417714069] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Shift work, especially that involving rotating and night shifts, is associated with an increased risk of diseases, including cancer. Attempts to explain the association between shift work and cancer in particular have focused on the processes of melatonin production and suppression. One hypothesis postulates that exposure to light at night (LAN) suppresses melatonin, whose production is known to slow the development of cancerous cells, while another proposes that circadian disruption associated with shift work, and not just LAN, increases health risks. This review focuses on six studies that employed quantitative measurement of LAN and melatonin levels to assess cancer risks in shift workers. These studies were identified via searching the PubMed database for peer-reviewed, English-language articles examining the links between shift work, LAN, and disease using the terms light at night, circadian disruption, health, risk, cancer, shift work, or rotating shift. While the results indicate a growing consensus on the relationship between disease risks (particularly cancer) and circadian disruption associated with shift work, the establishment of a direct link between LAN and disease has been impeded by contradictory studies and a lack of consistent, quantitative methods for measuring LAN in the research to date. Better protocols for assessing personal LAN exposure are required, particularly those employing calibrated devices that measure and sample exposure to workplace light conditions, to accurately assess LAN's effects on the circadian system and disease. Other methodologies, such as measuring circadian disruption and melatonin levels in the field, may also help to resolve discrepancies in the findings.
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Affiliation(s)
- Claudia M. Hunter
- Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA
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22
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Soleimani A, Rahmani Y, Farshchian N, Delpisheh A, Khassi K, Shahmohammadi A, Amirifard N. The Evaluation of p53 Polymorphism at Codon 72 and Association With Breast Cancer in Iran: A Systematic Review and Meta-analysis. J Cancer Prev 2017; 21:288-293. [PMID: 28053964 PMCID: PMC5207614 DOI: 10.15430/jcp.2016.21.4.288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/05/2016] [Accepted: 12/05/2016] [Indexed: 11/21/2022] Open
Abstract
Background Breast cancer is the most common cancer among women in Iran and the world. Multiple environmental factors and genetic variations such as genetic polymorphisms are of its main causes. p53 gene plays an important role in conserving and sustaining the genome as a tumor suppressing gene. Change and polymorphism at codon 72 of p53 gene are correlated with increased risk of lung, mouth, endometrial, prostate, and colorectal cancers, and could be considered an indicator of susceptibility to breast cancer. Methods Twelve studies (1,190 cases and 1,145 control studies with evaluation of three types of Arg/Arg, Arg/Pro, and Pro/Pro genotypes) have been conducted using keywords, such as polymorphism at codon 72, gene p53 polymorphisms, and the relation between polymorphisms and breast cancer, from databases in Iran, including Magiran, Medlibe, Sid, and Iranmedex, as well as Latin databases such as PubMed, Google Scholar, Science Direct, and Scopus. Results The OR for Arg/Arg is 1.58 (95% CI: 2.45 to 1.01), the OR for Arg/Pro is 0.75 (95% CI: 1.10 to 0.51), and the OR for Pro/Pro is 0.62 (95% CI: 0.93 to 0.42). p53 gene polymorphism at codon 72 is statistically significant in Arg/Arg and Pro/Pro genotypes. Conclusions Arg/Arg genotype can be considered as a risk factor for breast cancer, and Pro/Pro genotype can be accounted for as a protective factor against breast cancer.
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Affiliation(s)
- Abozar Soleimani
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Yousef Rahmani
- Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Negin Farshchian
- Cancer Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Delpisheh
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Kivan Khassi
- Province Health Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Afshar Shahmohammadi
- Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Amirifard
- Cancer Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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23
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To be young, Black, and living with breast cancer: a systematic review of health-related quality of life in young Black breast cancer survivors. Breast Cancer Res Treat 2016; 160:1-15. [PMID: 27601138 DOI: 10.1007/s10549-016-3963-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 08/26/2016] [Indexed: 12/24/2022]
Abstract
PURPOSE Compared with young White women, young Black women are more likely to present with aggressive breast cancer (BC) subtypes that are potentially linked to worse health-related quality of life (HRQOL); however, there is limited consensus regarding HRQOL needs among young Black BC survivors. Employing Ferrell's framework on QOL in BC (i.e., physical, psychological, social, and spiritual well-being), we conducted a systematic review on HRQOL among Black BC survivors aged <50 years and proposed recommendations for advancing HRQOL research and care for this population. METHODS Literature searches were conducted in MEDLINE/PubMed, EMBASE, CINAHL, and PsycINFO to identify relevant articles published from 1995 to 2015. Abstracts and full-text articles were screened using predetermined inclusion/exclusion criteria and evaluated for quality. RESULTS A total of 2533 articles were identified, but six met eligibility criteria. Most studies examined multiple HRQOL domains, with the psychological domain most represented. Compared with their older, White, and BC-free counterparts, young Black BC survivors reported greater fear of dying, unmet supportive care needs, financial distress, and lower physical/functional well-being. However, spiritual well-being appeared favorable for young Black survivors. Research gaps include the absence of longitudinal studies and under-representation of studies examining physical, social, and particularly, spiritual HRQOL in young Black BC survivors. CONCLUSIONS Young Black BC survivors generally experience suboptimal HRQOL after BC diagnosis. As few studies have reported on HRQOL among this group, future research and oncology care should prioritize young Black women in ways that recognize their unique concerns, in order to ensure better HRQOL outcomes both during and after treatment.
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24
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Krok-Schoen JL, Fisher JL, Baltic RD, Paskett ED. White-Black Differences in Cancer Incidence, Stage at Diagnosis, and Survival among Adults Aged 85 Years and Older in the United States. Cancer Epidemiol Biomarkers Prev 2016; 25:1517-1523. [PMID: 27528599 DOI: 10.1158/1055-9965.epi-16-0354] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/29/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Increased life expectancy, growth of minority populations, and advances in cancer screening and treatment have resulted in an increasing number of older, racially diverse cancer survivors. Potential black/white disparities in cancer incidence, stage, and survival among the oldest old (≥85 years) were examined using data from the SEER Program of the National Cancer Institute. METHODS Differences in cancer incidence and stage at diagnosis were examined for cases diagnosed within the most recent 5-year period, and changes in these differences over time were examined for white and black cases aged ≥85 years. Five-year relative cancer survival rate was also examined by race. RESULTS Among those aged ≥85 years, black men had higher colorectal, lung and bronchus, and prostate cancer incidence rates than white men, respectively. From 1973 to 2012, lung and bronchus and female breast cancer incidence increased, while colorectal and prostate cancer incidence decreased among this population. Blacks had higher rates of unstaged cancer compared with whites. The 5-year relative survival rate for all invasive cancers combined was higher for whites than blacks. Notably, whites had more than three times the relative survival rate of lung and bronchus cancer when diagnosed at localized (35.1% vs. 11.6%) and regional (12.2% vs. 3.2%) stages than blacks, respectively. CONCLUSIONS White and black differences in cancer incidence, stage, and survival exist in the ≥85 population. IMPACT Continued efforts are needed to reduce white and black differences in cancer prevention and treatment among the ≥85 population. Cancer Epidemiol Biomarkers Prev; 25(11); 1517-23. ©2016 AACR.
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Affiliation(s)
| | - James L Fisher
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio
| | - Ryan D Baltic
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Electra D Paskett
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.,Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio
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Cox C, Chen Y, Cress R, Semrad AM, Semrad T, Gosnell JE, Campbell MJ. Are there disparities in the presentation, treatment and outcomes of patients diagnosed with medullary thyroid cancer?-An analysis of 634 patients from the California Cancer Registry. Gland Surg 2016; 5:398-404. [PMID: 27563561 PMCID: PMC4971346 DOI: 10.21037/gs.2016.04.02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 03/22/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Race, gender and socioeconomic disparities have been suggested to adversely influence stage at presentation, treatment options and outcomes in patients with cancer. Underserved minorities and those with a low socioeconomic status (SES) present with more advanced disease and have worse outcomes for differentiated thyroid cancer, but this relationship has never been evaluated for medullary thyroid cancer (MTC). METHODS We used the California Cancer Registry (CCR) to evaluate disparities in the presentation, treatment and outcomes of patients diagnosed with MTC. RESULTS We identified 634 patients with MTC diagnosed between 1988 and 2011. Almost everyone (85%) underwent thyroidectomy with 50% having a central lymph node dissection (CLND). There were no statistically significant differences by age, race or SES in mean tumor size or the proportion of patients diagnosed with localized disease, but men were diagnosed with larger tumors than women and were less likely to be diagnosed at a localized stage. Younger patients and women were more likely to be treated with a thyroidectomy. There were no statistically significant differences in surgical treatment by race or SES. Patients in the highest SES category had a better overall survival, but not disease specific survival, than those in the lowest SES (HR =0.3, CI =0.1-0.7). Patients treated with thyroidectomy had a better overall and cause specific survival, but the effect of CLND was not statistically significant after adjustment for other factors. CONCLUSIONS In MTC, we did not find that race, gender or SES influenced the presentation, treatment or outcomes of patients with MTC. Men with MTC present with larger tumors and are less likely to have localized disease. Half of the MTC patients in California do not undergo a CLND at the time of thyroidectomy, which may suggest a lack appropriate care across a range of healthcare systems.
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Affiliation(s)
- Christine Cox
- Department of Internal Medicine, Division of Endocrinology, University of California, Davis, USA
| | - Yingjia Chen
- Department of Public Health Sciences, Division of Epidemiology, University of California, Davis, USA
| | - Rosemary Cress
- Department of Public Health Sciences, Division of Epidemiology, University of California, Davis, USA
| | - Alison M. Semrad
- Department of Internal Medicine, Division of Endocrinology, University of California, Davis, USA
| | - Thomas Semrad
- Department of Internal Medicine, Division of Hematology and Oncology, University of California, Davis, USA
| | - Jessica E. Gosnell
- Department of Surgery, Section of Endocrine Surgery, University of California, San Francisco, USA
| | - Michael J. Campbell
- Department of Surgery, Section of Endocrine Surgery, University of California, Davis, USA
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Yan X, Han R, Zhou J, Yu H, Yang J, Wu M. Incidence, mortality and survival of female breast cancer during 2003-2011 in Jiangsu province, China. Chin J Cancer Res 2016; 28:321-9. [PMID: 27478317 PMCID: PMC4949277 DOI: 10.21147/j.issn.1000-9604.2016.03.06] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To assess the incidence, mortality and survival status of female breast cancer in Jiangsu province of China. METHODS Population-based cancer registry data in Jiangsu province were collected during 2003-2011. Crude rates, age-specific rates, age-standardized rates and annual percent changes of incidence and mortality were calculated to describe the epidemiologic characteristics and time trends. Patients diagnosed from 2003 to 2005 were chosen for analyzing the survival status of breast cancer. RESULTS From 2003 to 2011, 17,605 females were diagnosed with breast cancer and 4,883 died in selected registry areas in Jiangsu province. The crude incidence rate was 25.18/100,000, and the age-standardized rates by Chinese population (ASRC) and by world population (ASRW) were 19.03/100,000 and 17.92/100,000, respectively. During the same period, the crude mortality rate was 6.98/100,000 and the ASRC and ASRW were 4.93/100,000 and 4.80/100,000, respectively. From 2003 to 2011, the incidence and mortality increased with annual percent change of 11.37% and 5.78%, respectively. For survival analysis, 1,392 patients in 7 areas were identified in 2003-2005 and finished 5 years of follow-up. Survival rates were found to decrease with survival years, the 5-year observed survival rate was 45.9% and the relative survival rate was 52.0%. We also found that the survival rate varied across the province, which was lower in the north and higher in the south of Jiangsu province. CONCLUSIONS Breast cancer has become a significant public health problem in Jiangsu province and China. More resources should be invested in primary prevention, earlier diagnosis and better health services in order to increase survival rates among Chinese females.
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Affiliation(s)
- Xinran Yan
- Department of Epidemiology and Medical Statistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Renqiang Han
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Jinyi Zhou
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Hao Yu
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Jie Yang
- Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Ming Wu
- Department of Epidemiology and Medical Statistics, School of Public Health, Southeast University, Nanjing 210009, China; Department of Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
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Abstract
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the National Cancer Institute (Surveillance, Epidemiology, and End Results [SEER] Program), the Centers for Disease Control and Prevention (National Program of Cancer Registries), and the North American Association of Central Cancer Registries. Mortality data were collected by the National Center for Health Statistics. In 2016, 1,685,210 new cancer cases and 595,690 cancer deaths are projected to occur in the United States. Overall cancer incidence trends (13 oldest SEER registries) are stable in women, but declining by 3.1% per year in men (from 2009-2012), much of which is because of recent rapid declines in prostate cancer diagnoses. The cancer death rate has dropped by 23% since 1991, translating to more than 1.7 million deaths averted through 2012. Despite this progress, death rates are increasing for cancers of the liver, pancreas, and uterine corpus, and cancer is now the leading cause of death in 21 states, primarily due to exceptionally large reductions in death from heart disease. Among children and adolescents (aged birth-19 years), brain cancer has surpassed leukemia as the leading cause of cancer death because of the dramatic therapeutic advances against leukemia. Accelerating progress against cancer requires both increased national investment in cancer research and the application of existing cancer control knowledge across all segments of the population.
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Affiliation(s)
- Rebecca L Siegel
- Director, Surveillance Information, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Kimberly D Miller
- Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Ahmedin Jemal
- Vice President, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
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E-Kobon T, Thongararm P, Roytrakul S, Meesuk L, Chumnanpuen P. Prediction of anticancer peptides against MCF-7 breast cancer cells from the peptidomes of Achatina fulica mucus fractions. Comput Struct Biotechnol J 2015; 14:49-57. [PMID: 26862373 PMCID: PMC4706611 DOI: 10.1016/j.csbj.2015.11.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 11/18/2015] [Accepted: 11/19/2015] [Indexed: 01/10/2023] Open
Abstract
Several reports have shown antimicrobial and anticancer activities of mucous glycoproteins extracted from the giant African snail Achatina fulica. Anticancer properties of the snail mucous peptides remain incompletely revealed. The aim of this study was to predict anticancer peptides from A. fulica mucus. Two of HPLC-separated mucous fractions (F2 and F5) showed in vitro cytotoxicity against the breast cancer cell line (MCF-7) and normal epithelium cell line (Vero). According to the mass spectrometric analysis, 404 and 424 peptides from the F2 and F5 fractions were identified. Our comprehensive bioinformatics workflow predicted 16 putative cationic and amphipathic anticancer peptides with diverse structures from these two peptidome data. These peptides would be promising molecules for new anti-breast cancer drug development.
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Affiliation(s)
- Teerasak E-Kobon
- Department of Genetics, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
| | - Pennapa Thongararm
- Department of Zoology, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
| | - Sittiruk Roytrakul
- National Center for Genetic Engineering and Biotechnology, Thailand Science Park, Pathum Thani 12120, Thailand
| | - Ladda Meesuk
- Faculty of Dentistry, Thammasat University, Pathum Thani 12120, Thailand
| | - Pramote Chumnanpuen
- Department of Zoology, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
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Hamel LM, Chapman R, Malloy M, Eggly S, Penner LA, Shields AF, Simon MS, Klamerus JF, Schiffer C, Albrecht TL. Critical Shortage of African American Medical Oncologists in the United States. J Clin Oncol 2015; 33:3697-700. [PMID: 26392105 DOI: 10.1200/jco.2014.59.2493] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Lauren M Hamel
- Karmanos Cancer Institute/Wayne State University, Detroit, MI
| | - Robert Chapman
- Josephine Ford Cancer Institute/Henry Ford Health System, Detroit, MI
| | - Mary Malloy
- Michigan Society of Hematology and Oncology, Detroit, MI
| | - Susan Eggly
- Karmanos Cancer Institute/Wayne State University, Detroit, MI
| | - Louis A Penner
- Karmanos Cancer Institute/Wayne State University, Detroit, MI
| | | | - Michael S Simon
- Karmanos Cancer Institute/Wayne State University, Detroit, MI
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Barni S, Collovà E, Frassoldati A, Amoroso D. Adjuvant hormonal therapy and fertility preservation in premenopausal breast cancer: a survey among Italian oncologists. Future Oncol 2015; 11:1181-9. [PMID: 25832875 DOI: 10.2217/fon.14.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Increasing age of first pregnancy among Italian women with premenopausal breast cancer makes adjuvant hormonal therapy a hot topic, justifying a survey on the therapeutic approach of Italian oncologists. MATERIALS & METHODS From April to July 2012, an 11-item electronic questionnaire was submitted to Italian oncologists and 611 out of 974 invited filled questionnaires were collected from all over Italy. RESULTS In total, 97.7% of patients aged <40 years needing only hormonal therapy would receive both tamoxifen and luteinizing hormone-releasing hormone agonists (LHRHa); 2.3% tamoxifen or LHRHa alone. For the majority of oncologists LHRHa was also the preferred choice to preserving fertility. CONCLUSION Results are rather consistent with major guidelines but with a greater use of LHRHa and aromatase inhibitor.
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Affiliation(s)
- Sandro Barni
- UO Oncologia Medica, Azienda Ospedaliera Treviglio, Treviglio BG, Italy
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LIU ZHEYU, ZHANG YEFEI, FRANZIN LUISA, CORMIER JANICEN, CHAN WENYAW, XU HUA, DU XIANGLINL. Trends and variations in breast and colorectal cancer incidence from 1995 to 2011: a comparative study between Texas Cancer Registry and National Cancer Institute's Surveillance, Epidemiology and End Results data. Int J Oncol 2015; 46:1819-26. [PMID: 25672365 PMCID: PMC4356494 DOI: 10.3892/ijo.2015.2881] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 12/23/2014] [Indexed: 12/18/2022] Open
Abstract
Few studies have examined the cancer incidence trends in the state of Texas, and no study has ever been conducted to compare the temporal trends of breast and colorectal cancer incidence in Texas with those of the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) in the United States. This study aimed to conduct a parallel comparison between the Texas Cancer Registry and the National Cancer Institute's SEER on cancer incidence from 1995 to 2011. A total of 951,899 breast and colorectal cancer patients were included. Age-adjusted breast cancer incidence was 134.74 per 100,000 in Texas and 131.78 per 100,000 in SEER in 1995-2011, whereas age-adjusted colorectal cancer incidence was 50.52 per 100,000 in Texas and 49.44 per 100,000 in SEER. Breast cancer incidence increased from 1995 to 2001, decreased from 2002 to 2006, and then remained relatively stable from 2007 to 2011. For colorectal cancer, the incidence increased in 1995-1997, and then decreased continuously from 1998 to 2011 in Texas and SEER areas. Incidence rates and relative risks by age, gender and ethnicity were identical between Texas and SEER.
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Affiliation(s)
- ZHEYU LIU
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
- Department of Biostatistics, University of Texas Health Science Center, Houston, TX, USA
| | - YEFEI ZHANG
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
- Department of Biostatistics, University of Texas Health Science Center, Houston, TX, USA
| | - LUISA FRANZIN
- Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center, Houston, TX, USA
| | - JANICE N. CORMIER
- The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - WENYAW CHAN
- Department of Biostatistics, University of Texas Health Science Center, Houston, TX, USA
| | - HUA XU
- The University of Texas School of Biomedical Informatics, Houston, TX, USA
| | - XIANGLIN L. DU
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
- Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center, Houston, TX, USA
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Abstract
Triple-negative breast cancers (TNBC), characterized by absence of the estrogen receptor (ER) and progesterone receptor (PR) and lack of overexpression of human epidermal growth factor receptor 2 (HER2), have a poor prognosis. To overcome therapy limitations of TNBC, various new approaches are needed. This mini-review focuses on discovery of new targets and drugs which might offer new hope for TNBC patients.
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Affiliation(s)
- Idil Cetin
- Department of Radiobiology, Faculty of Science, Istanbul University, Istanbul, Turkey E-mail :
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Role of Socioeconomic Status in Predicting Sonographically Detected Breast Cancer Compared With Family History, Age, or Ethnicity. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2015. [DOI: 10.1177/8756479314563333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To determine if socioeconomic status is another risk factor in the development and treatment of breast cancer, the records of 250 women, equally divided between those with and without breast cancer, were studied at an outpatient clinic. The frequency of sonographically detected breast cancer increased systematically with respect to age, from 0% at age <30 years to 70.5% at age ≥50 years. The frequency of detection was higher among white (non-Hispanic) women, 69.4%, compared with nonwhite (Hispanic, Black, Asian) women, 42.3%. Breast cancer detection was higher (55.3%) among the lowest income group (<$40,345) than among higher income groups (45.6%) and higher among patients with Medicare (89.2%) and Medicaid (50%) compared with private, other, or no medical insurance (38.1%–44.4%). Detection was higher among women with a family history of breast cancer (55.0%) compared with no family history (46.7%) and higher among nulliparous women (100%) than nonnulliparous women (29.1%). These data suggest that aspects of socioeconomic status may be as predictive of sonographically detected breast cancer as age, ethnicity, and nulliparity.
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Abstract
Each year the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the National Cancer Institute (Surveillance, Epidemiology, and End Results [SEER] Program), the Centers for Disease Control and Prevention (National Program of Cancer Registries), and the North American Association of Central Cancer Registries. Mortality data were collected by the National Center for Health Statistics. A total of 1,658,370 new cancer cases and 589,430 cancer deaths are projected to occur in the United States in 2015. During the most recent 5 years for which there are data (2007-2011), delay-adjusted cancer incidence rates (13 oldest SEER registries) declined by 1.8% per year in men and were stable in women, while cancer death rates nationwide decreased by 1.8% per year in men and by 1.4% per year in women. The overall cancer death rate decreased from 215.1 (per 100,000 population) in 1991 to 168.7 in 2011, a total relative decline of 22%. However, the magnitude of the decline varied by state, and was generally lowest in the South (∼15%) and highest in the Northeast (≥20%). For example, there were declines of 25% to 30% in Maryland, New Jersey, Massachusetts, New York, and Delaware, which collectively averted 29,000 cancer deaths in 2011 as a result of this progress. Further gains can be accelerated by applying existing cancer control knowledge across all segments of the population.
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Affiliation(s)
- Rebecca L Siegel
- Director, Surveillance Information, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
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Heidarnia MA, Monfared ED, Akbari ME, Yavari P, Amanpour F, Mohseni M. Social determinants of health and 5-year survival of colorectal cancer. Asian Pac J Cancer Prev 2014; 14:5111-6. [PMID: 24175785 DOI: 10.7314/apjcp.2013.14.9.5111] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early in the 21st century, cancers are the second cause of death worldwide. Colon cancer is third most common cancer and one of the few amenable to early diagnosis and treatment. Evaluation of factors affecting this cancer is important to increase survival time. Some of these factors affecting all diseases including cancer are social determinants of health. According to the importance of this disease and relation with these factors, this study was conducted to assess the relationship between social determinants of health and colon cancer survival. MATERIALS AND METHODS This was a cross-sectional, descriptive study for patients with colon cancer registered in the Cancer Research Center of Shahid Beheshti University of Medical Science, from April 2005 to November 2006, performed using questionnaires filled by telephone interview with patients (if patients had died, with family members). Data was analyzed with SPSS software (version 19) for descriptive analysis and STATA software for survival analysis including log rank test and three step Cox Proportional Hazard regression. RESULTS Five hundred fifty nine patients with ages ranging from 23 to 88 years with mean ± standard deviation of 63 ± 11.8 years were included in the study. The five year survival was 68.3%( 387 patients were alive and 172 patients were dead by the end of the study). The Cox proportional hazard regression showed 5-year survival was related to age (HR=0.53, p=0.042 for>50 years versus<50 years old) in first step, gender (HR=0.60, p=0.006 for female versus male) in second step, job (HR=1.7, p=0.001 for manual versus non manual jobs), region of residency (HR=3.49, p=0.018 for west versus south regions), parents in childhood (HR=2.87, p=0.012 for having both parents versus not having), anatomical cancer location (HR=2.16, p<0.033 for colon versus rectal cancer) and complete treatment (HR=5.96, p<0.001 for incomplete versus complete treatment). CONCLUSIONS Social determinants of health such as job, city region residency and having parents during childhood have significant effects in 5-year survival of colon cancer and it may be better to consider these factors in addition to developing cancer treatment and to focus on these determinants of health in long-time planning.
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Affiliation(s)
- Mohammad Ali Heidarnia
- Department of Community Medicine and Health, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail :
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Kobeissi L, Samari G, Telesca D, Esfandiari M, Galal O. The impact of breast cancer knowledge and attitudes on screening and early detection among an immigrant Iranian population in southern California. JOURNAL OF RELIGION AND HEALTH 2014; 53:1759-1769. [PMID: 24096382 PMCID: PMC3999292 DOI: 10.1007/s10943-013-9778-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Few studies explored factors influencing breast cancer screening and early detection behaviors among immigrant Iranian women residing in the USA. Using a cross-sectional survey, a convenience sample of 319 Iranian American women was selected to investigate the impact of breast cancer knowledge and attitude on screening. A self-administered questionnaire assessed breast cancer screening knowledge, attitude, and mammography use (ever, previous year, and future intention). 79 % of the women in the study reported ever receiving at least one mammogram and 74 % received a mammogram in the past year. Personal attitude had an independent significant effect on: mammography use in the last year, ever use of mammography, and future intention to screen. Knowledge and morality-induced attitude influenced screening behavior but not significantly. Interventions targeting breast cancer screening among immigrant Iranian women in the USA should focus on enhancing personal attitudes in order to influence actual screening behavior.
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Affiliation(s)
- L Kobeissi
- Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1250 N Martin Avenue, Tucson, AZ, 85724, USA,
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Niu L, Zhou L, Xu K. Cryosurgery of breast cancer. Gland Surg 2014; 1:111-8. [PMID: 25083433 DOI: 10.3978/j.issn.2227-684x.2012.08.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 08/10/2012] [Indexed: 01/07/2023]
Abstract
With recent improvements in breast imaging, the ability to identify small breast tumors is markedly improved, prompting significant interest in the use of cryoablation without surgical excision to treat early-stage breast cancer. The cryoablation is often performed using ultrasound-guided tabletop argon-gas-based cryoablation system with a double freeze/thaw cycle. Recent studies have demonstrated that, as a primary therapy for small breast cancer, cryoablation is safe and effective with durable results, and can successfully destroy all cancers <1.0 cm and tumors between 1.0 and 1.5 cm without a significant ductal carcinoma-in-situ (DCIS) component. Presence of noncalcified DCIS is the cause of most cryoablation failures. At this time, cryoablation should be limited to patients with invasive ductal carcinoma <1.5 cm and with <25% DCIS in the core biopsy. For unresectable advanced breast cancer, cryoablation is a palliation modality and may be used as complementary for subsequent resection or other therapies.
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Affiliation(s)
- Lizhi Niu
- 1 Department of Oncology, Affiliated Fuda Hospital, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Science, No. 91-93 Judezhong Road, Haizhu District, Guangzhou 510305, China ; 2 Guangzhou Fuda Cancer Hospital, Jinan University School of Medicine, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510305, China
| | - Liang Zhou
- 1 Department of Oncology, Affiliated Fuda Hospital, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Science, No. 91-93 Judezhong Road, Haizhu District, Guangzhou 510305, China ; 2 Guangzhou Fuda Cancer Hospital, Jinan University School of Medicine, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510305, China
| | - Kecheng Xu
- 1 Department of Oncology, Affiliated Fuda Hospital, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Science, No. 91-93 Judezhong Road, Haizhu District, Guangzhou 510305, China ; 2 Guangzhou Fuda Cancer Hospital, Jinan University School of Medicine, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510305, China
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Hasnain M, Menon U, Ferrans CE, Szalacha L. Breast cancer screening practices among first-generation immigrant muslim women. J Womens Health (Larchmt) 2014; 23:602-12. [PMID: 24865517 PMCID: PMC4089017 DOI: 10.1089/jwh.2013.4569] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The purpose of this study was to identify beliefs about breast cancer, screening practices, and factors associated with mammography use among first-generation immigrant Muslim women in Chicago, IL. METHODS A convenience sample of 207 first-generation immigrant Muslim women (Middle Eastern 51%; South Asian 49%) completed a culturally adapted questionnaire developed from established instruments. The questionnaire was administered in Urdu, Hindi, Arabic, or English, based on participant preference. Internal-consistency reliability was demonstrated for all scales (alpha coefficients ranged from 0.64 to 0.91). Associations between enabling, predisposing, and need variables and the primary outcome of mammography use were explored by fitting logistic regression models. RESULTS Although 70% of the women reported having had a mammogram at least once, only 52% had had one within the past 2 years. Four factors were significant predictors of ever having had a mammogram: years in the United States, self-efficacy, perceived importance of mammography, and intent to be screened. Five factors were significant predictors of adherence (having had a mammogram in the past 2 years): years in the United States, having a primary care provider, perceived importance of mammography, barriers, and intent to be screened. CONCLUSIONS This article sheds light on current screening practices and identifies theory-based constructs that facilitate and hinder Muslim women's participation in mammography screening. Our findings provide insights for reaching out particularly to new immigrants, developing patient education programs grounded in culturally appropriate approaches to address perceived barriers and building women's self-efficacy, as well as systems-level considerations for ensuring access to primary care providers.
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Affiliation(s)
- Memoona Hasnain
- Department of Family Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Usha Menon
- College of Nursing, The Ohio State University, Columbus, Ohio
| | | | - Laura Szalacha
- Center for Research and Transdisciplinary Scholarship, College of Nursing, The Ohio State University, Columbus, Ohio
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Bustami RT, Shulkin DB, O'Donnell N, Whitman ED. Variations in time to receiving first surgical treatment for breast cancer as a function of racial/ethnic background: a cohort study. JRSM Open 2014; 5:2042533313515863. [PMID: 25057404 PMCID: PMC4100229 DOI: 10.1177/2042533313515863] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective To evaluate surgical treatment delay disparities by race/ethnic group in a group of breast cancer patients treated in the New York region. Design Cohort study. Setting Two affiliated hospitals in the New York region. Participants Patients admitted at two affiliated hospitals in the New York region for breast cancer treatment during 2007–2011. Main outcome measure Time to receiving first surgery for breast cancer, defined as the time in days between initial diagnosis (biopsy) and definitive surgical treatment (lumpectomy or mastectomy). Predicted time to first surgery by race group was also analysed using a multivariate linear regression model with adjustments made for several demographic and clinical factors. Results Totally, 3071 patients who were first treated with surgery were identified. Racial background was classified as White, African American or Asian/other. Overall median time to surgery was 28 days: 28 days in whites, and 34 and 29 days in African Americans and Asian/others, respectively (p = 0.032). Multivariate analyses showed that only African Americans, not Asian/others, had significantly increased surgical delay compared to whites (p = 0.019). Conclusions This study demonstrates significant racial differences in surgical delay in a group of breast cancer patients treated in the New York region. These differences may reflect tacit attitudes of medical providers or processes insensitive to patient educational needs. Additional studies may improve our understanding of this delay.
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Affiliation(s)
- Rami T Bustami
- Atlantic Center for Research, Atlantic Health System, Morristown, NJ 07962-1905, USA
| | - Daniel B Shulkin
- New York University Robert F. Wagner Graduate School of Public Service, New York, NY 10012, USA
| | - Nancy O'Donnell
- Cancer Registry, Morristown Medical Center, Atlantic Health System, Morristown, NJ 07962-1905, USA
| | - Eric D Whitman
- Atlantic Center for Research, Atlantic Health System, Morristown, NJ 07962-1905, USA ; Carol Simon Cancer Center, Atlantic Health System, Morristown, NJ 07962-1905, USA
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Li CY, Zhang S, Zhang XB, Wang P, Hou GF, Zhang J. Clinicopathological and prognostic characteristics of triple- negative breast cancer (TNBC) in Chinese patients: a retrospective study. Asian Pac J Cancer Prev 2014; 14:3779-84. [PMID: 23886182 DOI: 10.7314/apjcp.2013.14.6.3779] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
AIMS To determine the clinical, pathological and prognostic features associated with triple-negative breast cancer (TNBC). METHODS Clinical and histologic data of 21,749 breast cancer patients who were treated at Tianjin Medical University Cancer Institute and Hospital between July 2002 and December 2011 were collected. Patients were divided into two groups: those with TNBC and those with other types of breast cancer. Patients and tumor characteristics were compared between the two groups using the Chi-square test. The prognostic results of 9,823 patients in the study population were also analyzed to determine long-term survival rates in the two groups of breast cancer patients. RESULTS Among the breast cancer patients treated in our hospital between 2003 and 2011, 10.4%-13.5% of them had triple-negative breast cancers. Data analyses revealed significant differences in disease onset age, family history of breast cancer, tumor size, tumor histologic grade, lymph note positivity and metastatic status between TNBC and non-TNBC patients. There were also significant differences in 5-year, 7-year and 9-year disease-free and 7-year and 9-year overall survival probability between the groups. CONCLUSIONS TNBC are associated with younger disease onset age, larger tumor size, higher rate of axillary lymph node positivity, and higher tumor histologic grade. TNBC is also related to family history of breast cancer, increased metastatic risk and poor prognosis.
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Affiliation(s)
- Chun-Yan Li
- 3rd Department of Breast Cancer, China Tianjin Breast Cancer Prevention, Treatment and Research Center, Tianjin Medical University, Cancer Institute and Hospital, Tianjin, China
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Mungrue K, Ramdath J, Ali S, Cuffie WA, Dodough N, Gangar M, Mohammed L, Mungroo V, Ramsahai J, Shah M. Challenges to the control of breast cancer in a small developing country. Breast Cancer (Auckl) 2014; 8:7-13. [PMID: 24526837 PMCID: PMC3921156 DOI: 10.4137/bcbcr.s12780] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The aim of this study is to determine the clinicopathological features of breast cancer in two dedicated cancer treatment centers in north Trinidad. The histological types and stage at presentation were also investigated. DESIGN AND METHODS A retrospective cohort design was used; data were collected from a review of medical records of patients meeting the entry criteria. Clinical and demographic data were extracted. RESULTS A total of 640 patients were selected for the study and were available for the analysis. The annual cumulative incidence rate of breast cancer for the calendar years 2010 and 2011 in north Trinidad was 32.4 per 100,000 and 24.6 per 100,000 of the population. The age group between 51-60 years had the highest proportion of cases of breast cancer. There was a significant ethnic disparity in the occurrence of breast cancer, as it was more common in people of African origin than among South East Asians. Surgery and chemotherapy were the major interventions employed. CONCLUSION Breast cancer prevalence continues to be high in Trinidad; we provide evidence of the extent of and the degree of sophistication required to care for patients with breast cancer in a health care system in a small developing country.
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Affiliation(s)
- Kameel Mungrue
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
| | - Jeremy Ramdath
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
| | - Siddiq Ali
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
| | - Winsie-Ann Cuffie
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
| | - Nicholas Dodough
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
| | - Misty Gangar
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
| | - Laura Mohammed
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
| | - Vikash Mungroo
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
| | - Justin Ramsahai
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
| | - Mariyah Shah
- University of the West Indies, Faculty of Medical Sciences, Department of Paraclinical Sciences, EMWSC, Mount Hope, Trinidad
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Abstract
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data were collected by the National Center for Health Statistics. A total of 1,665,540 new cancer cases and 585,720 cancer deaths are projected to occur in the United States in 2014. During the most recent 5 years for which there are data (2006-2010), delay-adjusted cancer incidence rates declined slightly in men (by 0.6% per year) and were stable in women, while cancer death rates decreased by 1.8% per year in men and by 1.4% per year in women. The combined cancer death rate (deaths per 100,000 population) has been continuously declining for 2 decades, from a peak of 215.1 in 1991 to 171.8 in 2010. This 20% decline translates to the avoidance of approximately 1,340,400 cancer deaths (952,700 among men and 387,700 among women) during this time period. The magnitude of the decline in cancer death rates from 1991 to 2010 varies substantially by age, race, and sex, ranging from no decline among white women aged 80 years and older to a 55% decline among black men aged 40 years to 49 years. Notably, black men experienced the largest drop within every 10-year age group. Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population.
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Affiliation(s)
- Rebecca Siegel
- Director, Surveillance Information, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
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Poum A, Promthet S, Duffy SW, Parkin DM. Factors associated with delayed diagnosis of breast cancer in northeast Thailand. J Epidemiol 2013; 24:102-8. [PMID: 24335087 PMCID: PMC3983282 DOI: 10.2188/jea.je20130090] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 09/17/2013] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND We identified factors associated with delayed first consultation for breast symptoms (patient delay), delayed diagnosis after first consultation (doctor delay), and advanced pathologic stage at presentation among 180 women with breast cancer in Thailand. METHODS In this cross-sectional study 180 patients with invasive breast cancer were interviewed about potential risk factors and markers of delayed presentation. Patient delay was defined as time from onset of symptoms to first consultation with a health care provider, and doctor delay was defined as time from first consultation with a health care provider to diagnosis of breast cancer. Linear regression and logistic regression were used for the data analyses. RESULTS Among the 180 patients, 17% delayed seeking consultation for longer than 3 months, and 42% reported a doctor delay of longer than 3 months. In multivariate linear analysis, a significant increase in patient delay was associated with higher family income and smoking; factors associated with increased doctor delay were previous breast symptoms, self-treatment, and travel time to the hospital. In multiple logistic regression, doctor delay was related to age at first birth (P = 0.003), previous breast symptoms (P = 0.01), and number of consultations with a surgeon before diagnosis (P = 0.007). Regarding stage of breast cancer, there were significant associations with age at diagnosis (P for trend = 0.04), education (P for trend = 0.01), family income (P for trend = 0.02), time to referral (P = 0.01), and number of consultations with a surgeon before diagnosis (P < 0.01). CONCLUSIONS Hospital referral from a health care provider was a major contributor to delayed diagnosis. Breast cancer awareness campaigns in Thailand should target individuals in low- and high-income groups, as well as practitioners.
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Affiliation(s)
- Amornsak Poum
- Graduate School, Khon Kaen University, Khon Kaen, Thailand
| | - Supannee Promthet
- Department of Epidemiology, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Stephen W Duffy
- Centre for Cancer Prevention, Wolfson Institute for Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Donald Maxwell Parkin
- Centre for Cancer Prevention, Wolfson Institute for Preventive Medicine, Queen Mary University of London, London, United Kingdom
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Granado MN, Guell C, Hambleton IR, Hennis AJ, Rose AM. Exploring breast cancer screening barriers among Barbadian women: a focus group study of mammography in a resource-constrained setting. CRITICAL PUBLIC HEALTH 2013. [DOI: 10.1080/09581596.2013.855704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Reproductive factors and risk of premenopausal breast cancer by age at diagnosis: are there differences before and after age 40? Breast Cancer Res Treat 2013; 142:165-75. [PMID: 24136668 DOI: 10.1007/s10549-013-2721-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 09/30/2013] [Indexed: 01/28/2023]
Abstract
We examined the relationship between reproductive factors and risk of premenopausal breast cancer among women less than age 40 compared with older premenopausal women. We documented 374 incident cases of breast cancer diagnosed before age 40, and 2,533 cases diagnosed at age 40 and older among premenopausal women in the Nurses' Health Study cohorts. Biennial questionnaires were used to determine age at menarche, age at first birth, parity, breastfeeding, and other reproductive factors. Multivariate relative risks (RR) and 95 % confidence intervals (CI) were calculated using Cox proportional hazards models within age at diagnosis groups. Tumors in younger women were significantly more likely to be higher grade, larger size, and hormone receptor negative than were tumors in older premenopausal women (p < 0.0001). There was no significant heterogeneity according to age in associations between reproductive factors and risk of premenopausal breast cancer. First birth at age 30 or older increased breast cancer risk in both age groups (age <40: RR 1.10, 95 % CI 0.80-1.50; age ≥ 40: RR 1.16, 95 % CI 1.02-1.32; p-heterogeneity = 0.44). Risk of premenopausal breast cancer decreased with each additional year of age at menarche in both age groups (age <40: RR 0.93, 95 % CI 0.87-0.99; p trend = 0.02; age ≥ 40: RR 0.94, 95 % CI 0.91-0.97; p trend = <0.0001). Among premenopausal parous women, breastfeeding was protective regardless of age at diagnosis (age <40: RR 0.84, 95 % CI 0.57-1.22; age ≥ 40: RR 0.85, 95 % CI 0.72-0.99; p-heterogeneity = 0.79). In the largest prospective examination of reproductive risk factors and risk of breast cancer before and after age 40, we found that younger women were more likely to develop tumors with less favorable prognostic characteristics. However, associations between reproductive factors and risk of breast cancer were similar regardless of age at diagnosis of premenopausal breast cancer.
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Chung S, Park SK, Sung H, Song N, Han W, Noh DY, Ahn SH, Yoo KY, Choi JY, Kang D. Association between chronological change of reproductive factors and breast cancer risk defined by hormone receptor status: results from the Seoul Breast Cancer Study. Breast Cancer Res Treat 2013; 140:557-65. [PMID: 23901017 DOI: 10.1007/s10549-013-2645-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 07/17/2013] [Indexed: 10/26/2022]
Abstract
Lifestyle factors have been chronologically changed into western style ones, which could result in the rapid increase of breast cancer incidence in Korea. It is plausible that reproductive factors through hormonal mechanisms are differentially related to the risk of breast cancer subtypes. We investigated the association of reproductive risk factors on breast cancer by birth year groups and also evaluated the differential associations on the hormone receptor-defined subtypes. Using the data from the Seoul Breast Cancer Study (SeBCS), a multicenter case-control study, 3,332 breast cancer patients and 3,620 control subjects were analyzed. The distribution of subtypes among cases was as follows: 61.0 % estrogen receptor (ER)-positive, 51.9 % progesterone receptor (PR)-positive, and 43.4 % both ER/PR-positive status, respectively. Polytomous logistic regression and Wald tests for heterogeneity have been used across the subtypes. The frequencies of reproductive-related risk factors including early age at menarche, nulligravid, age at first full-term pregnancy (FFTP), duration of estrogen exposure before FFTP (EEBF), less number of children, never breastfeeding, and short duration of breastfeeding has increased as women were born later in both cases and controls, respectively (p trend < 0.0001. Among breast cancer patients, either ER- or PR-positive subtypes were increased in women born in 1960s compared to women born in 1940s. Early age at menarche increased the risk of breast cancer regardless of the subtypes while nulligravid, late age at FFTP, and longer duration of EEBP were associated with hormone receptor-positive cancer risk only (p heterogeneity < 0.05), which associations were stronger among women born later. Our results suggest that the associations of age at menarche, parity, age at FFTP, and duration of EEBF with breast cancer risk were different based on the hormone receptor status and birth year groups in Korea.
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Affiliation(s)
- Seokang Chung
- Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehakro, Jongno-gu, Seoul 110-799,Korea.
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Pérez-Mayoral J, Pacheco-Torres AL, Morales L, Acosta-Rodríguez H, Matta JL, Dutil J. Genetic polymorphisms in RAD23B and XPC modulate DNA repair capacity and breast cancer risk in Puerto Rican women. Mol Carcinog 2013; 52 Suppl 1:E127-38. [PMID: 23776089 DOI: 10.1002/mc.22056] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 04/26/2013] [Accepted: 05/03/2013] [Indexed: 12/18/2022]
Abstract
Studies have shown that DNA repair capacity (DRC) is significantly decreased in breast cancer patients, but the molecular causes of inter-individual variation in DRC are unknown. We hypothesized that genetic variation in the nucleotide excision repair pathway genes can modulate DRC and breast cancer risk in Puerto Rican women. A total of 228 breast cancer cases and 418 controls were recruited throughout Puerto Rico. For all study participants, eight single nucleotide polymorphisms (SNPs) in the genes XPC, XPD, and RAD23B were genotyped using a TaqMan PCR, and the DRC levels of UV induced-DNA damage was measured in peripheral lymphocytes using a host cell reactivation assay. After adjustment for confounders, RAD23B rs1805329 (Ala249Val) was found to be significantly associated with breast cancer risk under all models tested (P < 0.001). There was also a significant association between breast cancer risk and RAD23B rs10739234 (intronic) under the recessive model (P = 0.003, OR: 2.72, 95% CI: 1.40-5.30). In cases, there was a statistically significant difference in mean DRC per genotype for RAD23B rs1805329 (P < 0.001) and XPC rs2607775 (P = 0.002). When we modeled the combined effect of multiple SNPs that each independently affected DRC on cancer risk, we observed incremental augmentations in risk with increasing number of risk genotypes at those loci (P overall model <0.001). The increase in adverse genotypes was also correlated with a progressive decrease in DRC values. Our data indicate an additive effect of the NER SNPs on DRC and breast cancer risk in Puerto Rican women.
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Affiliation(s)
- Julyann Pérez-Mayoral
- Department of Biochemistry, Ponce School of Medicine and Health Sciences, Ponce, Puerto Rico
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Manning MA, Duric N, Littrup P, Bey-Knight L, Penner L, Albrecht TL. Knowledge of breast density and awareness of related breast cancer risk. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:270-4. [PMID: 23467999 PMCID: PMC3794460 DOI: 10.1007/s13187-013-0457-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Little is known about women's knowledge of breast density or between-race differences in this knowledge. In the current study, we examined knowledge of breast density and awareness of its role as a breast cancer risk factor among women who had previously taken part in a breast imaging study. Seventy-seven women (54.5 % Black) returned a survey assessing perceptions and accuracy of breast density knowledge, knowledge of one's own breast density, and breast cancer risk awareness. White women had greater perceived knowledge of breast density compared to Black women; however, differences in the accuracy of definitions of breast density were due to education. Black women were less likely to know how dense their own breasts were. Black and White women both lacked awareness that having dense breast increased breast cancer risk. The results highlight the need to disseminate information regarding breast density to women, while ensuring that the information is equally accessible to both Black and White women.
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Affiliation(s)
- Mark A Manning
- Department of Oncology, Karmanos Cancer Institute/Wayne State University School of Medicine, 4100 John R-MM03CB, Detroit, MI, 48201, USA.
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Cell Proliferation (KI-67) Expression Is Associated with Poorer Prognosis in Nigerian Compared to British Breast Cancer Women. ISRN ONCOLOGY 2013; 2013:675051. [PMID: 23691362 PMCID: PMC3649293 DOI: 10.1155/2013/675051] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 03/14/2013] [Indexed: 02/05/2023]
Abstract
Background. Black women with breast cancer (BC) in Nigeria have higher mortality rate compared with British women. This study investigated prognostic features of cell proliferation biomarker (Ki-67) in Nigerian breast cancer women. Materials and Methods. The protein expression of Ki-67 was investigated in series of 308 Nigerian women, prepared as a tissue microarray (TMA), using immunohistochemistry. Clinic-pathological parameters, biomarkers, and patient outcome of tumours expressing Ki-67 in Nigerian women were correlated with UK grade-matched series. Results. A significantly larger proportion of breast tumours from Nigerian women showed high Ki-67 expression. Those tumours were significantly correlated with negative expression of the steroid hormone receptors (ER and PgR), p21, p27, E-cadherin, BRCA-1, and Bcl-2 (all P < 0.001), but positively associated with EGFR (P = 0.003), p53, basal cytokeratins: CK56, CK14, triple negative, and basal phenotype using Nielsen's classification (all P < 0.001) compared to UK women. Multivariate analyses showed that race was also associated with BCSS independent of tumour size, lymph node status, and ER status. Conclusion. Ki-67 expression was observed to have contributed to the difference in the BCSS in Nigerian compared with British BC women. Therefore, targeting Ki-67 in the indigenous black women with BC might improve the patient outcome in the black women with BC.
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Warner ET, Tamimi RM, Boggs DA, Rosner B, Rosenberg L, Colditz GA, Palmer JR. Estrogen receptor positive tumors: do reproductive factors explain differences in incidence between black and white women? Cancer Causes Control 2013; 24:731-9. [PMID: 23380944 PMCID: PMC3602276 DOI: 10.1007/s10552-013-0153-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 01/15/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE The incidence of estrogen receptor positive (ER+) breast cancer is higher among white women relative to black women. In two large prospective cohorts, the Black Women's Health Study (BWHS) and the Nurses' Health Study II (NHSII), we investigated whether reproductive factors explain the difference. METHODS During 1,582,083 person-years of follow-up of 140,914 women observed from 1995 to 2007, 327 ER+ breast cancers were identified among black women in BWHS and NHSII and 1,179 among white women in NHSII. Cox proportional hazards regression models, stratified by race and pooled, were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for the association of race, parity, age at first birth, and lactation in relation to risk of ER+ cancer with adjustment for age and other breast cancer risk factors. RESULTS Age at first birth differed markedly in the two groups, with 66 % of parous black women having their first child before age 25 as compared with 36 % of white women. Each additional year of age at first birth was associated with a 4 % increased risk of ER+ breast cancer among both racial groups. Relative to nulliparous women, parous women were at decreased risk of ER+ breast cancer (HR 0.59, 95 % CI 0.20, 1.77), in black women and (HR 0.63, 95 % CI 0.45, 0.87) in white women. The HR for the association of black race with ER+ cancer was 0.67 (95 % CI 0.53, 0.84) in a model that adjusted for age only, 0.77 (95 % CI 0.61, 0.99) in a model that controlled for parity, age at first birth, and other reproductive/hormonal factors, and 0.83 (95 % CI 0.70, 0.98) in a model that additionally controlled for other breast cancer risk factors such as alcohol consumption and use of hormone supplements. Similar associations were seen among premenopausal women and in an analysis restricted to ER+PR+ tumors. CONCLUSIONS Reproductive factors explained some of the higher incidence of ER+ tumors among white women as compared to black women.
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Affiliation(s)
- Erica T Warner
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
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