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Kluczynski MA, Rodriguez EM, McGillicuddy CS, Schlecht NF. Human Papillomavirus Vaccination in Pediatric, Adolescent, and Young Adult Cancer Survivors-Opportunity to Address Gaps in Cancer Prevention and Survivorship. Vaccines (Basel) 2024; 12:114. [PMID: 38400098 PMCID: PMC10892003 DOI: 10.3390/vaccines12020114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
The risks of secondary cancers associated with human papillomavirus (HPV) infection are as much as three times higher for survivors of pediatric, adolescent, and young adult cancer (PYAC) compared to the general population. Despite this, HPV vaccination rates among PYAC survivors remain low. Whereas pediatric oncology providers endorse HPV vaccination of PYAC survivors, many lack the resources or opportunities to intervene. The responsibility of HPV vaccination, therefore, falls to primary care providers and practices. This article provides an overview of the challenges with HPV vaccination that are distinct to PYAC survivors and discusses potential strategies to increase HPV vaccine coverage in this population.
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Affiliation(s)
| | | | | | - Nicolas F. Schlecht
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY 14263, USA; (M.A.K.); (E.M.R.); (C.S.M.)
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Garcia MA, Schlecht NF, Rokitka DA, Attwood KM, Rodriguez EM. Examining the Barriers and Opportunities for Human Papillomavirus Vaccine Delivery in Cancer Care Settings: A Mixed-Methods Study. Cancer Prev Res (Phila) 2023; 16:581-589. [PMID: 37258419 PMCID: PMC10810245 DOI: 10.1158/1940-6207.capr-23-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/14/2023] [Accepted: 05/30/2023] [Indexed: 06/02/2023]
Abstract
Although pediatric, adolescent, and young adult (PAYA) cancer survivors are at increased risks for secondary cancers, their HPV vaccine uptake rates are poor. Therefore, we conducted a mixed-methods study to identify the barriers and opportunities for HPV vaccine delivery among PAYA cancer care providers. We distributed a semistructured questionnaire to a professional organization comprised of PAYA oncology and hematology healthcare providers between April and July 2022. Questionnaire measures included demographic and practice characteristics, HPV vaccine knowledge, willingness, barriers, opportunities, and roles for HPV vaccine delivery. Descriptive characteristics were generated for quantitative data, and content analysis was used to identify themes. A total of 49 providers responded to our survey. A majority were female (68%) and non-Hispanic white (74%). Approximately 76% were oncology or hematology physicians, and most worked in a cancer center or children's hospital (86%). Over half (63%) had been practicing for >15 years, and a majority saw patients ages 11 to 17. Although less than half reported discussing HPV vaccination with their patients, 69% were willing to become involved in HPV vaccine delivery. The most frequently reported barriers identified in our content analysis were related to system-level factors. Furthermore, providers identified opportunities within cancer prevention education, transitions in care, and at the system-level. Although barriers to HPV vaccination persist in cancer care, most providers perceived there to be opportunities to become involved in HPV vaccine delivery. Identifying strategies for PAYA oncology and hematology healthcare providers to adopt a stronger role in HPV vaccination remains a significant opportunity for future implementation research. PREVENTION RELEVANCE This mixed-methods study is the first to investigate and assess barriers and opportunities for HPV vaccine delivery among PAYA cancer healthcare providers. Our findings can serve as an important framework for future implementation research targeted towards HPV vaccine delivery in cancer clinical settings. See related Spotlight, p. 545.
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Affiliation(s)
- Melany A. Garcia
- Roswell Park Comprehensive Cancer Center, Cancer Prevention and Control, Buffalo, NY, United States of America
| | - Nicolas F. Schlecht
- Roswell Park Comprehensive Cancer Center, Cancer Prevention and Control, Buffalo, NY, United States of America
| | - Denise A. Rokitka
- Department of Pediatrics; Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America
| | - Kristopher M. Attwood
- Roswell Park Comprehensive Cancer Center, Biostatistics and Bioinformatics, Buffalo, NY, United States of America
| | - Elisa M. Rodriguez
- Roswell Park Comprehensive Cancer Center, Cancer Prevention and Control, Buffalo, NY, United States of America
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Loh M, Niu L, Arden M, Burk RD, Diaz A, Schlecht NF. Long-acting reversible contraception and condom use: A cohort study of female adolescents and young adults in New York City. Contraception 2023; 125:110081. [PMID: 37263371 DOI: 10.1016/j.contraception.2023.110081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES This study aimed to determine whether condom use varied between adolescents and young women using long-acting reversible contraception (LARC) vs non-LARC hormonal methods and assess if the initiation of LARC was associated with lower condom use. STUDY DESIGN This study used data from a large longitudinal study of sexually active females aged 13-25 years. Questionnaires assessed contraception, condom use, sexual history, and partner characteristics at the baseline visit and every 6 months. Log-binomial regression analyses examined associations between hormonal contraceptive methods and condom use, and the moderating effects of age and number of sexual partners. Exploratory analyses compared condom use based on partner characteristics. RESULTS Of 1512 participants, 1116 reported LARC or non-LARC hormonal method use during any study visit. Among baseline and new LARC users, 75.7% and 84.7% reported intrauterine device (IUD) use, respectively. Condom use at baseline among hormonal non-LARC users (37.5%) was significantly higher (p < 0.01) than LARC users (23.5%). Condom use among LARC vs non-LARC users was moderated by age in that LARC was associated with lower condom use among participants aged 13-18 years, but not those aged 19-25 years. Number of sexual partners was not a significant moderator. Among participants with increased sexually transmitted infection (STI) risk based on partner characteristics, LARC users had lower condom use compared to non-LARC users. CONCLUSIONS Condom discontinuation was common following initiation of LARC and hormonal non-LARC methods. However, condom use was lower in LARC users at baseline, among younger adolescents, and if partners had risk factors for STIs. IMPLICATIONS Condom discontinuation following initiation of highly effective contraception increases the risk of STI. Young women using LARC may be at greater risk than non-LARC users given lower condom use despite having partners with risk factors for STIs. Condom use counseling for STI protection is critical for adolescents.
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Affiliation(s)
- Miranda Loh
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Li Niu
- Faculty of Psychology, Beijing Normal University, Beitaipingzhuang, Haidian District, Beijing, China
| | - Martha Arden
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Robert D Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States; Department of Pediatrics (Genetics), Albert Einstein College of Medicine, Bronx, NY, United States; Department Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, United States; Department Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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Usyk M, Schlecht NF, Viswanathan S, Gradissimo A, Valizadegan N, Sollecito CC, Nucci-Sack A, Diaz A, Burk RD. TRiCit: A High-Throughput Approach to Detect Trichomonas vaginalis from ITS1 Amplicon Sequencing. Int J Mol Sci 2023; 24:11839. [PMID: 37511598 PMCID: PMC10380363 DOI: 10.3390/ijms241411839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Trichomoniasis, caused by Trichomonas vaginalis (TV), is the most common non-viral sexually transmitted infection (STI) worldwide, affecting over 174 million people annually and is frequently associated with reproductive co-morbidities. However, its detection can be time-consuming, subjective, and expensive for large cohort studies. This case-control study, conducted at the Mount Sinai Adolescent Health Center in New York City, involved 36 women with prevalent TV infections and 36 controls. The objective was to examine Internal Transcribed Spacer region-1 (ITS1) amplicon-derived communities for the detection of prevalent TV infections with the same precision as clinical microscopy and the independent amplification of the TV-specific TVK3/7 gene. DNA was isolated from clinician-collected cervicovaginal samples and amplified using ITS1 primers in a research laboratory. Results were compared to microscopic wet-mount TV detection of concurrently collected cervicovaginal samples and confirmed against TV-specific TVK3/7 gene PCR. The area under the receiver operating characteristics curve (AUC) for diagnosing TV using ITS1 communities was 0.92. ITS1 amplicons displayed an intra-class correlation coefficient (ICC) of 0.96 (95% CI: 0.93-0.98) compared to TVK3/7 PCR fragment testing. TV cases showed an increased risk of bacterial vaginosis (BV) compared to the TV-negative controls (OR = 8.67, 95% CI: 2.24-48.54, p-value = 0.0011), with no significant differences regarding genital yeast or chlamydia infections. This study presents a bioinformatics approach to ITS1 amplicon next-generation sequencing that is capable of detecting prevalent TV infections. This approach enables high-throughput testing for TV in stored DNA from large-scale epidemiological studies.
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Affiliation(s)
- Mykhaylo Usyk
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Epidemiology and Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Nicolas F Schlecht
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Shankar Viswanathan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Ana Gradissimo
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Negin Valizadegan
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Christopher C Sollecito
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY 10029, USA
| | - Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY 10029, USA
| | - Robert D Burk
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Departments of Microbiology and Immunology, and Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Garcia M, McGillicuddy C, Rodriguez EM, Attwood K, Schweitzer J, Coley S, Rokitka D, Schlecht NF. Human papillomavirus vaccination uptake among childhood cancer survivors in Western New York. Pediatr Blood Cancer 2022; 69:e29962. [PMID: 36094384 PMCID: PMC9529834 DOI: 10.1002/pbc.29962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The risk of human papillomavirus (HPV)-associated cancers is significantly higher among survivors of a childhood cancer compared to the general population. Despite this, their HPV vaccine uptake rates are lower. We examined factors related to HPV vaccine uptake among childhood cancer survivors from Western New York over 13 years following the introduction of HPV vaccines. METHODS Retrospective review of patients diagnosed with invasive or noninvasive cancerous conditions at age 9 or younger treated at Roswell Park Oishei Children's Cancer and Blood Disorder Program. We matched vaccine date information for patients aged 9-26 years between 2006 and 2020 from the New York State Immunization Information System. Demographic and cancer-related information was abstracted from electronic medical records. Cumulative vaccine uptake was assessed by Kaplan-Meier and Cox proportional hazards regression models. RESULTS A total of 284 patients were included in the analyses. Most were non-Hispanic/White (80.3%) and resided in a metropolitan area (81.7%). Approximately half had leukemia or lymphoma (54.9%), and most received chemotherapy. Females were more likely to initiate the HPV vaccine and did so sooner (median = 5.5 years) than males (median = 5.7 years; log-rank p = .301). Patients who were older at vaccine eligibility and males who received blood product transfusions were significantly less likely to initiate the HPV vaccine. CONCLUSION While rates of HPV vaccine initiation have been increasing with time among childhood cancer survivors, they remain low overall, with differences seen by treatment and diagnosis. Our findings support the need for further research to optimize HPV vaccine delivery in cancer care.
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Affiliation(s)
- Melany Garcia
- Roswell Park Comprehensive Cancer Center, Cancer Prevention and Control, Buffalo, NY, United States of America
| | - Cailey McGillicuddy
- Roswell Park Comprehensive Cancer Center, Cancer Prevention and Control, Buffalo, NY, United States of America
| | - Elisa M. Rodriguez
- Roswell Park Comprehensive Cancer Center, Cancer Prevention and Control, Buffalo, NY, United States of America
| | - Kristopher Attwood
- Roswell Park Comprehensive Cancer Center, Biostatistics and Bioinformatics, Buffalo, NY, United States of America
| | - Jennifer Schweitzer
- Roswell Park Comprehensive Cancer Center, Clinical Research Services, Buffalo, NY, United States of America
| | - Scott Coley
- New York State Department of Health, Bureau of Immunization, NY, United States of America
| | - Denise Rokitka
- Department of Pediatrics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America
| | - Nicolas F. Schlecht
- Roswell Park Comprehensive Cancer Center, Cancer Prevention and Control, Buffalo, NY, United States of America
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Robbins HA, Ferreiro-Iglesias A, Waterboer T, Brenner N, Nygard M, Bender N, Schroeder L, Hildesheim A, Pawlita M, D'Souza G, Visvanathan K, Langseth H, Schlecht NF, Tinker LF, Agalliu I, Wassertheil-Smoller S, Ness-Jensen E, Hveem K, Grioni S, Kaaks R, Sánchez MJ, Weiderpass E, Giles GG, Milne RL, Cai Q, Blot WJ, Zheng W, Weinstein SJ, Albanes D, Huang WY, Freedman ND, Kreimer AR, Johansson M, Brennan P. Absolute Risk of Oropharyngeal Cancer After an HPV16-E6 Serology Test and Potential Implications for Screening: Results From the Human Papillomavirus Cancer Cohort Consortium. J Clin Oncol 2022; 40:3613-3622. [PMID: 35700419 PMCID: PMC9622695 DOI: 10.1200/jco.21.01785] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 07/21/2021] [Revised: 12/17/2021] [Accepted: 05/05/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Seropositivity for the HPV16-E6 oncoprotein is a promising marker for early detection of oropharyngeal cancer (OPC), but the absolute risk of OPC after a positive or negative test is unknown. METHODS We constructed an OPC risk prediction model that integrates (1) relative odds of OPC for HPV16-E6 serostatus and cigarette smoking from the human papillomavirus (HPV) Cancer Cohort Consortium (HPVC3), (2) US population risk factor data from the National Health Interview Survey, and (3) US sex-specific population rates of OPC and mortality. RESULTS The nine HPVC3 cohorts included 365 participants with OPC with up to 10 years between blood draw and diagnosis and 5,794 controls. The estimated 10-year OPC risk for HPV16-E6 seropositive males at age 50 years was 17.4% (95% CI, 12.4 to 28.6) and at age 60 years was 27.1% (95% CI, 19.2 to 45.4). Corresponding 5-year risk estimates were 7.3% and 14.4%, respectively. For HPV16-E6 seropositive females, 10-year risk estimates were 3.6% (95% CI, 2.5 to 5.9) at age 50 years and 5.5% (95% CI, 3.8 to 9.2) at age 60 years and 5-year risk estimates were 1.5% and 2.7%, respectively. Over 30 years, after a seropositive result at age 50 years, an estimated 49.9% of males and 13.3% of females would develop OPC. By contrast, 10-year risks among HPV16-E6 seronegative people were very low, ranging from 0.01% to 0.25% depending on age, sex, and smoking status. CONCLUSION We estimate that a substantial proportion of HPV16-E6 seropositive individuals will develop OPC, with 10-year risks of 17%-27% for males and 4%-6% for females age 50-60 years in the United States. This high level of risk may warrant periodic, minimally invasive surveillance after a positive HPV16-E6 serology test, particularly for males in high-incidence regions. However, an appropriate clinical protocol for surveillance remains to be established.
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Affiliation(s)
- Hilary A. Robbins
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Tim Waterboer
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nicole Brenner
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mari Nygard
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Noemi Bender
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lea Schroeder
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Michael Pawlita
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Hilde Langseth
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Nicolas F. Schlecht
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Lesley F. Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Ilir Agalliu
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | | | - Eivind Ness-Jensen
- HUNT Research Center and K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger/Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Kristian Hveem
- HUNT Research Center and K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | | | - Graham G. Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - William J. Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | | | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Aimée R. Kreimer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Mattias Johansson
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Paul Brennan
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
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Al-Soneidar WA, Harper S, Madathil SA, Schlecht NF, Nicolau B. Do cutaneous human papillomavirus genotypes affect head and neck cancer? Evidence and bias-correction from a case-control study. Cancer Epidemiol 2022; 79:102205. [PMID: 35780522 DOI: 10.1016/j.canep.2022.102205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Three genera of human papillomavirus (HPV) infect the oral cavity and oropharynx- alpha (α), beta (β) and gamma (γ). While α-HPV infection is an established risk factor for head and neck cancers (HNC), the role of other genera remains unclear. We aimed to estimate the effect of α-, β-, γ-HPV on HNC using a hospital-based case-control study. METHODS We recruited incident HNC cases (396) and controls (439), frequency-matched by age and sex from four main referral hospitals in Montreal, Canada. We collected information on sociodemographic and behavior characteristics using in-person interviews, and tested rinse, brush and tumor specimens for HPV genotypes. We estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the effect of HPV on HNC using logistic regression, adjusting for confounding. We conducted probabilistic bias analysis to account for potential exposure misclassification, selection bias, and residual confounding. RESULTS α-HPV genus had a strong effect on HNC, particularly HPV16 (aOR=22.6; 95% CI: 10.8, 47.2). β-HPV was more common among controls (aOR=0.80; 95% 0.57, 1.11). After adjustment for HPV16, we found weaker evidence for γ-HPV (aOR= 1.29; 95% CI: 0.80, 2.08). Combined bias analyses for HPV16 increased the strength of the point estimate, but added imprecision (aOR=54.2, 95% CI: 10.7, 385.9). CONCLUSIONS α-HPV, especially HPV16, appears to increase the risk for HNC, while there is little evidence for an effect of β- or γ-HPV. β-HPV may have a preventive effect, while γ-HPV may increase the risk of HNC, although to a lesser extent than that of α-HPV. Results for cutaneous HPV were imprecise and less conclusive. Due to possible epidemiologic biases, the true relation between HPV and HNC could be underestimated in the literature. Further improvement in current methods and more studies of the biologic mechanisms of the three genera in HNC development are warranted.
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Affiliation(s)
- Walid A Al-Soneidar
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada; Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada.
| | - Sam Harper
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Sreenath A Madathil
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Nicolas F Schlecht
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Belinda Nicolau
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
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Riddell J, Brouwer AF, Walline HM, Campredon LP, Meza R, Eisenberg MC, Andrus EC, Delinger RL, Yost ML, McCloskey JK, Thomas TB, Huang S, Ferris RL, Shin DM, Fakhry C, Ow T, Li D, Berlot A, Carey TE, Schlecht NF. Oral human papillomavirus prevalence, persistence, and risk-factors in HIV-positive and HIV-negative adults. Tumour Virus Res 2022; 13:200237. [PMID: 35460939 PMCID: PMC9062318 DOI: 10.1016/j.tvr.2022.200237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background HIV has been shown to increase the likelihood of oral HPV infection. In this study, we evaluated the risk of oral HPV in HIV infected patients compared with HIV-negative controls. Methods 101 healthy adult volunteers (HIV-) and 245 adults living with HIV infection (HIV+) were recruited from 5 academic medical centers. Questionnaires and saliva samples were obtained every 3–8 months over a period of 2 years (2015–2017). DNA was isolated from the saliva samples and tested for 18 high- and low-risk genotypes. Results Oral HPV was detected in 23% of HIV + vs. 10% of HIV- participants (p < 0.0001). Men had a higher oral HPV prevalence than women (27% vs. 15% HIV+, p = 0.03, 16% vs. 5% HIV-, p = 0.01). Risk factors among HIV + participants included more lifetime deep kissing and oral sex partners, and history of AIDS. Persistent oral HPV was detected in 23% of HIV + vs. 5% of HIV- participants (p < 0.001). Among 8 HIV + participants with CD4 counts <200 cell/μL none had cleared their HPV infection during the study. Conclusions Risk of oral HPV infection and persistence was significantly higher in HIV + adults with a history of poorly controlled HIV, which may put them at increased risk of HPV-associated cancer.
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Affiliation(s)
- James Riddell
- Division of Infectious Diseases, University of Michigan Medical School
| | | | | | | | - Rafael Meza
- Department of Epidemiology, University of Michigan
| | - Marisa C Eisenberg
- Department of Epidemiology, University of Michigan; Department of Otolaryngology, University of Michigan Medical School
| | | | | | | | | | | | | | - Robert L Ferris
- Department of Otolaryngology, and University of Pittsburgh Cancer Institute, Pittsburgh, PA
| | - Dong Moon Shin
- Department of Internal Medicine and Winship Cancer Center, Emory University, Atlanta, GA
| | - Carole Fakhry
- Departments of Epidemiology and Otolaryngology and Kimmel Cancer Center, John Hopkins University, Baltimore, MD
| | - Thomas Ow
- Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY; Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Daniel Li
- Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Ashley Berlot
- Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Thomas E Carey
- Departments of Otolaryngology Head & Neck Surgery and Pharmacology, and Rogel Cancer Center, University of Michigan, Michigan Medicine, Ann Arbor, MI
| | - Nicolas F Schlecht
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY; Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY; Department of Epidemiology & Population Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.
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Diaz A, Nucci-Sack A, Colon R, Guillot M, Hollman D, Brunelli M, Burk RD, Schlecht NF. Impact of COVID-19 Mitigation Measures on Inner-City Female Youth in New York City. J Adolesc Health 2022; 70:220-227. [PMID: 34836802 PMCID: PMC8547169 DOI: 10.1016/j.jadohealth.2021.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE New York City (NYC) was the global epicenter of the COVID-19 pandemic in spring 2020. A "shelter in place" mandate was issued in March 2020. The effect on vulnerable populations of adolescent and young adult females has not been well documented. METHODS We administered a monthly online survey between May and November 2020 to adolescent and young adult females participating in a longitudinal study at Mount Sinai Adolescent Health Center. Surveys asked about death of loved ones, financial impacts, social interactions, exposure to dangerous situations, and mental health impacts. Differences in responses by age, race/ethnicity, and living situation were assessed, and compared to data obtained on the same cohort prior to the pandemic. RESULTS Four hundred seventeen females aged 15-28 years completed at least one survey, 94% of whom were youth of color. A third of responders (33%) had lost relatives or other people they were close to (loved ones). Most (68%) reported one or more financial losses, and 21% reported food insecurity, with those not living with parents or a guardian experiencing significantly higher rates. One in 10 reported experiencing sexual abuse or interpersonal partner violence during the "shelter in place" period. Over a third (37%) reported symptoms of clinical depression, which represented a significant increase compared to before the pandemic (p = .01). The negative financial impacts and higher proportion of patients with depressive symptomatology remained elevated for adolescents without support at home. CONCLUSIONS The COVID-19 pandemic had unprecedented negative short-term financial and psychosocial health impacts on inner-city female youth with potential long-term negative impacts.
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Affiliation(s)
- Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, New York.
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Rachel Colon
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Mary Guillot
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Dominic Hollman
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Marie Brunelli
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Robert D Burk
- Departments of Pediatrics, Microbiology & Immunology, and Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, New York; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York; Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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10
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Usyk M, Schlecht NF, Pickering S, Williams L, Sollecito CC, Gradissimo A, Porras C, Safaeian M, Pinto L, Herrero R, Strickler HD, Viswanathan S, Nucci-Sack A, Diaz A, Burk RD. molBV reveals immune landscape of bacterial vaginosis and predicts human papillomavirus infection natural history. Nat Commun 2022; 13:233. [PMID: 35017496 PMCID: PMC8752746 DOI: 10.1038/s41467-021-27628-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 06/11/2021] [Accepted: 11/30/2021] [Indexed: 12/16/2022] Open
Abstract
Bacterial vaginosis (BV) is a highly prevalent condition that is associated with adverse health outcomes. It has been proposed that BV's role as a pathogenic condition is mediated via bacteria-induced inflammation. However, the complex interplay between vaginal microbes and host immune factors has yet to be clearly elucidated. Here, we develop molBV, a 16 S rRNA gene amplicon-based classification pipeline that generates a molecular score and diagnoses BV with the same accuracy as the current gold standard method (i.e., Nugent score). Using 3 confirmatory cohorts we show that molBV is independent of the 16 S rRNA region and generalizable across populations. We use the score in a cohort without clinical BV states, but with measures of HPV infection history and immune markers, to reveal that BV-associated increases in the IL-1β/IP-10 cytokine ratio directly predicts clearance of incident high-risk HPV infection (HR = 1.86, 95% CI: 1.19-2.9). Furthermore, we identify an alternate inflammatory BV signature characterized by elevated TNF-α/MIP-1β ratio that is prospectively associated with progression of incident infections to CIN2 + (OR = 2.81, 95% CI: 1.62-5.42). Thus, BV is a heterogeneous condition that activates different arms of the immune response, which in turn are independent risk factors for HR-HPV clearance and progression. Clinical Trial registration number: The CVT trial has been registered under: NCT00128661.
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Affiliation(s)
- Mykhaylo Usyk
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, USA
- Department of Epidemiology and Population Health, NYU School of Medicine, New York, USA
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Sarah Pickering
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - LaShanda Williams
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, USA
| | - Christopher C Sollecito
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, USA
| | - Ana Gradissimo
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, USA
| | - Carolina Porras
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, Costa Rica, USA
| | | | - Ligia Pinto
- HPV Serology Laboratory, Frederick National Laboratory for Cancer Research, Fredrick, MD, USA
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, Costa Rica, USA
| | - Howard D Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA
| | - Shankar Viswanathan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Robert D Burk
- Department of Pediatrics (Genetic Medicine), Albert Einstein College of Medicine, Bronx, USA.
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA.
- Departments of Microbiology and Immunology, and Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA.
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11
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Niu L, Hoyt LT, Pickering S, Nucci-Sack A, Salandy A, Shankar V, Rodriguez EM, Burk RD, Schlecht NF, Diaz A. Neighborhood Profiles and Body Mass Index Trajectory in Female Adolescents and Young Adults. J Adolesc Health 2021; 69:1024-1031. [PMID: 34312066 PMCID: PMC8612950 DOI: 10.1016/j.jadohealth.2021.06.010] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/24/2021] [Accepted: 06/07/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study is to identify distinct neighborhood profiles patterned by key structural, physical, and social characteristics and test whether living in different profiles are associated with body mass index trajectories during adolescence in racial/ethnic minority female youth. METHODS Participants were 1,328 sexually active female adolescents and young adults aged 14-23 years, predominately Hispanic and black, enrolled in an human papillomavirus type 4 vaccine (Gardasil) surveillance study at a large adolescent health clinic in New York City between 2007 and 2018. Body mass index was calculated from weight and height every 6 months. A comprehensive set of neighborhood structural, social, and physical characteristics from multiple national and state datasets was linked to each participant based on home address. RESULTS Latent profile analysis revealed five distinct neighborhood profiles in New York City: High Structural/High Social Advantage, Moderate Advantage/Low Crime, Low SES (Socioeconomic Status)/High Activity, Low SES/High Social Advantage, and High Disadvantage. Results from multilevel growth curve analysis revealed that living in Low SES/High Activity neighborhoods was associated with a lower BMI at age 22 (b = -1.32, 95% confidence interval -2.49, -.16), as well as a slower increase in BMI from age 14 to 22 years (b = -.22, 95% confidence interval -.46, .02), compared to the High Disadvantage profile. CONCLUSIONS Our findings suggest that improving neighborhood structural, social, and physical environments may help promote healthy weight and reduce health disparities during adolescence and young adulthood.
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Affiliation(s)
- Li Niu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, New York; Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, New York.
| | - Lindsay T. Hoyt
- Applied Developmental Psychology, Fordham University, Bronx, NY
| | - Sarah Pickering
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | - Anthony Salandy
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Elisa M. Rodriguez
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Robert D. Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA, Departments of Pediatrics, Microbiology & Immunology, and Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicolas F. Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA, Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Angela Diaz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA, Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
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Shyhalla K, Smith DM, Diaz A, Nucci-Sack A, Guillot M, Hollman D, Goniewicz ML, O'Connor RJ, Shankar V, Burk RD, Schlecht NF. Changes in cannabis, tobacco, and alcohol use among sexually active female adolescents and young adults over a twelve-year period ending in 2019. Addict Behav 2021; 121:106994. [PMID: 34087767 PMCID: PMC8223231 DOI: 10.1016/j.addbeh.2021.106994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/26/2021] [Accepted: 05/21/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND The United States has experienced an increasing divergence in cannabis, tobacco, and alcohol use among adolescents and young adults (AYA). We assessed the changes in cannabis, tobacco and alcohol use in an inner-city population of predominantly minority AYA females attending a large adolescent-specific health center in New York City. METHODS This was a longitudinal study of AYA women recruited and followed over a twelve-year period between 2007 and 2019. Lifetime and past 30-day use were assessed by self-administered questionnaire every six months. In addition, we assessed associations with race, ethnicity, sexual behaviors, receipt of social services, living situation at home (e.g., with or without parents), and use of other drugs. RESULTS Participants included 1549 AYA females aged 13-21 at baseline, 95% of whom were youth of color. Use of cannabis increased significantly over the twelve-year period, with frequent cannabis use (≥20 times in 30-days) increasing almost 18% per year (OR = 1.18; 95%CI:1.13-1.23). In contrast, past 30-day tobacco use declined over the same period (OR = 0.86; 95%CI:0.83-0.89). Past 30-day cannabis use was more likely among African Americans (OR = 1.33; 95%CI:1.08-1.63), women who had sex with both men and women compared to with men only (OR = 1.44; 95%CI:1.18-1.75), recent users of tobacco (OR = 2.20; 95%CI:1.92-2.52) and alcohol (OR = 2.84; 95%CI:2.52-3.20), and ever users of other drugs (OR = 1.69; 95%CI:1.44-1.99), independent of age, time and living situation. CONCLUSIONS Increasing rates of cannabis use and the association with concurrent tobacco and alcohol use in AYA females underscore the need to screen for unhealthy cannabis use, in addition to tobacco and alcohol, especially among inner-city AYA.
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Affiliation(s)
- Kathleen Shyhalla
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Danielle M Smith
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Mary Guillot
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Dominic Hollman
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert D Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Departments of Pediatrics, Microbiology & Immunology, and Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicolas F Schlecht
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
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13
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Ponduri A, Liao DZ, Schlecht NF, Rosenblatt G, Prystowsky MB, Kabarriti R, Garg M, Ow TJ, Schiff BA, Smith RV, Mehta V. Impact of Nonadherence to NCCN Adjuvant Radiotherapy Initiation Guidelines in Head and Neck Squamous Cell Carcinoma in an Underserved Urban Population. J Natl Compr Canc Netw 2021; 19:1-7. [PMID: 34555804 DOI: 10.6004/jnccn.2021.7007] [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] [Received: 07/30/2020] [Accepted: 01/13/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nonadherence to NCCN Guidelines during time from surgery to postoperative radiotherapy (S-PORT) can alter survival outcomes in head and neck squamous cell carcinomna (HNSCC). There is a need to validate this impact in an underserved urban population and to understand risk factors and reasons for delay. We sought to investigate the impact of delayed PORT with outcomes of overall survival (OS) in HNSCC, to analyze predictive factors of delayed PORT, and to identify reasons for delay. METHODS We conducted a retrospective cohort study in an urban, community-based academic center. A total of 184 patients with primary HNSCC were identified through the Montefiore Medical Center cancer registry who had been treated between March 1, 2005, and March 8, 2017, and met the inclusion and exclusion criteria. The primary exposure was S-PORT. OS, recurrence, and risk factors and reasons for treatment delay were the main outcomes and measures. RESULTS Among 184 patients with HNSCC treated with PORT, the median S-PORT was 48.5 days (interquartile range, 41-67 days). The S-PORT threshold that optimally differentiated worse OS outcomes was >50 days (46.7% of our cohort; n=86). Independent of other relevant factors, patients with HNSCC and S-PORT >50 days had worse OS (hazard ratio, 2.30; 95% CI, 1.34-3.95) and greater recurrence (odds ratio, 3.51; 95% CI, 1.31-9.39). Predictors of delayed S-PORT included being underweight or obese, prolonged postoperative length of stay, and age >70 years. The most frequent reasons for PORT delay were complications related to surgery (22.09%), unrelated medical comorbidities (18.60%), and nonadherence/missed appointments (6.98%). CONCLUSIONS Delayed PORT beyond 50 days after surgery was associated with decreased OS and greater recurrence. Identification of predictive factors and reasons for treatment delay helps to target at-risk patients and facilitates interventions in underserved populations.
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Affiliation(s)
| | | | - Nicolas F Schlecht
- 2Department of Pathology, and
- 3Department of Epidemiology & Population Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx
- 4Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo
| | | | | | - Rafi Kabarriti
- 5Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx; and
| | - Madhur Garg
- 5Department of Radiation Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx; and
| | - Thomas J Ow
- 2Department of Pathology, and
- 6Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Bradley A Schiff
- 6Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Richard V Smith
- 6Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Vikas Mehta
- 6Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
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Gradissimo A, Shankar V, Wiek F, St. Peter L, Studentsov Y, Nucci-Sack A, Diaz A, Pickering S, Schlecht NF, Burk RD. Anti-HPV16 Antibody Titers Prior to an Incident Cervical HPV16/31 Infection. Viruses 2021; 13:v13081548. [PMID: 34452413 PMCID: PMC8402915 DOI: 10.3390/v13081548] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 12/16/2022] Open
Abstract
The goal of this study was to investigate the serological titers of circulating antibodies against human papillomavirus (HPV) type 16 (anti-HPV16) prior to the detection of an incident HPV16 or HPV31 infection amongst vaccinated participants. Patients were selected from a prospective post-HPV vaccine longitudinal cohort at Mount Sinai Adolescent Health Center in Manhattan, NY. We performed a nested case-control study of 43 cases with incident detection of cervical HPV16 (n = 26) or HPV31 (n = 17) DNA who had completed the full set of immunizations of the quadrivalent HPV vaccine (4vHPV). Two control individuals whom had received three doses of the vaccine (HPV16/31-negative) were selected per case, matched on age at the first dose of vaccination and follow-up time in the study: a random control, and a high-risk control that was in the upper quartile of a sexual risk behavior score. We conducted an enzyme-linked immunosorbent assay (ELISA) for the detection of immunoglobulin G (IgG) antibodies specific to anti-HPV16 virus-like particles (VLPs). The results suggest that the average log antibody titers were higher among high-risk controls than the HPV16/31 incident cases and the randomly selected controls. We show a prospective association between anti-HPV16 VLP titers and the acquisition of an HPV16/31 incident infection post-receiving three doses of 4vHPV vaccine.
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Affiliation(s)
- Ana Gradissimo
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (V.S.); (N.F.S.)
| | - Fanua Wiek
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
| | - Lauren St. Peter
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
| | - Yevgeniy Studentsov
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
| | - Anne Nucci-Sack
- Department of Pediatrics, Icahn School of Medicine, Mount Sinai Adolescent Health Center, Manhattan, NY 10128, USA; (A.N.-S.); (A.D.); (S.P.)
| | - Angela Diaz
- Department of Pediatrics, Icahn School of Medicine, Mount Sinai Adolescent Health Center, Manhattan, NY 10128, USA; (A.N.-S.); (A.D.); (S.P.)
| | - Sarah Pickering
- Department of Pediatrics, Icahn School of Medicine, Mount Sinai Adolescent Health Center, Manhattan, NY 10128, USA; (A.N.-S.); (A.D.); (S.P.)
| | - Nicolas F. Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (V.S.); (N.F.S.)
- Department of Pediatrics, Icahn School of Medicine, Mount Sinai Adolescent Health Center, Manhattan, NY 10128, USA; (A.N.-S.); (A.D.); (S.P.)
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
| | - Robert D. Burk
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (A.G.); (F.W.); (L.S.P.); (Y.S.)
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA; (V.S.); (N.F.S.)
- Departments of Microbiology & Immunology, and Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence: ; Tel.: +1-718-430-3720
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15
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Schlecht NF, Diaz A, Nucci-Sack A, Shyhalla K, Shankar V, Guillot M, Hollman D, Strickler HD, Burk RD. Incidence and Types of Human Papillomavirus Infections in Adolescent Girls and Young Women Immunized With the Human Papillomavirus Vaccine. JAMA Netw Open 2021; 4:e2121893. [PMID: 34424304 PMCID: PMC8383132 DOI: 10.1001/jamanetworkopen.2021.21893] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Rates of human papillomavirus (HPV) infection have decreased since the introduction of HPV vaccines in populations with high vaccine uptake. Data are limited for adolescent and young adult populations in US metropolitan centers. OBJECTIVE To determine HPV infection rates in adolescent girls and young women aged 13 to 21 years in New York City following HPV vaccination. DESIGN, SETTING, AND PARTICIPANTS This cohort study of type-specific cervical HPV detection was conducted at a large adolescent-specific integrated health center in New York City between October 2007 and September 2019. Participants included an open cohort of adolescent girls and young adult women who received the HPV vaccine (Gardasil; Merck & Co) over a 12-year period following HPV vaccination introduction. Data analysis was concluded September 2019. EXPOSURES Calendar date and time since receipt of first vaccine dose. MAIN OUTCOMES AND MEASURES Temporal associations in age-adjusted postvaccine HPV rates. RESULTS A total of 1453 participants, with a mean (SD) age at baseline of 18.2 (1.4) years, were included in the cohort (African American with no Hispanic ethnicity, 515 [35.4%] participants; African American with Hispanic ethnicity, 218 [15.0%] participants; Hispanic with no reported race, 637 [43.8%] participants). Approximately half (694 [47.8%] participants) were vaccinated prior to coitarche. Age-adjusted detection rates for quadrivalent vaccine types (HPV-6, HPV-11, HPV-16, and HPV-18) and related types (HPV-31, and HPV-45) decreased year over year, with the largest effect sizes observed among individuals who had been vaccinated before coitarche (adjusted odds ratio [aOR], 0.81; 95% CI, 0.67-0.98). By contrast, detection was higher year over year for nonvaccine high-risk cervical HPV types (aOR, 1.08; 95% CI, 1.04-1.13) and anal HPV types (aOR, 1.11; 95% CI, 1.05-1.17). The largest effect sizes were observed with nonvaccine types HPV-56 and HPV-68. CONCLUSIONS AND RELEVANCE Whereas lower detection rates of vaccine-related HPV types were observed since introduction of vaccines in female youth in New York City, rates of some nonvaccine high-risk HPV types were higher. Continued monitoring of high-risk HPV prevalence is warranted.
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Affiliation(s)
- Nicolas F. Schlecht
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Kathleen Shyhalla
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mary Guillot
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Dominic Hollman
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Howard D. Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert D. Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
- Departments of Pediatrics (Genetics), Microbiology & Immunology and Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine, Bronx, New York
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16
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Li D, Thomas C, Shrivastava N, Gadsden N, Kawachi N, Schiff BA, Smith RV, Schlecht NF, Prystowsky MB, Rosenblatt G, Augustine S, Guha C, Gavathiotis E, Burk RD, Mehta V, Ow TJ. Abstract 2986: Conditional reprogramming of primary head and neck tumor cells to establish consistent and diverse cell line models. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-2986] [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
Introduction
Head and neck squamous cell carcinoma (HNSCC) most commonly arise in the oral cavity, pharynx, and larynx and exhibit diverse molecular characteristics and clinical behavior across sites. Current models of HNSCC largely rely on immortalized cell lines, which suffer from selection bias and clonality. Primary cell cultures, on the other hand, are difficult to maintain and are limited by their finite ability to proliferate. Here, we describe the establishment of a robust HNSCC cell line bank using a “conditional reprogramming” (CR) method which relies on treatment with a rho kinase inhibitor (Y-27632) and co-culture with irradiated fibroblast (J2 strain) feeder cells to support indefinite tumor cell survival.
Methods
HNSCC tumors were acquired on an IRB-approved prospective tissue banking protocol. Tumor tissue and blood were collected from each patient, and tumor cells were digested and cultured using previously described CR methods. DNA was collected from tumor tissue and CR cultures and short tandem repeat (STR) profiling was used to validate culture against patient tumor tissue. To verify that the cultures were of squamous origin, western blot analysis was used to detect cytokeratin 5, cytokeratin 6 and p63. Tumor cell phenotype and growth characteristics were examined with light microscopy. HPV testing was carried out on DNA from CR cultures and matched tumor samples using PCR and specific genotyping by oligonucleotide hybridization. HPV testing was correlated with clinical p16 testing results. Whole exome sequencing was carried out on a subset of blood/tumor/CR culture samples.
Results
Eighteen CR lines were successfully cultured and validated with STR genotyping from 25 sequentially procured tumors. 10/18 were derived from oral cavity squamous cell cancers (SCCs), 5/18 were derived from oropharyngeal SCCs, and 3/18 were derived from laryngeal SCCs. 18/18 lines were found to express p63 and either cytokeratin 5 or 6, verifying these cultures contained tumor cells of squamous origin. 4/5 tumors from oropharyngeal SCCs were p16-positive on clinical testing and considered HPV-mediated. These 4 tumors all tested positive for HPV DNA in both tumor samples and CR cultures. Preliminary comparison of exome sequencing results between CR cultures and primary tumors suggests that overall mutational profiles are preserved through the tumor “conditional programming” process. Tumor heterogeneity between original tumor and CR culture is being actively compared in ongoing analyses.
Conclusion
We have consistently generated primary tumor CR cultures from patients with HNSCC arising in three major anatomical subsites of HNSCC disease, including HPV-mediated tumors. CR methods can be readily applied to all HNSCC tumors regardless of disease site and molecular background, providing a translational research model that can capture the molecular and phenotypic breadth of HNSCC disease.
Citation Format: Daniel Li, Carlos Thomas, Nitisha Shrivastava, Nicholas Gadsden, Nicole Kawachi, Bradley A. Schiff, Richard V. Smith, Nicolas F. Schlecht, Michael B. Prystowsky, Gregory Rosenblatt, Stelby Augustine, Chandan Guha, Evripidis Gavathiotis, Robert D. Burk, Vikas Mehta, Thomas J. Ow. Conditional reprogramming of primary head and neck tumor cells to establish consistent and diverse cell line models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2986.
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Affiliation(s)
- Daniel Li
- 1Albert Einstein College of Medicine, Bronx, NY
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Alli BY, Burk RD, Fatahzadeh M, Kazimiroff J, Grossberg RM, Smith RV, Ow TJ, Wiltz M, Polanco J, Rousseau MC, Nicolau B, Schlecht NF. HIV Modifies the Effect of Tobacco Smoking on Oral Human Papillomavirus Infection. J Infect Dis 2021; 222:646-654. [PMID: 32211783 DOI: 10.1093/infdis/jiaa135] [Citation(s) in RCA: 4] [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: 11/22/2019] [Accepted: 03/23/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND People living with HIV (PLWH) are more likely to smoke and harbor oral human papillomavirus (HPV) infections, putting them at higher risk for head and neck cancer. We investigated effects of HIV and smoking on oral HPV risk. METHODS Consecutive PLWH (n = 169) and at-risk HIV-negative individuals (n = 126) were recruited from 2 US health centers. Smoking history was collected using questionnaires. Participants provided oral rinse samples for HPV genotyping. We used multivariable logistic regression models with interaction terms for HIV to test for smoking effect on oral HPV. RESULTS PLWH were more likely to harbor oral HPV than HIV-negative individuals, including α (39% vs 28%), β (73% vs 63%), and γ-types (33% vs 20%). HIV infection positively modified the association between smoking and high-risk oral HPV: odds ratios for smoking 3.46 (95% confidence interval [CI], 1.01-11.94) and 1.59 (95% CI, .32-8.73) among PLWH and HIV-negative individuals, respectively, and relative excess risk due to interaction (RERI) 3.34 (95% CI, -1.51 to 8.18). RERI for HPV 16 was 1.79 (95% CI, -2.57 to 6.16) and 2.78 for β1-HPV (95% CI, -.08 to 5.65). CONCLUSION Results show tobacco smoking as a risk factor for oral HPV among PLWH.
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Affiliation(s)
| | - Robert D Burk
- Departments of Pediatrics (Genetics), Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.,Department of Microbiology and Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.,Department of Obstetrics Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA
| | - Mahnaz Fatahzadeh
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, New Jersey, USA
| | - Julie Kazimiroff
- Department of Dentistry, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA
| | - Robert M Grossberg
- Department of Infectious Diseases, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA
| | - Richard V Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA
| | - Thomas J Ow
- Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA.,Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA
| | - Mauricio Wiltz
- Department of Dentistry, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA
| | - Jacqueline Polanco
- Department of Dentistry, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA
| | - Marie-Claude Rousseau
- Faculty of Dentistry, McGill University, Montreal, Canada.,Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique, Laval, Quebec, Canada
| | | | - Nicolas F Schlecht
- Faculty of Dentistry, McGill University, Montreal, Canada.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA.,Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA.,Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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Gadsden NJ, Fulcher CD, Li D, Shrivastava N, Thomas C, Segall JE, Prystowsky MB, Schlecht NF, Gavathiotis E, Ow TJ. Palbociclib Renders Human Papilloma Virus-Negative Head and Neck Squamous Cell Carcinoma Vulnerable to the Senolytic Agent Navitoclax. Mol Cancer Res 2021; 19:862-873. [PMID: 33495400 DOI: 10.1158/1541-7786.mcr-20-0915] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/06/2020] [Accepted: 01/19/2021] [Indexed: 02/06/2023]
Abstract
We demonstrate that inhibition of cyclin-dependent kinases 4/6 (CDK4/6) leads to senescence in human papillomavirus (HPV)-negative (-) head and neck squamous cell carcinoma (HNSCC), but not in HPV-positive (+) HNSCC. The BCL-2 family inhibitor, navitoclax, has been shown to eliminate senescent cells effectively. We evaluated the efficacy of combining palbociclib and navitoclax in HPV- HNSCC. Three HPV- HNSCC cell lines (CAL27, HN31, and PCI15B) and three HPV+ HNSCC cell lines (UPCI-SCC-090, UPCI-SCC-154, and UM-SCC-47) were treated with palbociclib. Treatment drove reduced expression of phosphorylated Rb (p-Rb) and phenotypic evidence of senescence in all HPV- cell lines, whereas HPV+ cell lines did not display a consistent response by Rb or p-Rb and did not exhibit morphologic changes of senescence in response to palbociclib. In addition, treatment of HPV- cells with palbociclib increased both β-galactosidase protein expression and BCL-xL protein expression compared with untreated controls in HPV- cells. Co-expression of β-galactosidase and BCL-xL occurred consistently, indicating elevated BCL-xL expression in senescent cells. Combining palbociclib with navitoclax led to decreased HPV- HNSCC cell survival and led to increased apoptosis levels in HPV- cell lines compared with each agent given alone. IMPLICATIONS: This work exploits a key genomic hallmark of HPV- HNSCC (CDKN2A disruption) using palbociclib to induce BCL-xL-dependent senescence, which subsequently causes the cancer cells to be vulnerable to the senolytic agent, navitoclax.
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Affiliation(s)
| | - Cory D Fulcher
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Daniel Li
- Medical Student, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Nitisha Shrivastava
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Carlos Thomas
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Jeffrey E Segall
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.,Department of Anatomy and Structural Biology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Michael B Prystowsky
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas F Schlecht
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada.,Department of Epidemiology and Population Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.,Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Evripidis Gavathiotis
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York.,Department of Medicine (Cardiology), Albert Einstein College of Medicine, Bronx, New York
| | - Thomas J Ow
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York. .,Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
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Niu L, Brown J, Till Hoyt L, Salandy A, Nucci-Sack A, Shankar V, Burk RD, Schlecht NF, Diaz A. Profiles of Childhood Maltreatment: Associations with Sexual Risk Behavior during Adolescence in a Sample of Racial/Ethnic Minority Girls. Child Dev 2021; 92:1421-1438. [PMID: 33442867 DOI: 10.1111/cdev.13498] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This study examines associations between childhood maltreatment and developmental trajectories of sexual risk behaviors (SRBs) in a sample of 882 sexually active adolescent girls, predominantly Hispanic or Black, assessed every 6 months between 13 and 23 years. Latent profile analyses revealed four distinct maltreatment profiles: Low Maltreatment (76%), Moderate Emotional Neglect Only (15%), Severe Physical/Emotional Abuse (3%), and Severe Sexual Abuse (6%). Multilevel growth analyses showed the Moderate Emotional Neglect Only and Severe Sexual Abuse profiles exhibited more SRBs starting in late adolescence, and the Severe Sexual Abuse profile also exhibited a faster increase than the Low Maltreatment profile. Understanding heterogeneity within maltreated populations may have important implications for healthy sexual development.
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Affiliation(s)
- Li Niu
- Fordham University.,Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai
| | | | | | | | | | | | | | - Nicolas F Schlecht
- Albert Einstein College of Medicine.,Roswell Park Comprehensive Cancer Center
| | - Angela Diaz
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai
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Moadel-Robblee A, Camacho F, Milner GE, Kertzner A, Schlecht NF. Peer navigation-delivered loving kindness meditation: A pilot project. Complement Ther Med 2021; 57:102661. [PMID: 33418067 DOI: 10.1016/j.ctim.2021.102661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022] Open
Abstract
Peer navigators (PNs), including trained cancer survivor volunteers, can be an important resource to the cancer care team in reducing barriers to screening, treatment, and psychosocial care among underserved communities through their roles in outreach, education, advocacy, and peer support. As cancer centers face growing patient demand and evidence for integrating complementary therapies into conventional care, opportunities to envision new roles for PN arise. Based on psychosocial assessments conducted at an academic cancer center serving the low-income population of Bronx, NY, we found strong interest in both providing (44 %) and receiving (76 %) peer support, as well as in (76 %) mind-body practices (e.g., meditation). In research, these mind-body modalities and peer support have both been found to improve many aspects of physical and emotional outcomes in cancer patients, but none has looked at PNs as a potential resource for delivering such mind-body interventions. Towards this end, we conducted two pilot studies to train PN from an onsite peer navigation program called the BOLD Buddy Program, to deliver a well-defined, easy to learn, and culturally-aligned mind-body practice, i.e., Loving Kindness (LK) Meditation, to each other and to patients. Incorporating comparison to professional meditation instructors, our pilot work demonstrated that peer-lead LKM was associated with benefits to emotional well-being, relaxation, satisfaction, and perceived usability and that PNs were equally well-received in delivering LK as their professional counterparts. Evaluating 8 domains of feasibility using standardized measures, we were able to demonstrate that peer-lead LK was: in demand, acceptable, implementable, practical, adaptable, adoptable, expandable, and promising in efficacy.
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Affiliation(s)
- Alyson Moadel-Robblee
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, United States; Albert Einstein Cancer Center, Montefiore Health System, Bronx, NY 10467, United States.
| | - Fernando Camacho
- Albert Einstein Cancer Center, Montefiore Health System, Bronx, NY 10467, United States
| | - Gabrielle E Milner
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, United States
| | - Alexander Kertzner
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, United States
| | - Nicolas F Schlecht
- Roswell Park Comprehensive Cancer Center, Department of Cancer Prevention & Control, Elm & Carlton Streets, Buffalo, NY, 14263, United States
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Niu L, Hoyt LT, Salandy A, Nucci-Sack A, Shankar V, Strickler H, Burk RD, Schlecht NF, Diaz A. The interaction between pubertal timing and childhood maltreatment on the risk of human papillomavirus infection among adolescent girls and young women. Prev Med 2020; 138:106126. [PMID: 32389680 PMCID: PMC7808758 DOI: 10.1016/j.ypmed.2020.106126] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/20/2020] [Accepted: 05/03/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE The goal of this study was to evaluate the effect of pubertal timing, and its interaction with prior childhood maltreatment, on the risk of cervical human papillomavirus (HPV) among sexually active adolescent minority female adolescents and young adults. METHODS This cross-sectional study includes 842 adolescent girls and young women (aged 12 to 20 years; predominately Black and Hispanic) enrolled in an HPV vaccine surveillance study at a large adolescent health clinic in New York City between 2007 and 2016. Pubertal timing was assessed by self-reported age at menarche at baseline, with "early" and "late" defined as one standard deviation below (<11 years) or above (>13 years) the mean. Childhood exposure to abuse (sexual, physical and emotional) and neglect (physical and emotional) was assessed using the Childhood Trauma Questionnaire. Over 40 types of HPV infection were detected using the polymerase chain reaction in cervical Pap specimens. RESULTS Results from multivariable logistic regression showed that early and late pubertal timing were marginally associated with a higher risk of HPV infection, adjusting for demographic and health covariates. Childhood maltreatment moderated the association between early pubertal timing and HPV infection: early pubertal timing was associated with a higher risk for HPV infection among maltreated girls (OR = 3.32, 95%CI:1.61-6.85), but not among non-maltreated girls (OR = 0.96, 95%CI:0.61-1.50; p-interaction<0.01). CONCLUSIONS Variation in the timing of puberty and history of childhood maltreatment may have implications for adolescent sexual and reproductive health. Findings suggest that clinicians need to assess the biological and psychosocial risks in caring for youth.
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Affiliation(s)
- Li Niu
- Department of Psychology, Fordham University, NY, USA; Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | | | - Anthony Salandy
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA.
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Howard Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert D Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Departments of Pediatrics, Microbiology & Immunology, Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Mount Sinai Hospital, New York, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
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Stenzel AE, Schlecht NF, Moysich KB. Racial/Ethnic Disparities in Survival Among Women Diagnosed with Invasive Cancer of the Anal Canal: an Analysis of Surveillance, Epidemiology, and End Results (SEER) Data. J Gastrointest Cancer 2020; 52:854-862. [PMID: 32803517 DOI: 10.1007/s12029-020-00472-2] [Citation(s) in RCA: 2] [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] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To identify differences in survival among women diagnosed with cancer of the anal canal from varying racial and ethnic backgrounds. METHODS Data from the Surveillance, Epidemiology and End Results (SEER) registry between the years of 1975 and 2016 were analyzed, which included 19,048 women with cancer of the anal canal. Multivariable Cox proportional hazard regression (HRs) was performed to examine the relative risk of dying among women with anal cancer. Multivariable odds ratios (ORs) with 95% confidence intervals (CIs) were used to examine odds of highly fatal disease (death within 12 months from diagnosis). RESULTS Non-Hispanic Black women (n = 1694) had greater risk of dying when compared with non-Hispanic White women (n = 15,821) with anal cancer (HR = 1.26, CI: 1.17-1.35), independent of other prognostic indicators. Stratifying by age at diagnosis, risk of death was highest for non-Hispanic Black women diagnosed younger than age 50 years compared with non-Hispanic White women of similar age (HR = 1.60, CI: 1.34-1.89), and lowest for Hispanic women (n = 1533) older than 74 years at diagnosis (HR = 0.80, CI: 0.69-0.92). Stratifying by stage at diagnosis, disparities were not observed. When comparing across years of diagnoses, non-Hispanic Black women consistently had poorer survival compared with non-Hispanic White women diagnosed in the same year intervals. Finally, non-Hispanic Black women had greater odds of highly fatal disease (OR = 1.23, CI: 1.08-1.40) compared with non-Hispanic White women. CONCLUSION Non-Hispanic Black women with anal cancer continue to experience poorer survival compared with non-Hispanic White women, whereas disparities were not identified for Hispanic women.
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Affiliation(s)
- Ashley E Stenzel
- Division of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14203, USA
| | - Nicolas F Schlecht
- Division of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14203, USA
| | - Kirsten B Moysich
- Division of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14203, USA.
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Ow TJ, Thomas C, Fulcher CD, Chen J, López A, Reyna DE, Prystowsky MB, Smith RV, Schiff BA, Rosenblatt G, Belbin TJ, Harris TM, Childs GC, Kawachi N, Schlecht NF, Gavathiotis E. In Response to Regarding: Apoptosis Signaling Molecules as Treatment Targets in Head and Neck Squamous Carcinoma. Laryngoscope 2020; 130:E458-E459. [PMID: 32421206 DOI: 10.1002/lary.28719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 04/14/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Thomas J Ow
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Carlos Thomas
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Cory D Fulcher
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Jianhong Chen
- Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, U.S.A
| | - Andrea López
- Department of Biochemistry, Department of Medicine, Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Denis E Reyna
- Department of Biochemistry, Department of Medicine, Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Michael B Prystowsky
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Richard V Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Bradley A Schiff
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Gregory Rosenblatt
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Thomas J Belbin
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Oncology, Memorial University of Newfoundland, Saint John's, Newfoundland and Labrador, Canada
| | - Thomas M Harris
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Geoffrey C Childs
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Nicole Kawachi
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Nicolas F Schlecht
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, U.S.A.,Department of Epidemiology & Population Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Medicine (Oncology), Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Evripidis Gavathiotis
- Department of Biochemistry, Department of Medicine, Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A
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Diaz A, Shankar V, Nucci-Sack A, Linares LO, Salandy A, Strickler HD, Burk RD, Schlecht NF. Effect of child abuse and neglect on risk behaviors in inner-city minority female adolescents and young adults. Child Abuse Negl 2020; 101:104347. [PMID: 31884248 PMCID: PMC7059863 DOI: 10.1016/j.chiabu.2019.104347] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 12/16/2019] [Accepted: 12/20/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Over six million children each year are referred to child protective services for child abuse (sexual, physical and emotional) and neglect (physical and emotional). OBJECTIVE While the relationship between child sexual abuse and sexually transmitted infections has been documented, there has been little research regarding the effects of other forms of maltreatment. PARTICIPANTS AND SETTING 882 inner-city females aged 12-20 years of age seen at a large adolescent and young adult (AYA) health center in New York City between 2012-2017. METHODS History of maltreatment was assessed using the Childhood Trauma Questionnaire. Associations with depressive symptoms, antisocial behavior, peer deviancy, drug/alcohol use, and risky sexual behaviors were assessed. RESULTS History of maltreatment was common in our cohort of inner-city AYA females, with 59.6 % reporting any type of maltreatment, including sexual abuse (17.5 %), physical abuse (19.5 %) or neglect (26.2 %), and emotional abuse (30.7 %) or neglect (40.4 %). We observed significant associations between all forms of maltreatment and risk of depression, drug/alcohol use, antisocial behaviors, peer deviancy, and risky sexual risk behaviors (including having a higher number of sexual partners, having a sexual partner 5+ years older, and anal sex). Physical and emotional abuse were associated with having unprotected sex while under the influence of drugs/alcohol. CONCLUSIONS AND RELEVANCE Reporting a history of maltreatment was associated with an increased likelihood of engaging in risky sexual and antisocial behaviors, as well as depression in inner-city female youth. These data highlight the broad, lingering repercussions of all types of child maltreatment.
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Affiliation(s)
- Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA.
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Lourdes Oriana Linares
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Anthony Salandy
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Howard D Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert D Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Departments of Pediatrics, Microbiology & Immunology, and Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Gu F, Farrugia MK, Duncan WD, Feng Y, Hutson AD, Schlecht NF, Repasky EA, Antoch MP, Miller A, Platek A, Platek ME, Iovoli AJ, Singh AK. Daily Time of Radiation Treatment Is Associated with Subsequent Oral Mucositis Severity during Radiotherapy in Head and Neck Cancer Patients. Cancer Epidemiol Biomarkers Prev 2020; 29:949-955. [PMID: 32098893 DOI: 10.1158/1055-9965.epi-19-0961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 11/25/2019] [Accepted: 02/20/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Limited treatment options are available for oral mucositis, a common, debilitating complication of cancer therapy. We examined the association between daily delivery time of radiotherapy and the severity of oral mucositis in patients with head and neck cancer. METHODS We used electronic medical records of 190 patients with head and neck squamous cell carcinoma who completed radiotherapy, with or without concurrent chemotherapy, at Roswell Park Comprehensive Cancer Center (Buffalo, NY) between 2015 and 2017. Throughout a 7-week treatment course, patient mouth and throat soreness (MTS) was self-reported weekly using a validated oral mucositis questionnaire, with responses 0 (no) to 4 (extreme). Average treatment times from day 1 until the day before each mucositis survey were categorized into seven groups. Multivariable-adjusted marginal average scores (LSmeans) were estimated for the repeated- and maximum-MTS, using a linear-mixed model and generalized-linear model, respectively. RESULTS Radiation treatment time was significantly associated with oral mucositis severity using both repeated-MTS (n = 1,156; P = 0.02) and maximum-MTS (n = 190; P = 0.04), with consistent patterns. The severity was lowest for patients treated during 8:30 to <9:30 am (LSmeans for maximum-MTS = 2.24; SE = 0.15), increased at later treatment times and peaked at early afternoon (11:30 am to <3:00 pm, LSmeans = 2.66-2.71; SEs = 0.16/0.17), and then decreased substantially after 3 pm. CONCLUSIONS We report a significant association between radiation treatment time and oral mucositis severity in patients with head and neck cancer. IMPACT Although additional studies are needed, these data suggest a potential simple treatment time solution to limit severity of oral mucositis during radiotherapy without increasing cost.
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Affiliation(s)
- Fangyi Gu
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
| | - Mark K Farrugia
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - William D Duncan
- University at Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Yingdong Feng
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Alan D Hutson
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Nicolas F Schlecht
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Elizabeth A Repasky
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Marina P Antoch
- Department of Pharmacology and Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Austin Miller
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Alexis Platek
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
- University at Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Mary E Platek
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
- D'Youville College, Buffalo, New York
| | - Austin J Iovoli
- University at Buffalo, The State University of New York, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Anurag K Singh
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
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Ow TJ, Thomas C, Fulcher CD, Chen J, López A, Reyna DE, Prystowsky MB, Smith RV, Schiff BA, Rosenblatt G, Belbin TJ, Harris TM, Childs GC, Kawachi N, Schlecht NF, Gavathiotis E. Apoptosis signaling molecules as treatment targets in head and neck squamous cell carcinoma. Laryngoscope 2020; 130:2643-2649. [PMID: 31894587 DOI: 10.1002/lary.28441] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 05/03/2019] [Revised: 10/10/2019] [Accepted: 11/08/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To evaluate BCL-2 family signaling molecules in head and neck squamous cell carcinoma (HNSCC) and examine the ability of therapeutic agents with variable mechanisms of action to induce apoptosis in HNSCC cells. METHODS messenger ribonculeic acid (mRNA) expression of BAK, BAX, B-cell lymphoma (Bcl-2), BCL2 Like 1 (BCL2L1), and MCL1 were measured in The Cancer Genome Atlas (TCGA) head and neck cancer dataset, as well as in a dataset from a cohort at Montefiore Medical Center (MMC). Protein expression was similarly evaluated in a panel of HNSCC cell lines (HN30, HN31, HN5, MDA686LN, UMSCC47). Cell viability and Annexin V assays were used to assess the efficacy and apoptotic potential of a variety of agents (ABT-263 [navitoclax], A-1210477, and bortezomib. RESULTS Expression of BAK, BAX, BCL2L1, and MCL1 were each significantly higher than expression of BCL2 in the TCGA and MMC datasets. Protein expression demonstrated the same pattern of expression when examined in HNSCC cell lines. Treatment with combined ABT-263 (navitoclax)/A-1210477 or with bortezomib demonstrated apoptosis responses that approached or exceeded treatment with staurospaurine control. CONCLUSION HNSCC cells rely on inhibition of apoptosis via BCL-xL and MCL-1 overexpression, and induction of apoptosis remains a potential therapeutic option as long as strategies overcome redundant anti-apoptotic signals. LEVEL OF EVIDENCE NA Laryngoscope, 130:2643-2649, 2020.
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Affiliation(s)
- Thomas J Ow
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Carlos Thomas
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Cory D Fulcher
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Jianhong Chen
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, U.S.A
| | - Andrea López
- Department of Biochemistry, Department of Medicine, Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Denis E Reyna
- Department of Biochemistry, Department of Medicine, Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Michael B Prystowsky
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Richard V Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Bradley A Schiff
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Gregory Rosenblatt
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Thomas J Belbin
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Oncology, Memorial University of Newfoundland, Newfoundland and Labrador, Canada
| | - Thomas M Harris
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Geoffrey C Childs
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Nicole Kawachi
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Nicolas F Schlecht
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Epidemiology & Population Health, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Medicine (Oncology), Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, U.S.A
| | - Evripidis Gavathiotis
- Department of Biochemistry, Department of Medicine, Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A
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Liao DZ, Schlecht NF, Rosenblatt G, Kinkhabwala CM, Leonard JA, Ference RS, Prystowsky MB, Ow TJ, Schiff BA, Smith RV, Mehta V. Association of Delayed Time to Treatment Initiation With Overall Survival and Recurrence Among Patients With Head and Neck Squamous Cell Carcinoma in an Underserved Urban Population. JAMA Otolaryngol Head Neck Surg 2019; 145:1001-1009. [PMID: 31513264 DOI: 10.1001/jamaoto.2019.2414] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Delay in time to treatment initiation (TTI) can alter survival and oncologic outcomes. There is a need to characterize these consequences and identify risk factors and reasons for treatment delay, particularly in underserved urban populations. Objectives To investigate the association of delayed treatment initiation with outcomes of overall survival and recurrence among patients with head and neck squamous cell carcinoma (HNSCC), to analyze factors that are predictive of delayed treatment initiation, and to identify specific reasons for delayed treatment initiation. Design, Setting, and Participants Retrospective cohort study at an urban community-based academic center. Participants were 956 patients with primary HNSCC treated between February 8, 2005, and July 17, 2017, identified through the Montefiore Medical Center Cancer Registry. Exposures The primary exposure was TTI, defined as the duration between histopathological diagnosis and initial treatment. The threshold for delayed treatment initiation was determined by recursive partitioning analysis. Main Outcomes and Measures Overall survival, recurrence, and reasons for treatment delay. Results Among 956 patients with HNSCC (mean [SD] age, 60.8 [18.2] years; 72.6% male), the median TTI was 40 days (interquartile range, 28-56 days). The optimal TTI threshold to differentiate overall survival was greater than 60 days (20.8% [199 of 956] of patients in our cohort). Independent of other relevant factors, patients with HNSCC with TTI exceeding 60 days had poorer survival (hazard ratio, 1.69; 95% CI, 1.32-2.18). Similarly, TTI exceeding 60 days was associated with greater risk of recurrence (odds ratio, 1.77; 95% CI, 1.07-2.93). Predictors of delayed TTI included African American race/ethnicity, Medicaid insurance, body mass index less than 18.5, and initial diagnosis at a different institution. Commonly identified individual reasons for treatment delay were missed appointments (21.2% [14 of 66]), extensive pretreatment evaluation (21.2% [14 of 66]), and treatment refusal (13.6% [9 of 66]). Conclusions and Relevance Delaying TTI beyond 60 days was associated with decreased overall survival and increased HNSCC recurrence. Identification of predictive factors and reasons for treatment delay will help target at-risk patients and facilitate intervention in hospitals with underserved urban populations.
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Affiliation(s)
- David Z Liao
- Medical student at the Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas F Schlecht
- Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.,Department of Epidemiology & Population Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.,Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Gregory Rosenblatt
- Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | | | - James A Leonard
- Medical student at the Albert Einstein College of Medicine, Bronx, New York
| | - Ryan S Ference
- Medical student at the Albert Einstein College of Medicine, Bronx, New York
| | - Michael B Prystowsky
- Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Thomas J Ow
- Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.,Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Bradley A Schiff
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Richard V Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
| | - Vikas Mehta
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York
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28
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Madathil S, Rousseau MC, Joseph L, Coutlée F, Schlecht NF, Franco E, Nicolau B. Latency of tobacco smoking for head and neck cancer among HPV-positive and HPV-negative individuals. Int J Cancer 2019; 147:56-64. [PMID: 31584196 DOI: 10.1002/ijc.32708] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 05/27/2019] [Revised: 09/10/2019] [Accepted: 09/13/2019] [Indexed: 02/06/2023]
Abstract
Human papillomavirus (HPV) infection and tobacco smoking are well-known risk factors for head and neck cancers (HNC). Although an effect modification between oral HPV infection and tobacco smoking may exist, evidence is lacking on how they interact temporally. We investigated the latency and life course effects of tobacco smoking on risk of HNC among HPV-positive (HPV+ve ) and negative (HPV-ve ) individuals. We used data from 631 ever-smoker participants of a hospital-based case-control study conducted in four major hospitals in Montréal, Canada. Cases (n = 320), incident, histologically confirmed, primary squamous cell carcinomas, were frequency-matched to controls (n = 311) by age and sex. Sociodemographic and behavioral factors (e.g., tobacco and alcohol use and sexual history) were collected using a structured interview applying a life grid technique. Oral exfoliated cells were used for HPV DNA detection and genotyping. Latency effects were estimated flexibly using a Bayesian relevant exposure model and further extended with a life course approach. Retrospective smoking trajectories for HPV+ve cases and controls had similar shapes. Exposure to tobacco smoking even 40 years before diagnosis was associated with an increased HNC risk among both HPV+ve and HPV-ve participants. The effect of smoking before the start of sexual activity compared to afterwards was higher among HPV+ve individuals. This pattern of association was less profound among HPV-ve participants. Temporal interactions may exists between oral HPV infection and life course smoking trajectories in relation to HNC risk.
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Affiliation(s)
- Sreenath Madathil
- Faculty of Dentistry, McGill University, Montréal, QC, Canada
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Marie-Claude Rousseau
- Faculty of Dentistry, McGill University, Montréal, QC, Canada
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Lawrence Joseph
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
| | - François Coutlée
- Department of Microbiology and Infectious Diseases, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Nicolas F Schlecht
- Faculty of Dentistry, McGill University, Montréal, QC, Canada
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Eduardo Franco
- Faculty of Dentistry, McGill University, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada
- Department of Oncology, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Belinda Nicolau
- Faculty of Dentistry, McGill University, Montréal, QC, Canada
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29
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Schlecht NF, Masika M, Diaz A, Nucci-Sack A, Salandy A, Pickering S, Strickler HD, Shankar V, Burk RD. Risk of Oral Human Papillomavirus Infection Among Sexually Active Female Adolescents Receiving the Quadrivalent Vaccine. JAMA Netw Open 2019; 2:e1914031. [PMID: 31651968 PMCID: PMC6822084 DOI: 10.1001/jamanetworkopen.2019.14031] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, and oral HPV infection is associated with increased risk of oropharyngeal cancer. OBJECTIVE To describe the risk factors for oral HPV in sexually active female adolescents receiving the quadrivalent vaccine. DESIGN, SETTING, AND PARTICIPANTS Longitudinal cohort study involving repeated collection of oral rinse specimens from sexually active female adolescents conducted between October 19, 2007, and March 9, 2017, at a large adolescent health center in New York, New York, that provides free health care, including HPV vaccination. EXPOSURES Human papillomavirus vaccination and self-reported history of sexual behavior. MAIN OUTCOMES AND MEASURES Prevalence of HPV in the oral cavity. RESULTS Among the 1259 participants who were included in this study, median age at entry into the study was 18 (range, 13-21) years; 638 (50.7%) were of African American descent, 569 (45.2%) were of Hispanic descent, 43 (3.4%) reported another race/ethnicity, and race/ethnicity was unspecified for 9 (0.7%). The median (mode) age at first sexual activity was 14.8 (14) years, and 1161 (92.2%) reported having had oral sex. Human papillomavirus DNA was detected in baseline oral rinse samples of 78 of the 1259 participants (6.2%; 95% CI, 4.9%-7.6%). There was a significant decrease in oral HPV detection with time (in years) since first engaging in sexual activities, independent of age and concurrent detection of cervical HPV; comparing 4 or more years with 1 year or less, the odds ratio was 0.45 (95% CI, 0.21-0.96). Detection of vaccine types (HPV-6, HPV-11, HPV-16, and HPV-18) was significantly lower among participants who had received at least 1 dose of the quadrivalent HPV vaccine at the time of enrollment compared with those who were unvaccinated (odds ratio, 0.20; 95% CI, 0.04-0.998). CONCLUSIONS AND RELEVANCE This study's findings suggest that detection of HPV in the oral cavity is not uncommon in sexually active female adolescents. In addition, HPV vaccination is associated with a significant decrease in detection of HPV vaccine types in the oral cavity.
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Affiliation(s)
- Nicolas F. Schlecht
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Martin Masika
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Angela Diaz
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Anne Nucci-Sack
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Anthony Salandy
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Sarah Pickering
- Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Howard D. Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert D. Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
- Department of Pediatrics, Division of Genetics, Albert Einstein College of Medicine, Bronx, New York
- Department of Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, New York
- Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, New York
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30
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ThekkePurakkal AS, Nicolau B, Burk RD, Franco EL, Schlecht NF. Genetic variants in CYP and GST genes, smoking and risk for head and neck cancers: a gene-environment interaction hospital-based case-control study among Canadian Caucasians. Carcinogenesis 2019; 40:1061-1069. [PMID: 30938417 DOI: 10.1093/carcin/bgz051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 01/28/2019] [Accepted: 03/22/2019] [Indexed: 12/23/2022] Open
Abstract
The evidence for genetic polymorphisms in genes encoding cytochrome P450 (CYP) and glutathione S-transferase (GST) enzymes as risk factors for squamous cell carcinomas of the head and neck (SCCHN) in Caucasians is conflicting. Furthermore, the interactive effects with smoking have not been documented. We estimated the effects of five single nucleotide polymorphisms and two copy number variants associated with CYP and GST genes, as well as their interactive effects with smoking, on SCCHN risk among Caucasians from a case-control study conducted in Montreal, Canada. The study involved 389 incident SCCHN cases and 429 controls, frequency-matched by age and sex, recruited from four main hospitals between 2005 and 2013. Life-course-based interviews collected information on tobacco smoking history and other risk behaviors. DNA was isolated from oral exfoliated cells and genotyped for genetic variants. Unconditional logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for main, joint effect, stratum-specific and interaction estimates among non-, moderate and heavy smokers. Carriers of GSTP1 105Val (versus non-carriers) had a lower risk of SCCHN (OR = 0.71, 95% CI: 0.53, 0.95), which was observed for heavy smokers (OR = 0.59, 95% CI: 0.36, 0.95) and non-smokers alike (OR = 0.49, 95% CI: 0.24, 0.98). The decreased risk associations were also conserved among human papillomavirus negative individuals. There was no evidence for statistical interaction with smoking on additive or multiplicative scales for any of the variants analyzed. Of CYP and GST polymorphisms detected in Canadian Caucasians, only GSTP1 105Val was associated with a decreased risk for SCCHN.
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Affiliation(s)
| | - Belinda Nicolau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada
| | - Robert D Burk
- Department of Pediatrics (Genetics), Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eduardo L Franco
- Department of Oncology, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Nicolas F Schlecht
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Kreimer AR, Ferreiro-Iglesias A, Nygard M, Bender N, Schroeder L, Hildesheim A, Robbins HA, Pawlita M, Langseth H, Schlecht NF, Tinker LF, Agalliu I, Smoller SW, Ness-Jensen E, Hveem K, D'Souza G, Visvanathan K, May B, Ursin G, Weiderpass E, Giles GG, Milne RL, Cai Q, Blot WJ, Zheng W, Weinstein SJ, Albanes D, Brenner N, Hoffman-Bolton J, Kaaks R, Barricarte A, Tjønneland A, Sacerdote C, Trichopoulou A, Vermeulen RCH, Huang WY, Freedman ND, Brennan P, Waterboer T, Johansson M. Timing of HPV16-E6 antibody seroconversion before OPSCC: findings from the HPVC3 consortium. Ann Oncol 2019; 30:1335-1343. [PMID: 31185496 PMCID: PMC6683856 DOI: 10.1093/annonc/mdz138] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Human papillomavirus type 16 (HPV16)-E6 antibodies are detectable in peripheral blood before diagnosis in the majority of HPV16-driven oropharyngeal squamous cell carcinoma (OPSCC), but the timing of seroconversion is unknown. PATIENTS AND METHODS We formed the HPV Cancer Cohort Consortium which comprises nine population cohorts from Europe, North America and Australia. In total, 743 incident OPSCC cases and 5814 controls provided at least one pre-diagnostic blood sample, including 111 cases with multiple samples. Median time between first blood collection and OPSCC diagnosis was 11.4 years (IQR = 6-11 years, range = 0-40 years). Antibodies against HPV16-E6 were measured by multiplex serology (GST fusion protein based Luminex assay). RESULTS HPV16-E6 seropositivity was present in 0.4% of controls (22/5814; 95% CI 0.2% to 0.6%) and 26.2% (195/743; 95% CI 23.1% to 29.6%) of OPSCC cases. HPV16-E6 seropositivity increased the odds of OPSCC 98.2-fold (95% CI 62.1-155.4) in whites and 17.2-fold (95% CI 1.7-170.5) in blacks. Seropositivity in cases was more frequent in recent calendar periods, ranging from 21.9% pre-1996 to 68.4% in 2005 onwards, in those with blood collection near diagnosis (lead time <5 years). HPV16-E6 seropositivity increased with lead time: 0.0%, 13.5%, 23.7%, and 38.9% with lead times of >30 years (N = 24), 20-30 years (N = 148), 10-20 years (N = 228), and <10 years (N = 301 cases) (p-trend < 0.001). Of the 47 HPV16-E6 seropositive cases with serially-collected blood samples, 17 cases seroconverted during follow-up, with timing ranging from 6 to 28 years before diagnosis. For the remaining 30 cases, robust seropositivity was observed up to 25 years before diagnosis. CONCLUSIONS The immune response to HPV16-driven tumorigenesis is most often detectable several decades before OPSCC diagnosis. HPV16-E6 seropositive individuals face increased risk of OPSCC over several decades.
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Affiliation(s)
- A R Kreimer
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA.
| | - A Ferreiro-Iglesias
- Genetic Epidemiology Group (GEP), International Agency for Research on Cancer (IARC), Lyon, France
| | - M Nygard
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - N Bender
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - L Schroeder
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Hildesheim
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - H A Robbins
- Genetic Epidemiology Group (GEP), International Agency for Research on Cancer (IARC), Lyon, France
| | - M Pawlita
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H Langseth
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - N F Schlecht
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
| | - L F Tinker
- Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - I Agalliu
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
| | - S W Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx
| | - E Ness-Jensen
- HUNT Research Center, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - K Hveem
- HUNT Research Center, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - G D'Souza
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - K Visvanathan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - B May
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - G Ursin
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Majorstuen, Oslo; Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - E Weiderpass
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, and Faculty of Medicine, Helsinki University, Helsinki, Finland; Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - G G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne; Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Parkville; School of Public Health and Preventive Medicine, Monash University Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne
| | - R L Milne
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne; Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Parkville; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Q Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, USA
| | - W J Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, USA
| | - W Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, USA
| | - S J Weinstein
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - D Albanes
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - N Brenner
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - R Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Barricarte
- Navarra Public Health Institute, Pamplona; Navarra Institute for Health Research (IdiSNA), Pamplona; CIBER Epidemiology and Public Health CIBERESP, Madrid, Spain
| | - A Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - C Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | | | - R C H Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University; Julius Centre for Public Health Sciences and Primary Care, Utrecht University Medical Centre, Utrecht, the Netherlands
| | - W-Y Huang
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - N D Freedman
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - P Brennan
- Genetic Epidemiology Group (GEP), International Agency for Research on Cancer (IARC), Lyon, France
| | - T Waterboer
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Johansson
- Genetic Epidemiology Group (GEP), International Agency for Research on Cancer (IARC), Lyon, France.
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Fattouh M, Chang GY, Ow TJ, Shifteh K, Rosenblatt G, Patel VM, Smith RV, Prystowsky MB, Schlecht NF. Association between pretreatment obesity, sarcopenia, and survival in patients with head and neck cancer. Head Neck 2019; 41:707-714. [PMID: 30582237 PMCID: PMC6709588 DOI: 10.1002/hed.25420] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [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: 03/23/2018] [Revised: 07/10/2018] [Accepted: 09/06/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Body mass index (BMI), sarcopenia, and obesity-related comorbidities have been associated with head and neck squamous cell carcinoma (HNSCC) progression. METHODS We conducted a retrospective analysis of 441 normal-weight, overweight, and obese HNSCC patients treated at Montefiore Medical Center (New York). Patients were grouped by BMI prior to treatment and assessed for differences in survival adjusting for comorbid conditions (cardiovascular disease and diabetes). Evidence of sarcopenia was also assessed using pretreatment abdominal CT scans in a subset of 113 patients. RESULTS Prior to treatment, 55% of HNSCC patients were overweight or obese. Overweight/obese patients had significantly better overall survival (hazard ratio [HR] = 0.4, 95% CI: 0.3-0.6) compared to normal-weight patients, independent of comorbid conditions. Patients with sarcopenia had significantly poorer survival (HR = 2.1, 95% CI: 1.1-3.9) compared to non-sarcopenic patients, with the strongest association seen among overweight/obese patients. CONCLUSION Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.
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Affiliation(s)
- Michael Fattouh
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461
| | - Gina Y. Chang
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461
| | - Thomas J. Ow
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Keivan Shifteh
- Department of Radiology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Gregory Rosenblatt
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Viraj M. Patel
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Richard V. Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Surgery, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Michael B. Prystowsky
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
| | - Nicolas F. Schlecht
- Department of Pathology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Medicine (Oncology), Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Epidemiology & Population Health, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY, 14263
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Laprise C, Madathil SA, Schlecht NF, Castonguay G, Soulières D, Nguyen-Tan PF, Allison P, Coutlée F, Hier M, Rousseau MC, Franco EL, Nicolau B. Increased risk of oropharyngeal cancers mediated by oral human papillomavirus infection: Results from a Canadian study. Head Neck 2019; 41:678-685. [PMID: 30605251 DOI: 10.1002/hed.25436] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 07/23/2018] [Accepted: 08/15/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study aimed to estimate the extent to which oral sex behavior is associated with an increased risk of oropharyngeal cancers (OPCs), and how much of the association is mediated by oral human papillomavirus (HPV) infection. METHODS We used data from a hospital-based case-control study conducted in Montreal, Canada. Information on oral sex behaviors was collected. Oral rinse and oral brush specimens were analyzed for HPV positivity and genotyping. Logistic regression estimated the odds ratios (OR) and 95% confidence intervals (CI) for the association between oral sex behaviors and OPC. RESULTS Onset of oral sex practice at age 16 years or younger had an increased risk of OPCs relative to those with onset after age 30 years (OR = 2.98; 95% CI 1.37-6.47). This association decreased (OR = 1.09; 95% CI 0.25-4.71) when restricted to those positive for HPV. CONCLUSIONS Our results suggest that the association between oral sex and OPC seems mediated by oral HPV infection.
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Affiliation(s)
- Claudie Laprise
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Sreenath Arekunnath Madathil
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada
| | - Nicolas F Schlecht
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Geneviève Castonguay
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Denis Soulières
- Department of Radiation Oncology, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Phuc Felix Nguyen-Tan
- Department of Hemato-Oncology, Hôpital Notre-Dame du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Paul Allison
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - François Coutlée
- Department of Microbiology and Infectious Diseases, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Michael Hier
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Marie-Claude Rousseau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Belinda Nicolau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
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ThekkePurakkal AS, Naimi AI, Madathil SA, Kumamangalam Puthiyannal SH, Netuveli G, Sacker A, Schlecht NF, Nicolau B. Differential impact of socioeconomic position across life on oral cancer risk in Kerala, India: An investigation of life-course models under a time-varying framework. Community Dent Oral Epidemiol 2018; 46:592-600. [PMID: 30004138 DOI: 10.1111/cdoe.12404] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 02/14/2018] [Accepted: 06/18/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The incidence of oral cancer has been rapidly increasing in India, calling for evidence contributing to a deeper understanding of its determinants. Although disadvantageous life-course socioeconomic position (SEP) is independently associated with the risk of these cancers, the explanatory mechanisms remain unclear. Possible pathways may be better understood by testing which life-course model most influences oral cancer risk. We estimated the association between life-course SEP and oral cancer risk under three life-course models: critical period, accumulation and social mobility. METHODS We recruited incident oral cancer cases (N = 350) and controls (N = 371) frequency-matched by age and sex from two main referral hospitals in Kozhikode, Kerala, India, between 2008 and 2012. We collected information on childhood (0-16 years), early adulthood (17-30 years) and late adulthood (above 30 years) SEP and behavioural factors along the life span using interviews and a life-grid technique. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for the association between life-course SEP and oral cancer risk using inverse probability weighted marginal structural models. RESULTS Relative to an advantageous SEP in childhood and early adulthood, a disadvantageous SEP was associated with oral cancer risk [(OR = 2.76, 95% CI: 1.99, 3.81) and (OR = 1.84, 95% CI: 1.21, 2.79), respectively]. In addition, participants who were in a disadvantageous (vs advantageous) SEP during all three periods of life had an increased oral cancer risk (OR = 4.86, 95% CI: 2.61, 9.06). The childhood to early adulthood social mobility model and overall life-course trajectories indicated strong influence of exposure to disadvantageous SEP in childhood on the risk for oral cancer. CONCLUSIONS Using novel approaches to existing methods, our study provides empirical evidence that disadvantageous childhood SEP is critical for oral cancer risk in this population from Kerala, India.
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Affiliation(s)
| | - Ashley I Naimi
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sreenath A Madathil
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | | | | | - Amanda Sacker
- UCL Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Nicolas F Schlecht
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Belinda Nicolau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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Wijetunga NA, Ben-Dayan M, Tozour J, Burk RD, Schlecht NF, Einstein MH, Greally JM. A polycomb-mediated epigenetic field defect precedes invasive cervical carcinoma. Oncotarget 2018; 7:62133-62143. [PMID: 27557505 PMCID: PMC5308716 DOI: 10.18632/oncotarget.11390] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/28/2016] [Indexed: 11/30/2022] Open
Abstract
Human papillomavirus (HPV)-associated cervical carcinoma is preceded by stages of cervical intra-epithelial neoplasia (CIN) that can variably progress to malignancy. Understanding the different molecular processes involved in the progression of pre-malignant CIN is critical to the development of improved predictive and interventional capabilities. We tested the role of regulators of transcription in both the development and the progression of HPV-associated CIN, performing the most comprehensive genomic survey to date of DNA methylation in HPV-associated cervical neoplasia, testing ~2 million loci throughout the human genome in biopsies from 78 HPV+ women, identifying changes starting in early CIN and maintained through carcinogenesis. We identified loci at which DNA methylation is consistently altered, beginning early in the course of neoplastic disease and progressing with disease advancement. While the loss of DNA methylation occurs mostly at intergenic regions, acquisition of DNA methylation is at sites involved in transcriptional regulation, with strong enrichment for targets of polycomb repression. Using an independent cohort from The Cancer Genome Atlas, we validated the loci with increased DNA methylation and found that these regulatory changes were associated with locally decreased gene expression. Secondary validation using immunohistochemistry showed that the progression of neoplasia was associated with increasing polycomb protein expression specifically in the cervical epithelium. We find that perturbations of genomic regulatory processes occur early and persist in cervical carcinoma. The results indicate a polycomb-mediated epigenetic field defect in cervical neoplasia that may represent a target for early, topical interventions using polycomb inhibitors.
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Affiliation(s)
- Neil Ari Wijetunga
- Department of Genetics and Center for Epigenomics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Miriam Ben-Dayan
- Department of Genetics and Center for Epigenomics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Jessica Tozour
- Department of Genetics and Center for Epigenomics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Robert D Burk
- Department of Pediatrics (Genetics), Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.,Department of Medicine (Oncology), Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Mark H Einstein
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.,Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - John M Greally
- Department of Genetics and Center for Epigenomics, Albert Einstein College of Medicine, Bronx, NY 10461, USA.,Department of Pediatrics (Genetics), Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Anayannis NV, Schlecht NF, Ben-Dayan M, Smith RV, Belbin TJ, Ow TJ, Blakaj DM, Burk RD, Leonard SM, Woodman CB, Parish JL, Prystowsky MB. Association of an intact E2 gene with higher HPV viral load, higher viral oncogene expression, and improved clinical outcome in HPV16 positive head and neck squamous cell carcinoma. PLoS One 2018; 13:e0191581. [PMID: 29451891 PMCID: PMC5815588 DOI: 10.1371/journal.pone.0191581] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 07/14/2017] [Accepted: 01/08/2018] [Indexed: 11/18/2022] Open
Abstract
To assess the relationship of E2 gene disruption with viral gene expression and clinical outcome in human papillomavirus (HPV) positive head and neck squamous cell carcinoma, we evaluated 31 oropharyngeal and 17 non-oropharyngeal HPV16 positive carcinomas using two PCR-based methods to test for disruption of E2, followed by Sanger sequencing. Expression of HPV16 E6, E7 and E2 transcripts, along with cellular ARF and INK4A, were also assessed by RT-qPCR. Associations between E2 disruption, E2/E6/E7 expression, and clinical outcome were evaluated by Kaplan-Meier analysis for loco-regional recurrence and disease-specific survival. The majority (n = 21, 68%) of HPV16 positive oropharyngeal carcinomas had an intact E2 gene, whereas the majority of HPV16 positive non-oropharyngeal carcinomas (n = 10, 59%) had a disrupted E2 gene. Three of the oropharyngeal tumors and two of the non-oropharyngeal tumors had deletions within E2. Detection of an intact E2 gene was associated with a higher DNA viral load and increased E2/E6/E7, ARF and INK4A expression in oropharyngeal tumors. Oropharyngeal carcinomas with an intact E2 had a lower risk of loco-regional recurrence (log-rank p = 0.04) and improved disease-specific survival (p = 0.03) compared to tumors with disrupted E2. In addition, high E7 expression was associated with lower risk of loco-regional recurrence (p = 0.004) as was high E6 expression (p = 0.006). In summary, an intact E2 gene is more common in HPV16 positive oropharyngeal than non-oropharyngeal carcinomas; the presence of an intact E2 gene is associated with higher HPV viral load, higher viral oncogene expression, and improved clinical outcome compared to patients with a disrupted E2 gene in oropharyngeal cancer.
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Affiliation(s)
- Nicole V. Anayannis
- Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
| | - Nicolas F. Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
- Department of Medicine (Oncology), Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, United States of America
| | - Miriam Ben-Dayan
- Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
| | - Richard V. Smith
- Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
- Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
| | - Thomas J. Belbin
- Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
- Discipline of Oncology, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Thomas J. Ow
- Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
- Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
| | - Duk M. Blakaj
- The James Cancer Center, Ohio State University, Columbus, OH, United States of America
| | - Robert D. Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
- Department of Pediatrics (Genetics), Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
- Department of Microbiology & Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
- Department of Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
| | - Sarah M. Leonard
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Ciaran B. Woodman
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Joanna L. Parish
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Michael B. Prystowsky
- Department of Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, United States of America
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Cho JK, Ow TJ, Lee AY, Smith RV, Schlecht NF, Schiff BA, Tassler AB, Lin J, Moadel RM, Valdivia A, Abraham T, Gulko E, Neimark M, Ustun B, Bello JA, Shifteh K. Preoperative 18F-FDG-PET/CT vs Contrast-Enhanced CT to Identify Regional Nodal Metastasis among Patients with Head and Neck Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2017; 157:439-447. [PMID: 28608737 DOI: 10.1177/0194599817703927] [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] [Indexed: 02/06/2023]
Abstract
Objective Our objective was to compare the accuracy of preoperative positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced CT (CECT) in detecting cervical nodal metastases in patients treated with neck dissection and to scrutinize the ability of each modality to determine nodal stage. Study Design Case series with chart review. Setting Montefiore Medical Center, Bronx, New York. Subjects and Methods Patients who underwent neck dissection at our institution for primary treatment of head and neck squamous cell carcinoma (HNSCC) and had received preoperative PET/CT and CECT were included in this study. Imaging studies were reinterpreted by 3 specialists within the field and compared for interreader agreement. Concordance between radiology and histopathology was measured using neck levels and sides, along with patient nodal stage. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and agreement coefficients were calculated. Results Seventy-three patients were included in the study. Sensitivity was 0.69 and 0.94 (level and side) for PET/CT vs 0.53 and 0.66 for CECT ( P = .056, P = .001). Specificity was 0.86 and 0.56 for PET/CT vs 0.91 and 0.76 for CECT ( P = .014, P = .024). No significant difference was found in overall accuracy ( P = .33, P = .88). The overall agreement percentages between N stage called by imaging modality and pathology were 52% and 55% for PET/CT and CECT, respectively. Conclusion No significant difference in sensitivity was found between PET/CT and CECT. CECT was found to have superior specificity compared with PET/CT. The information gleaned from each modality in the pretreatment evaluation of HNSCC appears to be complementary.
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Affiliation(s)
- Joshua K Cho
- 1 Albert Einstein College of Medicine, Bronx, New York, USA
| | - Thomas J Ow
- 2 Montefiore Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Bronx, New York, USA
| | - Andrew Y Lee
- 2 Montefiore Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Bronx, New York, USA
| | - Richard V Smith
- 2 Montefiore Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Bronx, New York, USA
| | - Nicolas F Schlecht
- 1 Albert Einstein College of Medicine, Bronx, New York, USA.,3 Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Bradley A Schiff
- 2 Montefiore Medical Center, Department of Otorhinolaryngology-Head and Neck Surgery, Bronx, New York, USA
| | - Andrew B Tassler
- 4 Weill Cornell Medical College, Department of Otolaryngology-Head and Neck Surgery, New York, New York, USA
| | - Juan Lin
- 1 Albert Einstein College of Medicine, Bronx, New York, USA
| | - Renee M Moadel
- 5 Montefiore Medical Center, Department of Radiology, Bronx, New York, USA
| | - Ana Valdivia
- 5 Montefiore Medical Center, Department of Radiology, Bronx, New York, USA
| | - Tony Abraham
- 5 Montefiore Medical Center, Department of Radiology, Bronx, New York, USA
| | - Edwin Gulko
- 5 Montefiore Medical Center, Department of Radiology, Bronx, New York, USA
| | - Matthew Neimark
- 5 Montefiore Medical Center, Department of Radiology, Bronx, New York, USA
| | - Berrin Ustun
- 5 Montefiore Medical Center, Department of Radiology, Bronx, New York, USA
| | - Jacqueline A Bello
- 5 Montefiore Medical Center, Department of Radiology, Bronx, New York, USA
| | - Keivan Shifteh
- 5 Montefiore Medical Center, Department of Radiology, Bronx, New York, USA
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Laprise C, Madathil SA, Schlecht NF, Castonguay G, Soulières D, Nguyen-Tan PF, Allison P, Coutlée F, Hier M, Rousseau MC, Franco EL, Nicolau B. Human papillomavirus genotypes and risk of head and neck cancers: Results from the HeNCe Life case-control study. Oral Oncol 2017; 69:56-61. [PMID: 28559021 DOI: 10.1016/j.oraloncology.2017.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 12/01/2016] [Revised: 02/24/2017] [Accepted: 03/25/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Human papillomaviruses (HPV) are changing dramatically the epidemiologic landscape of head and neck cancers (HNCs). Their role in the aetiology of these cancers varies widely among HNCs subsites, sex and geographical regions worldwide. We describe HPV prevalence and its association with HNCs risk overall and by anatomical subsite in a sample of Canadians. MATERIALS AND METHODS The HeNCe Life study recruited 460 incident HNCs cases and 458 controls frequency-matched by age and sex from four Montreal hospitals in 2005-2013. We tested oral rinse and oral brush specimens for mucosal HPV genotypes. HPV positivity was categorized hierarchically as either negative, exclusively non-α-9 species types, α-9 types other than HPV16, and HPV16. We estimated odds ratios (OR) and 95% confidence intervals (CI) for the associations between HPV and HNCs using unconditional logistic regression, controlling for confounders. RESULTS The prevalence of HPV infection among controls and cases was 14.5% and 41.2% in oral rinse and 3.1% and 24.4% in oral brush samples, respectively. HPV16 was the predominant genotype with an oral rinse and oral brush prevalence of 26.3% and 16.2% among cases and 2.4% and 0.2% among controls, respectively. HPV infection was associated with an increased risk of HNCs overall (OR=4.18; 95% CI, 2.94-5.95) and oropharyngeal cancer only (OR=10.3; 95% CI, 6.8-15.7). HNCs and oropharyngeal cancer were strongly associated with HPV16 (OR=18.1; 95% CI, 9.1-35.8, and OR=47.2; 95% CI, 23.1-96.6, respectively). CONCLUSION HPV infection, particularly HPV16, was associated with an increased HNCs risk, most strongly for oropharyngeal cancers.
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Affiliation(s)
- Claudie Laprise
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada; Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada
| | - Sreenath Arekunnath Madathil
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada; Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, United States
| | - Geneviève Castonguay
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada
| | - Denis Soulières
- Department of Hemato-Oncology, Hôpital Notre-Dame du Centre Hospitalier de I'Université de Montréal, Montreal, Canada
| | - Phuc Felix Nguyen-Tan
- Department of Radiation Oncology, Hôpital Notre-Dame du Centre Hospitalier de I'Université de Montréal, Montreal, Canada
| | - Paul Allison
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada
| | - François Coutlée
- Department of Microbiology and Infectious Diseases, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de I'Université de Montréal, Montreal, Quebec, Canada
| | - Michael Hier
- Faculty of Medicine, McGill University, Department of Otolaryngology-Head and Neck Surgery, Montreal, Quebec, Canada
| | - Marie-Claude Rousseau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada; Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Belinda Nicolau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada.
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Ben-Dayan MM, Ow TJ, Belbin TJ, Wetzler J, Smith RV, Childs G, Diergaarde B, Hayes DN, Grandis JR, Prystowsky MB, Schlecht NF. Nonpromoter methylation of the CDKN2A gene with active transcription is associated with improved locoregional control in laryngeal squamous cell carcinoma. Cancer Med 2017; 6:397-407. [PMID: 28102032 PMCID: PMC5313649 DOI: 10.1002/cam4.961] [Citation(s) in RCA: 13] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/14/2016] [Accepted: 10/21/2016] [Indexed: 12/17/2022] Open
Abstract
We previously reported a novel association between CDKN2A nonpromoter methylation and transcription (ARF/INK4a) in human papillomavirus associated oropharyngeal tumors. In this study we assessed whether nonpromoter CDKN2A methylation in laryngeal squamous cell carcinomas (LXSCC) conferred a similar association with transcription that predicted patient outcome. We compared DNA methylation and ARF/INK4a RNA expression levels for the CDKN2A locus using the Illumina HumanMethylation27 beadchip and RT‐PCR in 43 LXSCC tumor samples collected from a prospective study of head and neck cancer patients treated at Montefiore Medical Center (MMC). Validation was performed using RNAseq data on 111 LXSCC tumor samples from the Cancer Genome Atlas (TCGA). The clinical relevance of combined nonpromoter CDKN2A methylation and transcription was assessed by multivariate Cox regression for locoregional recurrence on a subset of 69 LXSCC patients with complete clinicopathologic data from the MMC and TCGA cohorts. We found evidence of CDKN2A nonpromoter hypermethylation in a third of LXSCC from our MMC cohort, which was significantly associated with increased ARF and INK4a RNA expression (Wilcoxon rank‐sum, P = 0.007 and 0.003, respectively). A similar association was confirmed in TCGA samples (Wilcoxon rank‐sum test P < 0.0001 for ARF and INK4a). Patients with CDKN2A hypermethylation or high ARF/INK4a expression were significantly less likely to develop a locoregional recurrence compared to those with neither of the features, independent of other clinicopatholgic risk factors (adjusted hazard ratio=0.21, 95% confidence interval:0.05–0.81). These results support the conclusion that CDKN2A nonpromoter methylation is associated with increased ARF and INK4a RNA expression, and improved locoregional control in LXSCC.
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Affiliation(s)
- Miriam M Ben-Dayan
- Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Thomas J Ow
- Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.,Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Thomas J Belbin
- Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.,Dicipline of Oncology, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland
| | - Joshua Wetzler
- Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Richard V Smith
- Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Geoffrey Childs
- Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Brenda Diergaarde
- Department of Epidemiology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - D Neil Hayes
- Department of Otolaryngology/Head and Neck Cancer Surgery, University of North Carolina, Chapel Hill, North Carolina
| | - Jennifer R Grandis
- Departments of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California.,Department of Clinical and Translational Science Institute, University of California, San Francisco, California
| | - Michael B Prystowsky
- Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Nicolas F Schlecht
- Departments of Epidemiology & Population Health and Medicine, Albert Einstein College of Medicine, Bronx, New York
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Schlecht NF, Diaz A, Shankar V, Szporn AH, Wu M, Nucci-Sack A, Peake K, Strickler HD, Burk RD. Risk of Delayed Human Papillomavirus Vaccination in Inner-City Adolescent Women. J Infect Dis 2016; 214:1952-1960. [PMID: 27738056 DOI: 10.1093/infdis/jiw486] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 08/05/2016] [Accepted: 10/06/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Uptake of human papillomavirus (HPV) vaccine in the United States is slow, and the effectiveness of the vaccine has not been assessed in high-risk adolescent populations. METHODS We conducted a longitudinal study of 1139 sexually active, inner-city adolescent women receiving the 3-dose quadrivalent (4vHPV) vaccine. Cervical and anal specimens collected semiannually were tested using an L1-specific polymerase chain reaction assay. Postvaccination incidence of 4vHPV vaccine and nonvaccine HPV types, and risk of cervical cytological abnormalities, were assessed in relation to time to completion of all 3 vaccine doses. RESULTS Compared to vaccine naive women at enrollment, vaccinated women had significantly lower incidence rate ratios of cervical infection with HPV6/11/16/18 (0.2; 95% confidence interval [CI], .1-.4) and the related types HPV31 and HPV45 (0.4 [95% CI, .2-1.0] and 0.3 [95% CI, .1-.6], respectively), as well as significantly lower incidence rate ratios of anal infection with HPV6/11/16/18 (0.4; 95% CI, .2-.7). Notably, we observed higher risks of cervical HPV6/11/16/18 infection (hazards ratio [HR], 2.9; 95% CI, 1.0-8.0) and associated cytological abnormalities (HR, 4.5; 95% CI, .7-26.0) among women immunized at ≥15 years of age who took ≥12 months (vs <12 months) to complete the 3-dose regimen. CONCLUSIONS Among adolescents immunized at ≥15 years of age, a longer time to complete the 3-dose schedule was associated with an increased risk of anogenital HPV6/11/16/18 infection and an increased incidence of associated cervical cytological abnormalities.
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Affiliation(s)
| | - Angela Diaz
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | | | - Arnold H Szporn
- Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Maoxin Wu
- Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Anne Nucci-Sack
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai, Manhattan, New York
| | - Ken Peake
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai, Manhattan, New York
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41
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Tilston-Lünel AM, Haley KE, Schlecht NF, Wang Y, Chatterton ALD, Moleirinho S, Watson A, Hundal HS, Prystowsky MB, Gunn-Moore FJ, Reynolds PA. Crumbs 3b promotes tight junctions in an ezrin-dependent manner in mammalian cells. J Mol Cell Biol 2016; 8:439-455. [PMID: 27190314 PMCID: PMC5055084 DOI: 10.1093/jmcb/mjw020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 01/19/2016] [Accepted: 01/25/2016] [Indexed: 01/30/2023] Open
Abstract
Crumbs 3 (CRB3) is a component of epithelial junctions, which has been implicated in apical-basal polarity, apical identity, apical stability, cell adhesion, and cell growth. CRB3 undergoes alternative splicing to yield two variants: CRB3a and CRB3b. Here, we describe novel data demonstrating that, as with previous studies on CRB3a, CRB3b also promotes the formation of tight junctions (TJs). However, significantly we demonstrate that the 4.1-ezrin-radixin-moesin-binding motif of CRB3b is required for CRB3b functionality and that ezrin binds to the FBM of CRB3b. Furthermore, we show that ezrin contributes to CRB3b functionality and the correct distribution of TJ proteins. We demonstrate that both CRB3 isoforms are required for the production of functionally mature TJs and also the localization of ezrin to the plasma membrane. Finally, we demonstrate that reduced CRB3b expression in head and neck squamous cell carcinoma (HNSCC) correlates with cytoplasmic ezrin, a biomarker for aggressive disease, and shows evidence that while CRB3a expression has no effect, low CRB3b and high cytoplasmic ezrin expression combined may be prognostic for HNSCC.
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Affiliation(s)
- Andrew M Tilston-Lünel
- Medical and Biological Sciences Building, School of Biology, University of St Andrews, St Andrews, KY16 9TF, UK
| | - Kathryn E Haley
- Medical and Biological Sciences Building, School of Medicine, University of St Andrews, St Andrews, KY16 9TF, UK
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
| | - Yanhua Wang
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
| | - Abigail L D Chatterton
- Medical and Biological Sciences Building, School of Medicine, University of St Andrews, St Andrews, KY16 9TF, UK
| | - Susana Moleirinho
- Medical and Biological Sciences Building, School of Biology, University of St Andrews, St Andrews, KY16 9TF, UK.,Medical and Biological Sciences Building, School of Medicine, University of St Andrews, St Andrews, KY16 9TF, UK.,Present address: Scripps Research Institute, Jupiter, FL, USA
| | - Ailsa Watson
- Department of Pathology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
| | - Harinder S Hundal
- Department of Pathology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
| | | | - Frank J Gunn-Moore
- Medical and Biological Sciences Building, School of Biology, University of St Andrews, St Andrews, KY16 9TF, UK
| | - Paul A Reynolds
- Medical and Biological Sciences Building, School of Medicine, University of St Andrews, St Andrews, KY16 9TF, UK
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42
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Smith BC, Zolnik CP, Usyk M, Chen Z, Kaiser K, Nucci-Sack A, Peake K, Diaz A, Viswanathan S, Strickler HD, Schlecht NF, Burk RD. Distinct Ecological Niche of Anal, Oral, and Cervical Mucosal Microbiomes in Adolescent Women. Yale J Biol Med 2016; 89:277-284. [PMID: 27698612 PMCID: PMC5045137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human body sites represent ecological niches for microorganisms, each providing variations in microbial exposure, nutrient availability, microbial competition, and host immunological responses. In this study, we investigated the oral, anal, and cervical microbiomes from the same 20 sexually active adolescent females, using culture-independent, next-generation sequencing. DNA from each sample was amplified for the bacterial 16S rRNA gene and sequenced on an Illumina platform using paired-end reads. Across the three anatomical niches, we found significant differences in bacterial community composition and diversity. Overall anal samples were dominated with Prevotella and Bacteriodes, oral samples with Streptococcus and Prevotella, and cervical samples with Lactobacillus. The microbiomes of a few cervical samples clustered with anal samples in weighted principal coordinate analyses, due in part to a higher proportion of Prevotella in those samples. Additionally, cervical samples had the lowest alpha diversity. Our results demonstrate the occurrence of distinct microbial communities across body sites within the same individual.
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Affiliation(s)
- Benjamin C. Smith
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA
| | - Christine P. Zolnik
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA
| | - Mykhaylo Usyk
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA
| | - Zigui Chen
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA
| | - Katherine Kaiser
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, The Mount Sinai Adolescent Health Center, Manhattan, New York, USA
| | - Ken Peake
- Department of Pediatrics, The Mount Sinai Adolescent Health Center, Manhattan, New York, USA
| | - Angela Diaz
- Department of Pediatrics, The Mount Sinai Adolescent Health Center, Manhattan, New York, USA,Department of Environmental Medicine and Public Health, The Icahn School of Medicine at Mount Sinai, Manhattan, New York, USA
| | - Shankar Viswanathan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA
| | - Howard D. Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA
| | - Nicolas F. Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA
| | - Robert D. Burk
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA,Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA,Department of Obstetrics, Gynecology & Women’s Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA,Department of Microbiology & Immunology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, USA,To whom all correspondence should be addressed: Robert D. Burk, M.D., Department of Pediatrics (Genetics), Albert Einstein College of Medicine, 1300 Morris Park Avenue, Ullmann Building, Room 515, Bronx, NY 10461, Tel: (718) 430-3720, Fax: (718) 430-8975,
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43
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Senkomago V, Backes DM, Hudgens MG, Poole C, Meshnick SR, Agot K, Moses S, Snijders PJ, Meijer CJ, Hesselink AT, Schlecht NF, Bailey RC, Smith JS. Higher HPV16 and HPV18 Penile Viral Loads Are Associated With Decreased Human Papillomavirus Clearance in Uncircumcised Kenyan Men. Sex Transm Dis 2016; 43:572-8. [PMID: 27513384 PMCID: PMC4985051 DOI: 10.1097/olq.0000000000000500] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/22/2022]
Abstract
BACKGROUND Whether higher penile human papillomavirus (HPV) viral load is associated with a lower rate of HPV clearance remains unknown. OBJECTIVES We examined the association between penile HPV16 and HPV18 viral load and subsequent HPV clearance in uncircumcised Kenyan men. STUDY DESIGN Participants were human immunodeficiency virus (HIV)-seronegative, sexually active, 18- to 24-year-old men randomized to the control arm of a male circumcision trial in Kisumu, Kenya. Men provided exfoliated penile cells from two anatomical sites (glans/coronal sulcus and shaft) every 6 months for 2 years. GP5+/6+ polymerase chain reaction was used to identify 44 HPV-DNA types. Human papillomavirus viral load testing was conducted using a LightCyler real-time polymerase chain reaction assay; viral load was classified as high (>250 copies/scrape) or low (≤250 copies/scrape), for nonquantifiable values. The Kaplan-Meier method and Cox regression modeling were used to examine the association between HPV viral load and HPV clearance. RESULTS A total of 1097 men, with 291 HPV16 and 131 HPV18 cumulative infections over 24 months were analyzed. Human papillomavirus clearance at 6 months after first HPV detection was lower for high versus low viral load HPV16 infections in the glans (adjusted hazard ratio [aHR], 0.65; 95% confidence interval [CI], 0.46-0.92)] and shaft (aHR, 0.44; 95% CI, 0.16-0.90), and HPV18 infections in the glans (aHR, 0.05; 95% CI, 0.01-0.17). DISCUSSION High versus low HPV viral load was associated with a reduced HPV clearance for HPV16 infections in the glans and shaft, and for HPV18 infections in the glans, among young uncircumcised men. Reduced clearance of high viral load HPV16 and HPV18 infections in men may increase HPV transmission to their female partners as well as enhance the development of penile lesions in comparison to men with low viral load HPV infections.
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Affiliation(s)
- Virginia Senkomago
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Danielle M. Backes
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Michael G. Hudgens
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Steven R. Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kawango Agot
- Impact Research and Development Organization, Kisumu, Kenya
| | - Stephen Moses
- Centre for Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Peter J.F. Snijders
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Chris J.L.M. Meijer
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Nicolas F. Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, USA
| | - Robert C. Bailey
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Illinois, USA
| | - Jennifer S. Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
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Madathil SA, Rousseau MC, Wynant W, Schlecht NF, Netuveli G, Franco EL, Nicolau B. Nonlinear association between betel quid chewing and oral cancer: Implications for prevention. Oral Oncol 2016; 60:25-31. [DOI: 10.1016/j.oraloncology.2016.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/25/2016] [Accepted: 06/14/2016] [Indexed: 12/19/2022]
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45
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Mehta-Lee SS, Palma A, Bernstein PS, Lounsbury D, Schlecht NF. A Preconception Nomogram to Predict Preterm Delivery. Matern Child Health J 2016; 21:118-127. [DOI: 10.1007/s10995-016-2100-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Laprise C, Shahul HP, Madathil SA, Thekkepurakkal AS, Castonguay G, Varghese I, Shiraz S, Allison P, Schlecht NF, Rousseau MC, Franco EL, Nicolau B. Periodontal diseases and risk of oral cancer in Southern India: Results from the HeNCe Life study. Int J Cancer 2016; 139:1512-9. [PMID: 27215979 DOI: 10.1002/ijc.30201] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 04/27/2016] [Accepted: 05/02/2016] [Indexed: 01/10/2023]
Abstract
Some studies suggest that periodontal diseases increase the risk of oral cancer, but contradictory results also exist. Inadequate control of confounders, including life course exposures, may have influenced prior findings. We estimate the extent to which high levels of periodontal diseases, measured by gingival inflammation and recession, are associated with oral cancer risk using a comprehensive subset of potential confounders and applying a stringent adjustment approach. In a hospital-based case-control study, incident oral cancer cases (N = 350) were recruited from two major referral hospitals in Kerala, South India, from 2008 to 2012. Controls (N = 371), frequency-matched by age and sex, were recruited from clinics at the same hospitals. Structured interviews collected information on several domains of exposure via a detailed life course questionnaire. Periodontal diseases, as measured by gingival inflammation and gingival recession, were evaluated visually by qualified dentists following a detailed protocol. The relationship between periodontal diseases and oral cancer risk was assessed by unconditional logistic regression using a stringent empirical selection of potential confounders corresponding to a 1% change-in-estimates. Generalized gingival recession was significantly associated with oral cancer risk (Odds Ratio = 1.83, 95% Confidence Interval: 1.10-3.04). No significant association was observed between gingival inflammation and oral cancer. Our findings support the hypothesis that high levels of periodontal diseases increase the risk of oral cancer.
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Affiliation(s)
- Claudie Laprise
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | | | - Sreenath Arekunnath Madathil
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | | | - Geneviève Castonguay
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Ipe Varghese
- Kerala University of Health Sciences, Medical College PO, Thrissur, Kerala, India
| | - Shameena Shiraz
- Oral Pathology, Government Dental College, Medical College Campus, Kozhikode 8, Kerala, India
| | - Paul Allison
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, NY
| | - Marie-Claude Rousseau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Eduardo L Franco
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Belinda Nicolau
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
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47
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Ho GYF, Zheng SL, Cushman M, Perez-Soler R, Kim M, Xue X, Wang T, Schlecht NF, Tinker L, Rohan TE, Wassertheil-Smoller S, Wallace R, Chen C, Xu J, Yu H. Associations of Insulin and IGFBP-3 with Lung Cancer Susceptibility in Current Smokers. J Natl Cancer Inst 2016; 108:djw012. [PMID: 27071409 DOI: 10.1093/jnci/djw012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 01/19/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The epidermal growth factor receptor (EGFR) signaling network is involved in lung carcinogenesis. This study examined whether ligands that activate or suppress the EGFR signaling network were associated with lung cancer risk in ever smokers. METHODS A nested case-control study within the Women's Health Initiative assessed baseline plasma levels of insulin, insulin-like growth factor (IGF)-1, insulin-like growth factor binding protein (IGFBP)-3, interleukin (IL)-6, hepatocyte growth factor (HGF), and nerve growth factor (NGF) in 1143 ever-smoking lung cancer cases and 1143 controls. Leptin was measured as an adiposity biomarker. Conditional logistic regression was used in data analyses. RESULTS Leptin was inversely associated with lung cancer risk (odds ratio [ORcontinuous] per Ln [pg/mL] = 0.85, 95% confidence interval [CI] = 0.74 to 0.98). After adjusting for adiposity and other risk factors, null associations were found for IL-6, HGF, and NGF. In current smokers, but not former smokers, high insulin levels were associated with increased lung cancer risk (OR for 4th quartile vs others [ORq4] = 2.06, 95% CI = 1.30 to 3.26) whereas IGFBP-3 had a linear inverse association (ORcontinuous per μg/mL = 0.64, 95% CI = 0.41 to 0.98). The insulin association was consistent across subgroups defined by body mass index and histological type, but the IGFBP-3 association was specific to small cell lung cancer. There was a modest positive association between IGF-1 and lung cancer risk in current smokers (ORq4 = 1.44, 95% CI = 0.90 to 2.29). CONCLUSIONS Independent of obesity, high insulin levels but reduced levels of IGFBP-3 were associated with increased lung cancer risk in current smokers.
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Affiliation(s)
- Gloria Y F Ho
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Siqun L Zheng
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Mary Cushman
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Roman Perez-Soler
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Mimi Kim
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Xiaonan Xue
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Tao Wang
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Nicolas F Schlecht
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Lesley Tinker
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Thomas E Rohan
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Sylvia Wassertheil-Smoller
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Robert Wallace
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Chu Chen
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Jianfeng Xu
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
| | - Herbert Yu
- Affiliations of authors:Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health; Hofstra-Northwell School of Medicine , Great Neck, NY (GYFH); Department of Epidemiology and Population Health (GYFH, MK, XX, TW, NFS, TER, SWS) and Department of Medicine (RPS, NFS), Albert Einstein College of Medicine, Bronx, NY; Center for Genomics and Personalized Medicine Research, Wake Forest University , Winston-Salem, NC (SLZ); Departments of Medicine & Pathology, University of Vermont , Burlington, VT (MC); Public Health Sciences Division, Fred Hutchinson Cancer Research Center , Seattle, WA (LT, CC); Department of Epidemiology, College of Public Health, University of Iowa , Iowa City, IA (RW); NorthShore University HealthSystem , Evanston, IL (JX); University of Hawaii Cancer Center , Honolulu, HI (HY)
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48
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Nagpal J, Linares LO, Weiss J, Schlecht NF, Shankar V, Braun-Courville D, Nucci-Sack A, Strickler HD, Burk RD, Diaz A. Knowledge about Human Papillomavirus and Time to Complete Vaccination among Vulnerable Female Youth. J Pediatr 2016; 171:122-7. [PMID: 26846571 PMCID: PMC4808615 DOI: 10.1016/j.jpeds.2015.12.070] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 10/23/2015] [Accepted: 12/28/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the association of knowledge about human papillomavirus (HPV) on the time to completion of the 3-dose quadrivalent vaccine series in an inner-city population of adolescent female subjects at high risk for infection. STUDY DESIGN We prospectively followed 139 female subjects aged 14-20 years enrolled in a vaccine surveillance study in New York City during a period of at least 24 months. Participants were given a 30-item true or false survey on HPV at enrollment and ranked according to the number of correct responses. Multivariate Cox regression was used to examine the association between level of knowledge about HPV and time to completion (in days) of vaccine dose 1-3, dose 1-2, and dose 2-3. RESULTS Overall time to completion of the 3-dose vaccine ranged from 158 days to 1114 days. Participants in the high knowledge group (top quartile) were significantly more likely to complete the 3-dose series earlier (hazard ratio 1.69, 95% CI 1.03-2.77; P = .04), in particular doses 2-3 (hazard ratio 1.71, 95% CI 1.02-2.89; P = .04), than those with low-to-moderate knowledge (bottom 3 quartiles). CONCLUSIONS These findings suggest that knowledge of HPV is associated with shorter time to complete the 3-dose HPV vaccine series. Educational campaigns at time of vaccination may be important to improve vaccine adherence.
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Affiliation(s)
- Julie Nagpal
- Department of Pediatrics, The Mount Sinai Medical Center, New York, NY.
| | | | - Jocelyn Weiss
- Department of Pediatrics, The Mount Sinai Medical Center, New York, NY
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; Departments of Pediatrics, Microbiology & Immunology, and Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | | | - Anne Nucci-Sack
- Department of Pediatrics, The Mount Sinai Medical Center, New York, NY
| | - Howard D Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Robert D Burk
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Angela Diaz
- Department of Pediatrics, The Mount Sinai Medical Center, New York, NY
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49
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Palma A, Lounsbury DW, Schlecht NF, Agalliu I. A System Dynamics Model of Serum Prostate-Specific Antigen Screening for Prostate Cancer. Am J Epidemiol 2016; 183:227-36. [PMID: 26702631 DOI: 10.1093/aje/kwv262] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 07/30/2015] [Indexed: 01/31/2023] Open
Abstract
Since 2012, US guidelines have recommended against prostate-specific antigen (PSA) screening for prostate cancer. However, evidence of screening benefit from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening trial and the European Randomized Study of Screening for Prostate Cancer has been inconsistent, due partly to differences in noncompliance and contamination. Using system dynamics modeling, we replicated the PLCO trial and extrapolated follow-up to 20 years. We then simulated 3 scenarios correcting for contamination in the PLCO control arm using Surveillance, Epidemiology, and End Results (SEER) incidence and survival data collected prior to the PSA screening era (scenario 1), SEER data collected during the PLCO trial period (1993-2001) (scenario 2), and data from the European trial's control arm (1991-2005) (scenario 3). In all scenarios, noncompliance was corrected using incidence and survival rates for men with screen-detected cancer in the PLCO screening arm. Scenarios 1 and 3 showed a benefit of PSA screening, with relative risks of 0.62 (95% confidence interval: 0.53, 0.72) and 0.70 (95% confidence interval: 0.59, 0.83) for cancer-specific mortality after 20 years, respectively. In scenario 2, however, there was no benefit of screening. This simulation showed that after correcting for noncompliance and contamination, there is potential benefit of PSA screening in reducing prostate cancer mortality. It also demonstrates the utility of system dynamics modeling for synthesizing epidemiologic evidence to inform public policy.
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50
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Gordon LP, Diaz A, Soghomonian C, Nucci-Sack AT, Weiss JM, Strickler HD, Burk RD, Schlecht NF, Ochner CN. Increased Body Mass Index Associated with Increased Risky Sexual Behaviors. J Pediatr Adolesc Gynecol 2016; 29:42-7. [PMID: 26358938 PMCID: PMC4670801 DOI: 10.1016/j.jpag.2015.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/27/2015] [Accepted: 06/01/2015] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE The increasing prevalence of adolescent obesity has led to consideration of the potential effect of obesity on risky sexual behaviors. In the current study we examined whether body mass index (BMI) was related to age at sexual debut, type of sexual behavior, partner number, and condom use in a population of adolescent women at high risk for obesity and risky sexual behaviors. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional examination of 860 sexually active, predominantly minority, adolescent women who received medical care at an urban health center from 2007 through 2013. INTERVENTION AND MAIN OUTCOME MEASURES Self-reported age at sexual debut, types of sexual intercourse, number of partners and condom use was compared with clinically assessed BMI. RESULTS BMI was positively associated with number of sexual partners (P = .001) and history of attempted anal intercourse (P = .002). An inverse association was observed with age at first anal intercourse (P = .040). CONCLUSION In this sample of adolescent women, increased BMI was associated with riskier sexual practices at a younger age. Results of this study suggest that overweight and obese adolescents are a vulnerable population who might need targeted sexual health counseling.
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Affiliation(s)
- Lonna P Gordon
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Angela Diaz
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Christine Soghomonian
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anne T Nucci-Sack
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jocelyn M Weiss
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Howard D Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert D Burk
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; Departments of Pediatrics, Microbiology and Immunology, and Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York
| | - Nicolas F Schlecht
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Christopher N Ochner
- The Mount Sinai Adolescent Health Center, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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