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Fan H, Yu Y, Nan H, Hoyt M, Reger MK, Prizment A, Anderson KE, Zhang J. Associations between intake of calcium, magnesium and phosphorus and risk of pancreatic cancer: a population-based, case-control study in Minnesota. Br J Nutr 2021; 126:1549-1557. [PMID: 33494844 DOI: 10.1017/s0007114521000283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Experimental studies suggest that abnormal levels of Ca, Mg and phosphorus are implicated in pancreatic carcinogenesis. We investigated the associations between intakes of these minerals and the risk of pancreatic cancer in a case-control study conducted in 1994-1998. Cases of pancreatic cancer (n 150) were recruited from all hospitals in the metropolitan area of the Twin Cities and Mayo Clinic, Minnesota. Controls (n 459) were randomly selected from the general population and frequency matched to cases by age, sex and race. All dietary variables were adjusted for energy intake using the residual method prior to data analysis. Logistic regression was performed to evaluate the associations between intake of three nutrients examined and the risk of pancreatic cancer. Total intake of Ca (936 v. 1026 mg/d) and dietary intake of Mg (315 v. 331 mg/d) and phosphorus (1350 v. 1402 mg/d) were significantly lower in cases than in controls. After adjustment for confounders, there were not significant associations of total and dietary intakes of Ca, Mg and phosphorus with the risk of pancreatic cancer. In addition, no significant interactions exist between intakes of these minerals and total fat on pancreatic cancer risk. In conclusion, the present study does not suggest that intakes of Ca, Mg and phosphorus were significantly associated with the risk of pancreatic cancer.
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Affiliation(s)
- Hao Fan
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Yunpeng Yu
- Department of Biostatistics, Indiana University Richard M. Fairbanks School of Public Health and School of Medicine, Indianapolis, IN, USA
| | - Haocheng Nan
- Department of Surgery, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Margaret Hoyt
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Michael K Reger
- College of Health Professions, Ferris State University, Big Rapids, MI, USA
| | - Anna Prizment
- Division of Hematology, Oncology and Transplantation, Medical School and Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Jianjun Zhang
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
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2
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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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3
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Oyenuga M, Vierkant RA, Lynch CF, Pengo T, Tillmans LS, Cerhan JR, Church TR, Lazovich D, Anderson KE, Limburg PJ, Prizment AE. Associations between tissue-based CD3+ T-lymphocyte count and colorectal cancer survival in a prospective cohort of older women. Mol Carcinog 2020; 60:15-24. [PMID: 33200476 DOI: 10.1002/mc.23267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/18/2020] [Accepted: 10/28/2020] [Indexed: 12/11/2022]
Abstract
Tumor-infiltrating lymphocytes in colorectal cancer (CRC) predict better survival. However, associations between T-lymphocyte count in histologically normal tissues from patients with CRC and survival remain uncertain. We examined associations of CD3+ T-cells in colorectal tumor and histologically normal tissues with CRC-specific and all-cause mortality in the prospective Iowa Women's Health Study. Tissue microarrays were constructed using paraffin-embedded colorectal tissue samples from 464 women with tumor tissues and 314 women with histologically normal tissues (55-69 years at baseline) diagnosed with incident CRC from 1986 to 2002 and followed through 2014 (median follow-up 20.5 years). Three tumor and two histologically normal tissue cores for each patient were immunostained using CD3+ antibody and quantified, and the counts were averaged across the cores in each tissue. Cox proportional hazards regression estimated hazard ratios (HR) and 95% confidence interval (CI) for CRC-specific and all-cause mortality. After adjustment for age at diagnosis, body mass index, smoking status, tumor grade, and stage, HRs (95% CI) for the highest versus lowest tertile of tumor CD3+ score were 0.59 (0.38-0.89) for CRC-specific mortality and 0.82 (0.63-1.05) for all-cause mortality; for histologically normal CD3+ score, the corresponding HRs (95% CI) were 0.47 (0.19-1.17) and 0.50 (0.27-0.90), respectively. The CD3+ score combining the tumor and histologically normal scores was inversely associated with CRC-specific and all-cause mortality. Although the association between tumor CD3+ score and all-cause mortality was not significant, both higher CD3+ T-lymphocyte counts in tumor and histologically normal scores tended to be associated with lower CRC-specific and all-cause mortality.
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Affiliation(s)
- Mosunmoluwa Oyenuga
- Department of Internal Medicine, SSM St Mary's Hospital, St. Louis, Missouri, USA.,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robert A Vierkant
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Thomas Pengo
- University of Minnesota Informatics Institute, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lori S Tillmans
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - James R Cerhan
- Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy R Church
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - DeAnn Lazovich
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Paul J Limburg
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Anna E Prizment
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.,Division of Hematology, Oncology, and Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
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4
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Yin H, Hardikar S, Lindstroem S, Hsu L, Anderson KE, Banbury BL, Berndt SI, Chan AT, Giovanucci EL, Harrison TA, Joshi AD, Nan H, Potter JD, Sakoda LC, Slattery ML, Schoen RE, White E, Peters U, Newcomb PA. Telomere Maintenance Variants and Survival after Colorectal Cancer: Smoking- and Sex-Specific Associations. Cancer Epidemiol Biomarkers Prev 2020; 29:1817-1824. [PMID: 32586834 PMCID: PMC7928192 DOI: 10.1158/1055-9965.epi-19-1507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/06/2019] [Revised: 02/14/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Telomeres play an important role in colorectal cancer prognosis. Variation in telomere maintenance genes may be associated with survival after colorectal cancer diagnosis, but evidence is limited. In addition, possible interactions between telomere maintenance genes and prognostic factors, such as smoking and sex, also remain to be investigated. METHODS We conducted gene-wide analyses of colorectal cancer prognosis in 4,896 invasive colorectal cancer cases from the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO); 1,871 common variants within 13 telomere maintenance genes were included. Cox models were fit to estimate associations of these variants individually with overall and colorectal cancer-specific survival. Likelihood ratio tests were used to test for interaction by smoking and sex. P values were adjusted using Bonferroni correction. RESULTS The association between minor allele of rs7200950 (ACD) with colorectal cancer-specific survival varied significantly by smoking pack-years (corrected P = 0.049), but no significant trend was observed. By sex, minor alleles for rs2975843 (TERF1), rs75676021 (POT1), and rs74429678 (POT1) were associated with decreased overall and/or colorectal cancer-specific survival in women but not in men. CONCLUSIONS Our study reported a gene-wide statistically significant interaction with sex (TERF1, POT1). Although significant interaction by smoking pack-years (ACD) was observed, there was no evidence of a dose response. Validation of these findings in other large studies and further functional annotation on these SNPs are warranted. IMPACT Our study found a gene-smoking and gene-sex interaction on survival after colorectal cancer diagnosis, providing new insights into the role of genetic polymorphisms in telomere maintenance on colorectal cancer prognosis.
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Affiliation(s)
- Hang Yin
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Sheetal Hardikar
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Sara Lindstroem
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Li Hsu
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Barbara L Banbury
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Andrew T Chan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Edward L Giovanucci
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Departments of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Tabitha A Harrison
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Amit D Joshi
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Hongmei Nan
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
- Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana
| | - John D Potter
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Lori C Sakoda
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Martha L Slattery
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Robert E Schoen
- Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Emily White
- Department of Epidemiology, University of Washington, Seattle, Washington
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ulrike Peters
- Department of Epidemiology, University of Washington, Seattle, Washington
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Polly A Newcomb
- Department of Epidemiology, University of Washington, Seattle, Washington.
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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5
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Wang S, Lo Galbo MD, Blair C, Thyagarajan B, Anderson KE, Lazovich D, Prizment A. Diabetes and kidney cancer risk among post-menopausal women: The Iowa women's health study. Maturitas 2020; 143:190-196. [PMID: 33308628 DOI: 10.1016/j.maturitas.2020.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 06/22/2020] [Accepted: 07/28/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Many studies have reported a positive association between diabetes and kidney cancer. However, it is unclear whether diabetes is a risk factor for kidney cancer independent of other risk factors, such as obesity and hypertension. We comprehensively examined the association of diabetes and its duration with incident kidney cancer in the prospective cohort Iowa Women's Health Study (1986-2011). METHODS Diabetes status was self-reported at baseline (1986) and on five follow-up questionnaires. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of baseline and time-dependent diabetes with the risk of incident kidney cancer. RESULTS During the 25 years of follow-up, 245 cases of kidney cancer occurred among 36,975 post-menopausal women. In an age-adjusted model, there was a significant association between time-dependent diabetes and the risk of kidney cancer [HR (95% CI) = 1.76 (1.26, 1.45)]; the association was attenuated after multivariable adjustment for age, body mass index (BMI), waist-to-hip ratio (WHR), hypertension, physical activity, diuretic use, pack-years of smoking, alcohol intake, and total caloric intake [HR = 1.35 (0.94, 1.94)]. However, among non-obese women or women with a waist circumference less than 34.6 in., diabetes was significantly associated with kidney cancer risk: for time-dependent diabetes, HRs (95% CIs) were 1.82 (1.10, 3.00) among those with BMI < 30 kg/m2 and 2.18 (1.08, 4.38) among those with a waist circumference <34.6 in.. CONCLUSIONS Our results suggest that diabetes is associated with kidney cancer risk among non-obese post-menopausal women.
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Affiliation(s)
- Shuo Wang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States
| | - Mark D Lo Galbo
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States; Children's Minnesota, Minneapolis, MN, United States
| | - Cindy Blair
- Department of Internal Medicine, University of New Mexico, United States; University of New Mexico Comprehensive Cancer Center, United States
| | - Bharat Thyagarajan
- Masonic Cancer Center, University of Minnesota, United States; Department of Laboratory Medicine and Pathology, Medical School, University of Minnesota, United States
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States; Masonic Cancer Center, University of Minnesota, United States
| | - DeAnn Lazovich
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States; Masonic Cancer Center, University of Minnesota, United States
| | - Anna Prizment
- Masonic Cancer Center, University of Minnesota, United States; Division of Hematology, Oncology and Transplantation, Medical School, University of Minnesota, United States.
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6
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Antwi SO, Bamlet WR, Pedersen KS, Chaffee KG, Risch HA, Shivappa N, Steck SE, Anderson KE, Bracci PM, Polesel J, Serraino D, La Vecchia C, Bosetti C, Li D, Oberg AL, Arslan AA, Albanes D, Duell EJ, Huybrechts I, Amundadottir LT, Hoover R, Mannisto S, Chanock SJ, Zheng W, Shu XO, Stepien M, Canzian F, Bueno-de-Mesquita B, Quirós JR, Zeleniuch-Jacquotte A, Bruinsma F, Milne RL, Giles GG, Hébert JR, Stolzenberg-Solomon RZ, Petersen GM. Pancreatic cancer risk is modulated by inflammatory potential of diet and ABO genotype: a consortia-based evaluation and replication study. Carcinogenesis 2019; 39:1056-1067. [PMID: 29800239 DOI: 10.1093/carcin/bgy072] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/30/2018] [Accepted: 05/23/2018] [Indexed: 12/12/2022] Open
Abstract
Diets with high inflammatory potential are suspected to increase risk for pancreatic cancer (PC). Using pooled analyses, we examined whether this association applies to populations from different geographic regions and population subgroups with varying risks for PC, including variation in ABO blood type. Data from six case-control studies (cases, n = 2414; controls, n = 4528) in the Pancreatic Cancer Case-Control Consortium (PanC4) were analyzed, followed by replication in five nested case-control studies (cases, n = 1268; controls, n = 4215) from the Pancreatic Cancer Cohort Consortium (PanScan). Two polymorphisms in the ABO locus (rs505922 and rs8176746) were used to infer participants' blood types. Dietary questionnaire-derived nutrient/food intake was used to compute energy-adjusted dietary inflammatory index (E-DII®) scores to assess inflammatory potential of diet. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable-adjusted logistic regression. Higher E-DII scores, reflecting greater inflammatory potential of diet, were associated with increased PC risk in PanC4 [ORQ5 versus Q1=2.20, 95% confidence interval (CI) = 1.85-2.61, Ptrend < 0.0001; ORcontinuous = 1.20, 95% CI = 1.17-1.24], and PanScan (ORQ5 versus Q1 = 1.23, 95% CI = 0.92-1.66, Ptrend = 0.008; ORcontinuous = 1.09, 95% CI = 1.02-1.15). As expected, genotype-derived non-O blood type was associated with increased PC risk in both the PanC4 and PanScan studies. Stratified analyses of associations between E-DII quintiles and PC by genotype-derived ABO blood type did not show interaction by blood type (Pinteraction = 0.10 in PanC4 and Pinteraction=0.13 in PanScan). The results show that consuming a pro-inflammatory diet and carrying non-O blood type are each individually, but not interactively, associated with increased PC risk.
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Affiliation(s)
- Samuel O Antwi
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - William R Bamlet
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Kari G Chaffee
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Susan E Steck
- Cancer Prevention and Control Program, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Jerry Polesel
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (PN), Italy
| | - Diego Serraino
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (PN), Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Cristina Bosetti
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Ann L Oberg
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Alan A Arslan
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.,Department of Population Health, New York University School of Medicine, New York, NY, USA.,Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Eric J Duell
- Unit of Nutrition and Cancer, Bellvitge Biomedical Research Institute-IDIBELL, Catalan Institute of Oncology-ICO. L'Hospitalet de Llobregat, Barcelona, Spain
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, France
| | - Laufey T Amundadottir
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Robert Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Satu Mannisto
- Department of Public Health Solutions, National Institute for Health and Welfare Helsinki, Finland
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
| | - Magdalena Stepien
- International Agency for Research on Cancer, World Health Organization, France
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, UK.,Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, Kuala Lumpur, Malaysia
| | | | - Anne Zeleniuch-Jacquotte
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Fiona Bruinsma
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, Melbourne, Australia
| | - Roger L Milne
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, Melbourne, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, Melbourne, Australia
| | - James R Hébert
- Cancer Prevention and Control Program, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Rachael Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Gloria M Petersen
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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Onyeaghala G, Lane J, Pankratz N, Nelson HH, Thyagarajan B, Walcheck B, Anderson KE, Prizment AE. Association between MICA polymorphisms, s-MICA levels, and pancreatic cancer risk in a population-based case-control study. PLoS One 2019; 14:e0217868. [PMID: 31166958 PMCID: PMC6550421 DOI: 10.1371/journal.pone.0217868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/20/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Pancreatic tumor cells may avoid immune surveillance by releasing the transmembrane major histocompatibility complex class I chain-related A (MICA) protein in soluble form (s-MICA). We hypothesized that the presence of the A5.1 polymorphism in the MICA gene, which encodes a truncated MICA protein, is associated with higher s-MICA levels and increased pancreatic cancer risk. METHODS MICA alleles and s-MICA levels were measured in 121 pancreatic cancer cases and 419 controls. General linear regression with a log transformation assessed geometric means of s-MICA levels across MICA alleles. Unconditional logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals (CI) for pancreatic cancer associated with MICA alleles. RESULTS After multivariate adjustment, participants with at least one copy of the A5.1 allele versus no A5.1 allele had 1.35 (95% CI: 1.05-1.74) times greater s-MICA levels (1.65 times higher for cases and 1.28, for controls) and increased risk of pancreatic cancer (OR = 1.91, 95% CI: 1.05-3.48). CONCLUSIONS Our study suggests higher risk of pancreatic cancer among those with the MICA A5.1 polymorphism, which may be explained by an increase in s-MICA secretion and impaired immune response. IMPACT These findings provide further evidence at the genetic and molecular level of the important role of MICA in pancreatic cancer development, and may have important implications with regards to pancreatic cancer screening.
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Affiliation(s)
- Guillaume Onyeaghala
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States of America
| | - John Lane
- University of Minnesota Masonic Cancer Center, Minneapolis, MN, United States of America
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States of America
| | - Nathan Pankratz
- University of Minnesota Masonic Cancer Center, Minneapolis, MN, United States of America
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States of America
| | - Heather H. Nelson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States of America
- University of Minnesota Masonic Cancer Center, Minneapolis, MN, United States of America
| | - Bharat Thyagarajan
- University of Minnesota Masonic Cancer Center, Minneapolis, MN, United States of America
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States of America
| | - Bruce Walcheck
- University of Minnesota Masonic Cancer Center, Minneapolis, MN, United States of America
- Department of Veterinary and Biomedical Sciences, University of Minnesota, Saint Paul, MN, United States of America
| | - Kristin E. Anderson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States of America
- University of Minnesota Masonic Cancer Center, Minneapolis, MN, United States of America
| | - Anna E. Prizment
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States of America
- University of Minnesota Masonic Cancer Center, Minneapolis, MN, United States of America
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8
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Webb PM, Na R, Weiderpass E, Adami HO, Anderson KE, Bertrand KA, Botteri E, Brasky TM, Brinton LA, Chen C, Doherty JA, Lu L, McCann SE, Moysich KB, Olson S, Petruzella S, Palmer JR, Prizment AE, Schairer C, Setiawan VW, Spurdle AB, Trabert B, Wentzensen N, Wilkens L, Yang HP, Yu H, Risch HA, Jordan SJ. Use of aspirin, other nonsteroidal anti-inflammatory drugs and acetaminophen and risk of endometrial cancer: the Epidemiology of Endometrial Cancer Consortium. Ann Oncol 2019; 30:310-316. [PMID: 30566587 PMCID: PMC6386026 DOI: 10.1093/annonc/mdy541] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Regular use of aspirin has been associated with a reduced risk of cancer at several sites but the data for endometrial cancer are conflicting. Evidence regarding use of other analgesics is limited. PATIENTS AND METHODS We pooled individual-level data from seven cohort and five case-control studies participating in the Epidemiology of Endometrial Cancer Consortium including 7120 women with endometrial cancer and 16 069 controls. For overall analyses, study-specific odds ratios (ORs) and 95% confidence intervals (CI) were estimated using logistic regression and combined using random-effects meta-analysis; for stratified analyses, we used mixed-effects logistic regression with study as a random effect. RESULTS At least weekly use of aspirin and non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with an approximately 15% reduced risk of endometrial cancer among both overweight and obese women (OR = 0.86 [95% CI 0.76-0.98] and 0.86 [95% CI 0.76-0.97], respectively, for aspirin; 0.87 [95% CI 0.76-1.00] and 0.84 [0.74-0.96], respectively, for non-aspirin NSAIDs). There was no association among women of normal weight (body mass index < 25 kg/m2, Pheterogeneity = 0.04 for aspirin, Pheterogeneity = 0.003 for NSAIDs). Among overweight and obese women, the inverse association with aspirin was stronger for use 2-6 times/week (OR = 0.81, 95% CI 0.68-0.96) than for daily use (0.91, 0.80-1.03), possibly because a high proportion of daily users use low-dose formulations. There was no clear association with use of acetaminophen. CONCLUSION Our pooled analysis provides further evidence that use of standard-dose aspirin or other NSAIDs may reduce risk of endometrial cancer among overweight and obese women.
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Affiliation(s)
- P M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia; School of Public Health, University of Queensland, Brisbane, Australia.
| | - R Na
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - E Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; 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; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland; Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - H O 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
| | - K E Anderson
- School of Public Health, University of Minnesota, Minneapolis, USA
| | - K A Bertrand
- Slone Epidemiology Center, Boston University, Boston, USA
| | - E Botteri
- Women and Children's Division, Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway; Department of Bowel Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - T M Brasky
- Ohio State University Comprehensive Cancer Center, Columbus, USA
| | - L A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - C Chen
- Fred Hutchinson Cancer Research Center, Seattle, USA
| | - J A Doherty
- Fred Hutchinson Cancer Research Center, Seattle, USA; Huntsman Cancer Institute, University of Utah, Salt Lake City, USA; Huntsman Cancer Institute, University of Utah, Salt Lake City, USA; Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - L Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA
| | - S E McCann
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, USA
| | - K B Moysich
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, USA
| | - S Olson
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - S Petruzella
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - J R Palmer
- Slone Epidemiology Center, Boston University, Boston, USA
| | - A E Prizment
- School of Public Health, University of Minnesota, Minneapolis, USA
| | - C Schairer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - V W Setiawan
- University of Southern California, Los Angeles, USA
| | - A B Spurdle
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - B Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - N Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - L Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
| | - H P Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - H Yu
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
| | - H A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA
| | - S J Jordan
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia; School of Public Health, University of Queensland, Brisbane, Australia
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9
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Salameh H, Sarairah H, Rizwan M, Kuo YF, Anderson KE, Singal AK. Relapse of porphyria cutanea tarda after treatment with phlebotomy or 4-aminoquinoline antimalarials: a meta-analysis. Br J Dermatol 2018; 179:1351-1357. [PMID: 29750336 DOI: 10.1111/bjd.16741] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Porphyria cutanea tarda (PCT) is the most common human porphyria. It is caused by hepatic deficiency of uroporphyrinogen decarboxylase activity, which is acquired in the presence of multiple susceptibility factors. PCT presents clinically with cutaneous blistering photosensitivity and is readily treatable with either repeated phlebotomy or 4-aminoquinoline antimalarials. OBJECTIVES To perform a systematic review and meta-analysis to compare the effectiveness of these quite different treatment approaches, especially on relapse rates (RRs) after achieving remission. METHODS Published studies that included follow-up for at least 1 year after treatment of PCT were included. The primary study outcome was PCT relapse. Pooled data are reported as the RRs per person-year of follow-up with 95% confidence intervals (CIs). RESULTS Of 375 articles identified as pertaining to PCT treatment, 12 were eligible for analysis. Of these, five used high-dose 4-aminoquinoline regimens (two combined with phlebotomy and three without phlebotomy), five used low-dose 4-aminoquinoline regimens and three used phlebotomy. RRs during the year after treatment were similar for the high- and low-dose 4-aminoquinoline groups (35-36%) and lower in the phlebotomy group (20%). The pooled RRs with their 95% CIs were 8·6 (3·9-13·3) per 100 person-years in the high-dose 4-aminoquinoline group, 17·1 (8·9-25·3) per 100 person-years in the low-dose 4-aminoquinoline group and 5·1 (0·5-10·6) per 100 person-years in the phlebotomy group. Subgroup and sensitivity analyses showed similar results. CONCLUSIONS Clinical or biochemical RRs ranged from 5 to 17 per 100 person-years after remission of PCT. Relapses were somewhat more frequent after remission with 4-aminoquinoline regimens than after remission following phlebotomy. Prospective studies are needed to define better how often relapses occur with these treatments after documenting both clinical and biochemical remission of PCT.
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Affiliation(s)
- H Salameh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, U.S.A
| | - H Sarairah
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, U.S.A
| | - M Rizwan
- Division of Gastroenterology and Hepatology, University of Alabama, Birmingham, AL, U.S.A
| | - Y-F Kuo
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, U.S.A
| | - K E Anderson
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, U.S.A.,Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, U.S.A
| | - A K Singal
- Division of Gastroenterology and Hepatology, University of Alabama, Birmingham, AL, U.S.A
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10
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Mocka EH, Stern RA, Fletcher OJ, Anderson KE, Petitte JN, Mozdziak PE. Chemoprevention of spontaneous ovarian cancer in the domestic hen. Poult Sci 2018; 96:1901-1909. [PMID: 27915270 DOI: 10.3382/ps/pew422] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 10/26/2016] [Indexed: 01/24/2023] Open
Abstract
The hen is an attractive animal model for in vivo testing of agents that thwart ovarian carcinogenesis because ovarian cancer in the domestic hen features clinical and molecular alterations that are similar to ovarian cancer in humans, including a high incidence of p53 mutations. The objective of the study was to test the potential ovarian cancer chemopreventive effect of the p53 stabilizing compound CP-31398 on hens that spontaneously present the ovarian cancer phenotype. Beginning at 79 wk of age, 576 egg-laying hens (Gallus domesticus) were randomized to diets containing different amounts of CP-31398 for 94 wk, 5 d, comprising a control group (C) (n = 144), which was fed a diet containing 0 ppm (mg/kg) of CP-31398; a low-dose treatment (LDT) group (n = 144), which was fed a diet containing 100 ppm of CP-31398; a moderate-dose treatment (MDT) group (n = 144) which was fed a diet containing 200 ppm of CP-31398; and a high-dose treatment (HDT) group (n = 144), which was fed a diet containing 300 ppm of CP-31398. Hens were killed at 174 wk of age to determine the incidence of ovarian and oviductal adenocarcinomas. Whereas the incidence of localized and metastatic ovarian cancers in the MDT and HDT groups was significantly lower (up to 77%) compared to levels in the C and LDT groups (P < 0.05), the incidence of oviductal cancer was unaffected by CP-31398. CP-31398 appears to be an effective tool for chemoprevention against ovarian malignancies, but does not appear to affect oviductal malignancies.
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Affiliation(s)
- E H Mocka
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, 27695.,Graduate Physiology Program, North Carolina State University, Raleigh, 27695
| | - R A Stern
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, 27695.,Graduate Physiology Program, North Carolina State University, Raleigh, 27695
| | - O J Fletcher
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, 27695
| | - K E Anderson
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, 27695.,Graduate Physiology Program, North Carolina State University, Raleigh, 27695
| | - J N Petitte
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, 27695.,Graduate Physiology Program, North Carolina State University, Raleigh, 27695
| | - P E Mozdziak
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, 27695.,Graduate Physiology Program, North Carolina State University, Raleigh, 27695
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11
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Onyeaghala GC, Lane J, Pankratz N, Nelson HH, Thyagarajan B, Anderson KE, Prizment AE. Abstract 1219: Association between MICA polymorphisms, s-MICA levels, and pancreatic cancer risk in a population-based case-control study. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-1219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives: The immune system has been shown to play an important role in pancreatic cancer. Abnormal cells express the transmembrane major histocompatibility complex class I chain-related gene A (MICA) protein, which is recognized by receptors present on NK and cytotoxic T cells. However, pancreatic tumor cells release MICA protein in soluble form (called s-MICA) from the tumor surface and thus avoid immune surveillance. In our previous study, we showed that a higher serum concentration of the s-MICA protein was associated with increased pancreatic cancer risk. In the current study, we hypothesized that functional variants in the MICA gene are associated with higher circulating s-MICA levels and increased pancreatic cancer risk. We focused on the A5.1 MICA allele, as this allele encodes a MICA protein that is shorter than its normal counterpart and is more easily cleaved from the cell surface.
Methods: MICA alleles and s-MICA levels were measured in 116 cases and 492 controls (n=608) in a population-based case-control study in Minnesota. Allele assignments were based on the number of repeat units in the amplified regions of the MICA gene, and s-MICA levels were measured by enzyme-linked immunoabsorbent assay. To address the non-normal distribution of s-MICA levels, general linear regression with a log link was used to assess mean s-MICA levels across MICA alleles. Unconditional logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals (CI) for pancreatic cancer after adjustment for age, sex, education, smoking status, alcohol consumption, and diabetes status. The analysis was restricted to Caucasians, who represented 96% of all study participants.
Results: 452 participants (74%) possessed at least one copy of the A5.1 allele. After adjustment for confounders, participants with at least one copy of the MICA A5.1 allele were at an increased risk of pancreatic cancer (multivariable OR=2.00, 95% CI: 1.06-3.79), compared to participants who did not possess any A5.1 allele. Participants who had at least one copy of the A5.1 allele had 2.46 (95%CI: 2.36-2.56) times greater mean s-MICA levels than those without the A5.1 allele. These associations were consistent among pancreatic cancer cases and controls.
Conclusions: Our study supports the role of the MICA A5.1 allele in impaired immune response, which may increase the risk of pancreatic cancer.
Citation Format: Guillaume C. Onyeaghala, John Lane, Nathan Pankratz, Heather H. Nelson, Bharat Thyagarajan, Kristin E. Anderson, Anna E. Prizment. Association between MICA polymorphisms, s-MICA levels, and pancreatic cancer risk in a population-based case-control study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1219.
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Affiliation(s)
| | - John Lane
- 2Univ. of Minnesota, Minneapolis, MN
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12
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Blair TA, Moore SF, Walsh TG, Hutchinson JL, Durrant TN, Anderson KE, Poole AW, Hers I. Phosphoinositide 3-kinase p110α negatively regulates thrombopoietin-mediated platelet activation and thrombus formation. Cell Signal 2018; 50:111-120. [PMID: 29793021 DOI: 10.1016/j.cellsig.2018.05.005] [Citation(s) in RCA: 8] [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] [Received: 02/06/2018] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 01/21/2023]
Abstract
Phosphoinositide 3-kinase (PI3K) plays an important role in platelet function and contributes to platelet hyperreactivity induced by elevated levels of circulating peptide hormones, including thrombopoietin (TPO). Previous work established an important role for the PI3K isoform; p110β in platelet function, however the role of p110α is still largely unexplored. Here we sought to investigate the role of p110α in TPO-mediated hyperactivity by using a conditional p110α knockout (KO) murine model in conjunction with platelet functional assays. We found that TPO-mediated enhancement of collagen-related peptide (CRP-XL)-induced platelet aggregation and adenosine triphosphate (ATP) secretion were significantly increased in p110α KO platelets. Furthermore, TPO-mediated enhancement of thrombus formation by p110α KO platelets was elevated over wild-type (WT) platelets, suggesting that p110α negatively regulates TPO-mediated priming of platelet function. The enhancements were not due to increased flow through the PI3K pathway as phosphatidylinositol 3,4,5-trisphosphate (PI(3,4,5)P3) formation and phosphorylation of Akt and glycogen synthase kinase 3 (GSK3) were comparable between WT and p110α KO platelets. In contrast, extracellular responsive kinase (ERK) phosphorylation and thromboxane (TxA2) formation were significantly enhanced in p110α KO platelets, both of which were blocked by the MEK inhibitor PD184352, whereas the p38 MAPK inhibitor VX-702 and p110α inhibitor PIK-75 had no effect. Acetylsalicylic acid (ASA) blocked the enhancement of thrombus formation by TPO in both WT and p110α KO mice. Together, these results demonstrate that p110α negatively regulates TPO-mediated enhancement of platelet function by restricting ERK phosphorylation and TxA2 synthesis in a manner independent of its kinase activity.
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Affiliation(s)
- T A Blair
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
| | - S F Moore
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
| | - T G Walsh
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
| | - J L Hutchinson
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
| | - T N Durrant
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
| | - K E Anderson
- Inositide Laboratory, Babraham Institute, Cambridge, United Kingdom
| | - A W Poole
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom
| | - I Hers
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences Building, University of Bristol, Bristol, United Kingdom.
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13
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Akbari Moghaddam Kakhki R, Mousavi Z, Anderson KE. An appraisal of moulting on post-moult egg production and egg weight distribution in white layer hens; meta-analysis. Br Poult Sci 2018; 59:278-285. [PMID: 29376738 DOI: 10.1080/00071668.2018.1432032] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
1. The aim of this study was to establish how different moulting methods and body weight losses influenced post-moult performance and USDA egg weight distribution. 2. Data on 5 laying flocks (#34-38) of the North Carolina Layer Performance and Management Test were used in this meta-analysis. 3. The moulting methods were non-fasted moulted (NF), short feed restricted (SF), 13-d feed restricted (FR), non-anorexic moult programme (NA), non-anorexic moult programme with low sodium (NALS) as well as non-moulting programme as control treatment. The percentages of targeted body weight loss during the moulting period were 20, 24, 25 and 30% of body weight at the end of the first egg production cycle. 4. Post-moult egg production and egg mass were influenced by all moulting methods. Maximum increase in post-moult egg production rate and egg mass occurred with FR and NF programmes, respectively, at 30% of body weight loss, compared to non-moulted hens. Non-fasting methods reduced mortality rate more effectively than fasting methods. 5. Moulting resulted in increases in percentage of grade A and decreases in percentage of grade B eggs. Non-fasting methods increased percentage of grade A eggs more effectively than fasting methods. Percentage of cracked eggs decreased in moulted rather than non-moulted hens and the lowest rate was associated with the NA programme. 6. Post-moult egg weight was not significantly influenced by moulting methods. However, percentage of body weight reduction affected egg weight. The optimum increment in egg weight was achieved by 24% body weight reduction. 7. Overall, non-fasting methods resulted in similar egg production compared with fasting methods. Considering post-moult mortality and USDA egg weight distribution, non-fasting methods, especially NF and NA programmes, performed much better than fasting methods, indicating that non-fasting moulting methods, which are better for animal welfare, are effective alternatives to fasting methods.
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Affiliation(s)
| | - Z Mousavi
- b Department of Animal Science, Faculty of Agriculture , Ferdowsi University of Mashhad, Research and Development Unit, Dam Keshavarz Binalood Co , Mashhad , Iran
| | - K E Anderson
- c Prestage Department of Poultry Science , North Carolina State University , Raleigh , NC , USA
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14
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Quist AJL, Inoue-Choi M, Weyer PJ, Anderson KE, Cantor KP, Krasner S, Freeman LEB, Ward MH, Jones RR. Ingested nitrate and nitrite, disinfection by-products, and pancreatic cancer risk in postmenopausal women. Int J Cancer 2017; 142:251-261. [PMID: 28921575 DOI: 10.1002/ijc.31055] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 05/11/2017] [Revised: 08/11/2017] [Accepted: 09/01/2017] [Indexed: 12/11/2022]
Abstract
Nitrate and nitrite are precursors of N-nitroso compounds (NOC), probable human carcinogens that cause pancreatic tumors in animals. Disinfection by-products (DBP) exposures have also been linked with digestive system cancers, but few studies have evaluated relationships with pancreatic cancer. We investigated the association of pancreatic cancer with these drinking water contaminants and dietary nitrate/nitrite in a cohort of postmenopausal women in Iowa (1986-2011). We used historical monitoring and treatment data to estimate levels of long-term average nitrate and total trihalomethanes (TTHM; the sum of the most prevalent DBP class) and the duration exceeding one-half the maximum contaminant level (>½ MCL; 5 mg/L nitrate-nitrogen, 40 µg/L TTHM) among participants on public water supplies (PWS) >10 years. We estimated dietary nitrate and nitrite intakes using a food frequency questionnaire. We computed hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression and evaluated nitrate interactions with smoking and vitamin C intake. We identified 313 cases among 34,242 women, including 152 with >10 years PWS use (N = 15,710). Multivariable models of average nitrate showed no association with pancreatic cancer (HRp95vs. Q1 = 1.16, 95% CI: 0.51-2.64). Associations with average TTHM levels were also null (HRQ4vs. Q1 = 0.70, 95% CI:0.42-1.18). We observed no trend with increasing years of exposure to either contaminant at levels >½ MCL. Positive associations were suggested in the highest dietary nitrite intake from processed meat (HRp95vs. Q1 = 1.66, 95% CI 1.00-2.75;ptrend = 0.05). We found no interactions of nitrate with known modifiers of endogenous NOC formation. Our results suggest that nitrite intake from processed meat may be a risk factor for pancreatic cancer.
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Affiliation(s)
- Arbor J L Quist
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.,Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC
| | - Maki Inoue-Choi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Peter J Weyer
- Center for Health Effects of Environmental Contamination, University of Iowa, Iowa City, IA
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.,Prevention and Etiology Research Program, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Kenneth P Cantor
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
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Prizment AE, Vierkant RA, Smyrk TC, Tillmans LS, Nelson HH, Lynch CF, Thibodeau SN, Church TR, Cerhan JR, Anderson KE, Limburg PJ. Abstract 2247: Associations between total T-lymphocytes and colorectal cancer survival in a prospective cohort study of older women. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-2247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The increased number of T-lymphocytes residing in the tumors of colorectal cancer (CRC) patients is consistently shown to predict better survival of CRC patients independent of stage. In addition to tumor itself, T-lymphocytes also infiltrate normal tissues adjacent to tumors; however, little is known about how the inter-individual T-cell variability in tumor-adjacent tissues affects CRC prognosis. Our goal was to characterize total T-cells in colorectal tumor and tumor-adjacent tissues and study their associations with all-cause and CRC-specific survival in the Iowa Women’s Health Study.
Methods: We constructed tissue microarrays and quantified CD3 antibody staining (Clone F.7.238; Dako), an established marker for total T-cells, in paraffin-embedded tissue samples from 463 women diagnosed with incident CRC from 1986-2002 (mean age at diagnosis was 74 years). Up to 3 tumor and 3 tumor-adjacent cores were immunostained for each person. An experienced pathologist quantified CD3+ T cells in each area using 4 categories: non-detected, mild (1-10 cells per 0.28 mm2); moderate (11-29 cells per 0.28 mm2); and strong infiltration (≥30 cells per 0.28 mm2). The obtained scores were averaged over all quantified cores for each person. Cox regression was used to estimate the hazard ratio (HR) and 95% CI for all-cause and CRC mortality in relation to (1) tumor score; (2) tumor-adjacent score; and (3) the ratio of tumor to tumor-adjacent score, hereafter called Score ratio. All scores were categorized in quartiles. The final model adjusted for age at diagnosis, SEER stage, tumor grade, body mass and smoking history.
Results: During follow-up for a maximum of 25 years, 67% of participants diagnosed with CRC died (~30% died from CRC). There was a weak but significant correlation between CD3 tumor and tumor-adjacent scores (Spearman coefficient: r=0.15, p=0.02). CD3 tumor score was inversely associated with stage and was higher in those with proximal colon cancer, and for MSI-high, CIMP-high and BRAF-mutated tumors. The HRs (95%CI) for the highest versus lowest category of CD3 tumor score were 0.61 (0.44-0.84) (p-trend=0.003) for all-cause mortality and 0.27 (0.15-0.48) (p-trend <0.0001) for CRC-specific mortality. The tumor-adjacent score was not associated with any characteristics or death. The associations between the Score ratio and all-cause and CRC survival mirrored those for the tumor score but were weaker. The HRs (95%CI) for the highest versus lowest quartile of the Score ratio were 0.70 (0.45-1.09) (p-trend=0.09) for all-cause and 0.45 (0.23-0.87) (p-trend=0.003) for CRC-specific mortality.
Conclusions. Based on data from prospectively identified CRC cases in the IWHS cohort, colorectal tumor T-cell infiltration is associated with improved survival. Further investigation is needed to determine the T-cell subtypes that are most predictive of CRC survival outcomes.
Citation Format: Anna E. Prizment, Robert A. Vierkant, Thomas C. Smyrk, Lori S. Tillmans, Heather H. Nelson, Charles F. Lynch, Stephen N. Thibodeau, Timothy R. Church, James R. Cerhan, Kristin E. Anderson, Paul J. Limburg. Associations between total T-lymphocytes and colorectal cancer survival in a prospective cohort study of older women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2247. doi:10.1158/1538-7445.AM2017-2247
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Gaudet MM, Carter BD, Brinton LA, Falk RT, Gram IT, Luo J, Milne RL, Nyante SJ, Weiderpass E, Beane Freeman LE, Sandler DP, Robien K, Anderson KE, Giles GG, Chen WY, Feskanich D, Braaten T, Isaacs C, Butler LM, Koh WP, Wolk A, Adami HO, White E, Margolis KL, Thun MJ, Gapstur SM. Pooled analysis of active cigarette smoking and invasive breast cancer risk in 14 cohort studies. Int J Epidemiol 2017; 46:881-893. [PMID: 28031315 PMCID: PMC5837778 DOI: 10.1093/ije/dyw288] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [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] [Accepted: 09/09/2016] [Indexed: 11/15/2022] Open
Abstract
Background The 2014 US Surgeon General's report noted research gaps necessary to determine a causal relationship between active cigarette smoking and invasive breast cancer risk, including the role of alcohol consumption, timing of exposure, modification by menopausal status and heterogeneity by oestrogen receptor (ER) status. Methods To address these issues, we pooled data from 14 cohort studies contributing 934 681 participants (36 060 invasive breast cancer cases). Cox proportional hazard regression models were used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results Smoking duration before first birth was positively associated with risk ( P -value for trend = 2 × 10 -7 ) with the highest HR for initiation >10 years before first birth (HR = 1.18, CI 1.12-1.24). Effect modification by current alcohol consumption was evident for the association with smoking duration before first birth ( P -value=2×10 -4 ); compared with never-smoking non-drinkers, initiation >10 years before first birth was associated with risk in every category of alcohol intake, including non-drinkers (HR = 1.15, CI 1.04-1.28) and those who consumed at least three drinks per day (1.85, 1.55-2.21). Associations with smoking before first birth were limited to risk of ER+ breast cancer ( P -value for homogeneity=3×10 -3 ). Other smoking timing and duration characteristics were associated with risk even after controlling for alcohol, but were not associated with risk in non-drinkers. Effect modification by menopause was not evident. Conclusions Smoking, particularly if initiated before first birth, was modestly associated with ER+ breast cancer risk that was not confounded by amount of adult alcohol intake. Possible links with breast cancer provide additional motivation for young women to not initiate smoking.
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Affiliation(s)
- Mia M Gaudet
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Brian D Carter
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Inger T Gram
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Roger L Milne
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Sarah J Nyante
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Department of Radiology, University of North Carolina, Chapel Hill, NC, USA
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, NC, USA
| | - Kim Robien
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Wendy Y Chen
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Diane Feskanich
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Tonje Braaten
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Claudine Isaacs
- Department of Oncology, School of Medicine, Georgetown University, Washington, DC, USA
- Lombardi Comprehensive Cancer Center at Georgetown University, Washington, DC, USA
| | - Lesley M Butler
- University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Woon-Puay Koh
- Duke-NUS Graduate Medical School Singapore, Singapore, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alicja Wolk
- Department of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health Community, Boston, MA, USA
| | - Emily White
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Karen L Margolis
- HealthPartners Institute for Education and Research, Minneapolis, MN, USA
| | - Michael J Thun
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
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Onyeaghala G, Nelson HH, Thyagarajan B, Linabery AM, Panoskaltsis-Mortari A, Gross M, Anderson KE, Prizment AE. Soluble MICA is elevated in pancreatic cancer: Results from a population based case-control study. Mol Carcinog 2017; 56:2158-2164. [PMID: 28470829 DOI: 10.1002/mc.22667] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 04/20/2017] [Accepted: 05/01/2017] [Indexed: 01/23/2023]
Abstract
Pancreatic cancer is diagnosed at a late stage and has one of the highest cancer mortality rates in the United States, creating an urgent need for novel early detection tools. A candidate biomarker for use in early detection is the soluble MHC class I-related chain A (s-MICA) ligand, which pancreatic tumors shed to escape immune detection. The objective of this study was to define the association between s-MICA levels and pancreatic cancer, in a population-based case-control study. S-MICA was measured in 143 pancreatic cancer cases and 459 controls. Unconditional logistic regression was used to calculate odds ratio (OR) for pancreatic cancer and 95% confidence intervals (CI). There was a positive association between increasing s-MICA levels and pancreatic cancer: compared to the lowest tertile, the ORs for pancreatic cancer were 1.25 (95%CI: 0.75-2.07) and 2.10 (95%CI: 1.29-3.42) in the second and highest tertiles, respectively (P-trend = 0.02). Our study supports previous work demonstrating a positive association between plasma s-MICA levels and pancreatic cancer.
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Affiliation(s)
- Guillaume Onyeaghala
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Heather H Nelson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.,University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
| | - Bharat Thyagarajan
- University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota.,Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Amy M Linabery
- University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
| | - Angela Panoskaltsis-Mortari
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Myron Gross
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.,University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
| | - Anna E Prizment
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.,University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
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18
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Prizment AE, Vierkant RA, Smyrk TC, Tillmans LS, Nelson HH, Lynch CF, Pengo T, Thibodeau SN, Church TR, Cerhan JR, Anderson KE, Limburg PJ. Cytotoxic T Cells and Granzyme B Associated with Improved Colorectal Cancer Survival in a Prospective Cohort of Older Women. Cancer Epidemiol Biomarkers Prev 2017; 26:622-631. [PMID: 27979806 PMCID: PMC5380516 DOI: 10.1158/1055-9965.epi-16-0641] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 12/06/2016] [Accepted: 12/06/2016] [Indexed: 12/22/2022] Open
Abstract
Background: Host immune response may predict the course of colorectal cancer. We examined the survival of 468 colorectal cancer patients associated with two tumor-infiltrating immune biomarkers, the number of cytotoxic T lymphocytes (CTLs), and the activated CTLs, as reflected by the number of cells expressing granzyme B (GZMB) in the prospective Iowa Women's Health Study.Methods: Using paraffin-embedded tissue samples, we constructed and immunostained tumor microarrays with CD8 (for CTL) and GZMB antibodies. We scored CTL and GZMB densities in tumor epithelial and stromal tissues and also created a composite score for each biomarker (sum of the scores across tissue compartments). Cox regression estimated the HR and 95% confidence intervals (CI) for all-cause and colorectal cancer-specific death associated with each composite score.Results: CTL and GZMB composite scores were positively correlated (r = 0.65) and each biomarker was inversely correlated with stage at diagnosis. Both composite scores were higher in proximal colon tumors and tumors characterized by MSI-high, CIMP-high, or BRAF mutation status. HRs (95% CI) were 0.53 (0.38-0.75; Ptrend = 0.0004) and 0.66 (0.51-0.86; Ptrend = 0.002) for all-cause death, respectively, and 0.30 (0.18-0.51; Ptrend < 0.0001) and 0.41 (0.27-0.63; Ptrend < 0.0001) for colorectal cancer-related death, respectively. Including CTL and GZMB scores simultaneously in the model significantly improved the predictive performance of the models for all-cause and colorectal cancer-related death.Conclusions: Higher tumor infiltration with CTL and GZMB cells is associated with improved all-cause and cancer-specific survival of colorectal cancer patients.Impact: Both the number of CTLs and GZMB appear to be useful prognostic factors in colorectal cancer, irrespective of stage. Cancer Epidemiol Biomarkers Prev; 26(4); 622-31. ©2016 AACR.
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Affiliation(s)
- Anna E Prizment
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.
- University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
| | - Robert A Vierkant
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Thomas C Smyrk
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Lori S Tillmans
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Heather H Nelson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
- University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa
| | - Thomas Pengo
- University Imaging Centers, University of Minnesota, Minneapolis, Minnesota
| | - Stephen N Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Timothy R Church
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - James R Cerhan
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
- University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
| | - Paul J Limburg
- Division of Gastroenterology & Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
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Vogel RI, Strayer LG, Engelman L, Nelson HH, Blaes AH, Anderson KE, Lazovich D. Sun Exposure and Protection Behaviors among Long-term Melanoma Survivors and Population Controls. Cancer Epidemiol Biomarkers Prev 2017; 26:607-613. [PMID: 28254810 DOI: 10.1158/1055-9965.epi-16-0854] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 01/21/2023] Open
Abstract
Introduction: Melanoma is considered a generally preventable cancer, with excessive ultraviolet radiation (UVR) exposure being a strong causal factor. UVR exposure following a melanoma diagnosis can be modified to reduce risk of second primary melanomas. The goal of this study was to compare measures of UVR exposure and protection behaviors between long-term melanoma survivors and controls.Methods: Participants from a previously conducted case-control study were recruited for a cross-sectional survey. Melanoma cases were 25 to 59 years old at diagnosis; controls were age and sex matched. Participants were asked about UVR exposure and protection measures used in the past year, and comparisons between melanoma survivors and controls were conducted using logistic regression models, adjusting for potential confounders.Results: A total of 724 (62.0%) long-term melanoma survivors and 660 (59.9%) controls completed the follow-up survey. Melanoma survivors were significantly less likely to report high sun exposure on a typical weekday [OR, 0.72 (0.55-0.94)], sunburns [OR, 0.40 (0.30-0.53)], or indoor tanning [OR, 0.20 (0.09-0.44)] than controls; however, high sun exposure on a typical weekend day was similar. Report of optimal sun protection behaviors was higher in melanoma survivors compared with controls. However, a few melanoma survivors reported indoor tanning, 10% reported intentionally seeking sun to tan, and 20% reported sunburns.Conclusions: Although long-term melanoma survivors reported healthier UVR exposure and protection behaviors compared with controls, a sizeable proportion still reported elevated sun exposure, sunburns, and suboptimal UVR protection behaviors.Impact: Opportunities remain for improving sun protection to reduce future melanoma risk among melanoma survivors. Cancer Epidemiol Biomarkers Prev; 26(4); 607-13. ©2017 AACR.
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Affiliation(s)
- Rachel Isaksson Vogel
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota. .,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Lori G Strayer
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Leah Engelman
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Anne H Blaes
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Hematology and Oncology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Kristin E Anderson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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Jones RR, Weyer PJ, DellaValle CT, Inoue-Choi M, Anderson KE, Cantor KP, Krasner S, Robien K, Freeman LEB, Silverman DT, Ward MH. Nitrate from Drinking Water and Diet and Bladder Cancer Among Postmenopausal Women in Iowa. Environ Health Perspect 2016; 124:1751-1758. [PMID: 27258851 PMCID: PMC5089883 DOI: 10.1289/ehp191] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 12/15/2015] [Accepted: 05/18/2016] [Indexed: 05/18/2023]
Abstract
BACKGROUND Nitrate is a drinking water contaminant arising from agricultural sources, and it is a precursor in the endogenous formation of N-nitroso compounds (NOC), which are possible bladder carcinogens. OBJECTIVES We investigated the ingestion of nitrate and nitrite from drinking water and diet and bladder cancer risk in women. METHODS We identified incident bladder cancers among a cohort of 34,708 postmenopausal women in Iowa (1986-2010). Dietary nitrate and nitrite intakes were estimated from a baseline food frequency questionnaire. Drinking water source and duration were assessed in a 1989 follow-up. For women using public water supplies (PWS) > 10 years (n = 15,577), we estimated average nitrate (NO3-N) and total trihalomethane (TTHM) levels and the number of years exceeding one-half the maximum contaminant level (NO3-N: 5 mg/L, TTHM: 40 μg/mL) from historical monitoring data. We computed hazard ratios (HRs) and 95% confidence intervals (CIs), and assessed nitrate interactions with TTHM and with modifiers of NOC formation (smoking, vitamin C). RESULTS We identified 258 bladder cancer cases, including 130 among women > 10 years at their PWS. In multivariable-adjusted models, we observed nonsignificant associations among women in the highest versus lowest quartile of average drinking water nitrate concentration (HR = 1.48; 95% CI: 0.92, 2.40; ptrend = 0.11), and we found significant associations among those exposed ≥ 4 years to drinking water with > 5 mg/L NO3-N (HR = 1.62; 95% CI: 1.06, 2.47; ptrend = 0.03) compared with women having 0 years of comparable exposure. TTHM adjustment had little influence on associations, and we observed no modification by vitamin C intake. Relative to a common reference group of never smokers with the lowest nitrate exposures, associations were strongest for current smokers with the highest nitrate exposures (HR = 3.67; 95% CI: 1.43, 9.38 for average water NO3-N and HR = 3.48; 95% CI: 1.20, 10.06 and ≥ 4 years > 5 mg/L, respectively). Dietary nitrate and nitrite intakes were not associated with bladder cancer. CONCLUSIONS Long-term ingestion of elevated nitrate in drinking water was associated with an increased risk of bladder cancer among postmenopausal women. Citation: Jones RR, Weyer PJ, DellaValle CT, Inoue-Choi M, Anderson KE, Cantor KP, Krasner S, Robien K, Beane Freeman LE, Silverman DT, Ward MH. 2016. Nitrate from drinking water and diet and bladder cancer among postmenopausal women in Iowa. Environ Health Perspect 124:1751-1758; http://dx.doi.org/10.1289/EHP191.
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Affiliation(s)
- Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Peter J. Weyer
- Center for Health Effects of Environmental Contamination, University of Iowa, Iowa City, Iowa, USA
| | - Curt T. DellaValle
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Maki Inoue-Choi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
- National Institute on Minority Health and Health Disparities, NIH, DHHS, Bethesda, Maryland, USA
| | - Kristin E. Anderson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
- Prevention and Etiology Research Program, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kenneth P. Cantor
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Stuart Krasner
- Metropolitan Water District of Southern California, La Verne, California, USA
| | - Kim Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Laura E. Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Debra T. Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Mary H. Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
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Turton-Weeks S, Barone GW, Gurley BJ, Ketel BL, Lightfoot ML, Abul-Ezz SR, Anderson KE. Pretransplant Evaluation of a Patient with Acute Intermittent Porphyria. Prog Transplant 2016; 11:214-6. [PMID: 11949465 DOI: 10.1177/152692480101100311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The pretransplant evaluation of a patient with a rare diagnosis requires knowledge of the pathophysiology and the transplant literature. A 55-year-old man presented with hypertensive kidney failure and the clinical diagnosis of acute intermittent porphyria. Complications of acute intermittent porphyria, which is a defect of heme production, are due to the accumulation of heme intermediates often precipitated by medications. Based on animal data, cyclosporine is considered unsafe in patients with acute intermittent porphyria. As part of the pretransplant evaluation, the patient received separate trials of tacrolimus and cyclosporine, which did not stimulate his acute intermittent porphyria. Four months after a kidney transplant, the patient still had no signs of rejection or symptoms of acute intermittent porphyria. This is the first documented patient with acute intermittent porphyria who successfully received a kidney transplant using tacrolimus. Because of individual variations, pretransplant testing of calcineurin inhibitors should be continued in patients with acute intermittent porphyria.
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Affiliation(s)
- S Turton-Weeks
- University of Arkansas for Medical Sciences, Little Rock, Ark., USA
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Regmi P, Nelson N, Steibel JP, Anderson KE, Karcher DM. Comparisons of bone properties and keel deformities between strains and housing systems in end-of-lay hens. Poult Sci 2016; 95:2225-34. [PMID: 27433008 DOI: 10.3382/ps/pew199] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 01/12/2016] [Accepted: 05/04/2016] [Indexed: 01/28/2023] Open
Abstract
Susceptibility of caged layers to osteoporosis and cage layer fatigue has generated interest in newer housing systems that favor increased load-bearing activities. However, high incidences of fractures incurred during lay period have been reported in these newer systems. This study is aimed at determining the housing and strain effects on bone properties: dry weight, percentage ash content, cortical density (CBD), cortical thickness (CBT), and keel bone deformities. Tibia, femur, and keel from Hy-Line Brown (HB), Hy-Line Silver Brown (SB), and Barred Plymouth Rock (BR) hens housed in conventional cages (CC), cage-free (CF), and cage-free with range (outdoor access; R) were studied. At 78 wk, 60 hens from each strain and housing system combination were euthanized and bones were excised for analysis. Quantitative computed tomography (QCT) was used to measure CBD and CBT in each bone. Three-dimensional images of keels were generated from software using QCT scans to analyze the deformities. Tibiae CBT was greater (P < 0.01) in BR compared to other two strains. Between housing systems, CBT was greater (P < 0.05) for mid and distal tibia of R and CF compared to CC. Tibiae and femoral cortex were denser (P < 0.05) in BR compared to HB and SB. There was no effect of housing system for femur CBD, but CBD was greater (P < 0.05) for middle and distal tibia of birds housed in R compared to CC. CBD for keel bone was greater (P < 0.05) in CF and R birds compared to CC birds. The housing system did not influence the dry bone weight and ash percentage of tibiae and femur. Each housing system was associated with high prevalence (>90%) of keel deformities and the housing and genotype influenced the type of deformity. These findings indicate that range and cage-free housing may have beneficial impact on tibia and keel bone integrity compared to conventional cages but the improvement may not be sufficient to prevent fractures or deformities of keel.
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Affiliation(s)
- P Regmi
- Department of Animal Sciences, Michigan State University, East Lansing, Michigan
| | - N Nelson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - J P Steibel
- Department of Animal Sciences, Michigan State University, East Lansing, Michigan
| | - K E Anderson
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, North Carolina
| | - D M Karcher
- Department of Animal Sciences, Michigan State University, East Lansing, Michigan
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Prizment AE, Vierkant RA, Smyrk TC, Tillmans LS, Nelson HH, Lynch CF, Thibodeau SN, Church TR, Cerhan JR, Anderson KE, Limburg PJ. Abstract 2636: Tumor-infiltrating cytotoxic T-cells are associated with improved survival of colorectal cancer patients. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-2636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The immune response has been shown to impact the course of colorectal cancer (CRC). Our goal was to examine the survival of CRC patients in relation to tumor-infiltrating cytotoxic (CD8+) T lymphocytes (CTL). We quantified CTLs in tumor epithelial and stromal tissues and correlated them with clinicopathological characteristics and survival of CRC patients in the Iowa Women's Health Study.
Methods: Paraffin-embedded tissue samples were available from 465 post-menopausal women diagnosed with incident CRC in 1986-2002. Tumor microarrays were constructed and immunostained with a CD8 antibody (Clone 144B; Dako). CTLs in tumor epithelial and stromal tissues were categorized by an experienced pathologist into non-detected; mild (1-10 cells per core); moderate (11-29 cells); and strong infiltration (≥30 cells per core), and averaged over cores per each person. We used Cox regression to estimate the hazard ratio (HR) and 95% CI for total and CRC death in relation to each CTL score after adjusting for age of diagnosis, SEER stage, grade, body mass, smoking history and integrated molecular pathway for CRC. The tumors were categorized by integrated pathway (traditional, alternate, serrated, unassigned) based on the combination of phenotypes: microsatellite instability (MSI) status, CpG island methylator (CIMP) phenotype; and mutations in BRAF and/or KRAS genes (described in Samadder, 2013).
Results: During follow-up until 2011, 31% of participants died from CRC, 36% from all other causes, and 33% were alive (median follow-up: 8.4 y). The Spearman correlation coefficient between epithelial and stromal CTL scores was 0.52. Both scores were inversely correlated with stage at diagnosis and were higher in tumors characterized by MSI-high, CIMP-high and BRAF mutation-positive status. The highest categories in the epithelial and stromal scores were associated with statistically significant decreases in total death (by 44% and 40%, respectively) and CRC death (by 68% and 56%, respectively) compared to lowest categories. After summing epithelial and stromal CTL scores, the combined HRs (95% CI) in the highest versus lowest category were 0.55 (0.38-0.78) for total death (p-trend = 0.0002) and 0.36 (0.20-0.63) for CRC death (p-trend<0.0001). Additional adjustment for surgery, chemotherapy, radiation, and comorbidities did not markedly change the associations. Finally, there was a statistically significant quantitative interaction between stromal score and MSI status in relation to total and CRC death (P for interaction were 0.02 and 0.0001, respectively); HRs were lower for MSI-high than for MS-stable tumors. There was also a significant interaction between smoking status (current versus never) and epithelial CTL score: the HRs for total and CRC death were lowest among never smokers with the highest score.
Conclusions. Our study further supports infiltration of tumors with CTLs as an important prognostic factor in CRC.
Citation Format: Anna E. Prizment, Robert A. Vierkant, Thomas C. Smyrk, Lori S. Tillmans, Heather H. Nelson, Charles F. Lynch, Stephen N. Thibodeau, Timothy R. Church, James R. Cerhan, Kristin E. Anderson, Paul J. Limburg. Tumor-infiltrating cytotoxic T-cells are associated with improved survival of colorectal cancer patients. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2636.
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Affiliation(s)
- Anna E. Prizment
- 1University of Minnesota School of Public Health, Minneapolis, MN
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Onyeaghala GC, Lutsey PL, Demerath EW, Anderson KE, Folsom AR, Joshu CE, Platz EA, Prizment AE. Abstract 4302: Associations of leg length with increased colorectal cancer incidence in the atherosclerosis risk in communities (ARIC) study. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-4302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose
There is growing evidence that taller people have an increased risk of colorectal cancer, which is thought to be explained by an increased production of growth hormones during puberty and/or a larger pool of at-risk colonic cells. Long bone growth during puberty is, in part, promoted by insulin-like growth factor-1, a higher circulating level of which is a risk factor for colorectal cancer. Thus, we hypothesized that long-bone growth indicated by leg length would be the component of height that is more strongly associated with colorectal cancer. To address this hypothesis, we evaluated the association of leg length, sitting height and total height with colorectal cancer risk in the Atherosclerosis Risk in Communities (ARIC) prospective cohort.
Methods
The ARIC participants included 14,605 men and women who were cancer-free at baseline (1987-1989), and followed until 2006. Information about demographic, lifestyle, and anthropometric characteristics was obtained at baseline. Leg length was estimated as standing height minus sitting height. Incident colorectal cancers (n = 344) were ascertained by linkage to cancer registries and supplemented by hospital records.
Statistical analysis
Cox proportional hazards regression was used to estimate hazard ratios (HR) of colorectal cancer and 95% confidence intervals (CI) across quartiles of height, leg length, and sitting height. The final models were adjusted for age, sex, race, study center, education level, waist-to-hip ratio, female hormone replacement therapy use, and smoking status.
Results
Participants with longer legs tended to be male, African-American, and had higher education. Leg length was correlated with total (Pearson r = 0.83), and sitting height (Pearson r = 0.52). Participants in the highest quartile of leg length were at a 42% greater risk of colorectal cancer, relative to the lowest quartile (95% CI, 1.01-2.00, p-trend = 0.04). After stratification by gender, leg length remained associated with colorectal cancer risk in men (HR = 1.83, 95% CI, 1.11-3.05) but not in women (HR = 1.14, 95% CI, 0.70-1.83) for the highest versus the lowest quartile of leg length (p-interaction = 0.16). The HRs for the highest quartiles of total height and sitting height compared to the lowest quartiles were also increased, but the associations were weaker (HR = 1.25, 95% CI, 0.90-1.74, p-trend = 0.10 and HR = 1.30, 95% CI, 0.95-1.79, p-trend = 0.18 respectively).
Conclusion
In this prospective study, longer leg length was more strongly associated with an increased risk of colorectal cancer than overall height or sitting height. While we cannot rule out that the association between taller height and colorectal cancer risk may be explained by a larger pool of colonic cells in taller people, these findings support the prior observation that this association is driven by biological mechanisms correlated to long bone growth during puberty, such as insulin-like growth factor-1.
Citation Format: Guillaume C. Onyeaghala, Pamela L. Lutsey, Ellen W. Demerath, Kristin E. Anderson, Aaron R. Folsom, Corinne E. Joshu, Elizabeth A. Platz, Anna E. Prizment. Associations of leg length with increased colorectal cancer incidence in the atherosclerosis risk in communities (ARIC) study. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4302.
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Corby-Harris V, Snyder L, Meador CAD, Naldo R, Mott B, Anderson KE. Parasaccharibacter apium, gen. nov., sp. nov., Improves Honey Bee (Hymenoptera: Apidae) Resistance to Nosema. J Econ Entomol 2016; 109:537-43. [PMID: 26875068 DOI: 10.1093/jee/tow012] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The honey bee, Apis mellifera L., is host to a variety of microorganisms. The bacterial community that occupies the adult worker gut contains a core group of approximately seven taxa, while the hive environment contains its own distribution of bacteria that is in many ways distinct from the gut. Parasaccharibacter apium, gen. nov., sp. nov., is a hive bacterium found in food stores and in larvae, worker jelly, worker hypopharyngeal glands, and queens. Parasaccharibacter apium increases larval survival under laboratory conditions. To determine if this benefit is extended to colonies in the field, we tested if P. apium 1) survives and reproduces in supplemental pollen patty, 2) is distributed throughout the hive when added to pollen patty, 3) benefits colony health, and 4) increases the ability of bees to resist Nosema. Parasaccharibacter apium survived in supplemental diet and was readily consumed by bees. It was distributed throughout the hive under field conditions, moving from the pollen patty to hive larvae. While P. apium did not significantly increase colony brood production, food stores, or foraging rates, it did increase resistance to Nosema infection. Our data suggest that P. apium may positively impact honey bee health.
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Malfatti MA, Kuhn EA, Turteltaub KW, Vickers SM, Jensen EH, Strayer L, Anderson KE. Disposition of the Dietary Mutagen 2-Amino-3,8-dimethylimidazo[4,5-f]quinoxaline in Healthy and Pancreatic Cancer Compromised Humans. Chem Res Toxicol 2016; 29:352-8. [PMID: 26918625 DOI: 10.1021/acs.chemrestox.5b00495] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pancreatic cancer is the fourth leading cause of cancer death in the U.S. Once diagnosed, prognosis is poor with a 5-year survival rate of less than 5%. Exposure to carcinogenic heterocyclic amines (HCAs) derived from cooked meat has been shown to be positively associated with pancreatic cancer risk. To evaluate the processes that determine the carcinogenic potential of HCAs for human pancreas, 14-carbon labeled 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), a putative human carcinogenic HCA found in well-done cooked meat, was administered at a dietary relevant dose to human volunteers diagnosed with pancreatic cancer undergoing partial pancreatectomy and healthy control volunteers. After (14)C-MeIQx exposure, blood and urine were collected for pharmacokinetic and metabolite analysis. MeIQx-DNA adducts levels were quantified by accelerator mass spectrometry from pancreatic tissue excised during surgery from the cancer patient group. Pharmacokinetic analysis of plasma revealed a rapid distribution of MeIQx with a plasma elimination half-life of approximately 3.5 h in 50% of the cancer patients and all of the control volunteers. In 2 of the 4 cancer patients, very low levels of MeIQx were detected in plasma and urine suggesting low absorption from the gut into the plasma. Urinary metabolite analysis revealed five MeIQx metabolites with 2-amino-3-methylimidazo[4,5-f]quinoxaline-8-carboxylic acid being the most abundant accounting for 25%-50% of the recovered 14-carbon/mL urine. There was no discernible difference in metabolite levels between the cancer patient volunteers and the control group. MeIQx-DNA adduct analysis of pancreas and duodenum tissue revealed adduct levels indistinguishable from background levels. Although other meat-derived HCA mutagens have been shown to bind DNA in pancreatic tissue, indicating that exposure to HCAs from cooked meat cannot be discounted as a risk factor for pancreatic cancer, the results from this current study show that exposure to a single dietary dose of MeIQx does not readily form measurable DNA adducts under the conditions of the experiment.
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Affiliation(s)
- Michael A Malfatti
- Biosciences and Biotechnology Division, Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory , 7000 East Avenue, L-452, Livermore, California 94550, United States
| | - Edward A Kuhn
- Biosciences and Biotechnology Division, Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory , 7000 East Avenue, L-452, Livermore, California 94550, United States
| | - Kenneth W Turteltaub
- Biosciences and Biotechnology Division, Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory , 7000 East Avenue, L-452, Livermore, California 94550, United States
| | - Selwyn M Vickers
- University of Alabama , 1720 2nd Avenue South, Birmingham, Alabama 35233, United States
| | - Eric H Jensen
- University of Minnesota , Minneapolis, Minnesota 55455, United States
| | - Lori Strayer
- University of Minnesota , Minneapolis, Minnesota 55455, United States
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Affiliation(s)
- R Thawani
- From the Department of Pediatric Hematology/Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India and
| | - A Moghe
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, USA
| | - T Idhate
- From the Department of Pediatric Hematology/Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India and
| | - M Kalra
- From the Department of Pediatric Hematology/Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India and
| | - A Mahajan
- From the Department of Pediatric Hematology/Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India and
| | - K E Anderson
- From the Department of Pediatric Hematology/Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India and
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Bardia A, Keenan TE, Ebbert JO, Lazovich D, Wang AH, Vierkant RA, Olson JE, Vachon CM, Limburg PJ, Anderson KE, Cerhan JR. Personalizing Aspirin Use for Targeted Breast Cancer Chemoprevention in Postmenopausal Women. Mayo Clin Proc 2016; 91:71-80. [PMID: 26678006 PMCID: PMC4807132 DOI: 10.1016/j.mayocp.2015.10.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 09/28/2015] [Accepted: 10/23/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the association of aspirin and other nonsteroidal anti-inflammatory drugs with the incidence of postmenopausal breast cancer for risk subgroups defined by selected nonmodifiable or difficult to modify breast cancer risk factors in order to better understand the potential risk-benefit ratio for targeted chemoprevention. PATIENTS AND METHODS Postmenopausal women with no history of cancer on July 1, 1992 (N=26,580), were prospectively followed up through December 31, 2005, for breast cancer incidence (N=1581). Risk subgroups were defined on the basis of family history of breast cancer, age at menarche, age at menopause, parity/age at first live birth, personal history of benign breast disease, and body mass index. Hazard ratios (HRs) and 95% CIs adjusted for other breast cancer risk factors were estimated using Cox models. RESULTS Aspirin use was associated with a lower incidence of breast cancer for women with a family history of breast cancer (HR, 0.62 for 6 or more times per week vs never use; 95% CI, 0.41-0.93) and those with a personal history of benign breast disease (HR, 0.69; 95% CI, 0.50-0.95) but not for women in higher-risk subgroups for age at menarche, age at menopause, parity/age at first live birth, or body mass index. In contrast, inverse associations with aspirin use were observed in all lower-risk subgroups. Nonsteroidal anti-inflammatory drug use had no association with breast cancer incidence. CONCLUSION On the basis of their increased risk of breast cancer, postmenopausal women with a family history of breast cancer or a personal history of benign breast disease could potentially be targeted for aspirin chemoprevention studies. Future studies are needed to confirm these findings.
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Affiliation(s)
- Aditya Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Tanya E Keenan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - Jon O Ebbert
- Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - DeAnn Lazovich
- School of Public Health, University of Minnesota, Minneapolis
| | - Alice H Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Celine M Vachon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Paul J Limburg
- Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | | | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
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Hu ZH, Connett JE, Yuan JM, Anderson KE. Role of survivor bias in pancreatic cancer case-control studies. Ann Epidemiol 2015; 26:50-6. [PMID: 26688282 DOI: 10.1016/j.annepidem.2015.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 11/02/2015] [Accepted: 11/03/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the impact of survivor bias on pancreatic cancer case-control studies. METHODS The authors constructed five case-loss scenarios based on the Iowa Women's Health Study cohort to reflect how case recruitment in population-based studies varies by case survival time. Risk factors for disease incidence included smoking, body mass index (BMI), waist circumference, diabetes, and alcohol consumption. Odds ratios (ORs) were estimated by conditional logistic regression and quantitatively compared by the interactions between risk factors and 3-month survival time. Additionally, Kaplan-Meier estimates for overall survival were compared within the subset cohort of pancreatic cancer cases. RESULTS BMI and waist circumference showed a significant inverse relationship with survival time. Decreasing trends in ORs for BMI and waist circumference were observed with increasing case survival time. The interaction between BMI and survival time based on a cutpoint of 3 months was significant (P < .01) as was the interaction between waist circumference and survival time (P < .01). CONCLUSIONS The findings suggested that case losses could result in survivor bias causing underestimated odds ratios for both BMI and waist circumference, whereas other risk factors were not significantly affected by case losses.
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Affiliation(s)
- Zhen-Huan Hu
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee.
| | - John E Connett
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis
| | - Jian-Min Yuan
- University of Pittsburgh Cancer Institute and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Kristin E Anderson
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis
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Waterhouse M, Risch HA, Bosetti C, Anderson KE, Petersen GM, Bamlet WR, Cotterchio M, Cleary SP, Ibiebele TI, La Vecchia C, Skinner HG, Strayer L, Bracci PM, Maisonneuve P, Bueno-de-Mesquita HB, Zatoński W, Lu L, Yu H, Janik-Koncewicz K, Polesel J, Serraino D, Neale RE. Vitamin D and pancreatic cancer: a pooled analysis from the Pancreatic Cancer Case-Control Consortium. Ann Oncol 2015; 27:208. [PMID: 26467470 DOI: 10.1093/annonc/mdv480] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Waterhouse
- Division of Population Health, QIMR Berghofer Medical Research Institute, Herston Centre for Research Excellence in Sun and Health, Queensland University of Technology, Kelvin Grove, Australia
| | - H A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA
| | - C Bosetti
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - K E Anderson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
| | - G M Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, USA
| | - W R Bamlet
- Department of Health Sciences Research, Mayo Clinic, Rochester, USA
| | - M Cotterchio
- Prevention and Cancer Control, Cancer Care Ontario, Toronto Dalla Lana School of Public Health, University of Toronto, Toronto
| | - S P Cleary
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto Department of Surgery, University of Toronto, Toronto, Canada
| | - T I Ibiebele
- Division of Population Health, QIMR Berghofer Medical Research Institute, Herston
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | | | - L Strayer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
| | - P M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA
| | - P Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment, Bilthoven Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK
| | - W Zatoński
- Department of Epidemiology, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology,Warsaw, Poland
| | - L Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA
| | - H Yu
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
| | - K Janik-Koncewicz
- Department of Epidemiology, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology,Warsaw, Poland
| | - J Polesel
- Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, IRCCS, Aviano, Italy
| | - D Serraino
- Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute, IRCCS, Aviano, Italy
| | - R E Neale
- Division of Population Health, QIMR Berghofer Medical Research Institute, Herston Centre for Research Excellence in Sun and Health, Queensland University of Technology, Kelvin Grove, Australia
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Genkinger JM, Kitahara CM, Bernstein L, Berrington de Gonzalez A, Brotzman M, Elena JW, Giles GG, Hartge P, Singh PN, Stolzenberg-Solomon RZ, Weiderpass E, Adami HO, Anderson KE, Beane-Freeman LE, Buring JE, Fraser GE, Fuchs CS, Gapstur SM, Gaziano JM, Helzlsouer KJ, Lacey JV, Linet MS, Liu JJ, Park Y, Peters U, Purdue MP, Robien K, Schairer C, Sesso HD, Visvanathan K, White E, Wolk A, Wolpin BM, Zeleniuch-Jacquotte A, Jacobs EJ. Central adiposity, obesity during early adulthood, and pancreatic cancer mortality in a pooled analysis of cohort studies. Ann Oncol 2015; 26:2257-66. [PMID: 26347100 DOI: 10.1093/annonc/mdv355] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 08/16/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Body mass index (BMI), a measure of obesity typically assessed in middle age or later, is known to be positively associated with pancreatic cancer. However, little evidence exists regarding the influence of central adiposity, a high BMI during early adulthood, and weight gain after early adulthood on pancreatic cancer risk. DESIGN We conducted a pooled analysis of individual-level data from 20 prospective cohort studies in the National Cancer Institute BMI and Mortality Cohort Consortium to examine the association of pancreatic cancer mortality with measures of central adiposity (e.g. waist circumference; n = 647 478; 1947 pancreatic cancer deaths), BMI during early adulthood (ages 18-21 years) and BMI change between early adulthood and cohort enrollment, mostly in middle age or later (n = 1 096 492; 3223 pancreatic cancer deaths). Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. RESULTS Higher waist-to-hip ratio (HR = 1.09, 95% CI 1.02-1.17 per 0.1 increment) and waist circumference (HR = 1.07, 95% CI 1.00-1.14 per 10 cm) were associated with increased risk of pancreatic cancer mortality, even when adjusted for BMI at baseline. BMI during early adulthood was associated with increased pancreatic cancer mortality (HR = 1.18, 95% CI 1.11-1.25 per 5 kg/m(2)), with increased risk observed in both overweight and obese individuals (compared with BMI of 21.0 to <23 kg/m(2), HR = 1.36, 95% CI 1.20-1.55 for BMI 25.0 < 27.5 kg/m(2), HR = 1.48, 95% CI 1.20-1.84 for BMI 27.5 to <30 kg/m(2), HR = 1.43, 95% CI 1.11-1.85 for BMI ≥30 kg/m(2)). BMI gain after early adulthood, adjusted for early adult BMI, was less strongly associated with pancreatic cancer mortality (HR = 1.05, 95% CI 1.01-1.10 per 5 kg/m(2)). CONCLUSIONS Our results support an association between pancreatic cancer mortality and central obesity, independent of BMI, and also suggest that being overweight or obese during early adulthood may be important in influencing pancreatic cancer mortality risk later in life.
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Affiliation(s)
- J M Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York
| | - C M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - L Bernstein
- Division of Cancer Etiology, City of Hope National Medical Center, Duarte
| | | | | | - J W Elena
- Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - G G Giles
- Cancer Epidemiology Centre, Cancer Council of Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - P Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - P N Singh
- Department of Epidemiology, Biostatistics and Population Medicine and The Center for Health Research, Loma Linda University School of Medicine, Loma Linda, USA
| | - R Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø Department of Research, Cancer Registry of Norway, Oslo, Norway Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - H-O Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Epidemiology, Harvard School of Public Health, Boston
| | - K E Anderson
- Division of Epidemiology and Community Health, School of Public Health, and Masonic Cancer Center, University of Minnesota, Minneapolis
| | - L E Beane-Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - J E Buring
- Department of Epidemiology, Harvard School of Public Health, Boston Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - G E Fraser
- Department of Epidemiology, Biostatistics and Population Medicine and The Center for Health Research, Loma Linda University School of Medicine, Loma Linda, USA
| | - C S Fuchs
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston Department of Medical Oncology, Dana-Farber Cancer Institute, Boston
| | - S M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta
| | - J M Gaziano
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston Massachusetts Veterans Epidemiology Research and Information Center, Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston
| | - K J Helzlsouer
- The Prevention & Research Center, Mercy Medical Center, Baltimore Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - J V Lacey
- Division of Cancer Etiology, City of Hope National Medical Center, Duarte
| | - M S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - J J Liu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - Y Park
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda Division of Public Health Sciences, Washington University School of Medicine, St Louis
| | - U Peters
- Fred Hutchinson Cancer Research Center, Seattle Department of Epidemiology, University of Washington, Seattle
| | - M P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - K Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington
| | - C Schairer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - H D Sesso
- Department of Epidemiology, Harvard School of Public Health, Boston Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - K Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Department of Medical Oncology, Sidney Kimmel Cancer Center, John Hopkins School of Medicine, Baltimore, USA
| | - E White
- Fred Hutchinson Cancer Research Center, Seattle Department of Epidemiology, University of Washington, Seattle
| | - A Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - B M Wolpin
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston Department of Medical Oncology, Dana-Farber Cancer Institute, Boston
| | - A Zeleniuch-Jacquotte
- Department of Population Health and Perlmutter Cancer Center, New York University, New York, USA
| | - E J Jacobs
- Epidemiology Research Program, American Cancer Society, Atlanta
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Prizment AE, Nelson HH, Thyagarajan B, Linabery AM, Anderson KE. Abstract 834: Plasma MICA and pancreatic cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We hypothesized that major histocompatibility complex class I chain-related protein (MICA) may be useful for detecting early pancreatic cancer and guiding immunotherapy. MICA, which is up-regulated on the tumor cell surface, is a major ligand for natural killer (NK) cell receptors - NKG2D. The binding of transmembrane MICA to NKG2D facilitates the recognition of tumors by NK cells, resulting in tumor elimination. However, many tumors release MICA into circulation in the soluble form and thus escape immune surveillance. Several small studies showed that soluble MICA levels (s-MICA) are higher in pancreatic cancer patients than healthy people. The goal of this project was to define whether s-MICA concentration is associated with pancreatic cancer in a population-based case-control study in Minnesota (1994-98, mean age 66 years).
Methods: Cases ≥20 years (n = 163) were ascertained from hospitals. Controls (n = 542) were randomly selected from the general population and frequency matched to cases by age (within 5 y), sex and race. All subjects were interviewed in-person regarding demographic information, lifestyle, and medical history. For this analysis, only Caucasians (96% of all participants) were included. S-MICA plasma concentrations were measured using a commercially available Luminex kit (R&D Systems, MN); level of detection was 2 pg/ml.
Unconditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for pancreatic cancer in relation to s-MICA concentration. S-MICA was modeled as 4 categories after adjustment for age, sex, smoking status, pack-years and diabetes. S-MICA concentration ≤2 pg/ml was assigned to the null category, whereas all other participants were divided into tertiles. The first tertile was the reference category since the number of cases in the null category was small (N = 20).
Results: Among controls, s-MICA concentrations were positively associated with older age (≥70 y) and diabetes. The ORs for pancreatic cancer were 1.17 (0.71-1.94) and 1.82 (1.12-2.97) in the second and third tertiles, respectively, compared to the first tertile (p-trend = 0.02), while ORs for the null category were 1.05 (0.57-1.92). For the 3rd versus 1st tertile, s-MICA was significantly associated with pancreatic cancer in the following groups: men, OR = 2.46 (1.31-4.64; p-trend = 0.007); people younger than 70 y, 2.42 (1.26-4.64; p-trend = 0.007), and in those without diabetes, 1.91 (1.15-3.19; p-trend = 0.02). Notably, among cases with known death dates (N = 107), s-MICA concentrations were significantly higher for those who died in the first three months of follow-up, suggesting a more virulent or later stage cancer for those with higher concentrations.
Conclusions: Our study supports the hypothesis that plasma s-MICA concentration is positively associated with increased odds of pancreatic cancer and suggests that s-MICA concentration may be a promising biomarker for early detection of pancreatic cancer.
Citation Format: Anna E. Prizment, Heather H. Nelson, Bharat Thyagarajan, Amy M. Linabery, Kristin E. Anderson. Plasma MICA and pancreatic cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 834. doi:10.1158/1538-7445.AM2015-834
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Affiliation(s)
- Anna E. Prizment
- 1Division of Epidemiology and Community Health, School of Public Health, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Heather H. Nelson
- 1Division of Epidemiology and Community Health, School of Public Health, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Bharat Thyagarajan
- 2Department of Medicine, School of Medicine, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Amy M. Linabery
- 3Division of Epidemiology and Clinical Research, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Kristin E. Anderson
- 1Division of Epidemiology and Community Health, School of Public Health, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
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Waterhouse M, Risch HA, Bosetti C, Anderson KE, Petersen GM, Bamlet WR, Cotterchio M, Cleary SP, Ibiebele TI, La Vecchia C, Skinner HG, Strayer L, Bracci PM, Maisonneuve P, Bueno-de-Mesquita HB, Zaton Ski W, Lu L, Yu H, Janik-Koncewicz K, Polesel J, Serraino D, Neale RE. Vitamin D and pancreatic cancer: a pooled analysis from the Pancreatic Cancer Case-Control Consortium. Ann Oncol 2015; 26:1776-83. [PMID: 25977560 DOI: 10.1093/annonc/mdv236] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/09/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The potential role of vitamin D in the aetiology of pancreatic cancer is unclear, with recent studies suggesting both positive and negative associations. PATIENTS AND METHODS We used data from nine case-control studies from the International Pancreatic Cancer Case-Control Consortium (PanC4) to examine associations between pancreatic cancer risk and dietary vitamin D intake. Study-specific odds ratios (ORs) were estimated using multivariable logistic regression, and ORs were then pooled using a random-effects model. From a subset of four studies, we also calculated pooled estimates of association for supplementary and total vitamin D intake. RESULTS Risk of pancreatic cancer increased with dietary intake of vitamin D [per 100 international units (IU)/day: OR = 1.13, 95% confidence interval (CI) 1.07-1.19, P = 7.4 × 10(-6), P-heterogeneity = 0.52; ≥230 versus <110 IU/day: OR = 1.31, 95% CI 1.10-1.55, P = 2.4 × 10(-3), P-heterogeneity = 0.81], with the association possibly stronger in people with low retinol/vitamin A intake. CONCLUSION Increased risk of pancreatic cancer was observed with higher levels of dietary vitamin D intake. Additional studies are required to determine whether or not our finding has a causal basis.
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Affiliation(s)
- M Waterhouse
- Division of Population Health, QIMR Berghofer Medical Research Institute, Herston Centre for Research Excellence in Sun and Health, Queensland University of Technology, Kelvin Grove, Australia
| | - H A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA
| | - C Bosetti
- Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - K E Anderson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
| | - G M Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, USA
| | - W R Bamlet
- Department of Health Sciences Research, Mayo Clinic, Rochester, USA
| | - M Cotterchio
- Prevention and Cancer Control, Cancer Care Ontario, Toronto Dalla Lana School of Public Health, University of Toronto, Toronto
| | - S P Cleary
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto Department of Surgery, University of Toronto, Toronto, Canada
| | - T I Ibiebele
- Division of Population Health, QIMR Berghofer Medical Research Institute, Herston
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | | | - L Strayer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
| | - P M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA
| | - P Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - H B Bueno-de-Mesquita
- National Institute for Public Health and the Environment, Bilthoven Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK
| | - W Zaton Ski
- Department of Epidemiology, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - L Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA
| | - H Yu
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
| | - K Janik-Koncewicz
- Department of Epidemiology, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | | | | | - R E Neale
- Division of Population Health, QIMR Berghofer Medical Research Institute, Herston Centre for Research Excellence in Sun and Health, Queensland University of Technology, Kelvin Grove, Australia
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Abstract
INTRODUCTION The Royal Victoria Hospital, a geriatric medicine assessment and rehabilitation hospital in Edinburgh, was re-provided into a new 130 bed purpose-built unit on the Western General Hospital site in June 2012. All patient rooms in the new unit are single occupancy with en-suite facilities. METHODS We surveyed inpatients on their room preference in 2008 and repeated the survey with inpatients in the new unit in 2013. Patients were asked whether they would prefer to be in a shared room or a single room and to explain the reason behind their choice. They were also asked whether they would prefer to eat their meals in a day/dining room or by their bed. The patients in the 2013 survey were also questioned as to whether they felt lonely in their single room. Forty-three inpatients agreed to participate in the 2008 survey and 46 in the 2013 survey. All had an abbreviated mental test score≥8/10. In 2008, those surveyed had a mean age of 78. In 2013, the mean age was 83. RESULTS In 2008, 37.2% of patients expressed a preference for single room accommodation, whereas in 2013, 84.8% said that they preferred a single room. The majority of patients, 60.5% in 2008 and 76.1% in 2013, preferred to eat their meal at their bedside. Only 8.7% of patients in 2013 would consider eating in a day/dining room compared with 34.9% in 2008. In the 2013 survey, 60.9% of patients reported that they never felt lonely in a single room. DISCUSSION The benefits of single room versus multi-occupancy room hospital accommodation has been recently debated. The results from our survey indicate a marked difference in the preference for a single room between 2008 and 2013. The introduction of open visiting and care rounding has reduced the risk of isolation in single rooms. Our survey introduces new discussion about social isolation, privacy, noise levels and patient well-being and recovery.
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Affiliation(s)
- J Reid
- Department of Medicine for the Elderly, Western General Hospital, Edinburgh EH4 2XU, UK
| | - K Wilson
- Department of Medicine for the Elderly, Western General Hospital, Edinburgh EH4 2XU, UK
| | - K E Anderson
- Department of Medicine for the Elderly, Western General Hospital, Edinburgh EH4 2XU, UK
| | - C P J Maguire
- Department of Medicine for the Elderly, Western General Hospital, Edinburgh EH4 2XU, UK
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Tillmans LS, Vierkant RA, Wang AH, Samadder NJ, Lynch CF, Anderson KE, French AJ, Haile RW, Harnack LJ, Potter JD, Slager SL, Smyrk TC, Thibodeau SN, Cerhan JR, Limburg PJ. Associations between Environmental Exposures and Incident Colorectal Cancer by ESR2 Protein Expression Level in a Population-Based Cohort of Older Women. Cancer Epidemiol Biomarkers Prev 2015; 24:713-9. [PMID: 25650184 DOI: 10.1158/1055-9965.epi-14-0756] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 12/13/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Cigarette smoking (smoking), hormone therapy (MHT), and folate intake (folate) are each thought to influence colorectal cancer risk, but the underlying molecular mechanisms remain incompletely defined. Expression of estrogen receptor β (ESR2) has been associated with colorectal cancer stage and survival. METHODS In this prospective cohort study, we examined smoking, MHT, and folate-associated colorectal cancer risks by ESR2 protein expression level among participants in the Iowa Women's Health Study (IWHS). Self-reported exposure variables were assessed at baseline. Archived, paraffin-embedded colorectal cancer tissue specimens were collected and evaluated for ESR2 protein expression by IHC. Multivariate Cox regression models were fit to estimate relative risks (RR) and 95% confidence intervals (CI) for associations between smoking, MHT, or folate and ESR2-defined colorectal cancer subtypes. RESULTS Informative environmental exposure and protein expression data were available for 491 incident colorectal cancer cases. Positive associations between ESR2-low and -high tumors and several smoking-related variables were noted, most prominently with average number of cigarettes per day (RR, 4.24; 95% CI, 1.81-9.91 for ESR2-low and RR, 2.15; 95% CI, 1.05-4.41 for ESR2-high for ≥40 cigarettes compared with nonsmokers). For MHT, a statistically significant association with ESR2-low tumors was observed with longer duration of exposure (RR, 0.54; 95% CI, 0.26-1.13 for >5 years compared with never use). No associations were found for folate. CONCLUSIONS In this study, smoking and MHT were associated with ESR2 expression patterns. IMPACT These data support possible heterogeneous effects from smoking and MHT on ERβ-related pathways of colorectal carcinogenesis in older women.
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Affiliation(s)
- Lori S Tillmans
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Robert A Vierkant
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Alice H Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Niloy Jewel Samadder
- Department of Medicine (Gastroenterology), Huntsman Cancer Institute and University of Utah, Salt Lake City, Utah
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa
| | - Kristin E Anderson
- Department of Epidemiology, University of Minnesota, Minneapolis, Minnesota
| | - Amy J French
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | | | - Lisa J Harnack
- Department of Epidemiology, University of Minnesota, Minneapolis, Minnesota
| | - John D Potter
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Susan L Slager
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Thomas C Smyrk
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Stephen N Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - James R Cerhan
- Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
| | - Paul J Limburg
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
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Prizment AE, Jensen EH, Hopper AM, Virnig BA, Anderson KE. Risk factors for pancreatitis in older women: the Iowa Women's Health Study. Ann Epidemiol 2015; 25:544-8. [PMID: 25656921 DOI: 10.1016/j.annepidem.2014.12.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 07/26/2014] [Revised: 11/21/2014] [Accepted: 12/27/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE Pancreatitis-an inflammation of pancreas-is a severe and costly disease. Although many risk factors for pancreatitis are known, many pancreatitis cases, especially in elderly women, are of unknown etiology. METHODS Risk factors for acute pancreatitis (AP) and chronic pancreatitis (CP) were assessed in a prospective cohort (n = 36,436 women, aged ≥ 65 years). Exposures were self-reported at baseline. Pancreatitis was ascertained by linkage to Medicare claims (1986-2004) categorized by a physician as follows: "AP", one AP episode (n = 511) or "CP", 2+ AP or 1+ CP episodes (n = 149). RESULTS Multivariable odds ratios (ORs) and 95% confidence intervals for AP and CP were calculated using multinomial logistic regression. Alcohol use was not associated with AP or CP. Heavy smoking (40+ vs. 0 pack-years) was associated with a twofold increased OR for CP. For body mass index greater than or equal to 30 versus less than 25 kg/m(2), the ORs were 1.35 (1.07-1.70) for AP (P trend = .009) and 0.59 (0.37-0.94) for CP (P trend = .01). ORs for AP and CP were increased for hormone replacement therapy use, heart disease, and hypertension. There were positive significant associations between protein and total fat intake for CP and AP. CONCLUSIONS We identified factors associated with AP and CP that may be specific to older women.
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Affiliation(s)
- Anna E Prizment
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis; Masonic Cancer Center, University of Minnesota, Minneapolis.
| | - Eric H Jensen
- Division of Surgical Oncology, University of Minnesota Medical School, Minneapolis
| | - Anne M Hopper
- Masonic Cancer Center, University of Minnesota, Minneapolis
| | - Beth A Virnig
- Division of Health Policy and Management, School of Public Health, Masonic Cancer Center, University of Minnesota, Minneapolis
| | - Kristin E Anderson
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis; Masonic Cancer Center, University of Minnesota, Minneapolis
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Inoue-Choi M, Jones RR, Anderson KE, Cantor KP, Cerhan JR, Krasner S, Robien K, Weyer PJ, Ward MH. Nitrate and nitrite ingestion and risk of ovarian cancer among postmenopausal women in Iowa. Int J Cancer 2014; 137:173-82. [PMID: 25430487 DOI: 10.1002/ijc.29365] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 10/09/2014] [Indexed: 01/29/2023]
Abstract
Nitrate and nitrite are precursors in the endogenous formation of N-nitroso compounds (NOC), potential human carcinogens. We evaluated the association of nitrate and nitrite ingestion with postmenopausal ovarian cancer risk in the Iowa Women's Health Study. Among 28,555 postmenopausal women, we identified 315 incident epithelial ovarian cancers from 1986 to 2010. Dietary nitrate and nitrite intakes were assessed at baseline using food frequency questionnaire data. Drinking water source at home was obtained in a 1989 follow-up survey. Nitrate-nitrogen (NO3 -N) and total trihalomethane (TTHM) levels for Iowa public water utilities were linked to residences and average levels were computed based on each woman's duration at the residence. We computed multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazards regression. We tested interactions of nitrate with TTHMs and dietary factors known to influence NOC formation. Ovarian cancer risk was 2.03 times higher (CI = 1.22-3.38, ptrend = 0.003) in the highest quartile (≥2.98 mg/L) compared with the lowest quartile (≤0.47 mg/L; reference) of NO3 -N in public water, regardless of TTHM levels. Risk among private well users was also elevated (HR = 1.53, CI = 0.93-2.54) compared with the same reference group. Associations were stronger when vitamin C intake was <median (pinteraction = 0.01 and 0.33 for private well and public supplies, respectively). Dietary nitrate was inversely associated with ovarian cancer risk (ptrend = 0.02); whereas, dietary nitrite from processed meats was positively associated with the risk (ptrend = 0.04). Our findings indicate that high nitrate levels in public drinking water and private well use may increase ovarian cancer risk among postmenopausal women.
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Affiliation(s)
- Maki Inoue-Choi
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD; National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
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Thyagarajan B, Barcelo H, Anderson KE, Swenson K, Nelson H, Gross MD. Abstract 3277: A low plasma mitchondrial DNA copy number is associated with increased breast cancer risk. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Previous studies have shown that plasma mtDNA can be separated into two fractions; a supernatant form that is cell-free and a pelleted form that is thought to be platelet associated. These fractions of plasma mtDNA should be measured in studies evaluating the role of plasma mtDNA as biomarkers for early detection or susceptibility to various cancers. Though one case-control study has shown lower plasma mitochondrial DNA (mtDNA) copy number to be associated with increased breast cancer risk this study did not evaluate the two fractions of plasma mtDNA. Hence, the role of plasma mtDNA in determining breast cancer risk was investigated further. We conducted a case-control study of 29 breast cancer cases and 28 cancer free controls to evaluate the association between (a) plasma mtDNA copy number and (b) peripheral blood leucocyte mtDNA copy number and breast cancer risk. Plasma obtained from the breast cancer cases and controls was centrifuged further at 18,000 g for 10 minutes to separate the plasma into the supernatant and pelleted fractions. Using flow cytometry, we stained the pelleted fraction of the plasma with Annexin V and CD61 to determine the cellular source of the plasma pellet. DNA from the two plasma fractions and the buffy coat was extracted using the Qiagen DNAesy DNA extraction kit. Nuclear DNA (18s) and mitochondrial DNA (ND1) copy numbers were measured using quantitative real time PCR. We used a two-sample independent t test to evaluate the difference in mtDNA in the two plasma fractions and mtDNA copy number in peripheral blood leucocytes among breast cancer cases and controls. The plasma pellet fraction predominantly contained particles that were 1-3 microns in size that stained positively for both Annexin V and CD61 indicating that these particles were platelet derived microparticles. The mtDNA in the plasma pellet accounted for 96% of all the plasma mtDNA seen in both cases and controls. Both the plasma supernatant mtDNA (2601034 mtDNA copies/ml of plasma vs. 4700446 mtDNA copies/ml of plasma; p = 0.004) and plasma pellet mtDNA (67787069 mtDNA copies/ml of plasma vs. 112883929 mtDNA copies/ml of plasma; p = 0.001) were significantly lower in the breast cancer cases as compared to controls. Peripheral blood leucocytes mtDNA copy number was not associated with breast cancer risk (4.27 vs. 3.73; p=0.14). There was no correlation between mtDNA in peripheral blood and the various fractions of plasma mtDNA (r= -0.08 - 0.07; p = 0.55 - 0.63). This is the first study to demonstrate platelet derived microparticles as the source of the plasma pellet mtDNA. This study shows that both the supernatant and pelleted fractions of plasma mtDNA are associated with breast cancer risk. Peripheral blood leucocytes mtDNA was not associated with breast cancer risk and was not correlated with plasma mtDNA. Future studies are needed to confirm these associations and evaluate possible mechanisms through which plasma mtDNA copy number is associated with breast cancer risk.
Citation Format: Bharat Thyagarajan, Helene Barcelo, Kristin E. Anderson, Karen Swenson, Heather Nelson, Myron D. Gross. A low plasma mitchondrial DNA copy number is associated with increased breast cancer risk. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3277. doi:10.1158/1538-7445.AM2014-3277
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LaBore BP, Prizment AE, Ondrey FG, Anderson KE. Abstract 2174: Association of diabetes and obesity with risk of esophageal and gastric adenocarcinoma in the Iowa Women's Health Study (IWHS). Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-2174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Incidence rates of esophageal and gastric cancers have increased rapidly in developing countries during the past four decades. The rate of esophageal adenocarcinomas has approximately tripled among US whites and now exceeds that of esophageal squamous cell carcinomas. Incidence of gastric cardia adenocarcinomas has also risen significantly during this period, though to a lesser extent. These cancers often respond poorly to treatment, highlighting the importance of identifying modifiable risk factors with a view to prevention. The association between diabetes and gastroesophageal adenocarcinoma has been examined in only a few studies and findings are inconsistent. While obesity is a significant risk factor for esophageal and gastric adenocarcinomas, few analyses have been conducted in prospective cohorts. We examined the association between diabetes, BMI, and waist circumference and incidence of esophageal, non-cardia gastric and gastric cardia adenocarcinomas in a large prospective cohort of postmenopausal women. A mailed survey at baseline (1986) collected information on self-reported diabetes and anthropometric measures and included a detailed food-frequency questionnaire. The 34,466 initially cancer free women were followed for 24 years with annual cancer incidence obtained through the State Health Registry of Iowa, part of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program; 83 women developed gastroesophageal adenocarcinoma. Associations were examined using proportional hazards regression models: hazard ratios (HR) and 95% confidence intervals (CI) were calculated. Significant associations were observed in age-adjusted models for diabetes (yes/no) [HR: 2.09, 95% CI: 1.01-4.34], body mass index (kg per meters squared) [HR: 1.09, 95% CI: 1.03-1.15], and waist circumference (cm) [HR: 1.24, 95% CI: 1.01-1.53]. Additionally, a positive association between diabetes and adenocarcinoma of the gastroesophageal junction was found in both age-adjusted [HR: 3.43, 95% CI: 1.32-8.90] and multivariate-adjusted models [HR: 3.00, 95% CI: 1.13-7.99]. An inverse association was found with increasing daily fiber intake (g/day) and all gastroesophageal adenocarcinomas [HR: 0.84, 95% CI: 0.73-0.96]. These findings support the view that diabetes, body mass index and waist circumference increase risk of gastroesophageal adenocarcinoma while increased fiber intake may decrease risk.
Citation Format: Bryan P. LaBore, Anna E. Prizment, Frank G. Ondrey, Kristin E. Anderson. Association of diabetes and obesity with risk of esophageal and gastric adenocarcinoma in the Iowa Women's Health Study (IWHS). [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2174. doi:10.1158/1538-7445.AM2014-2174
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Affiliation(s)
| | - Anna E. Prizment
- 2University of Minnesota, Masonic Cancer Center, Minneapolis, MN
| | - Frank G. Ondrey
- 2University of Minnesota, Masonic Cancer Center, Minneapolis, MN
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Yang HP, Cook LS, Weiderpass E, Adami HO, Anderson KE, Cai H, Cerhan JR, Clendenen T, Felix AS, Friedenreich C, Garcia-Closas M, Goodman MT, Liang X, Lissowska J, Lu L, Magliocco AM, McCann SE, Moysich KB, Olson SH, Pike MC, Polidoro S, Ricceri F, Risch H, Sacerdote C, Setiawan VW, Shu XO, Spurdle AB, Trabert B, Webb PM, Wentzensen N, Xiang YB, Xu Y, Yu H, Zeleniuch-Jacquotte A, Brinton LA. Abstract 2167: Infertility and risk of incident endometrial carcinoma: a pooled analysis from the Epidemiology of Endometrial Cancer Consortium. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-2167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Nulliparity is an established endometrial cancer risk factor, but whether this association is related to infertility is unclear. Although there are many underlying causes of infertility, few studies have assessed risk relationships according to specific causes. Despite concerns that most treatments induce ovulation and that the endometrium is highly hormonally-responsive, previous studies have provided conflicting results on treatment associations.
Methods: To address these issues, we conducted a pooled analysis of 8,151 cases and12,471 controls from 2 cohort and 12 case-control studies conducted in 1982 to 2009 (N. America, Europe, Australia, Asia). All studies provided self-reported infertility, causes and treatments, except for 1 study that relied on data from national registries. Study-specific exposures and covariate data were harmonized across studies. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusted for study, age, interview year, race, parity, oral contraceptive and menopausal hormone use, and body mass index. If data were not reported for a particular variable, that study was excluded from the variable-specific analysis.
Results: Nulliparous women had an elevated endometrial cancer risk compared with parous women (adjusted OR=1.73; 95% CI: 1.58-1.90).Women with self-reported infertility also had an increased risk (adjusted OR=1.22; 95% CI: 1.13-1.32) compared with those without infertility issues, even after adjusting for parity; the strongest associations was seen among studies that defined infertility as unsuccessfully trying to conceive for 2+ years (adjusted OR=1.31; 95% CI: 1.07-1.60). Infertility was associated with similar risks among nulliparous (1.22; 1.10-1.48) and parous (1.22; 1.12-1.34) women, although there was no increased risk associated with infertility among those who had given birth to 3+ children. Two infertility causes associated with risk elevation were endometriosis (adjusted OR=2.08; 95% CI: 1.46-2.95 compared with women no infertility problems) and anovulation (adjusted OR=1.40; 95% CI: 1.16-1.70). Based on relatively small numbers, none of the individual treatments (in vitro fertilization, selective estrogen response modulators, gonatropins, progestins, estrogens) were substantially related to risk.
Conclusion: Based on mainly self-reported infertility data, we found that parity and infertility independently contribute to endometrial cancer risk, with parity seemingly being the predominant risk predictor. Understanding residual endometrial cancer relationships related to causes of infertility and infertility treatment may benefit from documented medical information on causes of infertility and treatment parameters.
Citation Format: Hannah P. Yang, Linda S. Cook, Elisabete Weiderpass, Hans-Olov Adami, Kristin E. Anderson, Hui Cai, James R. Cerhan, Tess Clendenen, Ashley S. Felix, Christine Friedenreich, Montserrat Garcia-Closas, Marc T. Goodman, Xiaolin Liang, Jolanta Lissowska, Lingeng Lu, Anthony M. Magliocco, Susan E. McCann, Kristen B. Moysich, Sara H. Olson, Malcolm C. Pike, Silvia Polidoro, Fulvio Ricceri, Harvey Risch, Carlotta Sacerdote, V. Wendy Setiawan, Xiao Ou Shu, Amanda B. Spurdle, Britton Trabert, Penelope M. Webb, Nicolas Wentzensen, Yong-Bing Xiang, Youming Xu, Herbert Yu, Anne Zeleniuch-Jacquotte, Louise A. Brinton. Infertility and risk of incident endometrial carcinoma: a pooled analysis from the Epidemiology of Endometrial Cancer Consortium. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2167. doi:10.1158/1538-7445.AM2014-2167
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Affiliation(s)
| | | | | | | | | | - Hui Cai
- 5Vanderbilt University School of Medicine, Nashville, TN
| | | | | | | | | | | | | | - Xiaolin Liang
- 11Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jolanta Lissowska
- 12M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Lingeng Lu
- 13Yale School of Public Health, New Haven, CT
| | | | | | | | - Sara H. Olson
- 11Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | | | | | | | | | | | - Xiao O. Shu
- 5Vanderbilt University School of Medicine, Nashville, TN
| | | | | | | | | | | | - Youming Xu
- 11Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Herbert Yu
- 21University of Hawaii Cancer Center, Honolulu, HI
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Linabery AM, Prizment AE, Anderson KE, Cerhan JR, Poynter JN, Ross JA. Allergic diseases and risk of hematopoietic malignancies in a cohort of postmenopausal women: a report from the Iowa Women's Health Study. Cancer Epidemiol Biomarkers Prev 2014; 23:1903-12. [PMID: 24962839 DOI: 10.1158/1055-9965.epi-14-0423] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Allergic diseases signify immune dysregulation attributable to underlying genetics and environmental exposures. Associations between various allergies and hematopoietic cancers have been observed, albeit inconsistently; however, few prospective studies have examined the risk, and even fewer among older adults. METHODS We examined risk of incident hematopoietic cancers in those reporting allergic diseases in a population-based cohort of 22,601 older women (Iowa Women's Health Study). Self-reported allergic status, including asthma, hay fever, eczema, and/or other allergies, was determined via questionnaire in 1997 (mean age, 72 years; range, 63-81 years). Incident cancers were ascertained by linkage with the Iowa Cancer Registry from 1997 to 2011. Cox proportional hazards regression was performed to estimate multivariate-adjusted HR and 95% confidence intervals (CI) for myeloid (N = 177) and lymphoid (N = 437) malignancies, respectively. RESULTS Allergic diseases were not associated with risk of myeloid (HR, 1.00; 95% CI, 0.72-1.37) or lymphoid (HR, 0.99; 95% CI, 0.81-1.22) malignancies overall, or for most allergic and malignant subtypes examined. Self-reported asthma was positively associated with development of myelodysplastic syndrome (MDS; HR, 2.00; 95% CI, 0.93-4.32). In addition, there was a 30% to 40% decrease in risk of both lymphoid and myeloid cancers in those reporting rural residences but no association in those reporting urban residences; the interaction between residence and allergy was statistically significant for lymphoid malignancies (Pinteraction = 0.05). CONCLUSIONS AND IMPACT These results suggest that asthma may contribute to the pathogenesis of MDS, a finding consistent with the chronic antigen stimulation hypothesis. Susceptibility differences by location of residence are concordant with the hygiene hypothesis and merit additional exploration.
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Affiliation(s)
- Amy M Linabery
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
| | - Anna E Prizment
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Kristin E Anderson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Jenny N Poynter
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Julie A Ross
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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Zhang J, Prizment AE, Dhakal IB, Anderson KE. Cholecystectomy, gallstones, tonsillectomy, and pancreatic cancer risk: a population-based case-control study in Minnesota. Br J Cancer 2014; 110:2348-53. [PMID: 24667646 PMCID: PMC4007236 DOI: 10.1038/bjc.2014.154] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 02/27/2014] [Accepted: 02/28/2014] [Indexed: 12/14/2022] Open
Abstract
Background: Associations between medical conditions and pancreatic cancer risk are controversial and are thus evaluated in a study conducted during 1994–1998 in Minnesota. Methods: Cases (n=215) were ascertained from hospitals in the metropolitan area of the Twin Cities and the Mayo Clinic. Controls (n=676) were randomly selected from the general population and frequency matched to cases by age and sex. The history of medical conditions was gathered with a questionnaire during in-person interviews. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using unconditional logistic regression. Results: After adjustment for confounders, subjects who had cholecystectomy or gallstones experienced a significantly higher risk of pancreatic cancer than those who did not (OR (95% CI): 2.11 (1.32–3.35) for cholecystectomy and 1.97 (1.23–3.12) for gallstones), whereas opposite results were observed for tonsillectomy (0.67 (0.48–0.94)). Increased risk associated with cholecystectomy was the greatest when it occurred ⩽2 years before the cancer diagnosis (5.93 (2.36–15.7)) but remained statistically significant when that interval was ⩾20 years (2.27 (1.16–4.32)). Conclusions: Cholecystectomy, gallstones, and tonsillectomy were associated with an altered risk of pancreatic cancer. Our study suggests that cholecystectomy increased risk but reverse causality may partially account for high risk associated with recent cholecystectomy.
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Affiliation(s)
- J Zhang
- 1] Department of Epidemiology, Indiana University, Richard M. Fairbanks School of Public Health at IUPUI, Indianapolis, IN 46202, USA [2] Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN 46202, USA
| | - A E Prizment
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - I B Dhakal
- Department of Biostatistics, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - K E Anderson
- 1] Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA [2] Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
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Genkinger JM, Wang M, Li R, Albanes D, Anderson KE, Bernstein L, van den Brandt PA, English DR, Freudenheim JL, Fuchs CS, Gapstur SM, Giles GG, Goldbohm RA, Håkansson N, Horn-Ross PL, Koushik A, Marshall JR, McCullough ML, Miller AB, Robien K, Rohan TE, Schairer C, Silverman DT, Stolzenberg-Solomon RZ, Virtamo J, Willett WC, Wolk A, Ziegler RG, Smith-Warner SA. Dairy products and pancreatic cancer risk: a pooled analysis of 14 cohort studies. Ann Oncol 2014; 25:1106-15. [PMID: 24631943 DOI: 10.1093/annonc/mdu019] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Pancreatic cancer has few early symptoms, is usually diagnosed at late stages, and has a high case-fatality rate. Identifying modifiable risk factors is crucial to reducing pancreatic cancer morbidity and mortality. Prior studies have suggested that specific foods and nutrients, such as dairy products and constituents, may play a role in pancreatic carcinogenesis. In this pooled analysis of the primary data from 14 prospective cohort studies, 2212 incident pancreatic cancer cases were identified during follow-up among 862 680 individuals. Adjusting for smoking habits, personal history of diabetes, alcohol intake, body mass index (BMI), and energy intake, multivariable study-specific hazard ratios (MVHR) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazards models and then pooled using a random effects model. There was no association between total milk intake and pancreatic cancer risk (MVHR = 0.98, 95% CI = 0.82-1.18 comparing ≥500 with 1-69.9 g/day). Similarly, intakes of low-fat milk, whole milk, cheese, cottage cheese, yogurt, and ice-cream were not associated with pancreatic cancer risk. No statistically significant association was observed between dietary (MVHR = 0.96, 95% CI = 0.77-1.19) and total calcium (MVHR = 0.89, 95% CI = 0.71-1.12) intake and pancreatic cancer risk overall when comparing intakes ≥1300 with <500 mg/day. In addition, null associations were observed for dietary and total vitamin D intake and pancreatic cancer risk. Findings were consistent within sex, smoking status, and BMI strata or when the case definition was limited to pancreatic adenocarcinoma. Overall, these findings do not support the hypothesis that consumption of dairy foods, calcium, or vitamin D during adulthood is associated with pancreatic cancer risk.
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Affiliation(s)
- J M Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York
| | - M Wang
- Department of Epidemiology, Harvard School of Public Health, Boston Department of Biostatistics, Harvard School of Public Health, Boston
| | - R Li
- Department of Epidemiology, Harvard School of Public Health, Boston
| | - D Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - K E Anderson
- Division of Epidemiology and Community Health, School of Public Health, Masonic Cancer Center, University of Minnesota, Minneapolis
| | - L Bernstein
- Division of Cancer Etiology, Department of Population Science, Beckman Research Institute and City of Hope National Medical Center, Duarte, USA
| | - P A van den Brandt
- Department of Epidemiology, School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
| | - D R English
- Cancer Epidemiology Centre, Cancer Council of Victoria, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - J L Freudenheim
- Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo
| | - C S Fuchs
- Division of Medical Oncology, Dana-Farber Cancer Institute, Boston Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston
| | - S M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, USA
| | - G G Giles
- Cancer Epidemiology Centre, Cancer Council of Victoria, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - R A Goldbohm
- Department of Prevention and Health, TNO Quality of Life, Leiden, The Netherlands
| | - N Håkansson
- Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - P L Horn-Ross
- Cancer Prevention Institute of California, Fremont, USA
| | - A Koushik
- Department of Social and Preventive Medicine, University of Montreal, Montreal
| | - J R Marshall
- Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo
| | - M L McCullough
- Epidemiology Research Program, American Cancer Society, Atlanta, USA
| | - A B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - K Robien
- Department of Epidemiology and Biostatistics, School of Public Health and Health Services, George Washington University, Washington, DC
| | - T E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA
| | - C Schairer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - D T Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - R Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - J Virtamo
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - W C Willett
- Department of Epidemiology, Harvard School of Public Health, Boston Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston Department of Nutrition, Harvard School of Public Health, Boston, USA
| | - A Wolk
- Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - R G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - S A Smith-Warner
- Department of Epidemiology, Harvard School of Public Health, Boston Department of Nutrition, Harvard School of Public Health, Boston, USA
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Untawale S, Odegaard AO, Koh WP, Jin AZ, Yuan JM, Anderson KE. Body mass index and risk of pancreatic cancer in a Chinese population. PLoS One 2014; 9:e85149. [PMID: 24454807 PMCID: PMC3893175 DOI: 10.1371/journal.pone.0085149] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 11/22/2013] [Indexed: 12/14/2022] Open
Abstract
Few studies have examined the association between body mass index (BMI: kg/m2) and pancreatic cancer risk in Asian populations. We examined this relationship in 51,251 Chinese men and women aged 45–74 who enrolled between 1993 and 1998 in the population based, prospective Singapore Chinese Health Study. Data were collected through in-person interviews. By December 31, 2011, 194 cohort participants had developed pancreatic cancer. A Cox proportional hazards model was used to estimate hazard ratios (HR) and their 95% confidence intervals (95% CI). We hypothesized the association between BMI and pancreatic cancer risk may vary by smoking status (ever v. never) and there was evidence for this as the interaction between BMI and smoking status was significant (p = 0.018). Among ever smokers, being classified as underweight (BMI <18.5 kg/m2), was associated with a significantly elevated risk of pancreatic cancer relative to smokers with a BMI of 21.5–24.4 kg/m2 (HR = 1.99, 95% CI = 1.03–3.84). This association was strengthened after exclusion of the first three years of follow-up time. Among never smokers, there was no association between BMI and pancreatic cancer risk. However, after excluding pancreatic cancer cases and person-years in the first three years of follow-up, never smokers with a BMI ≥ 27.5 kg/m2 showed a suggestive increased risk of pancreatic cancer relative to never smokers with a BMI of 21.5–24.4 kg/m2 (HR = 1.75, 95% CI = 0.93–3.3). In conclusion, Singaporean Chinese who were underweight with a history of smoking had an increased risk of developing pancreatic cancer, whereas there was no significant association between BMI and pancreatic cancer in never smokers.
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Affiliation(s)
- Seema Untawale
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, United States of America
- Tacoma-Pierce County Health Department, Tacoma, Washington, United States of America
| | - Andrew O. Odegaard
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Woon-Puay Koh
- Duke-NUS Graduate Medical School Singapore, Singapore, Republic of Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - Ai Zhen Jin
- National Registry of Diseases Office, Health Promotion Board, Singapore, Republic of Singapore
| | - Jian-Min Yuan
- University of Pittsburgh Cancer Institute, Division of Cancer Control and Population Sciences, Pittsburgh, Pennsylvania, United States of America
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America
| | - Kristin E. Anderson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
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Tillmans LS, Vierkant RA, Wang AH, Jewel Samadder N, Lynch CF, Anderson KE, French AJ, Haile RW, Harnack LJ, Potter JD, Slager SL, Smyrk TC, Thibodeau SN, Cerhan JR, Limburg PJ. Associations between cigarette smoking, hormone therapy, and folate intake with incident colorectal cancer by TP53 protein expression level in a population-based cohort of older women. Cancer Epidemiol Biomarkers Prev 2013; 23:350-5. [PMID: 24343843 DOI: 10.1158/1055-9965.epi-13-0780] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cigarette smoking (CS), hormone therapy (HT), and folate intake (FI) are each thought to influence colorectal cancer risk, but the underlying molecular mechanisms remain incompletely defined. The TP53 (p53) protein, encoded by the TP53 tumor-suppressor gene that is commonly mutated in colorectal cancer, can be readily assessed to differentiate biologically distinct colorectal cancer subtypes. In this prospective cohort study, we examined CS-, HT-, and FI-associated colorectal cancer risks by TP53 protein expression level among Iowa Women's Health Study (IWHS) participants. The IWHS recruited 41,836 randomly selected Iowa women, ages 55 to 69 years, with a valid driver's license at study entry in 1986. Self-reported exposure variables were assessed at baseline. Incident colorectal cancer cases were ascertained by annual linkage with the Iowa Cancer Registry. Archived, paraffin-embedded tissue specimens were collected and evaluated for TP53 protein expression by immunohistochemistry. Multivariate Cox regression models were fit to estimate relative risks (RR) and 95% confidence intervals (CI) for associations between CS, HT, or FI and TP53-defined colorectal cancer subtypes. Informative environmental exposure and protein expression data were available for 492 incident colorectal cancer cases: 222 (45.1%) TP53 negative, 72 (14.6%) TP53 low, and 198 (40.2%) TP53 high. Longer duration (>5 years) of HT was inversely associated with TP53 high colorectal cancers (RR, 0.50; 95% CI, 0.27-0.94). No other statistically significant associations were observed. These data support possible heterogeneous effects from HT on TP53-related pathways of colorectal carcinogenesis in older women.
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Affiliation(s)
- Lori S Tillmans
- Authors' Affiliations: Departments of Laboratory Medicine and Pathology and Health Sciences Research; Division of Epidemiology; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester; Department of Epidemiology, University of Minnesota, Minneapolis, Minnesota; Department of Medicine (Gastroenterology), Huntsman Cancer Institute and University of Utah, Salt Lake City, Utah; Department of Epidemiology, University of Iowa, Iowa City, Iowa; Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, California; and Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
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Prizment AE, Folsom AR, Dreyfus J, Anderson KE, Visvanathan K, Joshu CE, Platz EA, Pankow JS. Plasma C-reactive protein, genetic risk score, and risk of common cancers in the Atherosclerosis Risk in Communities study. Cancer Causes Control 2013; 24:2077-87. [PMID: 24036889 PMCID: PMC3836434 DOI: 10.1007/s10552-013-0285-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 09/04/2013] [Indexed: 12/29/2022]
Abstract
PURPOSE Many studies, including the Atherosclerosis Risk in Communities (ARIC) cohort, reported a positive association between plasma C-reactive protein (CRP)-a biomarker of low-grade chronic inflammation-and colorectal cancer risk, although it is unclear whether the association is causal. Our aims were to assess the associations of a CRP genetic risk score (CRP-GRS) created from single-nucleotide polymorphisms (SNPs) with colorectal cancer risk, as well as examine plasma CRP and CRP-GRS in relation to common cancers in the ARIC cohort. METHODS Cox proportional hazards models were used to prospectively estimate hazard ratios (HRs) and 95 % confidence interval (95 % CI) of total, colorectal, lung, prostate, and breast cancers in relation to: (1) CRP-GRS among 8,657 Whites followed in 1987-2006 and (2) log-transformed plasma CRP among 7,603 Whites followed in 1996-2006. A weighted CRP-GRS was comprised of 20 CRP-related SNPs located in/near CRP, APOC1, HNF1A, LEPR, and 16 other genes that were identified in genome-wide association studies. RESULTS After multivariable adjustment, one standard deviation increment of the CRP-GRS was associated with colorectal cancer risk (HR 1.19; 95 % CI 1.03-1.37), but not with any other cancer. One unit of log-transformed plasma CRP was associated with the risk of total, colorectal, lung, and breast cancers: HRs (95 % CIs) were 1.08 (1.01-1.15), 1.24 (1.01-1.51), 1.29 (1.08-1.54), and 1.27 (1.07-1.51), respectively. HRs remained elevated, although lost statistical significance for all but breast cancer, after excluding subjects with <2 years of follow-up. CONCLUSIONS The study corroborates a causative role of chronic low-grade inflammation in colorectal carcinogenesis.
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Affiliation(s)
- Anna E Prizment
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 2nd Street South, Suite 300, Minneapolis, MN, 55455, USA,
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Inoue-Choi M, Robien K, Mariani A, Cerhan JR, Anderson KE. Sugar-sweetened beverage intake and the risk of type I and type II endometrial cancer among postmenopausal women. Cancer Epidemiol Biomarkers Prev 2013; 22:2384-94. [PMID: 24273064 DOI: 10.1158/1055-9965.epi-13-0636] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sugar-sweetened beverage (SSB) intake has been associated with an increased risk of obesity and type II diabetes. However, its association with endometrial cancer is unclear. METHODS We evaluated dietary intake of SSB, fruit juice, sugar-free beverages, sweets/baked goods, starch, and sugars among 23,039 postmenopausal women in the Iowa Women's Health Study. Incident estrogen-dependent type I and estrogen-independent type II endometrial cancers were identified via linkage with the Surveillance Epidemiology and End Results Registry. Risks of type I and type II endometrial cancers were separately compared by energy-adjusted dietary intake in Cox proportional hazards regression models. RESULTS From 1986 to 2010, 506 type I and 89 type II incident endometrial cancers were identified. An increased risk of type I endometrial cancer was observed with increasing SSB intake after adjustment for body mass index (BMI) and other cofounders (Ptrend = 0.0005). Compared with nondrinkers of SSB, the risk was 78% higher [95% confidence intervals (CI), 1.32-2.40] among women in the highest quintile of SSB intake. The observed association was not modified by BMI, physical activity, history of diabetes, or cigarette smoking. Higher risk of type I endometrial cancer was also observed with higher intake of sugars. None of the dietary items included in the analysis was associated with type II endometrial cancer risk. CONCLUSION Higher intake of SSB and sugars was associated with an increased risk of type I, but not type II, endometrial cancer. IMPACT SSB intake may be a risk factor for type I endometrial cancer regardless of other lifestyle factors.
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Affiliation(s)
- Maki Inoue-Choi
- Authors' Affiliations: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota; Masonic Cancer Center, University of Minnesota, Minneapolis; Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine; Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, Minnesota; and Department of Epidemiology and Biostatistics, School of Public Health and Health Services, George Washington University, Washington, District of Columbia
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Jansen RJ, Robinson DP, Frank RD, Anderson KE, Bamlet WR, Oberg AL, Rabe KG, Olson JE, Sinha R, Petersen GM, Stolzenberg-Solomon RZ. Fatty acids found in dairy, protein and unsaturated fatty acids are associated with risk of pancreatic cancer in a case-control study. Int J Cancer 2013; 134:1935-46. [PMID: 24590454 DOI: 10.1002/ijc.28525] [Citation(s) in RCA: 29] [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] [Received: 04/18/2013] [Accepted: 09/20/2013] [Indexed: 01/02/2023]
Abstract
Although many studies have investigated meat and total fat in relation to pancreatic cancer risk, few have investigated dairy, fish and specific fatty acids (FAs). We evaluated the association between intake of meat, fish, dairy, specific FAs and related nutrients and pancreatic cancer. In our American-based Mayo Clinic case-control study 384 cases and 983 controls frequency matched on recruitment age, race, sex and residence area (Minnesota, Wisconsin or Iowa, USA) between 2004 and 2009. All subjects provided demographic information and completed 144-item food frequency questionnaire. Logistic regression-calculated odds ratios (ORs) and 95% confidence intervals (95% CIs) were adjusted for age, sex, cigarette smoking, body mass index and diabetes mellitus. Significant inverse association (trend p-value < 0.05) between pancreatic cancer and the groupings (highest vs. lowest consumption quintile OR [95% CI]) was as follows: meat replacement (0.67 [0.43-1.02]), total protein (0.58 [0.39-0.86]), vitamin B12 (0.67 [0.44, 1.01]), zinc (0.48 [0.32, 0.71]), phosphorus (0.62 [0.41, 0.93]), vitamin E (0.51 [0.33, 0.78]), polyunsaturated FAs (0.64 [0.42, 0.98]) and linoleic acid (FA 18:2) (0.62 [0.40-0.95]). Increased risk associations were observed for saturated FAs (1.48 [0.97-2.23]), butyric acid (FA 4:0) (1.77 [1.19-2.64]), caproic acid (FA 6:0) (2.15 [1.42-3.27]), caprylic acid (FA 8:0) (1.87 [1.27-2.76]) and capric acid (FA 10:0) (1.83 [1.23-2.74]). Our study suggests that eating a diet high in total protein and certain unsaturated FAs is associated with decreased risk of developing pancreatic cancer in a dose-dependent manner, whereas fats found in dairy increase risk.
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Affiliation(s)
- Rick J Jansen
- Division of Epidemiology Department of Health Sciences Research, Mayo Clinic, Rochester, MN
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Jansen RJ, Robinson DP, Stolzenberg-Solomon RZ, Bamlet WR, Tan X, Cunningham JM, Li Y, Rider DN, Oberg AL, Rabe KG, Anderson KE, Sinha R, Petersen GM. Polymorphisms in metabolism/antioxidant genes may mediate the effect of dietary intake on pancreatic cancer risk. Pancreas 2013; 42:1043-53. [PMID: 24051964 PMCID: PMC3779344 DOI: 10.1097/mpa.0b013e3182968e00] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 12/13/2022]
Abstract
OBJECTIVES A source of variation for inconsistent dietary-pancreatic cancer associations may be individuals carrying constitutional metabolism/antioxidant gene variants that differentially benefit compared to homozygous individuals. Seventy-six tag single-nucleotide polymorphisms were genotyped in 13 candidate genes to test differential associations with pancreatic adenocarcinoma. METHODS A clinic-based case-control design was used to rapidly ascertain 251 cases and 970 frequency matched controls who provided blood samples and completed a 144-item food frequency questionnaire. Single-nucleotide polymorphisms were evaluated using a dominant genetic model and dietary categories split on controls' median intake. Logistic regression was used to calculate odds ratios and 95% confidence intervals, adjusted for potential confounders. RESULTS Significant increased associations (Bonferroni corrected P ≤ 0.0007) were observed for carriers of greater than or equal to 1 minor allele for rs3816257 (glucosidase, α; acid [GAA]) and lower intake of deep-yellow vegetables (1.90 [1.28-2.83]); and carriers of no minor allele for rs12807961 (catalase [CAT]) and high total grains intake (2.48 [1.50-4.09]), whereas those with greater than or equal to 1 minor allele had a decreasing slope (across grains). The reference group was no minor alleles with low dietary intake. CONCLUSIONS Interindividual variation in metabolism/antioxidant genes could interact with dietary intake to influence pancreatic cancer risk.
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Affiliation(s)
- Rick J Jansen
- From the Divisions of *Epidemiology, and †Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN; ‡Department of Epidemiology, National Institutes of Health, Bethesda, MD; §Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN; and ∥Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Olson SH, Hsu M, Satagopan JM, Maisonneuve P, Silverman DT, Lucenteforte E, Anderson KE, Borgida A, Bracci PM, Bueno-de-Mesquita HB, Cotterchio M, Dai Q, Duell EJ, Fontham EH, Gallinger S, Holly EA, Ji BT, Kurtz RC, La Vecchia C, Lowenfels AB, Luckett B, Ludwig E, Petersen GM, Polesel J, Seminara D, Strayer L, Talamini R. Allergies and risk of pancreatic cancer: a pooled analysis from the Pancreatic Cancer Case-Control Consortium. Am J Epidemiol 2013; 178:691-700. [PMID: 23820785 DOI: 10.1093/aje/kwt052] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [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] [Indexed: 12/23/2022] Open
Abstract
In order to quantify the risk of pancreatic cancer associated with history of any allergy and specific allergies, to investigate differences in the association with risk according to age, gender, smoking status, or body mass index, and to study the influence of age at onset, we pooled data from 10 case-control studies. In total, there were 3,567 cases and 9,145 controls. Study-specific odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression adjusted for age, gender, smoking status, and body mass index. Between-study heterogeneity was assessed by using the Cochran Q statistic. Study-specific odds ratios were pooled by using a random-effects model. The odds ratio for any allergy was 0.79 (95% confidence interval (CI): 0.62, 1.00) with heterogeneity among studies (P < 0.001). Heterogeneity was attributable to one study; with that study excluded, the pooled odds ratio was 0.73 (95% CI: 0.64, 0.84) (Pheterogeneity = 0.23). Hay fever (odds ratio = 0.74, 95% CI: 0.56, 0.96) and allergy to animals (odds ratio = 0.62, 95% CI: 0.41, 0.94) were related to lower risk, while there was no statistically significant association with other allergies or asthma. There were no major differences among subgroups defined by age, gender, smoking status, or body mass index. Older age at onset of allergies was slightly more protective than earlier age.
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Affiliation(s)
- Sara H Olson
- Department of Epidemiology and Biostatistics, 307 East 63rd Street, New York, NY 10065, USA.
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