News Article | May 1, 2017
Adjusted rates for cervical cancer do not decline until age 85, signaling a need for ongoing surveillance, according to a new study in the American Journal of Preventive Medicine Ann Arbor, MI, May 1, 2017 - Cervical cancer is often thought of as a disease that primarily affects young women. Because of this, many older women fail to keep up with appropriate screening as they age. While current guidelines indicate that screening can be stopped for average risk patients after age 65, many women lack the appropriate amount of screening history to accurately assess their risk. A new study in the American Journal of Preventive Medicine found that incidence rates of cervical cancer do not begin to decline until 85 years of age among women without a hysterectomy and that women over 65 who have not been recently screened may benefit from continued surveillance. "An older woman who has not had her cervix surgically removed has the same or even higher risk of developing cervical cancer compared to a younger woman," said lead investigator Mary C. White, ScD, Chief of the Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA. "Women who have not had a hysterectomy need to continue to be screened until age 65, and possibly later if they have not been screened for many years or are at special risk, consistent with current U.S. Preventive Services Task Force recommendations." In 2013, one-fifth of cervical cancer cases and one-third of cervical cancer deaths occurred among women 65 years of age and older. Current recommendations say that screening can be stopped at age 65 if an adequate testing history indicates consistently negative results. Three consecutive negative cytology results or two consecutive negative co-test results within the last 10 years, with the most recent test within the last 5 years, are considered sufficient reason to stop screening average risk women after age 65. Using data from the 2013 and 2015 National Health Interview Survey (NHIS), investigators looked at the use of screening tests and rates of cervical cancer for women 65 years of age and older. They found that when corrected for hysterectomy, incidence rates of cervical cancer increased with age until 70 and did not begin to decline until age 85. The data also revealed that many women approaching the "stopping" age of 65 were not getting sufficient screening. Researchers established that the proportion of women not recently screened increases with age. While only 12% of women in their 40s had no recent screening history, that number progressively increased for women in their 50s and 60s. Nearly 850,000 women aged 61-65 years had not been screened within the last five years. "A recommended upper age limit for routine screening may lead women and providers to assume that cervical cancer is a younger women's disease," explained Dr. White. "After adjustment for hysterectomy, some of the highest cervical cancer incidence rates occur among women older than 65 years, with notably higher rates among older black women. Premature discontinuation of routine screening among women in the years before age 65 could contribute to preventable cases of invasive cervical cancer and deaths." Cervical cancer can affect women of all ages. This new study highlights the importance of regular screening for older women who are at high risk or without documentation of adequate prior screening in order to help prevent cervical cancer deaths. Going forward, given increases in life expectancy and the high rates of cervical cancer after 65, women in midlife need to continue with routine cervical cancer screening to look for changes that may need further follow-up. "In the short term, efforts could be undertaken to clarify misperceptions about the risk of cervical cancer among older women and providers," concluded Dr. White. "Messages about a 'stopping age' need to emphasize the recommendation for an adequate screening history of previous negative tests before screening is discontinued, not just chronologic age."
News Article | April 17, 2017
Hypertension, or high blood pressure, may come with a plus side, at least for a subset of women with ovarian cancer. New research from epidemiologists at Roswell Park Cancer Institute, published in the journal Cancer Causes & Control, provides evidence that hypertension and diabetes and the use of medications to treat these common conditions may influence the survival of ovarian cancer patients — sometimes in a detrimental way, but in the case of hypertension medications, perhaps as a benefit. Using pooled data from 15 studies that were part of the Ovarian Cancer Association Consortium, an international team of collaborators led by Kirsten Moysich, PhD, MS, and Albina Minlikeeva, PhD, MPH, retroactively examined the associations between survival among patients diagnosed with invasive epithelial ovarian cancer and those patients’ history of hypertension, heart disease, diabetes, and medications taken for those conditions. They found that while a history of diabetes was associated with a 112% higher risk of mortality across more than 7,600 cases, no significant mortality associations were observed for hypertension or heart disease. In fact, the authors report, among women with endometrioid ovarian cancer, a subtype of epithelial ovarian cancer typically associated with better outcomes, hypertension — a condition that applied to nearly 26% of women in the pooled analysis — was associated with 46% lower risk of ovarian cancer progression. “This is a coincidental and unintended consequence of hypertension and its treatment, but it’s a silver lining to a serious but largely manageable medical condition that has reached epidemic prevalence in the U.S. and many other countries worldwide,” says Dr. Moysich, Distinguished Professor of Oncology in the departments of Cancer Prevention and Control and Immunology at the Buffalo cancer center. This study is the first to highlight the role of comorbidities in relation to ovarian cancer survival by histological subtype, and confirmed previous findings linking a history of diabetes to increased risk of death among ovarian cancer patients. It’s possible that commonly prescribed antihypertensive medications, including beta blockers, may influence the growth of ovarian tumors. But the team also documented a higher overall risk of death for patients who had ever taken beta blockers, and notes that further study is needed to better understand these processes and interactions. “Our results suggest that it is important to investigate factors that explain the difference in cancer outcomes among women with different types of ovarian cancer. Most studies only consider clinical characteristics at diagnosis, such as stage and histology in relation to ovarian cancer prognosis,” adds Dr. Minlikeeva, a postdoctoral Research Affiliate with Roswell Park’s Department of Cancer Prevention and Control. “Our findings emphasize the importance of understanding the full clinical profile for women with ovarian cancer in order to predict ovarian cancer outcomes.” Approximately 22,300 new cases of ovarian cancer are diagnosed each year in the U.S., with an estimated 14,200 women dying from the disease each year. Endometrioid carcinoma accounts for about 20% of all epithelial ovarian cancers. The study, “History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium,” is available at link.springer.com. This work was funded in part by grants and contracts from the National Cancer Institute (project nos. K07CA080668, K07CA095666, K22CA138563, N01CN55424 P30CA072720, P50CA105009, P50CA159981, R01CA074850, R01CA080742, R01CA095023, R01CA112523, R01CA126841, R01CA188900, R01CA54419, R01CA58598, R01CA61107, R01CA76016, R01CA87538, R25CA113951 and T32CA108456), National Library of Medicine (project no. K01LM012100), Division of Cancer Control and Population Sciences (project no. N01PC67001) and Roswell Park Alliance Foundation. A full list of funders is available in the Acknowledgments section at that link. For an online version of this release, please visit: https://www.roswellpark.org/media/news/epidemiological-analysis-shows-unexpected-benefit-related-high-blood-pressure-many The mission of Roswell Park Cancer Institute (RPCI) is to understand, prevent and cure cancer. Founded in 1898, RPCI is one of the first cancer centers in the country to be named a National Cancer Institute-designated comprehensive cancer center and remains the only facility with this designation in Upstate New York. The Institute is a member of the prestigious National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers; maintains affiliate sites; and is a partner in national and international collaborative programs. For more information, visit http://www.roswellpark.org, call 1-877-ASK-RPCI (1-877-275-7724) or email askrpci(at)roswellpark(dot)org. Follow Roswell Park on Facebook and Twitter.
PubMed | University of Michigan, Danish Cancer Society, University of New South Wales, Fred Hutchinson Cancer Research Center and 14 more.
Type: Journal Article | Journal: International journal of cancer | Year: 2016
Menopausal estrogen-alone therapy (ET) is a well-established risk factor for serous and endometrioid ovarian cancer. Genetics also plays a role in ovarian cancer, which is partly attributable to 18 confirmed ovarian cancer susceptibility loci identified by genome-wide association studies. The interplay among these loci, ET use and ovarian cancer risk has yet to be evaluated. We analyzed data from 1,414 serous cases, 337 endometrioid cases and 4,051 controls across 10 case-control studies participating in the Ovarian Cancer Association Consortium (OCAC). Conditional logistic regression was used to determine the association between the confirmed susceptibility variants and risk of serous and endometrioid ovarian cancer among ET users and non-users separately and to test for statistical interaction. A splicing variant in TERT, rs10069690, showed a statistically significant interaction with ET use for risk of serous ovarian cancer (p
News Article | November 10, 2016
When female employees of a mystery shopping firm called posing as 17-year-olds interested in tanning, 81 percent of indoor tanning facilities complied with the Texas ban on indoor tanning for those under the age of 18 in a study conducted by The University of Texas MD Anderson Cancer Center. Upon discovering the caller's age, employees at those facilities told the caller she could not use indoor tanning, even with the permission of her parents. "This level of compliance with the under-18 ban enacted by the Texas Legislature in 2013 underscores the importance of this approach as a strategy for skin cancer prevention," said Mary Tripp, Ph.D., instructor in Behavioral Science and lead author of the study, published as a letter to JAMA Dermatology. Research shows that indoor tanning before the age of 18 increases a person's risk of developing melanoma - the most lethal form of skin cancer - by 85 percent. In 2013, 1.6 million youths under the age of 18 reported indoor tanning, including 20 percent of female high school students. The incidence of melanoma has been rising in the United States for 30 years, while the frequency of most other solid tumors declined. From 1975 to 2012, cases of melanoma grew by about 3 percent per year. In 2016, an estimated 76,380 people will receive a diagnosis of invasive melanoma and 10,130 will die of the disease. Researchers identified 829 tanning facilities in Texas to contact in July and August of 2015. Of these, 635 could be reached by the mystery shopping firm callers; 445 were free-standing indoor tanning establishments, 133 were beauty salons or spas and 57 were other retail businesses that housed a tanning device. Of the 635 surveyed, 512 provided responses that complied with the ban and 120 did not, with the most common non-compliant responses indicating the shoppers could tan with a note from their parents or accompanied by a parent. Free-standing centers (86 percent) were most likely to comply, with beauty salons/spas (68 percent) least likely. Tripp noted an alarming proportion of facilities, 83 percent, told callers their clients could tan daily, in contrast to a schedule of three or fewer sessions during the first week recommended by the U.S. Food and Drug Administration. The vast majority of facilities responded directly (68 percent) or indirectly (25 percent) that a burn is possible with indoor tanning. Given that 15 states have enacted similar prohibitions and the FDA has proposed limiting indoor tanning to those age 18 and older, evaluating and improving compliance with under-18 bans will be critical to reducing the incidence of skin cancer, Tripp said. Providing educational information in support of indoor tanning bans for minors has been a central part of prevention efforts under MD Anderson's Cancer Moon Shots Program™, launched in 2012 to accelerate the pace of converting scientific discoveries into prevention, detection and treatment advances that significantly reduce cancer deaths. Faculty and governmental relations leaders in the Melanoma Moon Shot and the Cancer Prevention and Control Platform provided educational information about indoor tanning and cancer risk to Texas legislators and served as the primary clinical and research resources on the Texas prohibition law, which took effect in September 2013. Texas was the fourth state to enact a ban, and since then moon shots educational efforts have shifted to other states. Co-authors with Tripp are Jeffrey Gershenwald, M.D., of Surgical Oncology; Michael Davies, M.D., Ph.D., of Melanoma Medical Oncology; Joxel Garcia, M.D., executive director of the Cancer Prevention and Control Platform; Ernest Hawk, M.D., vice president and head of the division of Cancer Prevention and Population Sciences; and Ellen Gritz, Ph.D., and Susan Peterson, Ph.D., of Behavioral Science. Gershenwald and Davies are co-leaders of the Melanoma Moon Shot. The research was funded by contributions by the Lyda Hill Foundation to the Melanoma Moon Shot; MD Anderson's Cancer Center Support Grant from the National Cancer Institute of the National Institutes of Health (CA 16672), the Robert and Lynne Grossman Family Foundation and the Michael and Patricia Booker Melanoma Research Endowment.
News Article | February 28, 2017
Specific dairy foods may influence breast cancer risk in women, although risk varies by the source of the dairy product, according to a study published online ahead of print in the journal Current Developments in Nutrition. Researchers at Roswell Park Cancer Institute report that while high overall consumption of dairy products, and in particular of yogurt, is linked to a lower risk for breast cancer, high intake of American, cheddar and cream cheeses was associated with a slightly increased risk for breast cancer. The case-control study examined the association between the types and quantity of dairy foods consumed among 1,941 women diagnosed with breast cancer and 1,237 control participants in the Roswell Park Data Bank and BioRepository between 2003 and 2014. Participants’ usual intake of dairy foods was identified using a self-administered food frequency questionnaire and grouped into monthly intakes of total dairy, milk, yogurt, low-fat cheese, other cheese and sweet dairy products. The study adjusted for age, race, body-mass index, menopausal status, energy intake, type of milk usually consumed, cigarette smoking status and family history of breast cancer. “Dairy foods are complex mixtures of nutrients and non-nutrient substances that could be negatively as well as positively associated with breast cancer risk. Future studies are needed to confirm the protective potential of yogurt in this type of cancer,” says the lead author of the study, Susan McCann, PhD, RD, Professor of Oncology in the Department of Cancer Prevention and Control at Roswell Park. “This study of the differences among women and their consumption of dairy products offers significant new understanding into the potential risk factors associated with breast cancer,” says senior author Christine Ambrosone, PhD, Senior Vice President for Population Sciences and Chair of the Department of Cancer Prevention and Control. “While diet is thought to be responsible for 30% of all cancers, we hope that further research will help us to more fully understand which food products are most valuable in terms of reducing risk for this disease.” This research was supported, in part, by a grant from the National Cancer Institute (award no. P30CA016056). The study, “Usual consumption of specific dairy foods is associated with breast cancer in the Roswell Park Cancer Institute Data Bank and BioRespository,” is available at cdn.nutrition.org. For an online version of this release, please visit: https://www.roswellpark.org/media/news/dairy-intake-may-impact-risk-breast-cancer-reports-roswell-park-team The mission of Roswell Park Cancer Institute (RPCI) is to understand, prevent and cure cancer. Founded in 1898, RPCI is one of the first cancer centers in the country to be named a National Cancer Institute-designated comprehensive cancer center and remains the only facility with this designation in Upstate New York. The Institute is a member of the prestigious National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers; maintains affiliate sites; and is a partner in national and international collaborative programs. For more information, visit http://www.roswellpark.org, call 1-877-ASK-RPCI (1-877-275-7724) or email askrpci(at)roswellpark(dot)org. Follow Roswell Park on Facebook and Twitter.
Kegler M.C.,Emory University |
Alcantara I.,Emory University |
Haardorfer R.,Emory University |
Gazmararian J.A.,Emory University |
And 2 more authors.
Journal of Nutrition Education and Behavior | Year: 2014
Objective: To describe home food environments and examine which aspects are associated with fruit and vegetable intake and percent calories from fat among overweight and obese women. Design: Baseline data from a weight gain prevention trial collected through telephone interviews. Setting: Participants were recruited from 3 federally qualified health centers in rural Georgia. Participants: Overweight and obese patients (n = 319) were referred by their providers if they had a body mass index (BMI)> 25 and lived with at least 1 other person. Participants were primarily African American (83.7%), with a mean BMI of 38.4. Main Outcome Measures: Fruit and vegetable intake and percent calories from fat. Analysis: Descriptive statistics and multiple regression. Results: Participants reported a large variety of both fruits and vegetables and unhealthy foods in their homes, and an average of 2.6 family meals from non-home sources per week. Eating family meals with the television on was common. Availability of fruits and vegetables in the home (P <.001) and frequency of fruit shopping (P =.01) were associated with fruit and vegetable intake. The number of unhealthy foods in the home (P =.01) and food preparation methods (P =.01) were associated with percent calories from fat. Conclusions and Implications: Home food environments may be effective intervention targets for nutrition programs designed for overweight and obese women. © 2014 Society for Nutrition Education and Behavior.