Reproductive history in relation to breast cancer risk among Hispanic and non-Hispanic white women

Objective To evaluate reproductive history risk factors in breast cancer among Hispanic (HISP) women in the U.S. southwest, a population with approximately 33% lower breast cancer incidence than non-Hispanic whites (NHW). Methods Population-based case–control study of HISP (796 cases, 919 controls) and NHW (1,525 cases, 1,596 controls) women. Results 19.3% of HISP women reported five or more births and had a reduced risk of breast cancer, adjusted odds ratio (OR) 0.70 (95% confidence interval (CI): 0.50, 0.98) compared to those with one or two births. Breast cancer risk for HISP increased with older age at first birth, p trend = 0.008. Parity and age at first birth associations were specific to ER positive tumors. HISP women who had given birth within five years had higher breast cancer risk than women with 16–25 years since a birth, OR 2.62 (95% CI: 1.44, 4.78); the trend with years since last birth was stronger than for NHWs, p interaction = 0.05. Conclusions Reproductive history influences on breast cancer risk among HISP were similar to associations reported for NHWs. Differences in the prevalence of reproductive risk factors would explain an estimated 6.6% lower breast cancer incidence for HISP compared to NHWs.     

Family history and age at onset of breast cancer in Hispanic and non-Hispanic white women

Objectives  To evaluate the association between family history of breast cancer and breast cancer risk among Hispanic and non-Hispanic white (NHW) women. Methods  Logistic regression models were used to compute unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using data collected from the 4-Corners Breast Cancer Study, a population-based case–control study of breast cancer conducted in the Southwest United States (3,074 NHW and 1,647 Hispanic women). Results  The association between family history of breast cancer and early-onset breast cancer risk differs among NHW and Hispanic women. Among women <50 years old, having a family history of breast cancer was associated with a greater increase in risk among NHWs, with an OR of 2.34 (95% CI: 1.64–3.35) when compared to an OR of 1.32 (95% CI: 0.82–2.19) for Hispanics. This difference in risk was not observed among women 50 years and older, with an OR of 1.69 (95% CI: 1.34–2.13) for NHW and 1.47 (95% CI: 1.03–2.10) for Hispanics. Conclusions  Family history of breast cancer poses a greater risk for early-onset breast cancers among NHW when compared to Hispanic women and may reflect ethnic differences in certain predisposing genetic factors that promote breast cancer development.     

Body size,weight change,fat distribution and breast cancer risk in Hispanic and non-Hispanic white women

INTRODUCTION: The incidence of breast cancer varies among women living in the Southwestern part of the US. We evaluate how body size influences breast cancer risk among these women. METHODS: Cases (n = 2,325) diagnosed with breast cancer between October 1, 1999 and May 2004 residing in Arizona, Colorado, New Mexico, or Utah were matched to controls (n = 2,525). Participants were interviewed; height, weight, waist, and hip circumference were measured at the time of interview; blood was drawn. RESULTS: A large body mass index (BMI) at age 15 was inversely associated with pre-menopausal breast cancer risk in both non-Hispanic white (NHW) and Hispanic women (Odds ratio, ORs 0.68 95% CI 0.44, 1.04, and 0.65 95% CI 0.39, 1.08, respectively); BMI at age 15 also had an impact on subsequent breast cancer associated with obesity after menopause. Among post-menopausal women, recent exposure to hormones was an important modifier of risk associated with body size. Among women not recently exposed to hormones risk associated with obesity was 1.61 (95% CI 1.05, 2.45) for NHW women; gaining > or = 25 kg between 15 and age 50 was inversely associated with breast cancer among Hispanic women (OR 0.51, 95% CI 0.23, 1.14). A large weight gain and a large waist-to-hip ratio (WHR) was associated with an increased odds of having an estrogen receptor negative tumor among NHW only (OR 1.81, 95% CI 1.07, 3.08, and 2.04 95% CI 1.20,3.50). CONCLUSIONS: These findings suggest that the metabolic consequences of obesity on breast cancer risk differ between NHW and Hispanic women living in the Southwest.     

Depression and sexual adjustment following breast cancer in low‐income Hispanic and non‐Hispanic White women

Objective: Hispanics are the largest and fastest growing ethnic minority group in the United States and breast cancer is the most commonly diagnosed cancer in Hispanic women. However, Hispanics are underrepresented in the psychosocial breast cancer literature. Methods: This study included 677 low‐income women (425 Hispanic, 252 non‐Hispanic White) enrolled in the Medi‐Cal Breast and Cervical Cancer Treatment Program. Data were gathered through phone interviews conducted in English or Spanish 6 and 18 months following breast cancer diagnosis. We focus on three variables that the literature indicates are salient for breast cancer survivors: sexual function, body image and depression. Results: Results of an ANCOVA indicated worse sexual function for Hispanic women, even after controlling for significant covariates. Hispanics reported significantly less sexual desire, greater difficulty relaxing and enjoying sex, and greater difficulty becoming sexually aroused and having orgasms than non‐Hispanic White women. Both Hispanic and non‐Hispanic White women endorsed a lack of sexual desire more frequently than problems with sexual function. Body image did not differ between Hispanic and non‐Hispanic White women. In all, 38% of Hispanic and 48% of non‐Hispanic White women scored above cut‐off scores for depressive symptoms. While there was no ethnic difference in depressive symptoms, single women reported more depressive symptoms than partnered women. Conclusions: Findings suggest that low‐income breast cancer survivors may experience symptoms of depression more than a year following diagnosis, and that sexual dysfunction may be particularly salient for low‐income Hispanic women. Copyright © 2009 John Wiley & Sons, Ltd.     

Obesity is associated with breast cancer in African-American women but not Hispanic women in South Los Angeles

BACKGROUND:

Obesity is considered a risk factor for breast cancer. Modifying life styles that reduce obesity offers the potential for prevention and improved outcomes from cancer. The effects of obesity and breast cancer among African‐American women and Hispanic women have been explored in a limited number of studies. The objective of the current study was to investigate the association of obesity with breast cancer in a minority cohort.

METHODS:

This was a cross‐sectional study of 471 African‐American and Hispanic women with and without breast cancer in South Los Angeles. Data regarding body mass index (BMI) and clinical factors were obtained by medical record abstraction. Data were assessed using logistic regression with multivariate analysis. Kaplan‐Meier survival analysis was used to assess disease‐free survival.

RESULTS:

Women with breast cancer were more likely to be obese (BMI >30 kg/m²) than women without breast cancer (odds ratio [OR], 2.0; P = .01). There was a significant association of being overweight or obese and breast cancer among postmenopausal women (OR, 2.3 [P = .03] and 2.9 [P < .01], respectively). The association between obesity and breast cancer was significant only among African‐American women (OR, 2.70; P < .01) and was especially significant among postmenopausal African‐American women (OR, 4.8; P < .01). There was a borderline significant association between obesity and later disease stage at diagnosis (P = .06). An association also was observed between higher BMI (for cutoff points of both 30 kg/m² and 28 kg/m²) and poorer disease‐free survival (P = .045 and P = .019, respectively).

CONCLUSIONS:

The current data suggested an association between obesity and breast cancer, especially among postmenopausal women and most significantly in the African‐American cohort. Cancer 2011. © 2011 American Cancer Society.     

The risk of developing invasive breast cancer in Hispanic women

BACKGROUND:

Current evidence on breast cancer among US Hispanic women indicates a significant public health threat, although few studies have assessed the heterogeneity in breast cancer risk among Hispanics of different origin.

METHODS:

The 2000 and 2005 National Health Interview Survey Cancer Control Modules were used to examine the Breast Cancer Risk Assessment Tool (BCRAT) 5‐year risk and lifetime risk of invasive breast cancer among Mexican/Mexican American, Puerto Rican, Cuban/Cuban American, Dominican (Republic), Central/South American, Other Hispanic, and non‐Hispanic white (NHW) women ages 35 to 84 years. Multiple linear regression models were used to compare the BCRAT 5‐year and lifetime breast cancer risk between 1) Hispanics and NHWs and 2) Hispanic subgroups.

RESULTS:

Hispanic women had significantly lower mean BCRAT 5‐year and lifetime breast cancer risk compared with NHW women (P < .001). Among Hispanic subgroups, Cuban/Cuban Americans had a higher BCRAT 5‐year risk (P < .05), whereas Dominicans had a higher lifetime risk (P < .001) compared with Mexican/Mexican Americans. Approximately 2.6% of Hispanic women were at high risk for breast cancer (BCRAT 5‐year risk ≥1.67%), ranging from 1% of Central/South Americans to 3.7% of Puerto Ricans; few Hispanics (0.2%) had a lifetime risk ≥20%.

CONCLUSIONS:

The current findings indicate that Hispanic women have a significantly lower risk of breast cancer compared with NHW women, although the risk according to BCRAT differed significantly between specific Hispanic subgroups. We provide estimates of the number of US Hispanic women from six subgroups who may be eligible for prophylactic breast cancer chemoprevention. The authors concluded that future studies should further investigate the heterogeneity in breast cancer risk and risk factors between Hispanic women of different origins. Cancer 2013. © 2012 American Cancer Society.     

Physical inactivity and percent breast density among Hispanic women

Results of epidemiologic studies suggest an inverse association between breast cancer risk and physical activity; this is one of the few modifiable breast cancer risk factors identified to date. However, only 2 previous studies assessed the association between physical activity and the extent of mammographically-detected fibroglandular breast density, a marker of breast cancer risk. Moreover, there has been no study of physical inactivity and percent breast density, nor a study of this relationship in Hispanic women, who are less physically active than non-Hispanic whites. In the Chicago Breast Health Project, we collected information on sociodemographic, reproductive, medical and lifestyle factors and percent breast density, assessed quantitatively using full-field digital mammography, from 294 Hispanic women. In our study, we examined the independent associations of hours per day of physical inactivity with percent breast density using multivariate linear regression analysis adjusting for age, education, body mass index, parity, menopausal status, use of hormone replacement therapy and smoking status. Overall, the mean percent breast density was low (i.e., 17.7%) and ranged from 1.9% to 54.6%. There was no difference in percent breast density for women who reported 1.5-3.0 hr of physical inactivity per day compared to women who reported 0-1 hr per day (beta = -0.08, p = 0.95), but percent density was marginally significantly higher for women who were reported at least 3.5 hr per day of physical inactivity (beta = 3.18, p = 0.056). Results were similar, albeit less statistically significant, in analyses of pre/perimenopausal and postmenopausal women separately. These results support the need for further research investigating the effect of physical activity on breast cancer risk.     

Oral contraceptives and primary liver cancer among young women

The association of oral contraceptive use with liver cancer was examined in a study of 76 deaths from primary liver cancer, 22 deaths from cancer of the intrahepatic bile ducts, and 629 controls among women aged 25 to 49 years. The subjects in the study are from the 1986 National Mortality Followback Survey, which included a questionnaire sent or administered to the next-of-kin of almost 20,000 deceased individuals in the United States. Information on a number of lifestyle factors was collected, including questions on oral contraceptive use. Increased risks of primary liver cancer were found for ever-users (odds ratio [OR]=1.6, 95 percent confidence interval [CI]=0.9–2.6), and for long-term (10 years) users (OR=2.0, CI=0.8–4.8) of oral contraceptives. When the analysis was restricted to subjects whose spouse or parent was the respondent, more pronounced risks were seen for ever-users (OR=2.7, CI=1.4–5.3) and long-term users (OR=4.8, CI=1.7–14.0). No clear excess risk was found for cancer of the intrahepatic bile ducts. This study, the largest to date, adds to the number of investigations demonstrating an increased risk of primary liver cancer with use, particularly long-term use, of oral contraceptives.Authors are with the Epidemiology and Biostatistics Program, Division of Cancer Etiology, National Cancer Institute, with the exception of Mr Co-Chion who is at Westat Inc., Rockville, MD, USA. Address reprint requests to Dr Hsing at the National Cancer Institute, Executive Plaza North, Room 415, Bethesda, MD 20892, USA.     

No evidence of association between breast cancer risk and dietary carotenoids,retinols, vitamin C and tocopherols in Southwestern Hispanic and non-Hispanic White women

Objectives The effects of dietary intake of antioxidant vitamins on breast cancer risk are inconclusive. Moreover, little is known as to whether associations differ between non-Hispanic White (NHW) and Hispanic women. We assessed the associations of the dietary intake of antioxidant vitamins commonly found in fruits and vegetables with breast cancer risk and estrogen receptor (ER) status among NHW and Hispanic women living in the Southwestern U.S. Materials and methods Primary breast cancer cases in the 4-Corners region (Arizona, Colorado, New Mexico, Utah), diagnosed between October 1999 and May 2004, were identified through state cancer registries. Controls were frequency matched by ethnicity and age (±5 years). Information on demographic characteristics and other breast cancer risk factors prior to the referent year were collected by interviewer-administered computerized questionnaire. A modified extensive diet history questionnaire was used to assess dietary intake. Results We did not find a protective effect of dietary antioxidants, such as α or β-carotene, β -cryptoxanthin, lutein/zeaxanthin, lycopene, retinol, vitamin C, α, δ, β or γ-tocopherol, on breast cancer risk in populations living in the Southwest. We did not find any consistent associations with multivariate risk of breast cancer or estrogen receptor status. Cigarette smoking was not a significant effect modifier of these associations. Conclusion This case–control study did not find any meaningful association of the dietary intake of antioxidant vitamins with breast cancer risk or ER status.     

Comparative analysis of breast cancer risk factors among hispanic and non‐hispanic white women

BACKGROUND:

Hispanic and non‐Hispanic white (NHW) populations within the United States have different breast cancer incidence rates, yet there is limited research on how ethnic differences in the prevalence of established risk factors and their associations with breast cancer contribute to the observed differences.

METHODS:

Odds ratios and population‐attributable risk estimates for breast cancer were determined for Hispanic and NHW women in the population‐based, case‐control 4‐Corners Breast Cancer Study.

RESULTS:

When comparing NHW and Hispanic women, the authors observed differences in the prevalence of certain risk factors and in the magnitude and direction of their associations with breast cancer. Hispanic women were more likely to have characteristics associated with lower breast cancer risk, such as younger age at first birth, having more children, shorter height, less hormone use, and less alcohol consumption. Among premenopausal women, ethnic differences in risk were observed with taller height and positive family history, which were not associated with breast cancer among Hispanic women. Among postmenopausal women, associations for certain risk factors were either weaker or were not observed in Hispanics, such as recent estrogen plus progestin hormone therapy use and younger age at menarche. Among NHW women, an estimated 62% to 75% of breast cancers were attributed to the evaluated risk factors compared with 7% to 36% in Hispanic women.

CONCLUSIONS:

Breast cancer risk factors established in NHW populations had less influence on breast cancer risk in Hispanic women. These findings reflect the need to further evaluate breast cancer risk factors among different ethnic and racial populations. Cancer 2010. © 2010 American Cancer Society.     

Lifetime exercise activity and breast cancer risk among post-menopausal women.

Lifetime exercise activity has been linked to breast cancer risk among young women. However, no study has specifically evaluated whether lifetime exercise activity is related to the breast cancer risk of post-menopausal women. We conducted a population-based case-control study of post-menopausal white women (1123 newly diagnosed cases and 904 healthy controls) aged 55-64 who lived in Los Angeles County, California, USA to evaluate this relationship. Although neither exercise activity from menarche to age 40 years, nor exercise after age 40 separately predicted breast cancer risk, risk was lower among women who had exercised each week for at least 17.6 MET-hours (metabolic equivalent of energy expenditure multiplied by hours of activity) since menarche than among inactive women (odds ratio (OR) = 0.55; 95% confidence interval (CI) 0.37-0.83). Exercise activity was not protective for women who gained considerable (> 17%) weight during adulthood. However, among women with more stable weight, breast cancer risk was substantially reduced for those who consistently exercised at high levels throughout their lifetime (OR = 0.42; 95% CI 0.24-0.75), those who exercised more than 4 h per week for at least 12 years (OR = 0.59; 95% CI 0.40-0.88), and those who exercised vigorously (24.5 MET-hours per week) during the most recent 10 years (OR = 0.52; 95% CI 0.32-0.85). Strenuous exercise appears to reduce breast cancer risk among post-menopausal women who do not gain sizable amounts of weight during adulthood.     

Oral contraceptive use and breast cancer risk among African-American women

Recent epidemiologic studies, most of them in predominantly White populations, have suggested that long duration of oral contraceptive (OC) use may increase the risk of breast cancer at young ages. We assessed the relationship of OC use to the risk of breast cancer in African-American women aged 25 to 59 years, using interview data from a multipurpose hospital-based case-control study. Five hundred and twenty-four cases hospitalized for invasive breast cancer were compared with 1,021 controls with nonmalignant conditions unrelated to OC use. Relative risks (RR) and 95 percent confidence intervals (CI) were estimated relative to a reference category of use for less than 12 months; potential confounders were controlled by multiple logistic regression analysis. Among women under age 45, three or more years of OC use was associated with an increased risk of breast cancer: the RR estimate was 2.8 (CI=1.5–5.0) for three to four years of use, and declined to 1.5 (CI=0.8.3.0) for 10 or more years of use. Recency and timing of use did not explain the observed association. Among women aged 45 to 59, OC use was associated with little or no increase in risk: the RR estimate for three or more years of use was 1.3 (CI=0.7–2.4). The findings add to the evidence from studies of White women and a recent study of Black women which have suggested an increased risk of breast cancer at young ages for moderate or long duration use of OCs.This research was supported by the US National Cancer Institute (grants R01 CA55766 and R01 CA45762). Additional support was provided by the US Food and Drug Administration (FD-U-000082); the views expressed do not necessarily represent the views of the Food and Drug Administration. The Slone Epidemiology Unit also receives support from Hoffmann-La Roche, Inc., and Marion Merrell Dow Inc.     

Replication of five GWAS-identified loci and breast cancer risk among Hispanic and non-Hispanic white women living in the Southwestern United States

Genome-wide association studies (GWAS) have identified several loci as being associated with breast cancer in mostly European populations. We focus on TNRC9 rs3803662, FGFR2 rs1219648 and rs2981582, MAP3K1 rs889312, and 2q35 rs13387042, to replicate in the 4-Corner’s Breast Cancer Study of Hispanic (N = 565 cases and 714 controls) and non-Hispanic white (NHW) women (N = 1177 cases and 1330 controls). We evaluate associations by ethnicity, menopausal status, and tumor ER/PR status after adjusting for genetic admixture. TNRC9 AA genotype was associated with significant increased risk among NHW women (OR 1.54, 95% CI 1.14, 2.08; P trend 0.003). Both polymorphisms of FGFR2 were associated with statistically significant increased risk for NHW and Hispanic women; MAP3K1 was not associated with risk among either ethnic group. The polymorphism on 2q35 was associated with a statistically significant increased risk among Hispanic women (OR 1.53, 95% CI 1.08, 2.15 for the AA genotype; P trend = 0.004). Associations were significantly different among pre/peri-menopausal women for TNRC9 (P heterogeneity 0.008) and for 2q35 (P heterogeneity 0.08) for NHW and Hispanic women. Both FGFR2 polymorphisms reduced risk of ER−/PR− tumors in the presence of the minor allele among NHW women. Among Hispanic women, polymorphisms of the FGFR2 gene were associated with almost a twofold increase risk of an ER+/PR+ tumor, while non-significantly inversely associated with ER−/PR− tumors. Our data replicated some of the previously reported GWAS findings. Differences in associations were detected for NHW and Hispanic women by menopausal status and by ER/PR status of tumors.     

Low‐risk factor profile,estrogen levels,and breast cancer risk among postmenopausal women

Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI ≤ 30 kg/m², alcohol <1 drink/week, physically active and no current hormone use) and to evaluate their associations with estrogen. The 5,054 postmenopausal women in the Copenhagen City Heart Study were asked about risk factors at baseline in 1981–3 and were followed until 2002 in the Danish Cancer Registry, with <0.1% loss to follow‐up. Estradiol was measured in a subset of 1,042 women. During follow‐up, 263 women developed breast cancer. Twenty‐six percent of the women had a favourable risk factor profile, and their breast cancer rates were markedly lower (154 per 100,000 years) than women with 3+ risk factors (460 per 100,000 years). One, two and three risk factors were associated with hazard ratios of 1.38 (95% CI: 0.99; 1.92), 1.84 (1.26; 2.67) and 2.79 (1.59; 4.88) compared to women with a favourable profile. Each of the risk factors was associated with estrogen. In conclusion, the risk of breast cancer was markedly lower for women with a favourable risk profile than for other women and lower estrogen levels is a possible explanation. © 2008 Wiley‐Liss, Inc.     

Hormonal content and potency of oral contraceptives and breast cancer risk among young women

Recent use of oral contraceptive pills is associated with a modest risk of breast cancer among very young women. In this US population-based case-control study, we evaluated whether the excess risk associated with recent oral contraceptive use is ubiquitous for all pill types or attributable to specific oral contraceptive preparations. Hormonal content and potency of combination oral contraceptives used for the longest duration within 5 years of interview for breast cancer cases aged 20-44 years (N=1640) were compared with age-matched community controls (N=1492). Women who recently used oral contraceptives containing more than 35 microg of ethinyl oestradiol per pill were at higher risk of breast cancer than users of lower dose preparations when compared to never users (respective relative risks of 1.99 and 1.27, P(trend)<0.01). This relationship was more marked among women <35 years of age, where risks associated with high- and low-dose ethinyl oestradiol use were 3.62 and 1.91 (P(trend)<0.01), respectively. We also found significant trends of increasing breast cancer risk for pills with higher progestin and oestrogen potencies (P(trend)<0.05), which were most pronounced among women aged <35 years of age (P(trend)<0.01). Risk was similar across recently used progestin types. Our findings suggest that newer low-potency/low oestrogen dose oral contraceptives may impart a lower risk of breast cancer than that associated with earlier high-potency/high-dose preparations.     

Effect of family history,obesity and exercise on breast cancer risk among postmenopausal women

We examined effects of obesity and lifetime exercise patterns on postmenopausal breast cancer risk according to family history in a large population-based case control study conducted in Los Angeles County, California, because we hypothesized that both factors would affect risk through similar mechanistic pathways, and that their effects would be stronger among women with a family history. We studied 1883 postmenopausal breast cancer case subjects and 1628 postmenopausal control subjects ranging in age from 55-72 years. Cases were diagnosed with incident breast cancer in the late 1980s and 1990s. Controls were individually matched to case subjects on age, ethnic origin and neighborhood. In-person interviews determined known breast cancer risk factors including: height, weight, lifetime exercise, and family history of breast and other cancers. Breast cancer risk was raised among women who had at least 1 first-degree relative with breast cancer (odds ratio [OR] = 1.68; 95% confidence interval [CI] = 1.36-2.08). Risk increased with increasing levels of body-mass index (wt-kg/ht-m(2)) (p-trend = 0.005). Breast cancer risk was reduced among women who maintained, on average, 17.6 metabolic equivalent of energy expenditure (MET)-hr of activity/week from menarche onward (OR = 0.66; 95% CI = 0.48-0.90). Body-mass index, adjusted for lifetime exercise, was strongly associated with breast cancer risk among women with a positive family history of breast cancer (p-trend < 0.0001), but only weakly associated among women with no family history (p-trend = 0.08; homogeneity of trends p = 0.0005). In contrast, the risk reduction associated with exercise activity, adjusting for body-mass index, was limited to women without a family history of breast cancer (p-trend = 0.001; homogeneity of trends p = 0.005). Body-mass index and exercise activity, both modifiable risk factors for breast cancer, seem to have differential effects depending on a woman's family history of breast cancer, and may impact risk through different biological mechanisms.     

Prevalence and predictors of comorbid diabetes among newly diagnosed Hispanic cancer patients in Connecticut

Background: U.S. Hispanics are at elevated risk of diabetes, and comorbid diabetes has been associated with poorer prognosis among patients with certain cancers. This study examined prevalence and predictors of comorbid diabetes in newly diagnosed Hispanic cancer patients in Connecticut. Methods: For all Hispanic patients diagnosed (at age 10+ years) with cancer in 2002–2003 and reported to the population-based Connecticut cancer registry, information from hospital medical records in the state was sought for comorbid diabetes (i.e., in any hospital admission 12 months prior to cancer diagnosis) and its treatment, body weight and height, preferred or primary language, and type of health insurance. Multiple logistic regression (MLR) models were used to examine predictors of presence of comorbid diabetes. Results: Comorbid diabetes was found for 192 (25.1%) of 765 patients, and was statistically significantly associated with preferred language (30.3% of 535 with non-English vs. 15.1% of 166 with English), age, and body mass index in a MLR model. Type of diabetes treatment was found for 92% of the 192 patients with diabetes. Conclusions: The high prevalence of comorbid diabetes among newly diagnosed Hispanic cancer patients, especially those without English as their preferred language, should be an impetus to further research on quality of diabetes care and survival of these patients.     

Oral contraceptives and prognosis of breast cancer in women aged 35 to 50

Among 193 breast cancer patients aged 35-50 years, there was no appreciable difference in the extent of disease at diagnosis between 53 oral contraceptive (OC) users and 140 OC non-users. There was no overall significant difference between OC users and non-users for either the disease-free interval (P = .81), metastatic period (P = .41), or survival (P = .79), either alone or when adjusted for stage or family history. The survival rate of OC users of more than 2 years was similar to the survival rate of those of shorter duration (P = .36). Patients who began the use of OC 10 years or more before diagnosis showed no statistical difference from those beginning more recently (P = .69). Recent OC users within a year of diagnosis had a survival rate similar to that of other users who stopped the pills at least 1 year prior to diagnosis (P = .14). Our data suggest no adverse effects of OC use on the prognosis of breast cancer, regardless of duration of use, latency or recency period.