Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern Ireland

Objectives

To investigate the impact of different PSA testing policies and health-care systems on prostate cancer incidence and mortality in two countries with similar populations, the Republic of Ireland (RoI) and Northern Ireland (NI).

Methods

Population-level data on PSA tests, prostate biopsies and prostate cancer cases 1993–2005 and prostate cancer deaths 1979–2006 were compiled. Annual percentage change (APC) was estimated by joinpoint regression.

Results

Prostate cancer rates were similar in both areas in 1994 but increased rapidly in RoI compared to NI. The PSA testing rate increased sharply in RoI (APC = +23.3%), and to a lesser degree in NI (APC = +9.7%) to reach 412 and 177 tests per 1,000 men in 2004, respectively. Prostatic biopsy rates rose in both countries, but were twofold higher in RoI. Cancer incidence rates rose significantly, mirroring biopsy trends, in both countries reaching 440 per 100,000 men in RoI in 2004 compared to 294 in NI. Median age at diagnosis was lower in RoI (71 years) compared to NI (73 years) (p < 0.01) and decreased significantly over time in both countries. Mortality rates declined from 1995 in both countries (APC = ?1.5% in RoI, ?1.3% in NI) at a time when PSA testing was not widespread.

Conclusions

Prostatic biopsy rates, rather than PSA testing per se, were the main driver of prostate cancer incidence. Because mortality decreases started before screening became widespread in RoI, and mortality remained low in NI, PSA testing is unlikely to be the explanation for declining mortality.     

Measured body mass index in adolescence and the incidence of pancreatic cancer in a cohort of 720,000 Jewish men

Purpose

The increasing prevalence of adolescent obesity affects adult health. We investigated the association of adolescent overweight with pancreatic cancer incidence in a cohort of 720,927 Jewish Israeli men.

Methods

Body mass index (BMI) was measured during a general health examination at ages 16?C19 between the years 1967 and 1995. Overweight was defined as BMI????85th percentile of the reference US-CDC distribution in adolescence. Pancreatic cancer was identified by linkage with the Israel National Cancer Registry up to 2006.

Results

The mean follow-up period was 23.3?±?8.0?years. During 16.8 million person-years, 98 cases of pancreatic cancer were detected. Using Cox proportional hazards modeling, overweight in adolescence predicted an increased risk of pancreatic cancer [hazard ratio (HR)?=?2.09; 95% confidence interval (CI): 1.26?C3.50, p?=?0.005]. Compared with adolescents with ??normal?? range BMI Z-scores (?1 to +1), adolescents with Z-scores?>?1 showed significantly increased risk [HR, 2.28 (95% CI: 1.43?C3.64), p?=?0.001]. Lower education level (10 or less years of schooling vs. 11?C12?years) was also associated with increased risk of pancreatic cancer [HR 1.90 (95% CI: 1.27?C2.86, p?=?0.002)], whereas height, country of origin and immigration status were not.

Conclusions

Adolescent overweight is substantially associated with pancreatic cancer incidence in young to middle-aged adults. Applying our point estimates to the 16.8% prevalence of excess weight in Israeli adolescents in the past decade suggests a population fraction of 15.5% (95% CI: 4.2?C29.6%) for pancreatic cancer attributable to adolescent overweight in Israel.     

Reduced lung cancer incidence attributable to decreased tobacco use in urban Shanghai

Background

Lung cancer has been the most common type of cancer in the world for several decades, and by 2008, there were approximately 1.61 million new cases, representing 12.7 % of all new cancers. It has been well known for many years that smoking causes lung cancer. Tobacco control measures have been regarded as the principal causes of the declines in smoking-related mortality, including mortality from lung cancer.

Methods

The Joinpoint Regression Program was used to analyze the long-term trends in lung cancer incidence rates from 1983 to 2008 in urban Shanghai. In addition, this study estimates how many fewer cases of lung cancer have occurred in urban Shanghai because of tobacco control activities.

Results

The lung cancer incidence rate among males decreased slightly by 0.6 % [95 % confidence interval (95 % CI) ?0.1 to 1.3 %] from 1983 to 1999 and then declined rapidly at a rate of 3.8 % (95 % CI 2.1–5.4 %). Among females, the cancer incidence rate decreased by 0.1 % (95 % CI ?0.2 to 0.5 %) from 1983 to 2008. Overall, we estimated that approximately 2,711 cases of lung cancer were averted among urban men in Shanghai between 2000 and 2008 because of the reduction in tobacco smoking.

Conclusion

The reduction in tobacco smoking is a major factor in the decrease in the incidence rate of lung cancer. Sustained progress in tobacco control is essential.     

Functional and biologic metrics for predicting radiation pneumonitis in locally advanced non-small cell lung cancer patients treated with chemoradiotherapy

Objective

To study the predictive value of functional and biologic metrics for predicting radiation pneumonitis (RP) in locally advanced non-small cell lung cancer (LANSCLC) patients treated with chemoradiotherapy.

Methods

Between March 2006 and April 2010, 57 LANSCLC patients were enrolled in a prospective study. Fusion of SPECT and computed tomography scans provides perfusion-weighted functional dose?Cvolume histogram (DVH) and associated functional dosimetric parameters. Blood for serum biomarkers??interleukin-6 (IL-6), transforming growth factor-beta1, and superoxide dismutase (SOD)??was drawn pre-RT and then 40?Gy/4?weeks during the treatment. The incidence of RP was related to the functional and biologic metrics. The predictability of predictors was calculated and compared based on the area under receiver-operating characteristic (ROC) curve (AUC).

Results

Relative volumes of functional lung receiving more than a threshold dose of 5?C50?Gy at increments of 5?Gy and elevated levels of serum SOD after delivery of 40?Gy/4?weeks were associated with RP (p?<?0.05). The best predictive efficacy of SOD was observed for a cutoff value of 56?U/ml, with a sensitivity of 0.80 (95?% CI 0.28?C0.99) and a specificity of 0.67 (95?% CI 0.43?C0.65) (p?=?0.040). Functional DVH provided better predictive outcome (AUC 0.76?C0.98) than standard DVH (AUC 0.62?C0.86) for patients with poor baseline lung function.

Conclusion

Functional metrics were identified to be better predictors for RP in patients with poor baseline lung function. SOD seemed to be a potential predictor for RP; however, it will need to be further verified using a larger sample size.     

Development of treatment and clinical results in childhood acute myeloid leukemia in the Slovak Republic

Background

Acute myeloid leukemia (AML) in children is rare, and it is generally considered to be more resistant to chemotherapy than acute lymphoblastic leukemia. However, because of the gradual intensification of chemotherapy and better supportive care, outcomes have improved considerably over the past 20 years. The management of children with AML in the Slovak Republic was unified and centralized during the second half of the 1990s with the introduction of Berlin-Frankfurt-Munster (BFM) protocols. In 2000, the AML-BFM-1998 protocol was introduced, and data collection became centralized.

Methods and results

Between 2000 and 2009, 73 patients (f?=?38, m?=?35) were treated according to the AML-BFM 1998. Complete remission (CR) was achieved in 89 % of the patients. The 5-year event-free-survival (EFS) and overall survival rates were 47?±?6 % and 52?±?6 %, respectively. The cumulative incidence of relapse was 38 %. The early death (ED) rate and the death rate in CR were both 7 %. The prognosis of children with favorable cytogenetics (standard risk (SR) group) tended to be better than the high-risk group (all other patients; EFS 63 vs. 40 %, p?=?0.15). This tendency was supported by a significantly lower cumulative incidence of relapse in the SR-group (p?=?0.008 by the log-rank test).

Conclusion

Unified treatment protocols and centralized diagnostics improved the management of pediatric AML in the Slovak Republic and increased the overall survival rate to 52 % in the total group and 68 % in children with a favorable cytogenetics. The high relapse rate and treatment-related mortality will be reduced by improving diagnostics, disease control, and the management of treatment-related complications.     

Dietary B vitamin and methionine intakes and lung cancer risk among female never smokers in China

Purpose

B vitamins and methionine have been postulated to have potential effects on carcinogenesis; however, findings from previous epidemiologic studies on B vitamins, methionine, and lung cancer risk are inconsistent. We investigated associations of dietary intakes of B vitamins (i.e., riboflavin, niacin, vitamin B6, folate, and vitamin B12) and methionine with lung cancer risk among female never smokers.

Methods

The Shanghai Women’s Health Study, a population-based, prospective cohort study, included 74,941 women. During a median follow-up of 11.2?years, 428 incident lung cancer cases accrued among 71,267 women with no history of smoking or cancer at baseline. Baseline dietary intakes were derived from a validated, interviewer-administered food frequency questionnaire. Cancer incidence and vital status were ascertained through annual linkage to the Shanghai Cancer Registry and Shanghai Vital Statistics Registry databases and through biennial in-person follow-ups with participants. Adjusted hazard ratios (HR) and 95?% confidence intervals (CI) were calculated using Cox regression.

Results

Dietary riboflavin intake was inversely associated with lung cancer risk (HR?=?0.62; 95?% CI?=?0.43–0.89; p trend?=?0.03 for the highest quartile compared with the lowest). A higher than median intake of methionine was associated with lower risk of lung cancer (HR?=?0.78; 95?% CI?=?0.60–0.99); however, there was no dose–response relation. Intakes of other B vitamins were not associated with lung cancer risk.

Conclusions

Our study suggests that dietary riboflavin intake may be inversely associated with lung cancer risk among female never smokers, which warrants further investigation.     

Effects of intravenous zoledronic acid and oral ibandronate on early changes in markers of bone turnover in patients with bone metastases from non-small cell lung cancer

Background

The aim of this study was to assess the early effects of zoledronic acid (ZOL) and oral ibandronate (IBA) on the bone resorption marker s-CTX (serum C-telopeptide of collagen type I) and the bone formation marker B-ALP (bone-alkaline phosphatase) in patients with bone metastases from non-small cell lung cancer (NSCLC).

Methods

Fifty-five patients with at least one site of bone metastasis secondary to NSCLC were randomly assigned to receive intravenous ZOL 4?mg every 4?weeks, or oral IBA 50?mg/day.

Results

At 1?month of treatment, s-CTX was reduced by 54.8% (95% CI 40.4?C59.8%) in the ZOL group (26 evaluable patients) compared with 38.2% (95% CI 29.8?C48.7%) in the oral IBA group (27 evaluable patients) (p?=?0.03). At 3?months, s-CTX was reduced by 72.6% (95% CI 58.6?C71.3%) in the ZOL group, compared with 66.4% (95% CI 54.3?C79.5%) in the oral IBA group (p?=?0.22). Both bisphosphonates similarly decreased the bone marker B-ALP at 1?month (ZOL 24.7%, 95% CI 3.6?C39.5%, and IBA 24.2%, 95% CI 2.8?C43.4%) and 3?months (ZOL 28.6%, 95% CI +2.8?C43.3%, and IBA 24.2%, 95% CI 3.2?C47.4%). Both bisphosphonates were well tolerated.

Conclusion

Considering the changes in bone markers, ZOL and oral IBA show comparable efficacy in patients with NSCLC and bone metastases.     

Adapted ice cream as a nutritional supplement in cancer patients: impact on quality of life and nutritional status

Aims

The aim of this study was to assess the impact of adapted ice cream as a dietary supplement on the quality of life (QLQ) of malnourished patients with cancer.

Material and methods

We present an exploratory prospective observational study comparing two patterns of nutrition in cancer patients admitted during the study period who presented malnutrition disorders: adapted ice cream (Group I: 39 patients) and nutritional supplements (Group II: 31 patients). Patients were selected from two different hospitals from the same Oncologic Institute. QLQ was evaluated with the Hospital Anxiety and Depression Scale (HADS) and QLQ of the European Organization for Research and Treatment of Cancer (EORTC QLQ C30). Nutrition was determined by the PG-SGA test.

Results

HADS showed significant differences in anxiety (p=0.023) and depression (p=0.011) at the end of the study only in Group I. QLQ-C30 revealed statistically significant differences in baseline measures of global dimension between the two groups (Group I: 40.64?C56.36 CI; Group II: 25.70?C43.11 CI; p=0.017). Differences were also present in the social dimension (Group I: 77.42?C93.51 CI; Group II: 55.85?C82.85 CI; p=0.039). Statistically significant differences were observed between the two groups at the end of the study in the global scale: Group I had 49.36-63.88 CI and Group II had 33.05?C51.88 CI (p=0.016), and in the fatigue scale: Group I had 36.19-53.83 CI and Group II had mean=65.87, 52.50?C79.23 CI (p=0.007).

Conclusions

The administration of ice cream could cover, in part, the social aspect of food and improve QLQ in malnourished cancer patients. These results are encouraging and deserve further confirmation.     

Repetitive element hypomethylation in blood leukocyte DNA and cancer incidence, prevalence, and mortality in elderly individuals: the Normative Aging Study

Background

Global genomic hypomethylation is a common epigenetic event in cancer that mostly results from hypomethylation of repetitive DNA elements. Case?Ccontrol studies have associated blood leukocyte DNA hypomethylation with several cancers. Because samples in case?Ccontrol studies are collected after disease development, whether DNA hypomethylation is causal or just associated with cancer development is still unclear.

Methods

In 722 elderly subjects from the Normative Aging Study cohort, we examined whether DNA methylation in repetitive elements (Alu, LINE-1) was associated with cancer incidence (30 new cases, median follow-up: 89 months), prevalence (205 baseline cases), and mortality (28 deaths, median follow-up: 85 months). DNA methylation was measured by bisulfite pyrosequencing.

Results

Individuals with low LINE-1 methylation (Conclusion These findings suggest that individuals with lower repetitive element methylation are at high risk of developing and dying from cancer.     

Relationship between cardiopulmonary mortality and cancer risk and quantitative exposure to polycyclic aromatic hydrocarbons, fluorides, and dust in two prebake aluminum smelters

Objectives

We examined the risk of mortality and cancer incidence with quantitative exposure to benzene-soluble fraction (BSF), benzo(a)pyrene (BaP), fluoride, and inhalable dust in two Australian prebake smelters.

Methods

A total of 4,316 male smelter workers were linked to mortality and cancer incidence registries and followed from 1983 through 2002 (mean follow-up: 15.9 years, maximum: 20 years). Internal comparisons using Poisson regression were undertaken based on quantitative exposure levels.

Results

Smoking-adjusted, monotonic relationships were observed between respiratory cancer and cumulative inhalable dust exposure (trend p = 0.1), cumulative fluoride exposure (p = 0.1), and cumulative BaP exposure (p = 0.2). The exposure–response trends were stronger when examined across the exposed categories (BaP p = 0.1; inhalable dust p = 0.04). A monotonic, but not statistically significant trend was observed between cumulative BaP exposure and stomach cancer (n = 14). Bladder cancer was not associated with BaP or BSF exposure. No other cancer and no mortality outcomes were associated with these smelter exposures.

Conclusions

The carcinogenicity of Söderberg smelter exposures is well established; in these prebake smelters we observed an association between smelter exposures and respiratory cancer, but not bladder cancer. The exploratory finding for stomach cancer needs confirmation. These results are preliminary due to the young cohort and short follow-up time.     

Association of Type 2 Diabetes and Colon Adenomas

Introduction

Type 2 diabetes mellitus (DM) is associated with hyperinsulinemia, which may lead to increased risk of carcinogenesis by increasing insulin-like growth factor-1 level. In this study, we sought to determine the association between type 2 DM and colon adenomas.

Methods

In this retrospective case?Ccontrol study, all the colonoscopies performed in an urban medical center during a 3-year period were reviewed. Patients with adenomatous polyps were considered as cases (n?=?261). Age- and sex-matched controls with a 2:1 ratio were selected (n?=?522). Among diabetic subjects, the association of different anti-diabetic medications and HbA1C level with high-risk adenoma features was analyzed.

Results

Type 2 DM was significantly associated with colon adenomas (odds ratio (OR)?=?1.45, 95% confidence interval (CI)?=?1.05?C2.01, p?=?0.024). Exposure to insulin (OR?=?1.734, 95% CI?=?1.13?C2.65, p?=?0.013) and thiazolidinediones (OR?=?2.83, 95% CI?=?1.28?C6.26, p?=?0.01) was associated with developing adenomas. Neither the type of antidiabetic medication nor the level of HbA1C was a predictor for high-risk adenomas. Smoking (OR?=?1.47, 95% CI?=?1.07?C2.02, p?=?0.02), use of aspirin (OR?=?1.59, 95% CI?=?1.15?C2.20, p?=?0.005), and statins (OR?=?1.54, 95% CI?=?1.13?C2.10, p?=?0.007) appeared to increase the risk of adenomas.

Conclusion

This study shows a significant association between type 2 DM and colon adenomas. Establishing this association may lead to inclusion of diabetic patients in the high-risk group for developing colorectal cancer.     

Marriage and divorce among young adult cancer survivors

Purpose

We examined marital outcomes among cancer survivors diagnosed during early adulthood from the 2009 Behavioral Risk Factor Surveillance System dataset.

Methods

Eligible participants were ages 20?C39?years. Of the 74,433 eligible, N?=?1,198 self-reported a cancer diagnosis between the ages of 18 and 37, were ??2?years past diagnosis, and did not have non-melanoma skin cancer. The remaining N?=?67,063 were controls. Using generalized linear models adjusted for age, gender, race, and education, we generated relative risks (RR) and 95?% confidence intervals (95?% CI) to examine survivor status on indicators of ever married, currently married, and divorced/separated.

Results

Survivors were slightly older than controls [33.0 (SD?=?3.8) vs. 30.0 (SD?=?4.0); p?<?0.001]. Average time since diagnosis was 7.4?years. Most common diagnoses were cervical (females; 45?%) and non-Hodgkin lymphoma (males; 20?%). Survivors were less likely to be currently married than controls (58?% vs. 64?%; RR?=?0.92, 95?% CI 0.85?C0.99). Among ever married participants, survivors were at an increased risk of divorce/separation than controls (18?% vs. 10?%; RR?=?1.77, 95?% CI 1.43?C2.19). Divorce/separation risk persisted for female survivors (RR 1.83, 95?% CI 1.49?C2.25), survivors ages 20?C29 (RR 2.57, 95?% CI 1.53?C4.34), and survivors ages 30?C39 (RR 1.62, 95?% CI 1.29?C2.04).

Conclusions

The emotional and financial burdens of cancer may lead to marital stress for younger cancer survivors.

Implications for cancer survivors

Young survivors may face a higher risk of divorce; support systems are needed to assist them in the years following diagnosis.     

Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL Study

Objective

Research suggests that physical activity is associated with improved breast cancer survival, yet no studies have examined the association between post-diagnosis changes in physical activity and breast cancer outcomes. The aim of this study was to determine whether baseline activity and 1-year change in activity are associated with breast cancer events or mortality.

Methods

A total of 2,361 post-treatment breast cancer survivors (Stage I?CIII) enrolled in a randomized controlled trial of dietary change completed physical activity measures at baseline and one year. Physical activity variables (total, moderate?Cvigorous, and adherence to guidelines) were calculated for each time point. Median follow-up was 7.1 years. Outcomes were invasive breast cancer events and all-cause mortality.

Results

Those who were most active at baseline had a 53% lower mortality risk compared to the least active women (HR = 0.47; 95% CI: 0.26, 0.84; p = .01). Adherence to activity guidelines was associated with a 35% lower mortality risk (HR = 0.65, 95% CI: 0.47, 0.91; p < .01). Neither baseline nor 1-year change in activity was associated with additional breast cancer events.

Conclusions

Higher baseline (post-treatment) physical activity was associated with improved survival. However, change in activity over the following year was not associated with outcomes. These data suggest that long-term physical activity levels are important for breast cancer prognosis.     

Significant calendar period deviations in testicular germ cell tumors indicate that postnatal exposures are etiologically relevant

Purpose

The current working model of type II testicular germ cell tumor (TGCT) pathogenesis states that carcinoma in situ arises during embryogenesis, is a necessary precursor, and always progresses to cancer. An implicit condition of this model is that only in utero exposures affect the development of TGCT in later life. In an age-period-cohort analysis, this working model contends an absence of calendar period deviations. We tested this contention using data from the SEER registries of the United States.

Methods

We assessed age-period-cohort models of TGCTs, seminomas, and nonseminomas for the period 1973–2008. Analyses were restricted to whites diagnosed at ages 15–74?years. We tested whether calendar period deviations were significant in TGCT incidence trends adjusted for age deviations and cohort effects.

Results

This analysis included 32,250 TGCTs (18,475 seminomas and 13,775 nonseminomas). Seminoma incidence trends have increased with an average annual percentage change in log-linear rates (net drift) of 1.25?%, relative to just 0.14?% for nonseminoma. In more recent time periods, TGCT incidence trends have plateaued and then undergone a slight decrease. Calendar period deviations were highly statistically significant in models of TGCT (p?=?1.24^?9) and seminoma (p?=?3.99^?14), after adjustment for age deviations and cohort effects; results for nonseminoma (p?=?0.02) indicated that the effects of calendar period were much more muted.

Conclusion

Calendar period deviations play a significant role in incidence trends of TGCT, which indicates that postnatal exposures are etiologically relevant.     

Fixed-dose rate infusion and standard rate infusion of gemcitabine in patients with advanced non-small-cell lung cancer: a meta-analysis of six trials

Purpose

To compare the response, survival, hematological and non-hematological toxicities of gemcitabine administrated at fixed-dose rate infusion (10?mg/m²/min, FDR) and standard 30?min infusion in patients with advanced non-small-cell lung cancer (NSCLC).

Methods

Electronic databases of MEDLINE, EMBASE and Cochrane Library were searched using key words of ??gemcitabine,?? ??fixed-dose rate,?? ??non-small-cell lung cancer?? and their alternative spellings. An expanded search of references of relative articles was also performed. The last search was performed on September 10, 2012. Primary endpoints were overall survival rate (ORR) and 1-year survival rate (1-year SR); hematological and non-hematological toxicities were secondary endpoints.

Results

Six randomized controlled trials, involving 867 patients, met our inclusion criteria and were analyzed. Pooled results showed that FDR infusion of gemcitabine had an equal ORR (RR?=?0.91, 95?% CI: 0.74?C1.13; heterogeneity p?=?0.39) and 1-year SR (RR?=?1.09, 95?% CI: 0.93?C1.29; heterogeneity p?=?0.75) compared with standard infusion. Subgroup analysis found that chemotherapy drug combinations do not affect the results of ORR or 1-year SR. Patients received FDR infusion, however, experienced more grade 3/4 hematological (neutropenia, leukopenia and anemia) and non-hematological (diarrhea and fatigue) toxicities.

Conclusion

This meta-analysis found that FDR infusion of gemcitabine had equal ORR and 1-year SR with standard infusion in patients with advanced NSCLC, while FDR infusion was associated with more grade 3/4 hematological and non-hematological toxicities.     

Trends in lung cancer incidence by histologic subtype in the south of Spain, 1985–2012: a population-based study

Purpose

To analyze and interpret age- and sex-specific incidence trends of lung cancer in Granada over the period 1985–2012 and to further analyze these trends by histologic subtype.

Methods

Incidence data were obtained from the population-based cancer registry located in Granada (Southern Spain). All cases with newly diagnosed primary lung cancer over the period 1985–2012 (n = 8658) and defined by International Classification of Diseases 10th Revision (codes C33–C34) were included. Joinpoint regression analysis of age-standardized incidence rates was used to estimate the annual percent change (APC) and 95 % confidence intervals. Results are presented overall and by sex, age groups (0–34, 35–54, 55–64, 65–74, ≥75 years) and histologic subtypes.

Results

Temporal trends of incidence rates by sex, over the period 1985–2012, showed a distinct pattern. A significant change point of the trend was observed in males in 1994 (APC: +2.5 %; 95 % CI 0.7–4.4 from 1985 to 1994 and ?1.4 %; 95 % CI ?2.0 to ?0.7 from 1994 onward). This general change was mainly caused by the age group 65–74 years and by the higher incidence of squamous cell carcinoma histologic subtype. In females, lung cancer incidence increased over the entire study period by +4.2 % per year (95 % CI 3.1–5.4); this trend was mainly caused by the age group 55–64 years (APC = +7 %) and by adenocarcinoma incidence between women (APC = +6.8 %).

Conclusion

Male lung cancer incidence rates have decreased in Granada, while female rates have increased overall especially in younger women. These trends may reflect the increased consumption of cigarettes in women, especially during younger ages. Lung cancer prevention through tobacco control policies are therefore of utmost importance.

     

Tobacco consumption and genetic susceptibility to nasopharyngeal carcinoma (NPC) in Thailand

Background

The incidence of nasopharyngeal carcinoma (NPC) varies substantially worldwide, with an endemic pocket in Southeast Asia.

Method

We assessed lifestyle and genetic factors in relation to NPC risk among 681 NPC cases and 1,078 controls from Thailand. Evaluated lifestyle factors included traditionally preserved foods, tobacco smoking, betel quid chewing, and alcohol consumption. Genetic factors included six variants implicated in a previous a genome-wide association study (GWAS) of NPC and three variants residing near the CHRNA3 and TERT genes that were linked to lung cancer risk in Asian populations. Odds ratios (OR) and 95?% confidence intervals (95?% CI) were estimated using unconditional logistic regression.

Results

Frequent consumption of fermented vegetables was associated with increased NPC risk (OR of consumption ≥weekly vs. ≤rare 1.78, 95?% CI 1.24–2.55, p _trend?=?0.005), as was tobacco smoking (p _trend?<?0.001), former and current smokers displaying OR of 1.57 (95?% CI 1.10–2.30) and 2.00 (95?% CI 1.48–2.71) compared to never smokers, respectively. Four out of six genetic variants implicated in the recent NPC GWAS were associated with NPC risk (p _trend?≤?0.03), as well as two variants (rs402710 and rs2736098) on the TERT locus at 5p15.33 (p?=?0.004 and p?=?0.04, respectively).

Conclusions

These results strengthen our previous observation that tobacco smoking is an important risk factor of NPC in this population. Four out of six genetic variants identified in a recent NPC GWAS were confirmed, and the association noted with variants on 5p15.33 suggests that this locus is involved in NPC susceptibility, representing a novel finding in NPC epidemiology.     

ABO blood group and risk of epithelial ovarian cancer within the Ovarian Cancer Association Consortium

Purpose

Previous studies have examined the association between ABO blood group and ovarian cancer risk, with inconclusive results.

Methods

In eight studies participating in the Ovarian Cancer Association Consortium, we determined ABO blood groups and diplotypes by genotyping 3 SNPs in the ABO locus. Odds ratios and 95?% confidence intervals were calculated in each study using logistic regression; individual study results were combined using random effects meta-analysis.

Results

Compared to blood group O, the A blood group was associated with a modestly increased ovarian cancer risk: (OR: 1.09; 95 %?CI: 1.01–1.18; p?=?0.03). In diplotype analysis, the AO, but not the AA diplotype, was associated with increased risk (AO: OR: 1.11; 95 %?CI: 1.01–1.22; p?=?0.03; AA: OR: 1.03; 95 %?CI: 0.87–1.21; p?=?0.76). Neither AB nor the B blood groups were associated with risk. Results were similar across ovarian cancer histologic subtypes.

Conclusion

Consistent with most previous reports, the A blood type was associated modestly with increased ovarian cancer risk in this large analysis of multiple studies of ovarian cancer. Future studies investigating potential biologic mechanisms are warranted.