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Harvey SV, Wentzensen N, Bertrand K, Black A, Brinton LA, Chen C, Costas L, Dal Maso L, De Vivo I, Du M, Garcia-Closas M, Goodman MT, Gorzelitz J, Johnson L, Lacey JV, Liao L, Lipworth L, Lissowska J, Miller AB, O'Connell K, O'Mara TA, Ou X, Palmer JR, Patel AV, Paytubi S, Pelegrina B, Petruzella S, Prizment A, Rohan T, Sandin S, Setiawan VW, Sinha R, Trabert B, Webb PM, Wilkens LR, Xu W, Yang HP, Zheng W, Clarke MA. Associations of life course obesity with endometrial cancer in the Epidemiology of Endometrial Cancer Consortium (E2C2). Int J Epidemiol 2023:7111259. [PMID: 37029916 PMCID: PMC10396409 DOI: 10.1093/ije/dyad046] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 04/04/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Adult obesity is a strong risk factor for endometrial cancer (EC); however, associations of early life obesity with EC are inconclusive. We evaluated associations of young adulthood (18-21 years) and adulthood (at enrolment) body mass index (BMI) and weight change with EC risk in the Epidemiology of Endometrial Cancer Consortium (E2C2). METHODS We pooled data from nine case-control and 11 cohort studies in E2C2. We performed multivariable logistic regression analyses to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for BMI (kg/m2) in young adulthood and adulthood, with adjustment for BMI in adulthood and young adulthood, respectively. We evaluated categorical changes in weight (5-kg increments) and BMI from young adulthood to adulthood, and stratified analyses by histology, menopausal status, race and ethnicity, hormone replacement therapy (HRT) use and diabetes. RESULTS We included 14 859 cases and 40 859 controls. Obesity in adulthood (OR = 2.85, 95% CI = 2.47-3.29) and young adulthood (OR = 1.26, 95% CI = 1.06-1.50) were positively associated with EC risk. Weight gain and BMI gain were positively associated with EC; weight loss was inversely associated with EC. Young adulthood obesity was more strongly associated with EC among cases diagnosed with endometrioid histology, those who were pre/perimenopausal, non-Hispanic White and non-Hispanic Black, among never HRT users and non-diabetics. CONCLUSIONS Young adulthood obesity is associated with EC risk, even after accounting for BMI in adulthood. Weight gain is also associated with EC risk, whereas weight loss is inversely associated. Achieving and maintaining a healthy weight over the life course is important for EC prevention efforts.
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Affiliation(s)
- Summer V Harvey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Amanda Black
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Chu Chen
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Laura Costas
- Cancer Epidemiology Research Programme IDIBELL, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico, Aviano, Italy
| | - Immaculata De Vivo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Mengmeng Du
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Marc T Goodman
- Cedars-Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jessica Gorzelitz
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Lisa Johnson
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - James V Lacey
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Linda Liao
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Loren Lipworth
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kelli O'Connell
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tracy A O'Mara
- Cancer Research Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Xiao Ou
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Julie R Palmer
- Slone Epidemiology Center, at Boston University, Boston, MA, USA
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Sonia Paytubi
- Cancer Epidemiology Research Programme IDIBELL, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
| | - Beatriz Pelegrina
- Cancer Epidemiology Research Programme IDIBELL, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Stacey Petruzella
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anna Prizment
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Veronica Wendy Setiawan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Wanghong Xu
- Department of Epidemiology, Fudan University School of Public Health, Shanghai, China
| | - Hannah P Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Megan A Clarke
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Héroux P, Belyaev I, Chamberlin K, Dasdag S, De Salles AAA, Rodriguez CEF, Hardell L, Kelley E, Kesari KK, Mallery-Blythe E, Melnick RL, Miller AB, Moskowitz JM. Cell Phone Radiation Exposure Limits and Engineering Solutions. Int J Environ Res Public Health 2023; 20:5398. [PMID: 37048013 PMCID: PMC10094704 DOI: 10.3390/ijerph20075398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/17/2023] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
In the 1990s, the Institute of Electrical and Electronics Engineers (IEEE) restricted its risk assessment for human exposure to radiofrequency radiation (RFR) in seven ways: (1) Inappropriate focus on heat, ignoring sub-thermal effects. (2) Reliance on exposure experiments performed over very short times. (3) Overlooking time/amplitude characteristics of RFR signals. (4) Ignoring carcinogenicity, hypersensitivity, and other health conditions connected with RFR. (5) Measuring cellphone Specific Absorption Rates (SAR) at arbitrary distances from the head. (6) Averaging SAR doses at volumetric/mass scales irrelevant to health. (7) Using unrealistic simulations for cell phone SAR estimations. Low-cost software and hardware modifications are proposed here for cellular phone RFR exposure mitigation: (1) inhibiting RFR emissions in contact with the body, (2) use of antenna patterns reducing the Percent of Power absorbed in the Head (PPHead) and body and increasing the Percent of Power Radiated for communications (PPR), and (3) automated protocol-based reductions of the number of RFR emissions, their duration, or integrated dose. These inexpensive measures do not fundamentally alter cell phone functions or communications quality. A health threat is scientifically documented at many levels and acknowledged by industries. Yet mitigation of RFR exposures to users does not appear as a priority with most cell phone manufacturers.
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Affiliation(s)
- Paul Héroux
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC H3A 1G1, Canada
| | - Igor Belyaev
- Cancer Research Institute, Biomedical Research Center, Slovak Academy of Sciences, 814 38 Bratislava, Slovakia
| | - Kent Chamberlin
- Department of Electrical and Computer Engineering, University of New Hampshire, Durham, NH 03824, USA
| | - Suleyman Dasdag
- Biophysics Department, Medical School, Istanbul Medeniyet University, Istanbul 34700, Turkey
| | - Alvaro Augusto Almeida De Salles
- Graduate Program on Electrical Engineering (PPGEE), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre 90010-150, Brazil
| | | | - Lennart Hardell
- Department of Oncology, Orebro University Hospital, 701 85 Orebro, Sweden (Retired)
- The Environment and Cancer Research Foundation, 702 17 Orebro, Sweden
| | - Elizabeth Kelley
- ICBE-EMF and International EMF Scientist Appeal, and Electromagnetic Safety Alliance, Tempe, AZ 85282, USA
| | - Kavindra Kumar Kesari
- Department of Applied Physics, School of Science, Aalto University, 02150 Espoo, Finland
| | - Erica Mallery-Blythe
- Physicians’ Health Initiative for Radiation and Environment, East Sussex TN6, UK
- British Society of Ecological Medicine, London W1W 6DB, UK
- Oceania Radiofrequency Scientific Advisory Association, Scarborough, QLD 4020, Australia
| | - Ronald L. Melnick
- National Toxicology Program (Retired), National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC 27709, USA
- Ron Melnick Consulting LLC, North Logan, UT 84341, USA
| | - Anthony B. Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Joel M. Moskowitz
- School of Public Health, University of California, Berkeley, CA 94704, USA
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Yong JHE, Nadeau C, Flanagan WM, Coldman AJ, Asakawa K, Garner R, Fitzgerald N, Yaffe MJ, Miller AB. The OncoSim-Breast Cancer Microsimulation Model. Curr Oncol 2022; 29:1619-1633. [PMID: 35323336 PMCID: PMC8947518 DOI: 10.3390/curroncol29030136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 01/02/2023] Open
Abstract
Background: OncoSim-Breast is a Canadian breast cancer simulation model to evaluate breast cancer interventions. This paper aims to describe the OncoSim-Breast model and how well it reproduces observed breast cancer trends. Methods: The OncoSim-Breast model simulates the onset, growth, and spread of invasive and ductal carcinoma in situ tumours. It combines Canadian cancer incidence, mortality, screening program, and cost data to project population-level outcomes. Users can change the model input to answer specific questions. Here, we compared its projections with observed data. First, we compared the model’s projected breast cancer trends with the observed data in the Canadian Cancer Registry and from Vital Statistics. Next, we replicated a screening trial to compare the model’s projections with the trial’s observed screening effects. Results: OncoSim-Breast’s projected incidence, mortality, and stage distribution of breast cancer were close to the observed data in the Canadian Cancer Registry and from Vital Statistics. OncoSim-Breast also reproduced the breast cancer screening effects observed in the UK Age trial. Conclusions: OncoSim-Breast’s ability to reproduce the observed population-level breast cancer trends and the screening effects in a randomized trial increases the confidence of using its results to inform policy decisions related to early detection of breast cancer.
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Affiliation(s)
- Jean H. E. Yong
- Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada;
- Correspondence:
| | - Claude Nadeau
- Statistics Canada, Ottawa, ON K1A 0T6, Canada; (C.N.); (W.M.F.); (K.A.); (R.G.)
| | - William M. Flanagan
- Statistics Canada, Ottawa, ON K1A 0T6, Canada; (C.N.); (W.M.F.); (K.A.); (R.G.)
| | - Andrew J. Coldman
- British Columbia Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada;
| | - Keiko Asakawa
- Statistics Canada, Ottawa, ON K1A 0T6, Canada; (C.N.); (W.M.F.); (K.A.); (R.G.)
| | - Rochelle Garner
- Statistics Canada, Ottawa, ON K1A 0T6, Canada; (C.N.); (W.M.F.); (K.A.); (R.G.)
| | | | | | - Anthony B. Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada;
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4
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Miller AB, Murphy BA, Adams AA. Impact of blue light therapy on plasma adrenocorticotropic hormone (ACTH) and hypertrichosis in horses with pituitary pars intermedia dysfunction. Domest Anim Endocrinol 2022; 78:106651. [PMID: 34656964 DOI: 10.1016/j.domaniend.2021.106651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 06/30/2021] [Accepted: 07/21/2021] [Indexed: 11/19/2022]
Abstract
Blue light therapy can be used in horses to alter the natural photoperiod and inhibit winter hair coat growth. Seasonal increases in ACTH occur in the fall season but are exaggerated in horses with pituitary pars intermedia dysfunction (PPID). Additionally, PPID horses frequently present with hypertrichosis. Thus, blue light therapy was proposed as a potential management tool for hypertrichosis and for investigating the impact of photoperiod manipulation on ACTH. Eighteen PPID horses, aged 18 to 31 yr, from a university-owned research herd were selected and assigned to either the control group (n = 10) or the treatment (blue light therapy) group (n = 8) based on age and clinical history, which included the results of multiple endocrine tests. Consistent daylength of approximately 14.5 h was maintained for the treated horses from July 15 through approximately late October via the extension of natural daylength using wearable masks that provided short wavelength blue light (465 nm) to 1 eye. The control group was exposed to only the natural photoperiod during this time. All horses were housed on the same farm and remained on pasture for the duration of the study. On Day 0, thyrotropin-releasing hormone (TRH) stimulation tests were performed to confirm PPID status; there were no differences between the 2 groups in resting plasma ACTH or plasma ACTH at 10 min after TRH administration. To determine an effect of treatment on ACTH, blood was collected via jugular venipuncture for measurement of ACTH at sequential timepoints over a 16-h period in mid-October. Hair weights were also assessed throughout the study. No differences in resting plasma ACTH were observed between the 2 groups across the seasonal analysis (July and October) or during the 16-h testing. The PPID horses receiving blue light therapy had lighter hair weights compared to the PPID control horses. These results suggest that blue light therapy does not alter ACTH concentrations but could potentially be used as an additional management tool for hypertrichosis in PPID horses. Manipulation of the photoperiod using blue light therapy did not affect seasonal changes in ACTH in this study.
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Affiliation(s)
- A B Miller
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA.
| | - B A Murphy
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - A A Adams
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
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5
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Wu Y, Huang R, Wang M, Bernstein L, Bethea TN, Chen C, Chen Y, Eliassen AH, Freedman ND, Gaudet MM, Gierach GL, Giles GG, Krogh V, Larsson SC, Liao LM, McCullough ML, Miller AB, Milne RL, Monroe KR, Neuhouser ML, Palmer JR, Prizment A, Reynolds P, Robien K, Rohan TE, Sandin S, Sawada N, Sieri S, Sinha R, Stolzenberg-Solomon RZ, Tsugane S, van den Brandt PA, Visvanathan K, Weiderpass E, Wilkens LR, Willett WC, Wolk A, Zeleniuch-Jacquotte A, Ziegler RG, Smith-Warner SA. Dairy foods, calcium, and risk of breast cancer overall and for subtypes defined by estrogen receptor status: a pooled analysis of 21 cohort studies. Am J Clin Nutr 2021; 114:450-461. [PMID: 33964859 PMCID: PMC8326053 DOI: 10.1093/ajcn/nqab097] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/05/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Epidemiologic studies examining the relations between dairy product and calcium intakes and breast cancer have been inconclusive, especially for tumor subtypes. OBJECTIVE To evaluate the associations between intakes of specific dairy products and calcium and risk of breast cancer overall and for subtypes defined by estrogen receptor (ER) status. METHOD We pooled the individual-level data of over 1 million women who were followed for a maximum of 8-20 years across studies. Associations were evaluated for dairy product and calcium intakes and risk of incident invasive breast cancer overall (n = 37,861 cases) and by subtypes defined by ER status. Study-specific multivariable hazard ratios (HRs) were estimated and then combined using random-effects models. RESULTS Overall, no clear association was observed between the consumption of specific dairy foods, dietary (from foods only) calcium, and total (from foods and supplements) calcium, and risk of overall breast cancer. Although each dairy product showed a null or very weak inverse association with risk of overall breast cancer (P, test for trend >0.05 for all), differences by ER status were suggested for yogurt and cottage/ricotta cheese with associations observed for ER-negative tumors only (pooled HR = 0.90, 95% CI: 0.83, 0.98 comparing ≥60 g/d with <1 g/d of yogurt and 0.85, 95% CI: 0.76, 0.95 comparing ≥25 g/d with <1 g/d of cottage/ricotta cheese). Dietary calcium intake was only weakly associated with breast cancer risk (pooled HR = 0.98, 95% CI: 0.97, 0.99 per 350 mg/d). CONCLUSION Our study shows that adult dairy or calcium consumption is unlikely to associate with a higher risk of breast cancer and that higher yogurt and cottage/ricotta cheese intakes were inversely associated with the risk of ER-negative breast cancer, a less hormonally dependent subtype with poor prognosis. Future studies on fermented dairy products, earlier life exposures, ER-negative breast cancer, and different racial/ethnic populations may further elucidate the relation.
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Affiliation(s)
- You Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ruyi Huang
- Department of Medical Education, E-DA Hospital and School of Medicine for International Students, School of Medicine, I-SHOU University, Kaohsiung City, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Leslie Bernstein
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Traci N Bethea
- Slone Epidemiology Center at Boston University, Boston, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Chu Chen
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yu Chen
- Division of Epidemiology, Department of Population Health and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Mia M Gaudet
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Vittorio Krogh
- Epidemiology and Prevention Unit Department of Research, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Susanna C Larsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Marjorie L McCullough
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Kristine R Monroe
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Anna Prizment
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, Minneapolis, MN, USA
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Peggy Reynolds
- Department of Epidemiology and Biostatistics, University of California San Francisco, Berkeley, CA, USA
| | - Kim Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, WA, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment at Mount Sinai, New York, NY, USA
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Sabina Sieri
- Epidemiology and Prevention Unit Department of Research, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | | | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Piet A van den Brandt
- Department of Epidemiology, GROW–School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
- Department of Epidemiology, Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Alicja Wolk
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anne Zeleniuch-Jacquotte
- Division of Epidemiology, Department of Population Health and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephanie A Smith-Warner
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Belpomme D, Carlo GL, Irigaray P, Carpenter DO, Hardell L, Kundi M, Belyaev I, Havas M, Adlkofer F, Heuser G, Miller AB, Caccamo D, De Luca C, von Klitzing L, Pall ML, Bandara P, Stein Y, Sage C, Soffritti M, Davis D, Moskowitz JM, Mortazavi SMJ, Herbert MR, Moshammer H, Ledoigt G, Turner R, Tweedale A, Muñoz-Calero P, Udasin I, Koppel T, Burgio E, Vorst AV. The Critical Importance of Molecular Biomarkers and Imaging in the Study of Electrohypersensitivity. A Scientific Consensus International Report. Int J Mol Sci 2021; 22:7321. [PMID: 34298941 PMCID: PMC8304862 DOI: 10.3390/ijms22147321] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/23/2021] [Accepted: 06/26/2021] [Indexed: 02/07/2023] Open
Abstract
Clinical research aiming at objectively identifying and characterizing diseases via clinical observations and biological and radiological findings is a critical initial research step when establishing objective diagnostic criteria and treatments. Failure to first define such diagnostic criteria may lead research on pathogenesis and etiology to serious confounding biases and erroneous medical interpretations. This is particularly the case for electrohypersensitivity (EHS) and more particularly for the so-called "provocation tests", which do not investigate the causal origin of EHS but rather the EHS-associated particular environmental intolerance state with hypersensitivity to man-made electromagnetic fields (EMF). However, because those tests depend on multiple EMF-associated physical and biological parameters and have been conducted in patients without having first defined EHS objectively and/or endpoints adequately, they cannot presently be considered to be valid pathogenesis research methodologies. Consequently, the negative results obtained by these tests do not preclude a role of EMF exposure as a symptomatic trigger in EHS patients. Moreover, there is no proof that EHS symptoms or EHS itself are caused by psychosomatic or nocebo effects. This international consensus report pleads for the acknowledgement of EHS as a distinct neuropathological disorder and for its inclusion in the WHO International Classification of Diseases.
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Affiliation(s)
- Dominique Belpomme
- Association for Research Against Cancer (ARTAC), 57/59 rue de la Convention, 75015 Paris, France;
- European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium; (D.O.C.); (L.H.); (I.B.); (M.H.); (G.L.); (E.B.); (A.V.V.)
| | - George L. Carlo
- The Science and Public Policy Institute, Washington, DC 20006, USA;
| | - Philippe Irigaray
- Association for Research Against Cancer (ARTAC), 57/59 rue de la Convention, 75015 Paris, France;
- European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium; (D.O.C.); (L.H.); (I.B.); (M.H.); (G.L.); (E.B.); (A.V.V.)
| | - David O. Carpenter
- European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium; (D.O.C.); (L.H.); (I.B.); (M.H.); (G.L.); (E.B.); (A.V.V.)
- Institute for Health and the Environment, University at Albany, Albany, NY 12222, USA
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Lennart Hardell
- European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium; (D.O.C.); (L.H.); (I.B.); (M.H.); (G.L.); (E.B.); (A.V.V.)
- The Environment and Cancer Research Foundation, SE-702 17 Örebro, Sweden
| | - Michael Kundi
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria; (M.K.); (H.M.)
| | - Igor Belyaev
- European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium; (D.O.C.); (L.H.); (I.B.); (M.H.); (G.L.); (E.B.); (A.V.V.)
- Biomedical Research Center, Slovak Academy of Science, 845 05 Bratislava, Slovakia
| | - Magda Havas
- European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium; (D.O.C.); (L.H.); (I.B.); (M.H.); (G.L.); (E.B.); (A.V.V.)
- Trent School of the Environment, Trent University, 1600 West Bank Drive, Peterborough, ON K9J 0G2, Canada
| | - Franz Adlkofer
- Verum-Foundation for Behaviour and Environment c/o Regus Center Josephspitalstrasse 15/IV, 80331 München, Germany;
| | - Gunnar Heuser
- Formerly UCLA Medical Center, Department of Medicine, P.O. Box 5066, El Dorado Hills, Los Angeles, CA 95762, USA;
| | - Anthony B. Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S, Canada;
| | - Daniela Caccamo
- Department of Biomedical Sciences, Dental Sciences and Morpho Functional Imaging, Polyclinic Hospital University, 98122 Messina, Italy;
| | - Chiara De Luca
- Department of Registration & Quality Management, Medical & Regulatory Affairs Manager, MEDENA AG, 8910 Affoltern am Albis, Switzerland;
| | - Lebrecht von Klitzing
- Medical Physicist, Institute of Environmental and Medical Physic, D-36466 Wiesenthal, Germany;
| | - Martin L. Pall
- School of Molecular Biosciences, Washington State University, Pullman, WA 99164, USA;
| | - Priyanka Bandara
- Oceania Radiofrequency Scientific Advisory Association (ORSAA), P.O. Box 152, Scarborough, QLD 4020, Australia;
| | - Yael Stein
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91905, Israel;
- Hadassah Medical Center, Department of Anesthesiology, Critical Care and Pain Medicine, Jerusalem 91905, Israel
| | - Cindy Sage
- Sage Associates, Montecito, Santa Barbara, CA 93108, USA;
| | - Morando Soffritti
- Istituto Ramazzini, via Libia 13/A, 40138 Bologna, Italy;
- Collegium Ramazzini, Castello di Bentivoglio, via Saliceto, 3, 40010 Bentivoglio, Italy
| | - Devra Davis
- Environmental Health Trust, P.O. Box 58, Teton Village, WY 83025, USA;
| | - Joel M. Moskowitz
- School of Public Health, University of California, Berkeley, CA 94720, USA;
| | - S. M. J. Mortazavi
- Medical Physics and Medical Engineering Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz P.O. Box 71348-14336, Iran;
- Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences, Shiraz P.O. Box 71348-14336, Iran
| | - Martha R. Herbert
- A.A. Martinos Centre for Biomedical Imaging, Department of Neurology, MGH, Harvard Medical School, MGH/MIT/Harvard 149 Thirteenth Street, Charlestown, MA 02129, USA;
| | - Hanns Moshammer
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria; (M.K.); (H.M.)
- Department of Hygiene, Karakalpak Medical University, Nukus 230100, Uzbekistan
| | - Gerard Ledoigt
- European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium; (D.O.C.); (L.H.); (I.B.); (M.H.); (G.L.); (E.B.); (A.V.V.)
| | - Robert Turner
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA;
- Clinical Pediatrics and Neurology, School of Medicine, University of South Carolina, Columbia, SC 29209, USA
| | - Anthony Tweedale
- Rebutting Industry Science with Knowledge (R.I.S.K.) Consultancy, Blv. Edmond Machtens 101/34, B-1080 Brussels, Belgium;
| | - Pilar Muñoz-Calero
- Foundation Alborada, Finca el Olivar, Carretera M-600, Km. 32,400, 28690 Brunete, Spain;
| | - Iris Udasin
- EOHSI Clinical Center, School of Public Health, Rutgers University, Piscataway, NJ 08854, USA;
| | - Tarmo Koppel
- AI Institute, University of South Carolina, Columbia, SC 29208, USA;
| | - Ernesto Burgio
- European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium; (D.O.C.); (L.H.); (I.B.); (M.H.); (G.L.); (E.B.); (A.V.V.)
| | - André Vander Vorst
- European Cancer and Environment Research Institute (ECERI), 1000 Brussels, Belgium; (D.O.C.); (L.H.); (I.B.); (M.H.); (G.L.); (E.B.); (A.V.V.)
- European Microwave Association, Rue Louis de Geer 6, B-1348 Louvain-la-Neuve, Belgium
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7
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Ruan Y, Poirier AE, Pader J, Asakawa K, Lu C, Memon S, Miller AB, Walter SD, Villeneuve PJ, King WD, Volesky KD, Smith L, De P, Friedenreich CM, Brenner DR. Estimating the future cancer management costs attributable to modifiable risk factors in Canada. Can J Public Health 2021; 112:1083-1092. [PMID: 34036521 DOI: 10.17269/s41997-021-00502-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 02/23/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES An estimated 33-37% of incident cancers in Canada are attributable to modifiable risk factors. Interventions targeting these risk factors would minimize the substantial health and economic burdens Canadians face due to cancer. We estimate the future health and economic burden of cancer in Canada by incorporating data from the Canadian Population Attributable Risk of Cancer (ComPARe) study into OncoSim, a web-based microsimulation tool. METHODS Using the integrated OncoSim population attributable risk and population impact measures, we evaluated risk factor-targeted intervention scenarios implemented in 2020, assuming the targeted risk factor prevalence reduction would be achieved by 2032 with a 12-year latency period. RESULTS We estimate that smoking will be the largest contributor to cancer-related costs, with a cost of CAD $44.4 billion between 2032 and 2044. An estimated CAD $3.3 billion of the cost could be avoided with a 30% reduction in smoking prevalence by 2022. Following smoking, the next highest cancer management costs are associated with inadequate physical activity and excess body weight, accounting for CAD $10.7 billion ($2.7 billion avoidable) and CAD $9.8 billion ($3.2 billion avoidable), respectively. Avoidable costs for other risk factors range from CAD $90 million to CAD $2.5 billion. CONCLUSION Interventions targeting modifiable cancer risk factors could prevent a substantial number of incident cancer cases and billions of dollars in cancer management costs. With limited budgets and rising costs in cancer care in Canada, these simulation models and results are valuable for researchers and policymakers to inform decisions and prioritize and evaluate intervention programs.
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Affiliation(s)
- Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, T2S 3C3, Canada
| | - Abbey E Poirier
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, T2S 3C3, Canada
| | - Joy Pader
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, T2S 3C3, Canada
| | | | - Chaohui Lu
- Statistics Canada, Ottawa, Ontario, Canada
| | - Saima Memon
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada
| | - Anthony B Miller
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Stephen D Walter
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Will D King
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Karena D Volesky
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Leah Smith
- Canadian Cancer Society, Toronto, Ontario, Canada
| | | | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, T2S 3C3, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, T2S 3C3, Canada. .,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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8
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Jordan SJ, Na R, Weiderpass E, Adami HO, Anderson KE, van den Brandt PA, Brinton LA, Chen C, Cook LS, Doherty JA, Du M, Friedenreich CM, Gierach GL, Goodman MT, Krogh V, Levi F, Lu L, Miller AB, McCann SE, Moysich KB, Negri E, Olson SH, Petruzella S, Palmer JR, Parazzini F, Pike MC, Prizment AE, Rebbeck TR, Reynolds P, Ricceri F, Risch HA, Rohan TE, Sacerdote C, Schouten LJ, Serraino D, Setiawan VW, Shu XO, Sponholtz TR, Spurdle AB, Stolzenberg-Solomon RZ, Trabert B, Wentzensen N, Wilkens LR, Wise LA, Yu H, La Vecchia C, De Vivo I, Xu W, Zeleniuch-Jacquotte A, Webb PM. Pregnancy outcomes and risk of endometrial cancer: A pooled analysis of individual participant data in the Epidemiology of Endometrial Cancer Consortium. Int J Cancer 2021; 148:2068-2078. [PMID: 33105052 PMCID: PMC7969437 DOI: 10.1002/ijc.33360] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/27/2020] [Accepted: 10/01/2020] [Indexed: 12/20/2022]
Abstract
A full-term pregnancy is associated with reduced endometrial cancer risk; however, whether the effect of additional pregnancies is independent of age at last pregnancy is unknown. The associations between other pregnancy-related factors and endometrial cancer risk are less clear. We pooled individual participant data from 11 cohort and 19 case-control studies participating in the Epidemiology of Endometrial Cancer Consortium (E2C2) including 16 986 women with endometrial cancer and 39 538 control women. We used one- and two-stage meta-analytic approaches to estimate pooled odds ratios (ORs) for the association between exposures and endometrial cancer risk. Ever having a full-term pregnancy was associated with a 41% reduction in risk of endometrial cancer compared to never having a full-term pregnancy (OR = 0.59, 95% confidence interval [CI] 0.56-0.63). The risk reduction appeared the greatest for the first full-term pregnancy (OR = 0.78, 95% CI 0.72-0.84), with a further ~15% reduction per pregnancy up to eight pregnancies (OR = 0.20, 95% CI 0.14-0.28) that was independent of age at last full-term pregnancy. Incomplete pregnancy was also associated with decreased endometrial cancer risk (7%-9% reduction per pregnancy). Twin births appeared to have the same effect as singleton pregnancies. Our pooled analysis shows that, while the magnitude of the risk reduction is greater for a full-term pregnancy than an incomplete pregnancy, each additional pregnancy is associated with further reduction in endometrial cancer risk, independent of age at last full-term pregnancy. These results suggest that the very high progesterone level in the last trimester of pregnancy is not the sole explanation for the protective effect of pregnancy.
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Affiliation(s)
- Susan J Jordan
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Renhua Na
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Elisabete Weiderpass
- Director's Office, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Kristin E Anderson
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
- Screening, Prevention, Etiology and Cancer Survivorship Program, University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota, USA
| | - Piet A van den Brandt
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Chu Chen
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Linda S Cook
- Division of Epidemiology, Biostatistics & Preventive Medicine, Department of Internal Medicine, NM Health Sciences Center, University of New Mexico, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jennifer A Doherty
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Mengmeng Du
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gretchen L Gierach
- Integrative Tumor Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Marc T Goodman
- Cancer Prevention and Control Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Fabio Levi
- Department of Epidemiology and Health Services Research, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Lingeng Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Anthony B Miller
- Epidemiology Division, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Susan E McCann
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Sara H Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Stacey Petruzella
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston, Massachusetts, USA
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Department of Obstetrics and Gynaecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Malcolm C Pike
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Anna E Prizment
- Screening, Prevention, Etiology and Cancer Survivorship Program, University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota, USA
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota, USA
| | - Timothy R Rebbeck
- Division of Population Science, Dana-Farber Cancer Institute and Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Peggy Reynolds
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Leo J Schouten
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Veronica W Setiawan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Todd R Sponholtz
- Slone Epidemiology Center at Boston University, Boston, Massachusetts, USA
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Amanda B Spurdle
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Genetics and Computational Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Rachael Z Stolzenberg-Solomon
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Britton Trabert
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, Clinical Genetics Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Herbert Yu
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Immaculata De Vivo
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Wanghong Xu
- Department of Epidemiology, Fudan University School of Public Health, Shanghai, China
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health and Perlmutter Cancer Center, New York University Langone Health, New York, New York, USA
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
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9
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van den Brandt PA, Ziegler RG, Wang M, Hou T, Li R, Adami HO, Agnoli C, Bernstein L, Buring JE, Chen Y, Connor AE, Eliassen AH, Genkinger JM, Gierach G, Giles GG, Goodman GG, Håkansson N, Krogh V, Le Marchand L, Lee IM, Liao LM, Martinez ME, Miller AB, Milne RL, Neuhouser ML, Patel AV, Prizment A, Robien K, Rohan TE, Sawada N, Schouten LJ, Sinha R, Stolzenberg-Solomon RZ, Teras LR, Tsugane S, Visvanathan K, Weiderpass E, White KK, Willett WC, Wolk A, Zeleniuch-Jacquotte A, Smith-Warner SA. Body size and weight change over adulthood and risk of breast cancer by menopausal and hormone receptor status: a pooled analysis of 20 prospective cohort studies. Eur J Epidemiol 2021; 36:37-55. [PMID: 33128203 PMCID: PMC7847460 DOI: 10.1007/s10654-020-00688-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/26/2020] [Indexed: 12/21/2022]
Abstract
Associations between anthropometric factors and breast cancer (BC) risk have varied inconsistently by estrogen and/or progesterone receptor (ER/PR) status. Associations between prediagnostic anthropometric factors and risk of premenopausal and postmenopausal BC overall and ER/PR status subtypes were investigated in a pooled analysis of 20 prospective cohorts, including 36,297 BC cases among 1,061,915 women, using multivariable Cox regression analyses, controlling for reproductive factors, diet and other risk factors. We estimated dose-response relationships and tested for nonlinear associations using restricted cubic splines. Height showed positive, linear associations for premenopausal and postmenopausal BC risk (6-7% RR increase per 5 cm increment), with stronger associations for receptor-positive subtypes. Body mass index (BMI) at cohort baseline was strongly inversely associated with premenopausal BC risk, and strongly positively-and nonlinearly-associated with postmenopausal BC (especially among women who never used hormone replacement therapy). This was primarily observed for receptor-positive subtypes. Early adult BMI (at 18-20 years) showed inverse, linear associations for premenopausal and postmenopausal BC risk (21% and 11% RR decrease per 5 kg/m2, respectively) with stronger associations for receptor-negative subtypes. Adult weight gain since 18-20 years was positively associated with postmenopausal BC risk, stronger for receptor-positive subtypes, and among women who were leaner in early adulthood. Women heavier in early adulthood generally had reduced premenopausal BC risk, independent of later weight gain. Positive associations between height, baseline (adult) BMI, adult weight gain and postmenopausal BC risk were substantially stronger for hormone receptor-positive versus negative subtypes. Premenopausal BC risk was positively associated with height, but inversely with baseline BMI and weight gain (mostly in receptor-positive subtypes). Inverse associations with early adult BMI seemed stronger in receptor-negative subtypes of premenopausal and postmenopausal BC.
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Affiliation(s)
- Piet A van den Brandt
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
- Department of Epidemiology, Care and Public Health Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Tao Hou
- Department of Nutrition, Harvard T.H Chan School of Public Health, Boston, MA, USA
| | - Ruifeng Li
- Department of Nutrition, Harvard T.H Chan School of Public Health, Boston, MA, USA
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Clinical Effectiveness Group, Institute of Health, University of Oslo, Oslo, Norway
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Department of Research, Fondazione Istituto Nazionale Tumori, 20133, Milan, Italy
| | - Leslie Bernstein
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Julie E Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yu Chen
- Division of Epidemiology, Department of Population Health and Department of Environmental Medicine, New York University School of Medicine, New York, USA
| | - Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jeanine M Genkinger
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Gretchen Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Gary G Goodman
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Niclas Håkansson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Research, Fondazione Istituto Nazionale Tumori, 20133, Milan, Italy
| | - Loic Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - M Elena Martinez
- Department of Family Medicine and Public Health School of Medicine, University of California San Diego, La Jolla, CA, USA
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Alpa V Patel
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Anna Prizment
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, Minneapolis, MN, USA
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kim Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA
| | - Norie Sawada
- Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Leo J Schouten
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rachael Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lauren R Teras
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Kami K White
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H Chan School of Public Health, Boston, MA, USA
| | - Alicja Wolk
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Anne Zeleniuch-Jacquotte
- Division of Epidemiology, Department of Population Health and Department of Environmental Medicine, New York University School of Medicine, New York, USA
| | - Stephanie A Smith-Warner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H Chan School of Public Health, Boston, MA, USA
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10
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Miller AB, Loynachan AT, Bush HM, Hart KA, Barker VD, Campana-Emard AG, Grubbs ST, Adams AA. Effects of pituitary pars intermedia dysfunction and Prascend (pergolide tablets) treatment on endocrine and immune function in horses. Domest Anim Endocrinol 2021; 74:106531. [PMID: 32942194 DOI: 10.1016/j.domaniend.2020.106531] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/19/2020] [Accepted: 07/24/2020] [Indexed: 11/24/2022]
Abstract
It remains unclear how pituitary pars intermedia dysfunction (PPID) and pergolide treatment (Prascend [pergolide tablets]) affect endocrine and immune function in horses. To evaluate these effects, blood was collected regularly from 28 university-owned horses (10 Non-PPID, 9 PPID control [PC], and 9 PPID treatment [PT]) over approximately 15 mo. Pergolide treatment was initiated after Day 0 collections. Analyses included ACTH, insulin, total cortisol, free cortisol, complete blood counts, plasma myeloperoxidase, and cytokine/receptor gene expression in basal whole blood and in vitro stimulations (PMA/ionomycin, heat-inactivated Rhodococcus equi, and heat-inactivated Escherichia coli) of whole blood and peripheral blood mononuclear cells (PBMCs). The results were analyzed using a linear mixed model (SAS 9.4) with significance set at P < 0.05. Significant group (P = 0.0014) and group-by-time (P = 0.0004) effects were observed in resting ACTH such that PT horses differed from Non-PPID horses only at Day 0. PT horses had significantly lower changes in ACTH responses to thyrotropin-releasing hormone stimulation tests than PC horses at non-fall time points only, mid-late February 2018 (P = 0.016) and early April 2018 (P = 0.0172). When PT and PC horses did not differ, they were combined before comparison to Non-PPID horses. No significant group or group-by-time effects were seen in resting insulin, total cortisol, or free cortisol; however, significant time effects were observed in these measures. PPID horses had lower absolute lymphocyte (P = 0.028) and red blood cell (P = 0.0203) counts than Non-PPID horses. In unstimulated whole blood, PPID horses had increased IL-8 expression compared with Non-PPID horses (P = 0.0102). In addition, PPID horses had decreased interferon γ production from PBMCs after stimulation with R. equi (P = 0.0063) and E. coli (P = 0.0057) and showed increased transforming growth factor β expression after E. coli stimulation (P = 0.0399). The main limitations of this study were a limited sample size and an inability to truly randomize the PPID horses into treatment groups. Resting ACTH is likely the best choice for determining successful responses to pergolide. Neither PPID nor pergolide appears to influence insulin, total cortisol, and free cortisol. As measured, systemic immune function was altered in PPID horses, and it is likely that these horses are indeed at increased risk of opportunistic infection. Despite reducing ACTH, pergolide treatment did not appear to influence immune function.
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Affiliation(s)
- A B Miller
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA.
| | - A T Loynachan
- Veterinary Diagnostic Laboratory, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
| | - H M Bush
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - K A Hart
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - V D Barker
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
| | - A G Campana-Emard
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
| | - S T Grubbs
- Boehringer Ingelheim Animal Health USA, Inc, Duluth, GA, USA
| | - A A Adams
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
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11
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Miller AB. Recommendations for breast cancer screening – Author's reply. Lancet Oncol 2020; 21:514. [DOI: 10.1016/s1470-2045(20)30629-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022]
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12
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Rosato V, Negri E, Bosetti C, Malats N, Gomez-Rubio P, Consortium P, Maisonneuve P, Miller AB, Bueno-de-Mesquita HB, Baghurst PA, Zatonski W, Petersen GM, Scelo G, Holcatova I, Fabianova E, Serraino D, Olson SH, Vioque J, Lagiou P, Duell EJ, Boffetta P, La Vecchia C. Gallbladder disease, cholecystectomy, and pancreatic cancer risk in the International Pancreatic Cancer Case-Control Consortium (PanC4). Eur J Cancer Prev 2020; 29:408-415. [PMID: 32740166 DOI: 10.1097/cej.0000000000000572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The association among gallbladder disease, cholecystectomy, and pancreatic cancer is unclear. Moreover, time interval between gallbladder disease or cholecystectomy and pancreatic cancer diagnosis is not considered in most previous studies. AIM To quantify the association among gallbladder disease, cholecystectomy, and pancreatic cancer, considering time since first diagnosis of gallbladder disease or cholecystectomy. METHODS We used data from nine case-control studies within the Pancreatic Cancer Case-Control Consortium, including 5760 cases of adenocarcinoma of the exocrine pancreas and 8437 controls. We estimated pooled odds ratios and the corresponding 95% confidence intervals by estimating study-specific odds ratios through multivariable unconditional logistic regression models, and then pooling the obtained estimates using fixed-effects models. RESULTS Compared with patients with no history of gallbladder disease, the pooled odds ratio of pancreatic cancer was 1.69 (95% confidence interval, 1.51-1.88) for patients reporting a history of gallbladder disease. The odds ratio was 4.90 (95% confidence interval, 3.45-6.97) for gallbladder disease diagnosed <2 years before pancreatic cancer diagnosis and 1.11 (95% confidence interval, 0.96-1.29) when ≥2 years elapsed. The pooled odds ratio was 1.64 (95% confidence interval, 1.43-1.89) for patients who underwent cholecystectomy, as compared to those without cholecystectomy. The odds ratio was 7.00 (95% confidence interval, 4.13-11.86) for a surgery <2 years before pancreatic cancer diagnosis and 1.28 (95% confidence interval, 1.08-1.53) for a surgery ≥2 years before. CONCLUSIONS There appears to be no long-term effect of gallbladder disease on pancreatic cancer risk, and at most a modest one for cholecystectomy. The strong short-term association can be explained by diagnostic bias and reverse causation.
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Affiliation(s)
- Valentina Rosato
- Unit of Medical Statistics and Biometry, National Cancer Institute, IRCCS Foundation
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO) and CIBERONC, Madrid, Spain
| | - Paulina Gomez-Rubio
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO) and CIBERONC, Madrid, Spain
| | - PanGenEU Consortium
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO) and CIBERONC, Madrid, Spain
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - H Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Peter A Baghurst
- Public Health, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Witold Zatonski
- Health Promotion Foundation, Nadarzyn
- Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Gloria M Petersen
- Department of Health Sciences Research, Medicine and Medical Genetics, Mayo Clinic, Rochester, New York, USA
| | - Ghislaine Scelo
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Eleonora Fabianova
- Regional Authority of Public Health, Banská Bystrica, Slovak Republic
- Faculty of Health, Catholic University, Ružomberok, Slovak Republic
| | - Diego Serraino
- Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Sara H Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jesús Vioque
- Institute for Health and Biomedical Research ISABIAL-UMH, Alicante
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Eric J Duell
- Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Paolo Boffetta
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York, USA
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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13
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Miller AB. Final results of the UK Age trial on breast cancer screening age. Lancet Oncol 2020; 21:1125-1126. [DOI: 10.1016/s1470-2045(20)30428-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 11/28/2022]
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14
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Evans WK, Gauvreau CL, Flanagan WM, Memon S, Yong JHE, Goffin JR, Fitzgerald NR, Wolfson M, Miller AB. Clinical impact and cost-effectiveness of integrating smoking cessation into lung cancer screening: a microsimulation model. CMAJ Open 2020; 8:E585-E592. [PMID: 32963023 PMCID: PMC7641238 DOI: 10.9778/cmajo.20190134] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Low-dose computed tomography (CT) screening can reduce lung cancer mortality in people at high risk; adding a smoking cessation intervention to screening could further improve screening program outcomes. This study aimed to assess the impact of adding a smoking cessation intervention to lung cancer screening on clinical outcomes, costs and cost-effectiveness. METHODS Using the OncoSim-Lung mathematical microsimulation model, we compared the projected lifetime impact of a smoking cessation intervention (nicotine replacement therapy, varenicline and 12 wk of counselling) in the context of annual low-dose CT screening for lung cancer in people at high risk to lung cancer screening without a cessation intervention in Canada. The simulated population consisted of Canadians born in 1940-1974; lung cancer screening was offered to eligible people in 2020. In the base-case scenario, we assumed that the intervention would be offered to smokers up to 10 times; each intervention would achieve a 2.5% permanent quit rate. Sensitivity analyses varied key model inputs. We calculated incremental cost-effectiveness ratios with a lifetime horizon from the health system's perspective, discounted at 1.5% per year. Costs are in 2019 Canadian dollars. RESULTS Offering a smoking cessation intervention in the context of lung cancer screening could lead to an additional 13% of smokers quitting smoking. It could potentially prevent 12 more lung cancers and save 200 more life-years for every 1000 smokers screened, at a cost of $22 000 per quality-adjusted life-year (QALY) gained. The results were most sensitive to quit rate. The intervention would cost over $50 000 per QALY gained with a permanent quit rate of less than 1.25% per attempt. INTERPRETATION Adding a smoking cessation intervention to lung cancer screening is likely cost-effective. To optimize the benefits of lung cancer screening, health care providers should encourage participants who still smoke to quit smoking.
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Affiliation(s)
- William K Evans
- Department of Oncology (Evans, Goffin), McMaster University, Hamilton, Ont.; Canadian Partnership Against Cancer (Gauvreau, Memon, Yong, Fitzgerald), Toronto, Ont.; Statistics Canada (Flanagan); Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; Department of Public Health Sciences (Miller), University of Toronto, Toronto, Ont
| | - Cindy L Gauvreau
- Department of Oncology (Evans, Goffin), McMaster University, Hamilton, Ont.; Canadian Partnership Against Cancer (Gauvreau, Memon, Yong, Fitzgerald), Toronto, Ont.; Statistics Canada (Flanagan); Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; Department of Public Health Sciences (Miller), University of Toronto, Toronto, Ont
| | - William M Flanagan
- Department of Oncology (Evans, Goffin), McMaster University, Hamilton, Ont.; Canadian Partnership Against Cancer (Gauvreau, Memon, Yong, Fitzgerald), Toronto, Ont.; Statistics Canada (Flanagan); Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; Department of Public Health Sciences (Miller), University of Toronto, Toronto, Ont
| | - Saima Memon
- Department of Oncology (Evans, Goffin), McMaster University, Hamilton, Ont.; Canadian Partnership Against Cancer (Gauvreau, Memon, Yong, Fitzgerald), Toronto, Ont.; Statistics Canada (Flanagan); Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; Department of Public Health Sciences (Miller), University of Toronto, Toronto, Ont
| | - Jean Hai Ein Yong
- Department of Oncology (Evans, Goffin), McMaster University, Hamilton, Ont.; Canadian Partnership Against Cancer (Gauvreau, Memon, Yong, Fitzgerald), Toronto, Ont.; Statistics Canada (Flanagan); Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; Department of Public Health Sciences (Miller), University of Toronto, Toronto, Ont
| | - John R Goffin
- Department of Oncology (Evans, Goffin), McMaster University, Hamilton, Ont.; Canadian Partnership Against Cancer (Gauvreau, Memon, Yong, Fitzgerald), Toronto, Ont.; Statistics Canada (Flanagan); Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; Department of Public Health Sciences (Miller), University of Toronto, Toronto, Ont
| | - Natalie R Fitzgerald
- Department of Oncology (Evans, Goffin), McMaster University, Hamilton, Ont.; Canadian Partnership Against Cancer (Gauvreau, Memon, Yong, Fitzgerald), Toronto, Ont.; Statistics Canada (Flanagan); Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; Department of Public Health Sciences (Miller), University of Toronto, Toronto, Ont
| | - Michael Wolfson
- Department of Oncology (Evans, Goffin), McMaster University, Hamilton, Ont.; Canadian Partnership Against Cancer (Gauvreau, Memon, Yong, Fitzgerald), Toronto, Ont.; Statistics Canada (Flanagan); Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; Department of Public Health Sciences (Miller), University of Toronto, Toronto, Ont
| | - Anthony B Miller
- Department of Oncology (Evans, Goffin), McMaster University, Hamilton, Ont.; Canadian Partnership Against Cancer (Gauvreau, Memon, Yong, Fitzgerald), Toronto, Ont.; Statistics Canada (Flanagan); Faculties of Medicine and Law (Wolfson), University of Ottawa, Ottawa, Ont.; Department of Public Health Sciences (Miller), University of Toronto, Toronto, Ont.
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15
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Goldberg MS, Villeneuve PJ, Crouse D, To T, Weichenthal SA, Wall C, Miller AB. Associations between incident breast cancer and ambient concentrations of nitrogen dioxide from a national land use regression model in the Canadian National Breast Screening Study. Environ Int 2019; 133:105182. [PMID: 31648153 DOI: 10.1016/j.envint.2019.105182] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/30/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Air pollution has been classified as a human carcinogen based largely on epidemiological studies of lung cancer. Recent research suggests that exposure to ambient air pollution increases the risk of female breast cancer especially in premenopausal women. METHODS Our objective was to determine the association between residential exposure to ambient nitrogen dioxide (NO2) and newly diagnosed cases of invasive breast cancer in a cohort of 89,247 women enrolled in the Canadian National Breast Screening Study between 1980 and 1985. Vital status and incident breast cancers through 2005 were determined through record linkage to the Canadian national mortality and cancer registries. Estimates of exposures to NO2 using participants' addresses at time of entry into the study were derived from a national land use regression model. We classified women as reaching menopause according to information obtained at baseline. In addition, as we had no information from women on their menopausal status during the observation period, we conducted analyses using different cut-points for defining postmenopausal status (i.e., at 50 or at 52 years of age), and hence we had four non-independent cohorts. We computed rate ratios for the incidence of breast cancer and their 95% confidence intervals (CI) separately for premenopausal and postmenopausal women. Our Cox models used attained age as the time axis and the rate ratios were adjusted for several individual-level risk factors, including reproductive history, as well as census-based neighborhood-level characteristics. RESULTS The median concentration of NO2 was about 15 parts per billion (ppb). After adjusting for personal risk factors and contextual variables, we found no evidence of associations for the incidence of breast cancer in the postmenopausal cohorts. In premenopausal women, the rate ratio for an increase of 9.7 ppb (about the interquartile range) was 1.13 (95%CI: 0.94-1.37) for the 50 years of age cut-off for menopausal status and it was 1.17 (95%CI: 1.00-1.38) for the 52 years of age cut-off. CONCLUSIONS Our findings suggest that exposure to low concentrations of NO2, a marker for traffic-related air pollution, increases the risk of premenopausal breast cancer, but not postmenopausal breast cancer.
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Affiliation(s)
- Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Hospital Centre, Montreal, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, Canada; Gerald Bronfman Department of Oncology, McGill University, Montreal Canada.
| | - Paul J Villeneuve
- School of Mathematic and Statistics, Carleton University, Ottawa, Canada; CHAIM Research Centre, Carleton University, Ottawa, Canada
| | - Dan Crouse
- Department of Sociology, University of New Brunswick, Fredericton, Canada
| | - Teresa To
- The Hospital for Sick Children, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Scott A Weichenthal
- Department of Epidemiology, Biostatistics, and Occupational Health, Canada; Gerald Bronfman Department of Oncology, McGill University, Montreal Canada
| | - Claus Wall
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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16
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Miller AB, Sears ME, Morgan LL, Davis DL, Hardell L, Oremus M, Soskolne CL. Risks to Health and Well-Being From Radio-Frequency Radiation Emitted by Cell Phones and Other Wireless Devices. Front Public Health 2019; 7:223. [PMID: 31457001 PMCID: PMC6701402 DOI: 10.3389/fpubh.2019.00223] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/25/2019] [Indexed: 12/14/2022] Open
Abstract
Radiation exposure has long been a concern for the public, policy makers, and health researchers. Beginning with radar during World War II, human exposure to radio-frequency radiation (RFR) technologies has grown substantially over time. In 2011, the International Agency for Research on Cancer (IARC) reviewed the published literature and categorized RFR as a "possible" (Group 2B) human carcinogen. A broad range of adverse human health effects associated with RFR have been reported since the IARC review. In addition, three large-scale carcinogenicity studies in rodents exposed to levels of RFR that mimic lifetime human exposures have shown significantly increased rates of Schwannomas and malignant gliomas, as well as chromosomal DNA damage. Of particular concern are the effects of RFR exposure on the developing brain in children. Compared with an adult male, a cell phone held against the head of a child exposes deeper brain structures to greater radiation doses per unit volume, and the young, thin skull's bone marrow absorbs a roughly 10-fold higher local dose. Experimental and observational studies also suggest that men who keep cell phones in their trouser pockets have significantly lower sperm counts and significantly impaired sperm motility and morphology, including mitochondrial DNA damage. Based on the accumulated evidence, we recommend that IARC re-evaluate its 2011 classification of the human carcinogenicity of RFR, and that WHO complete a systematic review of multiple other health effects such as sperm damage. In the interim, current knowledge provides justification for governments, public health authorities, and physicians/allied health professionals to warn the population that having a cell phone next to the body is harmful, and to support measures to reduce all exposures to RFR.
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Affiliation(s)
- Anthony B. Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Margaret E. Sears
- Ottawa Hospital Research Institute, Prevent Cancer Now, Ottawa, ON, Canada
| | - L. Lloyd Morgan
- Environmental Health Trust, Teton Village, WY, United States
| | - Devra L. Davis
- Environmental Health Trust, Teton Village, WY, United States
| | - Lennart Hardell
- The Environment and Cancer Research Foundation, Örebro, Sweden
| | - Mark Oremus
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Colin L. Soskolne
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- Health Research Institute, University of Canberra, Canberra, ACT, Australia
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17
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Becker N, Motsch E, Trotter A, Heussel CP, Dienemann H, Schnabel PA, Kauczor HU, Maldonado SG, Miller AB, Kaaks R, Delorme S. Lung cancer mortality reduction by LDCT screening-Results from the randomized German LUSI trial. Int J Cancer 2019; 146:1503-1513. [PMID: 31162856 DOI: 10.1002/ijc.32486] [Citation(s) in RCA: 213] [Impact Index Per Article: 42.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/09/2019] [Indexed: 11/08/2022]
Abstract
In 2011, the U.S. National Lung Cancer Screening Trial (NLST) reported a 20% reduction of lung cancer mortality after regular screening by low-dose computed tomography (LDCT), as compared to X-ray screening. The introduction of lung cancer screening programs in Europe awaits confirmation of these first findings from European trials that started in parallel with the NLST. The German Lung cancer Screening Intervention (LUSI) is a randomized trial among 4,052 long-term smokers, 50-69 years of age, recruited from the general population, comparing five annual rounds of LDCT screening (screening arm; n = 2,029 participants) with a control arm (n = 2,023) followed by annual postal questionnaire inquiries. Data on lung cancer incidence and mortality and vital status were collected from hospitals or office-based physicians, cancer registries, population registers and health offices. Over an average observation time of 8.8 years after randomization, the hazard ratio for lung cancer mortality was 0.74 (95% CI: 0.46-1.19; p = 0.21) among men and women combined. Modeling by sex, however showed a statistically significant reduction in lung cancer mortality among women (HR = 0.31 [95% CI: 0.10-0.96], p = 0.04), but not among men (HR = 0.94 [95% CI: 0.54-1.61], p = 0.81) screened by LDCT (pheterogeneity = 0.09). Findings from LUSI are in line with those from other trials, including NLST, that suggest a stronger reduction of lung cancer mortality after LDCT screening among women as compared to men. This heterogeneity could be the result of different relative counts of lung tumor subtypes occurring in men and women.
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Affiliation(s)
- Nikolaus Becker
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Erna Motsch
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anke Trotter
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Claus P Heussel
- Department of Radiology, Thoraxklinik Heidelberg, Heidelberg University, Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology, Heidelberg University Clinic, Heidelberg, Germany.,Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC), Heidelberg, Germany
| | - Hendrik Dienemann
- Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC), Heidelberg, Germany.,Department of Surgery, Thoraxklinik Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Philipp A Schnabel
- Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC), Heidelberg, Germany.,Institute of Pathology, University of Saarland, Homburg (Saar), Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, Heidelberg University Clinic, Heidelberg, Germany.,Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC), Heidelberg, Germany
| | - Sandra González Maldonado
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC), Heidelberg, Germany
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC), Heidelberg, Germany
| | - Stefan Delorme
- Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC), Heidelberg, Germany.,Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Miller AB. Evaluation of Risks Associated with Hazardous Waste. Environ Epidemiol 2019. [DOI: 10.1201/9780429263361-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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19
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Miller AB. Improving Surveillance following Treatment for Lung Cancer. J Thorac Oncol 2019; 14:955. [PMID: 31122557 DOI: 10.1016/j.jtho.2019.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
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20
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Jatoi I, Anderson WF, Miller AB, Brawley OW. In Brief. Curr Probl Surg 2019. [DOI: 10.1067/j.cpsurg.2019.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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21
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Affiliation(s)
- Ismail Jatoi
- Division of Surgical Oncology, Dale H. Dorn Endowed Chair in Surgery, University of Texas Health Science Center, San Antonio, TX.
| | - William F Anderson
- National Institutes of Health/National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, MA
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Otis W Brawley
- Michael Bloomberg Distinguished Professor of Oncology and Public Health, Johns Hopkins University, Baltimore, MA
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Miller AB, Morgan LL, Udasin I, Davis DL. Cancer epidemiology update, following the 2011 IARC evaluation of radiofrequency electromagnetic fields (Monograph 102). Environ Res 2018; 167:673-683. [PMID: 30196934 DOI: 10.1016/j.envres.2018.06.043] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 06/14/2018] [Accepted: 06/20/2018] [Indexed: 06/08/2023]
Abstract
Epidemiology studies (case-control, cohort, time trend and case studies) published since the International Agency for Research on Cancer (IARC) 2011 categorization of radiofrequency radiation (RFR) from mobile phones and other wireless devices as a possible human carcinogen (Group 2B) are reviewed and summarized. Glioma is an important human cancer found to be associated with RFR in 9 case-control studies conducted in Sweden and France, as well as in some other countries. Increasing glioma incidence trends have been reported in the UK and other countries. Non-malignant endpoints linked include acoustic neuroma (vestibular Schwannoma) and meningioma. Because they allow more detailed consideration of exposure, case-control studies can be superior to cohort studies or other methods in evaluating potential risks for brain cancer. When considered with recent animal experimental evidence, the recent epidemiological studies strengthen and support the conclusion that RFR should be categorized as carcinogenic to humans (IARC Group 1). Opportunistic epidemiological studies are proposed that can be carried out through cross-sectional analyses of high, medium, and low mobile phone users with respect to hearing, vision, memory, reaction time, and other indicators that can easily be assessed through standardized computer-based tests. As exposure data are not uniformly available, billing records should be used whenever available to corroborate reported exposures.
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Affiliation(s)
- Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Canada.
| | - L Lloyd Morgan
- Environmental Health Trust, Berkeley, CA, United States.
| | - Iris Udasin
- Rutgers University School of Public Health, United States.
| | - Devra Lee Davis
- Environmental Health Trust, Teton Village, WY, United States; Hebrew University of Jerusalem, Israel.
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Burnett R, Chen H, Szyszkowicz M, Fann N, Hubbell B, Pope CA, Apte JS, Brauer M, Cohen A, Weichenthal S, Coggins J, Di Q, Brunekreef B, Frostad J, Lim SS, Kan H, Walker KD, Thurston GD, Hayes RB, Lim CC, Turner MC, Jerrett M, Krewski D, Gapstur SM, Diver WR, Ostro B, Goldberg D, Crouse DL, Martin RV, Peters P, Pinault L, Tjepkema M, van Donkelaar A, Villeneuve PJ, Miller AB, Yin P, Zhou M, Wang L, Janssen NAH, Marra M, Atkinson RW, Tsang H, Quoc Thach T, Cannon JB, Allen RT, Hart JE, Laden F, Cesaroni G, Forastiere F, Weinmayr G, Jaensch A, Nagel G, Concin H, Spadaro JV. Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter. Proc Natl Acad Sci U S A 2018; 115:9592-9597. [PMID: 30181279 PMCID: PMC6156628 DOI: 10.1073/pnas.1803222115] [Citation(s) in RCA: 906] [Impact Index Per Article: 151.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Exposure to ambient fine particulate matter (PM2.5) is a major global health concern. Quantitative estimates of attributable mortality are based on disease-specific hazard ratio models that incorporate risk information from multiple PM2.5 sources (outdoor and indoor air pollution from use of solid fuels and secondhand and active smoking), requiring assumptions about equivalent exposure and toxicity. We relax these contentious assumptions by constructing a PM2.5-mortality hazard ratio function based only on cohort studies of outdoor air pollution that covers the global exposure range. We modeled the shape of the association between PM2.5 and nonaccidental mortality using data from 41 cohorts from 16 countries-the Global Exposure Mortality Model (GEMM). We then constructed GEMMs for five specific causes of death examined by the global burden of disease (GBD). The GEMM predicts 8.9 million [95% confidence interval (CI): 7.5-10.3] deaths in 2015, a figure 30% larger than that predicted by the sum of deaths among the five specific causes (6.9; 95% CI: 4.9-8.5) and 120% larger than the risk function used in the GBD (4.0; 95% CI: 3.3-4.8). Differences between the GEMM and GBD risk functions are larger for a 20% reduction in concentrations, with the GEMM predicting 220% higher excess deaths. These results suggest that PM2.5 exposure may be related to additional causes of death than the five considered by the GBD and that incorporation of risk information from other, nonoutdoor, particle sources leads to underestimation of disease burden, especially at higher concentrations.
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Affiliation(s)
- Richard Burnett
- Population Studies Division, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Hong Chen
- Population Studies Division, Health Canada, Ottawa, ON K1A 0K9, Canada
- Department of Environmental and Occupational Health, Public Health Ontario, Toronto, ON M5G 1V2, Canada
| | | | - Neal Fann
- Risk and Benefits Group, Office of Air Quality Planning and Standards, US Environmental Protection Agency, Washington, DC 20460
| | - Bryan Hubbell
- Office of Research and Development, US Environmental Protection Agency, Washington, DC 20460
| | - C Arden Pope
- Department of Economics, Brigham Young University, Provo, UT 84602
| | - Joshua S Apte
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, TX 78712
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Aaron Cohen
- Health Effects Institute, Boston, MA 02110-1817
| | - Scott Weichenthal
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC H3A 0G4, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H3A 0G4, Canada
| | - Jay Coggins
- Department of Applied Economics, University of Minnesota, Minneapolis, MN 55455
| | - Qian Di
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA 02115
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Universiteit Utrecht, 3512 JE Utrecht, The Netherlands
| | - Joseph Frostad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai 200433, China
| | | | - George D Thurston
- Environmental Medicine and Population Health, Program in Human Exposures and Health Effects, New York University School of Medicine, New York, NY 10016
| | - Richard B Hayes
- Department of Population Health, NYU Langone Medical Center, New York, NY 10016
| | - Chris C Lim
- Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016
| | - Michelle C Turner
- ISGlobal, Barcelona Institute for Global Health, 08036 Barcelona, Spain
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA 90095
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Inc., Atlanta, GA 30303
| | - W Ryan Diver
- Epidemiology Research Program, American Cancer Society, Inc., Atlanta, GA 30303
| | - Bart Ostro
- Department of Civil and Environmental Engineering, University of California, Davis, CA 95616
| | - Debbie Goldberg
- Cancer Prevention Institute of California, Fremont, CA 94538
| | - Daniel L Crouse
- Department of Sociology, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Paul Peters
- Department of Health Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada
- Department of Geography and Environment, Carleton University, Ottawa, ON K1S 5B6, Canada
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
| | - Lauren Pinault
- Health Analysis Division, Statistics Canada, Ottawa, ON K1A 0T6, Canada
| | - Michael Tjepkema
- Health Analysis Division, Statistics Canada, Ottawa, ON K1A 0T6, Canada
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Lijun Wang
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands
| | - Marten Marra
- National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands
| | - Richard W Atkinson
- Population Health Research Institute, St. George's, University of London, London SW17 0RE, United Kingdom
- MRC-PHE Centre for Environment and Health, St. George's, University of London, London SW17 0RE, United Kingdom
| | - Hilda Tsang
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Thuan Quoc Thach
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - John B Cannon
- Department of Economics, Brigham Young University, Provo, UT 84602
| | - Ryan T Allen
- Department of Economics, Brigham Young University, Provo, UT 84602
| | - Jaime E Hart
- Department of Environmental Health, Harvard C.T. Channing School of Public Health, Harvard University, Boston, MA 02115
| | - Francine Laden
- Department of Environmental Health, Harvard C.T. Channing School of Public Health, Harvard University, Boston, MA 02115
| | - Giulia Cesaroni
- Department of Epidemiology, Regional Health Service, ASL Roma 1, 00147 Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Regional Health Service, ASL Roma 1, 00147 Rome, Italy
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, Germany
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, Germany
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, Germany
| | - Hans Concin
- Agency for Preventive and Social Medicine, 6900 Bregenz, Austria
| | - Joseph V Spadaro
- Spadaro Environmental Research Consultants (SERC), Philadelphia, PA 19142
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Shaevitch D, Taghipour S, Miller AB, Montgomery N, Harvey B. Tumor size distribution of invasive breast cancers and the sensitivity of screening methods in the Canadian National Breast Screening Study. J Cancer Res Ther 2018; 13:562-569. [PMID: 28862227 DOI: 10.4103/0973-1482.174539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION This study set out to explore if breast cancers of different sizes are detected with varying sensitivity. In addition, we attempt to determine the effect of tumor size on screening detectability. SUBJECTS AND METHODS Data arising from the Canadian National Breast Screening Study (CNBSS) was used to perform all analyses. The CNBSS consists of two randomized controlled trials, which includes data on detection methods, age, and allocation groups. We stratified tumor size by 5 mm; age into 40-49 and 50-59 years age groups; and cancer detection or presentation methods into mammography only, physical breast examination only, both mammography and physical breast examination, interval cancers, and incident cancers. RESULTS This study revealed that a difference in tumor size exists for age (smaller tumor sizes are found in older women) and breast cancer detection or presentation modes. More specifically, breast cancers detected by mammography screening are statistically smaller than those detected by physical breast examination or those presenting as incident or interval cancers. This study also found that tumor size affects screening detectability for women in their 50's but not in their forties. That is, a statistically significant difference between mammography screening alone and physical examination alone was observed for women between the ages of 50-59 for tumor sizes up to 20 mm, including prevalent cases, and up to 15 mm when prevalent cases were excluded. CONCLUSION The results of this study suggest that smaller breast cancers are more likely to be detected among women in their 50s.
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Affiliation(s)
- Dana Shaevitch
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada
| | - Sharareh Taghipour
- Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, Ontario M5B 2K3, Canada
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada
| | - Neil Montgomery
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario M5S 3G8, Canada
| | - Bart Harvey
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada
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25
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Prorok PC, Miller AB. Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials. Ann Intern Med 2018; 168:605-606. [PMID: 29677259 DOI: 10.7326/l17-0735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Perucci CA, Rapiti E, Davoli M, Lagorio S, Arca M, Miller AB. Rome Women's Screening Study: Knowledge, Attitudes and Practices of Women regarding Screening for Breast and Cervical Cancer. Tumori 2018; 76:365-9. [DOI: 10.1177/030089169007600412] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Marina Davoli
- Epidemiology Unit, Latium Regional Health Authority, Rome
| | | | - Massimo Arca
- Epidemiology Unit, Latium Regional Health Authority, Rome
| | - Anthony B. Miller
- Department of Preventive Medicine and Biostatistics, University of Toronto, Canada
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Gauvreau CL, Fitzgerald NR, Memon S, Flanagan WM, Nadeau C, Asakawa K, Garner R, Miller AB, Evans WK, Popadiuk CM, Wolfson M, Coldman AJ. The OncoSim model: development and use for better decision-making in Canadian cancer control. ACTA ACUST UNITED AC 2017; 24:401-406. [PMID: 29270052 DOI: 10.3747/co.24.3850] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The Canadian Partnership Against Cancer was created in 2007 by the federal government to accelerate cancer control across Canada. Its OncoSim microsimulation model platform, which consists of a suite of specific cancer models, was conceived as a tool to augment conventional resources for population-level policy- and decision-making. The Canadian Partnership Against Cancer manages the OncoSim program, with funding from Health Canada and model development by Statistics Canada. Microsimulation modelling allows for the detailed capture of population heterogeneity and health and demographic history over time. Extensive data from multiple Canadian sources were used as inputs or to validate the model. OncoSim has been validated through expert consultation; assessments of face validity, internal validity, and external validity; and model fit against observed data. The platform comprises three in-depth cancer models (lung, colorectal, cervical), with another in-depth model (breast) and a generalized model (25 cancers) being in development. Unique among models of its class, OncoSim is available online for public sector use free of charge. Users can customize input values and output display, and extensive user support is provided. OncoSim has been used to support decision-making at the national and jurisdictional levels. Although simulation studies are generally not included in hierarchies of evidence, they are integral to informing cancer control policy when clinical studies are not feasible. OncoSim can evaluate complex intervention scenarios for multiple cancers. Canadian decision-makers thus have a powerful tool to assess the costs, benefits, cost-effectiveness, and budgetary effects of cancer control interventions when faced with difficult choices for improvements in population health and resource allocation.
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Affiliation(s)
- C L Gauvreau
- Health Economics, Canadian Partnership Against Cancer, Toronto, ON
| | - N R Fitzgerald
- Health Economics, Canadian Partnership Against Cancer, Toronto, ON
| | - S Memon
- Health Economics, Canadian Partnership Against Cancer, Toronto, ON
| | | | - C Nadeau
- Health Analysis, Statistics Canada, Ottawa, ON
| | - K Asakawa
- Health Analysis, Statistics Canada, Ottawa, ON
| | - R Garner
- Health Analysis, Statistics Canada, Ottawa, ON
| | - A B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - W K Evans
- Department of Oncology, McMaster University, Hamilton, ON
| | - C M Popadiuk
- Faculty of Medicine, Memorial University, St. John's, NL
| | - M Wolfson
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON
| | - A J Coldman
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC
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Miller AB. Comment on 'Effect of population breast screening on breast cancer mortality up to 2005 in England and Wales: an individual-level cohort study'. Br J Cancer 2017; 117:e2. [PMID: 28399111 PMCID: PMC5520504 DOI: 10.1038/bjc.2017.101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Anthony B Miller
- Professor Emeritus, Dalla Lana School of Public Health, University of Toronto, Port Hope, Ontario L1A 1T3, Canada
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Lujan-Barroso L, Zhang W, Olson SH, Gao YT, Yu H, Baghurst PA, Bracci PM, Bueno-de-Mesquita HB, Foretová L, Gallinger S, Holcatova I, Janout V, Ji BT, Kurtz RC, La Vecchia C, Lagiou P, Li D, Miller AB, Serraino D, Zatonski W, Risch HA, Duell EJ. Menstrual and Reproductive Factors, Hormone Use, and Risk of Pancreatic Cancer: Analysis From the International Pancreatic Cancer Case-Control Consortium (PanC4). Pancreas 2016; 45:1401-1410. [PMID: 27088489 PMCID: PMC5065728 DOI: 10.1097/mpa.0000000000000635] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We aimed to evaluate the relation between menstrual and reproductive factors, exogenous hormones, and risk of pancreatic cancer (PC). METHODS Eleven case-control studies within the International Pancreatic Cancer Case-control Consortium took part in the present study, including in total 2838 case and 4748 control women. Pooled estimates of odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using a 2-step logistic regression model and adjusting for relevant covariates. RESULTS An inverse OR was observed in women who reported having had hysterectomy (ORyesvs.no, 0.78; 95% CI, 0.67-0.91), remaining significant in postmenopausal women and never-smoking women, adjusted for potential PC confounders. A mutually adjusted model with the joint effect for hormone replacement therapy (HRT) and hysterectomy showed significant inverse associations with PC in women who reported having had hysterectomy with HRT use (OR, 0.64; 95% CI, 0.48-0.84). CONCLUSIONS Our large pooled analysis suggests that women who have had a hysterectomy may have reduced risk of PC. However, we cannot rule out that the reduced risk could be due to factors or indications for having had a hysterectomy. Further investigation of risk according to HRT use and reason for hysterectomy may be necessary.
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Affiliation(s)
- Leila Lujan-Barroso
- From the *Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; †Department of Epidemiology, Shanghai Cancer Institute and Jiao Tong University, Shanghai, China; ‡Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY; §Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI; ∥Public Health, Women's and Children's Hospital, Adelaide, SA, Australia; ¶University of California, San Francisco, San Francisco, CA; #National Institute for Public Health and the Environment (RIVM), Bilthoven; **Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands; ††Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; ‡‡Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; §§Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Institute and MF MU, Brno, Czech Republic; ∥∥University Health Network, Department of Surgery, University of Toronto, Toronto, Canada; ¶¶Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University in Prague, Prague; ##Department of Preventive Medicine, Faculty of Medicine, Palacky University, Olomouc, Czech Republic; ***National Cancer Institute, Bethesda, MD; †††Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; ‡‡‡Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; §§§Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece; ∥∥∥Department of Epidemiology, Harvard School of Public Health, Boston, MA; ¶¶¶M.D. Anderson Cancer Center, University of Texas, Houston, TX; ###Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; ****Unit of Epidemiology and Biostatistics, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy; ††††Cancer Center and Institute of Oncology, Warsaw, Poland; and ‡‡‡‡Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
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Miller AB. Should We Continue to Perform Pap Smears on Women Who No Longer Have a Cervix? Am J Public Health 2016; 106:1900-1901. [PMID: 27715296 DOI: 10.2105/ajph.2016.303411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Anthony B Miller
- Anthony B. Miller is Professor Emeritus, Dalla Lana School of Public Health, University of Toronto, Canada
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Lloyd Morgan L, Miller AB, Davis DL. Has the incidence of brain cancer risen in Australia since the introduction of mobile phones 29 years ago? Cancer Epidemiol 2016; 44:112-113. [DOI: 10.1016/j.canep.2016.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 07/05/2016] [Accepted: 08/02/2016] [Indexed: 11/16/2022]
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Goffin JR, Flanagan WM, Miller AB, Fitzgerald NR, Memon S, Wolfson MC, Evans WK. Biennial lung cancer screening in Canada with smoking cessation-outcomes and cost-effectiveness. Lung Cancer 2016; 101:98-103. [PMID: 27794416 DOI: 10.1016/j.lungcan.2016.09.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 09/22/2016] [Accepted: 09/25/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Guidelines recommend low-dose CT (LDCT) screening to detect lung cancer among eligible at-risk individuals. We used the OncoSim model (formerly Cancer Risk Management Model) to compare outcomes and costs between annual and biennial LDCT screening. METHODS OncoSim incorporates vital statistics, cancer registry data, health survey and utility data, cost, and other data, and simulates individual lives, aggregating outcomes over millions of individuals. Using OncoSim and National Lung Screening Trial eligibility criteria (age 55-74, minimum 30 pack-year smoking history, smoking cessation less than 15 years from time of first screen) and data, we have modeled screening parameters, cancer stage distribution, and mortality shifts for screen diagnosed cancer. Costs (in 2008 Canadian dollars) and quality of life years gained are discounted at 3% annually. RESULTS Compared with annual LDCT screening, biennial screening used fewer resources, gained fewer life-years (61,000 vs. 77,000), but resulted in very similar quality-adjusted life-years (QALYs) (24,000 vs. 23,000) over 20 years. The incremental cost-effectiveness ratio (ICER) of annual compared with biennial screening was $54,000-$4.8 million/QALY gained. Average incremental CT scan use in biennial screening was 52% of that in annual screening. A smoking cessation intervention decreased the average cost-effectiveness ratio in most scenarios by half. CONCLUSIONS Over 20 years, biennial LDCT screening for lung cancer appears to provide similar benefit in terms of QALYs gained to annual screening and is more cost-effective. Further study of biennial screening should be undertaken in population screening programs. A smoking cessation program should be integrated into either screening strategy.
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Affiliation(s)
- John R Goffin
- Department of Oncology, McMaster University, 699 Concession St., Hamilton, ON, L8V 5C2, Canada.
| | | | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.
| | - Natalie R Fitzgerald
- Canadian Partnership Against Cancer, 1 University Ave., Suite 300, Toronto, ON M5J 2P1, Canada.
| | - Saima Memon
- Canadian Partnership Against Cancer, 1 University Ave., Suite 300, Toronto, ON M5J 2P1, Canada.
| | - Michael C Wolfson
- Department of Epidemiology and Community Medicine, University of Ottawa, 600 Peter Morand Crescent, Room 301 K, Ottawa, ON, K1G 5Z3, Canada.
| | - William K Evans
- Department of Oncology, McMaster University, 699 Concession St., Hamilton, ON, L8V 5C2, Canada.
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Baines CJ, To T, Miller AB. Revised estimates of overdiagnosis from the Canadian National Breast Screening Study. Prev Med 2016; 90:66-71. [PMID: 27374944 DOI: 10.1016/j.ypmed.2016.06.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/01/2016] [Accepted: 06/27/2016] [Indexed: 12/17/2022]
Abstract
We have re-estimated overdiagnosis of breast cancer from mammography screening by age group in the Canadian National Breast Screening Study (CNBSS), a randomized screening trial. In the CNBSS, participants were recruited in 15 centers. 89,835 women were randomized with informed consent, 50,430 age 40-49 and 39,405 age 50-59. Women aged 40-49 received annual mammography and physical examination (MA+PX) versus a single physical examination and usual care in the community (UC). Women aged 50-59 received (MA+PX) versus (PX-alone) annually. Individual randomization resulted in 44 almost identically distributed demographic and risk factors. Annual compliance over the five or four scheduled screens was 86-95%. The cumulative numbers of invasive and in situ breast cancers ascertained by year during screening and subsequent follow-up to 25 years post entry to the CNBSS in the mammography arm have been compared to those in the control arm. Estimates of overdiagnosis were derived using post-screening cessation cut-off points from 1 to 20years.⋯Overdiagnosis of invasive breast cancer at five years post cessation of screening for women aged 40-49 was estimated to be 32%, and 16% for women aged 50-59; 20years post cessation of screening 48% for women 40-49 and 5% for those 50-59. Including ductal carcinoma in situ with invasive cancer, estimates were 41%, 25%, 55% and 16%, respectively. We conclude that approximately 30% of invasive screen-detected breast cancers in women age 40-49 were overdiagnosed, and 20% of those screen-detected in women age 50-59. Including ductal carcinoma in situ, the estimates are 40% and 30%, respectively.
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Affiliation(s)
- Cornelia J Baines
- Dalla Lana School of Public Health, 155 College St, Room 576, University of Toronto, 416-978-1458, Toronto M5T 3M7, Canada
| | - Teresa To
- The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Canada
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Tomczak A, Miller AB, Weichenthal SA, To T, Wall C, van Donkelaar A, Martin RV, Crouse DL, Villeneuve PJ. Long-term exposure to fine particulate matter air pollution and the risk of lung cancer among participants of the Canadian National Breast Screening Study. Int J Cancer 2016; 139:1958-66. [PMID: 27380650 DOI: 10.1002/ijc.30255] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 05/09/2016] [Accepted: 06/22/2016] [Indexed: 11/07/2022]
Abstract
Recently, air pollution has been classified as a carcinogen largely on the evidence of epidemiological studies of lung cancer. However, there have been few prospective studies that have evaluated associations between fine particulate matter (PM2.5 ) and cancer at lower concentrations. We conducted a prospective analysis of 89,234 women enrolled in the Canadian National Breast Screening Study between 1980 and 1985, and for whom residential measures of PM2.5 could be assigned. The cohort was linked to the Canadian Cancer Registry to identify incident lung cancers through 2004. Surface PM2.5 concentrations were estimated using satellite data. Cox proportional hazards models were used to characterize associations between PM2.5 and lung cancer. Hazard ratios (HRs) and 95% confidence intervals (CIs) computed from these models were adjusted for several individual-level characteristics, including smoking. The cohort was composed predominantly of Canadian-born (82%), married (80%) women with a median PM2.5 exposure of 9.1 µg/m(3) . In total, 932 participants developed lung cancer. In fully adjusted models, a 10 µg/m(3) increase in PM2.5 was associated with an elevated risk of lung cancer (HR: 1.34; 95% CI = 1.10, 1.65). The strongest associations were observed with small cell carcinoma (HR: 1.53; 95% CI = 0.93, 2.53) and adenocarcinoma (HR: 1.44; 95% CI = 1.06, 1.97). Stratified analyses suggested increased PM2.5 risks were limited to those who smoked cigarettes. Our findings are consistent with previous epidemiological investigations of long-term exposure to PM2.5 and lung cancer. Importantly, they suggest associations persist at lower concentrations such as those currently found in Canadian cities.
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Affiliation(s)
- Anna Tomczak
- Department of Health Sciences, Carleton University, Ottawa, ON, K1S5B6, Canada
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada
| | - Scott A Weichenthal
- Department of Epidemiology, Biostatistics, and Occupational Health and Gerald Bronfman Department of Oncology, McGill University, Montreal, QC, H3A 1A2, Canada
| | - Teresa To
- Child Health Evaluative Sciences, The Hospital for Sick Children, Ottawa, ON, M5G1X8, Canada
| | - Claus Wall
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Dan Lawson Crouse
- NB Institute of Research, Data and Training, University of New Brunswick, Fredericton, NB, E3B 5A3, Canada
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, ON, K1S5B6, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada
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Portier CJ, Armstrong BK, Baguley BC, Baur X, Belyaev I, Bellé R, Belpoggi F, Biggeri A, Bosland MC, Bruzzi P, Budnik LT, Bugge MD, Burns K, Calaf GM, Carpenter DO, Carpenter HM, López-Carrillo L, Clapp R, Cocco P, Consonni D, Comba P, Craft E, Dalvie MA, Davis D, Demers PA, De Roos AJ, DeWitt J, Forastiere F, Freedman JH, Fritschi L, Gaus C, Gohlke JM, Goldberg M, Greiser E, Hansen J, Hardell L, Hauptmann M, Huang W, Huff J, James MO, Jameson CW, Kortenkamp A, Kopp-Schneider A, Kromhout H, Larramendy ML, Landrigan PJ, Lash LH, Leszczynski D, Lynch CF, Magnani C, Mandrioli D, Martin FL, Merler E, Michelozzi P, Miligi L, Miller AB, Mirabelli D, Mirer FE, Naidoo S, Perry MJ, Petronio MG, Pirastu R, Portier RJ, Ramos KS, Robertson LW, Rodriguez T, Röösli M, Ross MK, Roy D, Rusyn I, Saldiva P, Sass J, Savolainen K, Scheepers PTJ, Sergi C, Silbergeld EK, Smith MT, Stewart BW, Sutton P, Tateo F, Terracini B, Thielmann HW, Thomas DB, Vainio H, Vena JE, Vineis P, Weiderpass E, Weisenburger DD, Woodruff TJ, Yorifuji T, Yu IJ, Zambon P, Zeeb H, Zhou SF. Differences in the carcinogenic evaluation of glyphosate between the International Agency for Research on Cancer (IARC) and the European Food Safety Authority (EFSA). J Epidemiol Community Health 2016; 70:741-5. [PMID: 26941213 PMCID: PMC4975799 DOI: 10.1136/jech-2015-207005] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | | | | | - Xaver Baur
- Charité University Medicine Berlin, Berlin, Germany
| | - Igor Belyaev
- Cancer Research Institute, Bratislava, Slovak Republic
| | - Robert Bellé
- Sorbonne Universités, UPMC Univ Paris 06, UMR8227, Roscoff, France
| | | | - Annibale Biggeri
- Institute for Cancer Prevention and Research, University of Florence, Italy
| | | | - Paolo Bruzzi
- National Cancer Research Institute, San Martino—IST Hospital, Genoa, Italy
| | | | - Merete D Bugge
- STAMI, National Institute of Occupational Health, Oslo, Norway
| | | | - Gloria M Calaf
- Instituto de Alta Investigación, Universidad de Tarapacá, Arica, Chile
| | - David O Carpenter
- Institute for Health and the Environment, University at Albany, Rensselaer, New York, USA
| | | | | | - Richard Clapp
- Boston University School of Public Health, Boston, Massachusetts, USA
| | - Pierluigi Cocco
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Dario Consonni
- Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pietro Comba
- Department of Environment and Primary Prevention, IstitutoSuperiore di Sanità, Rome, Italy
| | - Elena Craft
- Environmental Defense Fund, Austin, Texas, USA
| | - Mohamed Aqiel Dalvie
- Center for Environmental and Occupational Health, University of Cape Town, Cape Town, South Africa
| | - Devra Davis
- Environmental Health Trust, Jackson Hole, Wyoming, USA and The Hebrew University Hadassah School of Medicine, Jerusalem, Israel.
| | - Paul A Demers
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jamie DeWitt
- Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | | | | | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Caroline Gaus
- Department of Environmental Toxicology, The University of Queensland, Brisbane, Australia
| | - Julia M Gohlke
- Department of Population Health Sciences, Virginia Tech, Blacksburg, Virginia, USA
| | | | | | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Michael Hauptmann
- Biostatistics Branch, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wei Huang
- Faculty of Department of Occupational and Environmental Health, Peking Univ School of Public Health, Beijing, China
| | - James Huff
- National Institute for Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | | | - C W Jameson
- CWJ Consulting, LLC, Cape Coral, Florida, USA
| | - Andreas Kortenkamp
- Institute of Environment, Health and Societies, Brunel University London, London, UK
| | | | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marcelo L Larramendy
- National Council of Scientific and Technological Research, National University of La Plata, Argentina
| | - Philip J Landrigan
- Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai,New York, USA
| | - Lawrence H Lash
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | | | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Corrado Magnani
- Cancer Epidemiology Unit, University of Eastern Piedmont, Novara, Italy
| | | | | | - Enzo Merler
- Department of Prevention, Occupational Health Unit, National Health Service, Padua, Italy
| | | | - Lucia Miligi
- Occupational and Environmental Epidemiology Unit, ISPO-Cancer Prevention and Research Institute, Florence, Italy
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, University of Turin and CPO-Piemonte, Torino, Italy
| | - Franklin E Mirer
- Department of Environmental and Occupational Health Sciences, City University of New York School of Public Health, USA
| | - Saloshni Naidoo
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington DC, USA
| | - Maria Grazia Petronio
- Health and Environment-Department of Prevention, Local Health Authority-Empoli, Florence, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnology “Charles Darwin”, Sapienza Rome University, Italy
| | - Ralph J Portier
- Department of Environmental Sciences, School of the Coast & Environment, Louisiana State University, Baton Rouge, Los Angeles, USA
| | - Kenneth S Ramos
- Center for Applied Genetics and Genomic Medicine, University of Arizona Health Sciences, Tucson, Arizona, USA
| | - Larry W Robertson
- Iowa Superfund Research Program and the Interdisciplinary Graduate Program in Human Toxicology, University of Iowa, Iowa City, Iowa, USA
| | - Theresa Rodriguez
- Center for Research in Health, Work and Environment (CISTA), National Autonomous University of Nicaragua (UNAN-León), León, Nicaragua
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Associated Institute of the University of Basel, Basel, Switzerland
| | - Matt K Ross
- College of Veterinary Medicine, Mississippi State University, Mississippi State, USA
| | - Deodutta Roy
- Department of Environmental and Occupational Health, Florida International University, Miami, Florida, USA
| | - Ivan Rusyn
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, USA
| | - Paulo Saldiva
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jennifer Sass
- Natural Resources Defense Council and George Washington University, Washington DC, USA
| | - Kai Savolainen
- Nanosafety Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Consolato Sergi
- Department of Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Ellen K Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Martyn T Smith
- School of Public Health, University of California, Berkeley, California, USA
| | - Bernard W Stewart
- Faculty of Medicine, University of New South Wales, Randwick, New South WalesAustralia
| | - Patrice Sutton
- Program on Reproductive Health and the Environment, University of California, San Francisco, California, USA
| | - Fabio Tateo
- Istituto di Geosceinze e Georisorse (CNR), Padova, Italy
| | | | - Heinz W Thielmann
- German Cancer Research Center, Heidelberg and Faculty of Pharmacy, Heidelberg University, Germany
| | - David B Thomas
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington, USA
| | - Harri Vainio
- Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
| | - John E Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Paolo Vineis
- Department of Environmental Epidemiology, Imperial College London, London, UK
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; and Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
| | | | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, USA
| | | | - Il Je Yu
- Institute of Nanoproduct Safety Research, Hoseo University, Asan, The Republic of Korea
| | | | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Shu-Feng Zhou
- College of Pharmacy, University of South Florida, Tampa, Florida, USA
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Taghipour S, Caudrelier LN, Miller AB, Harvey B. Using Simulation to Model and Validate Invasive Breast Cancer Progression in Women in the Study and Control Groups of the Canadian National Breast Screening Studies I and II. Med Decis Making 2016; 37:212-223. [PMID: 27465113 DOI: 10.1177/0272989x16660711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Modeling breast cancer progression and the effect of various risk is helpful in deciding when a woman should start and end screening, and how often the screening should be undertaken. METHODS We modeled the natural progression of breast cancer using a hidden Markov process, and incorporated the effects of covariates. Patients are women aged 50-59 (older) and 40-49 (younger) years from the Canadian National Breast Screening Studies. We included prevalent cancers, estimated the screening sensitivities and rates of over-diagnosis, and validated the models using simulation. RESULTS We found that older women have a higher rate of transition from a healthy to preclinical state and other causes of death but a lower rate of transition from preclinical to clinical state. Reciprocally, younger women have a lower rate of transition from a healthy to preclinical state and other causes of death but a higher rate of transition from a preclinical to clinical state. Different risk factors were significant for the age groups. The mean sojourn times for older and younger women were 2.53 and 2.96 years, respectively. In the study group, the sensitivities of the initial physical examination and mammography for older and younger women were 0.87 and 0.81, respectively, and the sensitivity of the subsequent screens were 0.78 and 0.53, respectively. In the control groups, the sensitivities of the initial physical examination for older and younger women were 0.769 and 0.671, respectively, and the sensitivity of the subsequent physical examinations for the control group aged 50-59 years was 0.37. The upper-bounds for over-diagnosis in older and younger women were 25% and 27%, respectively. CONCLUSIONS The present work offers a basis for the better modeling of cancer incidence for a population with the inclusion of prevalent cancers.
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Affiliation(s)
- Sharareh Taghipour
- Ryerson University, Department of Mechanical and Industrial Engineering, Toronto, ON, Canada (ST)
| | | | - Anthony B Miller
- University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada (ABM, BH)
| | - Bart Harvey
- University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada (ABM, BH)
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Miller AB, Feld R, Fontana R, Gohagan JK, Jatoi I, Lawrence W, Miller A, ProroK PC, Rajput A, Sherman M, Welch G, Wright P, Yurgalevitch S, Albertsen P. Changes in and Impact of the Death Review Process in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Rev Recent Clin Trials 2016; 10:206-11. [PMID: 26238119 DOI: 10.2174/1574887110666150730120752] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/14/2015] [Accepted: 07/16/2015] [Indexed: 11/22/2022]
Abstract
Death review was conducted for the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial to avoid the biases associated with causes of death entered on death certificates. An algorithm selected deaths for review. Records on diagnosis and terminal illness were perused in the coordinating center and by the chair of the death review committee (DRC). Identifying information and randomization arm was removed. Three reviewers independently determined the cause of death. Disagreement was resolved at a meeting of the DRC. This process was subsequently simplified. The cause of death was determined by one DRC member and compared to the death certificate. With agreement the case was finalized. When discordant, the records were sent to a second DRC member. If the reviewers agreed, the case was finalized. If not, a third member reviewed. If two of the three reviewers agreed, the case was sent back to the discordant reviewer. If the reviewer remained discordant the case was resolved by a conference call. Of the 4728 death reviews that were completed, the DRC confirmed the death certificate underlying cause for over 90%. Between 5% and 13% of the certified deaths were regarded as indirect causes of death, associated with the treatment of the ascertained cancer; differential for prostate cancer, 11% in the intervention arm and 6% in the control. Without review, between 1% and 6% of the deaths that occurred would not have been assigned to the relevant PLCO cancer. The DRC completed 76% of those requiring review before the process ceased.
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Affiliation(s)
- Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada.
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Affiliation(s)
- Matti Hakama
- Tampere School of Public Health, University of Tampere, Tampere FI-33014, Finland; Finnish Cancer Registry, Helsinki FI-00170, Finland
| | - Anssi Auvinen
- Finnish Cancer Institute and Tampere School of Public Health, University of Tampere, Tampere FI-33014, Finland
| | - Nicholas E Day
- Strangeways Research Laboratory, Institute of Public Health, Cambridge CB1 8RN, UK
| | - Anthony B Miller
- Department of Public Health Sciences, University of Toronto, Toronto, ON LOS 1JO, Canada
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Homenauth E, Ghiasi M, Feldman L, Arrouf N, Mallya S, Lacombe J, Pichika SC, Zhao K, Aibibula W, Krishnan R, Kajeguka D, Kaaya R, Protopopoff N, Mosha F, Desrochers R, Watts A, Kulkarni M, Saravu K, Nair S, Mukhopadhyay C, George LS, Pai M, Jiang H, Brown P, Blais L, Lefebvre G, Samoilenko M, Kulkarni M, Jolly A, Roy-Gagnon MH, Sander B, Gauvreau CL, Memon S, Popadiuk C, Flanagan WM, Nadeau C, Coldman AJ, Wolfson MC, Miller AB, Acar E, Cox J, Hamelin AM, McLinden T, Klein MB, Brassard P, Chong M, Martin J. The Canadian Society for Epidemiology and Biostatistics 2016 National Student Conference001INVESTIGATING ECOLOGICAL DETERMINANTS OF MALARIA VECTOR DISTRIBUTION IN RURAL TANZANIA “A MULTI-SCALAR INVESTIGATION”002PREVALENCE AND RISK FACTORS OF TUBERCULOSIS INFECTION AMONG HEALTHCARE TRAINEES IN SOUTH INDIA003SPATIAL MODELLING OF LUNG AND THYROID CANCERS IN UNITED STATES COUNTIES004A MEDIATION ANALYSIS TO ASSESS THE IMPACT OF INHALED CORTICOSTEROIDS (ICSS) DURING PREGNANCY ON BIRTHWEIGHT005MODELLING HUMAN RISK OF WEST NILE VIRUS IN ONTARIO, 2002-2013: INCORPORATING SURVEILLANCE AND ENVIRONMENTAL DATA006EXPLORING THE HEALTH OUTCOMES OF VARIOUS PAN-CANADIAN CERVICAL CANCER SCREENING PROGRAMS USING MICROSIMULATION MODELING007INTEGRATIVE ANALYSIS OF MICRORNA AND GENE EXPRESSION DATA USING SPARSE CANONICAL CORRELATION ANALYSIS008CONDITIONAL DEPENDENCE MODELS UNDER COVARIATE MEASUREMENT ERROR009ASSOCIATION BETWEEN FOOD INSECURITY AND HIV VIRAL SUPPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS010ANTIBIOTICS VERSUS APPENDECTOMY FOR UNCOMPLICATED APPENDICITIS: A GLOBAL HEALTH PERSPECTIVE. Am J Epidemiol 2016. [DOI: 10.1093/aje/kww058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Evans WK, Flanagan WM, Miller AB, Goffin JR, Memon S, Fitzgerald N, Wolfson MC. Implementing low-dose computed tomography screening for lung cancer in Canada: implications of alternative at-risk populations, screening frequency, and duration. ACTA ACUST UNITED AC 2016; 23:e179-87. [PMID: 27330355 DOI: 10.3747/co.23.2988] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Low-dose computed tomography (ldct) screening has been shown to reduce mortality from lung cancer; however, the optimal screening duration and "at risk" population are not known. METHODS The Cancer Risk Management Model developed by Statistics Canada for the Canadian Partnership Against Cancer includes a lung screening module based on data from the U.S. National Lung Screening Trial (nlst). The base-case scenario reproduces nlst outcomes with high fidelity. The impact in Canada of annual screening on the number of incident cases and life-years gained, with a wider range of age and smoking history eligibility criteria and varied participation rates, was modelled to show the magnitude of clinical benefit nationally and by province. Life-years gained, costs (discounted and undiscounted), and resource requirements were also estimated. RESULTS In 2014, 1.4 million Canadians were eligible for screening according to nlst criteria. Over 10 years, screening would detect 12,500 more lung cancers than the expected 268,300 and would gain 9200 life-years. The computed tomography imaging requirement of 24,000-30,000 at program initiation would rise to between 87,000 and 113,000 by the 5th year of an annual nlst-like screening program. Costs would increase from approximately $75 million to $128 million at 10 years, and the cumulative cost nationally over 10 years would approach $1 billion, partially offset by a reduction in the costs of managing advanced lung cancer. CONCLUSIONS Modelling various ways in which ldct might be implemented provides decision-makers with estimates of the effect on clinical benefit and on resource needs that clinical trial results are unable to provide.
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Affiliation(s)
| | | | - A B Miller
- Dalla Lana School of Public Health, Toronto, ON
| | | | - S Memon
- Canadian Partnership Against Cancer, Toronto, ON
| | - N Fitzgerald
- Canadian Partnership Against Cancer, Toronto, ON
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Miller AB. Response to: “[Yaffe’s] Response to: ‘Beyond the Mammography Debate: A Moderate Perspective’”. Curr Oncol 2016; 23:e322-3. [DOI: 10.3747/co.23.3105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In his response to Constantine Kaniklidis and to my colleague Dr. Steven Narod, Martin Yaffe makes two assertions about the Canadian National Breast Screening Study (CNBSS), one of which we have previously responded to; the other, however, is new [...]
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Marcus PM, Doria-Rose VP, Gareen IF, Brewer B, Clingan K, Keating K, Rosenbaum J, Rozjabek HM, Rathmell J, Sicks J, Miller AB. Did death certificates and a death review process agree on lung cancer cause of death in the National Lung Screening Trial? Clin Trials 2016; 13:434-8. [PMID: 27006427 DOI: 10.1177/1740774516638345] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND/AIMS Randomized controlled trials frequently use death review committees to assign a cause of death rather than relying on cause of death information from death certificates. The National Lung Screening Trial, a randomized controlled trial of lung cancer screening with low-dose computed tomography versus chest X-ray for heavy and/or long-term smokers ages 55-74 years at enrollment, used a committee blinded to arm assignment for a subset of deaths to determine whether cause of death was due to lung cancer. METHODS Deaths were selected for review using a pre-determined computerized algorithm. The algorithm, which considered cancers diagnosed during the trial, causes and significant conditions listed on the death certificate, and the underlying cause of death derived from death certificate information by trained nosologists, selected deaths that were most likely to represent a death due to lung cancer (either directly or indirectly) and deaths that might have been erroneously assigned lung cancer as the cause of death. The algorithm also selected deaths that might be due to adverse events of diagnostic evaluation for lung cancer. Using the review cause of death as the gold standard and lung cancer cause of death as the outcome of interest (dichotomized as lung cancer versus not lung cancer), we calculated performance measures of the death certificate cause of death. We also recalculated the trial primary endpoint using the death certificate cause of death. RESULTS In all, 1642 deaths were reviewed and assigned a cause of death (42% of the 3877 National Lung Screening Trial deaths). Sensitivity of death certificate cause of death was 91%; specificity, 97%; positive predictive value, 98%; and negative predictive value, 89%. About 40% of the deaths reclassified to lung cancer cause of death had a death certificate cause of death of a neoplasm other than lung. Using the death certificate cause of death, the lung cancer mortality reduction was 18% (95% confidence interval: 4.2-25.0), as compared with the published finding of 20% (95% confidence interval: 6.7-26.7). CONCLUSION Death review may not be necessary for primary-outcome analyses in lung cancer screening trials. If deemed necessary, researchers should strive to streamline the death review process as much as possible.
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Affiliation(s)
| | | | - Ilana F Gareen
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA
| | | | | | | | | | | | | | - JoRean Sicks
- Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Portier CJ, Armstrong BK, Baguley BC, Baur X, Belyaev I, Bellé R, Belpoggi F, Biggeri A, Bosland MC, Bruzzi P, Budnik LT, Bugge MD, Burns K, Calaf GM, Carpenter DO, Carpenter HM, López-Carrillo L, Clapp R, Cocco P, Consonni D, Comba P, Craft E, Dalvie MA, Davis D, Demers PA, De Roos AJ, DeWitt J, Forastiere F, Freedman JH, Fritschi L, Gaus C, Gohlke JM, Goldberg M, Greiser E, Hansen J, Hardell L, Hauptmann M, Huang W, Huff J, James MO, Jameson CW, Kortenkamp A, Kopp-Schneider A, Kromhout H, Larramendy ML, Landrigan PJ, Lash LH, Leszczynski D, Lynch CF, Magnani C, Mandrioli D, Martin FL, Merler E, Michelozzi P, Miligi L, Miller AB, Mirabelli D, Mirer FE, Naidoo S, Perry MJ, Petronio MG, Pirastu R, Portier RJ, Ramos KS, Robertson LW, Rodriguez T, Röösli M, Ross MK, Roy D, Rusyn I, Saldiva P, Sass J, Savolainen K, Scheepers PTJ, Sergi C, Silbergeld EK, Smith MT, Stewart BW, Sutton P, Tateo F, Terracini B, Thielmann HW, Thomas DB, Vainio H, Vena JE, Vineis P, Weiderpass E, Weisenburger DD, Woodruff TJ, Yorifuji T, Yu IJ, Zambon P, Zeeb H, Zhou SF. Differences in the carcinogenic evaluation of glyphosate between the International Agency for Research on Cancer (IARC) and the European Food Safety Authority (EFSA). J Epidemiol Community Health 2016. [PMID: 26941213 DOI: 10.1136/jech-2015-207005.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | | | - Xaver Baur
- Charité University Medicine Berlin, Berlin, Germany
| | - Igor Belyaev
- Cancer Research Institute, Bratislava, Slovak Republic
| | - Robert Bellé
- Sorbonne Universités, UPMC Univ Paris 06, UMR8227, Roscoff, France
| | | | - Annibale Biggeri
- Institute for Cancer Prevention and Research, University of Florence, Italy
| | | | - Paolo Bruzzi
- National Cancer Research Institute, San Martino-IST Hospital, Genoa, Italy
| | | | - Merete D Bugge
- STAMI, National Institute of Occupational Health, Oslo, Norway
| | | | - Gloria M Calaf
- Instituto de Alta Investigación, Universidad de Tarapacá, Arica, Chile
| | - David O Carpenter
- Institute for Health and the Environment, University at Albany, Rensselaer, New York, USA
| | | | | | - Richard Clapp
- Boston University School of Public Health, Boston, Massachusetts, USA
| | - Pierluigi Cocco
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Dario Consonni
- Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pietro Comba
- Department of Environment and Primary Prevention, IstitutoSuperiore di Sanità, Rome, Italy
| | - Elena Craft
- Environmental Defense Fund, Austin, Texas, USA
| | - Mohamed Aqiel Dalvie
- Center for Environmental and Occupational Health, University of Cape Town, Cape Town, South Africa
| | - Devra Davis
- Environmental Health Trust, Jackson Hole, Wyoming, USA and The Hebrew University Hadassah School of Medicine, Jerusalem, Israel
| | - Paul A Demers
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jamie DeWitt
- Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | | | | | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Caroline Gaus
- Department of Environmental Toxicology, The University of Queensland, Brisbane, Australia
| | - Julia M Gohlke
- Department of Population Health Sciences, Virginia Tech, Blacksburg, Virginia, USA
| | | | | | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Michael Hauptmann
- Biostatistics Branch, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wei Huang
- Faculty of Department of Occupational and Environmental Health, Peking Univ School of Public Health, Beijing, China
| | - James Huff
- National Institute for Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | | | - C W Jameson
- CWJ Consulting, LLC, Cape Coral, Florida, USA
| | - Andreas Kortenkamp
- Institute of Environment, Health and Societies, Brunel University London, London, UK
| | | | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marcelo L Larramendy
- National Council of Scientific and Technological Research, National University of La Plata, Argentina
| | - Philip J Landrigan
- Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Lawrence H Lash
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | | | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Corrado Magnani
- Cancer Epidemiology Unit, University of Eastern Piedmont, Novara, Italy
| | | | | | - Enzo Merler
- Department of Prevention, Occupational Health Unit, National Health Service, Padua, Italy
| | | | - Lucia Miligi
- Occupational and Environmental Epidemiology Unit, ISPO-Cancer Prevention and Research Institute, Florence, Italy
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, University of Turin and CPO-Piemonte, Torino, Italy
| | - Franklin E Mirer
- Department of Environmental and Occupational Health Sciences, City University of New York School of Public Health, USA
| | - Saloshni Naidoo
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington DC, USA
| | - Maria Grazia Petronio
- Health and Environment-Department of Prevention, Local Health Authority-Empoli, Florence, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnology "Charles Darwin", Sapienza Rome University, Italy
| | - Ralph J Portier
- Department of Environmental Sciences, School of the Coast & Environment, Louisiana State University, Baton Rouge, Los Angeles, USA
| | - Kenneth S Ramos
- Center for Applied Genetics and Genomic Medicine, University of Arizona Health Sciences, Tucson, Arizona, USA
| | - Larry W Robertson
- Iowa Superfund Research Program and the Interdisciplinary Graduate Program in Human Toxicology, University of Iowa, Iowa City, Iowa, USA
| | - Theresa Rodriguez
- Center for Research in Health, Work and Environment (CISTA), National Autonomous University of Nicaragua (UNAN-León), León, Nicaragua
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Associated Institute of the University of Basel, Basel, Switzerland
| | - Matt K Ross
- College of Veterinary Medicine, Mississippi State University, Mississippi State, USA
| | - Deodutta Roy
- Department of Environmental and Occupational Health, Florida International University, Miami, Florida, USA
| | - Ivan Rusyn
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, USA
| | - Paulo Saldiva
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jennifer Sass
- Natural Resources Defense Council and George Washington University, Washington DC, USA
| | - Kai Savolainen
- Nanosafety Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Consolato Sergi
- Department of Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Ellen K Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Martyn T Smith
- School of Public Health, University of California, Berkeley, California, USA
| | - Bernard W Stewart
- Faculty of Medicine, University of New South Wales, Randwick, New South Wales Australia
| | - Patrice Sutton
- Program on Reproductive Health and the Environment, University of California, San Francisco, California, USA
| | - Fabio Tateo
- Istituto di Geosceinze e Georisorse (CNR), Padova, Italy
| | | | - Heinz W Thielmann
- German Cancer Research Center, Heidelberg and Faculty of Pharmacy, Heidelberg University, Germany
| | - David B Thomas
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington, USA
| | - Harri Vainio
- Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
| | - John E Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Paolo Vineis
- Department of Environmental Epidemiology, Imperial College London, London, UK
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; and Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | | | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, USA
| | | | - Il Je Yu
- Institute of Nanoproduct Safety Research, Hoseo University, Asan, The Republic of Korea
| | | | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Shu-Feng Zhou
- College of Pharmacy, University of South Florida, Tampa, Florida, USA
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Popadiuk C, Gauvreau CL, Bhavsar M, Nadeau C, Asakawa K, Flanagan WM, Wolfson MC, Coldman AJ, Memon S, Fitzgerald N, Lacombe J, Miller AB. Using the Cancer Risk Management Model to evaluate the health and economic impacts of cytology compared with human papillomavirus DNA testing for primary cervical cancer screening in Canada. ACTA ACUST UNITED AC 2016; 23:S56-63. [PMID: 26985148 DOI: 10.3747/co.23.2991] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In Canada, discussion about changing from cytology to human papillomavirus (hpv) dna testing for primary screening in cervical cancer is ongoing. However, the Canadian Task Force on Preventive Health Care has not yet made a recommendation, concluding that the evidence is insufficient. METHODS We used the cervical cancer and hpv transmission models of the Cancer Risk Management Model to study the health and economic outcomes of primary cytology compared with hpv dna testing in 14 screening scenarios with varying screening modalities and intervals. Projected cervical cancer cases, deaths, colposcopies, screens, costs, and incremental cost-effectiveness were evaluated. We performed sensitivity analyses for hpv dna test costs. RESULTS Compared with triennial cytology from age 25, 5-yearly hpv dna screening alone from age 30 resulted in equivalent incident cases and deaths, but 55% (82,000) fewer colposcopies and 43% (1,195,000) fewer screens. At hpv dna screening intervals of 3 years, whether alone or in an age-based sequence with cytology, screening costs are greater, but at intervals of more than 5 years, they are lower. Scenarios on the cost-effectiveness frontier were hpv dna testing alone every 10, 7.5, 5, or 3 years, and triennial cytology starting at age 21 or 25 when combined with hpv dna testing every 3 years. CONCLUSIONS Changing from cytology to hpv dna testing as the primary screening test for cervical cancer would be an acceptable strategy in Canada with respect to incidence, mortality, screening and diagnostic test volumes.
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Affiliation(s)
- C Popadiuk
- Department of Women's Health, Memorial University, St. John's, NL
| | - C L Gauvreau
- Canadian Partnership Against Cancer, Toronto, ON
| | - M Bhavsar
- Canadian Partnership Against Cancer, Toronto, ON
| | | | | | | | | | - A J Coldman
- Canadian Partnership Against Cancer, Toronto, ON
| | - S Memon
- Canadian Partnership Against Cancer, Toronto, ON
| | - N Fitzgerald
- Canadian Partnership Against Cancer, Toronto, ON
| | - J Lacombe
- Canadian Partnership Against Cancer, Toronto, ON
| | - A B Miller
- Dalla Lana School of Public Health, Toronto, ON
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Bleyer A, Baines C, Miller AB. Impact of screening mammography on breast cancer mortality. Int J Cancer 2015; 138:2003-12. [PMID: 26562826 DOI: 10.1002/ijc.29925] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 09/14/2015] [Accepted: 11/04/2015] [Indexed: 11/09/2022]
Abstract
The degree to which observed reductions in breast cancer mortality is attributable to screening mammography has become increasingly controversial. We examined this issue with three fundamentally different approaches: (i) Chronology--the temporal relationship of the onset of breast cancer mortality decline and the national implementation of screening mammography; (ii) Magnitude--the degree to which breast cancer mortality declined relative to the amount (penetration) of screening mammography; (iii) Analogy--the pattern of mortality rate reductions of other cancers for which population screening is not conducted. Chronology and magnitude were assessed with data from Europe and North America, with three methods applied to magnitude. A comparison of eight countries in Europe and North America does not demonstrate a correlation between the penetration of national screening and either the chronology or magnitude of national breast cancer mortality reduction. In the United States, the magnitude of the mortality decline is greater in the unscreened, younger women than in the screened population and regional variation in the rate of breast cancer mortality reduction is not correlated with screening penetrance, either as self-reported or by the magnitude of screening-induced increase in early-stage disease. Analogy analysis of United States data identifies 14 other cancers with a similar distinct onset of mortality reduction for which screening is not performed. These five lines of evidence from three different approaches and additional observations discussed do not support the hypothesis that mammography screening is a primary reason for the breast cancer mortality reduction in Europe and North America.
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Affiliation(s)
- Archie Bleyer
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Cornelia Baines
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Affiliation(s)
- Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Miller AB, Harirchi I, Lotfi MH, Noori M, Mirzaei M, Jafarizadea M, Sadeghian MR, Minosepehr M. Yazd Breast Cancer Project Profile; A Community Based Trial for the Evaluation of Self-Examination and Physical Examination of the Breast Cancer Disease. Iran J Med Sci 2015; 40:531-6. [PMID: 26538783 PMCID: PMC4628145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There is some evidence to suggest that a benefit might be derived from a program that incorporated both annual physical examination of the breast (BPx) and the teaching of breast self-examination (BSE). Current investigation presents the profile of a multicenter community based intervention for evaluating the effect of BSE+BPx on the reduction of morbidity and mortality due to breast cancer amongst women residing in urban areas of Yazd (Iran) from 2008 to 2018. There were three distinctive phases in this trial with 10 years duration: pilot phase with the duration of 1 year, active intervention phase with 4 rounds of annual screening of BPx+BSE and follow up phase with 5 years duration. Tools of enquiry included a pre-tested questionnaire, repeated annual physical examination of the breast and more importantly mammography, sonography, and fine needle aspiration (FNA). Data were analyzed using descriptive statistics such as frequencies, percent, mean (SD), tests of chi-square and student t-test with 95% confidence level. Comparison of socio-demographic and socio-economic factors such as age, age at marriage, family size, number of live births, occupation, education level, total family income and marital status showed that no significant difference was seen between the groups (P>0.05). A response rate of 84.5% was seen by participants of the experiment group visiting the health centers for the first BPx. Our results showed that except for the education and marital status, the difference in other main demographic and socio-economic factors between the groups were not significant, and the response rate of individuals in the experiment group was at an acceptable level.
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Affiliation(s)
- Anthony B Miller
- Department of Preventive Medicine and Biostatistics, University of Toronto, Toronto, Ontario, Canada, Iran
| | - Iraj Harirchi
- Department of Surgery, Medical Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Lotfi
- Department of Biostatistics and Epidemiology, Health Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,Correspondence: Mohammad Hassan Lotfi, MD, PhD; Department of Biostatistics and Epidemiology, Health Faculty, Shahid Sadoughi University of Medical Sciences, Daneshju Blvd., Yazd, Iran Tel: +98 35 36245853 Fax: +98 35 37247074
| | - Mahmoud Noori
- Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Mirzaei
- Deputy for Health Affairs, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Majid Jafarizadea
- Deputy for Health Affairs, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Mojgan Minosepehr
- Deputy for Health Affairs, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Affiliation(s)
- Ismail Jatoi
- Division of Surgical Oncology and Endocrine Surgery, University of Texas Health Science Center, San Antonio
| | - Anthony B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Prorok PC, Kramer BS, Miller AB. Study designs for determining and comparing sensitivities of disease screening tests. J Med Screen 2015; 22:213-20. [DOI: 10.1177/0969141315600003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 07/21/2015] [Indexed: 11/16/2022]
Abstract
Objective To investigate the capability of various study designs to determine the sensitivity of a disease screening test. Methods Quantities that can be calculated from these designs were derived and examined for their relationship to true sensitivity (the ability to detect unrecognized disease that would surface clinically in the absence of screening) and overdiagnosis. Results To examine the sensitivity of one test, the single cohort design, in which all participants receive the test, is particularly weak, providing only an upper bound on the true sensitivity, and yields no information about overdiagnosis. A randomized design, with one control arm and participants tested in the other, that includes sufficient post-screening follow-up, allows calculation of bounds on, and an approximation to, true sensitivity and also determination of overdiagnosis. Without follow-up, bounds on the true sensitivity can be calculated. To compare two tests, the single cohort paired design in which all participants receive both tests is precarious. The three arm randomized design with post screening follow-up is preferred, yielding an approximation to the true sensitivity, bounds on the true sensitivity, and the extent of overdiagnosis of each test. Without post screening follow-up, bounds on the true sensitivities can be calculated. When an unscreened control arm is not possible, the two-arm randomized design is recommended. Individual test sensitivities cannot be determined, but with sufficient post-screening follow-up, an order relationship can be established, as can the difference in overdiagnosis between the two tests.
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Affiliation(s)
- John R. Goffin
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | | | - Anthony B. Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Saima Memon
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada
| | - Michael C. Wolfson
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - William K. Evans
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
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