Neighborhood disadvantage and racial disparities in colorectal cancer incidence: a population-based study in Louisiana

Purpose

Colorectal cancer (CRC) continues to demonstrate racial disparities in incidence and survival in the United States. This study investigates the role of neighborhood concentrated disadvantage in racial disparities in CRC incidence in Louisiana.

Familial ovarian cancer: a population-based case-control study

Data from a multicenter population-based case-control study were analyzed to assess the degree of aggregation of ovarian cancer in families. Included as cases were 493 women aged 20-54 who had been newly diagnosed with epithelial ovarian cancer. The frequency with which cases reported a family history of ovarian cancer was compared with the frequency for a group of 2,465 controls selected by random digit dialing. The odds ratios for ovarian cancer in first- and second-degree relatives were 3.6 (95% confidence interval (Cl) 1.8-7.1) and 2.9 (95% Cl 1.6-5.3), respectively, compared with women with no family history of ovarian cancer. The null hypothesis of no association was excluded on both the maternal and paternal sides of the families studied. Ovarian cancer in relatives was reported by women with malignant lesions but not by women with borderline lesions. These results did not seem to be attributable to the possible confounding effects of any of several covariates or to errors in reporting family history of ovarian cancer.     

Intrauterine device use among women with ovarian cancer: a systematic review

Background

Fertility-sparing treatment may be an option for women with early stage ovarian cancer and certain tumor types. This systematic review evaluated the evidence on the safety of intrauterine device (IUD) use by women with ovarian cancer.

Study Design

We searched the PubMed database for peer-reviewed articles relevant to IUD (copper or levonorgestrel-releasing) use and ovarian cancer published in any language from database inception through August 2009. We sought studies that examined outcomes among women using an IUD at or after ovarian cancer diagnosis.

Results

Of the 250 articles identified by our search strategy, none provided evidence (direct or indirect) regarding the safety of IUD use among women with ovarian cancer.

Conclusions

No evidence on the safety of IUD use among women with ovarian cancer was identified. While there are some theoretical concerns that IUD use might affect monitoring of disease progression of sex cord-stromal tumors, or increase risk of pelvic infection or vaginal bleeding among women undergoing chemotherapy, we did not find any data to suggest that IUD use would lead to worsening of primary ovarian cancer.     

Cervical cancer sociodemographic and diagnostic disparities in Florida: a population-based study (1981–2013) by stage at presentation

ABSTRACT

Objective: Florida has one of the highest cervical cancer mortality rates and socioeconomically diverse populations in the United States. We used statewide population-based cancer registry data to assess disparities in cervical cancer stage at diagnosis.

Design: Primary invasive adult female cervical cancer patients in the Florida Cancer Data Registry (1981–2013) were linked with 2000 United States Census data. Early (localized) and advanced (regional and distant) stage at diagnosis was assessed by age, race, ethnicity, neighborhood socioeconomic-, marital-, and smoking- status. Univariate and multivariable logistic regression models were fit to identify factors associated with the risk of advanced cervical cancer stage at diagnosis. Adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95%CI) were calculated.

Results: Of 18,279 women (mean_age 51.3 years old), most were non-Hispanic (83.5%), white (79.1%), middle-low neighborhood socioeconomic status (NSES) (34.7%), married (46.0%), and never smoked (56.0%). Higher odds of advanced stage was observed for blacks (aOR: 1.42, 95%CI: 1.30–1.55, p?<?0.001) compared to whites, Hispanics (1.15, 1.06–1.25, p?=?0.001) compared to non-Hispanics, and middle-low (1.13, 1.02–1.25, p?=?0.02) and low NSES (1.42, 1.28–1.57, p?<?0.001) compared to high NSES. Previously (1.30, 1.21–1.39, p?<?0.001) and never married (1.37, 1.27–1.48, p?<?0.001) had higher odds of presenting with advanced stage versus married women. Never smokers had decreased odds of presenting with advanced stage compared to women with history of (1.41, 1.32–1.52, p?<?0.001) or current (1.29, 1.18-1.42, p < 0.001)smoking status.

Conclusions: There are cancer disparities in women of black race, Hispanic ethnicity and of middle-low and lowest NSES in Florida. Evidence-based interventions targeting these vulnerable groups are needed.

Abbreviations: HPV: Human Papilloma Virus; CDC: Center for Disease Control and Prevention; SES: socioeconomic status; FCDS: Florida Cancer Data System; NSES: Neighborhood Socioeconomic Status; NPCR: National Program of Cancer Registries; IRB: Institutional Review Board; ACS: American Community Survey; SEER: Surveillance, Epidemiology and End Results; OR: Odds Ratio; CI: Confidence Interval     

年轻早期宫颈癌患者卵巢移位术后卵巢功能变化

目的:探讨早期宫颈癌患者实施卵巢移位术后卵巢功能的变化及术后补充放疗对移位卵巢的影响。方法:对大连医科大学附属第一医院2002年1月～2006年1月期间收治的29例年龄≤40岁ⅠA～ⅡA期宫颈癌患者实施宫颈癌根治术的同时行卵巢移位术。将这29例患者作为研究组,其中术后无辅助放疗者12例为研究组1,有辅助放疗者17例为研究组2;选取同年龄段、同期入院的32例行子宫全切并保留双侧卵巢于原解剖位置的子宫良性病变患者作为对照组1,7例行传统宫颈癌根治术(不保留卵巢)的宫颈癌患者作为对照组2。术后3个月、半年、1年随访研究组及两个对照组了解有无围绝经期症状,对研究组同时还调查性生活情况。测定术后1年左右研究组、对照组的FSH、E2水平,进行比较,并作统计学分析。结果:研究组中29例患者2例分别于术后9个月、11个月死亡,17例术后补充放疗。①更年期症状调查:出现更年期症状的患者,术后3个月为10例。未补充放疗的患者占2例,其中1例于术后半年症状消失,另1例及其余8例补充放疗的患者术后1年症状仍持续存在。②性生活调查:术后3个月有性生活者5例,均为术后未补充放疗者,性生活基本满意;术后半年有性生活者16例,11例性生活满意或基本满意;术后1年29例患者除2例死亡以外均有性生活,18例满意或基本满意。③术后1年左右测定FSH、E2水平。研究组1(未放疗组)与对照组1(子宫全切组)比较,P>0.05,无统计学意义;研究组1(未放疗组)与研究组2(放疗组)比较,P<0.05,有统计学意义;研究组2(放疗组)与对照组2(切除卵巢组)比较,P<0.05,有统计学意义。结论:宫颈癌患者术中行卵巢移位术可保留卵巢的功能。术后辅助放疗对卵巢功能有影响,但对于术后需要辅助放疗的宫颈癌患者行卵巢移位术仍能部分保留卵巢功能。     

Familial breast and ovarian cancer: a Swedish population-based register study

A cohort of offspring of mothers with breast or ovarian cancer diagnosed in 1958-1993 was established using Swedish population-based registers. The children (n = 158,041) were born between 1941 and 1993, and their cancer incidence was followed between 1961 and 1993. A total of 3,257 tumors in 3,102 children were found. Observed numbers of cases were compared with expected numbers based on national calendar year-, age-, and sex-specific incidences. For daughters of women with breast cancer, the standardized morbidity ratios for being diagnosed with breast cancer and ovarian cancer before age 50 years were 1.99 (95% confidence interval (CI): 1.86, 2.14) and 1.28 (95% CI: 1.05, 1.54), respectively. The corresponding figures for daughters of women with ovarian cancer were 1.79 (95% CI: 1.55, 2.07) and 2.38 (95% CI: 1.77, 3.12). The risks were raised if the mother's cancer was diagnosed at a young age, the mother had multiple breast/ovarian diagnoses, or there was a sister with breast/ovarian cancer. Among all offspring, increased risks were found for thyroid cancer, testicular cancer, and malignant melanoma, while lung cancer risk was decreased if the mother had had breast cancer. The authors developed a variance estimator for the standardized morbidity ratio to cope with overdispersion due to dependency within families.     

卵巢移位在年轻宫颈癌根治术中的应用分析

目的:探讨卵巢移位在年轻宫颈癌根治术中应用的可行性和安全性。方法:年轻宫颈癌(年龄40岁以下)36例,临床分期ⅠB～ⅡA期,随机分为两组进行临床观察。其中19例在宫颈癌根治术中行卵巢移位以保留卵巢为观察组;17例在宫颈癌根治术中切除卵巢为对照组。术后应用血FSH、LH、E2及Kuppermann评分测定卵巢功能,随访1～5年。结果:观察组术后5年内卵巢功能基本正常,对照组术后1个月卵巢功能丧失。两组记录生存质量的Kuppermann评分比较差异有非常显著性意义(P<0.01)。而复发率和存活率比较差异无显著性意义(P>0.05)。结论:年轻宫颈癌患者在宫颈癌根治术中行卵巢移位是安全可行的,可保留卵巢功能。     

Recruitment of newly diagnosed ovarian cancer patients proved challenging in a multicentre biobanking study

Objective

To explore the challenges of recruiting ovarian cancer patients and healthy controls to a cancer biobanking study.

Study Design and Setting

The study was set up in gynecological cancer centers in 10 National Health Service trusts across the United Kingdom. Women were approached if they were undergoing investigations/awaiting treatment for ovarian cancer, had a previous diagnosis of ovarian cancer, or were attending for annual screening in an ovarian cancer screening trial. Those who consented completed a detailed epidemiologic questionnaire, provided blood and tissue samples if appropriate.

Results

The overall proportion of those recruited compared with the expected targets was 76.4% for healthy controls, 86.0% for old cases, and 46.9% for new cases. Only 4 of 10 (40%) centers recruited over 50% of their target for new cases. Unwillingness to participate was reported as primarily because of patients being too unwell, wanting to focus only on their treatment, or having insufficient time because of conflicting medical appointments. Concerns about use of personal data or tissue and blood samples for genetic research and lack of direct benefit were reported as significant challenges to recruitment.

Conclusion

When setting recruitment targets for patients undergoing investigations or awaiting treatment for cancer (new cases), it is important to consider lower response rates because of various patient, logistical, and trial-specific challenges.     

Increased risk for familial ovarian cancer among Jewish women: A population-based case-control study

Jewish women have been reported to have a higher risk for familial breast cancer than non-Jewish women and to be more likely to carry mutations in breast cancer genes such as BRCA1. Because BRCA1 mutations also increase women's risk for ovarian cancer, we asked whether Jewish women are at higher risk for familial ovarian cancer than non-Jewish women. To determine the effects of 1) Jewish religion and 2) ovarian cancer in a first-degree relative on women's risk for epithelial ovarian cancer, we used data from a population-based, case-control study conducted in 8 geographic regions in the United States from 1980 through 1982. The study group included 471 cases and 4,025 controls. Jewish women were more likely to have familial ovarian cancer than non-Jewish women [odds ratio (OR) = 8.4,95% confidence interval (CI) = 2.6–28]. The risk of having ovarian cancer appeared to be greater in Jewish women having a first-degree relative with ovarian cancer (OR = 8.81,95% CI = 2.02–38.23) than in non-Jewish women having a first-degree relative with ovarian cancer (OR = 3.01,95% CI = 1.61–5.64), but differences between Jewish and non-Jewish women were not statistically significant. Jewish women with no first-degree relative with ovarian cancer had no increased risk for ovarian cancer (OR = 1.27,95% CI = 0.74–2.91) compared to non-Jewish women. These results suggest that Jewish women may have a higher rate of familial ovarian cancer than non-Jewish women, but because the results are based on a small number of Jewish women with familial ovarian cancer, the results need to be confirmed in larger studies. Genet. Epidemiol. 15:51–59,1998. © 1998 Wiley-Liss, Inc. This article was prepared by a group consisting of both United States government employees and non-United States government employees, and as such is subject to 17 U.S.C. Sec. 105.     

进展期卵巢癌术后肠外营养支持治疗

目的：探讨肠外营养支持（PN）在进展期卵巢癌病人术后应用的效果。方法：将我院应用肠外营养支持的30例作为试验组，未应用PN的35例作为对照组。对血清蛋白、氮平衡、并发症、病死率进行对比分析。结果：试验组血清蛋白和氮平衡在术后第8天均优于对照组；并发症发生率及病死率明显低于对照组。结论：肠外营养支持治疗可有效地改善进展期卵巢癌病人术后营养状态，降低并发症的发生率及病死率。     

免疫球蛋白G在卵巢上皮性癌中的表达

目的:研究免疫球蛋白G(IgG)在卵巢上皮性癌中的表达,探讨IgG的表达强度与卵巢上皮性癌病理分级的相关性。方法:应用免疫组化法检测177例卵巢上皮性癌,50例卵巢良性肿瘤上皮组织中IgG的表达水平。结果:IgG在卵巢上皮性癌组织中的表达水平明显高于卵巢良性肿瘤上皮组织,差异有统计学意义(P<0.001);IgG的表达强度与卵巢上皮性癌病理分级的关系呈正相关(r=0.410,P<0.001)。结论:IgG在卵巢上皮性癌组织中高表达;IgG在卵巢上皮性癌组织中的异常表达提示与肿瘤的发生、发展密切相关。     

FADD在卵巢癌中的表达及其临床意义

目的:研究Fas相关死亡域蛋白(FADD)在卵巢癌中的表达,探讨其在卵巢癌发生、发展中的作用及临床意义,并判断卵巢癌的恶性程度、估计其预后。方法:采用SP免疫组织化学方法检测62例卵巢癌、15例卵巢良性肿瘤和16例正常卵巢组织中FADD的表达,并分析卵巢癌的临床病理资料。结果:①正常卵巢组织中FADD阳性表达率为87.5%,卵巢良性肿瘤阳性表达率为73.3%,卵巢癌阳性表达率为32.3%,正常卵巢与卵巢癌中的阳性表达率差异有高度显著性(P<0.01),卵巢良性肿瘤与卵巢癌中的阳性表达率差异亦有高度显著性(P<0.01),而正常卵巢与卵巢良性肿瘤的阳性表达率差异无显著性(P>0.05)。②各组标本中FADD的表达阳性程度较低,并以弱阳性为主(共36例),阳性共11例,强阳性标本数为0。③FADD的阳性表达率在Ⅰ期、Ⅱ期及Ⅲ期和Ⅳ期合并组间比较有显著性差异(P<0.05);FADD的阳性表达率与临床分期呈负相关(P<0.001)。④中分化组与低分化组的FADD的阳性表达明显低于高分化组,差异有高度显著性(P<0.01)。⑤浆液性囊腺癌阳性表达率为31.8%;非浆液性囊腺癌阳性表达率为33.3%。两组FADD的表达无显著性(P>0.05)。结论:FADD在卵巢癌的发生发展中起着重要的作用,根据其表达率的高低可以判断肿瘤的恶性程度,估计卵巢癌的预后,为基因水平治疗卵巢癌提供新的思路。     

光动力疗法对人卵巢癌细胞系Skov3凋亡的影响

目的 通过对经光动力疗法(PDT)处理后卵巢癌细胞系Skov3发生凋亡情况的研究,探讨光动力学疗法对体外培养的人卵巢癌细胞的影响. 方法 采用不同能最激光对不同浓度光敏剂(5-ALA)处理过的卵巢癌细胞系(Skov3)进行照射,48 h后应用光镜、电镜进行形态学观察,同时利用流式细胞仪检测细胞凋亡情况. 结果 倒置显微镜下经光动力学处理后Skov3细胞体积缩小,细胞变形、皱缩,细胞核浓缩、深染,染色质密集成斑块状,细胞间失去彼此连接,透射电镜下可见致密的染色质沿核膜下聚集,有凋亡小体形成.流式细胞仪定量分析最大细胞凋亡率为60.5%. 结论 PDT通过诱导捅亡对体外培养的Skov3细胞产生杀伤作用.     

功能基因组学方法筛选卵巢癌风险microRNA

目的:寻找新的卵巢癌发病相关microRNA并为研究人员提供优化后的卵巢癌风险microRNA参照列表。方法:通过在生物网络中度量microRNA靶基因与卵巢癌基因间的功能相似性设计并实现优化卵巢癌风险microRNA计算学方法。采用留一法交叉证实检测该方法的准确性。应用该方法对人类1 527个microRNA进行优化排序。结果:留一法交叉证实所得ROC曲线下面积0.92,该方法有着较高的灵敏度和特异度。排序后,一些已知的卵巢癌相关microRNA如let-7、miR-34/200排在了优化结果的前20位。与新一代测序数据结果进行比较,发现排序前20位microRNA中的大部分都在正常和卵巢癌组织中呈差异表达。结论:应用计算学方法可筛选出卵巢癌相关microRNA,并提供优化后的风险microRNA列表。miR-449a等7个未被报道与卵巢癌有关的miRNA有望成为新的卵巢癌相关的风险因子。     

缺氧诱导因子-1α在卵巢癌中的表达及其临床意义

目的:探讨缺氧诱导因子-1α在卵巢癌中的表达及临床意义。方法:选取2005年1月～2006年12月承德医学院附属医院卵巢上皮性肿瘤及正常卵巢的蜡块组织145例,利用免疫组织化学S-P方法对卵巢组织HIF-1α表达情况进行检查。结果:与正常卵巢和良性卵巢肿瘤相比,交界性卵巢肿瘤及卵巢癌组织HIF-1α表达相对较高(P<0.05);卵巢癌组织HIF-1α表达与病理分级间具有正相关关系(P<0.01)。结论:卵巢癌初期HIF-1α表达水平开始增加,随着病情发展水平逐渐上升,以HIF-1α为靶点的治疗对于卵巢癌治疗具有重要意义。     

卵巢癌手术治疗的总结

目的 目前,卵巢癌的治疗存在很大挑战,主要方式还是手术治疗,配合以放化疗的辅助治疗.方法 回顾相关的文献,从中总结出卵巢癌的最佳手术治疗方案.检索MEDLINE数据库.此外,还回顾近期国际、国内肿瘤协会的会议摘要.结果 在欧洲,原发性卵巢癌很少见,在北美洲也仅占所有卵巢癌的5％以下,其方法目前主要是手术治疗.结论 要想更全面的了解这些肿瘤、评价治疗方法和改善患者预后,必须联合国际、国内的多家研究机构才能实现.     

二甲双胍与卵巢癌发生及预后关系的研究

卵巢癌是世界上严重的妇科肿瘤之一,其死亡率位居妇科恶性肿瘤首位。二甲双胍不仅作为一线口服降糖药用于治疗2型糖尿病,而且对卵巢癌的发生发展还具有一定的抑制作用。近年来,国内外学者开展了关于二甲双胍与卵巢癌关系的实验和流行病学研究,共纳入了二甲双胍服用与卵巢癌发病及预后的7项队列和2项病例对照研究。结果提示使用二甲双胍可能改善卵巢癌的预后,但由于发病的流行病学研究较少,因此其与卵巢癌发病关系仍需进一步的探索。     

Geographic disparities in colorectal cancer survival

Background  

Examining geographic variation in cancer patient survival can help identify important prognostic factors that are linked by geography and generate hypotheses about the underlying causes of survival disparities. In this study, we apply a recently developed spatial scan statistic method, designed for time-to-event data, to determine whether colorectal cancer (CRC) patient survival varies by place of residence after adjusting survival times for several prognostic factors.