bluuebunny/crossref_metadata_2025_split huggingface dataset:
Misconceptions about Breast Lumps and Delayed Medical Presentation in Urban Breast Cancer Patients
Authors: Rauscher Garth H. , Ferrans Carol Estwing , Kaiser Karen , Campbell Richard T. , Calhoun Elizabeth E. , Warnecke Richard B. 
Published: March 2010

Abstract
Background: Despite current recommendations for women to be screened for breast cancer with mammography every 1 to 2 years, less than half of all newly diagnosed breast cancers are initially detected through screening mammography. Prompt medical attention to a new breast symptom can result in earlier stage at diagnosis, yet many patients delay seeking medical care after becoming aware of a breast symptom.
Methods: In a population-based study of breast cancer, we examined factors potentially associated with patient delay in seeking health care for a breast symptom among 436 symptomatic urban breast cancer patients (146 white, 197 black, and 95 Hispanic). Race/ethnicity, socioeconomic status, health care access and utilization, and misconceptions about the meaning of breast lumps were the key independent variables.
Results: Sixteen percent of patients reported delaying more than 3 months before seeking medical advice about breast symptoms. Misconceptions about breast lumps and lacking a regular provider, health insurance, and recent preventive care were all associated with prolonged patient delay (P &lt; 0.005 for all). Misconceptions were much more common among ethnic minorities and women of lower socioeconomic status.
Conclusion: Reducing patient delay and disparities in delay will require educating women about the importance of getting breast lumps evaluated in a timely manner and providing greater access to regular health care. Cancer Epidemiol Biomarkers Prev; 19(3); 640–7
Antioxidant Micronutrients and Biomarkers of Oxidative Stress and Inflammation in Colorectal Adenoma Patients: Results from a Randomized, Controlled Clinical Trial
Authors: Hopkins Myfanwy H. , Fedirko Veronika , Jones Dean P. , Terry Paul D. , Bostick Roberd M. 
Published: March 2010

Abstract
Previous epidemiologic observational and experimental studies investigated the potential of antioxidant micronutrients to modulate cancer risk, but these studies produced inconsistent results. In this pilot, randomized, double-blind, placebo-controlled clinical trial (n = 47), we assessed the effects of an antioxidant micronutrient combination (800 mg dl-α-tocopherol acetate, 24 mg β-carotene, 1.0 g vitamin C, 200 μg l-selenomethionine, 7.2 mg riboflavin, 80 mg niacin, 60 mg zinc, 5 mg manganese) given daily over 4 months on oxidative and inflammatory biomarkers in patients with a history of sporadic colorectal adenoma. Plasma tumor necrosis factor-α (TNF-α), interleukin-6, and F2-isoprostane concentrations were measured using ELISAs, and cystine (CySS) was measured using high-performance liquid chromatography. Plasma TNF-α concentration decreased in the active treatment group by 37% relative to the placebo group (P = 0.002), and CySS decreased by 19% (P = 0.03); however, interleukin-6 and F2-isoprostane concentrations decreased in antioxidant-treated nonsmokers but increased in smokers, although these findings were not statistically significant. The decreases of TNF-α and CySS were more pronounced in nonsmokers. These data suggest that (a) an antioxidant micronutrient cocktail can modulate biomarkers of oxidative stress and inflammation in humans and (b) the effects of antioxidant micronutrient supplementation on biomarkers of inflammation and oxidative stress may differ according to smoking status. Cancer Epidemiol Biomarkers Prev; 19(3); 850–8
Breast Cancer and Urinary Biomarkers of Polycyclic Aromatic Hydrocarbon and Oxidative Stress in the Shanghai Women's Health Study
Authors: Lee Kyoung-Ho , Shu Xiao-Ou , Gao Yu-Tang , Ji Bu-Tian , Yang Gong , Blair Aaron , Rothman Nathaniel , Zheng Wei , Chow Wong-Ho , Kang Daehee 
Published: March 2010

Abstract
Polycyclic aromatic hydrocarbon (PAH) exposure and oxidative stress from such and other exposures have been associated with breast cancer in some studies. To further evaluate the role of PAH metabolites and oxidative stress on the development of breast cancer, we conducted a nested case-control study in the Shanghai Women’s Health Study.
We measured urinary 1-hydroxypyrene and 2-naphthol as PAH metabolites and urinary levels of 8-hydroxy-2′-deoxyguanosine and malondialdehyde as oxidative stress biomarkers in 327 breast cancer cases and 654 controls in the Shanghai Women’s Health Study. Information on demographic characteristics, past medical history, lifestyles, history of menstruation, pregnancy history, eating and drinking habit, history of residence, employment history, family history, husband’s information, and physical activity were collected by a self-administered questionnaire.
The mean age was 52.3 in breast cancer cases (n = 354) and 52.5 in controls (n = 708). Age at menarche (P = 0.04), months of breast-feeding the first baby (P = 0.05), and grade of education (Ptrend &lt; 0.01) were significantly different between cases and controls. No association was observed for PAH metabolites and the oxidative stress biomarkers of urinary malondialdehyde and 8-hydroxy-2′-deoxyguanosine and risk of breast cancer.
This nested case-control study provides no evidence of association between PAH exposure and oxidative stress and risk of breast cancer in Shanghai women. Cancer Epidemiol Biomarkers Prev; 19(3); 877–83
Coherence and Completeness of Population-based Family Cancer Reports
Authors: Wideroff Louise , Garceau Anne O. , Greene Mark H. , Dunn Marsha , McNeel Timothy , Mai Phuong , Willis Gordon , Gonsalves Lou , Martin Michael , Graubard Barry I. 
Published: March 2010

Abstract
Background: Although family history of cancer is widely ascertained in research and clinical care, little is known about assessment methods, accuracy, or other quality measures. Given its widespread use in cancer screening and surveillance, better information is needed about the clarity and accuracy of family history information reported in the general population.
Methods: This telephone survey in Connecticut examined coherence and completeness of reports from 1,019 respondents about 20,504 biological relatives.
Results: Of 2,657 cancer reports, 97.7% were judged consistent with malignancy (versus benign or indeterminate conditions); 79% were site specific, 10.1% had unspecified cancer sites, and 8.6% had “ill-defined” sites. Only 6.1% of relatives had unknown histories. Unknown histories and ambiguous sites were significantly higher for second-degree relatives. The adjusted percentage of first-degree relative reports with ambiguous sites increased with decreasing education and African-American race of survey respondents, and with deceased vital status of relatives. Ambiguous second-degree relative reports were also associated with deceased vital status and with male gender of respondents.
Conclusions: These findings suggest that family history of cancer reports from the general population are generally complete and coherent.
Impact: Strategies are needed to improve site specificity and thus maximize the utility of such information in primary care settings. Cancer Epidemiol Biomarkers Prev; 19(3); 799–810
Up-regulation of Endothelin-2 as a Common andEarly Event in localized Clear Cell Renal Cell Carcinoma
Authors: Parker A , Bot B , LeGrand S , Eckel-Passow J 
Published: March 2010

Abstract
Purpose: Despite incidence rates that have been rising for decades, the molecular underpinnings that support the development of clear cell renal cell carcinoma (ccRCC) remain unclear. Herein, we evaluate expression levels of the hypoxia-induced autocrine survival factor endothelin-2 (EDN2) in patient-matched ccRCC and normal kidney samples.
Methods: We identified 169 patients who underwent nephrectomy for histologically confirmed, localized ccRCC at our institution from 2000 to 2003 and had fresh-frozen tumor and normal kidney samples available. After mRNA was extracted from microdissected tissue, we conducted real time PCR to determine expression levels of EDN2. We normalized the expression data using four control genes and then fit linear mixed models to evaluate differential expression between tumor and normal samples. In addition, we explored potential interactions with relevant clinicopathologic characteristics including tumor stage and grade.
Results: Of the 161 patients analyzed, 65% were male, 58% were stage pT1, and 43% were nuclear grade 1 or 2. Overall, EDN2 expression was higher in tumor samples compared to paired normal samples with an average fold change (FC) of 2.0 (P-value &lt; 0.0001). This over-expression in tumor versus normal tissue was apparent in early stage (pT1) tumors but not later stage (pT2, pT3) tumors (FC of 2.9 v. 1.1 respectively; interaction P-value = 0.001). Similarly, over-expression was more pronounced in low grade (1, 2) tumors compared to high grade (3, 4) tumors (FC of 3.5 v. 1.3 respectively; interaction P-value = 0.0002).
Conclusions: While independent validation is required, our patient-based data suggest that up-regulation of EDN2 is a common and early event in localized ccRCC. If confirmed in future studies, EDN2 could represent a target for the development of novel chemopreventive or neo-adjuvant therapeutics for ccRCC.
Circulating 25-Hydroxyvitamin-D and Risk of Colorectal Adenomas and Hyperplastic Polyps
Authors: Adams S , Newcomb P , Burnett-Hartman A , Mandelson M , Potter J 
Published: March 2010

Abstract
Background: Colorectal adenomas are clear precursors of cancer; hyperplastic polyps have recently been hypothesized to also have malignant potential. However, these two distinct colorectal lesions are probably on different molecular pathways to neoplasia. An inverse association between vitamin D and adenoma risk has been reported, but this is the first study, to our knowledge, that examines circulating 25(OH)D in relation to risk of hyperplastic polyps.
Methods: We conducted a colonoscopy-based case-control study of adenomas and hyperplastic polyps among 474 members of a large integrated health plan. Self-administered questionnaires provided data on demographics and colorectal polyp risk factors, and we assayed plasma samples donated by participants at the time of the colonoscopy for total 25-hydroxyvitamin-D (25(OH)D) concentration. Polytomous regression was used to estimate separate odds ratios for adenomas (n = 153) and hyperplastic polyps (n = 91) by tertile of 25(OH)D.
Results: An inverse association between 25(OH)D and adenomas was observed (comparing upper to lower tertiles: adjusted OR [95%CI]: 0.60 [0.34-1.08]). After restriction of the analyses to study participants with no history of polyps, this OR estimate moved further from the null and became statistically significant (adjusted OR [95%CI]: 0.43 [0.20-0.96]). In comparison, no statistically significant association between hyperplastic polyps and 25(OH)D was observed among the full study participants (adjusted OR [95%CI]: 1.12 [0.59-2.13]) nor among those without prior polyps (adjusted OR [95%CI]: 1.27 [0.57-2.35]).
Conclusions: There is no evidence in our study that the established inverse association between circulating 25(OH)D and colorectal adenoma applies to hyperplastic polyps.
PACE+ Nutrition and Exercise Counseling for Obese Patients Based on Stage of Change at an Urban Primary Care Clinic
Authors: Sun G , Peechakara S , Thomas CL , Seeholzer EL 
Published: March 2010

Abstract
Background: Obesity screening and behavioral counseling for adults is recommended but rarely feasible to reduce the risk of developing cancer and many chronic diseases. We intiated obesity screening at an urban clinic and offered obese patients tailored counseling using PACE+, a validated tool designed for the primary care setting.
Aim: To evaluate obesity screening rates, readiness to change, preferences for change and change in BMI in patients counseled with PACE+.
Methods: Electronic medical record (EMR) review of patient data from May 2006 to March 2008. Analyses comparing stage of change to patient characteristics was conducted using the Cochran-Armitage Trend Test. Bivariate comparisons of the continuous items were analyzed using the Chi-square.
Results: Of 5,390 patients in the clinic practice, 2532 (47%) were obese, 2269 (42%) were normal or overweight, and 589 (11%) were not screened. PACE+ educators counseled 843 obese patients (33%) May 2006-March 2008. Mean age 50, mean BMI 39, 79% female and 98% African American. 31% of PACE+ participants had hypertension, diabetes mellitus and hyperlipidemia. Stage of change for exercise was most often contemplation (38%) and preparation (40%). The preferred activity was walking (62%). Most cited reasons to change behavior were to lower blood pressure, improve health, reduce weight, and increase energy. Most reported activity barriers were pain (20%), weather (13%), and time (10%). Most patients rated their stage of change for reducing calories as preparation (62%). Anticipated nutrition adherence barriers were “will-power,” cost, and time. Participants rated their self-confidence for activity and dietary changes highly. A trend to weight stabilization and weight loss was observed with follow-up.
Conclusion: Obesity screening and a structured low-intensity behavioral counseling by educators was feasible and reached 33% of obese patients in the practice. PACE+ evaluation in the EMR provides retrievable and measurable information about patient stage of change, preferences and perceived adherence barriers. This data can direct efforts to link community and personal resources to optimize behavioral and weight outcomes. Pain cited as an activity barrier by 20% needs further study.
Associations of Telomere Length and Diabetes with Pancreatic Cancer
Authors: Skinner H , Gangnon R , Chari S , Johnson R , Boardman L 
Published: March 2010

Abstract
Risk for pancreatic cancer increases strongly with older age, and diabetic conditions have been consistently associated with pancreatic cancer, although the temporal relation between diabetes and pancreatic cancer remains uncertain. Telomeres are complexes of proteins and hexameric DNA repeats that cap and protect the ends of chromosomes. Telomere length decreases with subsequent cell divisions and the length of telomeres in peripheral blood leukocytes (PBL) has been observed to be shorter with older age, and shorter among cases of several cancer types than in controls. We conducted a hospital-based case-control study with 500 cases of pancreatic cancer, and 1,000 controls without pancreatic cancer (500 diabetic and 500 non-diabetic). We examined associations between PBL telomere length and pancreatic cancer status using generalized additive models (GAM), adjusting for age, body mass index, and gender. We observed significant heterogeneity in the association between PBL telomere length and pancreatic cancer by fasting blood glucose status (P &lt; 0.003). Among those with impaired fasting blood glucose (&gt;100 mg/dL) there was a continuous inverse association between pancreatic cancer and telomere length in the GAM adjusted for age, body mass index, sex, and cigarette smoking status. The adjusted odds ratio for pancreatic cancer comparing the 10th percentile of telomere length (4,184 bp) to the 90th percentile (7,823 bp) was 3.21 (95% C.I. 1.87, 5.52). In contrast, no significant association was found between telomere length and pancreatic cancer status among those with normal fasting blood glucose (OR = 0.67; 95% C.I. 0.39, 1.05; comparing 10th to 90th percentiles). We did not find strong evidence for effect modification of the relation between PBL telomere length and pancreatic cancer by age, gender, or cigarette smoking status. Shorter telomeres in peripheral blood may portend higher risk for pancreatic cancer among those with impaired fasting blood glucose, or may indicate cases who are more likely to have tumors that result in diabetes.
Expression of Inflammatory Molecules Among Breast Cancer Patients Receiving Different Chemotherapies:Implications for Chemobrain
Authors: Janelsins M , Roscoe J , Mustian K , Palesh O , Peppone L , Sprod L , Morrow G 
Published: March 2010

Abstract
Increased levels of MCP-1, IL-8 and IL-6 are associated with mild cognitive impairment, defined as frequent and irregular bouts of forgetfulness, difficulties with attention and/or difficulties with language-a condition with comparable symptomology reported by cancer patients experiencing chemobrain. High levels of these molecules may compromise neuronal and synaptic integrity, leading to cognitive impairment. Patients receiving doxorubicin-based (with cyclophosphamide, or cyclophosphamide and fluorouracil; AC/CAF) chemotherapy or a combination of cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy report experiencing chemobrain, but MCP-1, IL-8 and IL-6 may be differentially influenced by these regimens. The purpose of this study was to examine changes in expression of these molecules among breast cancer patients (N = 54) receiving combinations of AC/CAF or CMF. Changes in MCP-1, IL-8 and IL-6 were assessed at baseline (T1) and after 2 chemotherapy cycles (T2). T-tests were used to compare between group and within group differences on raw means and mean change (T2-T1). IL-6 significantly increased in the AC/CAF group (4.95 pg/mL,SEM = 2.31;P &lt; 0.05), but MCP-1 (42.8 pg/mL;SEM = 40.36) and IL-8 (0.25 pg/mL;SEM = 1.19) did not. IL-6 (−1.46 pg/mL,SEM = 0.94), MCP-1 (−15.8 pg/mL,SEM = 49.95) and IL-8 (−0.79 pg/mL,SEM = 1.04) all decreased in the CMF group; however, none of these changes were significant. No significant differences in IL-6 (1.06 pg/mL, SEM = 1.05), MCP-1(73.48 pg/mL, SEM = 67.30), or IL-8 (−1.95 pg/mL, SEM = 3.28) at T1 were observed between AC/CAF and CMF groups. At T2, there was a significant difference in IL-6 (7.72 pg/mL,SEM = 3.82; P ≤ 0.05) between AC/CAF and CMF groups, but not in MCP-1 (131.91 pg/mL,SEM = 87.09) or IL-8 (5.72 pg/mL,SEM = 4.0). A significant change (T2-T1) in IL-6 (6.41 pg/mL,SEM = 2.57;P &lt; 0.05) between AC/CAF and CMF groups was observed. Changes in MCP-1 (58.65 pg/mL,SEM = 63.94) and IL-8 (1.08 pg/mL,SEM = 1.58) between groups were not significant. These results suggest AC/CAF and CMF chemotherapy regimens elicit distinct inflammatory response patterns in MCP-1, IL-8 and IL-6 suggesting different mechanisms may be responsible for the development of chemobrain. Future research is needed to confirm these findings. Funding:NCI R25CA10618.
Focus on Survivorship: Refining Complete Prevalence Estimates Using Local Cancer Registry Data
Authors: Wobker S , Yeh W , Carpenter W 
Published: March 2010

Abstract
Purpose: This study applies NCI's ComPrev software to ten years of North Carolina Central Cancer Registry (NCCCR) data to demonstrate the added value of using complete prevalence (CP) methods to estimate cancer prevalence compared with the prior standard, limited-duration prevalence (LDP).
Methods: All cases for years 1995-2004 were obtained from the NCCCR and merged with vital status and date of death from the NC State Center for Health Statistics' vital statistics to form the “case data.” Population data for four expanded races and individual ages, originally from the U.S. Census Bureau, were obtained from the SEER program. Case and population data were integrated using SEER*Prep software. SEER*Stat software was used to calculate 10-year LDP based on first primary cancer as of January 1, 2005. ComPrev software was subsequently used to convert LDP into CP for each cancer site, gender, and race combination. CP applies a completeness index based on incidence and survival to adjust for underascertainment of cases due to limited years of surveillance, providing a more accurate estimate of survivor burden.
Results: LDP methods estimated 228,457 cancer survivors living in NC as of January 1, 2005. CP methods estimated 371,537 individuals living with cancer, 63% more than LDP estimates. Compared to cancers with typically short survival duration or later age at diagnosis, cancers of greater survival duration or earlier age at diagnosis tended to have greater difference between LDP and CP estimates. Breast, prostate, colorectal, and melanoma comprise 205,747 (55%) of the cancer survivors in NC as estimated by CP methods.
Conclusions: The number of cancer survivors in the US is expected to grow from the 2006 estimate of &gt;11 million, and more refined prevalence estimates are needed for survivorship planning. In North Carolina, the commonly used method of LDP based on SEER data underestimates the survivor burden by nearly 40%. Regional, gender-based, and racial differences suggest local programs should understand their community's prevalent cancer population when prioritizing local survivorship services. Future analysis will use MIAMOD methods as a supporting method of estimating CP, and updated case data to generate January 1, 2008 prevalence estimates.
Neighborhood Socio-Economic Status and Individual Smoking Status Interact to Predict PAH-DNA Adduct Levels in Prostate Tissue
Authors: Richards C , Rybicki B , Tang D , Neslund-Dudas C , Rundle A 
Published: March 2010

Abstract
Background: We extend our work studying environmental and genetic determinants of polycyclic aromatic hydrocarbon (PAH) DNA adducts in radical prostatectomy specimens, to consider cross-level interactions between cigarette smoking and indicators of neighborhood level socio-economic status.
Methods: PAH-DNA adducts were measured in 397 prostatectomy specimens from the Henry Ford Health System using immunohistochemistry with image analysis to measure staining intensity in optical density units. Subjects' home addresses were geo-coded to Census tracts and linked to 2000 Census data. Tracts were classified for educational attainment using the median value across tracts for the percentage of residents who graduated college. GEE models, accounting for clustering at the Census tract level, were used to determine if smoking was associated with adduct levels in tumor tissue by strata of neighborhood educational attainment. Analyses adjusted for race, age, tumor volume, primary Gleason grade and PSA level at diagnosis.
Results: Among those living in tracts with high educational attainment, smoking status predicted adduct levels. The covariate adjusted mean staining intensity for current smokers was 0.17 (95% CI = 0.15-0.19), for ex-smokers was 0.16 (95% CI = 0.15-0.17) and never-smokers was 0.13 (95% CI = 0.12-0.14). For those living in tracts with low educational attainment there was no significant difference in adduct levels by smoking status, the covariate adjusted mean staining intensity for current smokers was 0.16 (95% CI = 0.14-0.18), for ex-smokers was 0.15 (95% CI = 0.14-0.16) and for never smokers was 0.16 (95% CI = 0.15-0.17). The P-value for the interaction term between smoking status and tract level educational attainment was 0.02. Further adjustment for individual level education and for tract median household income did not alter these results.
Conclusion: The results suggest that neighborhood context modifies the relationship between individual smoking status and PAH-DNA adduct levels in prostate tissue; smoking is only predictive of adduct levels in higher SES tracts. The spatial segregation of income groups in and around Detroit suggests that indicators of lower neighborhood SES serve as a proxy for other environmental sources of PAH.