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Genetic correlation and causal associations between circulating C-reactive protein levels and lung cancer risk. 循环 C 反应蛋白水平与肺癌风险之间的遗传相关性和因果关系。
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-08 DOI: 10.1007/s10552-024-01855-7
Jiajun Shi, Wanqing Wen, Jirong Long, Haoran Xue, Yaohua Yang, Ran Tao, Wei Pan, Xiao-Ou Shu, Qiuyin Cai

Purpose: We aimed to characterize genetic correlations and causal associations between circulating C-reactive protein (CRP) levels and the risk of lung cancer (LC).

Methods: Leveraging summary statistics from genome-wide association studies of circulating CRP levels among 575,531 individuals of European ancestry, and LC risk among 29,266 cases and 56,450 controls, we investigated genetic associations of circulating CRP levels with the risk of overall lung cancer and its histological subtypes, by using linkage disequilibrium score (LDSC) regression and Mendelian randomization (MR) analyses.

Results: Significant positive genetic correlations between circulating CRP levels and the risk of LC and its histological subtypes were identified from LDSC regression, with correlation coefficients ranging from 0.12 to 0.26, and all false discovery adjusted p < 0.05. Univariable MR demonstrated a nominal association between CRP levels and an increased risk of lung squamous cell carcinoma (SCC) (inverse variance-weighted OR = 1.15, 95% CI 1.01-1.30). However, this association disappeared when multivariable MR included cigarettes per day and/or body mass index. By using our recently developed constrained maximum likelihood-based MR method, we identified significant associations of CRP levels with the risk of overall LC (OR 1.06, 95% CI 1.03-1.09), SCC (OR 1.06, 95% CI 1.02-1.09), and small cell lung cancer (SCLC, OR 1.09, 95% CI 1.03-1.15). Moreover, most univariable and multivariable MR analyses also revealed consistent CRP-SCLC associations.

Conclusion: There may be a genetic and causal association between circulating CRP levels and the risk of SCLC, which is in line with previous population-based observational studies.

目的:我们旨在描述循环C反应蛋白(CRP)水平与肺癌(LC)风险之间的遗传相关性和因果关系:利用对 575,531 名欧洲血统个体的循环 CRP 水平以及 29,266 例病例和 56,450 例对照的肺癌风险进行的全基因组关联研究的汇总统计数据,我们采用关联不平衡评分(LDSC)回归和孟德尔随机化(MR)分析,研究了循环 CRP 水平与总体肺癌及其组织学亚型风险之间的遗传关联:结果:通过 LDSC 回归发现,循环 CRP 水平与 LC 风险及其组织学亚型之间存在显著的正遗传相关性,相关系数在 0.12 至 0.26 之间,所有假发现调整后的 p 均为 0:循环 CRP 水平与 SCLC 风险之间可能存在遗传和因果关系,这与以往基于人群的观察性研究结果一致。
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引用次数: 0
Circulating lipids, lipid-lowering drug targets, and breast cancer risk: Comprehensive evidence from Mendelian randomization and summary data-based Mendelian randomization. 循环血脂、降脂药物靶点与乳腺癌风险:孟德尔随机化和基于数据摘要的孟德尔随机化的综合证据。
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-06-01 Epub Date: 2024-03-02 DOI: 10.1007/s10552-024-01857-5
Zhongxu Zhang, Daxin Zhang

Background: Breast cancer (BC) is the most common and fatal cancer among women, yet the causal relationship between circulating lipids, lipid-lowering drugs, and BC remains unclear.

Methods: Mendelian randomization (MR) and summary data-based MR (SMR) analysis are used to explore the causal relationship between plasma lipids, lipid-lowering drug targets, and BC.

Results: The result of MR suggested that per mg/dL higher levels of LDL-C (OR = 1.045, FDR = 0.023), HDL-C (OR = 1.079, FDR = 0.003), TC (OR = 1.043, FDR = 0.026), and APOA-I (OR = 1.085, FDR = 2.64E-04) were associated with increased BC risk, while TG was associated with reduced BC risk (OR = 0.926, FDR = 0.003). Per mg/dL higher levels of HDL-C (OR = 1.080, FDR = 0.011) and APOA-I (OR = 1.083, FDR = 0.002) were associated with increased ER+BC risk, while TG was associated with reduced ER+BC risk (OR = 0.909, FDR = 0.002). For every per 1 mg/dL decrease in LDL, HMGCR (OR: 0.839; FDR = 0.016), NPC1L1 (OR: 0.702; FDR = 0.004), and PCSK9 (OR: 0.916; FDR = 0.026) inhibition were associated with reduced BC risk, whereas CETP inhibition (OR: 1.194; FDR = 0.026) was associated with increased BC risk. For every per 1 mg/dL decrease in LDL, HMGCR (OR: 0.822; FDR = 0.023), NPC1L1 (OR: 0.633; FDR = 2.37E-03), and APOB inhibition (OR: 0.816; FDR = 1.98E-03) were associated with decreased ER-BC risk, while CETP inhibition (OR: 1.465; FDR = 0.011) was associated with increased ER-BC risk. SMR analysis indicated that HMGCR was associated with increased BC risk (OR: 1.112; p = 0.044).

Conclusion: Lipids are associated with the BC risk, and lipid-lowering drugs targets HMGCR, NPC1L1, PCSK9, and APOB may be effective strategies for preventing BC. However, lipid-lowering drugs target CETP may potentially increase BC risk.

背景:乳腺癌(BC)是女性最常见和最致命的癌症:乳腺癌(BC)是女性中最常见和最致命的癌症,但循环血脂、降脂药物与乳腺癌之间的因果关系仍不清楚:方法:采用孟德尔随机分析法(MR)和基于汇总数据的MR分析法(SMR)探讨血浆脂质、降脂药物靶点与乳腺癌之间的因果关系:MR结果表明,每毫克/分升低密度脂蛋白胆固醇(OR = 1.045,FDR = 0.023)、高密度脂蛋白胆固醇(OR = 1.079,FDR = 0.003)、总胆固醇(OR = 1.043,FDR = 0.026)和APOA-I(OR = 1.085,FDR = 2.64E-04)水平越高,BC风险越高,而总胆固醇与BC风险降低相关(OR = 0.926,FDR = 0.003)。高密度脂蛋白胆固醇(HDL-C)(OR = 1.080,FDR = 0.011)和APOA-I(OR = 1.083,FDR = 0.002)水平每升高1毫克/分升与ER+BC风险升高有关,而总胆固醇与ER+BC风险降低有关(OR = 0.909,FDR = 0.002)。低密度脂蛋白每降低 1 毫克/分升,HMGCR(OR:0.839;FDR = 0.016)、NPC1L1(OR:0.702;FDR = 0.004)和 PCSK9(OR:0.916;FDR = 0.026)抑制与 BC 风险降低相关,而 CETP 抑制(OR:1.194;FDR = 0.026)与 BC 风险增加相关。低密度脂蛋白每降低 1 毫克/分升,HMGCR(OR:0.822;FDR = 0.023)、NPC1L1(OR:0.633;FDR = 2.37E-03)和 APOB 抑制(OR:0.816;FDR = 1.98E-03)与 ER-BC 风险降低相关,而 CETP 抑制(OR:1.465;FDR = 0.011)与 ER-BC 风险增加相关。SMR分析表明,HMGCR与BC风险增加有关(OR:1.112;P = 0.044):结论:血脂与 BC 风险相关,针对 HMGCR、NPC1L1、PCSK9 和 APOB 的降脂药物可能是预防 BC 的有效策略。然而,以 CETP 为靶点的降脂药可能会增加 BC 风险。
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引用次数: 0
A framework for building comprehensive cancer center's capacity for bidirectional engagement. 建立综合癌症中心双向参与能力的框架。
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-25 DOI: 10.1007/s10552-023-01848-y
Erika S Trapl, Sarah Koopman Gonzalez, Kristina Austin

Purpose: Community engagement has benefits for cancer centers' work and for its researchers. This study examined the experiences and perceptions of community engagement by members of the Case Comprehensive Cancer Center (Case CCC) to create and implement a framework to meet the needs of the entire cancer center.

Methods: This study included three phases: 1) Semi-structured interviews with 12 researchers from a basic science program to identify needs and suggestions for the support of community engagement; 2) Preliminary interview results informed the development of a survey of 86 cancer center members' about their awareness of and readiness to integrate community outreach and engagement into their research; and 3) The Case CCC Office of Community Outreach and Engagement reviewed the results from phases 1 and 2 to develop and then utilize a framework of engagement opportunities.

Results: In the interviews and surveys, cancer center members recognized the importance of community engagement and expressed an interest in participating in COE-organized opportunities for bidirectional engagement. While participation barriers include communication issues, limited awareness of opportunities, and competing priorities, members were open to learning new skills, changing approaches, and utilizing services to facilitate engagement. The framework outlines engagement opportunities ranging from high touch, low reach to low touch, and high reach and was used to develop specific services.

Conclusion: This study identified varying needs around community engagement using an approach aimed at understanding the perspectives of a community of scientists. Implementing the framework enables reaching scientists in different ways and facilitates scientists' recognition of and engagement with opportunities.

目的:社区参与对癌症中心的工作和研究人员都有好处。本研究考察了凯斯综合癌症中心(Case CCC)成员对社区参与的经验和看法,以创建和实施一个框架,满足整个癌症中心的需求:本研究包括三个阶段:1)对基础科学项目的 12 名研究人员进行半结构式访谈,以确定支持社区参与的需求和建议;2)根据初步访谈结果,对 86 名癌症中心成员进行调查,了解他们对将社区外联和参与纳入其研究工作的认识和准备情况;3)凯斯癌症中心社区外联和参与办公室审查第 1 和第 2 阶段的结果,以制定并利用参与机会框架:在访谈和调查中,癌症中心成员认识到社区参与的重要性,并表示有兴趣参与由 COE 组织的双向参与机会。虽然参与的障碍包括沟通问题、对机会的认识有限以及优先事项相互竞争,但成员们对学习新技能、改变方法和利用服务来促进参与持开放态度。该框架概述了从高接触、低接触到低接触、高接触的参与机会,并用于开发具体服务:本研究采用旨在了解科学家群体观点的方法,确定了围绕社区参与的不同需求。实施该框架能够以不同的方式接触科学家,并促进科学家认识和参与各种机会。
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引用次数: 0
Persistent poverty and incidence-based melanoma mortality in Texas. 得克萨斯州的持续贫困与基于发病率的黑色素瘤死亡率。
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-29 DOI: 10.1007/s10552-023-01841-5
Karla Madrigal, Lillian Morris, Kehe Zhang, Emelie Nelson, Tiffaney Tran, Marcita Galindez, Zhigang Duan, Adewole S Adamson, Hui Zhao, Hung Q Doan, Madison M Taylor, Cici Bauer, Kelly C Nelson

Purpose: Previous studies have shown that individuals living in areas with persistent poverty (PP) experience worse cancer outcomes compared to those living in areas with transient or no persistent poverty (nPP). The association between PP and melanoma outcomes remains unexplored. We hypothesized that melanoma patients living in PP counties (defined as counties with ≥ 20% of residents living at or below the federal poverty level for the past two decennial censuses) would exhibit higher rates of incidence-based melanoma mortality (IMM).

Methods: We used Texas Cancer Registry data to identify the patients diagnosed with invasive melanoma or melanoma in situ (stages 0 through 4) between 2000 and 2018 (n = 82,458). Each patient's PP status was determined by their county of residence at the time of diagnosis.

Results: After adjusting for demographic variables, logistic regression analyses revealed that melanoma patients in PP counties had statistically significant higher IMM compared to those in nPP counties (17.4% versus 11.3%) with an adjusted odds ratio of 1.35 (95% CI 1.25-1.47).

Conclusion: These findings highlight the relationship between persistent poverty and incidence-based melanoma mortality rates, revealing that melanoma patients residing in counties with persistent poverty have higher melanoma-specific mortality compared to those residing in counties with transient or no poverty. This study further emphasizes the importance of considering area-specific socioeconomic characteristics when implementing place-based interventions to facilitate early melanoma diagnosis and improve melanoma treatment outcomes.

目的:以往的研究表明,与生活在短暂贫困或无持续贫困地区(nPP)的人相比,生活在持续贫困地区(PP)的人患癌的几率更低。但持续贫困与黑色素瘤预后之间的关系仍未得到探讨。我们假设,生活在持续贫困县(指在过去两个十年一次的人口普查中,生活在联邦贫困线或以下的居民比例≥20%的县)的黑色素瘤患者将表现出更高的基于发病率的黑色素瘤死亡率(IMM):我们利用德克萨斯州癌症登记数据,确定了 2000 年至 2018 年期间确诊为浸润性黑色素瘤或原位黑色素瘤(0 至 4 期)的患者(n = 82,458 人)。每位患者的PP状态由其确诊时的居住县决定:调整人口统计学变量后,逻辑回归分析表明,与nPP县的黑色素瘤患者相比,PP县的黑色素瘤患者的IMM明显更高(17.4%对11.3%),调整后的几率比为1.35(95% CI 1.25-1.47):这些发现凸显了持续贫困与基于发病率的黑色素瘤死亡率之间的关系,揭示了与居住在短暂贫困或无贫困县的黑色素瘤患者相比,居住在持续贫困县的黑色素瘤患者的黑色素瘤特异性死亡率更高。这项研究进一步强调了在实施基于地方的干预措施以促进黑色素瘤早期诊断和改善黑色素瘤治疗效果时考虑特定地区社会经济特征的重要性。
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引用次数: 0
Performance of urine samples compared to cervical samples for detection of precancer lesions among HPV-positive women attending colposcopy clinic in Mexico City. 在墨西哥城接受阴道镜检查的 HPV 阳性妇女中,尿液样本与宫颈样本在检测癌前病变方面的性能比较。
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-18 DOI: 10.1007/s10552-024-01852-w
Joacim Meneses-León, Sonia Hernández-Salazar, Leticia Torres-Ibarra, Rubí Hernández-López, Berenice Rivera-Paredez, Karina Robles-Rivera, Eduardo Lazcano-Ponce, Alba García-Vera, Mélany Godínez-Pérez, Leith León-Maldonado, Jorge Salmerón

Background: High-risk human papillomavirus (hrHPV) detection in self-collected urine samples (SeCUS) may be a promising alternative for cervical cancer screening because of its greater acceptability, as long as it can offer comparable sensitivity to clinician-collected cervical samples (CCoS) for detecting precancer lesions.

Objective: To evaluate the performance of the SeCUS compared to that of the CCoS for cervical intraepithelial neoplasia grade 3 (CIN3) detection among hrHPV-positive women receiving colposcopy in Mexico City using different specific extended HPV typing procedures: HPV16/18, HPV16/18/35/39/68 or HPV16/18/35/39/68/31.

Methods: From March 2017 to August 2018, 4,158 female users of the cervical cancer screening program at Tlalpan Sanitary Jurisdiction in Mexico City were invited to participate in the FRIDA-Tlalpan study. All participants provided ≥ 30 mL of SeCUS, and then a CCoS was obtained with Cervex-Brush®, which was used for hrHPV typing. Participants who tested positive for hrHPV in CCoS were referred for colposcopy for diagnostic confirmation, and all SeCUS of these women were also tested for hrHPV typing.

Results: In total, 561 hrHPV-positive women were identified by CCoS via colposcopy, and 82.2% of the SeCUS of these women were also hrHPV positive. From both CCoS and SeCUS, 7 cases of CIN3 were detected. Considering HPV16/18 typing, CCoS and SeCUS detected 4 cases of CIN3, but after HPV16/18/35/39/68/31 extension typing, both CCoS and SeCUS detected all 7 of the CIN3 cases among the hrHPV-positive women.

Conclusions: Using extended hrHPV typing based on HPV16/18/35/39/68/31, our results suggest that the performance of SeCUS may be equivalent to that of CCoS for detecting CIN3 lesions. Although our results are inconclusive, they support the hypothesis that SeCUS may be an attractive alternative worthy of further research.

背景:在自采尿液样本(SeCUS)中检测高危人乳头状瘤病毒(hrHPV)可能是宫颈癌筛查的一种有前途的替代方法,因为它具有更高的可接受性,只要它在检测癌前病变方面具有与临床医生采集的宫颈样本(CCoS)相当的灵敏度:在墨西哥城接受阴道镜检查的 hrHPV 阳性妇女中,使用不同的特定扩展 HPV 分型程序,评估 SeCUS 与 CCoS 检测宫颈上皮内瘤变 3 级(CIN3)的性能比较:HPV16/18、HPV16/18/35/39/68或HPV16/18/35/39/68/31.方法:2017年3月至2018年8月,墨西哥城特拉尔潘卫生辖区的4158名宫颈癌筛查项目女性用户受邀参加了FRIDA-特拉尔潘研究。所有参与者都提供了 ≥ 30 mL 的 SeCUS,然后用 Cervex-Brush® 采集了 CCoS,用于 hrHPV 分型。在 CCoS 中检测出 hrHPV 阳性的参与者将被转诊至阴道镜进行确诊,这些妇女的所有 SeCUS 也将进行 hrHPV 分型检测:结果:通过阴道镜检查,CCoS 共发现 561 名 hrHPV 阳性女性,其中 82.2% 的 SeCUS 也为 hrHPV 阳性。从 CCoS 和 SeCUS 中均检测出 7 例 CIN3。考虑到HPV16/18分型,CCoS和SeCUS检测出4例CIN3,但在HPV16/18/35/39/68/31扩展分型后,CCoS和SeCUS在hrHPV阳性妇女中检测出全部7例CIN3:结论:使用基于 HPV16/18/35/39/68/31 的 hrHPV 扩展分型,我们的结果表明 SeCUS 检测 CIN3 病变的性能可能与 CCoS 相当。尽管我们的结果还不确定,但它们支持了 SeCUS 可能是一种有吸引力的替代方法的假设,值得进一步研究。
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引用次数: 0
Financial burden among metastatic breast cancer patients: a qualitative inquiry of costs, financial assistance, health insurance, and financial coping behaviors. 转移性乳腺癌患者的经济负担:关于费用、经济援助、医疗保险和经济应对行为的定性调查。
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-22 DOI: 10.1007/s10552-024-01854-8
Austin R Waters, Victoria M Petermann, Arrianna Marie Planey, Michelle Manning, Jennifer C Spencer, Lisa P Spees, Donald L Rosenstein, Mindy Gellin, Neda Padilla, Katherine E Reeder-Hayes, Stephanie B Wheeler

Purpose: Metastatic breast cancer (MBC) patients often face substantial financial burden due to prolonged and expensive therapy. However, in-depth experiences of financial burden among MBC patients are not well understood.

Methods: Qualitative interviews were conducted to describe the experiences of financial burden for MBC patients, focusing on the drivers of financial burden, their experience using their health insurance, accessing financial assistance, and any resulting cost-coping behaviors. Interviews were transcribed and qualitatively analyzed using a descriptive phenomenological approach to thematic analysis.

Results: A total of n = 11 MBC patients or caregiver representatives participated in the study. MBC patients were on average 50.2 years of age (range: 28-65) and 72.7% non-Hispanic White. MBC patients were diagnosed as metastatic an average of 3.1 years (range: 1-9) before participating in the study. Qualitative analysis resulted in four themes including (1) causes of financial burden, (2) financial assistance mechanisms, (3) health insurance and financial burden, and (4) cost-coping behaviors. Both medical and non-medical costs drove financial burden among participants. All participants reported challenges navigating their health insurance and applying for financial assistance. Regardless of gaining access to assistance, financial burden persisted for nearly all patients and resulted in cost-coping behaviors.

Conclusion: Our findings suggest that current systems for health insurance and financial assistance are complex and difficult to meet patient needs. Even when MBC patients accessed assistance, excess financial burden persisted necessitating use of financial coping-behaviors such as altering medication use, maintaining employment, and taking on debt.

目的:转移性乳腺癌(MBC)患者往往因长期昂贵的治疗而面临巨大的经济负担。然而,人们对 MBC 患者经济负担的深入体验还不甚了解:我们进行了定性访谈,以描述 MBC 患者的经济负担经历,重点是经济负担的驱动因素、他们使用医疗保险的经历、获得经济援助的经历以及由此产生的任何费用应对行为。采用描述性现象学方法对访谈内容进行转录和定性分析:共有 n = 11 名乳腺癌患者或护理人员代表参与了研究。MBC患者平均年龄为50.2岁(范围:28-65岁),72.7%为非西班牙裔白人。MBC 患者在参与研究前平均 3.1 年(范围:1-9 年)被诊断为转移性癌症。定性分析得出四个主题,包括:(1)经济负担的原因;(2)经济援助机制;(3)医疗保险和经济负担;以及(4)费用应对行为。医疗和非医疗费用都是造成参与者经济负担的原因。所有参与者都报告了在办理医疗保险和申请经济援助时遇到的挑战。无论是否获得援助,几乎所有患者的经济负担都持续存在,并导致了费用应对行为:我们的研究结果表明,目前的医疗保险和经济援助系统非常复杂,难以满足患者的需求。即使乳腺增生患者获得了援助,过重的经济负担依然存在,因此他们不得不采取经济应对行为,如改变药物使用、维持就业和举债。
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引用次数: 0
Association between blood lipid levels and the risk of liver cancer: a systematic review and meta-analysis. 血脂水平与肝癌风险之间的关系:系统回顾和荟萃分析。
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-06-01 Epub Date: 2024-02-20 DOI: 10.1007/s10552-024-01853-9
Zhihui Zhang, Shicong Xu, Meixuan Song, Weirong Huang, Manlin Yan, Xianrong Li

Purpose: The association between blood lipid levels and the risk of developing liver cancer remains a subject of ongoing debate. To elucidate this association, we conducted a meta-analysis by systematically incorporating data from all relevant prospective cohort studies.

Methods: We conducted a systematic search of the PubMed, Embase, Web of Science, and Cochrane Library databases covering studies published from database inception through July 2023. This study included prospective cohort studies related to lipid profiles (e.g., total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels) that reported hazard ratios (HRs) or relative risks (RRs) with corresponding 95% confidence intervals (95% CIs) to investigate their association with the risk of liver cancer. During the analysis process, we used fixed-effects or random-effects models based on the level of heterogeneity among the studies and obtained pooled risk ratios using these models. To ensure the robustness and reliability of the study findings, we also conducted sensitivity analyses and publication bias analyses.

Results: After conducting a systematic search, 12 studies were identified from a total of 11,904 articles and were included in the meta-analysis. These studies included a combined population of 10,765,221 participants, among whom 31,055 cases of liver cancer were reported. The analysis revealed that the pooled HR for the serum TC concentration (highest versus lowest) was 0.45 (95% CI = 0.35-0.58, I2 = 78%). For TGs, the HR was 0.67 (95% CI = 0.46-0.96, I2 = 86%), while for HDL-C, the HR was 0.72 (95% CI = 0.58-0.90, I2 = 65%). The HR for LDL-C was 0.51 (95% CI = 0.23-1.13, I2 = 93%).

Conclusion: The findings of this study indicate that serum TC, TG, and HDL-C levels are negatively associated with liver cancer risk, suggesting that higher concentrations of these lipids are associated with a reduced risk of liver cancer. However, no significant association has been found between LDL-C levels and liver cancer risk.

目的:血脂水平与肝癌发病风险之间的关系仍是一个争论不休的话题。为了阐明这种关联,我们系统地纳入了所有相关前瞻性队列研究的数据,进行了一项荟萃分析:我们对 PubMed、Embase、Web of Science 和 Cochrane Library 数据库进行了系统检索,涵盖了从数据库建立到 2023 年 7 月期间发表的研究。本研究纳入了与血脂概况(如总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平)相关的前瞻性队列研究,这些研究报告了危险比(HRs)或相对危险度(RRs)及相应的 95% 置信区间(95% CIs),以调查它们与肝癌风险的关系。在分析过程中,我们根据研究之间的异质性程度使用固定效应或随机效应模型,并通过这些模型获得汇总风险比。为确保研究结果的稳健性和可靠性,我们还进行了敏感性分析和发表偏倚分析:经过系统检索,我们从 11904 篇文章中筛选出 12 项研究,并将其纳入荟萃分析。这些研究共纳入了10,765,221名参与者,其中有31,055例肝癌病例。分析结果显示,血清 TC 浓度(最高与最低)的汇总 HR 为 0.45(95% CI = 0.35-0.58,I2 = 78%)。TGs的HR为0.67(95% CI = 0.46-0.96,I2 = 86%),而HDL-C的HR为0.72(95% CI = 0.58-0.90,I2 = 65%)。低密度脂蛋白胆固醇的 HR 为 0.51(95% CI = 0.23-1.13,I2 = 93%):本研究结果表明,血清总胆固醇、总胆固醇和高密度脂蛋白胆固醇水平与肝癌风险呈负相关,表明这些血脂浓度越高,肝癌风险越低。然而,低密度脂蛋白胆固醇(LDL-C)水平与肝癌风险之间并无明显关联。
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引用次数: 0
LGBTQ+ cancer: priority or lip service? A qualitative content analysis of LGBTQ+ considerations in U.S. state, jurisdiction, and tribal comprehensive cancer control plans LGBTQ+ 癌症:优先考虑还是口惠而实不至?对美国各州、辖区和部落癌症综合控制计划中 LGBTQ+ 考虑因素的定性内容分析
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-05-25 DOI: 10.1007/s10552-024-01887-z
Austin R. Waters, Madeline H. Bono, Mayuko Ito Fukunaga, Manal Masud, Megan A. Mullins, Ryan Suk, Meghan C. O’Leary, Swann A. Adams, Renée M. Ferrari, Mary Wangen, Olufeyisayo O. Odebunmi, Sarah H. Nash, Lisa P. Spees, Stephanie B. Wheeler, Prajakta Adsul, Perla Chebli, Rachel Hirschey, Jamie L. Studts, Aaron Seaman, Matthew Lee

The National Comprehensive Cancer Control Program, a Centers for Disease Control and Prevention funded program, supports cancer coalitions across the United States (US) in efforts to prevent and control cancer including development of comprehensive cancer control (CCC) plans. CCC plans often focus health equity within their priorities, but it is unclear to what extent lesbian, gay, bisexual, transgender, queer/questioning, plus (LGBTQ+) populations are considered in CCC plans. We qualitatively examined to what extent LGBTQ+ populations were referenced in 64 U.S. state, jurisdiction, tribes, and tribal organization CCC plans. A total of 55% of CCC plans mentioned LGBTQ+ populations, however, only one in three CCC plans mentioned any kind of LGBTQ+ inequity or LGBTQ+ specific recommendations. Even fewer plans included mention of LGBTQ+ specific resources, organizations, or citations. At the same time almost three fourths of plans conflated sex and gender throughout their CCC plans. The findings of this study highlight the lack of prioritization of LGBTQ+ populations in CCC plans broadly while highlighting exemplar plans that can serve as a roadmap to more inclusive future CCC plans. Comprehensive cancer control plans can serve as a key policy and advocacy structure to promote a focus on LGBTQ+ cancer prevention and control.

国家癌症综合控制计划是美国疾病控制与预防中心资助的一项计划,该计划支持全美癌症联盟开展癌症预防和控制工作,包括制定癌症综合控制(CCC)计划。CCC 计划通常将健康公平作为其优先事项的重点,但目前还不清楚 CCC 计划在多大程度上考虑了女同性恋、男同性恋、双性恋、变性人、同性恋者/疑似同性恋者及以上(LGBTQ+)人群。我们对美国 64 个州、辖区、部落和部落组织的 CCC 计划中提及 LGBTQ+ 群体的程度进行了定性研究。共有 55% 的 CCC 计划提及 LGBTQ+ 群体,但是,只有三分之一的 CCC 计划提及任何类型的 LGBTQ+ 不平等或 LGBTQ+ 具体建议。提及 LGBTQ+ 特定资源、组织或引文的计划则更少。同时,近四分之三的计划在其 CCC 计划中混淆了性与性别。本研究的结果凸显了癌症综合防治计划中缺乏对 LGBTQ+ 群体的优先考虑,同时也强调了可作为未来更具包容性的癌症综合防治计划路线图的典范计划。癌症综合控制计划可以作为一个重要的政策和宣传结构,促进对 LGBTQ+ 癌症预防和控制的关注。
{"title":"LGBTQ+ cancer: priority or lip service? A qualitative content analysis of LGBTQ+ considerations in U.S. state, jurisdiction, and tribal comprehensive cancer control plans","authors":"Austin R. Waters, Madeline H. Bono, Mayuko Ito Fukunaga, Manal Masud, Megan A. Mullins, Ryan Suk, Meghan C. O’Leary, Swann A. Adams, Renée M. Ferrari, Mary Wangen, Olufeyisayo O. Odebunmi, Sarah H. Nash, Lisa P. Spees, Stephanie B. Wheeler, Prajakta Adsul, Perla Chebli, Rachel Hirschey, Jamie L. Studts, Aaron Seaman, Matthew Lee","doi":"10.1007/s10552-024-01887-z","DOIUrl":"https://doi.org/10.1007/s10552-024-01887-z","url":null,"abstract":"<p>The National Comprehensive Cancer Control Program, a Centers for Disease Control and Prevention funded program, supports cancer coalitions across the United States (US) in efforts to prevent and control cancer including development of comprehensive cancer control (CCC) plans. CCC plans often focus health equity within their priorities, but it is unclear to what extent lesbian, gay, bisexual, transgender, queer/questioning, plus (LGBTQ+) populations are considered in CCC plans. We qualitatively examined to what extent LGBTQ+ populations were referenced in 64 U.S. state, jurisdiction, tribes, and tribal organization CCC plans. A total of 55% of CCC plans mentioned LGBTQ+ populations, however, only one in three CCC plans mentioned any kind of LGBTQ+ inequity or LGBTQ+ specific recommendations. Even fewer plans included mention of LGBTQ+ specific resources, organizations, or citations. At the same time almost three fourths of plans conflated sex and gender throughout their CCC plans. The findings of this study highlight the lack of prioritization of LGBTQ+ populations in CCC plans broadly while highlighting exemplar plans that can serve as a roadmap to more inclusive future CCC plans. Comprehensive cancer control plans can serve as a key policy and advocacy structure to promote a focus on LGBTQ+ cancer prevention and control.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141147890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The association of cancer-preventive lifestyle with colonoscopy screening use in border Hispanic adults along the Texas-Mexico border. 德克萨斯州与墨西哥边境地区的西班牙裔成年人的防癌生活方式与结肠镜筛查使用率的关系。
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-05-14 DOI: 10.1007/s10552-024-01885-1
Paul Gerardo Yeh, Audrey C Choh, Susan P Fisher-Hoch, Joseph B McCormick, David R Lairson, Belinda M Reininger

Purpose: The relationship between engaging in two domains of cancer-preventive behaviors, lifestyle behaviors and colonoscopy screening, is unknown in Hispanic adults. Accordingly, the study examined the association between lifestyle and colonoscopy screening in Hispanic adults along the Texas-Mexico border, where there is suboptimal colorectal cancer prevention.

Methods: Lifestyle behavior adherence and compliance with colonoscopy screening schedules were assessed using 2013-2023 data from the Cameron County Hispanic Cohorta population-based sample of Hispanic adults living along the Texas-Mexico border. The 2018 World Cancer Research Fund scoring system characterized healthy lifestyle engagement. Multivariable logistic regression quantified the association between lifestyle behaviors and colonoscopy screening.

Results: Among 914 Hispanic adults, there was a mean adherence score of 2.5 out of 7 for recommended behaviors. Only 33.0% (95% CI 25.64-41.39%) were up-to-date with colonoscopy. Complete adherence to fruit and vegetable (AOR [adjusted odds ratio] 5.2, 95% CI 1.68-16.30; p = 0.004), fiber (AOR 2.2, 95% CI 1.06-4.37; p = 0.04), and ultra-processed foods (AOR 2.8, 95% CI 1.30-6.21; p = 0.01) consumption recommendations were associated with up-to-date colonoscopy screening. Having insurance versus being uninsured (AOR 10.8, 95% CI 3.83-30.62; p < 0.001) and having local medical care versus in Mexico (AOR 7.0, 95% CI 2.26-21.43; p < 0.001) were associated with up-to-date colonoscopy.

Conclusions: Adherence to dietary lifestyle recommendations was associated with being up-to-date with colonoscopy screenings. Those with poor dietary behavior are at risk for low-colonoscopy use. Improving lifestyle behaviors may complement colonoscopy promotion interventions. Healthcare accessibility influences up-to-date colonoscopy prevalence. Our findings can inform cancer prevention strategies for the Hispanic population.

目的:在西班牙裔成年人中,生活方式行为和结肠镜筛查这两个癌症预防行为领域之间的关系尚不清楚。因此,本研究对德克萨斯州与墨西哥边境地区的西班牙裔成年人的生活方式与结肠镜筛查之间的关系进行了调查,那里的结肠直肠癌预防效果并不理想:研究利用卡梅伦县西班牙裔人群抽样调查(Cameron County Hispanic Cohorta)的2013-2023年数据,对生活方式的坚持情况和结肠镜筛查计划的依从性进行了评估。2018 年世界癌症研究基金会评分系统对健康生活方式的参与度进行了表征。多变量逻辑回归量化了生活方式行为与结肠镜筛查之间的关联:在 914 名西班牙裔成年人中,推荐行为的平均坚持率为 2.5 分(满分为 7 分)。只有 33.0%(95% CI 25.64-41.39%)的人接受了最新的结肠镜检查。完全遵守水果和蔬菜(AOR [调整后的几率比例] 5.2,95% CI 1.68-16.30;p = 0.004)、纤维(AOR 2.2,95% CI 1.06-4.37;p = 0.04)和超加工食品(AOR 2.8,95% CI 1.30-6.21;p = 0.01)消费建议与及时进行结肠镜检查有关。有保险与无保险(AOR 10.8,95% CI 3.83-30.62;P = 0.01)与最新结肠镜筛查有关:遵守饮食生活方式建议与及时进行结肠镜筛查有关。饮食行为不良者有可能很少接受结肠镜检查。改善生活方式可作为结肠镜检查推广干预措施的补充。医疗服务的可及性影响着结肠镜检查的及时性。我们的研究结果可为西班牙裔人群的癌症预防策略提供参考。
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引用次数: 0
Benign breast disease and breast cancer risk in African women: a case-control study. 非洲妇女的良性乳腺疾病与乳腺癌风险:一项病例对照研究。
IF 2.3 4区 医学 Q3 Medicine Pub Date : 2024-05-01 Epub Date: 2024-01-05 DOI: 10.1007/s10552-023-01837-1
Olasubomi J Omoleye, Jincong Q Freeman, Mojisola Oluwasanu, Adenike Adeniji-Sofoluwe, Anna E Woodard, Benjamin S Aribisala, Prisca O Adejumo, Atara Ntekim, Timothy Makumbi, Paul Ndom, IkeOluwapo O Ajayi, Olufunmilayo I Olopade, Dezheng Huo

Purpose: To examine the association between benign breast disease (BBD) and breast cancer (BC) in a heterogeneous population of African women.

Methods: BC cases and controls were enrolled in three sub-Saharan African countries, Nigeria, Cameroon, and Uganda, between 1998 and 2018. Multivariable logistic regression was used to test the association between BBD and BC. Risk factors dually associated with BBD and BC were selected. Using a parametric mediation analysis model, we assessed if selected BC risk factors were mediated by BBD.

Results: Of 6,274 participants, 55.6% (3,478) were breast cancer cases. 360 (5.7%) self-reported BBD. Fibroadenoma (46.8%) was the most commonly reported BBD. Women with a self-reported history of BBD had greater odds of developing BC than those without (adjusted odds ratio [aOR] 1.47, 95% CI 1.13-1.91). Biopsy-confirmed BBD was associated with BC (aOR 2.25, 95% CI 1.26-4.02). BBD did not significantly mediate the effects of any of the selected BC risk factors.

Conclusions: In this study, BBD was associated with BC and did not significantly mediate the effects of selected BC risk factors.

目的:研究非洲女性异质性人群中良性乳腺疾病(BBD)与乳腺癌(BC)之间的关联:1998年至2018年期间,在三个撒哈拉以南非洲国家(尼日利亚、喀麦隆和乌干达)招募了乳腺癌病例和对照组。采用多变量逻辑回归法检验BBD与BC之间的关联。选择了与BBD和BC双重相关的风险因素。利用参数中介分析模型,我们评估了所选的 BC 风险因素是否受到 BBD 的中介作用:在 6274 名参与者中,55.6%(3478 人)为乳腺癌病例。360人(5.7%)自述患有BBD。纤维腺瘤(46.8%)是最常报告的 BBD。自述有 BBD 病史的妇女比没有 BBD 病史的妇女患 BC 的几率更高(调整后的几率比 [aOR] 1.47,95% CI 1.13-1.91)。活组织检查证实 BBD 与 BC 相关(aOR 2.25,95% CI 1.26-4.02)。BBD对任何选定的BC风险因素的影响都没有明显的中介作用:在这项研究中,BBD与BC相关,但对选定的BC风险因素的影响没有明显的中介作用。
{"title":"Benign breast disease and breast cancer risk in African women: a case-control study.","authors":"Olasubomi J Omoleye, Jincong Q Freeman, Mojisola Oluwasanu, Adenike Adeniji-Sofoluwe, Anna E Woodard, Benjamin S Aribisala, Prisca O Adejumo, Atara Ntekim, Timothy Makumbi, Paul Ndom, IkeOluwapo O Ajayi, Olufunmilayo I Olopade, Dezheng Huo","doi":"10.1007/s10552-023-01837-1","DOIUrl":"10.1007/s10552-023-01837-1","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between benign breast disease (BBD) and breast cancer (BC) in a heterogeneous population of African women.</p><p><strong>Methods: </strong>BC cases and controls were enrolled in three sub-Saharan African countries, Nigeria, Cameroon, and Uganda, between 1998 and 2018. Multivariable logistic regression was used to test the association between BBD and BC. Risk factors dually associated with BBD and BC were selected. Using a parametric mediation analysis model, we assessed if selected BC risk factors were mediated by BBD.</p><p><strong>Results: </strong>Of 6,274 participants, 55.6% (3,478) were breast cancer cases. 360 (5.7%) self-reported BBD. Fibroadenoma (46.8%) was the most commonly reported BBD. Women with a self-reported history of BBD had greater odds of developing BC than those without (adjusted odds ratio [aOR] 1.47, 95% CI 1.13-1.91). Biopsy-confirmed BBD was associated with BC (aOR 2.25, 95% CI 1.26-4.02). BBD did not significantly mediate the effects of any of the selected BC risk factors.</p><p><strong>Conclusions: </strong>In this study, BBD was associated with BC and did not significantly mediate the effects of selected BC risk factors.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Cancer Causes & Control
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