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  • 1
    Electronic Resource
    Electronic Resource
    Tamoxifen and risk of large bowel cancer in women with breast cancer (1999)
    Springer
    Breast cancer research and treatment 53 (1999), S. 271-277 
    Details
    ISSN: 1573-7217
    Keywords: breast neoplasms ; therapy ; colorectal neoplasms ; estrogen antagonists ; estrogen replacement therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The increasingly consistent association between estrogen replacement therapy and colorectal cancer suggests that the anti-estrogen tamoxifen may also be associated with large bowel cancer incidence. Methods: Women with new diagnoses of breast cancer were identified from the Surveillance Epidemiology and End Results (SEER) Program, a set of geographically defined, population based cancer registries representing approximately ten percent of the U.S. population. Of 85,411 women with local or regional breast cancer diagnosed from 1983–90, 14,984 women were reported to have received hormonal therapy and 70,427 were not known to have received hormonal therapy. Subsequent cancer diagnoses were identified in this cohort beginning 6 months after initial breast cancer diagnosis until death, or December 31, 1994. Multivariate Cox proportional hazards models were used to estimate the risk of developing colorectal cancer and other second cancers according to hormonal therapy use. Results: Over the follow-up period 793 colorectal, 2,648 contralateral breast, 506 endometrial, 250 ovarian, 98 gastric, and 1,765 other cancers were identified in the study cohort. While overall there was no association between hormonal therapy use and colorectal cancer (relative risk (RR) 1.09, 95% confidence interval (CI) 0.88–1.35), in the period five or more years after diagnosis, risk was increased significantly by about 50% (95% CI 1.00–2.15). As expected, based upon clinical trials data, cancers of the contralateral breast were significantly decreased, and cancers of the uterine endometrium were significantly increased. No other meaningful associations were observed. When women were excluded for whom hormonal therapy might represent therapy other than tamoxifen (premenopausal women and those who received chemotherapy), this did not meaningfully alter these estimates. Conclusions: The results of this large population based cohort study suggest that tamoxifen therapy may modestly increase risk of large bowel cancer in women, but only after 5 years following initiation of breast cancer therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006117220284
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  • 2
    Electronic Resource
    Electronic Resource
    A population-based study of contralateral breast cancer following a first primary breast cancer (Washington, United States) (1996)
    Springer
    Cancer causes & control 7 (1996), S. 382-390 
    Details
    ISSN: 1573-7225
    Keywords: Breast neoplasms ; menopausal status ; second primary neoplasms ; United States ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: To evaluate predictors of contralateral breast cancer risk, we examined data from a nested case-control study of second primary cancers among a cohort of women in western Washington (United States) diagnosed with breast cancer during 1978 through 1990 and identified through a population-based cancer registry. Cases included all women in the cohort who subsequently developed contralateral breast cancer at least six months after the initial diagnosis, but prior to 1992 (n=234). Controls were sampled randomly from the cohort, matched to cases on age, stage, and year of initial breast cancer diagnosis. Information on potential risk factors for second primary cancer was obtained through medical record abstractions and physician questionnaires. Women who were postmenopausal due to a bilateral oophorectomy (i.e., a surgical menopause) at initial breast cancer diagnosis had a reduction in contralateral breast cancer risk compared with premenopausal women (matched odds ratio [mOR]=0.25, 95 percent confidence interval [CI]=0.09–0.68), whereas no reduction in risk was noted among postmenopausal women who had had a natural menopause (mOR=0.90, CI=0.39–2.09). Among postmenopausal women, there was a suggestion of a lower risk associated with relatively high parity (2+). A family history of breast cancer was associated with an increased risk (mOR=1.96, CI=1.22–5.15) and varied little by menopausal status. Having an initial tumor with a lobular component (c.f. a ductal histology) was not related strongly to risk (mOR=1.47, CI=0.79–2.74). The results of the present and earlier studies argue that we have limited ability to predict the occurrence of a contralateral breast tumor. Better predictors will be required before diagnostic and preventive interventions can be targeted to subgroups of patients with unilateral breast cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00052945
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  • 3
    Electronic Resource
    Electronic Resource
    Nevi and migration within the United States and Canada: a population-based cross-sectional study (1996)
    Springer
    Cancer causes & control 7 (1996), S. 464-473 
    Details
    ISSN: 1573-7225
    Keywords: Age ; melanoma ; migration ; nevus ; pigmentation ; sunlight ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: A survey to ascertain factors associated with benign melanocytic nevi or moles was conducted among randomly-selected White adults (aged 18 to 50 years) in Washington State (United States). Participants of the telephone interview in 1990–91 were questioned about lifetime places of residence and constitutional factors. Subjects counted raised nevi on their arms at the end of the survey. Logistic regression was used to examine the risk for two or more nevi compared with no nevi. Individuals who resided in warmer areas and lower latitudes than Washington State were at higher risk of having multiple nevi. This association held for residence at birth, during childhood, adolescence, and over lifetime: an odds ratio (OR) of 2.3 (95 percent confidence interval =1.2–4.3) for lifetime average daily maximum temperature of ≥64°F compared with 58.9°F, and similar ORs of 2.1 for adolescence and 1.8 for childhood. These associations remained significant after adjusting for potential confounding effects of constitutional factors and for childhood sunburns as a potential mechanism. Risk of multiple nevi was reduced for both early age at migration and longer duration of stay in Washington. These data are consistent with the importance of childhood and adolescent sun exposure in the etiology of nevi, but also suggest an effect of lifetime sun exposure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00052673
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  • 4
    Electronic Resource
    Electronic Resource
    Leisure-time physical activity in relation to breast cancer among young women (Washington, United States) (1997)
    Springer
    Cancer causes & control 8 (1997), S. 77-84 
    Details
    ISSN: 1573-7225
    Keywords: Breast cancer ; physical activity ; United States ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract It has been hypothesized that women who participate in vigorous physical activity may have lower risk of breast cancer due to lower lifetime exposure to ovarian hormones. A population-based case-control study was conducted to investigate the association between leisure-time physical activity and risk of breast cancer among women aged 21 to 45 years. Cases were 747 women diagnosed with invasive breast cancer between 1983 and 1990 in three counties of western Washington state (United States), and were identified through the Seattle-Puget Sound Surveillance, Epidemiology, and End Results (SEER) registry. Controls were 961 women selected from the same area by random-digit telephone dialing. Physical activity was assessed through personal interview, with questions on frequency and duration of each type of recreational activity during the two-year period immediately prior to reference date (date of diagnosis for cases and a comparable assigned date for controls) and between ages 12 and 21. For the two-year time period before diagnosis, there was no association with frequency of activity (age-adjusted odds ratio [OR]=0.93, 95 percent confidence interval [CI]=0.71-1.22 for four or more episodes per week cf none), total hours spent in physical activity (age-adjusted OR=0.92, CI=0.71-1.22 for four or more hours per week cf none) or MET (metabolic equivalent energy expenditure unit) (age-adjusted OR=0.95, CI=0.73-1.23 for 18 or more METs per week cf none), nor any trend in risk with increasing activity levels. Similarly, there was no association between leisure activity during adolescence and breast cancer risk. These results were not confounded further by body mass index (wt/ht2), age at menarche, age at first full-term pregnancy, parity, family history of breast cancer, or other measured health behaviors. Our findings do not support a protective effect of leisure-time physical activity either in the adolescent years or in adulthood on breast cancer in young women.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1018439306604
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  • 5
    Electronic Resource
    Electronic Resource
    Community organization to promote breast cancer screening ordering by primary care physicians (1996)
    Springer
    Journal of community health 21 (1996), S. 277-291 
    Details
    ISSN: 1573-3610
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Community organization has been viewed as a promising approach to changing preventive behaviors. We evaluated the impact of community organization strategies to promote breast cancer screening ordering by primary care physicians in Washington State. Physicians practicing in two intervention and two control communities were surveyed by mail pre-intervention (1989) and post-intervention (1993). Intervention activities targeting the health care sector included the formation of local physician planning groups, a series of informational mailings, medical office staff training sessions, and reminder system support. There were no significant post-intervention differences in the self-reported mammography ordering of physicians practicing in the intervention and control areas. Over the four-year study period, the proportions of physicians who ordered regular mammography increased by 36%. By 1993, over 80% of the respondents routinely used mammographie screening. Concerns about the high price of mammograms and inadequate insurance coverage were significantly reduced over time in both community pairs. Also, use of patient reminder systems increased significantly between 1989 and 1993. Secular trends resulting from diffusion of strategies to promote mammography were responsible for increases in physician ordering of the procedure. Year 2000 goals for breast cancer screening use by physicians may already have been met in some communities.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01794878
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