Cancer Risk

Lifestyle factors (eg, smoking, diet) and compliance with screening recommendations play a role in cancer risk, and emerging technologies (eg, new vaccines, genetic testing) hold promise for improved risk management. However, optimal outcomes from cancer control efforts require better preparation of health professionals in risk assessment, risk communication, and implementing health behavioral change strategies that are vitally important to cancer control. Although physician assistants (PAs) are substantively engaged in cancer-related service delivery in primary care settings, few models exist to facilitate integration of cancer control learning experiences into the curricula used in intense, fast-paced, 24- to 30-month PA training programs.

Both insulin resistance and estrogen deficiency result in complex metabolic disorder based mainly on defective cellular glucose uptake and on an atherogenic serum lipid profile. These alterations may be regarded as high risks for several life-threatening human diseases, such as type-2 diabetes, cardiovascular lesions and malignancies. Insulin resistance and estrogen deficiency are concomitant disorders with mutual interrelationship. Insulin resistance and the compensatory hyperinsulinemia provoke increased androgen synthesis at the expense of decreased estrogen production. Similarly, a moderate or severe decrease in serum estrogen levels enhances the prevalence of insulin resistant states both in men and women. Healthy premenopausal women enjoy the defensive effect of estrogens against metabolic and hormonal disorders. However, even a slight decrease in their circulatory estrogen levels associated with insulin resistance may increase the risk for cancers, particularly in the organs having high estrogen demand (breast, endometrium and ovary). On the other hand, postmenopausal state with profound estrogen deficiency confers high risk for cancers in different organs with either high or moderate estrogen demand. After menopause, hormone replacement therapy improves insulin sensitivity and decreases the enhanced inclination to malignancies in postmenopausal women. Recognition of the thorough interplay between insulin resistance and estrogen deficiency may illuminate many apparently controversial experimental and clinical findings concerning cancer development and therapeutic possibilities. Moreover, their interactions in the initiation and progression of human malignancies may supply new strategies in primary cancer prevention and cancer cure.

Abstract –  Objective:  The aim of the study was to evaluate the role of alcohol drinking and patterns of consumption in oral cancer incidence and mortality in a cohort study using data from the Trivandrum Oral Cancer Screening Study, India.Methods:  At baseline, the study participants completed a lifestyle questionnaire including items on frequency and duration of alcohol consumption. They were followed up for oral cancer incidence and mortality. Data from 32 347 subjects, of whom 134 eventually developed oral cancer, were analysed to estimate risk of oral cancer incidence and mortality according to drinking patterns, using a Cox regression model adjusted for age, religion, education, occupation, body mass index (BMI), standard of living index, chewing habits, smoking habits, and vegetable and fruit intake.Results:  Current and past drinkers were each associated with significantly increased risk of developing oral cancer. The hazard ratio increased significantly by 49% (95% CI = 1–121%) among current drinkers and 90% (95% CI = 13–218%) among past drinkers. A significant dose–response relationship between intake frequency, duration and oral cancer risk (incidence and mortality) was observed.Conclusions:  As with other lifestyle factors, alcohol intake plays an important role in oral carcinogenesis in this population, and understanding this role is relevant to developing public health policies targeting at-risk population.

It is studied the psychosocial impact of Counselling Genetic Oncology (CGO) on the participants who have received the genetic test results. A sample of 59 participants that had undertaken genetic testing and received results was assessed by The Multidimensional Impact of Cancer Risk Assessment (MICRA) Questionnaire.It was studied possible differences in psychosocial impact according to: result type of, previous oncologist diagnosis, time passed from result communication and type of hereditarysyndrome. The outcomes showed that GCO does notproduce negative psychosocial impact. There were not differences by previous diagnosis,time communication and type of hereditary syndrome on MICRA. It is necessary more research for Spanish MICRA adaptation with the purpose to dispose of a specific instrument effective for psyhosocial impact study of genetic testing.

Individuals at increased risk of developing breast cancer due to their family history of the disease face a number of uncertainties. Personal cancer risk estimates are imprecise and current methods for early detection or prevention are not 100% effective. It is therefore not surprising that adverse psychosocial outcomes have been described within this population. Research attempting to predict the incidence of distress and dysfunction in individuals at increased risk of cancer has been largely a-theoretical and has overlooked a number of potentially important predictive variables. In particular, the influence of personal experience of cancer through involvement with affected relatives has been neglected. There are strong theoretical grounds for hypothesising that dimensions of personal experience may influence response to cancer risk. This paper discusses the potential impact of personal experience on risk perception, illness representations and decision-making. Systematic research ...

This paper examines the effects of systematic and random errors in recall and of selection bias in case-control studies of mobile phone use and cancer. These sensitivity analyses are based on Monte-Carlo computer simulations and were carried out within the INTERPHONE Study, an international collaborative case-control study in 13 countries. Recall error scenarios simulated plausible values of random and systematic, non-differential and differential recall errors in amount of mobile phone use reported by study subjects. Plausible values for the recall error were obtained from validation studies. Selection bias scenarios assumed varying selection probabilities for cases and controls, mobile phone users, and non-users. Where possible these selection probabilities were based on existing information from non-respondents in INTERPHONE. Simulations used exposure distributions based on existing INTERPHONE data and assumed varying levels of the true risk of brain cancer related to mobile phone use. Results suggest that random recall errors of plausible levels can lead to a large underestimation in the risk of brain cancer associated with mobile phone use. Random errors were found to have larger impact than plausible systematic errors. Differential errors in recall had very little additional impact in the presence of large random errors. Selection bias resulting from underselection of unexposed controls led to J-shaped exposure-response patterns, with risk apparently decreasing at low to moderate exposure levels. The present results, in conjunction with those of the validation studies conducted within the INTERPHONE study, will play an important role in the interpretation of existing and future case-control studies of mobile phone use and cancer risk, including the INTERPHONE study.

An integrated, quantitative approach to incorporating both uncertainty and interindividual variability into risk prediction models is described. Individual risk R is treated as a variable distributed in both an uncertainty dimension and a variability dimension, whereas population risk I (the number of additional cases caused by R) is purely uncertain. I is shown to follow a compound Poisson-binomial distribution, which in low-level risk contexts can often be approximated well by a corresponding compound Poisson distribution. The proposed analytic framework is illustrated with an application’to cancer risk assessment for a California population exposed to 1,2-dibromo-3-chloropropane from ground water.

Prediction of cancer risk is a minor component of current health risk appraisals. Perception of individual cancer risk is poor. A Cancer Risk Index was developed to predict individual cancer risk for cancers accounting for 80% of the cancer burden in the United States. We used group consensus among researchers at the Harvard Medical School and Harvard School of Public Health to identify risk factors as definite, probable and possible causes of cancer. Risk points were allocated according to the strength of the causal association and summed. Population average risk of cancer and cumulative 10-year risk was obtained from SEER data. Individual ranking relative to the population average was determined. The risk index was evaluated for validity using colon cancer incidence in prospective cohort data. The Harvard Cancer Risk Index provides a broad classification of cancer risk. Validation against cohort data shows good agreement for colon cancer. The Harvard Cancer Risk Index offers a sim...

Today vegetarian nutrition is more accepted and widespread in Europe than in former years. For a long time scientific research on vegetarian diets has focused mostly on malnutrition, whereas nowadays research centers increasingly on the preventive potential of plant-based diets. We followed a nutritive and a metabolic-epidemiological approach to obtain dietary recommendations. A MEDLINE research was performed for all plant food groups relevant for a vegetarian diet (key words: all relevant food groups, "vegetarian diet", "chronic disease", "cancer", "cardiovascular disease", "diabetes mellitus", "osteoporosis"). All relevant food groups were characterized regarding their nutrient content and rated with respect to the available metabolic-epidemiological evidence. Based on the evidence criteria of the WHO/FAO, cancer risk reduction by a high intake of vegetables and fruits is assessed as probable or possible, while a lowered risk of cardiovascular disease is convincing and a lowered risk of osteoporosis is probable. The evidence of a risk reducing effect of whole grain relating to colorectal cancer is assessed as possible, whereas it is probable relating to cardiovascular disease and diabetes mellitus type 2. There is an insufficient risk-reducing effect of legumes like soja relating to epithelial tumours and cardiovascular disease. The evidence of a risk-reducing effect of nuts to cardiovascular disease is assessed as probable, and in relation to cholelithiasis and diabetes mellitus type 2 as possible and insufficient, respectively. In conclusion, high consumption of fruits, vegetables, whole grains and nuts can lower the risk for several chronic diseases. In Europa findet der Vegetarismus zunehmend Verbreitung und Akzeptanz. Während früher mögliche Mangelerscheinungen bei vegetarischer Ernährung im Fokus der Ernährungswissenschaft standen, rückt heute zunehmend das präventive Potential einer pflanzenbetonten Ernährung in den Vordergrund des Interesses. Für die Entwicklung entsprechender Ernährungsempfehlungen fanden ein nutritiver und ein metabolischepidemiologischer Ansatz Verwendung. Dazu wurde eine MEDLINE-Recherche für die im Rahmen einer vegetarischen Kostform relevanten pflanzlichen Lebensmittelgruppen durchgeführt (Schlüssel-Suchbegriffe: alle relevanten Lebensmittelgruppen, "vegetarian diet", "chronic disease", "cancer", "cardiovascular disease", "diabetes mellitus", "osteoporosis"). Die einzelnen Lebensmittelgruppen wurden hinsichtlich ihrer ernährungsphysiologischen Eignung und anhand der verfügbaren metabolisch-epidemiologischen Evidenz bewertet. Auf Basis der Evidenzkriterien der WHO/FAO zeigt sich, dass ein risikosenkender Effekt eines hohen Obst- und Gemüseverzehrs bei epithelialen Tumoren als wahrscheinlich oder möglich, bei kardiovaskulären Erkrankungen als überzeugend, bei Diabetes mellitus Typ 2 als unzureichend sowie bei Osteoporose als möglich gilt. Die Evidenz für einen risikosenkenden Effekt des Vollkornverzehrs im Hinblick auf Tumoren des Kolons und Rektums gilt als möglich, bei kardiovaskulären Erkrankungen und Diabetes mellitus Typ 2 als wahrscheinlich. Bei Hülsenfrüchten wie Soja wird die Evidenz für einen risikosenkenden Effekt sowohl in Bezug zum Risiko epithelialer Tumoren als auch bei kardiovaskulären Erkrankungen als unzureichend bewertet. Die Evidenz für einen risikosenkenden Effekt des Nussverzehrs gilt bei kardiovaskulären Erkrankungen als wahrscheinlich, bei Diabetes mellitus Typ 2 als unzureichend und bei Cholelithiasis als möglich. Daraus lässt sich schließen, dass der reichliche Konsum von Obst, Gemüse, Vollkornprodukten und Nüssen das Risiko für verschiedene chronisch-degenerative Erkrankungen vermindert.

We studied cancer prevalence and exposure to 2,3,7,8-tetra chlorodibenzo-p-dioxin (dioxin) in veterans of Operation Ranch Hand, the Air Force unit responsible for the aerial spraying of herbicides in Vietnam from 1962 to 1971. A comparison group of Air Force veterans who served in Southeast Asia during the same period and who were not involved with spraying herbicides was included. Comparison

Today vegetarian nutrition is more accepted and widespread in Europe than in former years. For a long time scientific research on vegetarian diets has focused mostly on malnutrition, whereas nowadays research centers increasingly on the preventive potential of plant-based diets. We followed a nutritive and a metabolic-epidemiological approach to obtain dietary recommendations. A MEDLINE research was performed for all plant food groups relevant for a vegetarian diet (key words: all relevant food groups, "vegetarian diet", "chronic disease", "cancer", "cardiovascular disease", "diabetes mellitus", "osteoporosis"). All relevant food groups were characterized regarding their nutrient content and rated with respect to the available metabolic-epidemiological evidence. Based on the evidence criteria of the WHO/FAO, cancer risk reduction by a high intake of vegetables and fruits is assessed as probable or possible, while a lowered risk of cardiovascular disease is convincing and a lowered risk of osteoporosis is probable. The evidence of a risk reducing effect of whole grain relating to colorectal cancer is assessed as possible, whereas it is probable relating to cardiovascular disease and diabetes mellitus type 2. There is an insufficient risk-reducing effect of legumes like soja relating to epithelial tumours and cardiovascular disease. The evidence of a risk-reducing effect of nuts to cardiovascular disease is assessed as probable, and in relation to cholelithiasis and diabetes mellitus type 2 as possible and insufficient, respectively. In conclusion, high consumption of fruits, vegetables, whole grains and nuts can lower the risk for several chronic diseases. In Europa findet der Vegetarismus zunehmend Verbreitung und Akzeptanz. Während früher mögliche Mangelerscheinungen bei vegetarischer Ernährung im Fokus der Ernährungswissenschaft standen, rückt heute zunehmend das präventive Potential einer pflanzenbetonten Ernährung in den Vordergrund des Interesses. Für die Entwicklung entsprechender Ernährungsempfehlungen fanden ein nutritiver und ein metabolischepidemiologischer Ansatz Verwendung. Dazu wurde eine MEDLINE-Recherche für die im Rahmen einer vegetarischen Kostform relevanten pflanzlichen Lebensmittelgruppen durchgeführt (Schlüssel-Suchbegriffe: alle relevanten Lebensmittelgruppen, "vegetarian diet", "chronic disease", "cancer", "cardiovascular disease", "diabetes mellitus", "osteoporosis"). Die einzelnen Lebensmittelgruppen wurden hinsichtlich ihrer ernährungsphysiologischen Eignung und anhand der verfügbaren metabolisch-epidemiologischen Evidenz bewertet. Auf Basis der Evidenzkriterien der WHO/FAO zeigt sich, dass ein risikosenkender Effekt eines hohen Obst- und Gemüseverzehrs bei epithelialen Tumoren als wahrscheinlich oder möglich, bei kardiovaskulären Erkrankungen als überzeugend, bei Diabetes mellitus Typ 2 als unzureichend sowie bei Osteoporose als möglich gilt. Die Evidenz für einen risikosenkenden Effekt des Vollkornverzehrs im Hinblick auf Tumoren des Kolons und Rektums gilt als möglich, bei kardiovaskulären Erkrankungen und Diabetes mellitus Typ 2 als wahrscheinlich. Bei Hülsenfrüchten wie Soja wird die Evidenz für einen risikosenkenden Effekt sowohl in Bezug zum Risiko epithelialer Tumoren als auch bei kardiovaskulären Erkrankungen als unzureichend bewertet. Die Evidenz für einen risikosenkenden Effekt des Nussverzehrs gilt bei kardiovaskulären Erkrankungen als wahrscheinlich, bei Diabetes mellitus Typ 2 als unzureichend und bei Cholelithiasis als möglich. Daraus lässt sich schließen, dass der reichliche Konsum von Obst, Gemüse, Vollkornprodukten und Nüssen das Risiko für verschiedene chronisch-degenerative Erkrankungen vermindert.

The purpose of this paper is to assess fatal cancer risk after external and internal (inhalation and ingestion) exposure from natural radionuclides in soil like (238)U, (232)Th, (40)K, and (226)Ra on the territory of Bela Crkva, Serbia. Although receiving doses are low from sources like natural radionuclides in soil, because of stochastic effects of ionizing radiation, risk for developing cancer exists and can be quantified. Concentrations of radionuclides from 80 soil samples are measured using HPGe detector. Fatal cancer risk is assessed from calculated ambient dose rate in the target organs of body due to external and internal exposure. Monte Carlo simulations are used to obtain conversion factors which are required to calculate absorbed dose rate in target organs. Assessed cancer risk for (238)U in the case of both inhalation and ingestion exposure is from 1.11 × 10(-6) to 24 × 10(-6) for minimal and maximal activity in soil samples, from 1.02 × 10(-6) to 23.3 × 10(-6) for exposure to (226)Ra, from 1.89 × 10(-6) to 50.3 × 10(-6) for exposure to (232)Th, and from 0.265 × 10(-6) to 9.83 × 10(-6) for exposure to (40)K. Overall risk from (40)K as external and internal source is from 0.8 × 10(-6) to 31.9 × 10(-6). Calculated cancer risks from both inhalation and ingestion exposure could be related to all tissues that are on the way of distribution of particles within the body but especially to deposition sites in the body. Assessed risks for fatal cancer development from inhaled and ingested natural radionuclides originating in soil are not increased.

Human progress, driven by technical advances, increases wealth and well-being in society. However, socioeconomic and technological progress does not always lead to general wellbeing of people in society. In particular, this study shows some inconsistencies of human progress, technology-driven, on physical and mental health, given by a greater incidence of cancer and suicide in highly developed societies. Overall, then, empirical evidence seems to reveal that human progress generates positive effects but also leads to disorders for physical and mental health in the continuous evolution of society over time and space.