Reduction of Aflatoxin Bioavailability with ACCS100 in an Exposed South Texas Population

s / Annals of Epidemiology 25 (2015) 702e719 704 models contained all threeMWFs and controlled for age, calendar year hired, plant. Results: There were 103 cases of kidney cancer overall and 59 histologically confirmed cases of RCC. We observed an increased risk of kidney cancer with straightMWFamong those in the highest category of exposure HR1⁄41.98 (95% CI: 1.12-3.52). For RCC only, the HR increased to 3.29 (95% CI: 1.53-7.06). There was a weaker elevated association with soluble fluids no associations with synthetic fluids. Conclusions: Our results indicate that RCC should be considered to be among the cancers impacted by exposure to straight MWFs. P06. Reduction of Aflatoxin Bioavailability with ACCS100 in an Exposed South Texas Population Brad H. Pollock PhD, Amelia Romoser PhD, Sarah E. Elmore, Lili Tang PhD, Min-su Kang MS, Kathy Xue, Marisa F. Rodriguez, Nicole A. Jaime MPH, Andy Hansen MD, Fernando A. Guerra MD, MPH, Jia-Sheng Wang PhD, Timothy D. Phillips PhD. University of California, Davis Purpose: Latinos in South Texas have the highest incidence of hepatocellular carcinoma in the U.S. Aflatoxin B1 (AFB1) is a potent liver carcinogen that can be present in food. We conducted a trial to reduce AFB1 absorption in an exposed population and hypothesized that calcium montmorillonite clay (ACCS100) would decrease persistent AFB1 biomarkers of exposure (AFB1albumin adduct levels). Methods: We conducted a 3-month randomized placebo controlled doubleblind intervention trial of ACCS100 administered 3x daily to reduce absorption of AFB1. We screened 380 participants fromBexar County, Texas during 9/2012-5/2014. Those with detectable biomarker levels (n1⁄4233) were then randomized to 3 groups: High Dose (1000 mg), Low Dose (500 mg) and Placebo. Differences in biomarker levels at baseline, and months 1 and 3, were compared across treatment groups. Results: Adverse event rates were similar across groups suggesting that ACCS100 was safe for the 3-month period. The adjusted mean biomarker levels (pg/mg albumin) were: Week Placebo High Dose Low Dose M S.D. M S.D. M S.D. 0 4.26 3.15 3.77 2.52 4.09 2.25 4 3.06 1.66 3.00 1.30 2.62 1.08 12 3.22 1.85 2.87 1.53 2.71 1.35 Significantly lower biomarker concentrationswere detected in both ACCS100 groups at 1 month, and in the low dose group at 3 months. However, the treatment group x time interaction was not statistically significant (p>0.05). Sensitivity for group differences in biomarker levels was possibly reduced due to higher-than-anticipated attrition. Conclusions: The use of ACCS100 may be a viable strategy to reduce dietary AFB1 bioavailability in populations chronically exposed to this carcinogen. P07. Unequal Changes in Cigarette Consumption Over Time by Birth Decade and Among Latino National Background Groups Erik Joseph Rodriquez PhD, MPH, Sam S. Oh PhD, MPH, Eliseo J. Perez-Stable MD, Steve A. Schroeder MD. University of California, San Francisco Purpose: Recent estimates indicate that the decline in smoking prevalence has slowed since 2005. Solely assessing prevalencemay not accurately reflect changes in related behaviors such as number of cigarettes smoked per day (CPD). This analysis describes nationwide changes in cigarette consumption among U.S. Latinos and non-Latinos from 1997-2010. Methods: National Health Interview Survey data between 1997 and 2010 were used to determine CPD among Latino and non-Latino adults who were current smokers at the time of interview (i.e., smoked at least 100 cigarettes in their lifetime and were currently smoking every day or some days). Trend analyses were conducted using multivariable linear regression by modeling cigarette consumption against survey year, stratified by gender and ethnicity, and adjusted for year of birth and Latino national background for Latino smokers only. Results: CPD has declined steadily throughout the observation period. However, decreases have not been equal across birth decades or among Latino national background groups. CPD declined least among younger generations and Central or South American women and most among Puerto Rican men and women. Additionally, declines in cigarette consumption seemed to have approached a floor over time among low CPD consumers. Conclusions: Although cigarette consumption has decreased substantially since the late 1990s, CPD among younger generations and certain Latino national background groups suggest that declines are slowing, possibly flattening. Effective tobacco control strategies such as policies, taxes, and cessation should be developed now among low CPD smokers to further discourage smoking in the near future as smokers smoke fewer CPD. P08. Individual and Zip Code Level Predictors of Radical Resection vs. Local Excision in Surveillance, Epidemiology, and End Results (SEER)-Medicare Stage I Rectal Cancer Cases Jennifer A. Schlichting PhD, Bradley D. McDowell PhD, John C. Byrn MD, Mary E. Charlton PhD. University of Iowa College of Public Health Purpose: Although survival outcomes are superior for stage I rectal cancer patients who receive radical resection (RR), many patients still receive local excision (LE). We examined individual and zip code level variables to determine their association with receipt of RR vs. LE. Methods: Stage I rectal cancer cases aged 66+ years diagnosed 2000-2009 who received surgery were included (N1⁄47,015). To account for clustering of cases within zip codes, multilevel logistic regression models were fit with zip code as the random effect. Zip code level fixed effects included an index combining %below poverty and %less than high school education (>1⁄420% for both vs. other) and rural/urban residence, while individual fixed effects included age, race, marital status, tumor grade, insurance with state buy-in (low SES indicator), and 16 function-related indicators (FRI). Results: A little over half of the cases received RR (n1⁄43,595, 53%). The average age of those receiving RR was 2 years younger than those receiving LE (76 vs. 78, p 500 beds was associated with receipt of surgery compared to those with 300-499 beds or <300 beds (41% vs. 35% vs. 12%, respectively; p1⁄4.0099). No other variables were associated with treatment selection in univariate or multivariate analyses.