bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract B113: Determinants of serum sex hormone binding globulin and testosterone in overweight and weight-reduced premenopausal women
Authors: Azrad Maria , Gower Barbara A. , Hunter Gary R. , Nagy Tim R.
Published: May 2012

Introduction: Epidemiological studies have linked androgens and low sex hormone binding globulin (SHBG) with increased risk for breast cancer in premenopausal women. Obesity and the metabolic complications associated with increased adiposity have been shown to mediate both of these factors. The purpose of this study was to determine whether weight reduction through caloric restriction (CR), CR + aerobic exercise (CR+AE) or CR + resistance training (CR+RT) modifies serum total testosterone, bioavailable testosterone and SHBG.

Methods: Participants were 138 healthy, over weight (BMI 27–79) premenopausal women not taking oral contraceptives randomized to CR, CR+AE or CR+RT in order to achieve normal body weight (BMI<25).

Results: All three groups significantly reduced BMI from baseline to follow-up. There was no significant difference in adjusted mean BMI among the groups following weight loss. All three groups significantly increased SHBG (p<0.0001) and significantly decreased bioavailable testosterone (p<0.0001) from baseline to follow up. With all participants combined there was significant decrease in total testosterone as well as in the CR group (p≤0.05 for both). There was no difference in adjusted mean total testosterone, bioavailable testosterone and SHBG concentrations among the three groups following weight loss. Multiple linear regression models revealed that 64% of the variance in baseline SHBG was explained by age, intra-abdominal fat, bioavailable testosterone, insulin, and high density lipoprotein (HDL). After adjusting for baseline SHBG, 81% of the variance was explained by age, free testosterone and HDL in the weight reduced state. Twenty-three percent of the variance in baseline total testosterone was explained by age, estradiol, norepinephrine, low density lipoprotein (LDL) and leptin. After adjusting for baseline total testosterone, 58% of the variance was explained by age, estradiol and leptin in the weight reduced state.

Conclusions: Testosterone, bioavailable testosterone and SHBG are highly influenced by obesity and can be modified through weight loss. Weight loss through CR or in combination with exercise achieves similar effects on testosterone and SHBG concentrations. The determinants of serum total testosterone and SHBG are different in the overweight and weight reduced state.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B113.
Abstract B117: Association of endogenous sex hormone levels with breast cancer risk factors in premenopausal Japanese women
Authors: Nagata Chisato , Nakamura Kozue , Wada Keiko , Hayashi Makoto , Takeda Noriyuki , Yasuda Keigo
Published: May 2012

We assessed associations between blood levels of estrogen and androgen and breast cancer risk factors in premenopausal Japanese women. A total of 551 premenopausal women who reported having regular menstrual cycles less than 40 days long were included in the present study. Women were not included if they were using oral contraceptives or hormone therapy, or if they had cancer, diabetes mellitus, chronic hepatitis, or thyroid disease. Information on potential breast cancer risk factors including body size, physical activity, and reproductive factors were obtained using a self-administered questionnaire. The phase of menstrual cycle at blood donation, categorized in early follicular, late follicular, peri-ovulatory, midluteal, or other luteal, was used for adjustment together with age. Estradiol level was significantly inversely associated with body mass index (BMI), while testosterone and DHEAS levels were significantly positively associated with BMI; the geometric mean of estradiol in women with BMI at or above 24 kg/m2 was about 25% lower than that in women with BMI below 18 kg/m2. The geometric means of testosterone and DHEAS were 31% and 24% higher, respectively, in women in the high BMI group. Nulliparous women had significantly higher testosterone levels than parous women. Breastfeeding was associated with decreased levels of testosterone and DHEAS. Physical activity, age at menarche, number of births, and age at first birth were not significantly associated with these hormone levels. A reduced breast cancer risk of obese premenopausal women may be due, in part, to a decreased estradiol level.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B117.
Abstract B118: Modifiable correlates of low testosterone in U.S. men
Authors: Corinne Joshu E. , Platz Elizabeth A.
Published: May 2012

Background: In some studies, men with low total, free, or SHBG-adjusted testosterone possibly had a higher risk of cancer death. Because testosterone replacement therapy for men with clinically low testosterone has an uncertain risk versus benefit ratio, identifying modifiable factors that influence testosterone level and that are public health targets is needed. Obesity (lower testosterone) and cigarette smoking (higher testosterone) are two behavioral factors that are recognized to influence testosterone levels; given the great magnitude of the adverse effects of cigarette smoking, it is not a prevention strategy. Thus, in this study we investigated obesity as well as dietary and lifestyle factors in association with low total and free testosterone.

Methods: The Third National Health and Nutrition Examination Survey (NHANES III), conducted 1988–1994, was a cross-sectional study of the U.S. civilian non-institutionalized population. Subjects participated in an interview, underwent a physical examination, and provided a blood specimen. Serum was available for 1470 men who participated in the morning session of Phase I (1988–1991) and were ≥20 years old. Testosterone and sex hormone binding globulin (SHBG) were measured by competitive electrochemiluminescence immunoassay. Free testosterone was estimated by mass action. We excluded men whose testosterone level was ≤2nd percentile because these men may have had congenital hypogonadism. We defined low total and free testosterone as ≤ 3.0 ng/mL and ≤ 0.07 ng/mL, respectively. We estimated the associations of the modifiable factors with low total and free testosterone using logistic regression adjusting for age and race/ethnicity.

Results: Measures of overall and central adiposity were positively associated with low total and free testosterone. After mutual adjustment, men with high waist circumference (ethnic specific cutpoints; vs. low) were 2.59 (95% CI: 1.12–6.00) times more likely to have low total testosterone and 2.65 (95% CI: 1.44–4.89) times more likely to have low free testosterone, whereas body mass index and percent body fat did not remain statistically significantly associated. Independent of waist circumference, percent of calories from protein, fruit and vegetable intake, alcoholic beverage consumption, and physical activity were not statistically significantly associated with low total and free testosterone. These results were similar in men who did not have comorbidities at time of blood draw and in non-smokers.

Discussion: Cross-sectionally, high waist circumference was the most consistent correlate of low total and free testosterone. These findings suggest that avoiding or reducing central adiposity may be one way to prevent clinically low androgen levels. Given that men with low androgens may have a higher risk of cancer death, our results may have import for cancer prevention and/or survival.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B118.
Abstract B12: Racial disparities in breast cancer treatment delay and type in three North Carolina counties
Authors: Vines Anissa I. , Nie Yonghong , Amos Keith
Published: May 2012

Objective: The purpose of this study was to explore racial disparities in delays in treatment and type of treatment received among breast cancer patients in three North Carolina counties represented in the Carolina Community Network to Reduce Cancer Health Disparities (CCN). The CCN is a regional community-based cancer network that aims to reduce prostate, breast and colorectal cancer disparities among adult African Americans in North Carolina.

Methods: North Carolina Central Cancer Registry data on black and white women diagnosed with breast cancer in Orange, Edgecombe, and Nash counties between 2000 and 2005 (n=1205) were used to obtained information on treatment and tumor status. Using standard guidelines for breast cancer care, delay in first course of treatment, type of treatment received, and tumor receptor status were assessed.

Results: Although within the recommended guidelines, treatment delay was longer for black breast cancer patients in comparison to white patients, regardless of stage at diagnosis. Treatment delay was highest for black patients in Edgecombe, a county with the highest proportion of blacks overall. Majority of stage I and II breast cancer patients received surgery and tended to elect for breast conservation surgery over mastectomy. Estrogen and Progesterone receptor negative breast cancers were more common in blacks than whites across the three counties, especially in Edgecombe County.

Conclusions: Our findings suggest treatment standards are not equivalently met among black and white women. Findings warrant further research into the identified treatment delays and tumor type differences to improve survival for black women, especially those in Edgecombe County. These preliminary results suggest that patients in Edgecombe County may have a higher prevalence of the hormone receptor negative phenotype of breast cancer. This more aggressive type of breast cancer may be attributing to the higher mortality rates in comparison to the other two counties.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B12.
Abstract B120: Metastatic differentiated thyroid cancer: Could we preview (and prevent) when the metastasis will develop? A recent experience from Brazilian Institute
Authors: Miasaki Fabíola Y. , Mesa Cleo O. , Paes Aline , Nakatani Viviane Y. , de Carvalho Gisah A. , Graf Hans
Published: May 2012

Since the new data about molecular signature of undifferentiated thyroid cancer suggest that they can develop from differentiated thyroid cancers (mainly those with BRAF mutations). The aim of this study was to identify clinical risk factors to metastasis development after the diagnosis and/or undifferentiation in non-medullary thyroid cancers. For this purpose, we follow up all 125 patients with non-medullary thyroid carcinomas who have been seen in our institution in the last 2 years. The data were collected and analyzed. From these patients, we identify 15 patients with distant metastasis: only one with anaplastic thyroid cancer. Between the differentiated thyroid carcinomas, 11 were female and 3 were male (3.1:1 ratio). Although the majority of differentiated thyroid carcinomas have a good prognosis, distant metastasis was found in the initial diagnosis in 9 of 14 patients (64.3%) with differentiated thyroid carcinomas. No correlation between type of tumor (follicular or papillary) and metastasis development was observed. All of them had received radioiodine therapy until clinical stabilization or the maximum dose allowed (638.57mCi ± 281.43). All the metastasis from differentiated thyroid carcinomas had uptake iodine. Although the majority of patients could not be considered cured, classic undifferentiation was not detected in these patients. The patient with anaplastic thyroid cancer had died in the first year of follow-up. Only one patient had died because COPD complications and all the others were still alive. Interestingly, 64.3% of patients had 9 or more years of survival until the present moment. Because we had few patients who developed metastasis after the diagnosis, we cannot valuate the meaning of our findings. However, since the majority of distant metastasis are present from the very beginning, it seems that the correct and precocious diagnosis of thyroid nodules and/or goiter prevent thyroid cancer progression.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B120.
Abstract B122: Multi-SNP analysis of one-carbon metabolism genes and prostate cancer outcomes
Authors: Zeigler-Johnson Charnita M. , Chang Bao-Li , Panossian Saarene , Spangler Elaine , Malkowicz S. Bruce , Rebbeck Timothy
Published: May 2012

Introduction: There is little known about the epigenetics of prostate severity. One-carbon metabolism genes in conjunction with folate and B-vitamins influence DNA repair mechanisms and methylation patterns. Better understanding of the relationship of gene activity that may potentially be altered by nutrient intake can provide new strategies for decreasing the prevalence of advanced prostate cancer. The goal of this project is to determine the association of one-carbon cycle genes in relation to prostate cancer outcomes.

Materials and Methods: We studied prostate cancer patients with one-carbon genotypes (604 European American, 92 African American.) The genes of interest included CBS, MTHFD1, MTHFR, MTRR, MTR, SHMT1, TYMS, SLC19A1 and TCN2. Data were analyzed with race stratification. Odds ratios (OR) were calculated by logistic regression models adjusted for age and percent African ancestry (African-Americans only.) These models were used to examine case-case associations analyzing tumor stage, grade and aggressiveness (high stage and high grade combined) and age at onset. Cox regression models were used to calculate hazard ratios (HR) for the incidence of biochemical failure after treatment. Multi-SNP associations were conducted in European American cases only using risk scores derived from the per allele ORs from a combination of 6 SNPs (MTHFD1 R653Q, MTHFR A222V, MTRR L333V, MTR D919G, SHMT L474F, TCN R259P) and 9 SNPs (the 6 mentioned previously plus CBS 68bp Ins, SLC19A1 61bpDel and Tyms 3UTRdel6.)

Results: Genotypes involved in one-carbon metabolism differed significantly by race. Among African-American cases, a significant protective association was found for SLC19A1 61bpDel for aggressive disease (OR=0.1, 95% CI=0.01–0.9, additive model.) Associations with biochemical failure in European Americans were observed for recessive carriage of MTR D919G (HR=2.8, 95% CI=1.1–7.3) and MTRR K350R (HR=4.3, OR=1.1–16.3, additive model.) In the multi-SNP model, biochemical failure was associated with the risk scores of 9 SNPs (HR=0.77, 95% CI=0.61–0.94.) No additional associations were observed for other clinical characteristics of prostate cancer.

Conclusions: These results suggest that one-carbon metabolism genotypes in combination may be associated with prostate cancer in specific subgroups. Multi-SNP models may provide more information than single SNP analyses for studying complex genetic pathways. Additional research of gene interactions and effects of nutrient intake may provide clues about prevention and treatment of prostate cancer, especially in groups at high risk for poor outcomes.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B122.
Abstract B123: Sequence variants in inflammatory genes, plasma antioxidants, and prostate cancer risk
Authors: Zhang Jianjun , Dhakal Ishwori , Greene Graham , Lang Nicholas , Kadlubar Fred
Published: May 2012

Background: Presence of xenotropic murine leukemia virus-related virus and chronic inflammation in prostate tumor tissue suggests that inflammation plays a role in prostate cancer etiology. This study thus investigated whether variants in genes involved in inflammation influence alone or interact with plasma antioxidants to influence prostate cancer risk in a population-based case-control study in Central Arkansas.

Methods: Cases (n=193) were men, ages 40–80 years, diagnosed with prostate cancer in three major hospitals in 1998–2003, and controls (n=197) were matched to cases by age, race, and county of residence.

Results: After adjustment for confounders, polymorphisms in COX2 (rs689466) and IL-8 (rs4073) were not significantly associated with prostate cancer risk. However, significant interactions were observed between these genetic variants and plasma antioxidants on the risk of this malignancy. The protective effect of the mutant allele of the COX polymorphism was more pronounced among subjects with high plasma levels of β-cryptoxanthin, lycopene, β-carotene, or selenium (≥median) [e.g., OR (95% CI): 0.37 (0.15–0.86) (AG/GG vs. AA) for β-cryptoxanthin]. Conversely, the promoting effect of the variant allele of the IL-8 polymorphism was more remarkable in subjects with low plasma levels of Lutein/zeaxanthin, β-cryptoxanthin, and β-carotene (<median) [e.g., OR (95% CI): 2.44 (1.08–5.75) (AT/TT vs. AA) for β-carotene].

Conclusions: We found that genetic variants in inflammatory genes interact with plasma antioxidants to modulate the risk of prostate cancer. The results obtained from our study need to be replicated in large epidemiologic studies.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B123.
Abstract B124: Genetic variants in sex hormone production, energy regulation and vitamin C and D uptake influence risk of non-Hodgkin's lymphoma
Authors: Skibola Christine F. , Conde Lucia , Halperin Eran , Agana Luz , Holly Elizabeth A. , Riby Jacques , Smith Martyn T. , Bracci Paige M.
Published: May 2012

Infectious and autoimmune diseases associated with B-cell lymphomas involve inflammation, chronic activation and proliferation of lymphocytes. Since most lymphomas develop in the absence of any known chronic antigenic stimulation, genetic polymorphisms may provide alternative means to exert proinflammatory responses that fuel lymphoproliferation and promote B-cell growth and survival that contribute to lymphoma risk. We have previously reported associations between non-Hodgkin lymphoma (NHL) risk and genetic polymorphisms in pathways involving sex hormone synthesis/metabolism, energy regulation, and uptake and metabolism of dietary nutrients. To further corroborate the relevance of these pathways and to identify additional risk loci, we used data from our recent genome-wide association study of NHL (748 cases, 811 controls) and conducted focused candidate gene/pathway analyses.

A number of SNPs in the estrogen related genes, ESR1, CYP17A1, CYP19A1, and HSD17B2, influenced risk of diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) in men and women. ESR1 encodes estrogen receptor 1 (ER) and regulates estrogen production by direct modulation of the CYP19A1 promoter. CYP17A1, CYP19A1 and HSD17B2 produce important enzymes involved in estrogen and testosterone synthesis. Estrogen and testosterone exert dose-dependent biphasic immunomodulatory effects. Thus, SNPs in these genes may mediate sex hormone levels and influence B-cell survival and growth characteristics, and possibly the potential for B-cells with pre-neoplastic lesions to undergo transformation.

Several SNPs in LEP and/or LEPR, involved in energy regulation, were associated with risk of FL and DLBCL. Leptin, the LEP gene product, is a proinflammatory adipokine that once bound to its receptor (LEPR) exerts immune-mediated responses including pro-survival signals to B-cells. SNPs in the vitamin C (SLC23A2) and vitamin D (VDR) receptor genes were associated with FL risk. Vitamin C is an antioxidant that may play a key role in preventing oxidative-stress related DNA damage and genotoxicity to B-cells. Vitamin D inhibits proliferation and induces lymphocyte differentiation. An inverse association with lymphoma risk and UV exposure supports a role for low vitamin D in lymphomagenesis. These studies provide further evidence for the important roles of sex hormones, leptin, and vitamins C and D in the etiology of lymphoma.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B124.
Abstract B125: Genomic methylation levels in white blood cell DNA among young girls
Authors: Wu Hui-Chen , Esther John M. , Keegan Theresa H. , Jennifer Ferris S. , Cruzata Lissette Delgado , Kappil Maya , Gonzalez Karina , Regina Santella M. , Beth Terry Mary
Published: May 2012

Lower levels of genomic DNA methylation in white blood cell DNA (WBC) have been observed in individuals with breast or other cancers. Genomic methylation in WBC has been also associated with risk factors for cancer in adulthood; data on the association with exposures earlier in life are limited. Using information from 31 girls 6 to 17 years of age from families enrolled in the Breast Cancer Family Registry, and 20 girls of similar age from families without breast cancer, we conducted a pilot study to examine whether genomic methylation in WBC is associated with selected breast cancer risk factors. Genomic methylation levels were measured by MethyLight for three repetitive elements (LINE1, Sat2M1 and AluM2), the luminometric methylation assay (LUMA), and LINE1-pyrosequencing. We found that age of menarche was inversely correlated with LINE1 MethyLight (r=−0.41, p=0.02) and pyrosequencing methylation (r=−0.48, p=0.01) levels. Girls with a body mass index (BMI, kg/m2) between 18.5 and 24.9 had lower methylation of LINE1 pyrosequencing compared with girls with higher or lower BMI values. Genomic methylation levels, measured by LUMA, AluM2 MethyLight, and LINE1 pyrosequencing, differed between girls with and without a family history of breast cancer. These data, if replicated in larger samples, suggest that breast cancer risk factors may be associated with genomic methylation in WBC in early life.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B125.
Abstract B127: Family history of breast cancer and risk of contralateral breast cancer
Authors: Reiner Anne S. , Begg Colin B. , Bernstein Leslie , Haile Robert W. , Knight Julia A. , Lynch Charles F. , John Esther M. , Capanu Marinela , Pike Malcolm C. ,   The WECARE Study Collaborative Group, Bernstein Jonine L.
Published: May 2012

Purpose: Family history of breast cancer increases a woman's risk of developing a first primary breast cancer. A meta-analysis of case-control studies of first primary breast cancer reported an increased risk associated with having an affected first-degree relative (OR=2.1, 95% CI=2.0–2.2), and the risk was even greater when subject and relative were diagnosed before age 50 (OR=3.3, 95% CI=2.8–3.9) (Int J Ca 1997;71:800–9). In this study, we examined family history of breast cancer as a risk factor for developing asynchronous contralateral breast cancer (CBC) and compared these risks to those from the aforementioned meta-analysis.

Methods: The Women's Environmental Cancer and Radiation Epidemiology (WECARE) Study is a case-control study including women from five population-based cancer registries: four in the US and one in Denmark. The 708 cases in this study were women with CBC and the 1399 individually matched controls were women with unilateral breast cancer (UBC). All participants were initially diagnosed between January 1985 and December 2000 at age 54 years or younger, and were queried about family history of breast cancer among female first- and second-degree relatives. Multivariable-adjusted rate ratios (RR) and corresponding 95% confidence intervals (CI) were calculated using conditional logistic regression.

Results: Compared with women who reported no affected relatives, women with at least one first-degree relative with breast cancer were at increased risk of developing CBC (RR=2.1, 95% CI=1.6–2.7); the risk was greater when more than one relative was affected (RR=2.6, 95% CI=1.5–4.6), and was nearly 4-fold (RR=3.9, 95% CI=2.3–6.4) for women having a relative diagnosed with CBC. The risk of CBC was 3.1 (95% CI=1.8–5.3) when both relative and subject were diagnosed before age 45. When the relative was diagnosed before age 45, regardless of subject age, the risk of CBC was 2.6 (95% CI=1.7–4.1). Similarly, when the subject was diagnosed before age 45, regardless of relative's age, the risk of CBC was 2.5 (95% CI=1.7–3.6).

Conclusions: The risk of developing CBC is increased among women with a family history of breast cancer, and this risk is significantly greater among those with an affected relative with bilateral cancer, having more than one affected relative, and having relatives affected at young ages. Our results comparing CBC cases to UBC controls were similar to studies where UBC cases are compared to population controls.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B127.
Abstract B132: Risk factors for uncommon histologically defined subgroups of breast cancer using the Breast Cancer Family Registry
Authors: Boedges Meghan W. , Andrulis Irene L. , John Esther M. , Hopper John L. , Knight Julia A. , Liao Yuyan , O'Malley Frances , Mulligan Anna Marie , Southey Melissa , Hibshoosh Hanina , Zhang Fang Fang , Terry Mary Beth
Published: May 2012

Breast cancer is a heterogeneous disease; risk factors may differ for histologically-defined subgroups. Because most breast cancers are of ductal or lobular histology, previous studies have been limited in their ability to evaluate risk factors in rarer histologies, such as medullary, mucinous, and tubular, due to small sample sizes. We evaluated risk factors for histologically-defined breast cancer subgroups (ductal, lobular, tubular, medullary, or mucinous) using population-based data from the Breast Cancer Family Registry. Data were available for 3260 incident breast cancer cases (including 92 cases of medullary, 90 cases of mucinous, and 86 cases of tubular histology) and 2997 unrelated controls. Several reproductive factors were associated with the risk of mucinous breast cancer, whereas cigarette smoking and body mass index (BMI) were associated with the risk of medullary breast cancer. For the mucinous subtype, we observed positive associations with nulliparity (OR=2.54, 95%CI 1.17–5.50) and age at first birth (OR=1.08, 95%CI=1.02–1.14, for each additional year of age), and an inverse association with age at menarche (≥13 vs. ≤11) (OR=0.52, 95%CI 0.29–0.94). These reproductive factors were not associated with other histologic subtypes. Mucinous cases were less likely than controls to have used oral contraceptives (OC use ≤ 5 years: OR=0.50, 95%CI 0.28–0.92; OC use > 5 years, OR=0.45, 95%CI 0.24–0.84), and these findings did not differ by menopausal status. Oral contraceptive use was also inversely associated with tubular histology among premenopausal women only (OC use > 5 years, OR=0.35, 95%CI 0.14–0.87), but was not associated with other histologic subtypes when compared with controls. Medullary histology was inversely associated with smoking status (former smoker vs. never smoker, OR=0.30, 95%CI 0.14–0.62), and positively associated with BMI (OR=1.05, 95%CI 1.01–1.09, for each one-unit increase in BMI). Other known breast cancer risk factors, such as hormone-replacement therapy (HRT), breastfeeding history, and alcohol use, were not associated with the any of the rarer subtypes. Family history of breast cancer was associated with increased risk of all histologic subtypes. If replicated, these findings suggest different patterns for selected breast cancer risk factors, such as parity, oral contraceptive use, and smoking, by tumor histology.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B132.
Abstract B133: Menopausal hormone therapy and colorectal cancer risk in the NIH-AARP Diet and Health Study cohort
Authors: Johnson Jill R. , Lacey James V. , Danforth Kim N. , Hollenbeck Albert R. , Schatzkin Arthur , Flood Andrew
Published: May 2012

Menopausal hormone therapy has been associated with a reduced risk of colorectal cancer yet few studies have evaluated cancer risk by specific formulations (i.e., estrogen versus estrogen plus progestin) or regimens (i.e., sequential versus continuous estrogen plus progestin). We prospectively analyzed colorectal cancer risk associated with duration and recency of specific menopausal hormone therapy formulations and regimens among 121,891 postmenopausal women participants of the National Institutes of Health-AARP Diet and Health Study. Hormone therapy use and other risk factors were ascertained through two questionnaires in 1995–1996 and 1996-1997. We used state cancer registry and vital status databases to identify 1,141 women who were newly diagnosed with invasive colorectal cancer during 653,774 years of follow-up. We used multivariable Cox proportional hazards regression to estimate relative risks (RRs) and 95% confidence intervals (95% CIs) of colorectal cancer relative to never-use of menopausal hormone therapy. Use of only unopposed estrogen was associated with a statistically significant 30% reduced risk of colorectal cancer (RR, 0.70; 95% CI, 0.56–0.87). The greatest risk reduction in estrogenonly users occurred among current, medium duration (6–9 years) users (RR, 0.49; 95% CI, 0.28-0.85). Women who used exclusively estrogen plus progestin had a marginally-significant 17% reduced risk of colorectal cancer (RR, 0.83; 95% CI, 0.68–1.00). The greatest risk reduction in this therapy formulation group occurred among current users of short duration (<5 years) (RR, 0.73; 95% CI, 0.52–1.04). With respect to regimen, both continuous (progestin ≥ 15 days per cycle: RR, 0.82; 95% CI, 0.65–1.03) and sequential (progestin < 15 days per cycle: RR, 0.84; 95% CI, 0.62–1.13) users of estrogen plus progestin had similarly reduced risks, neither of which was statistically significant. Among those on a continuous regimen, current use of short duration (<5 years) was associated with a statistically significant 45% reduced risk of colorectal cancer (RR, 0.65; 95% CI, 0.43–0.98). Our data indicate that both unopposed estrogen and estrogen plus progestin menopausal hormone therapies are associated with a reduced risk of colorectal cancer and that the degree of risk reduction varies by duration and recency of use.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B133.
Abstract B137: Cancer in population exposed to the Persian Gulf War
Authors: Mosavi-Jarrahi Alireza
Published: May 2012

Introduction: Two specific events that occurred during the Persian Gulf War made a severe impact on the environment of the region. In late January 1991, millions of barrels of crude oil were released into the Persian Gulf from tankers and oil terminals and Less than one month later, nearly 700 Kuwaiti oil wells, storage tanks, refineries and facilities were blown up and set on fire and sizeable amount of depleted uranium was introduced into the environment. The aim of this study was to examine the effect of exposure in the incidence cancer.

Methods: A cancer registry monitoring both cancer incidence and mortality was set up in the exposed population (provinces bordering Iraq) and unexposed population (provinces located where no exposures were documented, eastern part of the country). The cancer specific incidence and mortality ration was calculated for the exposed and unexposed.

Results: Apart from the cancers of stomach, prostate, colon and breast, the solid tumors of lung, liver were relatively and unexpectedly more frequent than other cancer sites in the exposed population compared with unexposed. In female the average rate ration for Lymphoma was as high as 3.5 but in the male this figure was 1.4. No differences in Leukemia were seen in male but the female experienced in average 40% more risk of leukemia in comparison with the females in the non exposed area. Different cancer sites were examined. And wide ranges of varation were seen in terms of mortality or morbidity ratios.

Conclusion: The highly diverse nature of the exposure has imposed a certain degree of cancer risk to the population exposed.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B137.
Abstract B138: Chronic lead exposure: A cause of the current breast cancer epidemic in Nigerian women?
Authors: Alatise Olusegun I. , Schrauzer Gerhard N.
Published: May 2012

Objective: Breast cancer is the most common cancer in Nigeria women. The continuing rise of the breast cancer incidence in Nigerian women suggested contaminations of the soil and water supplies by industrial metals as a major contributing cause. Within this context, lead (Pb) is of particular concern, as it is one of the chief environmental pollutants in Nigeria and is known to promote tumorigenesis by abolishing the cancer-protecting effects of selenium (Se). We assess the possible effect of lead on the occurrence of breast cancer in Nigerian patients.

Patients and Methods: Twelve consenting patients with breast cancer seen at Obafemi Awolowo University were recruited into the study. The hair and fasting blood samples were taken for analysis using ICP-MS method. Samples from twelve age-matched controls were also analyzed.

Results: Consistent with this hypothesis, high and occasionally excessive levels of Pb were detected in blood and scalp hair of Nigerian women with and without breast cancer. These levels were sufficient to overwhelm the anti-carcinogenic effects of Se.

Conclusions: In the clinical setting, multi-element hair analysis provides a non-invasive means of assessing toxic metal exposures, cancer risk and disease progression. Any program of reducing breast cancer risk in Nigerian women thus must include effective measures to reduce the toxic metal burden of the population.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B138.
Abstract B141: The risk of breast cancer among women who start smoking as teenagers
Authors: Odiase Emmanuel O.
Published: May 2012

Goal: To examine the effect of smoking on breast cancer risk in a large population-based cohort of women, many of whom started smoking as teenagers.

Methods: We followed 102,098 women, ages 30 to 50 years, completing a mailed questionnaire at recruitment to the Nigerian-Kenyan Cohort Study in 1995/1996, through December 2004. We used Cox proportional hazard regression models to estimate relative risk (RR) of breast cancer associated with different measures of smoking initiation, duration, and intensity adjusting for confounding variables. We conducted analyses on the entire study population, among women who had smoked for at least 20 years, among non drinkers, and separately for each country.

Results: Altogether, 1,240 women were diagnosed with incident, invasive breast cancer. Compared with never smokers, women who smoked for at least 20 years and who smoked 10 cigarettes or more daily had a RR of 1.34 (95 CI, 1.06–1.70). Likewise, those who initiated smoking prior to their first birth (1.27, 1.00–1.62), before menarche (1.39, 1.03–1.87), or before age 15 (1.48, 1.03–2.13) had an increased risk. In contrast, women who had smoked for at least 20 years, but started after their first birth, did not experience an increased breast cancer risk. The increased RR associated with smoking was observed among nondrinkers of alcohol, women with and without a family history of breast cancer, premenopausal and postmenopausal women, and in both countries.

Conclusion: Our results support the notion that women who start smoking as teenagers and continue to smoke for at least 20 years may increase their breast cancer risk.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B141.
Abstract B142: The risk level of liver cancer cases among smokers in developing countries
Authors: Odiase Emmanuel O.
Published: May 2012

Introduction: Tobacco use is a rising concern for the developing world. It causes about 5million deaths yearly and is projected to cause 10 million deaths yearly by 2025 with 80% of these deaths from the developing countries if current trends continue. Tobacco is also a majo risk factor for all kinds of cancer including Liver cancer.

Goal: To help determine whether the risk of liver cancer from smoking was less or greater than other forms of cancers caused by tobacco.

Methods: In this study, we ascertained retrospectively the smoking habits of 24,000 adults who had died from liver cancer (cases) in 10 Chines cities, 7 Indian Cities and 5 Nigerian Cities. These areas were choosen for reasons of high population. Smokers from these three countries constitute 40% of smokers worldwide. Calculations of the smoker risk ratios (RR) for liver cancer mortality were standardised for age and locality. We used Cox proportional hazard regression models to adjust for confounding variables. We conducted analyses on the entire study population, among male and females who had smoked for at least 20 years separately for each country.

Results: Among adult men (aged 35+) there was a 36% excess risk of death from liver cancer (smoker standardised risk ratio [RR] =1.36, with 95% confidence interval [Cl] 1.29–1.43, 2p<0.00001; attributable fraction 18%). In the general male population, this indicates absolute risks of death from liver cancer before age 70 of about 4% in smokers (in the absence of other causes). The RR was approximately independent of age, was similar in urban and rural areas, was not significantly related to the age when smoking started but was significantly (p<0.001) greater for cigarette smokers than for smokers of other forms of tobacco. Among men who smoked only cigarettes, the RR was significantly (p<0.001 for trend) related to daily consumption, with a greater hazard among those who smoked 20/day (RR 1.50, 95% CI 1.39–1.62) than among those who smoked fewer (mean 10/day: RR=1.32, 95% Cl 1.23–1.41). Smoking was also associated with a significant excess of liver cancer death in women (RR 1.17, 95% CI 1.06–1.29, 2p=0.003; attributable fraction 3%), but fewer women (17%) than men (62%) were smokers, and their cigarette consumption per smoker was lower. Among women who smoked only cigarettes, there was a significantly greater hazard among those who smoked at least 20/day (mean 22/day: RR=1.45, 95% Cl 1.18–1.79) than among those who smoked fewer (mean 8/day: RR=1.09, 95% Cl 0.94–1.25).

Conclusion: This study goes to show that even though liver cancer from tobacco use kills about 200,000 people yearly in these three developing countries, the deaths from lung cancer (1.5 million yearly worldwide) is still higher than liver cancer deaths.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B142.
Abstract B145: The role of biomarkers of risk and smoking cessation
Authors: Hopkins Raewyn , Eaton Tam , Young Robert
Published: May 2012

Smoking prevalence fell steeply after the 1960s when smoking was linked to lung cancer through epidemiological studies, which is long before public health measures were adopted. It is generally accepted that although most smokers want to quit, their smoking habit is maintained by the combination of addiction and optimistic bias (denial). Smokers demonstrate varying degrees of optimistic bias, the belief that complications of smoking will affect other smokers but not them. A new paradigm in smoking cessation called the 3Ts encompasses Tension, Trigger and Treatment. Motivational tension is the state of anxiety a smoker feels about their smoking. This tension can be elevated by triggers (teachable moments) such aswhich might be a health scare highlighting their vulnerability to smoking the complications of smoking and thereby undermining the optimistic bias. There is growing evidence that smokers respond to triggers by quitting, with at greater quit rates being relative to theaccording to the severity of the trigger. Quit rates in smokers are as high as 50–60% after a heart attack or diagnosis of lung cancer. Triggers may also involve the assessment of risk for a future life threatening event. Older smokers cite fear of future poor health as the most important trigger to quitting. Advances in genetic technology hasAdvances in genetic technology have revealed a number aof genetic variants that are associated with lung cancer susceptibility and that in combination (several susceptibility variants and along with clinical variables), identifies identify those smokers who are at greatest risk. There is growing evidence that personalized genomics information is accepted by lay people, promotes positive treatment changes by doctors and helps smokers to quit. There is also data to suggest that smokers taking these susceptibility tests are not de-motivated from quitting by taking the results of these tests. The paper will present data to support these claims suggesting personalized genomics could assist existing public health measures to promote smoking cessation. Such a personalized approach has been successfully used in the risk factor modification of coronary risk factors and significant reduction in coronary mortality over the last 2 decades.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B145.
Abstract B16: The influence of cultural beliefs on breast cancer risk factor knowledge of women in Kumasi, Ghana
Authors: Williams Michelle S. , Kuffuor George , Ekuadzi Edmund , Ampem Prince Tuffuor , Brandt Heather M. , El-Duah Miriam , Korang-Yeboa Maxwell , Messias DeAnne
Published: May 2012

Background and Significance: Breast cancer is the second leading cause of cancer death among women in Ghana, West Africa. Previous studies of breast cancer among women in Ghana indicate that 70 – 80% of women who seek treatment for breast problems are diagnosed with Stage III and IV breast cancer tumors. The objectives of this study were to determine 1) the knowledge of general cancer risk factors, and 2) the knowledge of general cancer signs and symptoms among women in Kumasi, Ghana; and 3) to identify cultural factors that influence their beliefs about breast cancer risk factors.

Methods: Semi-structured interviews were conducted using a questionnaire with 53 qualitative and quantitative items. Female residents (n=220) of Kumasi, Ghana where selected to participate in the study. A purposive sampling plan was designed to ensure that women with breast or cervical cancer (n = 49) where included in the study. Interviews where conducted in public areas, the Peace and Love Hospital, and the Komfo Anokye Teaching Hospital. Comparative and descriptive statistics were used analyze the data.

Results: Findings indicated that the respondents' cancer risk factor knowledge was relatively low (mean score 2.91; range 0 – 5) and the difference in the cancer risk factor knowledge scores of women with various levels of education was not statistically significantly different. The overall knowledge of cancer signs and symptoms was also low (mean score 2.19; range 0 –6). In addition, cultural beliefs had an influence on women's beliefs about the risk factors for breast cancer e.g. 10.9% of respondents indicated that money in the bra causes breast cancer.

Conclusions: There is a wide-spread lack of accurate knowledge of general cancer risk factors and cancer signs and symptoms. There is a need for a mass breast cancer education intervention. Inaccurate cultural beliefs must be addressed to correct misconceptions about the causes of breast cancer.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B16.
Abstract B21: Depression and quality of life in breast cancer survivors: 6–13 years postchemotherapy
Authors: ReyesGibby Cielito C. , Anderson Karen , Morrow P.K. , Buzdar Aman , Shete Sanjay , Hassan Sohela
Published: May 2012

Background: Advances in breast cancer treatment have markedly prolonged survival time. This study examines the prevalence of and risk factors for depression and its impact on quality of life in breast cancer patients 6–13 years post-treatment.

Method: The Patient Health Questionnaire (PHQ-8) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were mailed to assess depression and quality of life, respectively, in breast cancer patients who participated in clinical trials for paclitaxel chemotherapy treatment between 1994 and 2001.

Results: Two hundred forty patients participated (56% response rate). The years since treatment were between 6–13 years (mean= 7.9 and median=8). The mean score on the PHQ-8 scale was 4 points (SD=4.8; median=2.0) which decreased by years since treatment (Kruskal-Wallis, p< 0.001). Prevalence of depression (PHQ score ≥10) was 16%. Reports of depression decreased every year from treatment by as much as 30%. Depression had a negative impact on quality of life measures (function, symptoms, financial and global health), irrespective of years from treatment. Logistic regression showed that younger age (OR age in years= 0.92; 95% Confidence Interval [C.I.] = 0.86, 0.99; p<0.02), rheumatoid arthritis (OR=8.4; 95%C.I.=1.3–57.4; p<0.03) and years from treatment (OR=0.70; 95% C.I.=0.46–0.99; p<0.05) were significant predictors of depression.

Conclusion: While reports of depression decreased over the survival period, it remains a significant health concern for breast cancer survivors. The results suggest the need to monitor patients and provide resources for monitoring and treatment of depression within the clinical oncology setting.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B21.
Abstract B23: Evaluating an intervention to improve perceptions of cancer clinical trials among minority communities in South Carolina
Authors: Ford Marvella E. , Wahlquist Amy E. , Blake Rashell , Streets June , Johnson Erica , Sweat Melanie A. , Johnson Shannon , Garrett-Mayer Elizabeth
Published: May 2012

Objective: Cancer mortality rates for African Americans in South Carolina are among the highest in the nation. However, African Americans are less likely than other groups to participate in cancer clinical trials. Results of previous investigations have shown that their low participation rates are related to negative perceptions of trials. We conducted a community based cancer clinical trials education intervention to improve perceptions of cancer clinical trials in this population.

Methods: The study was conducted at eight different sites in six counties in South Carolina. The intervention consisted of a 30-minute cancer clinical trials educational presentation developed by the National Institutes of Health/National Cancer Institute. The intervention was part of a larger 3.5-hour education program aimed at increasing general cancer knowledge, prostate cancer knowledge, and perceived self efficacy in patient-physician interaction among minority populations in South Carolina. Study participants were recruited by community partners in each locale where the training sessions were conducted. A pre- and post-intervention survey was administered immediately before and after the intervention was delivered at each site. The survey instrument included seven items. Sample items include the following: Do you think that patients should be asked to take part in medical research? Would you be prepared to take part in a study comparing different treatments? Would you be prepared to take part in a study where treatment was chosen at random?

Results: The study sample consisted of 164 predominantly African American participants. One-hundred and twenty-five (78.6%) of the 159 participants who provided data on race were African American, 19 (12.0%) were Caucasian and 15 (9.4%) were Native American. The majority of the 160 participants who provided data on age were ages 50+ years (62.5%). The majority of the 154 participants who reported their income had an annual household income > = $40,000 (53.8%). For each of the seven survey items assessing perceptions of cancer clinical trials, 74%, 69%, 56%, 49%, 61%, 50% and 58% of the participants, respectively, changed to more favorable responses on the post-test vs. pre-test. All results were statistically significant at the p<0.001 level.

Conclusions: Providing cancer clinical trials information to African American community members positively influenced their trial perceptions. Future research could incorporate a longer follow-up assessment period.

Citation Information: Cancer Prev Res 2010;3(1 Suppl):B23.