gout is often defined by self-report in epidemiologic studies. Yet the validity of self-reported gout is uncertain. We evaluated the reliability and sensitivity of the self-report of ...physician-diagnosed gout in the Campaign Against Cancer and Heart Disease (CLUE II) and the Atherosclerosis Risk in the Community (ARIC) cohorts.
the CLUE II cohort comprises 12,912 individuals who self-reported gout status on either the 2000, 2003, or 2007 questionnaires. We calculated reliability as the percentage of participants reporting having gout on more than 1 questionnaire using Cohen's κ statistic. The ARIC cohort comprises 11,506 individuals who self-reported gout status at visit 4. We considered a hospital discharge diagnosis of gout or use of a gout-specific medication as the standard against which to calculate the sensitivity of self-reported, physician-diagnosed gout.
of the 437 CLUE II participants who self-reported physician-diagnosed gout in 2000, and subsequently answered the 2003 questionnaire, 75% reported gout in 2003 (κ = 0.73). Of the 271 participants who reported gout in 2000, 73% again reported gout at the 2007 followup questionnaire (κ = 0.63). In ARIC, 196 participants met the definition for gout prior to visit 4 and self-reported their gout status at visit 4. The sensitivity of a self-report of physician-diagnosed gout was 84%. Accuracy was similar across sex and race subgroups, but differed across hyperuricemia and education strata.
these 2 population-based US cohorts suggest that self-report of physician-diagnosed gout has good reliability and sensitivity. Thus, self-report of a physician diagnosis of gout is appropriate for epidemiologic studies.
Allergic rhinitis (AR) is a common disease that affects approximately one-fifth of the U.S. population. Few studies have evaluated the association between secondhand tobacco smoke (SHS) exposure and ...the impacts on symptom severity in AR. In this study, we evaluated the association of SHS and AR in a community-based study of adult nonsmokers.
In Washington County, Maryland, 83 subjects with AR (physician diagnosed or reported skin test positive), and 117 nonallergic subjects from the same community were recruited and interviewed. A validated questionnaire was used to assess past and present SHS exposure as well as disease-specific quality of life.
SHS was reported in 34/83 allergic subjects. Compared with AR subjects with no SHS exposure, subjects with AR and SHS were more likely to report a family history of chronic sinusitis (p = 0.04) and use nasal decongestants (p = 0.012). There was also a borderline association with reporting more severe nasal obstruction (p = 0.14) and nasal drainage (p = 0.08). Compared with nonallergic subjects, allergic subjects were more likely to report longer SHS exposure currently (adjusted mean difference = 1.6 hours/week; p = 0.01) and 20 years ago (adjusted mean difference = 2.9 hours/week; p = 0.03).
Past and current SHS may be a risk factor for AR. Allergic subjects with SHS exposure were more likely to use nasal decongestants and to report more severe nasal symptoms such as nasal obstruction and nasal drainage than nonexposed allergic subjects.
BACKGROUND Obesity has been proposed as a risk factor for pancreatic cancer. METHODS Pooled data were analyzed from the National Cancer Institute Pancreatic Cancer Cohort Consortium (PanScan) to ...study the association between prediagnostic anthropometric measures and risk of pancreatic cancer. PanScan applied a nested case-control study design and included 2170 cases and 2209 control subjects. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression for cohort-specific quartiles of body mass index (BMI calculated as weight in kilograms divided by height in meters squared), weight, height, waist circumference, and waist to hip ratio as well as conventional BMI categories (underweight, <18.5; normal weight, 18.5-24.9; overweight, 25.0-29.9; obese, 30.0-34.9; and severely obese, ≥35.0). Models were adjusted for potential confounders. RESULTS In all of the participants, a positive association between increasing BMI and risk of pancreatic cancer was observed (adjusted OR for the highest vs lowest BMI quartile, 1.33; 95% CI, 1.12-1.58; Ptrend < .001). In men, the adjusted OR for pancreatic cancer for the highest vs lowest quartile of BMI was 1.33 (95% CI, 1.04-1.69; Ptrend < .03), and in women it was 1.34 (95% CI, 1.05-1.70; Ptrend = .01). Increased waist to hip ratio was associated with increased risk of pancreatic cancer in women (adjusted OR for the highest vs lowest quartile, 1.87; 95% CI, 1.31-2.69; Ptrend = .003) but less so in men. CONCLUSIONS These findings provide strong support for a positive association between BMI and pancreatic cancer risk. In addition, centralized fat distribution may increase pancreatic cancer risk, especially in women.Arch Intern Med. 2010;170(9):791-802-->
Genome-wide association studies have found type 2 diabetes-associated variants in the HNF1B gene to exhibit reciprocal associations with prostate cancer risk. We aimed to identify whether these ...variants may have an effect on cancer risk in general versus a specific effect on prostate cancer only.
In a collaborative analysis, we collected data from GWAS of cancer phenotypes for the frequently reported variants of HNF1B, rs4430796 and rs7501939, which are in linkage disequilibrium (r(2) = 0.76, HapMap CEU). Overall, the analysis included 16 datasets on rs4430796 with 19,640 cancer cases and 21,929 controls; and 21 datasets on rs7501939 with 26,923 cases and 49,085 controls. Malignancies other than prostate cancer included colorectal, breast, lung and pancreatic cancers, and melanoma. Meta-analysis showed large between-dataset heterogeneity that was driven by different effects in prostate cancer and other cancers. The per-T2D-risk-allele odds ratios (95% confidence intervals) for rs4430796 were 0.79 (0.76, 0.83) per G allele for prostate cancer (p<10(-15) for both); and 1.03 (0.99, 1.07) for all other cancers. Similarly for rs7501939 the per-T2D-risk-allele odds ratios (95% confidence intervals) were 0.80 (0.77, 0.83) per T allele for prostate cancer (p<10(-15) for both); and 1.00 (0.97, 1.04) for all other cancers. No malignancy other than prostate cancer had a nominally statistically significant association.
The examined HNF1B variants have a highly specific effect on prostate cancer risk with no apparent association with any of the other studied cancer types.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
B145
Background
Physical activity is known to be protective for multiple cancers including breast. Modulation of hormonal factors such as leptin, ghrelin, and hyperinsulinemia as well as ...energy balance and BMI are thought to play a protective role. Short duration of sleep appears to have an opposite effect on many of these factors.
Methods
In a population based prospective cohort (CLUE II), we assessed the association between physical activity energy expenditure (PAEE), sleep duration, and incidence of first cancer (all-site) in women. 5968 adult females who answered questions on sleep and physical activity on a 1998 follow up questionnaire were included in the study population. Incident cases were identified through linkage of cohort participants with the Washington County Cancer Registry and Maryland State Cancer Registry. Adjusted hazard ratios (HR) and 95% confidence intervals were estimated from Cox proportional hazards models. All statistical tests were two sided.
Results
During 9.6 years of follow up, 604 1st incident cancer cases including 186 breast cancers were diagnosed. Overall cancer risk (HR=0.80, 95% CI 0.68, 0.95) and breast cancer risk (HR=0.75, 95% CI 0.55, 1.01) were significantly reduced among women in the upper 50% of PAEE compared to the lower. Sleep duration was not significantly associated with overall or breast cancer risk in adjusted HR models, but with an increase in colon cancer risk (HR = 1.72, 95% CI 0.99, 2.78) though the sample size was small. Excluding elderly women (> 65 yrs in 1998) who may have different sleep patterns, sleep duration ≥ 7hrs/day vs. < 7hrs/day significantly modified the association between PAEE upper vs. lower 50% and overall cancer risk (p interaction=0.014). A 1.5 fold increase in cancer risk (HR=1.47, 95% CI 1.05, 2.06) was observed among women ≤ 65 years in the upper 50% of PAEE who did not have sufficient sleep (< 7 hrs/day).
Conclusions
Increased PAEE was protective for cancer risk irrespective of age. In addition insufficient sleep may modify the observed protective effect of increased PAEE on cancer incidence among young and middle aged women.
Citation Information: Cancer Prev Res 2008;1(7 Suppl):B145.
Abstract
B16
Background
Behaviors such as sunscreen use and use of skin-protective clothing can help prevent skin cancer, but little is known about how these sun protection behaviors vary by ...phenotypic risk factors for skin cancer.
Objective
We carried out a cross-sectional study (n = 6898) nested within a community-based prospective cohort in Washington County, MD. We measured the associations between skin cancer risk characteristics (skin type, complexion, freckling, and eye color) and personal sun protection behaviors (sunscreen and sun-protective clothing use).
Results
The prevalence of regular use of sunscreen was 23%, and the prevalence of regular use of sun-protective clothing was 21%. There were consistent trends indicating those at highest risk of skin cancer were most likely to engage in sun protection behaviors. For example, compared to those who tan without burning, those who develop blistering sunburns were more likely to use sunscreen (OR 6.55, 95% CI 3.08 -13.92 men, OR 4.87, 95% CI 3.34 - 7.09 women) and sun-protective clothing (OR 2.90, 95% CI 1.73 - 4.85 men, OR 4.29, 95% CI 2.81 - 6.55 women). Those with fair skin were more likely than those with medium or dark brown complexion to use sunscreen or sun-protective clothing. Other factors significantly associated with sun protection behaviors were lifestyle-related factors such as lower body mass index and never smoking.
Conclusion
The overall prevalence of sun protection behaviors was low. Our results indicate individuals with the highest skin cancer susceptibility are most likely to use sunscreen and sun-protective clothing, and may also be most receptive to skin cancer prevention educational interventions.
Citation Information: Cancer Prev Res 2008;1(7 Suppl):B16.
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