Population science

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Population science

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PubMed | Research Division, Danish Cancer Society, Arbeitsgemeinschaft Gynaekologische Onkologie AGO Study Group, Beatson West of Scotland Cancer Center and 46 more.
Type: | Journal: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology | Year: 2016

The precise mechanism by which the immune system is adversely affected in cancer patients remains poorly understood, but the accumulation of immune suppressive/pro-tumorigenic myeloid-derived suppressor cells (MDSCs) is thought to be one prominent mechanism contributing to immunologic tolerance of malignant cells in epithelial ovarian cancer (EOC). To this end, we hypothesized genetic variation in MDSC pathway genes would be associated with survival after EOC diagnoses.We measured the hazard of death due to EOC within 10 years of diagnosis, overall and by invasive subtype, attributable to SNPs in 24 genes relevant in the MDSC pathway in 10,751 women diagnosed with invasive EOC. Versatile Gene-based Association study (VEGAS) and the Admixture Likelihood method (AML), were used to test gene and pathway associations with survival.We did not identify individual SNPs that were significantly associated with survival after correction for multiple testing (p<3.5 x 10-5), nor did we identify significant associations between the MDSC pathway overall, or the 24 individual genes and EOC survival.In this well-powered analysis, we observed no evidence that inherited variations in MDSC-associated SNPs, individual genes, or the collective genetic pathway contributed to EOC survival outcomes.Common inherited variation in genes relevant to MDSCs were not associated with survival in women diagnosed with invasive EOC.

Kruper L.,General and Oncologic Surgery | Xu X.,Population science | Henderson K.,Population science | Bernstein L.,Population science
Annals of Surgical Oncology | Year: 2011

Background: Many factors influence whether breast cancer patients undergo reconstruction after mastectomy. This study was undertaken to determine the patterns of care and variables associated with the use of reconstruction for ductal carcinoma in situ (DCIS) and to compare previous results for invasive carcinoma. Methods: Postmastectomy reconstruction rates were collected from the California Office of Statewide Health Planning and Development (OSHPD) for 2003-2007. International Classification of Disease-9 codes were used to identify patients undergoing reconstruction after mastectomy. Variations in reconstruction rates were examined by type of breast cancer (DCIS vs. invasive), calendar year, age, type of insurance, type of hospital, and race/ethnicity. Univariate and multivariate odds ratios (OR) with 95% confidence intervals (CI) were estimated for relative odds of immediate reconstruction versus mastectomy only. Results: For multivariate analysis, age, race/ethnicity, type of insurance, and type of hospital were significantly associated with the use of reconstruction for DCIS patients. DCIS patients were twice as likely to undergo reconstruction as patients with invasive cancer (odds ratio (OR) = 1.93, 95% confidence interval (CI) = 1.75-2.13). DCIS patients with private insurance were nine times more likely to undergo reconstruction as patients with Medicaid (OR = 8.84, 95% CI = 5.92-13.21). Both Hispanic white and Asian patients were one-fifth as likely to undergo reconstruction compared with non-Hispanic white patients (OR = 0.18, 95% CI = 0.1-0.3; OR = 0.17, 95% CI = 0.09-0.31). Conclusions: Postmastectomy rates for DCIS were twice those for invasive cancer mostly because stage was not a limiting factor. However, significant factors remain that limit the use of reconstruction in this breast cancer population: age, race/ethnicity, type of hospital, and type of insurance. © Society of Surgical Oncology 2011.

Wong F.L.,Population science | Francisco L.,Population science | Togawa K.,Population science | Kim H.,Population science | And 7 more authors.
Blood | Year: 2013

This prospective study described the trajectory of sexual well-being from before hematopoietic cell transplantation (HCT) to 3 years after in 131 allogeneic and 146 autologous HCT recipients using Derogatis Interview for Sexual Function and Derogatis Global Sexual Satisfaction Index. Sixty-one percent of men and 37% of women were sexually active pre-HCT; the prevalence declined to 51%(P 5.01) in men and increased to 48% (P 5 .02) in women at 3 years post-HCT. After HCT, sexual satisfaction declined in both sexes (P < .001). All sexual function domains were worse in women compared with men (P ≤ .001). Orgasm (P 5 .002) and drive/relationship (P < .001) declined inmen, but sexual cognition/fantasy (P 5.01) and sexual behavior/ experience (P 5 .01) improved in women. Older age negatively impacted sexual function post-HCT in both sexes (P < .01). Chronic graft-versus-host disease was associated with lower sexual cognition/fantasy (P 5 .003) and orgasm (P 5 .006) in men and sexual arousal (P 5.05) and sexual satisfaction (P 5.005) in women. Allmale sexual function domains declined after total body irradiation (P < .05). This study identifies vulnerable subpopulations that could benefit from interventional strategies to improve sexual well-being. © 2013 by The American Society of Hematology.

Sun C.-L.,Population science | Francisco L.,Population science | Baker K.S.,Fred Hutchinson Cancer Research Center | Weisdorf D.J.,University of Minnesota | And 2 more authors.
Blood | Year: 2011

Little information exists regarding long-term psychological health of hematopoietic cell transplantation (HCT) survivors. Using resources offered by the Bone Marrow Transplant Survivor Study (BMTSS), we evaluated adverse psychological outcomes in 1065 long-term HCT survivors and a healthy comparison group composed of siblings. Psychological health status was evaluated using the Brief Symptom Inventory-18. Twenty-two percent of the HCT survivors reported adverse psychological outcomes, compared with 8% of the siblings. Exposure to prednisone was associated with psychological distress across all domains (anxiety, depression, and somatic distress). Fifteen percent of the HCT survivors reported somatic distress, representing an almost 3-fold higher risk comparing to siblings. Among survivors, in addition to low annual household income and self-reported poor health, having severe/life-threatening conditions and presence of active chronic GVHD were associated with a 2-fold increased risk for somatic distress. Seven percent of the HCT survivors expressed suicidal ideation; patients with higher scores on depression subscale were most vulnerable. This study demonstrates that somatic distress is the biggest challenge faced by survivors long after HCT. These results identify vulnerable subpopulations and provide patients, families, and healthcare providers with necessary information to plan for post-HCT needs many years after HCT. © 2011 by The American Society of Hematology.

Armenian S.H.,Population science | Sun C.-L.,Population science | Kawashima T.,Fred Hutchinson Cancer Research Center | Arora M.,University of Minnesota | And 14 more authors.
Blood | Year: 2011

HSCT is being increasingly offered as a curative option for children with hematologic malignancies. Although survival has improved, the long-term morbidity ascribed to the HSCT procedure is not known. We compared the risk of chronic health conditions and adverse health among children with cancer treated with HSCT with survivors treated conventionally, as well as with sibling controls. HSCT survivors were drawn from BMTSS (N = 145), whereas conventionally treated survivors (N = 7207) and siblings (N = 4020) were drawn from CCSS. Self-reported chronic conditions were graded with CTCAEv3.0. Fifty-nine percent of HSCT survivors reported ≥ 2 conditions, and 25.5% reported severe/life-threatening conditions. HSCT survivors were more likely than sibling controls to have severe/life-threatening (relative risk [RR] = 8.1, P < .01) and 2 or more (RR = 5.7, P < .01) conditions, as well as functional impairment (RR = 7.7, P < .01) and activity limitation (RR = 6.3, P < .01). More importantly, compared with CCSS survivors, BMTSS survivors demonstrated significantly elevated risks (severe/life-threatening conditions: RR = 3.9, P < .01; multiple conditions: RR = 2.6, P < .01; functional impairment: RR = 3.5, P < .01; activity limitation: RR = 5.8, P < .01). Unrelated donor HSCT recipients were at greatest risk. Childhood HSCT survivors carry a significantly greater burden of morbidity not only compared with noncancer populations but also compared with conventionally treated cancer patients, providing evidence for close monitoring of this high-risk population. © 2011 by The American Society of Hematology.

Bell A.D.,Duke University | Hockenberry M.,Duke University | Landier W.,Population science | Ewing N.,City of Hope
Journal of Pediatric Hematology/Oncology | Year: 2015

No widely accepted method exists to evaluate pediatric hematology oncology patients for the risk of venous thromboembolism (VTE) and the need for prophylaxis. The use of a VTE risk-assessment tool and standardized guidelines for prophylaxis could increase the use of appropriate prophylaxis and reduce the number of VTEs in patients, thereby decreasing morbidity, mortality, hospitalization, and cost. The purpose of this project was to implement and assess the compliance of a pediatric-specific VTE risk-assessment tool in hospitalized pediatric, adolescent, and young adult hematology oncology patients. From the 114 pediatric, adolescent, and young adult patients requiring assessment, 91 (80%) VTE assessments were completed and 87 (96%) were completed accurately. Eighty percent of the at-risk patients were ordered VTE prophylaxis. The use of a VTE risk-assessment tool in pediatric hematology oncology patients is a feasible way to assess patients for their risk of developing a VTE. © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Taylor S.,Edith Cowan University | Mclean B.,University of Western Australia | Falkmer T.,Curtin University Australia | Carey L.,La Trobe University | And 3 more authors.
Child: Care, Health and Development | Year: 2016

Background: Somatosensory modalities, such as touch, proprioception and haptic ability, greatly influence the achievement of developmental milestones for children. Describing somatosensory impairment, natural variability and typical or expected developmental changes across age groups will help establish frameworks for intervention in clinical populations. This systematic review aimed to determine how different somatosensory modalities develop across childhood into adolescence to use as a point of reference for children at risk of somatosensory impairment. Methods: Searches of five electronic databases were undertaken through EBSCO-host (MEDLINE, CINAHL, PsycINFO, SPORTDiscus and ERIC) for studies measuring at least one somatosensory modality in typically developing individuals between birth and 18years and analysed by age. Characteristics of studies were collected including country of origin, sample size, demographics and outcome measure used. Quality assessment and data extraction were performed by two independent reviewers. Results: Twenty three cross-sectional studies were included from a total of 188 articles retrieved: 8 examined aspects of touch, 5 proprioception and 10 haptic ability. Variability of study designs and variation in assessment tools precluded any formal meta-analysis. Conclusions: Somatosensation matures through childhood into adolescence; however, the present review found the pattern of somatosensory development varied depending on the assessment tool used and the aspect of somatosensation being measured, making it difficult to describe typical performance. There is a need for comprehensive assessment batteries to measure the somatosensation, including touch, proprioception and haptic ability, of children at risk of somatosensory impairment to aid in the development of effective interventions. © 2016 John Wiley & Sons Ltd.

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