Higher body mass index (BMI) is a well‐established risk factor for colorectal cancer (CRC), but is inconsistently associated with CRC survival. In 6 prospective studies participating in the Genetics ...and Epidemiology of Colorectal Cancer Consortium (GECCO), 2,249 non‐Hispanic white CRC cases were followed for a median 4.5 years after diagnosis, during which 777 died, 554 from CRC‐related causes. Associations between prediagnosis BMI and survival (overall and CRC‐specific) were evaluated using Cox regression models adjusted for age at diagnosis, sex, study and smoking status (current/former/never). The association between BMI category and CRC survival varied by cancer stage at diagnosis (I‐IV) for both all‐cause (p‐interaction = 0.03) and CRC‐specific mortality (p‐interaction = 0.04). Compared to normal BMI (18.5–24.9 kg/m2), overweight (BMI 25.0–29.9) was associated with increased mortality among those with Stage I disease, and decreased mortality among those with Stages II–IV disease. Similarly, obesity (BMI ≥30) was associated with increased mortality among those with Stages I–II disease, and decreased mortality among those with Stages III–IV disease. These results suggest the relationship between BMI and survival after CRC diagnosis differs by stage at diagnosis, and may emphasize the importance of adequate metabolic reserves for colorectal cancer survival in patients with late‐stage disease.
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Being overweight increases a person's risk of developing colorectal cancer, but does it also influence the likelihood of surviving it? These authors investigated. Drawing on data from six prospective cohort studies, they analyzed the relationship between body mass index before diagnosis and odds of survival. Because survival depends greatly on how advanced the cancer is when it's discovered, they controlled for stage at diagnosis. Interestingly, the effect of weight differed depending on disease stage. Among those with Stage I disease, being overweight appeared to increase mortality, but for those with Stage II–IV disease, higher BMI meant better survival.
A family history of colorectal cancer (CRC) in first‐degree relatives (FDRs) increases the risk of CRC. However, the influence of family history on survival among CRC patients remains unclear. We ...conducted a pooled analysis of survival in 5010 incident CRC cases. Cox proportional hazards models were used to estimate the association of family history with overall survival (OS) and CRC‐specific survival (CSS). We also assessed the impact of the number of affected FDRs and age at CRC diagnosis in the affected FDRs on survival. Among CRC cases, 819 (16%) patients reported a family history of CRC. There were 1580 total deaths over a median follow‐up of 4.6 years, of which 1046 (66%) deaths were due to CRC. Having a family history of CRC was not associated with OS hazard ratio (HR), 1.03; 95% confidence interval (CI), 0.89–1.19 or CSS (HR, 1.13; 95% CI, 0.95–1.36). There were no associations between the number of affected relatives or age at CRC diagnosis of the affected relative with survival (all Ptrend > 0.05). However, a family history of CRC did confer worse CSS in patients diagnosed with distal colon cancer (HR, 1.45, 95% CI, 1.03–2.04). A family history of CRC was generally not associated with survival after CRC diagnosis. However, having a family history of CRC was associated with worse CRC prognosis in individuals with distal colon cancer, suggesting a possible genetic predisposition with distinct pathogenic mechanism that may lead to worse survival in this group.
In a pooled analysis of 5010 patients with colorectal cancer (CRC), having a family history of CRC in first‐degree relatives was not associated with overall survival hazard ratio (HR), 1.03; 95% confidence interval (CI), 0.89–1.19 or CRC‐specific survival (CSS) HR, 1.13; 95% CI, 0.95–1.36. However, having a family history of CRC was associated with worse CSS in patients with distal colon cancer (HR, 1.45; 95% CI, 1.03–2.04), suggesting a possible genetic predisposition with distinct pathogenic mechanism that may lead to worse survival in this group.
Considerable evidence suggests that cigarette smoking is associated with a higher risk of colorectal cancer (CRC). What is unclear, however, is the impact of quitting smoking on risk attenuation and ...whether other risk factors for CRC modify this association.
We conducted a pooled analysis of eight studies, including 6,796 CRC cases and 7,770 controls, to evaluate the association between cigarette smoking history and CRC risk and to investigate potential effect modification by other risk factors.
Current smokers OR, 1.26; 95% confidence interval (CI), 1.11-1.43 and former smokers (OR, 1.18; 95% CI, 1.09-1.27), relative to never smokers, showed higher risks of CRC. Former smokers remained at higher CRC risk, relative to never smokers, for up to about 25 years after quitting. The impact of time since quitting varied by cancer subsite: The excess risk due to smoking decreased immediately after quitting for proximal colon and rectal cancer but not until about 20 years post-quitting for distal colon cancer. Furthermore, we observed borderline statistically significant additive interactions between smoking status and body mass index BMI; relative excess risk due to interaction (RERI), 0.15; 95% CI, -0.01 to 0.31; P = 0.06 and significant additive interaction between smoking status and fruit consumption (RERI, 0.16; 95% CI, 0.01-0.30; P = 0.04).
CRC risk remained increased for about 25 years after quitting smoking, and the pattern of decline in risk varied by cancer subsite. BMI and fruit intake modified the risk associated with smoking.
These results contribute to a better understanding of the mechanisms through which smoking impacts CRC etiology.
Selenium is an essential trace element and circulating selenium concentrations have been associated with a wide range of diseases. Candidate gene studies suggest that circulating selenium ...concentrations may be impacted by genetic variation; however, no study has comprehensively investigated this hypothesis. Therefore, we conducted a two-stage genome-wide association study to identify genetic variants associated with serum selenium concentrations in 1203 European descents from two cohorts: the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening and the Women's Health Initiative (WHI). We tested association between 2,474,333 single nucleotide polymorphisms (SNPs) and serum selenium concentrations using linear regression models. In the first stage (PLCO) 41 SNPs clustered in 15 regions had p < 1 × 10(-5). None of these 41 SNPs reached the significant threshold (p = 0.05/15 regions = 0.003) in the second stage (WHI). Three SNPs had p < 0.05 in the second stage (rs1395479 and rs1506807 in 4q34.3/AGA-NEIL3; and rs891684 in 17q24.3/SLC39A11) and had p between 2.62 × 10(-7) and 4.04 × 10(-7) in the combined analysis (PLCO + WHI). Additional studies are needed to replicate these findings. Identification of genetic variation that impacts selenium concentrations may contribute to a better understanding of which genes regulate circulating selenium concentrations.
Higher body mass index (BMI) is a well-established risk factor for colorectal cancer (CRC), but is inconsistently associated with CRC survival. In 6 prospective studies participating in the Genetics ...and Epidemiology of Colorectal Cancer Consortium (GECCO), 2,249 non-Hispanic white CRC cases were followed for a median 4.5 years after diagnosis, during which 777 died, 554 from CRC-related causes. Associations between pre-diagnosis BMI and survival (overall and CRC-specific) were evaluated using Cox regression models adjusted for age at diagnosis, sex, study, and smoking status (current/former/never). The association between BMI category and CRC survival varied by cancer stage at diagnosis (I–IV) for both all-cause (
P-
interaction=0.03) and CRC-specific mortality (
P-
interaction=0.04). Compared to normal BMI (18.5–24.9 kg/m
2
), overweight (BMI 25.0–29.9) was associated with increased mortality among those with stage I disease, and decreased mortality among those with stages II–IV disease. Similarly, obesity (BMI ≥30) was associated with increased mortality among those with stages I–II disease, and decreased mortality among those with stages III–IV disease. These results suggest the relationship between BMI and survival after CRC diagnosis differs by stage at diagnosis, and may emphasize the importance of adequate metabolic reserves for colorectal cancer survival in patients with late-stage disease.
Complex congenital heart disease is often accompanied by extracardiac manifestations; , the significance of genitourinary involvement remains unclear. We present 3 patients with palliated complex ...congenital heart disease and with pregnancies complicated by premature delivery who were found to have congenital uterine anomalies that may have contributed to their obstetrical complications.
Chromosomal abnormalities provide clinical utility in the diagnosis and treatment of hematologic malignancies, and may be predictive of malignant transformation in individuals without apparent ...clinical presentation of a hematologic cancer. In an effort to confirm previous reports of an association between clonal mosaicism and incident hematologic cancer, we applied the anomDetectBAF algorithm to call chromosomal anomalies in genotype data from previously conducted Genome Wide Association Studies (GWAS). The genotypes were initially collected from DNA derived from peripheral blood of 12,176 participants in the Group Health electronic Medical Records and Genomics study (eMERGE) and the Women's Health Initiative (WHI). We detected clonal mosaicism in 169 individuals (1.4%) and large clonal mosaic events (>2 mb) in 117 (1.0%) individuals. Though only 9.5% of clonal mosaic carriers had an incident diagnosis of hematologic cancer (multiple myeloma, myelodysplastic syndrome, lymphoma, or leukemia), the carriers had a 5.5-fold increased risk (95% CI: 3.3-9.3; p-value = 7.510-11) of developing these cancers subsequently. Carriers of large mosaic anomalies showed particularly pronounced risk of subsequent leukemia (HR = 19.2, 95% CI: 8.9-41.6; p-value = 7.310-14). Thus we independently confirm the association between detectable clonal mosaicism and hematologic cancer found previously in two recent publications.
Writing in the wake of neoliberalism, where human rights and social justice have increasingly been subordinated to proliferating “consumer choices” and ideals of market justice, contributors to this ...collection argue that feminist ethnographers are in a key position to reassert the central feminist connections between theory, methods, and activism. Together, we suggest avenues for incorporating methodological innovations, collaborative analysis, and collective activism in our scholarly projects. What are the possibilities (and challenges) that exist for feminist ethnography 25 years after initial debates emerged in this field about reflexivity, objectivity, reductive individualism, and the social relevance of activist scholarship? How can feminist ethnography intensify efforts towards social justice in the current political and economic climate? This collection continues a crucial dialog about feminist activist ethnography in the 21st century—at the intersection of engaged feminist research and activism in the service of the organizations, people, communities, and feminist issues we study.
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