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Biomedical subjects

N C Lee

Publications and source records attributed to N C Lee.

At least 73 records · Page 4Linked to original sources
PubMed1991

Current treatment approaches to obsessive-compulsive disorder.

The two most useful treatments in obsessive-compulsive disorder are pharmacotherapy with potent serotonin reuptake-blocking agents and behavioral techniques, such as exposure and response prevention. Based on the authors' cumulative clinical experience, it is suggested that patient education, cognitive therapy, and psychodynamic psychotherapy are helpful adjuncts during various treatment stages of obsessive-compulsive disorder. The patient's strengths and knowledge of the illness can be used by the nurse-therapist to determine the implementation and timing of these therapeutic measures. Specific behavioral and cognitive techniques that may be useful in treating specific symptoms of obsessive-compulsive disorder are highlighted. Suggestions for future nursing research are outlined.

Behavior Therapy↗
PubMed1991

The relationship between body mass and breast cancer among women enrolled in the Cancer and Steroid Hormone Study.

We examined the relationship between body mass [weight (kg)/height (m)2] and breast cancer using data from the Cancer and Steroid Hormone Study. The study compared 4323 women aged 20-54 years with newly diagnosed breast cancer identified through population-based tumor registries with 4358 women randomly selected from the general population of the same geographic areas. Among naturally menopausal women, risk of breast cancer increased with increasing body mass index (BMI); those severely overweight (BMI greater than or equal to 32.30) had nearly 3-fold higher risk of breast cancer compared with women in the leanest category (BMI less than 20.00). This positive association appeared stronger with increasing years since menopause and in women who had ever used estrogen replacement therapy. A positive association between body mass and breast cancer risk also was observed among premenopausal women; however, risk estimates were substantially lower. Substantial weight gain from adolescence to adulthood was a more important risk factor than lifelong obesity. Prevalence of obesity increases with age; our results suggest that interventions that prevent this trend could have an important effect on breast cancer risk, especially during the menopausal years.

Adult↗
PubMed1991

Infertility-associated endometrial cancer risk may be limited to specific subgroups of infertile women.

Data from previous studies suggest that infertility is a risk factor for endometrial cancer. We used data from the Cancer and Steroid Hormone Study to further characterize this relationship. The subject group comprised 399 women ages 20-54 with newly diagnosed epithelial endometrial cancer ascertained through six cancer registries. The control group comprised 3040 women in the same age range selected by random-digit telephone dialing from the same geographic areas where cancer patients resided. Compared with women who reported no fertility problem, women with physician-diagnosed infertility who had reported at least 2 years of infertility had an odds ratio for endometrial cancer, adjusted for age, of 1.7 (95% confidence interval 1.1-2.6). Women who reported infertility resulting from ovarian factors had an adjusted odds ratio of 4.2 (95% confidence interval 1.7-10.4). These results suggest that factors such as anovulation may explain much of the increased risk of endometrial cancer found among subgroups of infertile women.

Adult↗
PubMed1991

Measures of sexual behavior and the risk of pelvic inflammatory disease.

A women's sexual behavior affects her risk of acquiring pelvic inflammatory disease, but the risks have not been well characterized. To study the association between pelvic inflammatory disease and sexual behavior, we analyzed data from a multicenter, case-control study involving 712 women hospitalized with an initial episode of pelvic inflammatory disease and 2719 hospitalized control women without a history of pelvic inflammatory disease. Study participants provided information on their frequency of intercourse, number of recent sexual partners, and previous history of gonorrhea. Logistic regression methods were used to adjust for confounding factors. Women who reported having four or more sexual partners were over three times more likely to be hospitalized for pelvic inflammatory disease (relative risk 3.4; 95% confidence interval 2.2-5.3) than were women who reported only one recent sexual partner. To a lesser extent, frequent sexual intercourse and history of gonorrhea also increased a woman's risk of pelvic inflammatory disease. Frequent intercourse was a strong risk factor for pelvic inflammatory disease among a subgroup of women who were at low risk for acquiring a sexually transmitted disease: Married women with one recent sexual partner with intercourse six or more times per week had a risk of pelvic inflammatory disease of 3.2 (1.4-7.2) compared with similar women having intercourse less than once per week. Frequent intercourse, which does not by itself increase the risk of acquiring a sexually transmitted disease, may increase a woman's risk of pelvic inflammatory disease.

Adult↗
PubMed1991

Age-specific differences in the relationship between oral contraceptive use and breast cancer.

Nearly all studies have suggested that the use of oral contraceptives (OC) is not associated with the aggregate risk of breast cancer diagnosed in women aged 20-54. Because of age-specific differences in the breast cancer-parity relationship and because of age-specific differences in other breast cancer risk factors, the Centers for Disease Control reexamined data from the Cancer and Steroid Hormone Study to assess whether OC use has different effects on the risk of breast cancer at different ages of diagnosis. This was a population-based case-control study conducted in eight geographic areas in the United States during 1980-1982. In these data, the relationship between the risk of breast cancer and OC use appeared to vary by age at diagnosis. Among women aged 20-34 years at diagnosis or interview, those who had ever used OC had a slightly increased risk of breast cancer (odds ratio 1.4, 95% confidence interval 1.0-2.1) when compared with women of the same ages who had never used OC. Among these women, there were no trends of increasing or decreasing risk with any measure of OC use. Among women aged 35-44 years, there was no association between OC use and breast cancer. Among women aged 45-54 years, those who used OC had a slightly decreased risk of breast cancer (odds ratio 0.9, 95% confidence interval 0.8-1.0). Among these women, the risk estimates decreased significantly with increasing time since first and last use. Although the slightly increased risk estimates for the youngest women are compatible with findings by other investigators, the decreased risk estimates for the oldest women have not been described in as many studies. Available data provide no reasons for changes in prescribing practices or in the use of OC as related to breast cancer risk.

Adult↗
PubMed1990

Estrogen replacement therapy and the risk of endometrial cancer: remaining controversies.

To examine the relationship between exogenous estrogen administration and endometrial cancer, we used data from the Cancer and Steroid Hormone Study, a multicenter, population-based case-control study. Estrogen replacement therapy for greater than or equal to 2 years was associated with an increased risk of both localized and extrauterine cancer (relative risk = 2.8, 95% confidence limits 1.6, 4.6; relative risk = 2.9, 95% confidence limits 0.9, 9.4, respectively). However, the latter finding was based on a small number of cases in which estrogen was used. Women who underwent estrogen replacement therapy for greater than or equal to 2 years had significantly elevated risks of endometrial cancer (2.1 for 2 to 5 years and 3.5 for greater than or equal to 6 years). An elevated risk persisted for greater than or equal to 6 years after discontinuation of therapy. Women who exclusively used conjugated equine estrogen preparations less than or equal to 0.625 mg had no increased risk of endometrial cancer. A history of oral contraceptive use appeared to reduce the risk of endometrial cancer associated with estrogen replacement therapy. However, these latter two potentially important findings were based on a small number of cases in which hormones were used.

Adult↗
PubMed1990

Cigarette smoking as a risk factor for pelvic inflammatory disease.

To examine the relationship between cigarette smoking and pelvic inflammatory disease we analyzed data from a hospital-based, case-control study of pelvic inflammatory disease. Case subjects were 197 women hospitalized with their first episode of pelvic inflammatory disease; control subjects were 667 women hospitalized with nongynecologic conditions. Logistic regression was used to control for potentially confounding factors, including number of recent sexual partners, frequency of intercourse, and previous episodes of gonorrhea. Compared with women who had never smoked, current cigarette smokers had a significantly elevated relative risk of pelvic inflammatory disease of 1.7 (95% confidence interval, 1.1 to 2.5). Similarly, former cigarette smokers had a significantly elevated relative risk of pelvic inflammatory disease of 2.3 (95% confidence interval, 1.3 to 4.2). However, a dose-response relationship was not observed. These results suggest that cigarette smoking is associated with pelvic inflammatory disease. Whether or not this association is causal requires clarification. The high prevalence of cigarette smoking and the serious consequences of pelvic inflammatory disease make such clarification an important consideration for future research.

Adolescent↗
PubMed1990

Pregnancy, breast feeding, and oral contraceptives and the risk of epithelial ovarian cancer.

To quantify the effects of cumulative months of pregnancy, breast feeding, and oral contraceptive use on the risk of developing epithelial ovarian cancer, the authors used data collected for the Cancer and Steroid Hormone Study--a multicenter, population-based, case-control study. Detailed reproductive histories were obtained from 436 women aged 20-54 with epithelial ovarian cancer newly diagnosed between December 1980 and December 1982, and from 3833 women aged 20-54 selected at random from the same geographic areas. Estimated relative risks of epithelial ovarian cancer were 0.6 (95% confidence interval (CI) 0.5-0.8) for women who had ever been pregnant, 0.6 (95% CI 0.5-0.8) for women who had ever breast fed, and 0.5 (95% CI 0.5-0.7) for women who had ever used oral contraceptives. Logistic regression analysis revealed a strong trend in decreasing risk of epithelial ovarian cancer with increasing cumulative months of pregnancy; this effect was less pronounced in women aged 50-54 than in younger women. In contrast, a marked reduction in risk was associated with ever having breast fed or used oral contraceptives, while the decrease in risk from additional months of either of these exposures was less than that for pregnancy.

Adult↗
PubMed1990

Agreement of self-reported ovarian number following gynecologic surgery with medical record reports.

In case-control studies of breast cancer, cardiovascular disease, and osteoporosis, a woman's ovarian function may be considered as a main exposure, confounding factor, or effect modifier. To evaluate the agreement between self-reported ovarian number following ovarian surgery for nonmalignant disease and medical record reports, we analyzed data from a population-based case-control study, the Cancer and Steroid Hormone Study. Reports on ovarian number after the most recent surgery for a who had been diagnosed with breast cancer and 496 control subjects. We then calculated agreement rates by comparing the number of ovaries indicated by the medical record with the number reported by the woman. Agreement rates on the presence or absence of ovaries exceeded 90% for both case and control subjects. Agreement rates on exact ovarian number exceeded 84% for both groups. Women who had been diagnosed with breast cancer had slightly higher agreement rates than did control women for both presence or absence of ovaries and exact ovarian number. Our data suggest that investigators can rely on self-reported ovarian number as an accurate measure of actual ovarian number in women who have had surgery for nonmalignant conditions.

Adult↗
PubMed1990

Cigarette smoking and the risk of breast cancer.

The authors examined the relation between cigarette smoking and breast cancer in the Centers for Disease Control Cancer and Steroid Hormone Study, a multicenter, population-based case-control study. The study compared 4,720 women aged 20-54 years with newly diagnosed breast cancer identified through population-based tumor registries with 4,682 women randomly selected from the same geographic areas. Women who reported ever smoking cigarettes had a risk of breast cancer of 1.2 (95 percent confidence interval 1.1-1.3) compared with never smokers. There was no consistent dose-response pattern with any measure of smoking (pack-years of smoking, average number of cigarettes per day, or total years smoked) and little difference in risk between current and former smokers. There was some variation in risk by age, with slightly higher risk estimates for younger women than for older women. Although current smokers had an earlier natural menopause than did never smokers, the authors found no evidence of a protective effect of cigarette smoking on breast cancer risk. These findings suggest that the risk of breast cancer in women who smoke is the same as, or perhaps slightly higher than, women who have never smoked.

Adult↗
PubMed1990

Long-term health risks and benefits of oral contraceptive use.

The contraceptive effect of oral contraceptive use provides an important health benefit, particularly in developing countries, where the risks of pregnancy and childbearing are increased. Several important noncontraceptive health benefits of oral contraceptive use include the prevention of endometrial and ovarian cancers. Data are generally reassuring concerning the risks of oral contraceptive use, which include cardiovascular disease and breast and cervical cancer.

Adult↗
PubMed1989

Alcohol consumption and the risk of breast cancer.

To examine the relation between alcohol consumption and breast cancer, the authors used data from the Centers for Disease Control's Cancer and Steroid Hormone Study, a multicenter population-based case-control study. Between August 1981 and December 1982, 3,498 US women aged 20-54 years with newly diagnosed breast cancer and 3,157 women aged 20-54 years selected at random from the same geographic areas were asked about their consumption of alcoholic beverages during the previous five years. Women who drank any alcohol had a risk of breast cancer of 1.0 (95% confidence interval 0.9-1.2) compared with nondrinkers. The risk of breast cancer did not increase appreciably with increasing alcohol consumption: Risk estimates for women consuming 8-14, 15-21, and 22 or more drinks per week were 1.1, 1.0, and 1.2, respectively. The authors also found no notable differences by type of beverage or within specific risk factor subgroups. These findings do not support the hypothesis that alcohol consumption increases the risk of breast cancer.

Adult↗