Ethnicity, but not cancer family history, is related to response to a population-based mailed questionnaire

PURPOSE: To determine if family history and ethnic background are factors affecting response to a mailed cancer family history questionnaire from the Ontario Familial Breast Cancer Registry. METHODS: Individuals diagnosed with primary invasive breast carcinomas (probands) were mailed a family history questionnaire, the first contact in a multi-stage process. This questionnaire obtained cancer family history and ethnicity data. After one month, a follow up telephone call was made to those who did not return this questionnaire and attempts were made to ask similar questions by telephone interview. Characteristics of those responding to the mailed questionnaire were compared to those who responded to the telephone interview only. RESULTS: 339 probands were included in this study: 242 returned a mailed version of the questionnaire; 57 completed the questionnaire over the phone. Cancer family history/genetic risk criteria was not significantly related to type of response. Probands identifying themselves as visible minorities were significantly less likely to respond to the mailed questionnaire than the telephone interview (11.6% vs. 22.8%, P=0.03). CONCLUSIONS: Having a family history of cancer did not appear to influence response to a mailed questionnaire, but those reporting an ethnic/racial background other than White were more likely to respond to a telephone interview.     

Mothers' attitudes toward nutrition are related to daughters' but not to sons' plasma cholesterol levels

OBJECTIVE: To examine the relationship between parents' attitudes toward nutrition and plasma lipid levels of their children. DESIGN: Parents' nutrition attitudes were assessed with the Nutritional Attitude Scale, a self-report questionnaire measuring attitudes toward the adoption of a low-fat, low-cholesterol diet. Parents' and children's plasma lipid and lipoprotein levels were obtained. Data were collected during the baseline period and a 1-year follow-up of the Family Heart Study, a small community study of cholesterol-lowering via dietary change. PARTICIPANTS/SETTING: Participants were 33 girls and 34 boys (aged 6 to 13 years), and their parents. They were a subsample of European-American, middle-class, Portland, Ore, families participating in the Family Heart Study. STATISTICAL ANALYSES: Associations between parents' nutrition attitudes and plasma lipid levels of their children were evaluated using multiple linear regression analyses, controlling for the contribution of parents' lipid levels to those of their children. RESULTS: Mothers' nutrition attitudes interacted with their daughters' ages, accounting for 14% of the variance in plasma total cholesterol level and 11% in low-density lipoprotein cholesterol level in their daughters. Mothers' unhealthful nutrition attitudes were associated with elevated levels of plasma total and low-density lipoprotein cholesterol levels among older daughters, but not among younger daughters nor their sons. Fathers' nutrition attitudes were unrelated to their children's plasma lipid levels. Mothers' nutrition attitudes assessed at baseline remained a significant predictor of their daughters' lipid levels measured 1 year later. APPLICATIONS/CONCLUSIONS: The previously reported relationships between adults' unhealthful nutrition attitudes and their own elevated plasma lipid levels appear to extend to that of their children. The association between mothers' nutrition attitudes and their daughters' lipid levels highlights the importance of focusing on nutrition attitudes when designing intervention programs to reduce plasma lipids and lipoproteins via dietary changes in the family.     

Alcohol involvement in Swedish University freshmen related to gender, age, serious relationship and family history of alcohol problems

AIM: The primary aim of this study was to describe alcohol involvement in relation to gender and different age cohorts among freshmen at two Swedish universities. The secondary aim was to investigate whether the results were related to a likelihood of students being in serious relationships and/or had a first-degree relative with alcohol problems. METHODS: Two complete cohorts of university freshmen at two homogeneous universities were asked to participate in an intervention study, and the results of the basic assessments are presented in this article. The following instruments were used: the Alcohol Use Disorders Identification Test (AUDIT), the Estimated Blood Alcohol Concentration (eBAC) and a shortened version of the Alcohol Expectancy Questionnaire (AEQ). RESULTS: A total of 2032 (72%) freshmen agreed to participate. The mean AUDIT score was 8.8 (+/-4.9) for men and 6.0 (+4.0) for women, and there were high correlations between the AUDIT and other instruments. There were significant differences between different age groups for both men and women. Both genders were more likely to have AUDIT scores higher than the usual cut-off levels for high-risk interventions among those with first-degree heredity of alcohol problems, while those students in serious relationships were less likely to have AUDIT scores above the usual cut-off levels for high-risk interventions. CONCLUSIONS: This study reveals a high level of alcohol involvement among Swedish university freshmen. This is affected by age, gender, heredity of alcohol problems and serious relationships.     

Cardiovascular disease risk factors are related to adult adiposity but not birth weight in young guatemalan adults

Fetal undernutrition has been hypothesized to program inappropriate metabolic responses to nutritional abundance in later life. Most studies have been conducted in industrialized countries. We studied the relationship between birth weight and risk factors for cardiovascular disease (CVD) among 187 men and 198 women age 20-29 y (mean age 24 y) who had participated in a longitudinal study conducted in Guatemala between 1969 and 1977. In women, birth weight was positively associated with adult body mass index (BMI; P < 0.01), systolic (P < 0.001) and diastolic blood pressure (P < 0.05), but not with glucose or any lipid measure. In men, birth weight was not associated with adult BMI, blood pressure or glucose, and was weakly and inversely related to total cholesterol and LDL cholesterol (test for trend: P = 0.06 and P = 0.09, respectively). Adult BMI was associated with increased prevalence of CVD risk factors in both men and women. Our data offer no support for the fetal programming of cardiovascular disease risk hypothesis in young adult women, and weak support in young adult men. Overweight in adults is a strong determinant of variance in CVD risk factor prevalence.     

Validation of family history data in cancer family registries

BACKGROUND: Although family history information on cancer is used to infer risk of the disease in population-based, case-control, cohort, or family-based studies, little information is available on the accuracy of a proband's report. In this study, we sought to determine the validity of the reporting of family history of cancer by probands in population-based and clinic-based family registries of breast, ovarian, and colorectal cancers. METHODS: To assess the accuracy of probands' reported family history of cancer in their relatives, we compared the family history from the personal interview of each proband to a reference standard that included pathology reports, self-reports, or death certificates on the relatives. Our study included 1111 families that accounted for 3222 relatives who were verified. To account for within-family correlations in the responses, we used a generalized estimating equation approach. RESULTS: The probability of agreement between the proband-reported cancer status in a relative with the reference standard varied by cancer site and by degree of relationship to the proband. This probability for first-degree relatives was 95.4% (95% confidence interval [CI]=92.6-98.3) for female breast cancer; 83.3% (95% CI=72.8-93.8) for ovarian cancer; 89.7% (95% CI=85.4-94.0) for colorectal cancer; and 79.3% (95% CI=70.0-88.6) for prostate cancer. CONCLUSIONS: We found high reliability of probands' reporting on most cancer sites when they reported on first-degree relatives and moderate reliability for their reporting on second- and third-degree relatives. Overreporting of cancer was rare (2.4%). Race or ethnicity and gender of the proband did not influence the accuracy of reporting. However, degree of relationship to the proband, type of cancer, age at diagnosis of the proband, and source of ascertainment of probands were statistically significant predictors of accuracy of reporting.     

Family history of cancer related to cholesterol level in young adults

Cancer family history was quantified in 229 subjects (122 female, 107 male) screened for total serum cholesterol as seventh graders in 1972-1973 and repeated nine years later as young adults. Division of the subjects on the basis of cholesterol quintile resulted in significantly lower cancer family history scores in participants with persistently low total serum cholesterol levels and a significant excess of cancer mortality in parents and grandparents of young adult males with high-density lipoprotein (HDL) levels in the upper quintile. A trend toward increased cancer in families of young adults who were smokers was independent of the cholesterol levels. It is suggested that such a quantification of family history score will be more useful than simply designating the family history as positive or negative in future modeling schemes for predicting risk.     

Mothers’ attitudes toward nutrition are related to daughters’ but not to sons’ plasma cholesterol levels

Objective To examine the relationship between parents’ attitudes toward nutrition and plasma lipid levels of their children.     

A case-cohort study on prostate cancer risk in relation to family history of prostate cancer

We investigated the risk of prostate cancer in relation to a family history of prostate cancer in 58,279 men ages 55-69 years. We found 704 incident cases after 6.3 years of follow-up. Rate ratios and 95% confidence intervals for having an affected vs nonaffected father and brother were, respectively 1.44 (0.80-2.58) and 5.57 (1.61-19.26). We found no evidence for an increasing risk with an increasing percentage of affected family members. The associations we observed were stronger for cases diagnosed before age 70 compared with cases diagnosed after age 70 and for advanced compared with localized tumors.     

Blood type and family cancer history in relation to precancerous gastric lesions

BACKGROUND: The increased odds of stomach cancer among subjects with blood type A have been reported in epidemiological studies. AIM: To study the relation of family history of gastric cancer and ABO blood type with precancerous gastric lesions in a high-risk area for stomach cancer. Subjects and setting We examined 3400 adults aged 35-64 in a population-based gastric endoscopic screening in a county in China with one of the highest rates of stomach cancer in the world. METHODS: In this cross-sectional study, data on family cancer history, ABO blood type and other characteristics of the participants were obtained by interview and blood test. Responses were compared between those with the most advanced gastric lesions, dysplasia (DYS) or intestinal metaplasia (IM), versus those with chronic atrophic gastritis (CAG) or superficial gastritis (SG). RESULTS: The prevalence odds ratio (OR) for blood type A relative to other types was 1.39 (95% CI : 1.12-1.73) for DYS and 1.28 (95% CI : 1.06-1.53) for IM. The OR associated with parental history of stomach cancer was 1.88 (95% CI : 1.20-2.95) for DYS, but the numbers were too small to evaluate aggregation among siblings. The combined OR associated with blood type A and a parental of history of gastric cancer was 2.61 (95% CI : 1.59-4.30) for DYS and 1.46 (95% CI : 0.93-2.31) for IM. CONCLUSIONS: The findings suggest that genetic factors play a role in developing precancerous gastric lesions.     

Effect of personal cancer history and family cancer history on levels of psychological distress

This study examined the impact of personal and family cancer history on psychological distress. Regression analyses were conducted on a nationally representative sample of adult individuals who participated in the 2000 National Health Interview Survey, USA. Effects on distress of a personal cancer history, any family cancer history, or mother, father, sister or brother with a cancer history were examined. The interaction of personal and family cancer histories and three-way interactions with gender were also assessed. Analyses indicate that having either a personal or family cancer history is linked with significantly greater psychological distress and there is evidence of an interaction. Three-way interactions with gender were not found. Consistent with prior research, results demonstrated that cancer survivors are more distressed than the general population. Results extend prior research by indicating that having a first-degree relative with cancer increases risk for distress, and having personal and family cancer histories may exert a synergistic effect on distress.     

Assessment of family history information in case-control cancer studies

Evidence for the genetic basis of cancer has increased in recent years, and thus, assessing familial aggregation may play an important role in epidemiologic studies. To assess the degree to which family history variables are collected in cancer case-control studies, the authors conducted a literature review of studies published in six journals during 1982-1984. Only 25% of these included a family history component. The authors review some of the literature in favor of inclusion of family information and argue for its routine collection in cancer case-control studies.     

Paternal relatives and family history of breast cancer

BACKGROUND: Reported family medical history may be the most widely accessible genomics screen currently available. The worth of any population-screening tool may be measured by parameters such as sensitivity and specificity. There is some evidence and theory suggesting that family history of breast cancer may be more frequently communicated about maternal (versus paternal) lines. If true, a discrepancy in reporting family history of breast cancer could mean suboptimal accuracy for this genomics-screening tool. METHODS: A cross-sectional analysis of reported family history of breast cancer was conducted beginning in early fall 2005 of data collected from April 2003 to March 2005. Study participants were Women's Health Clinic patients without breast cancer aged at least 40 years. The number of women reporting extended paternal relatives (e.g., aunts, grandmothers) with breast cancer was compared to the number of women reporting maternal relatives. RESULTS: More women reported a maternal relative with breast cancer (16%) compared to those reporting paternal relatives (10%) (McNemar odds ratio = 1.71, 95% confidence interval = 1.26 to 2.34). A discrepancy remained in analyses adjusting for potential covariates (race/ethnicity, awareness of breast cancer, family communication about breast cancer, and perceived risk). CONCLUSIONS: Self-reported family history of breast cancer may not optimally capture inherited risk from the father's side of the family. Further research is needed to look for modifiable contributors to this discrepancy to optimize screening for familial breast cancer.     

Oral contraceptives and family history of breast cancer

Background

Questions remain regarding whether oral contraceptive (OC) use among women with a family history of breast cancer increases disease risk.

Study Design

We conducted a systematic review by searching MEDLINE and CENTRAL databases for evidence (in all languages) published in peer-reviewed journals from 1966 to July 2008 that provided estimates of breast cancer risk according to family history. Twelve articles were identified and the quality of each study was assessed using the United States Preventive Services Task Force grading system.

Results

Results from 10 studies and one pooled analysis of 54 studies suggest that the use of OCs does not significantly modify the risk of breast cancer among women with a familial history of breast cancer; however, evidence from four studies shows that some women may be at a greater risk, particularly women who took OCs prior to 1975.

Conclusions

Current evidence shows that women with a family history of breast cancer do not increase their disease risk by using OCs.     

Serum leptin concentrations are not related to dietary patterns but are related to sex, age, body mass index, serum triacylglycerol, serum insulin, and plasma glucose in the US population

Background

The conjugated linoleic acid (CLA) content of beef can be increased by supplementing appropriate beef cattle diets with vegetable oil or oil seed. Yet the effect of consumption of such beef on adipose tissue characteristics is unclear, thus the study was conducted to compare adipose tissue responses of rats to diets containing beef from steers either not provided or provided the oil supplements to alter CLA composition of the fat in muscle.

Methods

Effects of feeding synthetic (industrial hydrogenation) CLA or CLA from beef on growth and adipose tissue responses of weanling, male, Wistar rats (n = 56; 14 per treatment diet) were investigated in a completely randomized design experiment. Diets were: control (CON) diet containing casein and soybean oil, synthetic CLA (SCLA) diet; where 1.69% synthetic CLA replaced soybean oil, two beef-diets; CONM and CLAM, containing freeze dried beef from steers either not fed or fed 14% sunflower seeds to increase CLA content of beef. Diets were isonitrogenous (20% protein) and isocaloric. Rat weights and ad libitum intakes were recorded every 2 wk. After 9 wk, rats were fasted for 24 h, blood sampled by heart puncture, sacrificed, tissue and organs were harvested and weights recorded. The adipose tissue responses with regard to cellularity and fatty acid compositions of retroperitoneal and inguinal adipose tissue were determined.

Results

Body weights and gains were comparable, but organ weights as percent of body weight were greater for rats fed SCLA than CONM. Fasting blood glucose concentration was lower (p < 0.01) in rats fed SCLA than those fed CONM or CLAM. Retroperitoneal and inguinal fat weights, as percent of body weight were greater (p < 0.01) in rats fed CONM or CLAM than those fed CON or SCLA diets. Adipocyte numbers were least in retroperitoneal tissue of rats fed SCLA, while inguinal tissue cell density and total number were lower (p = 0.02) in rats fed CLAM (7.26 × 10⁷ cells/g and 8.03 × 10⁸ cells) than those fed CONM (28.88 × 10⁷ cells/g and 32.05 × 10⁸ cells, respectively).

Conclusion

Study suggests that dietary CLA either as synthetic or high CLA-beef may alter adipose tissue characteristics by decreasing the number of adipocytes and by decreasing the size of the tissue.     

An approach to the patient with a family history of breast cancer

This eleventh article in our series on breast disease discusses the management of a patient with a family history of breast disease. Apart from increasing age and female gender, family history is the most important risk factor for breast cancer. However, women with a family history of breast cancer often overestimate their risk of developing the disease. Much of the clinician's role is to reassure the patient and clarify the risk based on a careful assessment of the family history.     

How are attitudes towards condoms related to gender and sexual experiences among adolescents in Finland?

This survey is a part of the international HBSC Study (HealthBehaviour in School-aged Children). The purpose of this studywas to investigate 15-year-old adolescents' condom attitudes.In 1990, data were compiled from 928 students and in 1994 from1183 students. In 1994, 70% of boys and 55% of girls reportedthat they had used a condom with their partner in past intercourse.The percentage of adolescents who did not use any contraceptivemethod decreased from 26% to ~13% between 1990 and 1994. Theattitudes of the adolescents who did not use any contraceptivemethod were, on average, somewhat more negative towards purchasingcondoms than the attitudes of those who used condoms or pillsas their contraceptive method. Adolescents were well aware thatcondoms prevented unwanted pregnancies and protected againstsexually transmitted disease. Boys reported more frequentlythan girls that it was easy to use a condom and that a condomdiminished sexual pleasure. Generally speaking, adolescentswere still quite embarrassed to buy condoms. Adolescents whohad experienced sexual intercourse reported more often thanthose who had not that it was easy to purchase and carry condoms.A majority of adolescents reported that it was easy for themto purchase condoms when necessary. The major change between1990 and 1994 occurred in the attitudes of girls who had experiencedsexual intercourse. In 1990, the attitudes of girls towardspurchasing and carrying condoms were more negative than thoseof boys, but in 1994 they were similar to those of sexuallyexperienced boys.     

Platelet monoamine oxidase B in family history positive and family history negative type 1 alcohol-dependent subjects

- AIMS AND METHODS: In the present study platelet monoamine oxidase B (MAO-B) activity was investigated in 76 male type 1 alcohol-dependent subjects with and without a family history of alcoholism. RESULTS: Platelet MAO-B activity did not differ between family history positive (FHP) and family history negative alcohol-dependent subjects. The smoking status of the subjects was registered and there was still no difference between the groups when possible effects of smoking were taken into account. It should, however, be noted that platelet MAO-B activity was lower in alcohol-dependent subjects with three or four alcohol-dependent first-degree relatives. CONCLUSIONS: Although this latter finding should be interpreted with caution due to the small number of subjects, it cannot be excluded that FHP alcohol-dependent subjects with a large number of alcohol-dependent first-degree relatives may have lower platelet MAO-B activity.     

Never-smokers with a positive family smoking history are more likely to be overweight or obese than never-smokers with a negative family smoking history

To shed light on the complex relationship between smoking and body weight, we used never-smokers stratified on family smoking history to model the effects of a diathesis for smoking on body weight without the potential confound of metabolic changes or decreased physical activity caused by chronic tobacco smoke exposure. Participants were 100 family history negative never-smokers (FH?; 2 never-smoking parents) and 71 family history positive never-smokers (FH+; 2 ever-smoking parents). Controlling for significant group differences in race and age, BMI was significantly higher in FH+ (26.7 ± .6) than in FH? (24.5 ± .4; F = 10.351 p < .01). Further analysis using logistic regression showed that FH+ were 2.7 times as likely to be overweight/obese (BMI ≥ 25; 95% C.I. 1.398–5.351; p < .01). FH+ scored significantly higher on the Dieting and Bingeing Severity Scale than FH? and were significantly more likely to score in the severe or at-risk range. FH+ drank significantly more alcohol than FH?; they scored significantly higher on the CAGE and on the Michigan Alcohol Screening Test. Our analyses provide support for the role of inherited and/or environmentally-driven tendencies towards disinhibited eating and/or risky behaviors in general in the observed differences in BMI. No group differences in BMI or likelihood of being overweight/obese emerged based on prenatal exposure to nicotine in FH+ smokers, although our sample was too small to rule out an association. Further research in larger samples, using more complex statistical models, will be needed to disentangle these issues and identify causal pathways.     

Fibrinogen and factor VII levels are related to adiposity but not to fetal growth or social class in children aged 10-11 years.

Factors operating in fetal life or during childhood may be important in determining fibrinogen and factor VII concentrations in adult life, and particularly in explaining social gradients in cardiovascular disease risk. In 1994, the authors measured fibrinogen and factor VIIc levels in 641 children aged 10-11 years (61% response rate) from schools in five towns in England and Wales. Birth weight was obtained by maternal recall, and other data on measures of fetal growth were obtained from birth records. Fibrinogen levels were higher in girls (258.8 mg/dl) than in boys (245.4 mg/dl) (95% confidence interval (CI) for difference: 5.5, 21.5). Fibrinogen and factor VIIc levels were linearly related to adiposity, rising by 37.1 mg/dl (95% CI: 24.7, 49.5) and 13.0% of standard (95% CI: 6.3, 19.7), respectively, between the bottom and top quintiles of ponderal index (weight (kg)/height (m)3). Fibrinogen was independently related to heart rate (p < 0.001) and was negatively but nonsignificantly related to measures of physical activity. Factor VIIc was positively correlated with total cholesterol (p < 0.001). No relations were found with measures of fetal growth or social class. These data do not support the concept that fibrinogen or factor VII levels are determined in utero or by social factors in childhood. Adiposity and physical training appear to be the important determinants of fibrinogen and factor VII levels in childhood.