Vitamin D Status and Risk of Breast Cancer in Iranian Women: A Case–Control Study

Objective: Considering the rising incidence of breast cancer and high prevalence of vitamin D deficiency in Iran, this case–control study aimed to investigate the relationship between serum concentration and intake of vitamin D and risk of breast cancer.

Methods: A total of 135 incident breast cancer cases at the Cancer Research Center of Shahid Beheshti University of Medical Sciences were matched with 135 controls by age and menopausal status. A validated and reliable 168-item food frequency questionnaire was completed by participant interviews. To determine the vitamin D content of foods we used the U.S. Department of Agriculture (USDA) nutrient database. To analyze the food frequency questionnaires we used the data collected in the Iranian Household Food Pattern Study, conducted by the National Nutrition and Food Technology Research Institute and the Iranian Ministry of Agriculture. Five-milliliter blood samples were collected to measure serum 25-hydroxyvitamin D (25(OH)D) using an enzyme-linked immunosorbent assay method.

Results: Women in the fourth quartile of serum 25(OH)D level had 3 times lower risk of developing breast cancer compared to those in the first quartile. In the adjusted model the inverse relationship remained significant (odds ratio [OR] = 0.269; 95% confidence interval [CI], 0.122–0.593). In the stratified model by menopausal status the inverse association was only seen in premenopausal women (OR = 0.25; 95% CI, 0.094–0.687).

Dietary intake of vitamin D was inversely associated with risk of breast cancer (OR fourth quartile [Q4] vs first quartile [Q1] = 0.39; 95% CI, 0.196–0.784; p = 0.008). After adjusting for the confounding factors, this inverse association remained significant.

Conclusion: Results from this case–control study support the protective effect of higher serum concentration of 25(OH)D against breast cancer. Moreover, dietary but not total intake of vitamin D was associated with decreased risk of breast cancer.     

How do Iranian Women with Breast Cancer Conceptualize Sex and Body Image?

Women’s sexual dysfunction after breast cancer diagnosis and treatment has received little research attention in Iran (I.R). Our goal was to identify sexual dysfunction and its related factors in Iranian women after diagnosis of breast cancer. A sample of 82 female breast cancer survivors seen for routine follow-up appointment from March 2006 to March 2007 completed a survey questionnaire regarding their sexual experiences, body image perception and opinion about sex after cancer diagnosis and treatment. The various aspects of sexual function that were disturbed was related to factors such as age, marital status, body image perception, and perceived husband’s attitude. The authors conclude that healthcare workers’ education is very important, so taking time to do research and passing along knowledge will go a long way in helping to address sexual disturbances in breast cancer survivor in our community.     

Soy Food Intake and Biomarkers of Breast Cancer Risk: Possible Difference in Asian Women?

Soy foods may protect against breast cancer in Asian but not in Western populations. We examined if the levels of various markers of breast cancer risk and inflammation, as well as the effects of soy food consumption on these markers, differ between Asian and non-Asian premenopausal women in two soy intervention trials. One study randomized 220 women to a 2-yr intervention and the other one randomized 96 women in a crossover design to examine the effects of consumption of 2 daily soy servings on nipple aspirate fluid (NAF) volume; estrogens in serum, NAF, and urine; insulin-like growth factor-1 (IGF-1), IGF-binding protein 3, and inflammatory markers in serum; and mammographic densities. Mixed linear models were applied to assess ethnic differences in biomarkers and response to the soy diet. Serum C-reactive protein, serum leptin, NAF volume, and NAF estrone sulfate were lower, while urinary isoflavones were higher in Asian than in non-Asian women. A significant interaction (p_interaction = 0.05) between ethnicity and soy diet was observed for IGF-1 but not for other biomarkers. The current findings suggest possible ethnic differences in levels of biomarkers for breast cancer risk but little evidence that Asian women respond differently to soy foods than non-Asian women.     

A Case–Control Study of Lung Cancer Nested in a Cohort of European Asphalt Workers

Background

We conducted a nested case–control study in a cohort of European asphalt workers in which an increase in lung cancer risk has been reported among workers exposed to airborne bitumen fume, although potential bias and confounding were not fully addressed.

Objective

We investigated the contribution of exposure to bitumen, other occupational agents, and tobacco smoking to the risk of lung cancer among asphalt workers.

Methods

Cases were cohort members in Denmark, Finland, France, Germany, the Netherlands, Norway, and Israel who had died of lung cancer between 1980 and the end of follow-up (2002–2005). Controls were individually matched in a 3:1 ratio to cases on year of birth and country. We derived exposure estimates for bitumen fume and condensate, organic vapor, and polycyclic aromatic hydrocarbons, as well as for asbestos, crystalline silica, diesel motor exhaust, and coal tar. Odds ratios (ORs) were calculated for ever-exposure, duration, average exposure, and cumulative exposure after adjusting for tobacco smoking and exposure to coal tar.

Results

A total of 433 cases and 1,253 controls were included in the analysis. The OR was 1.12 [95% confidence interval (CI), 0.84–1.49] for inhalation exposure to bitumen fume and 1.17 (95% CI, 0.88–1.56) for dermal exposure to bitumen condensate. No significant trend was observed between lung cancer risk and duration, average exposure, or cumulative exposure to bitumen fume or condensate.

Conclusions

We found no consistent evidence of an association between indicators of either inhalation or dermal exposure to bitumen and lung cancer risk. A sizable proportion of the excess mortality from lung cancer relative to the general population observed in the earlier cohort phase is likely attributable to high tobacco consumption and possibly to coal tar exposure, whereas other occupational agents do not appear to play an important role.     

Dietary Phytochemical Index and Benign Breast Diseases: A Case–Control Study

Abstract

Background: Dietary phytochemical index (DPI) is an inexpensive method for estimating the amounts of phytochemicals in foods. No study has investigated the association of DPI and benign breast diseases (BBD). Our study aimed to compare DPI in patients with BBD and the control group.

Subjects: This is a case–control study of 115 subjects with BBD and 116 healthy women attending the Iranian Center for Breast Cancer affiliated with Academic Center for Education, Culture and Research. Energy-adjusted DPI was calculated based on data collected from 168-item validated food frequency questionnaire. Sociodemographic data, physical activity, and anthropometric measures such as body weight, height, and waist circumference were determined.

Results: After adjustment for age, estrogen therapy, family history of breast disease, intake of dietary supplement, menopause status, waist circumference and physical activity, the odds ratio (OR) of BBD across the energy-adjusted DPI quartiles decreased significantly (OR = 0.3, 95%CI = 0.12–0.93) (P?trend?=?0.02).

Conclusion: We found that higher DPI score is related to lower BBD OR. This simple method may be used for the improvement of dietary intake to prevent BBD.     

Sexual Offending in Women and Psychiatric Disorder: A National Case–Control Study

Women commit 4–5% of all sexual crimes, but there is considerable uncertainty about associations with psychosis and substance abuse. We examined the prevalence of psychiatric hospitalization, psychotic disorders, and substance abuse in a nationwide sample of female sexual offenders. We obtained data from Swedish national registers for criminal convictions, hospital discharge diagnoses, and demographic and socioeconomic factors between 1988 and 2000, and merged them using unique identifiers. Convicted female sexual offenders (n = 93) were compared with all females convicted of non-sexual violent offences (n = 13,452) and a random sample of general population women (n = 20,597). Over 13 years, 36.6% of female sexual offenders had been admitted to psychiatric hospital and 7.5% been discharged with a diagnosis of a psychotic disorder. Compared to non-sexual violent offenders, there were no significant differences in the proportion diagnosed with psychosis or substance abuse. Compared to women in the general population, however, there was a significantly increased risk in sex offenders of psychiatric hospitalization (age-adjusted odds ratio [AOR] = 15.4; 95% CI: 10.0–23.7), being diagnosed with a psychotic disorder (AOR = 16.2; 95% CI: 7.2–36.4), and with substance use disorders (AOR = 22.6; 95% CI: 13.0–39.1). We conclude that the prevalence of psychotic and substance use disorders was not different between sexual offenders and other violent offenders, suggesting non-specificity of sexual offending in women. Nevertheless, substantially increased prevalences of psychiatric disorder, underline the importance of screening and assessment of female sexual and other violent offenders.     

Endometriosis and Organochlorinated Environmental Pollutants: A Case–Control Study on Italian Women of Reproductive Age

Background

Endometriosis is a common gynecologic disease characterized by the ectopic growth of endometrial tissue. In industrialized countries, it affects approximately 10% of women of reproductive age. Its etiology is unclear, but a multifactorial origin is considered to be most plausible. Environmental organochlorinated persistent pollutants, in particular dioxins and polychlorinated biphenyls (PCBs), have been hypothesized to play a role in the disease etiopathogenesis. However, results of studies carried out on humans are conflicting.

Objective

We evaluated the exposure to organochlorinated persistent pollutants as a risk factor for endometriosis.

Methods

We conducted a case–control study in Rome on 158 women comprising 80 cases and 78 controls. In all women, serum concentrations of selected non-dioxin-like PCBs (NDL-PCBs) and dioxin-like PCBs (DL-PCBs), 1,1-dichloro-2,2,-bis(4-chlorophenyl)-ethene (p,p′-DDE), and hexachlorobenzene (HCB) were determined by ion-trap mass spectrometry. DR-CALUX bioassay was employed to assess the 2,3,7,8-tetrachlorodibenzo-p-dioxin toxicity equivalent (TEQ) concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and DL-PCBs.

Results

We found an increased risk of endometriosis for DL-PCB-118 [odds ratio (OR) = 3.79; 95% confidence interval (CI), 1.61–8.91], NDL-PCB-138 (OR = 3.78; 95% CI, 1.60–8.94), NDL-PCB-153 (OR = 4.88; 95% CI, 2.01–11.0), NDL-PCB-170 (OR = 3.52; 95% CI, 1.41–8.79), and the sum of DL-PCBs and NDL-PCBs (OR = 5.63; 95% CI, 2.25–14.10). No significant associations were observed with respect to HCB or to the sum of PCDDs, PCDFs, and DL-PCBs given as total TEQs.

Conclusions

The results of this study show that an association exists between increased PCB and p,p′-DDE serum concentrations and the risk of endometriosis.     

Fatalism or Destiny? A Qualitative Study and Interpretative Framework on Dominican Women’s Breast Cancer Beliefs

Background A growing literature on Latino’s beliefs about cancer focuses on the concept of fatalismo (fatalism), despite numerous conceptual ambiguities concerning its meaning, definition, and measurement. This study explored Latina women’s views on breast cancer and screening within a cultural framework of destino (“destiny”), or the notion that both personal agency and external forces can influence health and life events. Methods Semi-structured interviews were conducted with 25 Latinas from the Dominican Republic aged 40 or over. Results Respondents reported complex notions of health locus of control that encompassed both internal (e.g., individual action) and external (e.g., the will of God) forces shaping breast cancer prevention efforts. Furthermore, women actively participated in screening because they believed that cancer could become a death sentence if diagnosed late or left untreated. Discussion In contrast to simplistic notions of “fatalism”, our analysis suggests complex strategies and beliefs regarding breast cancer and cancer screening that speak of resiliency rather than hopelessness.

Is Adolescents’ Free Sugar Intake Associated with the Free Sugar Intake of Their Parents?

High free sugar intake can lead to increased dental caries, obesity, and other health risks among adolescents. Studies have shown that family factors, especially parents, are one of the primary factors influencing adolescents’ sugar intake. This study aims to investigate the influence of adolescent parents’ free sugar intake, knowledge, attitude, and practice (KAP) on adolescents’ free sugar intake. A total of 1090 pairs of adolescents and their parents from 10 secondary schools in Changsha were enrolled in a cross-sectional study. Free sugar intakes of parents and adolescents were measured using the food frequency questionnaire (FFQ). The current status of parents’ knowledge, attitude, and practice in consuming free sugar was investigated using online and offline questionnaires. Parental free sugar intake was 11.55 (5.08, 21.95) g/d, and that of adolescents was 41.13 (19.06, 80.58) g/d. Parental free sugar intake, free sugar knowledge level, intake behavior, and guidance behavior were associated with adolescent free sugar intake. A superior level of parental free sugar knowledge (adjusted OR = 0.726, 95% CI: 0.557~0.946) was a protective factor for adolescent free sugar intake. Moderate and high levels of parental free sugar intake (adjusted OR = 1.706, 95% CI: 1.212~2.401; adjusted OR = 2.372, 95% CI: 1.492~3.773, respectively) were risk factors for free sugar intake in adolescents. Given the importance of parental influence on the adolescent free sugar intake, further limiting parental intake and increasing awareness of free sugars could play an active role in future interventions for adolescents’ free sugar intake.     

Sociodemographic and Lifestyle Factors in Relation to Gastric Cancer in a High-Risk Region of China: A Matched Case–Control Study

Abstract

Objectives: To explore the role of sociodemographic and lifestyle factors in the development of gastric cancer in a high-risk region of China.

Methods: In a case–control study, all newly diagnosed patients with gastric cancer were compared with healthy controls matched (1:1) by sex, age (±3?years), and place of residence during 2013–2017.

Results: A total of 622 gastric cancer and 622 healthy controls were included. Larger household size (>4 family members) appeared to decrease gastric cancer risk for Helicobacter pylori-negative ones (odd ratio?=?0.43, 95% CI?=?0.26–0.70). Similarly, longer refrigerator ownership was associated with a 67% decreased risk in H. pylori-negative group (95% CI?=?0.15–0.77). Participants with a family history of gastric cancer had nearly fivefold higher risk (odd ratio?=?4.88, 95% CI?=?2.49–9.55). Smoking attributed to 83% increased risk (odd ratio?=?1.83, 95% CI?=?1.19–2.80). Tea consumption dramatically decreased risk in whole study population (odd ratio?=?0.28, 95% CI?=?0.17–0.45).

Conclusions: In summary, family history, smoking, H. pylori-related chronic atrophic gastritis, and H. pylori infection were positively associated with gastric cancer. Whereas, tea consumption and refrigerator use negatively associated with gastric cancer and could be promoted to reduce gastric cancer rate in high-risk populations, especially in the developing regions.     

Is Sexual Dysfunction Associated with Diabetes Control and Related Factors in Women with Diabetes?

This study was performed to evaluate the sexual dysfunction (SD) in women with diabetes and to correlate SD with the factors related to diabetes and its control. The study was conducted in 310 non-pregnant women with diabetes, 19 years and over. Socio-demographic characteristics and other factors related to diabetes were evaluated using Participant Information Form. The Arizona Sexual Experience Scale was used to evaluate sexual function. Rate of SD was found as 46.7%. SD was frequent in sexual desire(36.8%), satisfaction from orgasm(25.5%) and orgasm(24.8%). Type of diabetes and treatment, blood pressure, cholesterol levels, BMI were not associated with SD (P > 0.05). SD increased with age, HbA_1c, high number of diabetic complications and poor education (P < 0.05). An one unit increase in HbA_1c value caused 19.1% of dysfunction increase on sexual dysfunction, 23.2% on drive, 20.7% on satisfaction from orgasm and 17.5% on orgasm(P < 0.05). Increasing HbA_1c, number of diabetic complications and low literacy should be considered as risk factors of SD and evaluated in routine clinical care of women with diabetes.     

Is Cumulated Pyrethroid Exposure Associated With Prediabetes? A Cross-sectional Study

Pyrethroids are a class of insecticides used widely for vector control programs. Acute pyrethroid poisoning is rare, but well documented, whereas effects of cumulative exposure are insufficiently described, including possible negative effect on glucose regulation. The objective of this study was to investigate an association between exposure to pyrethroids and abnormal glucose regulation (prediabetes or diabetes). A cross-sectional study was performed among 116 pesticide sprayers from public vector control programs in Bolivia and 92 nonexposed controls. Pesticide exposure (duration, intensity, cumulative exposure) was assessed from questionnaire data. Participants were asked about symptoms of diabetes. Blood samples were analyzed for glycosylated hemoglobin (HbA_1c), a measure of glucose regulation. No association was found between pyrethroid exposure and diabetes symptoms. The prevalence of abnormal glucose regulation (defined as HbA_1c ≥ 5.6%) was 61.1% among sprayers and 7.9% among nonexposed controls, corresponding to an adjusted odds ratio (OR [95% confidence interval]) for all sprayers of 11.8 [4.2–33.2] and 18.5 [5.5–62.5] for pyrethroid-exposed only. Among sprayers who had only used pyrethroids, a significant positive trend was observed between cumulative pesticide exposure (total number of hours sprayed) and adjusted OR of abnormal glucose regulation, with OR 14.7 [0.9–235] in the third exposure quintile. The study found a severely increased prevalence of prediabetes among Bolivian pesticide sprayers compared with a control group, but the relevance of the control group is critical. Within the spraying group, an association between cumulative exposure to pyrethroids and abnormal glucose regulation was seen. Further studies are needed to confirm this association.     

Association of TNF-α 308?G/A Polymorphism With Type 2 Diabetes: A Case–Control Study in the Iranian Kurdish Ethnic Group

Objectives

Tumor necrosis factor-α (TNF-α) plays roles in the development of obesity, insulin resistance, and possibility of Type 2 diabetes mellitus (T2DM). The objective of the current study was to evaluate the association of TNF-α promoter−308 G/A polymorphism with T2DM.

Methods

In all, 1038 patients with T2DM and 1023 normoglycemic controls were included in this study. All participants were genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. Genotypic and allelic frequencies were then analyzed in each group. Serum lipids, fasting glucose, fasting serum insulin, homeostatic model assessment of insulin resistance, and hemoglogin A1c levels were determined by conventional methods.

Results

The allelic frequency of the A allele was significantly different between case and control participants (p = 0.006). Genotypes GA and AA were found to be significantly associated with 2.24- and 3.18-fold increased risk for T2DM, respectively. Similarly, the dominant model of -308 G/A polymorphism was found to have a higher risk for T2DM (odds ratio = 2.34, p = 0.001). Individuals with T2DM carrying the GA + AA genotypes of -308 G/A variation had significantly lower fasting plasma insulin than those carrying GG genotype.

Conclusion

Our findings revealed that there is an association between the TNF-α promoter -308 G/A polymorphism and T2DM in this population.     

Is Quality of Life Related to Cardiorespiratory Fitness in Overweight and Obese Breast Cancer Survivors?

This study assessed changes in quality of life (QoL) and cardiorespiratory fitness (CRF) during a diet and physical activity (PA) intervention in breast cancer (BC) survivors and investigated the relation between these changes. The intervention of this single-arm pre-post study involved supervised, 1-hour weekly, diet sessions and 75-minute bi-weekly PA sessions of moderate-to-high intensity. This 12-week intervention targeted overweight/obese women who had recently completed BC treatment. Pre- and post-CRF and QoL measurements were compared using paired t-tests. Linear regression models, including baseline participants’ characteristics and weight change, were used to assess the association between changes in CRF and QoL. The 37 BC survivors who completed the intervention between May 7, 2012 and July 27, 2012 showed significant increases in CRF and QoL. Peak oxygen uptake (mL/kg/min) increased from 19.0 ± 2.8 to 24.0 ± 4.1 while peak workload (watts/kg) increased from 1.3 ± 0.3 to 1.7 ± 0.3. Although statistical significance was not reached, the increase in workload seemed associated with increases in physical, mental, and general health and with a decrease in fatigue. This lifestyle intervention improved BC survivors’ QoL and CRF and suggested possible relationships between CRF and QoL. More research needs to confirm these associations and promote lifestyle interventions aiming at improving BC survivors’ QoL.     

Breast Cancer Worry among Women Awaiting Mammography: Is It Unfounded? Does Prior Counseling Help?

The purpose of this study was to explore the prevalence of breast cancer anxiety and risk counseling in women undergoing mammography, and the association with known risk factors for cancer. Women awaiting mammography were surveyed regarding anxiety, prior breast cancer risk counseling, demographic and risk factors. Anxiety was assessed via 7-point Likert-type scale (LS). Risk was defined by Gail model or prior breast cancer. Data were analyzed by nonparametric methods; significance determined at alpha = 0.05. Of 227 women surveyed, 54 were classified “higher risk”. Counseling prevalence was similar (52%) for all ethnic groups, but higher (72%, P<0.001) for “higher risk” women. On average, women awaiting screening/diagnostic mammography were somewhat worried (median LS = 4). Worry was significantly higher (P<0.05) in “higher risk” women (LS = 5), and in women living outside Honolulu (LS = 6). Counseling by primary care physicians (PCP) did not correlate with lower worry scores. It was concluded that most women awaiting mammography are not unduly anxious. Additionally, the findings showed a correlation between a woman''s concern about developing cancer with known risk factors and rural residence.     

Is Caffeine Intake Associated With Urinary Incontinence in Japanese Adults?

Objectives

To investigate whether caffeine intake is associated with urinary incontinence (UI) among Japanese adults.

Methods

A total of 683 men and 298 women aged 40 to 75 years were recruited from the community in middle and southern Japan. A validated food frequency questionnaire was administered face-to-face to obtain information on dietary intake and habitual beverage consumption. Urinary incontinence status was ascertained using the International Consultation on Incontinence Questionnaire-Short Form.

Results

Mean daily caffeine intake was found to be similar between incontinent subjects (men 120 mg, women 94 mg) and others without the condition (men 106 mg, women 103 mg), p=0.33 for men and p=0.44 for women. The slight increases in risk of UI at the highest level of caffeine intake were not significant after adjusting for confounding factors. The adjusted odds ratios (95% confidence interval) were 1.36 (0.65 to 2.88) and 1.12 (0.57 to 2.22) for men and women, respectively.

Conclusions

No association was evident between caffeine intake and UI in middle-aged and older Japanese adults. Further studies are required to confirm the effect of caffeine in the prevention of UI.     

Is Neighbourhood Linking Social Capital Associated With Colorectal Cancer Incidence and Mortality? A National Cohort Study From Sweden

Journal of Prevention - Past research on the social determinants of colorectal cancer (CRC) has shown that lower socioeconomic status (SES) is associated with a higher risk of CRC. Similar to SES...     

Paraneoplastic Syndrome in Hawai‘i: A Case of Dermatomyositis Associated with Endometrial Cancer

Dermatomyositis as a paraneoplastic consequence of gynecological malignancy has rarely been reported in literature and never been reported in Honolulu. This case report describes a local Honolulu resident who was diagnosed with endometrial adenocarcinoma upon presenting with acute dermatomyositis symptoms.     

End-stage Renal Disease in Taiwan: A Case–Control Study

Background

Taiwan has the highest incidence of end-stage renal disease (ESRD) in the world. The epidemiologic features of ESRD, however, have not been investigated. In this case–control study, we evaluated the risk of ESRD associated with a number of putative risk factors.

Methods

We studied 200 patients among whom ESRD had been newly diagnosed between 1 January 2005 and 31 December 2005; 200 controls were selected from among relatives of patients treated in the general surgery unit. Using a structured questionnaire, we collected information related to socioeconomic factors, history of disease, regular blood or urine screening, lifestyle, environmental exposure, consumption of vitamin supplements, and regular drug use at 5 years before disease onset.

Results

Our primary multivariate risk models indicated that low socioeconomic status was a strong predictor of ESRD (education: odds ratio [OR], 2.78; 95% confidence interval [CI], 1.49–5.19; income: OR, 2.86, 95% CI, 1.48–5.52), even after adjusting for other risk factors. Other significant predictors for ESRD were a history of hypertension (OR, 3.63–3.90), history of diabetes (OR, 3.85–5.50), and regular intake of folk remedies or over-the-counter Chinese herbs (OR, 10.84–12.51). Regular intake of a multivitamin supplement 5 years before diagnosis was associated with a decreased risk of ESRD (OR, 0.12–0.14).

Conclusions

Our findings indicate that low socioeconomic status, history of hypertension, diabetes, and regular use of folk remedies or over-the-counter Chinese herbs were significant risk factors for ESRD, while regular intake of a multivitamin supplement was associated with a decreased risk of ESRD.Key words: end-stage renal disease, case–control study, risk factors, Taiwan