TGF-β1基因多态性与头颈部肿瘤遗传易感性关系的Meta分析

目的:综合分析TGF-β1基因多态性与头颈部肿瘤遗传易感性之间的关系。方法:按照统一的检索策略,在Pubmed、Embase、万方、CNKI等中英文数据库中全面检索,收集2017年12月31日之前发表的关于TGF-β1基因多态性与头颈部肿瘤易感性关系的相关文献,然后按照纳入及排除标准筛选文献,提取数据和评价质量后应用Stata12.0软件进行数据分析。结果:共纳入10个病例对照研究,分别对包含869T/C位点的8篇,509C/T位点的5篇,915G/C位点的3篇文章进行统计分析。在869T/C研究中我们观察到:病例组1 607例,对照组1 981例,总体分析显示其与头颈部肿瘤之间有关联,OR=1.181,95%CI:1.035~1.348,P=0.014。对不同病种、不同人种、样本量大小进行亚组分析显示,869T/C各基因位点与鼻咽癌和口腔癌这两种病种无关联,与亚裔人种有关联,OR=1.431,95%CI:1.191~1.720,P=0.000。该位点多态性同时与样本量大于100有关联性,OR=1.230,95%CI:1.078~1.404,P=0.002。在509C/T 的5篇研究中:病例组1 355例,对照组1 579例,我们仅分析了鼻咽癌相关的4项研究,很遗憾我们并没有发现该位点与鼻咽癌之间有关联,OR=1.090,95%CI:0.865~1.374,P=0.464。在915G/C位点的3篇研究中我们共收集了病例组340例,对照组368例,均为口腔癌,统计结果显示该位点与口腔癌之间有关联,OR=2.815,95%CI:1.581~5.012,P=0.000。在等位基因和显性基因中显示出有统计学差异（C vs G:OR=3.800,95%CI:1.125~12.843,P=0.032;GC+CC vs GG:OR=5.113,95%CI:1.224~21.367,P=0.025）;其余基因型未显示统计学差异。同时分别对三种基因位点的相关研究进行敏感性分析显示结果稳定,Begger和Egger检验均提示无发表偏倚。结论:Meta分析显示869T/C基因与头颈部肿瘤的遗传易感性相关,在亚组分析中与亚洲人种和样本量大于100有关联性;915G/C等位基因C vs G,显性基因GC+CC vs GG与口腔癌发生有关,但是509C/T基因与头颈部肿瘤遗传易感性无关。     

DNA修复基因XPD G312A多态性与肺癌易感性关系的meta分析

背景与目的已有的研究结果显示DNA修复基因XPD G312A多态位点与肺癌发生存在相关性,但研究结果尚未有一致性结论。本研究旨在通过meta分析的方法,综合评价DNA修复基因XPD G312A多态位点与肺癌发病风险的相关性。方法检索PUBMED、EMBASE、清华CNKI全文数据库、万方全文数据库中XPD基因G312A多态位点与肺癌易感性关系的病例对照研究。对符合纳入标准的研究用meta分析的方法进行数据合并,采用RevMan5.0和STATA11.0评价研究间异质性,计算合并OR值及95%CI。并进行敏感性分析和发表偏倚检验。结果共纳入18项研究,累计病例6554例,对照8322例。总体人群中A等位基因及AA基因型携带者肺癌风险明显升高(A vs G:OR=1.06,95%CI:1.00-1.12;AA vs AG+GG:OR=1.20,95%CI:1.06-1.36;AA vs GG:OR=1.19,95%CI:1.04-1.36)。亚洲人群中,AA基因型携带者肺癌风险明显升高(AA vs AG+GG:OR=7.15,95%CI:1.90-26.94;AA vs GG:OR=7.20,95%CI:1.91-27.15)。高加索人群中,AA基因型携带者肺癌风险升高(AA vs AG+GG:OR=1.15,95%CI:1.01-1.31)。结论XPD312A等位基因为肺癌发生的风险等位基因,AA基因型携带者肺癌风险升高,尤其在亚洲人群这种影响更为明显。     

人工流产与乳腺癌关系的Meta分析

目的定量综合评价人工流产与乳腺癌的相关性。方法 通过电子资源数据库搜索1991年1月-2011年1月期间发表的人工流产和乳腺癌关系为主要内容的病例对照研究。经严格筛选后,采用RevMan 5.0软件对纳入文献进行异质性检验,计算合并的比值比(OR)及95%置信区间(95%CI),对结果进行敏感度分析和发表偏倚分析。结果 共纳入17篇文献,包括20 421例乳腺癌患者和34 261例对照。Meta分析结果显示,所纳入的资料间存在显著的异质性,故采用随机效应模型得出合并的比值比OR值及95%CI为1.28(1.06,1.54)。分层分析显示,女性人工流产1次与乳腺癌关系并无统计学意义,OR=1.05,95%CI(0.92,1.19);而≥2次人工流产可使乳腺癌发病的危险性增加,差异有统计学意义,OR=1.34,95%CI(1.03,1.75)。结论 人工流产是女性乳腺癌的危险因素之一,尤其是≥2次人工流产可以增加妇女患乳腺癌的危险性。     

p27Val109Gly基因多态性与肿瘤易感性的Meta分析

目的:通过Meta分析系统评价p27Val109Gly基因多态性与肿瘤易感性的关系。方法:检索PubMed、Medline、Web of Science和中国知网等数据库中研究p27Val109Gly基因多态性与肿瘤易感性关系的研究。运用Rev-Man5.0软件进行异质性检验、系统性评价和分层亚组分析,计算合并OR及95%CI;应用State 11.0软件进行定量发表偏倚检验。结果:共纳入13项研究,累计病例组4 894例,对照组5 413例。G等位基因携带者肿瘤总体易感性降低,OR=0.81,95%CI=0.66～0.99,P=0.04,尤其是前列腺癌(OR=0.60,95%CI=0.36～0.98,P=0.04)和食管癌(OR=0.34,95%CI=0.22～0.55,P<0.01)。剔除不符合或不能进行HWE检验的研究后,再次行Meta分析。结果显示,G等位基因与肿瘤易感性无相关性,OR=0.82,95%CI=0.64～1.03,P=0.09。高加索人群(OR=0.97,95%CI=0.84～1.12,P=0.67)和亚洲人群(OR=0.77,95%CI=0.57～1.02,P=0.07)、基于医院(OR=0.70,95%CI=0.42～1.17,P=0.17)和社区(OR=0.86,95%CI=0.67～1.11,P=0.24)的肿瘤患者,p27Val109Gly基因多态性与肿瘤易感性无明显相关性。结论:p27Val109Gly基因多态性G等位基因与肿瘤的易感性呈负相关,尤其是前列腺癌和食管癌。这种相关性在高加索人、亚洲人及对照组来源于医院或社区的患者中不显著。     

UGT1A7基因多态与肿瘤遗传易感性的Meta分析

目的:根据已发表文献,综合评估尿苷二磷酸葡糖醛基转移酶1A7(UGT1A7)基因多态性与肿瘤易感性之间的关系.方法:按照统一的检索策略在相关中英文数据库中全面检索相关文献,对文献进行筛选、评价后获得相关研究的结果数据,然后在Stata 10软件中用Meta分析的方法,计算合并的OR值及95%CI,并进行敏感性分析和发表偏倚的估计.结果:共有国内外17篇合格文献纳入本研究,累计病例和对照数分别为3 081和5 426例.合并结果显示,携带UGTA7*3等位基因者患肿瘤的危险性是携带野生型UGTlA7*1等位基因型的1.38倍(95%CI=1.18～1.62,P<0.001),携带UGTA7*2等位基因可能与肿瘤的危险性无关.亚组分析显示,UGT1A7*3等位基因型与肝癌和结直肠癌的危险性升高有关.发表偏倚评估未发现明显的偏倚,敏感性分析显示结论稳定可靠.结论:UGT1A7*3等位基因型可能与肿瘤的易感性升高有关.     

一氧化氮合酶3基因多态性(894G>T)与前列腺癌易感性关系的Meta分析

目的:综合评价一氧化氮合酶3(nitric oxide synthase 3,NOS3)基因多态性(894G>T)与前列腺癌易感性的关系。方法:利用计算机检索Cochrane Library、PubMed、EMBase、中国知网、万方和维普等数据库,按照文献纳入标准和排除标准选择研究文献,评价文献质量,并提取资料。采用STATA 12.0软件进行Meta分析,计算NOS 3 894G>T与前列腺癌易感性关系的合并比值比(odds ratio,OR),并进行亚组分析、敏感性分析和发表偏倚检验。结果:终纳入5项病例-对照研究,共包括3 078例患者和3 677例正常对照。Meta分析结果显示,NOS 3 894G>T基因多态性与前列腺癌易感性之间无显著相关性[TT vs GG,OR=0.95,95%可信区间(coni dence interval,CI):0.80~1.14;TT vs GT,OR=0.88,95%CI:0.73~1.05;TT+GT vs GG,OR=1.07,95%CI:0.97~1.18;TT vs GG+GT,OR=0.92,95%CI:0.77~1.09]。种族亚组分析中,在欧洲人群中发现两者也无显著相关性[TT vs GG,OR=0.87,95%CI:0.73~1.04;TT vs GT,OR=0.85,95%CI:0.71~1.02;TT+GT vs GG,OR=1.00,95%CI:0.90~1.11;TT vs GG+GT,OR=0.86,95%CI:0.72~1.02]。结论:NOS 3 894G>T基因多态性与前列腺癌易感性之间不存在关联性,在欧洲人群中亦无关联性。     

中国人群FGFR2基因多态性与乳腺癌易感相关性研究的Meta分析

目的系统评估成纤维细胞生长因子受体2(fibroblast growth factor receptor 2,FGFR2)基因内含子的3个单核苷酸位点rs2981582、rs1219648和rs2420946多态性与中国人群乳腺癌的易感性的关系。方法计算机检索PubMed、Embase、Cochrane library、中国知网、维普、万方数据库及中国生物医学文献数据库中,2014-06-01之前关于FGFR2基因内含子的3个单核苷酸位点rs2981582、rs1219648和rs2420946多态性与中国人群乳腺癌易感性的相关研究,按纳入与排除标准筛选文献、提取资料并评价纳入研究的质量后,采用Stata 12.0软件进行Meta分析,计算合并OR值及其95%CI,并进行发表偏倚评估及敏感性分析。结果共纳入18篇文献,包括14 568例患者和12 864名对照。Meta分析结果显示,FGFR2rs2981582、rs1219648和rs2420946基因多态性与中国人群乳腺癌有显著相关性。以地域进行亚组分析,rs2981582的T等位基因在南方人群(OR=1.13,95%CI:1.06~1.22,P=0.001)和北方人群(OR=1.26,95%CI:1.06~1.49,P=0.008)中与乳腺癌显著相关;rs2420946的T等位基因在南方人群(OR=1.15,95%CI:1.08~1.23,P<0.05)中与乳腺癌显著相关,北方人群中差异无统计学意义(OR=1.03,95%CI:0.87~1.22,P=0.695);rs1219648的G等位基因在南方人群(OR=1.19,95%CI:1.10~1.28,P<0.05)和北方人群(OR=1.17,95%CI:1.00~1.37,P=0.05)中与乳腺癌有显著相关。结论 FGFR2rs2981582、rs1219648和rs2420946基因多态性与中国人群乳腺癌易感性显著相关,但以地域进行亚组分析时则表现有差异。     

MDM2基因多态与肝癌遗传易感性的Meta分析

目的:根据已发表的相关文献,综合评估鼠双微体同源基因2(MDM2)多态与肝癌遗传易感性之间的关系。方法:按照统一的检索策略在相关中英文数据库中全面检索相关文献,对文献进行筛选、评价后获得相关研究的结果数据,然后应用Stata 10软件中Meta分析的方法,计算合并OR值及95%CI,并进行敏感性分析和发表偏倚的估计。结果:共有国内外5篇合格文献纳入本研究,累计病例和对照数分别为738和1 062例。合并结果显示,携带GG等位基因型者患肝癌的危险性是携带TT等位基因型的2.39倍(95%CI=1.81～3.15,P<0.001),携带TG等位基因型者患肝癌的危险性是携带TT等位基因型的1.65倍(95%CI=1.31～2.08,P<0.001)。发表偏倚评估未发现明显的偏倚。结论:MDM2SNP309多态中GG、TG等位基因型可能与肝癌的易感性升高有关。     

OPN基因多态性与广西壮族人群鼻咽癌易感性的关系

目的研究骨桥蛋白(osteopontin,OPN)基因单核苷酸多态性及其单倍型与广西壮族人群鼻咽癌(nasopharyngeal carcinoma,NPC)易感性的关系。方法采用病例-对照研究方法,收集2010-03-01-2013-03-20入住右江民族医学院附属医院的广西壮族鼻咽癌患者150例,同时随机选取2012-01-01-2012-08-01右江民族医学院附属医院常规体检的广西壮族人150名作为对照。采用单碱基延伸PCR技术和DNA测序法,检测150例广西壮族鼻咽癌患者和150名壮族对照者的OPN基因rs11728697和rs4754位点单核苷酸多态性,并分析OPN基因的单倍型频率。结果在OPN基因rs11728697位点上,携带CT基因型的个体相比携带常见的CC基因型个体罹患鼻咽癌的风险更高,OR=1.78,95%CI为1.05~2.98,χ2=5.863,P=0.033;但TT基因型并不增个体罹患鼻咽癌的风险,OR=0.92,95%CI为0.55~1.77,χ2=0.012,P=0.921。同时,鼻咽癌组在该位点的等位基因型频率与对照组的频率相比差异无统计学意义,OR=1.14,95%CI为0.69~1.45,χ2=0.545,P=0.466。在OPN基因rs4754位点上,对照组和鼻咽癌组的基因型及等位基因型频率分布差异无统计学意义,P>0.05。对照组和鼻咽癌组的单倍型频率分布差异亦无统计学意义,P>0.05。结论在广西壮族人群中,OPN基因rs11728697位点的CT基因型可能增加个体鼻咽癌的易感性,而rs4754位点的多态性与鼻咽癌的易感性无关。     

豆制品与乳腺癌相关性的Meta分析

目的收集豆制品与乳腺癌发病风险的文献,并对文献进行统计学Meta分析,探讨豆制品摄入与乳腺癌的相关性。方法以“豆制品”和“乳腺肿瘤”等为关键词,检索CHKD期刊全文数据库、中国生物医学文献数据库（CBM）和Pubmed数据库,收集2001—2011年发表的豆制品与乳腺癌发病风险的文献。应用统计学软件对文献数据进行统计分析。结果共14项研究被纳入分析。14项研究存在异质性（Q=15.7,P=0.000）,采用随机效应模型进行合并计算,豆制品的合并RR值为0.61,95%CI为0.40~0.82;豆腐的合并RR值为0.77,95%CI为0.69~0.88。合并分析表明,豆制品的摄入可以降低乳腺癌的发病风险。偏倚分析显示,无发表偏倚。结论豆制品是乳腺癌的保护性因素,豆制品的摄入可以有效降低乳腺癌发病风险。     

Family history of cancer and subsequent risk of cancer: A large-scale population-based prospective study in Japan

Family history (FH) of cancer is an important factor of increased risk of several cancers. Although the association between FH of cancer and concordant cancer risk has been reported in many previous epidemiological studies, no comprehensive prospective study with adjustment for lifestyle habits has evaluated the association of FH of cancer and concordant cancer risk. We investigated the association between FH of cancer and concordant cancer risk in a Japanese population-based prospective study, initiated in 1990 for cohort I and in 1993 for cohort II. We analyzed data on 103,707 eligible subjects without a history of cancer who responded to a self-administered questionnaire including FH of cancer at baseline. Study subjects were followed through 2012 and analyzed using multivariable-adjusted Cox proportional hazards regression models. During 1,802,581 person-years of follow-up, a total of 16,336 newly diagnosed cancers were identified. Any site (Hazard ratios = 1.11 (95% confidence interval = 1.07–1.15]), esophagus (2.11 [1.00–4.45]), stomach (1.36 [1.19–1.55]), liver (1.69 [1.10–2.61]), pancreas (2.63 [1.45–4.79]), lung (1.51 [1.14–2.00]), uterus (1.93 [1.06–3.51]) and bladder cancers (6.06 [2.49–14.74]) with FH of the concordant cancer were associated with an increased risk compared to those without FH. Our findings suggest that having FH of cancer is associated with an increased risk of several concordant cancer incidences in an Asian population. Enquiring about FH of several types of cancer may be important in identifying groups at high-risk of those cancers.     

Consistency of self-reported first-degree family history of cancer in a population-based study

The aim of this study was to assess the prevalence and consistency of self-reported family history of cancer among first-degree relatives (FDR) in a population-based study. Women at primary care units (PCU) were submitted to a questionnaire about cancer family history. Consistency of the report was determined by comparing self-reported history at the PCU to data from subsequent genetic evaluations and/or cancer confirmatory documents. Consistency in relation to degree of education, reported tumor type and reported age at cancer diagnosis in FDR was assessed. In 8,881 women interviewed, the prevalence of cancer in an FDR was 25.14% (CI 95%: 24.14; 25.94). Mean age was 40.29 years and most (70.26%) had ≤8 years of education. There was a good agreement of self-reported cancer history at the PCU and in subsequent genetic evaluations [Kappa coefficient = 0.76 (P < 0.05)]. Inconsistencies were not related to low literacy (χ ² = 2.027; P = 0.363). Consistency of the reported information for cancer status, cancer type and age of onset was 92.59%, 85.33% and 92.64%, respectively. The prevalence of cancer history in an FDR was similar to previous reports in other populations. Consistency and reliability of the self-reported information was high, regardless of educational level.     

Family history of cancer and renal cell cancer risk in Caucasians and African Americans

Background:

The association between renal cell carcinoma (RCC) risk and family history of cancer has not been examined with an adequate number of African Americans (AAs).

Methods:

In a population-based case–control study, unconditional logistic regression was used to calculate the association between RCC risk and a family history of cancer among 1217 RCC cases and 1235 controls.

Results:

Increased RCC risk was shown for subjects with at least one first-degree relative with kidney cancer (odds ratio=2.29; 95% confidence interval=1.31–4.00). No differences in risk were observed when analyses were stratified by race. For Caucasians, excess risk was observed among those reporting a sibling with kidney cancer, whereas for AAs, increased risk occurred among subjects reporting either a sibling or parent affected with the disease. A family history of non-renal cancers, and those related to smoking or to the von Hippel–Lindau syndrome, revealed no association with RCC risk.

Conclusion:

The RCC risk associated with a family history of kidney cancer is similar among Caucasians and AAs.     

肝癌核心家系调查分析及标本数据库的建立

目的对肝癌核心家系进行调查并对其进行分析。建立肝癌核心家系标本数据库,为肝癌遗传易感性的研究提供实验标本和研究资料。方法对经县级及以上医院确诊的肝癌先证者及其血缘父母进行调查和填写调查表,并采集外周静脉血液8ml,其中抗凝血5ml分离、冻存,3ml非抗凝血进行乙肝两对半、AFP及肝功能检测。结果共收集肝癌核心家系251例,具备完整的血样标本及相关资料。调查发现30例家系有肝癌家族史,通过追踪随访新发现肝癌1例。结论建立规范的肝癌核心家系数据库是进行肝癌遗传学研究的基本手段,完善的血样标本及相关资料为后续研究提供了保证,肝癌核心家系标本数据库建立过程中面临的伦理、社会等问题值得探讨。     

Colon cancer screening, lifestyle, and risk of colon cancer

Objectives: Sigmoidoscopy screening and fecal occult blood (FOB) tests have been demonstrated as effective ways to reduce mortality from colorectal cancer. However, most studies of colorectal cancer screening and cancer mortality have not taken into consideration lifestyle factors that could account for the observed associations. The purpose of this study was to determine the association between screening and incidence of colon cancer, taking into consideration important lifestyle factors. Methods: We estimated the association between screening and colon cancer after taking into consideration health and lifestyle factors using data obtained as part of population-based case–control study of incident colon cancers. Results: Sigmoidoscopy screening, especially as part of a checkup, was protective against incident colon cancer in both men (OR 0.56, 95% CI 0.44–0.77) and women (OR 0.53, 95% CI 0.33–0.77) after adjusting for other risk factors for colon cancer. For men, associations were stronger for distal tumors (OR 0.48, 95% CI 0.31–0.71) than for proximal tumors (OR 0.67, 95% CI 0.45–1.11). We did not observe significant associations between FOB test and colon cancer. Differences in characteristics between those who were screened and not screened were also observed. Men were more likely to report having a sigmoidoscopy as part of a checkup than were women, as were people with higher levels of education. People who reported having a sigmoidoscopy as part of a checkup also reported eating diets lower in fat and higher in fiber, folate, and vegetables. Men were more likely to report higher levels of physical activity, and women were more likely to report taking hormone replacement therapy (HRT) if they also reported a sigmoidoscopy. Both men and women who reported a sigmoidoscopy for screening purposes were more likely to have a family history of colorectal cancer. Conclusions: These data provide additional support for the benefits of having a screening sigmoidoscopy. The associations between screening sigmoidoscopy and colon cancer do not appear to be the result of lifestyle factors.     

A case-control analysis of lymphocytic chromosome 9 aberrations in lung cancer

Cytogenetic aberrations on chromosome 9 have been reported to be one of the most frequent genetic changes in lung tumorigenesis. Although many of these changes have been detected in lung carcinoma specimens, there is growing evidence showing the concordance between chromosomal alterations in primary lung tumors and peripheral blood lymphocytes (PBLs). We investigated whether spontaneous aberrations on chromosome 9 in PBLs are associated with the presence of lung cancer and with a family history of cancer. A personal interview, to construct a detailed epidemiologic profile including family history of cancer, was conducted on 174 lung cancer cases and 162 matched controls. One hundred metaphases from PBLs of each subject were analyzed for chromosome 9 aberrations using the whole chromosome painting technique. Overall, the mean proportion of individuals with chromosome 9 abnormalities in their PBLs was significantly higher in cases (96.0%) than in controls (60.5%) (p < 0.05). After adjustment by age, gender, ethnicity, family size, and pack-years, there was a 16.63-fold significantly elevated odds ratio (OR) for lung cancer associated with chromosome 9 aberrations. When subjects were categorized by frequencies of the chromosome 9 lesions, we observed significantly increased odds ratios of 11.13 (4.66, 26.58) and 27.45 (11.15, 67.54) for individuals with 1 chromosome 9 aberration and >/=2 chromosome 9 aberrations, respectively. By performing family history analyses, we further observed that control individuals with chromosome 9 aberrations were more likely to report a family history of any cancer (OR = 1.67 [0.84, 3.32]) and lung cancer (OR = 2.49 [0.81, 7.67]). Our findings suggest that chromosome 9 aberrations in PBLs might be considered a marker of lung cancer predisposition and may be associated with familial aggregation of cancer.     

Family history of cancer predicts Papanicolaou screening behavior for African American and white women

BACKGROUND:

Understanding women's motivations for getting Papanicolaou (Pap) screening has the potential to impact cancer disparities. This study examined whether having a family history of cancer was a predictor for Pap screening.

METHODS:

By using the National Health Interview Survey 2000 Cancer Control and Family modules, we identified a subsample (n=15,509) of African American (n=2774) and white women (n=12,735) unaffected by cancer, with and without a family history of cancer. Data were analyzed using logistic regression models.

RESULTS:

African American and white women with a positive family history of cancer were 42% (P < .0001) more likely to have had a recent Papanicolaou (Pap) test than their counterparts without a family history of cancer. Among African American women, those with a positive family history of cancer were 53% more likely to have had a recent Pap test, whereas among white women those with a positive family history of cancer were 41% more likely to have received a Pap test. African American women with a family history of cancer were more likely to have had a recent Pap test than white women with or without a family history of cancer.

CONCLUSIONS:

This study presents a unique perspective on Pap screening behavior. Having an immediate family member with any cancer statistically predicted having a recent Pap test for both African American and white women. Because these results demonstrated that regardless of the cancer type, having an immediate affected family member is a motivator for cervical cancer screening behavior, healthcare providers managing cancer treatment patients have a teachable opportunity that extends beyond the patient. Cancer 2009. © 2008 American Cancer Society.     

Familial bilateral breast cancer

The occurrence of bilateral breast cancers in three members of one family is reported. In two members, evidence of a distinct primary lesion in each breast was verified. The occurrence of unilateral breast cancer and other cancers in other members of the family was surveyed. Recommendations for early detection and surveillance in familial breast cancer at the present time should be by aggressive and close follow-up of the affected members. Absence of reliable markers preclude effective surveillance for early detection or susceptibility.     

Family history of breast cancer and short-term effects of childbirths on breast cancer risk

The long-term protective effect of a pregnancy on breast cancer risk is preceded by a short-term adverse effect, possibly reflecting a promoting effect of pregnancy hormones. In the present study, we explore whether a family history of breast cancer modifies time-related effects of pregnancies, with special emphasis on the transient increase in risk of breast cancer shortly after birth. Our study cohort comprises 1,067,289 Norwegian women aged 20-74 years. The mean follow-up time was 18 years. Incidence rate ratios were estimated by Poisson regression analyses of person-years at risk. Of the 7,377 women diagnosed with breast cancer during follow-up, a total of 828 (11%) had a mother or a sister with breast cancer diagnosis. Women with a family history of breast cancer had a 2-3-fold higher risk of breast cancer than did women without any affected family member, highest for those with a relative diagnosed before they were 50 years. Similar to women without a familial excess risk, increasing parity was associated with an overall protective effect among women with a familial predisposition, regardless of age at diagnosis of the relative. Whereas women with no familial excess risk experienced a transient increase in risk mainly after late age births, women with a family history of breast cancer experienced an adverse effect of pregnancies also at younger ages. The present results give further support to the hypothesis that the adverse effect of a term birth can be explained by a promoting effect of pregnancy hormones.     

Disparities in cancer screening in individuals with a family history of breast or colorectal cancer

BACKGROUND:

Understanding racial/ethnic disparities in cancer screening by family history risk could identify critical opportunities for patient and provider interventions tailored to specific racial/ethnic groups. The authors evaluated whether breast cancer (BC) and colorectal cancer (CRC) disparities varied by family history risk using a large, multiethnic population‐based survey.

METHODS:

By using the 2005 California Health Interview Survey, BC and CRC screening were evaluated separately with weighted multivariate regression analyses, and stratified by family history risk. Screening was defined for BC as mammogram within the past 2 years for women aged 40 to 64 years; for CRC, screening was defined as annual fecal occult blood test, sigmoidoscopy within the past 5 years, or colonoscopy within the past 10 years for adults aged 50 to 64 years.

RESULTS:

The authors found no significant BC screening disparities by race/ethnicity or income in the family history risk groups. Racial/ethnic disparities were more evident in CRC screening, and the Latino‐white gap widened among individuals with family history risk. Among adults with a family history for CRC, the magnitude of the Latino‐white difference in CRC screening (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.11‐0.60) was more substantial than that for individuals with no family history (OR, 0.74; 95% CI, 0.59‐0.92).

CONCLUSIONS:

Knowledge of their family history widened the Latino‐white gap in CRC screening among adults. More aggressive interventions that enhance the communication between Latinos and their physicians about family history and cancer risk could reduce the substantial Latino‐white screening disparity in Latinos most susceptible to CRC. Cancer 2011;. © 2011 American Cancer Society.