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Peer Reviewed

Title: ACOG Committee Opinion No. 434: induced abortion and breast cancer risk.
Author: Committee on Gynecologic Practice
Source: Obstetrics and Gynecology. 2009 Jun;113(6):1417-8.
Abstract: The Relationship between induced abortion and the subsequent development of breast cancer has been the subject of a substantial amount of epidemiologic study. Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.
Language: English
Keywords:
GLOBAL | CRITIQUE | RETROSPECTIVE STUDIES | PROSPECTIVE STUDIES | ABORTION | BREAST CANCER | RISK FACTORS | EPIDEMIOLOGY | BIAS | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Cancer | Neoplasms | Diseases | Health | Public Health | Error Sources | Measurement
Document Number: 341807 Notification

Title: Reproductive and hormonal factors, and ovarian cancer risk for BRCA1 and BRCA2 mutation carriers: results from the International BRCA1/2 Carrier Cohort Study.
Author: Antoniou AC; Rookus M; Andrieu N; Brohet R; Chang-Claude J
Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Feb;18(2):601-10.
Abstract: BACKGROUND: Several reproductive and hormonal factors are known to be associated with ovarian cancer risk in the general population, including parity and oral contraceptive (OC) use. However, their effect on ovarian cancer risk for BRCA1 and BRCA2 mutation carriers has only been investigated in a small number of studies. METHODS: We used data on 2,281 BRCA1 carriers and 1,038 BRCA2 carriers from the International BRCA1/2 Carrier Cohort Study to evaluate the effect of reproductive and hormonal factors on ovarian cancer risk for mutation carriers. Data were analyzed within a weighted Cox proportional hazards framework. RESULTS: There were no significant differences in the risk of ovarian cancer between parous and nulliparous carriers. For parous BRCA1 mutation carriers, the risk of ovarian cancer was reduced with each additional full-term pregnancy (P trend = 0.002). BRCA1 carriers who had ever used OC were at a significantly reduced risk of developing ovarian cancer (hazard ratio, 0.52; 95% confidence intervals, 0.37-0.73; P = 0.0002) and increasing duration of OC use was associated with a reduced ovarian cancer risk (P trend = 0.0004). The protective effect of OC use for BRCA1 mutation carriers seemed to be greater among more recent users. Tubal ligation was associated with a reduced risk of ovarian cancer for BRCA1 carriers (hazard ratio, 0.42; 95% confidence intervals, 0.22-0.80; P = 0.008). The number of ovarian cancer cases in BRCA2 mutation carriers was too small to draw definitive conclusions. CONCLUSIONS: The results provide further confirmation that OC use, number of full-term pregnancies, and tubal ligation are associated with ovarian cancer risk in BRCA1 carriers to a similar relative extent as in the general population.
Language: English
Keywords:
DEVELOPED COUNTRIES | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | CLINICAL RESEARCH | WOMEN | PREVALENCE | RISK ASSESSMENT | OVARIAN CANCER | CHROMOSOME ABNORMALITIES | PARITY | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | TUBAL LIGATION | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Measurement | Evaluation | Cancer | Neoplasms | Diseases | Neonatal Diseases and Abnormalities | Fertility Measurements | Fertility | Population Dynamics | Health | Contraceptive Safety | Safety | Public Health | Female Sterilization | Sterilization, Sexual | Family Planning
Document Number: 331025

Title: Human papillomavirus typing and soluble interleukin-2 receptor levels in female sex workers with a negative cervical smear result.
Author: Arioz DT; Altindis M; Tokyol C; Kalayci R; Saylan A; Yilmazer M
Source: International Journal of Gynaecology and Obstetrics. 2009 May 20;
Abstract: OBJECTIVE: To investigate the association between high-risk human papillomavirus (HPV) types and soluble interleukin-2 receptor (sIL-2R) levels in female sex workers with a negative cervical smear result, and to determine the effectiveness of using sIL-2R levels to screen for high-risk strains of HPV. METHOD: A negative cervical smear result and a blood sample were obtained from 68 women: 43 female sex workers and 25 women acting as controls. HPV DNA genotyping was performed and sIL-2R levels were assessed. RESULTS: Female sex workers had significantly higher sIL-2R levels than women in the control group (318.37+/-239.7 vs 114.4+/-56.5 U/mL, respectively P<0.001). In addition, female sex workers with high-risk strains of HPV had significantly higher sIL-2R levels than those who did not have high-risk strains of HPV (736.7+/-251.5 vs 250.5+/-156.1 U/mL, respectively; P=0.001). CONCLUSION: High sIL-2R levels may be useful in screening for high-risk strains of HPV in female sex workers who have a negative cervical smear result.
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CONTROL GROUPS | SEX WORKERS | HPV | CERVICAL CANCER | RISK FACTORS | CYTOLOGIC EFFECTS | SCREENING | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Sex Behavior | Behavior | Viral Diseases | Diseases | Cancer | Neoplasms | Health | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 341451

5.
Title: The abortion-breast cancer connection.
Author: Brind J
Source: Specialty Law Digest. Health Care Law. 2009 Jan;(340):9-35.
Abstract: This article examines the abortion breast cancer link in some historical scientific detail, offering a perspective on an issue that is at the center of a long-running public policy debate that plays out in legislatures, courtrooms, and newspaper editorials, as well as in scientific and medical journals. Even as politically correct studies have been promulgated to neutralize the data proving the abortion breast cancer link, even stronger data have emerged in recent years that firmly link abortion to premature births in subsequent pregnancies, which in turn raise the risk of breast cancer in mothers and cerebral palsy in prematurely born children.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | RESEARCH ACTIVITIES | ABORTION | BREAST CANCER | RISK FACTORS | EPIDEMIOLOGY | HORMONES | PREMATURE BIRTH | POLITICAL FACTORS | Developed Countries | North America | Americas | Research Methodology | Fertility Control, Postconception | Family Planning | Cancer | Neoplasms | Diseases | Health | Public Health | Endocrine System | Physiology | Biology | Pregnancy Outcomes | Pregnancy | Reproduction | Sociocultural Factors
Document Number: 341317

Title: Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer [letter]
Author: Dizdar O; Aksoy S; Altundag K
Source: Cancer. 2009 Apr 15;115(8):1802; author reply 1802-3.
Abstract: We read with great interest the article by Phipps et al, in which they examined the risk factors for different subtypes of postmenopausal breast cancer. They found that certain reproductive factors have a greater effect on the risk of certain molecular subtypes of disease compared with others. However, the authors did not analyze oral contraceptive use as a risk factor. Oral contraceptive use has been associated with an increased risk of breast cancer in young women. Narod et al demonstrated that among BRCA1 mutation carriers, women who first used oral contraceptives before 1975, who used them before age 30 years, or who used them for > or = 5 years may have an increased risk of developing breast cancer. Sporadic triple-negative breast cancers and tumors that are noted in carriers of the BRCA1 mutation share similar features, including estrogen receptor negativity, high nuclear grade, high Ki-67 staining, cytokeratin 5/6 expression, and epidermal growth factor receptor expression. Furthermore, BRCA1 is rarely mutated in sporadic breast cancers. However, the pathologic similarities suggest that BRCA1 or associated pathways can become inactivated in triple-negative tumors via other mechanisms, such as gene promoter methylation. We previously reported a positive association between oral contraceptive use and triple-negative breast cancer. Although we did not take into consideration the menopausal status of the patients, the frequency of oral contraceptive use in our small cohort was found to be higher in patients with the triple-negative subtype compared with patients with other subtypes of breast cancer (35.3% vs 12.2%; P=.02). Taken together, we propose that oral contraceptive use may be associated with an increased risk of developing triple-negative breast cancer. However, to identify the exact role of oral contraceptive use in the development of breast cancer, more preclinical and clinical studies are warranted. (full-text)
Language: English
Keywords:
TURKEY | UNITED STATES OF AMERICA | CRITIQUE | BREAST CANCER | RISK FACTORS | GENETICS | ORAL CONTRACEPTIVES | MENOPAUSE | AGE FACTORS | Europe, Southeastern | Europe | Developing Countries | Developed Countries | North America | Americas | Cancer | Neoplasms | Diseases | Health | Biology | Contraceptive Methods | Contraception | Family Planning | Reproduction | Population Characteristics | Demographic Factors | Population
Document Number: 341636

Title: Risk factors for triple-negative breast cancer in women under the age of 45 years.
Author: Dolle JM; Daling JR; White E; Brinton LA; Doody DR; Porter PL; Malone KE
Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Apr;18(4):1157-66.
Abstract: Little is known about the etiologic profile of triple-negative breast cancer (negative for estrogen receptor/progesterone receptor/human epidermal growth factor), a breast cancer subtype associated with high mortality and inadequate therapeutic options. We undertook this study to assess the risk for triple-negative breast cancer among women 45 years of age and younger in relation to demographic/lifestyle factors, reproductive history, and oral contraceptive use. Study participants were ascertained in two previous population-based, case-control studies. Eligible cases included all primary invasive breast cancers among women ages 20 to 45 years in the Seattle-Puget Sound area, diagnosed between January 1983 and December 1992, for whom complete data was obtained for estrogen receptor, progesterone receptor, and human epidermal growth factor status (n = 897; including n = 187 triple-negative breast cancer cases). Controls were age matched and ascertained via random digit dialing. Oral contraceptive use > or =1 year was associated with a 2.5-fold increased risk for triple-negative breast cancer (95% confidence interval, 1.4-4.3) and no significantly increased risk for non-triple-negative breast cancer (P(heterogeneity) = 0.008). Furthermore, the risk among oral contraceptive users conferred by longer oral contraceptive duration and by more recent use was significantly greater for triple-negative breast cancer than non-triple-negative breast cancer (P(heterogeneity) = 0.02 and 0.01, respectively). Among women < or =40 years, the relative risk for triple-negative breast cancer associated with oral contraceptive use > or =1 year was 4.2 (95% confidence interval, 1.9-9.3), whereas there was no significantly increased risk with oral contraceptive use for non-triple-negative breast cancer among women < or =40 years, nor for triple-negative breast cancer or non-triple-negative breast cancer among women 41 to 45 years of age. In conclusion, significant heterogeneity exists for the association of oral contraceptiveuse and breast cancer risk between triple-negative breast cancer and non-triple-negative breast cancer among young women, lending support to a distinct etiology.
Language: English
Keywords:
UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | CASE CONTROL STUDIES | BREAST CANCER | RISK FACTORS | ORAL CONTRACEPTIVES | TIME FACTORS | AGE FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Cancer | Neoplasms | Diseases | Health | Contraceptive Methods | Contraception | Family Planning | Population Dynamics | Demographic Factors | Population | Population Characteristics
Document Number: 341655

Title: Endometrial hyperplasia risk in relation to recent use of oral contraceptives and hormone therapy.
Author: Epplein M; Reed SD; Voigt LF; Newton KM; Holt VL; Weiss NS
Source: Annals of Epidemiology. 2009 Jan;19(1):1-7.
Abstract: PURPOSE: We sought to examine the relationship between recent use of oral contraceptives and hormone therapy and endometrial hyperplasia (EH) risk. METHODS: Cases comprised women diagnosed with complex EH (n = 289) or atypical EH (n = 173) between 1985 and 2003. One age-matched control was selected for each case; excluded were women with a prior hysterectomy or diagnosis of EH or endometrial cancer. Hormone use in the 6 months prior to the date of the case's first symptoms was ascertained using a pharmacy database and medical records. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS: Three (1.1%) cases had used oral contraceptives, compared to 16 (6.0%) controls (OR = 0.2, 95% CI: 0.0-0.6). Fifty-one (16.8%) cases had taken estrogen-only hormone therapy, in contrast to two (0.7%) controls (OR = 37.6, 95% CI: 8.8-160.0). The risk of EH among estrogen plus progestin hormone users did not differ from that of non-users (OR = 0.7, 95% CI: 0.4-1.1). CONCLUSIONS: This study suggests that previous findings of the association of estrogen-only hormone therapy with increased risk of EH and the lack of an association between estrogen plus progestin hormone therapy and EH risk are likely to apply to both complex EH and atypical EH. Further examination of the association between oral contraceptives and EH, with greater numbers of OC users, is warranted.
Language: English
Keywords:
WASHINGTON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | PREVALENCE | ENDOMETRIAL CANCER | HORMONE REPLACEMENT THERAPY | CONTRACEPTIVE SAFETY | ORAL CONTRACEPTIVES, SIDE EFFECTS | TIME FACTORS | CONTRACEPTIVE AGENTS, ESTROGEN | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, PROGESTIN | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Measurement | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Population Dynamics | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods
Document Number: 330386

9.
Peer Reviewed

Title: Family planning provider referral, facilitation behavior, and patient follow-up for abnormal Pap smears.
Author: Felix HC; Bronstein J; Bursac Z; Stewart MK; Foushee HR; Klapow J
Source: Public Health Reports. 2009 Sep-Oct;124(5):733-44.
Abstract: OBJECTIVES: Family planning (FP) clinics are important access points for cervical cancer screening and referrals for follow-up care for abnormal Papanicolaou (Pap) smears for a substantial number of U.S. women. Because little is known about referral and facilitation practices in these clinics or client action based on referrals, we sought to determine FP provider referral and facilitation practices when seeing FP clients with abnormal Pap smear results, and FP client follow-up for abnormal Pap smears due to FP provider referrals. METHODS: We conducted a mail survey of Medicaid-enrolled FP providers in Arkansas and Alabama, and conducted a telephone survey with a sample of FP clients of those providers responding to the provider survey. RESULTS: Major provider factors associated with referral included rural location, health department and clinic institutional setting, large Title X practice/clinic size, and high FP clinic focus. Major factors associated with facilitation included rural location, non-physician specialty, health department and clinic institutional setting, and small Title X clinic size. Of women reporting abnormal results, 62.4% reported follow-up care. Of those who received follow-up care, 40.0% received some care and a referral from their FP provider. A major factor associated with clients seeking follow-up care was being told by their FP provider where to go for follow-up care. Age was a major factor associated with clients actually obtaining follow-up care. CONCLUSIONS: Where follow-up care is not available at the FP site, referrals are critical and are a major factor associated with whether women seek care for the condition. Interventions to increase follow-up rates should focus on provider and system features, rather than clients.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | REFERRAL AND CONSULTATION | FAMILY PLANNING | CERVICAL CANCER | SCREENING | PAP SMEAR | HEALTH SERVICES | QUALITY OF HEALTH CARE | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Cancer | Neoplasms | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Health Services Evaluation | Program Evaluation
Document Number: 342766

10.

Title: Oral contraceptives and postmenopausal hormones and risk of contralateral breast cancer among BRCA1 and BRCA2 mutation carriers and noncarriers: the WECARE Study.
Author: Figueiredo JC; Haile RW; Bernstein L; Malone KE; Largent J; Langholz B; Lynch CF; Bertelsen L; Capanu M; Concannon P; Borg A; Borresen-Dale AL; Diep A; Teraoka S; Torngren T; Xue S; Bernstein JL
Source: Breast Cancer Research and Treatment. 2009 Jul 14;
Abstract: The potential effects of oral contraceptive (OC) and postmenopausal hormone (PMH) use are not well understood among BRCA1 or BRCA2 (BRCA1/2) deleterious mutation carriers with a history of breast cancer. We investigated the association between OC and PMH use and risk of contralateral breast cancer (CBC) in the WECARE (Women's Environment, Cancer, and Radiation Epidemiology) Study. The WECARE Study is a population-based case-control study of 705 women with asynchronous CBC and 1,398 women with unilateral breast cancer, including 181 BRCA1/2 mutation carriers. Risk-factor information was assessed by telephone interview. Mutation status was measured using denaturing high-performance liquid chromatography followed by direct sequencing in all participants. Outcomes, treatment, and tumor characteristics were abstracted from medical records. Ever use of OCs was not associated with risk among noncarriers (RR = 0.87; 95% CI = 0.66-1.15) or BRCA2 carriers (RR = 0.82; 95% CI = 0.21-3.13). BRCA1 carriers who used OCs had a nonsignificant greater risk than nonusers (RR = 2.38; 95% CI = 0.72-7.83). Total duration of OC use and at least 5 years of use before age 30 were associated with a nonsignificant increased risk among mutation carriers but not among noncarriers. Few women had ever used PMH and we found no significant associations between lifetime use and CBC risk among carriers and noncarriers. In conclusion, the association between OC/PMH use and risk of CBC does not differ significantly between carriers and noncarriers; however, because carriers have a higher baseline risk of second primaries, even a potential small increase in risk as a result of OC use may be clinically relevant.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | BREAST CANCER | RISK FACTORS | GENETICS | ORAL CONTRACEPTIVES | HORMONE REPLACEMENT THERAPY | AGE FACTORS | TIME FACTORS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Health | Biology | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Population Characteristics | Population Dynamics
Document Number: 342125

11.

Peer Reviewed

Title: Cervical human papillomavirus incidence and persistence in a cohort of HIV-negative women in Zimbabwe.
Author: Fukuchi E; Sawaya GF; Chirenje M; Magure T; Tuveson J; Ma Y; Shiboski S; Da Costa M; Palefsky J; Moscicki AB; Makunike-Mutasa R; Chipato T; Smith-McCune KK
Source: Sexually Transmitted Diseases. 2009 May;36(5):305-11.
Abstract: BACKGROUND: Persistent infections with oncogenic human papillomavirus (HPV) types are causally related to cervical cancer. Little is known about the distribution of HPV types, independent risk factors of incidence and persistence, and patterns of persistence in sub-Saharan Africa. METHODS: A cohort of 2040 Zimbabwean women was enrolled in a randomized trial assessing the effect of diaphragm/gel provision on human immunodeficiency virus and HPV acquisition. Data from the study arms were pooled for this analysis because diaphragm/gel provision did not affect HPV acquisition and clearance. Clinicians collected cervical samples for HPV testing at enrollment, 12 months, and exit (median 21 months). RESULTS: HPV prevalence was 24.5% for any HPV type and 16.1% for oncogenic types. HPV incidence at 12 months was 23.3% for any HPV type and 11.4% for oncogenic types. HPV58 had the highest baseline prevalence (5.0%) and incidence (2.4%). Type-specific persistence was 29.8% among all HPV infections over a median of 21 months of follow-up. Baseline predictors of incident HPV infection were younger age, having more than 1 lifetime sexual partner, infrequent condom use, herpes simplex virus-2 positive serology, and having a sexually transmissible infection or a different HPV type at enrollment. Baseline predictors of persistent HPV infection were younger age, having more than 1 lifetime sexual partner, and having a high-risk partner. CONCLUSIONS: The novel association between herpes simplex virus-2 seropositivity and incident HPV infection warrants further investigation. Having a high-risk partner is a potentially modifiable risk factor for persistent HPV infection. The relatively high prevalence of HPV58 has implications for vaccine development.
Language: English
Keywords:
ZIMBABWE | RESEARCH REPORT | COHORT ANALYSIS | WOMEN | HPV | INCIDENCE | PREVALENCE | CERVICAL CANCER | RISK FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Cancer | Neoplasms | Health
Document Number: 341440

12.

Peer Reviewed

Title: Oral contraceptives and family history of breast cancer.
Author: Gaffield ME; Culwell KR; Ravi A
Source: Contraception. 2009 Oct;80(4):372-80.
Abstract: 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.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGY | ORAL CONTRACEPTIVES | BREAST CANCER | HEREDITY | Developed Countries | North America | Americas | Public Health | Health | Contraceptive Methods | Contraception | Family Planning | Cancer | Neoplasms | Diseases | Biology
Document Number: 342769

13.

Title: Breastfeeding and breast cancer risk in India: a multicenter case-control study.
Author: Gajalakshmi V; Mathew A; Brennan P; Rajan B; Kanimozhi VC; Mathews A; Mathew BS; Boffetta P
Source: International Journal of Cancer. 2009 Aug 1;125(3):662-5.
Abstract: Breast cancer incidence is low in India compared with high-income countries, but it has increased in recent decades, particularly among urban women. The reasons for this pattern are not known although they are likely related to reproductive and lifestyle factors. Here, we report the results of a large case-control study on the association between breastfeeding and breast cancer risk. The study was conducted in 2 areas in South India during 2002-2005 and included 1,866 cases and 1,873 controls. Detailed information regarding menstruation, reproduction, breastfeeding and physical activity was collected through in-person interview. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression models. Breastfeeding for long duration was common in the study population. Lifetime duration of breastfeeding was inversely associated with breast cancer risk among premenopausal women (p-value of linear trend, 0.02). No such protective effect was observed in postmenopausal women, among whom a protective effect of parity was suggested. A reduction of breast cancer risk with prolonged breastfeeding was shown among premenopausal women. Health campaign focusing on breastfeeding behavior by appropriately educating women would contribute to reduce breast cancer burden.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | BREAST CANCER | RISK FACTORS | BREASTFEEDING | TIME FACTORS | MENOPAUSE | PARITY | Asia, Southern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Health | Infant Nutrition | Nutrition | Population Dynamics | Reproduction | Fertility Measurements | Fertility
Document Number: 342166

14.

Peer Reviewed

Title: Prevention of tamoxifen induced endometrial polyps using a levonorgestrel releasing intrauterine system long-term follow-up of a randomised control trial.
Author: Gardner FJ; Konje JC; Bell SC; Abrams KR; Brown LJ; Taylor DJ; Habiba M
Source: Gynecologic Oncology. 2009 Sep;114(3):452-6.
Abstract: OBJECTIVES: In a RCT, we have previously shown that the levonorgestrel intrauterine system (LNG-IUS, Mirena) produces a decidual response protecting the endometrium at one year follow-up. We here report on the long-term follow-up of this group of women, to test the hypothesis that a LNG-IUS could prevent the pro-proliferative uterine responses of tamoxifen for up to 4.5 years. METHODS: A randomised-controlled trial of postmenopausal women who had taken at least one year of adjuvant tamoxifen therapy. RESULTS: One hundred twenty-two women were recruited. Nine were found to be ineligible after randomisation. The average duration of follow-up was 26.25 months (IQR 14.5-36 months) in the surveillance group and 24.2 months (IQR 13.75-32.5 months) in the LNG-IUS group. Women with LNG-IUS in situ at the time of final assessment had decidualised endometrium, and no polyps. In the surveillance group new polyps arose in 8 cases. There were 3 new polyps in the group initially randomised to LNG-IUS, one in a patient who did not have the device inserted and 2 occurred in patients following the removal of the LNG-IUS. Univariate Cox proportional hazards regression models identified only endometrial thickness at trial entry as a statistically significant variable (HR 1.12, 95% CI 1.02 to 1.22, p=0.01) for the development of polyps. CONCLUSION: This study confirms that LNG-IUS induces benign endometrial changes and prevents endometrial polyps but only during its use in women taking tamoxifen. Endometrial thickness is a risk factor for the development of polyps.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | BREAST CANCER | TAMOXIFEN | ENDOMETRIAL EFFECTS | IUD, HORMONE RELEASING | LEVONORGESTREL | HYSTEROSCOPY | ULTRASONICS | Developed Countries | Europe, Western | Europe | Research Methodology | Program Activities | Programs | Organization and Administration | Cancer | Neoplasms | Diseases | Fertility Agents | Reproductive Control Agents | Family Planning | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | IUD | Contraceptive Methods | Contraception | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342402

15.

16.

Title: Contraception and screening for cervical and breast cancer in neuromuscular disease: A retrospective study of 50 patients monitored at a clinical reference centre.
Author: Goutard S; Baron C; Bouton C; Penisson-Besnier I; Fosse G; Aube-Nathier AC; Havet-Thomassin V; Dubas F; Richard I
Source: Annals of Physical and Rehabilitation Medicine. 2009 Aug 14;
Abstract: OBJECTIVE: To analyse contraceptive methods and the extent of screening for breast and cervical cancer in women with neuromuscular disease, compare these results with data and guidelines for the general population and determine the environmental and attitudinal barriers encountered. PATIENTS AND METHODS: A retrospective, descriptive study in a population of female neuromuscular disease patients (aged 20 to 74) monitored at a clinical reference centre. RESULTS: Complete datasets were available for 49 patients. Seventy percent used contraception (hormonal contraception in most cases). Sixty-eight percent had undergone screening for cervical cancer at some time in the previous 3 years and 100% of the patients over 50 had undergone a mammography. Architectural accessibility and practical problems were the most common barriers to care and were more frequently encountered by wheelchair-bound, ventilated patients. CONCLUSIONS: In general, the patients had good access to contraceptive care and cervical and breast cancer screening. However, specific measures may be useful for the most severely disabled patients.
Language: English
Keywords:
FRANCE | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLIENTS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTION | BREAST CANCER | CERVICAL CANCER | SCREENING | MUSCULAR EFFECTS | PROGRAM EVALUATION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Contraceptive Methods | Family Planning | Cancer | Neoplasms | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology
Document Number: 342589

17.

18.

Peer Reviewed

Title: Depot-medroxyprogesterone acetate and combined oral contraceptive use and cervical neoplasia among women with oncogenic human papillomavirus infection.
Author: Harris TG; Miller L; Kulasingam SL; Feng Q; Kiviat NB; Schwartz SM; Koutsky LA
Source: American Journal of Obstetrics and Gynecology. 2009 May;200(5):489.e1-8.
Abstract: OBJECTIVE: The objective of the study was to examine the relationship of depot-medroxyprogesterone acetate (DMPA) and combined oral contraceptive (COC) use with cervical intraepithelial neoplasia (CIN). STUDY DESIGN: Two case-control studies of women who presented for gynecologic care and underwent cytologic and human papillomavirus (HPV) testing were performed. The first included oncogenic HPV-positive women grouped based on histology: negative (n = 152), CIN1 (n = 133), and CIN2-3 or greater (n = 173). For the second, 2 groups were identified: negative HPV/negative histology (n = 107) and positive oncogenic HPV/negative histology (n = 152). RESULTS: Among oncogenic HPV-positive women, DMPA use was inversely associated with CIN2-3 or greater (adjusted odds ratio [OR(adj)], 0.4; 95% confidence interval [CI], 0.2-1.1) and CIN1 (OR(adj), 0.1; 95% CI, 0.01-0.6); COC use was not associated with either. Among histologically negative women, DMPA use was associated with oncogenic HPV (OR(adj), 4.7; 95% CI, 1.4-15.8). CONCLUSION: Among women with oncogenic HPV, hormonal contraceptive use was not associated with an increased risk of CIN2-3 or greater. Longer-term DMPA use may attenuate the colposcopic and histologic features of CIN because women reporting such use were more likely than others to have cervical oncogenic HPV without evidence of CIN.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | PREVALENCE | HPV | CERVICAL CANCER | RISK FACTORS | DEPO-PROVERA | ORAL CONTRACEPTIVES, COMBINED | RISK ASSESSMENT | COLPOSCOPY | HISTOLOGY | Developed Countries | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Measurement | Viral Diseases | Diseases | Cancer | Neoplasms | Health | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Evaluation | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Biology
Document Number: 331078

19.

Title: Breast cancer in young women and its impact on reproductive function.
Author: Hickey M; Peate M; Saunders CM; Friedlander M
Source: Human Reproduction Update. 2009 May-Jun;15(3):323-39.
Abstract: BACKGROUND: Breast cancer is the most common cancer in women in developed countries, and 12% of breast cancer occurs in women 20-34 years. Survival from breast cancer has significantly improved, and the potential late effects of treatment and the impact on quality of life have become increasingly important. Young women constitute a minority of breast cancer patients, but commonly have distinct concerns and issues compared with older women, including queries regarding fertility, contraception and pregnancy. Further, they are more likely than older women to have questions regarding potential side effects of therapy and risk of relapse or a new primary. In addition, many will have symptoms associated with treatment and they present a management challenge. Reproductive medicine specialists and gynaecologists commonly see these women either shortly after initial diagnosis or following adjuvant therapy and should be aware of current management of breast cancer, the options for women at increased genetic risk, the prognosis of patients with early stage breast cancer and how adjuvant systemic treatments may impact reproductive function. METHODS: No systematic literature search was done. The review focuses on the current management of breast cancer in young women and the impact of treatment on reproductive function and subsequent management. With reference to key studies and meta-analyses, we highlight controversies and current unanswered questions regarding patient management. RESULTS: Chemotherapy for breast cancer is likely to negatively impact on reproductive function. A number of interventions are available which may increase the likelihood of future successful pregnancy, but the relative safety of these interventions is not well established. For those who do conceive following breast cancer, there is no good evidence that pregnancy is detrimental to survival. We review current treatment; effects on reproductive function; preservation of fertility; contraception; pregnancy; breastfeeding and management of menopausal symptoms following breast cancer. CONCLUSION: This paper provides an update on the management of breast cancer in young women and is targeted at reproductive medicine specialists and gynaecologists.
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | BREAST CANCER | SURGERY | DRUGS | GENETICS | FERTILITY | CONTRACEPTION | PREGNANCY | BREASTFEEDING | MENOPAUSE | AGE FACTORS | TAMOXIFEN | Oceania | Developed Countries | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Population Dynamics | Demographic Factors | Population | Family Planning | Reproduction | Infant Nutrition | Nutrition | Population Characteristics | Fertility Agents | Reproductive Control Agents
Document Number: 341960

20.

Peer Reviewed

Title: HPV infection in women with and without cervical cancer in Conakry, Guinea.
Author: Keita N; Clifford GM; Koulibaly M; Douno K; Kabba I; Haba M; Sylla BS; van Kemenade FJ; Snijders PJ; Meijer CJ; Franceschi S
Source: British Journal of Cancer. 2009 Jul 7;101(1):202-8.
Abstract: BACKGROUND: Cervical cancer incidence in western Africa is among the highest in the world. METHODS: To investigate human papillomavirus (HPV) infection in Guinea, we obtained cervical specimens from 831 women aged 18-64 years from the general population of the capital Conakry and from 77 locally diagnosed invasive cervical cancers (ICC). Human papillomavirus was detected using a GP5+/6+ PCR-based assay. RESULTS: Among the general population, the prevalence of cervical abnormalities was 2.6% by visual inspection and 9.5% by liquid-based cytology. Fourteen of 15 high-grade squamous intraepithelial lesions were visual inspection-negative. Human papillomavirus prevalence was 50.8% (32.1% for high-risk types) and relatively constant across all age groups. Being single or reporting > or =3 sexual partners was significantly associated with HPV positivity. HPV16 was the most common type, both among the general population (7.3%) and, notably in ICC (48.6%). HPV45 (18.6%) and HPV18 (14.3%), the next most common types in ICC, were also more common in ICC than in HPV-positive women with normal cytology from the general population. CONCLUSION: The heavy burden of HPV infection and severe cervical lesions in Guinean women calls for new effective interventions. Sixty-three per cent of cervical cancers are theoretically preventable by HPV16/18 vaccines in Guinea; perhaps more if some cross-protection exists with HPV45.
Language: English
Keywords:
GUINEA | RESEARCH REPORT | STATISTICAL REGRESSION | WOMEN | HPV | CERVICAL CANCER | PREVALENCE | PELVIC EXAM | CYTOLOGY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Data Analysis | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Cancer | Neoplasms | Measurement | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology
Document Number: 341991

21.
Title: The effects of hormonal contraception.
Author: Kent A
Source: Reviews In Obstetrics and Gynecology. 2009 Winter;2(1):66.
Abstract: There are many claims made about the beneficial effects of hormonal contraceptives other than their ability to prevent pregnancy. Studies have tracked women's responses to oral contraceptives (OCs) or depot medroxyprogesterone acetate (DMPA), but few have taken into account the woman's entry status or baseline symptoms, and fewer still have looked at control groups on nonhormonal contraception. Another problem has been the duration of follow-up, which should be longer than 1 year to properly assess the steady state of a changed hormonal environment. A study by Berenson and colleagues deals with the issues of baseline status and prolonged use in a series of women using injectable DMPA and low-dose OCs (typically 20 microg estrogen-containing pills). The first important finding was that symptoms are common in the absence of contraceptive use, such as acne, cyclical mastalgia, cramping, and mood swings. They found these symptoms improved on sustained use of OCs compared with control groups, and therewas no evidence that depression was a problem, despite lowered mood being a commonly quoted negative effect among those prescribing OCs. The most frequent side effect was intermenstrual bleeding with OCs and an increased risk of bleeding for more than 20 days, amenorrhea, weight gain, and loss of energy and libido on DMPA. Most of these effects resolved after 6 months and almost all resolved by 12 months, with amenorrheaic women often welcoming the side effect. Finally, the researchers found that women were not clearly informed of the potential side effects, or of their resolution with ongoing use. They recommend careful counseling about what to expect and more frequent follow-up after initiation to provide reassurance or a change to another method if required. (full-text)
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | WOMEN IN DEVELOPMENT | INJECTABLES | PSYCHOLOGICAL FACTORS | PHYSIOLOGY | CONTRACEPTIVE AGENTS, SIDE EFFECTS | DEPO-PROVERA | ORAL CONTRACEPTIVES, LOW-DOSE | CONTRACEPTIVE AGENTS, ESTROGEN | METRORRHAGIA | ADMINISTRATION AND DOSAGE | BREAST CANCER | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Economic Development | Economic Factors | Contraceptive Methods | Contraception | Family Planning | Behavior | Biology | Contraceptive Agents | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Oral Contraceptives | Bleeding | Signs and Symptoms | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cancer | Neoplasms
Document Number: 331284

22.

Title: Acceptability of human papillomavirus vaccination among Chinese women: concerns and implications.
Author: Kwan TT; Chan KK; Yip AM; Tam KF; Cheung AN; Lo SS; Lee PW; Ngan HY
Source: BJOG. 2009 Mar;116(4):501-10.
Abstract: OBJECTIVE: To explore Chinese women's perceptions of human papillomavirus (HPV) vaccination and their intention to be vaccinated. DESIGN: A cross-sectional community-based survey study. SETTING: Thirteen community women's health centres of The Family Planning Association of Hong Kong. SAMPLE: A total of 1450 ethnic Chinese women aged 18 or above who attended the health centres. METHODS: Participants completed a written consent and an anonymous questionnaire onsite. MAIN OUTCOME MEASURES: Knowledge and beliefs about HPV and HPV vaccination against cervical cancer and participants' own intention to be vaccinated. RESULTS: About 38% of the participants (n = 527) had heard of HPV and 50% (n = 697) had heard of vaccination against cervical cancer. HPV infection was perceived to be stigmatising and detrimental to intimate, family and social relationships. Despite misconceptions and a grossly inadequate knowledge about HPV and HPV vaccination, 88% of the participants (n = 1219) indicated that they would likely be vaccinated. Majority of the participants believed that sexually experienced women should be vaccinated, while 27% opposed vaccinating sexually naive women. Younger age women who perceived a disruptive impact of HPV infection on intimate relationship and their partners' approval were significantly associated with a positive intention to be HPV vaccinated. CONCLUSIONS: The easy acceptability of HPV vaccination among the mostly sexually experienced Chinese participants and their knowledge deficit on the subject may implicate potential misuse of the vaccines and a false sense of security against cervical cancer. There is a dire need for culturally sensitive and tailored education for the public, women of different ages and their partners about HPV and HPV vaccination. Emphasis must be placed on the prophylactic nature of the current vaccines, the uncertain effects when given to sexually experienced women, the importance of adolescent vaccination and the need for continued cervical screening whether vaccinated or not.
Language: English
Keywords:
CHINA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | HPV | VACCINES | BELIEFS | CERVICAL CANCER | HIV INFECTIONS | KNOWLEDGE | PROGRAM ACCEPTABILITY | Asia, Eastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Culture | Sociocultural Factors | Cancer | Neoplasms | Program Evaluation | Programs | Organization and Administration
Document Number: 341002

23.

Title: Cervical intraepithelial neoplasia recurrence after conization in HIV-positive and HIV-negative women.
Author: Lima MI; Tafuri A; Araujo AC; de Miranda Lima L; Melo VH
Source: International Journal of Gynaecology and Obstetrics. 2009 Feb;104(2):100-4.
Abstract: OBJECTIVES: To evaluate the recurrence rates of cervical intraepithelial neoplasia (CIN) in a cohort of HIV-infected and noninfected women who underwent the loop electrosurgical excision procedure (LEEP). METHODS: A prospective cohort study of 94 HIV-positive and 107 HIV-negative women, both with CIN, treated with LEEP. The diagnosis of recurrence was established after biopsy. The Kaplan-Meier method was used for survival analysis and multivariate analyses were carried out using the Cox proportional hazards regression model. RESULTS: There was a predominance of low-grade lesions in HIV-positive compared with HIV-negative women (P<0.01). Recurrence was more frequent with compromised margins and glandular involvement (P<0.01). A multivariate analysis showed that HIV-infection, glandular involvement, and positive margins were independently associated with recurrence of lesions. CONCLUSIONS: Recurrence rate of CIN in HIV-positive women was higher than in HIV-negative women. The factors associated with recurrence were HIV infection, glandular involvement, and positive margins.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | CERVICAL CANCER | NEOPLASMS | SURGERY | COLPOSCOPY | HISTOLOGY | HIV INFECTIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Cancer | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Biology | Viral Diseases
Document Number: 341387

24.

Title: Involution of latent endometrial precancers by hormonal and nonhormonal mechanisms.
Author: Lin MC; Burkholder KA; Viswanathan AN; Neuberg D; Mutter GL
Source: Cancer. 2009 May 15;115(10):2111-8.
Abstract: BACKGROUND: Inactivation of the PTEN suppressor gene has been shown to occur in the majority of endometrial cancer cases. Somatic PTEN inactivation by deletion and/or mutation, the first detectible change of endometrial carcinogenesis, has been reported to occur at a high frequency in the endometrium of normal premenopausal women, although few of these cases progress to cancer. It was hypothesized that the 50% to 60% reduced cancer risk attributed to oral contraceptives (OCPs) and intrauterine devices (IUDs) occurred in part through their activity as negative selection factors for these subclinical mutated glands. METHODS: A total of 71 women with a history of OCP use and 80 with a history of IUD use were age matched with 191 and 119 controls, respectively. Endometrial biopsy specimens were immunostained for PTEN, and each was scored for the presence or absence of PTEN-null glands (latent precancer). RESULTS: The frequency of latent precancers was found to be significantly reduced in OCP-exposed (13%; odds ratio [OR], 0.19 [P < .001]) and IUD-exposed (18%; OR, 0.42 [P = .015]) women compared with respective matched controls (43% and 34%). The presence or absence of endometritis did not appear to be significantly correlated with PTEN status within the IUD-exposed group (P = .24). CONCLUSIONS: Normal-appearing PTEN mutated endometrial glands, which are highly prevalent in the normal population, may be targets of endometrial cancer risk-modulating exposures. Some exposures reported to diminish the incidence of endometrial cancer in epidemiologic outcome studies, including OCP and IUD use, are associated with a proportionate decline in the frequency of latent precancers. Involution of pre-existing endometrial latent precancers, as evaluated by PTEN analysis, may provide an accessible surrogate marker for long-term endometrial cancer risk.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CASE CONTROL STUDIES | WOMEN | ENDOMETRIAL CANCER | RISK FACTORS | ENDOMETRITIS | HISTOLOGY | ORAL CONTRACEPTIVES | IUD | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Health | Reproductive Tract Infections | Infections | Biology | Contraceptive Methods | Contraception | Family Planning
Document Number: 341658

25.

26.

Title: Diffusion Weighted Imaging of the Uterus: Regional ADC Variation with Oral Contraceptive Usage and Comparison with Cervical Cancer.
Author: Messiou C; Morgan VA; De Silva SS; Ind TE; Desouza NM
Source: Acta Radiologica. 2009 May 15;:1-6.
Abstract: Background: There is growing interest in diffusion weighted magnetic resonance imaging (MRI) of cervical carcinoma but normal uterine appearances and effects of the oral contraceptive pill (OCP) have not been described. Purpose: To establish apparent diffusion coefficient (ADC) values for normal regions of uterus, determine the effect of the OCP on these values, and compare them with ADCs from cervical cancer. Material and Methods: Twenty-seven premenopausal women (19 taking the OCP) with cervical intraepithelial neoplasia (CIN) were studied with T2W and diffusion weighted MRI (DW-MRI). Regions of interest were drawn on ADC maps by visual matching with T2W images on different zones of the uterus and values compared between women not taking and taking the OCP. A further group of 25 women with clinically obvious tumors of the cervix were also studied with T2W and DW-MRI and ADC values of tumor were compared with ADC values of cervical epithelium and stroma. Results: The ADC values of adjacent zones of the uterus and cervix were significantly different from one another (P<0.001). The junctional zone was seen as a band of restricted diffusion between endometrium and outer myometrium. The ADC value of the junctional zone of the uterus was significantly greater (P<0.001) in patients taking the OCP than those patients not taking the OCP. There was no significant affect of the OCP on the ADC values of other uterine zones. Conclusion: The zonal anatomy of the uterus is well demonstrated by DW-MRI with hormonal effects secondary to the OCP affecting junctional zone alone. ADC of cervical tumor is significantly different to cervical epithelium and stroma indicating a role in cervical cancer detection and local staging.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | WOMEN | SCREENING | CERVICAL CANCER | ORAL CONTRACEPTIVES | SIDE EFFECTS | UTERINE EFFECTS | EXAMINATIONS AND DIAGNOSES | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cancer | Neoplasms | Diseases | Contraceptive Methods | Contraception | Family Planning | Treatment | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology
Document Number: 341253

27.

Peer Reviewed

Title: Ovarian cancer risk factors in African-American and white women.
Author: Moorman PG; Palmieri RT; Akushevich L; Berchuck A; Schildkraut JM
Source: American Journal of Epidemiology. 2009 Sep 1;170(5):598-606.
Abstract: Ovarian cancer is the most lethal gynecologic malignancy in both African-American and white women. Although prevalences of many ovarian cancer risk factors differ markedly between African Americans and whites, there has been little research on how the relative contributions of risk factors may vary between racial/ethnic groups. Using data from a North Carolina case-control study (1999-2008), the authors conducted unconditional logistic regression analyses to calculate odds ratios and 95% confidence intervals for ovarian cancer risk factors in African-American (143 cases, 189 controls) and white (943 cases, 868 controls) women and to test for interactions by race/ethnicity. They also calculated attributable fractions within each racial/ethnic group for the modifiable factors of pregnancy, oral contraceptive use, tubal ligation, and body mass index. Many risk factors showed similar relations across racial/ethnic groups, but tubal ligation and family history of breast or ovarian cancer showed stronger associations among African Americans. Younger age at menarche was associated with risk only in white women. Attributable fractions associated with tubal ligation, oral contraceptive use, and obesity were markedly higher for African Americans. The relative importance of ovarian cancer risk factors may differ for African-American women, but conclusions were limited by the small sample. There is a clear need for further research on etiologic factors for ovarian cancer in African-American women.
Language: English
Keywords:
UNITED STATES OF AMERICA | NORTH CAROLINA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | BLACKS | WHITES | OVARIAN CANCER | RISK FACTORS | ORAL CONTRACEPTIVES | TUBAL LIGATION | OBESITY | BREASTFEEDING | GENETICS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Cancer | Neoplasms | Diseases | Health | Contraceptive Methods | Contraception | Family Planning | Female Sterilization | Sterilization, Sexual | Body Weight | Physiology | Biology | Infant Nutrition | Nutrition
Document Number: 342784

29.

Title: Prevalence of human papillomavirus and Chlamydia trachomatis infection among women attending cervical cancer screening in the Republic of Korea.
Author: Oh JK; Franceschi S; Kim BK; Kim JY; Ju YH; Hong EK; Chang YC; Rha SH; Kim HH; Kim JH; Kim CY; Shin HR
Source: European Journal of Cancer Prevention. 2009 Feb;18(1):56-61.
Abstract: Cervical cancer screening with the conventional Papanicolaou test is recommended for the women aged 30 years and more in Korea. Cervical infection with human papillomavirus (HPV) is the most important cause of cervical cancer and Chlamydia trachomatis (CT) is the most common bacterial sexually transmitted infection and may also be associated with risk of cervical cancer. A cross-sectional study of women attending the National Cervical Cancer Screening Program in Busan and Suwon was carried out. Exfoliated cervical cells were collected, and questionnaires were administered to 4595 women. High-risk HPV types and CT were tested by Hybrid Capture 2 (HC2). HPV genotyping of 355 high-risk HPV-positive women at HC2 was performed using linear array. Age-standardized prevalence of high-risk HPV types and CT was 10.4% (95% confidence interval: 9.5-11.3) and 4.3% (95% confidence interval: 3.7-4.8). That 68.5% of women were high-risk HPV-positive at HC2 was confirmed by Linear Array whereas 17.5% seemed to be infected with only low-risk HPV types, not normally detected by HC2. Korean women showed a relatively high prevalence of high-risk HPV and a rather low prevalence of CT. As in cancer-free women in other Asian populations, HPV 52, 58, and 39 were detected more frequently than HPV 16. Cross-reaction of HC2 with low-risk HPV types is of some concern, were the test to be used in primary screening.
Language: English
Keywords:
REPUBLIC OF KOREA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | PREVALENCE | HPV | CERVICAL CANCER | SCREENING | CHLAMYDIA | Asia, Eastern | Asia | Developed Countries | Research Methodology | Economic Development | Economic Factors | Measurement | Viral Diseases | Diseases | Cancer | Neoplasms | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections
Document Number: 330253

30.

Title: Oral Contraceptive Use and BRCA Penetrance: A Case-Only Study.
Author: Pasanisi P; Hedelin G; Berrino J; Chang-Claude J; Hermann S; Steel M; Haites N; Hart J; Peled R; Gafa L; Leggio L; Traina A; Amodio R; Primic-Zakelj M; Zadnik V; Veidebaum T; Tekkel M; Berrino F
Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Jun 23;
Abstract: BACKGROUND: Women with deleterious mutations in BRCA genes are at increased risk of breast cancer. However, the penetrance of the genetic trait may be regulated through environmental factors. This multinational case-only study tested the interaction between oral contraceptive use and genetic susceptibility in the occurrence of breast cancer.METHODS: We recruited 3,123 patients diagnosed with breast cancer before the age of 45 years. Participants were classified according to their probability of carrying a BRCA mutation on the basis of their family history of breast and ovarian cancer. According to a case-only approach, the frequency of relevant exposures among breast cancer cases with high probability of BRCA mutation ("genetic cases") was compared with the frequency of the same exposures among breast cancer cases with a low probability of BRCA mutation ("sporadic cases"). The interaction odds ratios (OR) and 95% confidence intervals (CI) for oral contraceptive use were estimated by unconditional logistic regression, after controlling for potentially confounding variables.RESULTS: The analysis was carried out comparing 382 "genetic" and 1,333 "sporadic" cases. We found a borderline significant interaction between genetic breast cancer and oral contraceptive use for ever users compared with never users (OR, 1.3; 95% CI, 1.0-1.7). The greatest interaction OR was found for women who started using pill at 18 to 20 years (OR, 1.6; 95% CI, 1.1-2.3).CONCLUSION: These results suggest that BRCA mutation carriers, as well as women with a significant family history of breast and ovarian cancer are more vulnerable to exogenous hormones in oral contraceptives. (Cancer Epidemiol Biomarkers Prev 2009;18(7):2107-13).
Language: English
Keywords:
EUROPE | RESEARCH REPORT | CASE STUDIES | DATA ANALYSIS | WOMEN | ORAL CONTRACEPTIVES | GENETICS | BREAST CANCER | RISK FACTORS | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Biology | Cancer | Neoplasms | Diseases | Health
Document Number: 341746


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