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Alcohol consumption and smoking history at time of diagnosis, and risk of colorectal cancer recurrence and mortality: Results from the ColoCare Study. 诊断时的饮酒和吸烟史与结直肠癌复发和死亡风险:ColoCare 研究的结果。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-07 DOI: 10.1158/1055-9965.EPI-24-0834
Nicole C Loroña, Caroline Himbert, Jennifer Ose, Stacey A Cohen, Ildiko Strehli, Cornelia M Ulrich, Sofia Cobos, Esther Jean-Baptiste, Amanda M Bloomer, Jane C Figueiredo, Biljana Gigic, Sheetal Hardikar, Meghana Karchi, Matthew Mutch, Anita R Peoples, Martin Schneider, David Shibata, Erin M Siegel, Adetunji T Toriola, Elizabeth H Wood, Christopher I Li

Background: Findings from studies investigating the impacts of alcohol use and smoking on colorectal cancer (CRC) outcomes are inconclusive. This study aimed to investigate associations between alcohol use and smoking status at the time of diagnosis on recurrence and overall mortality among patients with CRC.

Methods: The present study included 2,216 stage I-IV patients with CRC from the longitudinal multi-center ColoCare study, with available data on recurrence and CRC-specific mortality. Cox proportional hazards models adjusted for age, sex, race, ethnicity, stage, tumor site, treatment, comorbidities, body mass index, and study site were fit, with imputations for missing data.

Results: We observed 235 recurrences and 308 CRC-specific deaths over an average of 3 years of follow-up. After adjusting for confounders, current alcohol consumption and ever smoking, relative to not current consumption and never smoking, respectively, were not statistically significantly associated with CRC recurrence (Alcohol - HR: 0.95. 95% CI: 0.71-1.29; Ever smoking - HR: 0.98, 95% CI: 0.75-1.29) or CRC-specific mortality (Alcohol - HR: 0.95. 95% CI: 0.74-1.22; Ever smoking - HR: 0.98, 95% CI: 0.77-1.24).

Conclusions: No associations were observed between alcohol and smoking at diagnosis and clinical outcomes in this well-annotated longitudinal cohort.

Impact: Our cohort study reports no significant associations; however, limiting alcohol use and avoiding smoking are health behaviors recommended for CRC survivors for prevention of other cancers and chronic conditions.

背景:有关饮酒和吸烟对结直肠癌(CRC)预后影响的研究结果尚无定论。本研究旨在调查确诊时饮酒和吸烟状况对 CRC 患者复发和总死亡率的影响:本研究纳入了 2,216 名 I-IV 期 CRC 患者,这些患者来自纵向多中心 ColoCare 研究,并提供了复发和 CRC 特异性死亡率数据。拟合了根据年龄、性别、种族、民族、分期、肿瘤部位、治疗、合并症、体重指数和研究地点进行调整的 Cox 比例危险模型,并对缺失数据进行了估算:在平均 3 年的随访中,我们观察到 235 例复发和 308 例 CRC 特异性死亡。在对混杂因素进行调整后,当前饮酒和曾经吸烟与当前未饮酒和从未吸烟相比,在统计学上与 CRC 复发无显著相关性(饮酒 - HR:0.95。95%CI:0.71-1.29;曾经吸烟 - HR:0.98,95%CI:0.75-1.29)或 CRC 特异性死亡率(酒精 - HR:0.95。95%CI:0.74-1.22;曾经吸烟--HR:0.98,95%CI:0.77-1.24):结论:在这一记录详实的纵向队列中,未观察到诊断时饮酒和吸烟与临床结果之间存在关联:我们的队列研究报告显示两者之间没有明显的关联;但是,为了预防其他癌症和慢性疾病,建议 CRC 幸存者限制饮酒和避免吸烟。
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引用次数: 0
Assessing 1 year Comorbidity Prevalence and Its Survival Implications in Medicare Beneficiaries Diagnosed with Cancer: Insights from a new SEER-Medicare Resource. 评估确诊癌症的医疗保险受益人的 1 年合并症患病率及其对生存的影响:从 SEER-Medicare 新资源中获得的启示。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-07 DOI: 10.1158/1055-9965.EPI-24-0833
Anne-Michelle Noone, Angela B Mariotto, Yoon Duk Hong, Lindsey Enewold

Background: Almost half of Medicare beneficiaries diagnosed with cancer from 1992-2005 had at least one comorbid condition. Conditions impact a range of domains from clinical decision making to quality of life which are important to consider when conducting cancer research. We introduce a new SEER-Medicare resource to facilitate using claims data for cancer patients.

Methods: We use the SEER-Medicare resource to estimate prevalence of comorbidities, 5-year survival rate by cancer site, stage, age and comorbidity severity, and prevalence of surgery by comorbidity for breast, prostate, colorectal and lung cancer.

Results: Overall, the most prevalent comorbidities in the year prior to cancer diagnosis were diabetes (27%), COPD (22%), peripheral vascular disease (14%), and congestive heart failure (12%). Comorbidity severity had a greater impact on the probability of dying from non-cancer causes than from dying from cancer. Severity of comorbidity and age consistently increased the probability of non-cancer death. The percentage of persons receiving surgery tended to be lower among those with severe comorbidity.

Conclusions: This study demonstrates the utility of new SEER*stat databases that contain Medicare beneficiaries and claims-based measures of comorbidity. Our results demonstrate that comorbidity is common among older persons diagnosed with cancer and the impact of comorbidity on the probability of dying from cancer varies by cancer site, stage at diagnosis and age.

Impact: Comorbidity is common among persons with cancer and impacts survival. Future research on the impact of comorbidity among cancer survivors is facilitated by new databases.

背景:1992-2005 年期间,近一半被诊断患有癌症的医疗保险受益人至少患有一种并发症。并发症会影响从临床决策到生活质量等一系列领域,这在进行癌症研究时是需要考虑的重要因素。我们介绍了一种新的 SEER-Medicare 资源,以方便使用癌症患者的索赔数据:我们利用 SEER-Medicare 资源估算了乳腺癌、前列腺癌、结直肠癌和肺癌的合并症患病率、按癌症部位、分期、年龄和合并症严重程度分类的 5 年生存率以及按合并症分类的手术率:总体而言,癌症确诊前一年最常见的合并症是糖尿病(27%)、慢性阻塞性肺病(22%)、外周血管疾病(14%)和充血性心力衰竭(12%)。与死于癌症相比,合并症严重程度对死于非癌症原因的概率影响更大。合并症的严重程度和年龄会持续增加非癌症死亡的概率。合并症严重者接受手术的比例往往较低:这项研究证明了新的 SEER*stat 数据库的实用性,该数据库包含医疗保险受益人和基于索赔的合并症测量指标。我们的研究结果表明,合并症在确诊癌症的老年人中很常见,合并症对癌症死亡概率的影响因癌症部位、确诊阶段和年龄而异:影响:合并症在癌症患者中很常见,会影响患者的生存。新的数据库有助于今后研究合并症对癌症幸存者的影响。
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引用次数: 0
Utilization of anal cytology screening among sexual and gender minority populations in Pennsylvania. 宾夕法尼亚州性与性别少数群体中肛门细胞学筛查的使用情况。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1158/1055-9965.EPI-24-0765
Sarah L Bennis, Elliot G Arsoniadis, Christopher W Wheldon

Background: Despite the risk of anal cancer in sexual and gender minority populations (SGM), anal cancer screening remains infrequent and inconsistent in these populations. The objective of this analysis was to identify factors associated with anal cancer screenings among sexual and gender minority populations (SGM) using the Andersen's Behavioral Model of Health Services Use.

Methods: Secondary analyses of two cross-sectional surveys from the 2020 (N=1125) and 2022 (N=630) "Pennsylvania LGBTQ Health Needs Assessment." Multiple logistic regression analyses were used to identify correlates of anal cytology screening.

Results: Average age was 37.7 (SD=13.3) and 39.7 (SD=13.6) in 2020 and 2022, respectively. Approximately 16-18% reported living with HIV. A minority of respondents reported past year screening (14.0% 2020 and 13.6% 2022). Enabling and need-based factors consistently associated with screening included STI treatment, living with HIV, PrEP use, and multiple sex partners. Robust factors associated with ever being screened were age and living with HIV.

Conclusions: Anal cytology screening is being done in Pennsylvania at a small but not insignificant rate. In accordance with existing guidelines, SGM living with HIV were most likely to be screened, but still at a low rate. Predictive factors associated with screening in this study can inform future interventions to implement guideline-specific anal cancer prevention.

Impact: Factors that reflect consistent connection to healthcare are associated with increased rates of screening via anal cytology testing, indicating there are opportunities to implement anal cancer screening as part of a larger, more comprehensive SGM-focused care pathway.

背景:尽管性少数群体和性别少数群体(SGM)有罹患肛门癌的风险,但在这些人群中,肛门癌筛查仍然很少且不一致。本分析的目的是利用安德森健康服务使用行为模型(Andersen's Behavioral Model of Health Services Use)确定与性少数群体和性别少数群体(SGM)肛门癌筛查相关的因素:对来自 2020 年(N=1125)和 2022 年(N=630)"宾夕法尼亚州 LGBTQ 健康需求评估 "的两项横截面调查进行二次分析。多重逻辑回归分析用于确定肛门细胞学筛查的相关因素:2020 年和 2022 年的平均年龄分别为 37.7 岁(SD=13.3)和 39.7 岁(SD=13.6)。约 16-18% 的受访者称自己感染了 HIV。少数受访者报告了过去一年的筛查情况(2020 年为 14.0%,2022 年为 13.6%)。与筛查始终相关的有利因素和基于需求的因素包括性传播感染治疗、艾滋病毒感染者、使用 PrEP 和多个性伴侣。与曾经接受筛查有关的可靠因素包括年龄和感染艾滋病毒:宾夕法尼亚州正在进行肛门细胞学筛查,筛查率虽小,但并不低。根据现有指南,感染 HIV 的 SGM 最有可能接受筛查,但筛查率仍然很低。本研究中与筛查相关的预测因素可为未来实施针对肛门癌预防指南的干预措施提供参考:通过肛门细胞学检测进行筛查的比例增加与反映与医疗保健的持续联系的因素有关,这表明有机会将肛门癌筛查作为更广泛、更全面的以SGM为重点的护理途径的一部分来实施。
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引用次数: 0
Identification of High-Incidence Populations in the United States for anti-Epstein Barr Virus Serologic Screening for Nasopharyngeal Carcinoma. 确定美国鼻咽癌抗爱泼斯坦巴氏病毒血清学筛查的高发人群。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1158/1055-9965.EPI-24-0576
Payton Elizabeth Clark, Kekoa Taparra, Jacob Allen Miller

Background: In the United States (US), Epstein-Barr Virus (EBV)-associated nasopharyngeal carcinoma (NPC) disproportionately impacts Asian Americans (AA) and Native Hawaiians and other Pacific Islanders (NHPI) who have no access to screening. EBV-based screening trials in Asia have detected most cases at early stages. We sought to identify a US target population for NPC screening and hypothesized that once-lifetime screening could be cost-effective.

Methods: We obtained NPC incidence data from the SEER Asian and Pacific Islander datasets. We estimated the number needed to screen, mortality reduction, and resource utilization using a validated model and performance data from trials. Six evaluated strategies incorporated serology, nasopharyngeal swab PCR, and endoscopy or MRI.

Results: Intermediate-incidence and high-incidence populations accounted for 10.7% of US person-years yet 42.7% of cases. Anti-BNLF2b screening with selective endoscopy was the preferred strategy. In high-incidence populations, the median NNS to detect one case was 1,992, with a median of 7.12 NPC deaths averted per 100,000 screened. Screening met the willingness-to-pay threshold in all five high-incidence populations (median ICER/GDP 0.82) and among men in intermediate-incidence populations.

Conclusions: Nearly half of NPC in the US arises among the 10% with AA or NHPI ethnicity. A suitable target population for US screening trials would be men and women age 35-65 of Chinese, Sāmoan, or Southeast Asian ethnicity, or men age 35-60 of Guamanian/Chamorro, Filipino, or Native Hawaiian ethnicity. Once-lifetime anti-BNLF2b screening could be cost-effective.

Impact: These data may aid the design of US screening trials. Targeted NPC screening might mitigate health disparities.

背景:在美国,与爱泼斯坦-巴氏病毒(EBV)相关的鼻咽癌(NPC)对亚裔美国人(AA)和夏威夷原住民及其他太平洋岛民(NHPI)的影响尤为严重,他们无法接受筛查。在亚洲进行的基于 EBV 的筛查试验在早期阶段就发现了大多数病例。我们试图确定鼻咽癌筛查的美国目标人群,并假设终生一次的筛查具有成本效益:我们从 SEER 亚洲和太平洋岛民数据集中获得了鼻咽癌发病率数据。我们使用验证模型和试验数据估算了筛查所需人数、死亡率降低率和资源利用率。六项评估策略包括血清学、鼻咽拭子 PCR、内窥镜检查或核磁共振成像:中等发病率和高发病率人群占美国人年的 10.7%,但占病例的 42.7%。抗BNLF2b筛查和选择性内窥镜检查是首选策略。在高发人群中,发现一个病例的 NNS 中位数为 1992,每 100,000 例筛查者中可避免 7.12 例鼻咽癌死亡。在所有五个高发病人群中(ICER/GDP 中位数为 0.82),在中等发病人群的男性中,筛查符合支付意愿阈值:结论:美国近一半的鼻咽癌发生在10%的AA族或NHPI族人群中。美国筛查试验的合适目标人群是 35-65 岁的华裔、沙门或东南亚裔男性和女性,或 35-60 岁的瓜曼/夏莫洛、菲律宾或夏威夷原住民裔男性。一生一次的抗BNLF2b筛查可能具有成本效益:这些数据可能有助于美国筛查试验的设计。有针对性的鼻咽癌筛查可减轻健康差异。
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引用次数: 0
Plasma ghrelin and risks of sex-specific, site-specific, and early-onset colorectal cancer: A Mendelian randomization analysis. 血浆胃泌素与性别特异性、部位特异性和早发性结直肠癌的风险:孟德尔随机分析
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1158/1055-9965.EPI-24-0926
Emma Hazelwood, Catalina Lopez Manzano, Emma E Vincent, Demetrius Albanes, D Timothy Bishop, Loïc Le Marchand, Cornelia M Ulrich, Ulrike Peters, Gwen Murphy, N Jewel Samadder, Laura Anderson, Marc J Gunter, Neil Murphy, Bethany Van Guelpen, Nikos Papadimitriou

Background: Epidemiological and laboratory-based studies have provided conflicting evidence for a role of ghrelin in colorectal cancer (CRC) development. We conducted two-sample Mendelian randomization (MR) analyses to evaluate evidence for an association of circulating ghrelin and CRC risk overall and by sex, cancer subsite and age at diagnosis.

Methods: Genetic instruments proxying plasma total ghrelin levels were obtained from a recent genome-wide association study of 54,219 participants. Summary data for CRC risk were obtained from a recent meta-analysis of several genetic consortia (up to 73,673 cases and 86,854 controls). A two-sample MR approach and several sensitivity analyses were applied.

Results: We found no evidence for an association of genetically-predicted plasma total ghrelin levels and CRC risk (0.95, 95% confidence interval: 0.81-1.12; R2 of ghrelin genetic instruments: 4.6%), with similarly null results observed when stratified by sex, anatomical subsite, and for early-onset CRC.

Conclusions: Our study suggests that plasma ghrelin levels are unlikely to have a causal relationship with overall, early-onset, and sex- and cancer subsite-stratified CRC risk.

Impact: This large-scale analysis adds to the growing body of evidence that plasma total ghrelin levels are not associated with CRC risk.

背景:关于胃泌素在结直肠癌(CRC)发病中的作用,流行病学和实验室研究提供了相互矛盾的证据。我们进行了双样本孟德尔随机化(MR)分析,以评估循环胃泌素与总体 CRC 风险以及与性别、癌症分部位和诊断年龄相关的证据:代理血浆总胃泌素水平的遗传工具来自最近一项对 54,219 名参与者进行的全基因组关联研究。有关 CRC 风险的汇总数据来自最近对几个基因联盟(多达 73,673 例病例和 86,854 例对照)的荟萃分析。我们采用了双样本 MR 方法和几种敏感性分析:结果:我们发现,没有证据表明基因预测的血浆总胃泌素水平与 CRC 风险有关(0.95,95% 置信区间:0.81-1.12;胃泌素基因工具的 R2:4.6%):结论:我们的研究表明,血浆总胃泌素水平与癌症风险之间的关系是不确定的(0.95,95% 置信区间:0.81-1.12;胃泌素基因工具的 R2:4.6%):我们的研究表明,血浆胃泌素水平不太可能与总体、早发、按性别和癌症亚部位分层的 CRC 风险有因果关系:这项大规模分析补充了越来越多的证据,即血浆总胃泌素水平与 CRC 风险无关。
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引用次数: 0
Cancer Mortality among Hispanic groups in the US, by birthplace (2003-2017). 按出生地分列的美国西班牙裔群体癌症死亡率(2003-2017 年)。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1158/1055-9965.EPI-24-0792
Yuelin He, Paulo S Pinheiro, Osika Tripathi, Helen Nguyen, Malathi Srinivasan, Latha P Palaniappan, Caroline A Thompson

Background: The Hispanic population is the second largest racial/ethnic group in the US, consisting of multiple distinct ethnicities. Ethnicity-specific variations in cancer mortality may be attributed to countries of birth, so we aimed to understand differences in cancer mortality among disaggregated Hispanics by nativity (native- or foreign- born vs. US-born) over 15 years.

Methods: 228,197 Hispanic decedents (Mexican, Puerto Rican [PR], Cuban, and Central or South American) with cancer-related deaths from US death certificates (2003-2017) were analyzed. Seven cancers that contribute significantly to Hispanic male (lung and bronchus, colon and rectum, liver, prostate, and pancreas cancers) and female (lung and bronchus, liver, pancreas, colon and rectum, female breast, and ovary cancers) mortality were selected for analysis. 5-year age-adjusted mortality rates [AAMR (95% CI); per 100,000] and standardized mortality ratios [SMR (95% CI)] using foreign-born as the reference group were calculated. Joinpoint regression analysis was used to model cancer-related mortality trends.

Results: Puerto Rico-born PRs, Cuba-born Cubans, and US-born Mexicans had some of the highest cancer death rates among all the Hispanic groups. In general, foreign-born Hispanics had higher cancer mortality rates than US-born, except Mexicans. Overall, US-born and non-US-born (i.e. native- or foreign- born) Hispanic groups experienced decreasing rates of cancer deaths over the years.

Conclusions: We noted vast heterogeneity in mortality rates by nativity across Hispanic groups, a fast-growing diverse US population.

Impact: Understanding disaggregated patterns and trends in cancer burden can motivate deeper discussion around community health resources, which may improve the health of Hispanics across the US.

背景:西班牙裔人口是美国第二大种族/民族群体,由多个不同的民族组成。癌症死亡率的种族特异性差异可能归因于出生国,因此我们旨在了解按出生地(本地出生或外国出生与美国出生)分类的西班牙裔人群在 15 年内癌症死亡率的差异。方法:我们分析了美国死亡证明中 228197 名与癌症相关死亡的西班牙裔死者(墨西哥人、波多黎各人、古巴人、中美洲或南美洲人)(2003-2017 年)。选取了对西语裔男性(肺癌和支气管癌、结肠癌和直肠癌、肝癌、前列腺癌和胰腺癌)和女性(肺癌和支气管癌、肝癌、胰腺癌、结肠癌和直肠癌、女性乳腺癌和卵巢癌)死亡率影响较大的七种癌症进行分析。计算了以外国出生者为参照组的 5 年年龄调整死亡率[AAMR (95% CI);每 10 万人]和标准化死亡率[SMR (95% CI)]。连接点回归分析用于建立癌症相关死亡率趋势模型:结果:在所有西语裔群体中,波多黎各出生的波多黎各人、古巴出生的古巴人和美国出生的墨西哥人的癌症死亡率最高。总体而言,除墨西哥人外,外国出生的西班牙裔人的癌症死亡率高于美国出生的人。总体而言,美国出生和非美国出生(即本地出生或外国出生)的拉美裔群体的癌症死亡率逐年下降:我们注意到,作为一个快速增长的多元化美国人口群体,西语裔群体的死亡率因其出生地不同而存在巨大差异:影响:了解癌症负担的分类模式和趋势可促使人们围绕社区卫生资源展开更深入的讨论,从而改善全美拉美裔美国人的健康状况。
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引用次数: 0
Social determinants of breast cancer screening: a multilevel analysis of proximal and distal factors related to the practice of mammography. 乳腺癌筛查的社会决定因素:与乳房 X 射线照相术相关的近端和远端因素的多层次分析。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1158/1055-9965.EPI-24-1001
Daiana Denis Sarmiento, Natalia Tumas, Sofia Aynelen Pereyra, Graciela Fabiana Scruzzi, Sonia Alejandra Pou

Background: Mammography is crucial for early breast cancer detection. In Latin America, Argentina faces a significant breast cancer burden, with varying mammography rates. The social factors influencing mammography practices remain unclear. This study aimed to identify the proximal and distal social determinants of this practice among Argentinean women using a multilevel approach.

Methods: This nationwide cross-sectional study included 4,924 women aged 50-70 participating in the 2018 National Risk Factor Survey of Argentina. Two-level logistic models were used to estimate measures of association (ORs) between timely mammography practice (within the last 2 years) and selected covariates (sociodemographics, proximal environment, and distal-level variables). The intraclass correlation coefficient (ICC) and proportional change in variance (PCV) were calculated.

Results: 62.8% of women underwent timely mammography. Age (OR=0.96; 95%CI 0.94-0.97), health insurance (OR=2.22; 95%CI 1.87-2.63), education (OR=2.1; 95%CI 1.74-2.64), and income (OR=1.56; 95%CI 1.23-1.97) were associated with mammography practice. Women in non-marital (OR=0.61; 95%CI 0.52-0.72) or larger households (OR=0.61; 95%CI 0.51-0.63) were less likely to have timely mammograph; living in a larger city was positively associated (OR=1.28; 95%CI 1.12-1.46). Women in provinces with higher physician density (OR=1.06; 95%CI 1.01-1.11) and lower maternal mortality ratio (OR=0.9; 95%CI 0.87-0.96) had higher chances of timely mammography. The ICC and PCV suggested that the explored healthcare indicators largely explained the macro-contextual effect.

Conclusions: Multilevel factors influenced mammography practices in Argentina. The results highlight disparities linked to sociodemographic characteristics and healthcare resources.

Impact: Efforts to address social inequalities in breast cancer screening must consider multilevel determinants, including in healthcare settings.

背景介绍乳房 X 射线照相术对早期乳腺癌检测至关重要。在拉丁美洲,阿根廷面临着严重的乳腺癌负担,但乳房 X 射线照相术的普及率却参差不齐。影响乳房 X 射线照相做法的社会因素仍不清楚。本研究采用多层次方法,旨在确定阿根廷妇女进行乳房 X 射线照相术的近端和远端社会决定因素:这项全国性横断面研究纳入了参加2018年阿根廷全国风险因素调查的4924名50-70岁女性。研究采用两级逻辑模型来估算及时进行乳腺放射摄影(过去两年内)与选定协变量(社会人口学、近端环境和远端变量)之间的关联度(ORs)。计算了类内相关系数(ICC)和方差比例变化(PCV):结果:62.8%的妇女及时进行了乳腺 X 射线检查。年龄(OR=0.96;95%CI 0.94-0.97)、医疗保险(OR=2.22;95%CI 1.87-2.63)、教育程度(OR=2.1;95%CI 1.74-2.64)和收入(OR=1.56;95%CI 1.23-1.97)与乳腺 X 射线照相实践相关。非婚家庭(OR=0.61;95%CI 0.52-0.72)或人口较多的家庭(OR=0.61;95%CI 0.51-0.63)的妇女不太可能及时进行乳腺X光检查;居住在较大城市的妇女则与此呈正相关(OR=1.28;95%CI 1.12-1.46)。在医生密度较高(OR=1.06;95%CI 1.01-1.11)和孕产妇死亡率较低(OR=0.9;95%CI 0.87-0.96)的省份,妇女及时接受乳腺放射摄影的几率较高。ICC和PCV表明,所探讨的医疗指标在很大程度上解释了宏观背景的影响:结论:多层次因素影响了阿根廷的乳腺放射摄影实践。结果凸显了与社会人口特征和医疗资源相关的差异:影响:要解决乳腺癌筛查中的社会不平等问题,就必须考虑多层次的决定因素,包括在医疗保健环境中。
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引用次数: 0
Association between Long-term Energy Balance-Related Factors and Survival in Colorectal Cancer Overall and by Metabolic Warburg-Subtypes. 结直肠癌总体及沃伯格代谢亚型的长期能量平衡相关因素与存活率之间的关系。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-02 DOI: 10.1158/1055-9965.EPI-24-0199
Kelly Offermans, Josien C A Jenniskens, Colinda C J M Simons, Iryna Samarska, Gregorio E Fazzi, Kim M Smits, Leo J Schouten, Matty P Weijenberg, Heike I Grabsch, Piet A van den Brandt

Background: Long-term energy balance-related factors (i.e., lifestyle and physiologic factors that influence the equilibrium between energy intake and energy expenditure over an extended period) such as body mass index (BMI) are linked to colorectal cancer risk, but their impact on colorectal cancer survival is unclear. We explored associations between these long-term energy balance-related factors and survival and examined potential differences across metabolic Warburg-subtypes.

Methods: Associations between long-term energy balance-related factors and survival in the total series of patients with colorectal cancer (n = 2,347) obtained from the prospective Netherlands Cohort Study, as well as according to Warburg-subtype (Warburg-low: n = 652, Warburg-moderate: n = 802, Warburg-high: n = 797), were investigated using Cox regression analysis.

Results: Among the long-term energy balance-related factors studied, only increasing prediagnostic BMI was associated with a borderline significant poorer overall survival in patients with colorectal cancer [HR5kg/m2, 1.07; 95% confidence interval (CI), 0.99-1.15]. Stratified analyses showed that prediagnostic weight gain (HR5kg, 1.04; 95% CI, 0.99-1.09) and potentially increased height (HR5cm, 1.04; 95% CI, 0.98-1.11) were associated with poor overall survival only in patients with Warburg-high colorectal cancer. Increasing prediagnostic BMI was associated with poor survival only in patients with Warburg-moderate colorectal cancer (colorectal cancer-specific: HR5kg/m2, 1.12; 95% CI, 0.96-1.32; overall: HR5kg/m2, 1.20; 95% CI, 1.05-1.36). No consistent patterns were observed across energy restriction proxies.

Conclusions: Maintaining a healthy prediagnostic BMI may be beneficial for colorectal cancer survival. Moreover, associations between prediagnostic BMI, weight change, early-life energy restriction, height, and colorectal cancer survival differed according to Warburg-subtypes.

Impact: Understanding the biologic pathways involved in associations between energy balance-related factors and colorectal cancer survival could help refine prevention strategies in the future.

背景:身体质量指数(BMI)等长期能量平衡相关因素(即影响长期能量摄入和能量消耗平衡的生活方式和生理因素)与结直肠癌(CRC)风险有关,但它们对CRC存活率的影响尚不清楚。我们探讨了这些长期能量平衡相关因素与生存之间的关系,并研究了不同代谢沃伯格亚型之间的潜在差异:方法:我们使用 Cox 回归分析法研究了前瞻性荷兰队列研究中所有 CRC 患者(2347 人)的长期能量平衡相关因素与生存率之间的关系,并根据沃伯格亚型(沃伯格-低:652 人,沃伯格-中:802 人,沃伯格-高:797 人)对长期能量平衡相关因素与生存率之间的关系进行了研究:结果:在所研究的长期能量平衡相关因素中,只有诊断前体重指数(BMI)的升高与 CRC 患者较差的总生存率(HR5kg/m2:1.07;95%CI:0.99-1.15)有边缘显著相关性。分层分析显示,诊断前体重增加(HR5kg 1.06;95%CI 1.00-1.12)和潜在身高增加(HR5cm 1.04;95%CI 0.98-1.11)仅与沃伯格高CRC患者总生存率较低有关。诊断前体重指数的增加仅与沃伯格中度 CRC 患者生存率低有关(CRC 特异性:HR5kg/m2 1.12;95%CI 0.96-1.32;总体:HR5kg/m2 1.20;95%CI 1.05-1.36)。在能量限制代用指标中未观察到一致的模式:结论:保持诊断前健康的 BMI 可能有利于 CRC 的生存。此外,诊断前体重指数、体重变化、生命早期能量限制、身高与 CRC 存活率之间的关系因沃伯格亚型而异:影响:了解能量平衡相关因素与 CRC 存活率之间关系的生物学途径有助于完善未来的预防策略。
{"title":"Association between Long-term Energy Balance-Related Factors and Survival in Colorectal Cancer Overall and by Metabolic Warburg-Subtypes.","authors":"Kelly Offermans, Josien C A Jenniskens, Colinda C J M Simons, Iryna Samarska, Gregorio E Fazzi, Kim M Smits, Leo J Schouten, Matty P Weijenberg, Heike I Grabsch, Piet A van den Brandt","doi":"10.1158/1055-9965.EPI-24-0199","DOIUrl":"10.1158/1055-9965.EPI-24-0199","url":null,"abstract":"<p><strong>Background: </strong>Long-term energy balance-related factors (i.e., lifestyle and physiologic factors that influence the equilibrium between energy intake and energy expenditure over an extended period) such as body mass index (BMI) are linked to colorectal cancer risk, but their impact on colorectal cancer survival is unclear. We explored associations between these long-term energy balance-related factors and survival and examined potential differences across metabolic Warburg-subtypes.</p><p><strong>Methods: </strong>Associations between long-term energy balance-related factors and survival in the total series of patients with colorectal cancer (n = 2,347) obtained from the prospective Netherlands Cohort Study, as well as according to Warburg-subtype (Warburg-low: n = 652, Warburg-moderate: n = 802, Warburg-high: n = 797), were investigated using Cox regression analysis.</p><p><strong>Results: </strong>Among the long-term energy balance-related factors studied, only increasing prediagnostic BMI was associated with a borderline significant poorer overall survival in patients with colorectal cancer [HR5kg/m2, 1.07; 95% confidence interval (CI), 0.99-1.15]. Stratified analyses showed that prediagnostic weight gain (HR5kg, 1.04; 95% CI, 0.99-1.09) and potentially increased height (HR5cm, 1.04; 95% CI, 0.98-1.11) were associated with poor overall survival only in patients with Warburg-high colorectal cancer. Increasing prediagnostic BMI was associated with poor survival only in patients with Warburg-moderate colorectal cancer (colorectal cancer-specific: HR5kg/m2, 1.12; 95% CI, 0.96-1.32; overall: HR5kg/m2, 1.20; 95% CI, 1.05-1.36). No consistent patterns were observed across energy restriction proxies.</p><p><strong>Conclusions: </strong>Maintaining a healthy prediagnostic BMI may be beneficial for colorectal cancer survival. Moreover, associations between prediagnostic BMI, weight change, early-life energy restriction, height, and colorectal cancer survival differed according to Warburg-subtypes.</p><p><strong>Impact: </strong>Understanding the biologic pathways involved in associations between energy balance-related factors and colorectal cancer survival could help refine prevention strategies in the future.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1356-1367"},"PeriodicalIF":3.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Nonadditive Effects of Common Genetic Variants Have a Negligent Contribution to Cancer Heritability. 常见遗传变异的非加成效应对癌症遗传性的影响微乎其微。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-02 DOI: 10.1158/1055-9965.EPI-24-0496
Austin Hammermeister Suger, Tabitha A Harrison, Barbara Henning, Constance Turman, Peter Kraft, Sara Lindström

Background: Contribution of dominance effects to cancer heritability is unknown. We leveraged existing genome-wide association data for seven cancers to estimate the contribution of dominance effects to the heritability of individual cancer types.

Methods: We estimated the proportion of phenotypic variation caused by dominance genetic effects using genome-wide association data for seven cancers (breast, colorectal, lung, melanoma, nonmelanoma skin, ovarian, and prostate) in a total of 166,772 cases and 284,824 controls.

Results: We observed no evidence of a meaningful contribution of dominance effects to cancer heritability. By contrast, additive effects ranged between 0.11 and 0.34.

Conclusions: In line with studies of other human traits, the dominance effects of common genetic variants play a minimal role in cancer etiology.

Impact: These results support the assumption of an additive inheritance model when conducting cancer association studies with common genetic variants.

背景:显性效应对癌症遗传性的贡献尚不清楚。我们利用现有的七种癌症的全基因组关联数据来估计优势效应对单个癌症类型遗传率的贡献:方法:我们利用七种癌症(乳腺癌、结直肠癌、肺癌、黑色素瘤、非黑色素瘤皮肤癌、卵巢癌和前列腺癌)的全基因组关联数据,对166772例病例和284824例对照的表型变异比例进行了估计:我们没有发现任何证据表明显性效应对癌症遗传性有重大影响。相反,加性效应介于 0.11 和 0.34 之间:结论:与对人类其他性状的研究一致,常见遗传变异的显性效应在癌症病因学中的作用微乎其微:这些结果支持在进行常见遗传变异的癌症关联研究时采用加性遗传模型的假设。
{"title":"Nonadditive Effects of Common Genetic Variants Have a Negligent Contribution to Cancer Heritability.","authors":"Austin Hammermeister Suger, Tabitha A Harrison, Barbara Henning, Constance Turman, Peter Kraft, Sara Lindström","doi":"10.1158/1055-9965.EPI-24-0496","DOIUrl":"10.1158/1055-9965.EPI-24-0496","url":null,"abstract":"<p><strong>Background: </strong>Contribution of dominance effects to cancer heritability is unknown. We leveraged existing genome-wide association data for seven cancers to estimate the contribution of dominance effects to the heritability of individual cancer types.</p><p><strong>Methods: </strong>We estimated the proportion of phenotypic variation caused by dominance genetic effects using genome-wide association data for seven cancers (breast, colorectal, lung, melanoma, nonmelanoma skin, ovarian, and prostate) in a total of 166,772 cases and 284,824 controls.</p><p><strong>Results: </strong>We observed no evidence of a meaningful contribution of dominance effects to cancer heritability. By contrast, additive effects ranged between 0.11 and 0.34.</p><p><strong>Conclusions: </strong>In line with studies of other human traits, the dominance effects of common genetic variants play a minimal role in cancer etiology.</p><p><strong>Impact: </strong>These results support the assumption of an additive inheritance model when conducting cancer association studies with common genetic variants.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1383-1388"},"PeriodicalIF":3.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breast, Colorectal, and Prostate Cancer Incidence among Filipino Americans by Generational Status in the Multiethnic Cohort Study. 多民族队列研究》中按世代状况分列的美籍菲律宾人乳腺癌、结直肠癌和前列腺癌发病率。
IF 3.7 3区 医学 Q2 ONCOLOGY Pub Date : 2024-10-02 DOI: 10.1158/1055-9965.EPI-24-0647
Janine V Abe, Justin Legaspi, Cherie Guillermo, David Bogumil, Veronica Wendy Setiawan, Loïc Le Marchand, Brenda Y Hernandez, Lynne R Wilkens, Gertraud Maskarinec

Background: Filipino Americans constitute 12% and 4% of the respective populations of Hawaii and California, with a large proportion of immigrants experiencing increasing cancer rates. This study investigated the incidence of colorectal, breast, and prostate cancers by generational status in the Multiethnic Cohort.

Methods: We analyzed 10,495 Filipino Multiethnic Cohort first-, second-, and third-generation participants, in which 26.8% were of mixed race and ethnicity. Linkage to statewide cancer registries identified 375 breast, 249 colorectal, and 436 prostate cancer incident cases. Cox models were used to calculate HRs and 95% confidence intervals (CI) for the association between generational status and cancer incidence. Models were adjusted for age at cohort entry and cancer-specific covariates that were chosen based on stepwise regression.

Results: Compared with the first generation, colorectal cancer showed a significantly higher incidence in the second and third generations with respective HRs of 1.43 (95% CI, 1.04, 1.98) and 1.76 (95% CI, 1.29, 2.38). This association was attenuated after adjustment for relevant covariates. Breast cancer incidence was elevated in the third versus first generation (HR = 1.29; 95% CI, 1.01, 1.63) even in the fully adjusted model, whereas little difference was observed for prostate cancer.

Conclusions: In this prospective study, we found differences in incidence by generational status, specifically colorectal cancer among men and female breast cancer.

Impact: Understanding behavioral changes due to acculturation is warranted to mitigate cancer risks in migrant populations.

背景:菲律宾裔美国人分别占夏威夷和加利福尼亚州人口的 12% 和 4%,其中很大一部分移民的癌症发病率不断上升。本研究调查了多民族队列(MEC)中不同世代的大肠癌、乳腺癌和前列腺癌发病率:我们分析了 10,495 名菲律宾籍 MEC 第一代、第二代和第三代参与者,其中 26.8% 为混合种族和族裔。通过与全州癌症登记处的链接,发现了 375 例乳腺癌、249 例结直肠癌和 436 例前列腺癌病例。我们使用 Cox 模型来计算世代状况与癌症发病率之间关系的危险比 (HR) 和 95% 置信区间 (CI)。模型根据队列加入时的年龄和基于逐步回归法选择的癌症特异性协变量进行了调整:与第一代相比,第二代和第三代的结直肠癌发病率明显较高,HR 分别为 1.43(95%CI:1.04,1.98)和 1.76(95%CI:1.29,2.38)。在对相关协变量进行调整后,这种关联性有所减弱。即使在完全调整模型中,第三代与第一代的乳腺癌发病率也有所上升(HR=1.29,95%CI:1.01,1.63),而前列腺癌的发病率几乎没有差异:在这项前瞻性研究中,我们发现不同世代的发病率存在差异,特别是男性结直肠癌和女性乳腺癌:影响:了解文化差异导致的行为变化有助于降低流动人口的癌症风险。
{"title":"Breast, Colorectal, and Prostate Cancer Incidence among Filipino Americans by Generational Status in the Multiethnic Cohort Study.","authors":"Janine V Abe, Justin Legaspi, Cherie Guillermo, David Bogumil, Veronica Wendy Setiawan, Loïc Le Marchand, Brenda Y Hernandez, Lynne R Wilkens, Gertraud Maskarinec","doi":"10.1158/1055-9965.EPI-24-0647","DOIUrl":"10.1158/1055-9965.EPI-24-0647","url":null,"abstract":"<p><strong>Background: </strong>Filipino Americans constitute 12% and 4% of the respective populations of Hawaii and California, with a large proportion of immigrants experiencing increasing cancer rates. This study investigated the incidence of colorectal, breast, and prostate cancers by generational status in the Multiethnic Cohort.</p><p><strong>Methods: </strong>We analyzed 10,495 Filipino Multiethnic Cohort first-, second-, and third-generation participants, in which 26.8% were of mixed race and ethnicity. Linkage to statewide cancer registries identified 375 breast, 249 colorectal, and 436 prostate cancer incident cases. Cox models were used to calculate HRs and 95% confidence intervals (CI) for the association between generational status and cancer incidence. Models were adjusted for age at cohort entry and cancer-specific covariates that were chosen based on stepwise regression.</p><p><strong>Results: </strong>Compared with the first generation, colorectal cancer showed a significantly higher incidence in the second and third generations with respective HRs of 1.43 (95% CI, 1.04, 1.98) and 1.76 (95% CI, 1.29, 2.38). This association was attenuated after adjustment for relevant covariates. Breast cancer incidence was elevated in the third versus first generation (HR = 1.29; 95% CI, 1.01, 1.63) even in the fully adjusted model, whereas little difference was observed for prostate cancer.</p><p><strong>Conclusions: </strong>In this prospective study, we found differences in incidence by generational status, specifically colorectal cancer among men and female breast cancer.</p><p><strong>Impact: </strong>Understanding behavioral changes due to acculturation is warranted to mitigate cancer risks in migrant populations.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1311-1317"},"PeriodicalIF":3.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Cancer Epidemiology Biomarkers & Prevention
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