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PubMed1994

Exogenous hormones, reproductive history, and colon cancer (Seattle, Washington, USA).

The associations between exogenous hormones, reproductive history, and colon cancer were investigated in a case-control study among women aged 30-62 years. The study was conducted in the Seattle, Washington (USA) metropolitan area between 1985 and 1989 and included 193 incident cases of colon cancer and 194 controls. There was little overall association between colon cancer and oral contraceptive use, parity, age at first birth, hysterectomy or oophorectomy status, or age at menopause. Use of noncontraceptive hormones at or after age 40, most likely hormone replacement therapy (HRT), was associated with decreased risk of colon cancer (adjusted odds ratio [OR] = 0.60, 95 percent confidence interval [CI] = 0.35-1.01), particularly among women with more than five years of use (OR = 0.47, 95 percent CI = 0.24-0.91). While results from previous studies have not been consistent, any protective effect of HRT against colon cancer would be important given the continuing debate over its potential risks and benefits.

Adult↗
PubMed1996

Regularity and length of menstrual cycles in women aged 41-46 in relation to breast cancer risk: results from the DOM-project.

The effect of regularity and length of the menstrual cycle on breast cancer risk was studied prospectively in 78 cases and 383 age-matched controls who participated in a breast cancer screening programme, the DOM-project, in Utrecht, the Netherlands. Before entering the screening programme when they were aged 41-46, the women kept a menstrual calendar during at least three consecutive cycles. Cycles were considered to be irregular if any of three cycles was shorter than 21 days or longer than 35 days and/or if variation between cycle lengths was more than five days. Women with irregular cycles had a significantly reduced risk of breast cancer (odds ratio = 0.44; 95% confidence interval 0.22-0.86) after adjustment for age at menarche, age at first birth, parity, Quetelet's index and family history of breast cancer. Among regularly menstruating women, long cycles (28 days or more) were not significantly associated with increased risk of breast cancer (odds ratio 1.17; 95% confidence interval 0.66-2.09). To the extent that irregular menstrual cycles reflect anovulatory cycles, our findings support the hypothesis that the cumulative number of regular ovulatory cycles increases breast cancer risk.

Adult↗
PubMed1989

Risk factors and 10-year breast cancer survival in northern Alberta.

1,121 women in northern Alberta diagnosed as having breast cancer between 1971-74 were followed for 10 years. Risk factors for breast cancer were studied with respect to their possible influence on survival by comparing survival curves, using both Logrank and Cox's regression model, and controlling for intercurrent death, stage and axillary node status. A complex interaction was found between age and menopausal status and survival rates. Premenopausal women aged 45-55 had a better survival rate than postmenopausal women of the same age. However, one subgroup of premenopausal women aged 35-39 had a significantly worse prognosis than those aged 40-44 as did a group of post menopausal women aged 70-74. No cause was found other than the effect of age. There was a significant trend to worsening survival with heavier weight at time of diagnosis and with breast feeding. Parity of five or more and family history of breast cancer were less consistently associated with worse survival. Oral contraceptive use was only associated with worsened prognosis significantly when stage was controlled for; there was no overall effect. Age at menarche and age at first birth did not influence prognosis. Theories to explain the findings are discussed.

Adult↗
PubMed1982

Parity and breast cancer: confirmed evidence of an effect on age at diagnosis.

An evaluation is made of the hypothesis of Woods et al. (1) that the number of full-term pregnancies constitutes a factor of growth acceleration in breast cancer. Our results confirm, at least in part, the effect of parity on age at diagnosis of breast cancer. Patients with two or more children were significantly younger at the time of diagnosis than were those with none or one child. Age at first birth and duration of lactation do not seem to be, in this analysis, confounding factors for the observed association.

Adult↗
PubMed1990

[The treatment of children with cheilognathopalatoschisis--a contribution to psychosocial rehabilitation].

The long-term treatment of cleft palate patients starts immediately after birth and is pursued in orderly fashion [correction of persecuted orderly] to adolescence. The results of anonymous survey of the opinion of parents of cleft palate children who undergo or underwent early treatment procedures, up to seven years of age, are presented. Questions concerned mother's or parent's experience of birth, first medical information, early orthopedic care and treatment, and psychosocial adjustment of the children as well. This study suggests that objective findings in children and subjective conditions of parents do not correlate in the beginning, as is to be seen in cleft palate versus cleft lip palate group. One other conclusion indicates the existence of a small quantity of parents able to accept their affected child without additional problems arising from the cleft.

Adult↗
PubMed2002

The making of a polio-free India.

Rotary one of the largest non-government international organization focused mainly towards the up-liftment of the downtrodden worldwide, got involved in the Polio Eradication Program way back in 1979 with a five-year pledge to immunize about six million Philippine children from the crippling disease of poliomyelitis. By 1982, Rotary committed itself to implement the most ambitious program ever, "to immunize all the world's children against polio by 2005" -Rotary's first birth centenary year. Encouraged by Rotary's commitment towards this objective, the World Health Organization (WHO) adopted a resolution of eradicating polio, as part of the Expanded Programme on Immunization (EPI). The World Health Assembly in 1988, in which Governments of over 100 countries including the Government of India resolved to eradicate polio, recognized Rotary International as the key non-government, private partner on the global team. Ever since Rotary has been providing financial assistance to national governments for the purchase of Oral Polio Vaccine and conducting the highest level of advocacy efforts to see that soon polio is eradicated globally. Rotary called its Polio Eradication Initiative" Polio Plus Program" and focused primarily on social mobilization and voluntarism.

Charities↗
PubMed2006

Early breast cancer.

Breast cancer remains a common disease throughout the world. Here we review new knowledge about early breast cancer obtained during the past 5 years. The prognosis of early breast cancer is generally favorable. Especially, ductal carcinoma in situ has been regarded as a non-life-threatening disease. Therefore, early diagnosis and early onset of the treatment has been important. Early age at menarche, late age at first birth, and late age at menopause are related to breast cancer risk. Examination by mammography and ultrasonography is still the most effective means of detection for premenopausal and postmenopausal women, respectively. Additionally, there have been important advances in MRI, sentinel lymph node biopsy, breast-conserving surgery, partial breast irradiation, neoadjuvant systemic therapy, and adjuvant systemic therapy. Another approach to keeping the disease under control is the elucidation of breast cancer's molecular biological features. Assessment of potential molecular targets can lead to early diagnosis and molecular targeted treatment.

Breast Neoplasms↗
PubMed2005

A predictive model for the development of hormone-responsive breast cancer.

BACKGROUND: Effective therapies to reduce the risk of hormone-sensitive breast cancers (ER or PR positive) exist. Available models predict the risk of breast cancer without addressing hormone receptor status. The purpose of this study was to identify risk factors predictive of the development of hormone-sensitive cancers. METHODS: A total of 1285 invasive breast cancers in 1263 women were identified from a prospectively maintained database. Risk factors were compared for ER+ and ER- cancers by using Fisher's exact test. RESULTS: Models were developed for premenopausal and postmenopausal women. In premenopausal women, white race, age at menarche < 12 years, and nulliparity or age at first birth > 20 years were used. The risk of ER+ cancer increased from 67.7% with 0 variables to 83.8% with all three (P = .013). In postmenopausal women, white race and a history of estrogen therapy were used. With none of the variables present, the incidence of ER+ cancer was 70.0%; it was 77.6% with one variable and 85.4% with both variables (P = .002). In postmenopausal women, variables predicted significant differences in hormone sensitivity only for those aged < or = 60 years. In the subset of women with information on alcohol use, adding this variable to the model improved the prediction of hormonal status. CONCLUSIONS: Our findings, if prospectively validated, may help identify those who would obtain the greatest benefit from hormonal chemoprevention strategies for breast cancer risk reduction.

Adult↗
PubMed2004

Life course breast cancer risk factors and adult breast density (United Kingdom).

OBJECTIVE: To determine whether risk factors in childhood and early adulthood affect later mammographic breast density. METHODS: Subjects were 628 women who attended a medical examination at the University of Glasgow Student Health Service (1948-1968), responded to a questionnaire (2001) and had a screening mammogram in Scotland (1989-2002). Mammograms (median age of 59 years) were classified using a six category classification (SCC) of breast density percent. Logistic regression was used to determine associations between risk factors and having a high-risk mammogram (>or = 25% dense). RESULTS: In multi-variable analyses, high-risk mammograms were associated with parity (adjusted odds ratio (OR) per child: 0.77 (95% confidence interval (CI) 0.61-0.99)), age at first birth, OR per year: 1.05 (0.99-1.11), smoking at university, OR smokers versus non-smokers: 0.58 (0.36-0.92) and body mass index (BMI) while at university, OR per 1 kg/m2 0.75 (0.69-0.82). No associations with SCC were found for age at menarche, birth weight, oral contraceptive (OC) use, height, leg length or exercise at age 20. CONCLUSIONS: We confirm previous findings that breast density is affected by reproductive events and some anthropometric measures, however most of the risk factors acting throughout the life course which we examined were not closely related to adult breast density.

Adolescent↗
PubMed2005

Breast cancer risk factors and mammographic breast density in women over age 70.

BACKGROUND: Breast density is a strong risk factor for breast cancer, but little is known about factors associated with breast density in women over 70. METHODS: Percent breast density, sex hormone levels and breast cancer risk factor data were obtained on 239 women ages 70-92 recruited from 1986 to 1988 in the United States. Multivariable linear regression was used to develop a model to describe factors associated with percent density. RESULTS: Median (range) percent density among women was 23.7% (0-85%). Body mass index (beta=-0.345, p<0.001 adjusted for age and parity) and parity (beta=-0.277, p<0.001 adjusted for age and BMI) were significantly and inversely associated with percent breast density. After adjusting for parity and BMI, age was not associated with breast density (beta=0.05, p=0.45). Parous women had lower percent density than nulliparous women (23.7 versus 34.7%, p=0.005). Women who had undergone surgical menopause had greater breast density than those who had had a natural menopause (33.4 versus 24.8%, p=0.048), as did women who were not current smokers (26.0 versus 17.3% for smokers, p=0.02). Breast density was not associated with age at menarche, age at menopause, age at first birth, breastfeeding, estrogen levels or androgen levels. In a multivariable model, 24% of the variance in percent breast density was explained by BMI (beta=-0.35), parity (beta=-0.29), surgical menopause (beta=0.13) and current smoking (beta=-0.12). CONCLUSION: Factors associated with breast density in older, post-menopausal women differ from traditional breast cancer risk factors and from factors associated with breast density in pre-menopausal and younger post-menopausal women.

Aged↗
PubMed2006

Reproductive factors and breast cancer risk among older women.

Reproductive factors have been shown to affect pre- and postmenopausal breast cancer risk differently, but whether there are additional age-specific differences among menopausal women as they age has not been clarified. We analyzed data from a large population-based case-control study that included 1,508 breast cancer cases and 1,556 controls, aged 20-98 years, who completed an in-home interviewer-administered questionnaire. The following subgroups were created to examine if the associations between reproductive factors and breast cancer risk varied by age- and menopausal-status: premenopausal (n=968), postmenopausal <65 years (n=1,045), postmenopausal >or=65 years (n=958). Among postmenopausal women >or=65 years, ever having breastfed decreased risk (odds ratio (OR)=0.67, 95% confidence interval (CI)=0.48, 0.92), and a strong dose-response relationship was observed for longer durations of breastfeeding (P trend=0.02), with the most pronounced protective effect observed for >or=14 months of breastfeeding (OR=0.40, 95% CI=0.21,0.76). Late age at first birth (AFB) and older age at last birth (ALB) were associated with non-statistically significant increases in breast cancer risk in this older group, while late age at menarche and surgical menopause decreased risk. ORs for multiparity were close to the null. Among premenopausal women and postmenopausal women <65 years, multiparity significantly decreased risk, and older AFB nonsignificantly increased risk. Our findings suggest that the well-known protective effect of multiparity attenuates with older age. Moreover, breastfeeding, one of the few potentially modifiable risk factors for breast cancer, was an important factor in decreasing risk among older parous postmenopausal women.

Adult↗
PubMed1994

Adolescent body mass index and infertility caused by ovulatory disorder.

OBJECTIVE: Our aim was to examine the association between body mass index at age 18 and subsequent primary ovulatory infertility. STUDY DESIGN: A nested case-control study was conducted within a cohort of 116,678 female registered nurses residing in 14 U.S. states. Cases comprised 2527 married nulliparous nurses unable to become pregnant for at least 1 year because of ovulatory disorder; controls comprised 46,718 married parous nurses with no history of infertility. The risk of ovulatory infertility for women at different levels of body mass index at age 18 was compared with that for women whose body mass index at age 18 was 20 to 21.9 (median for the cohort). Logistic regression was used to adjust for age at infertility or first birth, year of birth, age at menarche, physical activity during ages 18 to 22, smoking at ages 15 to 19, ethnicity, alcohol use at ages 18 to 22, use of oral contraceptives before age 22, and diagnosis of diabetes mellitus. RESULTS: Multivariate relative risks for infertility were: 1.2 (body mass index < 16), 1.1 (body mass index 16 to 17.9), 1.0 (body mass index 18 to 19.9), 1.0 (referent body mass index 20 to 21.9), 1.1 (body mass index 22 to 23.9), 1.3 (body mass index 24 to 25.9), 1.7 (body mass index 26 to 27.9), 2.4 (body mass index 28 to 29.9), 2.7 (body mass index 30 to 31.9), and 2.7 (body mass index > or = 32). The relative risks for all categories of body mass index above 23.9 were statistically significantly elevated. Greater body mass index at age 18 was a predictor of ovulatory infertility in women with and without a diagnosis of polycystic ovary syndrome. CONCLUSION: These findings suggest that elevated body mass index at age 18, even at levels lower than those considered to be obese, is a risk factor for subsequent ovulatory infertility.

Adolescent↗
PubMed1995

Oxytocin and vasopressin release in the olfactory bulb of parturient ewes: changes with maternal experience and effects on acetylcholine, gamma-aminobutyric acid, glutamate and noradrenaline release.

Maternal behaviour and the ewe's ability to recognize her lamb depend on olfactory cues and parturition, and are facilitated by maternal experience. Parturition induces a variety of neurochemical changes in the brain and, in particular, oxytocin (OT) release. This peptide injected centrally induces maternal behaviour. Oxytocin release occurs in the olfactory bulb (OB) at parturition and yet this structure is involved in the process of selective bonding with lamb. The present study therefore investigated the possibility that oxytocin release in the OB might modulate the release of classical transmitters that are known to be important in controlling selective recognition and whether maternal experience has any effect on this. We have first used in vivo microdialysis to measure OT release, as well as that of the related peptide, arginine-vasopressin (AVP), in the OB of maternally experienced and inexperienced ewes during parturition. While OT release significantly increased in both primiparous and multiparous ewes at parturition this increase was significantly greater in multiparous ewes. No significant change of AVP release was observed in either group. However, vagino-cervical stimulation (VCS) performed at 6 h post-partum caused similar increases in OT but not AVP release in both primiparous and multiparous ewes suggesting that the first birth experience potentiates the ability of VCS to evoke OT release within 6 h of parturition. Using retrodialysis, either OT (10 microM) or AVP (10 microM) were infused into the OB of multiparous and nulliparous ewes and their effects on modulating acetylcholine (ACh), noradrenaline (NA), glutamate and gamma-aminobutyric acid (GABA) release were monitored. Both peptides produced an increase of ACh and NA in multiparous animals and this effect was either absent or less pronounced in nulliparous animals. OT, but not AVP, also increased GABA release equivalently in nulliparous and multiparous animals. Glutamate release was not altered in response to OT or AVP infusion. These results suggest that OT release in the OB at parturition may facilitate the recognition of lamb odours by modulating NA, ACh and GABA release which are of primary importance for olfactory memory. The reduced release of OT in the OB of primiparous ewes at parturition, together with its reduced ability to modulate NA and ACh release, might also partly explain why maternally inexperienced animals require a longer period to selectively bond with their lambs.

Acetylcholine↗
PubMed1992

Predicting childlessness for recent cohorts of American women.

Over 50% of the American women now in the midst of the childbearing years have never borne a child. These levels of childlessness for women in their 20s are the highest ones in a time series that spans most of the twentieth century. Will postponed parenthood be translated into very high levels of permanent childlessness? Or will these cohorts "catch-up" with a late fertility flurry in their 30s and 40s? The authors examine 3 projection strategies: one using women's stated fertility expectations, a second relying on the patterns of previous cohorts, and a third which posits that current rates will persist into the future. The predictive validity of these different projection strategies are tested with data for the 1980-87 period. They show that the projection based on current period rates performs well. Further, the authors argue that it better captures the first birth process than other models. They forecast levels of 20% childless for cohorts of white women born in the early 1960s. Recent trends for nonwhites are very different from those for whites: levels of 4% are forecast for nonwhite women.

Age Distribution↗
PubMed1989

Breast cancer and combined oral contraceptives: an Italian case-control study.

The risk of breast cancer in relation to use of oral contraceptives was evaluated using data from a hospital-based case-control study from Northern Italy on 1517 cases below age 60 and 1351 controls admitted for acute diseases unrelated to any of the known or potential risk factors for breast cancer. The multivariate relative risk for ever vs. never users was 1.3 (95% confidence interval = 1.0-1.7). However, the risk was not related to duration of use: indeed the highest risk was observed among short-term users (less than 2 years), and the point estimate was 0.9 among users for 5 years or more. The elevated risk among short-term users, if not due to residual confounding or selection mechanisms, is probably explainable in terms of recall bias (i.e. more careful report of short or very short use by cases). No definite pattern was observed in relation to latency or recency of use, and the point estimates were 0.8 for women who had ever used the pill before age 25 and 0.8 for those who had ever used the pill before first full-term pregnancy. Thus, the study presents further reassuring information on the oral contraceptive/breast cancer debate. Its major limitation lies in the low prevalence of oral contraceptive users in Italy, with a consequently reduced statistical power, although, with the number of cases involved, it was possible to exclude a relative risk of 1.4 for long-term use or for ever use before first birth.

Adult↗
PubMed1988

Review of cancer among 4 religious sects: evidence that life-styles are distinctive sets of risk factors.

The occurrence of various types of cancer have been reviewed and evaluated in 4 religious groups. These patterns have been critically assessed in light of the distinctive life-style features of these groups. All 4 religious groups considered in this paper have reduced overall rates of cancer, suggesting that the life-styles of all 4 groups have merit in terms of reducing the overall risk of cancer. The rate of smoking among these groups is nearly nil, and the lung cancer rate in all 4 of these religious groups is strikingly low. Cancer of the oral structures, pharynx, larynx, and esophagus is also generally quite low. Amish and Hutterites have unusually high rates of breast cancer and juvenile leukemia. Reproductive factors frequently mentioned as risk factors for breast cancer cannot explain the excess breast cancer in the Amish and Hutterite women because they should have had the effect of reducing the rate. None of the numerous risk factors, normally suggested for leukemia, are consistent with this observation. The observations on ovarian cancer tend to confirm low parity and late age at first birth as risk factors, although the evidence is not entirely consistent. Also, contrary to common observations, the pattern of ovarian cancer contrasts greatly with the breast cancer pattern, suggesting dissimilar risk factors. Their low rate of cervical cancer is consistent with promiscuity being a strong risk factor, but other frequently suggested risk factors were generally inconsistent with the observations. Cancers of the stomach, colon, rectum, urinary bladder and prostate, in these 4 religious groups, are not readily explained by the risk factors commonly implicated in cancer of these sites. The patterns of a few types of cancers were consistent with the prevailing opinions of risk factors, but some cancers were poorly explained and, in some cases, the cancer patterns contradicted commonly held opinions concerning risk factors. Religions that provide strong directives for the personal lives of adherents result in distinctive life-style, reflecting multiple disease related factors (risk factors and protective factors). Disease related factors are related to each other in simple or more complex ways (e.g. additive, multiplicative or even more complex). Therefore, when dealing with distinctive life-styles, it may be unwarranted to attempt to isolate individual risk factors.

Adult↗
PubMed1985

A case-control study of endometrial cancer within a cohort.

In a population-based prospective study it was shown that weight, height, overweight, total body size, age at first birth, parity and age at menopause are risk factors for the development of endometrial cancer. The finding that the patients had had a higher oestrogen excretion level than the controls some time before diagnosis constitutes the biochemical background for the effect of some of the above variables.

Age Factors↗