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  • 1
    Electronic Resource
    Electronic Resource
    [s.l.] : Macmillan Magazines Ltd.
    Nature 389 (1997), S. 922-922 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Perls et al. in Scientific Correspondence present intriguing data suggesting that bearing children in middle age may be a harbinger for extreme longevity. We have reanalysed another study, which does not lead to the same conclusion. Perls et al. report a significant fourfold excess of ...
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  • 2
    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.
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  • 3
    ISSN: 1573-7225
    Keywords: abortion ; breast cancer ; pregnancy ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective:Previous studies of induced abortion and breast cancer may have been limited by differential reporting of abortion history. We conducted a population-based case–control study to evaluate abortion (both induced and spontaneous) and breast cancer risk. Methods:All study subjects were aged 20–69 years and members of Group Health Cooperative of Puget Sound (GHC). Incident invasive breast cancer cases (n = 138) were identified from the linkage between the GHC enrollment file and the Seattle–Puget Sound SEER Cancer Registry. Controls (n = 252) were randomly selected from GHC enrollment files and matched to cases on age and enrollment period. All subjects had to have been enrolled at GHC for the 2 years preceding diagnosis (cases) or reference (controls) date. The unified medical record of each case was abstracted for pregnancy history, including prior induced and spontaneous abortions, menopause status, height and weight, screening practices, and other risk factors. Results:Compared to all women who had never had an induced abortion, the multivariate adjusted relative risk of breast cancer in women with an induced abortion was 0.9 (95% confidence interval 0.5–1.6). This risk was similar in parous women, and nulliparous women. There was no association between spontaneous abortion and breast cancer risk. Conclusions:These results do not support a relation between induced abortion and breast cancer incidence.
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  • 4
    ISSN: 1573-7225
    Keywords: Body mass index ; case-control study ; colorectal neoplasms ; height ; United States ; weight ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Body size is associated with the risk of many diseases, including diabetes, heart disease, and some cancers. To evaluate the association of body size with large bowel cancer, height and weight measurements were ascertained by telephone interview from 779 Wisconsin (United States) women with newly reported diagnoses of carcinoma of the colon and rectum. Controls (n=2,315) interviewed for this case-control study were selected randomly from Wisconsin driver's license files and Health Care Financing Administration files. The effects of weight and height were examined using multiple logistic regression to control for potential confounding variables. In this study, weight adjusted for height increased the risk of colon cancer (odds ratio [OR] for 72.57–148.33 kg cf 36.29–58.05 kg=1.4,95 percent confidence interval [CI]=1.0–1.9) but did not increase the risk of rectal cancer. Height did not influence risk for cancer of either the colon or the rectum. Left-colon subsite analysis showed especially strong associations with current weight and with percent change in weight since age 18. These data suggest that a dose-response relationship exists between body size and risk of colon cancer in women; body size did not appear to influence risk of rectal cancer. Cancer Causes Control 1995, 6, 30–36
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1573-7039
    Keywords: Breast neoplasms ; breast feeding ; lactation ; risk
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Breast cancer is a common disease with few practical preventive measures. The recent evidence that lactation, like other reproductive experiences, is associated with a modest reduction in breast cancer risk is therefore of great interest. Overall, the reduction in risk appears to be about 20% for ever breast feeding and is even greater for women with histories of prolonged lactation, or who initiate breast feeding at young ages. In many studies this risk reduction seems to be limited to premenopausal women. It appears unlikely that this inverse association is attributable either to higher risk among women who use lactation suppressants or who have difficulty either starting or continuing breast feeding. While a strong or consistent protective effect of lactation on breast cancer risk has not been observed in some large and well conducted studies, this likely reflects the limited breast feeding practices among modern women. If early, exclusive and extended breast feeding is necessary to achieve a breast cancer risk reduction, future studies among U.S. women may be unable to clarify this association.
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  • 6
    ISSN: 1573-7217
    Keywords: tamoxifen ; bone density ; osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary While in limited animal studies tamoxifen is reported to protect against loss of bone mineral, data in humans are lacking. We measured bone mineral density (BMD) using single photon absorptiometry at the radius and dual photon absorptiometry at the lumbar spine in breast cancer patients treated with chemotherapy at our institution. In this group, 37 women were not treated with tamoxifen (NT) and 48 women were treated with tamoxifen (T) for at least two years. Younger age, greater weight and height, premenopausal status, and shorter time since menopause were found to be significant predictors of greater BMD. Tamoxifen-treated women had been postmenopausal for more years (p = 0.012). Regression analyses used to adjust for differences in risk of bone loss did not reveal significant differences in BMD between the two groups of women. For the postmenopausal women (27 NT and 34 T subjects), the adjusted mean BMD (g/cm2) at the spine was 1.11 (NT), 1.11 (T) (p = 0.93); and at the radius 0.63 (NT), 0.62 (T) (p = 0.30). This limited retrospective study suggests that tamoxifen does not have ‘anti-estrogenic’ effects on BMD.
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  • 7
    ISSN: 1573-7217
    Keywords: breast cancer ; early detection ; incidence ; mammography ; mortality ; screening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The recent trends in mammography, and in breast cancer incidence and mortality, demonstrate the impact of an effective cancer control effort. The number of women over age 40 years who have ever had mammography has increased over 200% since 1980. Concomitantly, breast cancer incidence has increased about 32%, with nearly all of the increase in early stage disease. Analytic studies of these changes have demonstrated persuasively that the vast majority of this increase is temporary and is attributable to the lead-time afforded by mammography. As a result of this early detection and treatment of breast cancer, mortality has begun to decline in 1991–92. Although the search for practical preventive measures should continue, the benefits of early detection can be realized now. Further research is needed to define age groups most appropriately screened and the optimum intervals for screening.
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  • 8
    ISSN: 1573-7225
    Keywords: Breast cancer ; detection ; females ; mammography ; screening ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Early detection is advocated widely as the best method to reduce the high rate of breast cancer mortality in women. The purpose of this study was to describe the detection histories of women with breast cancer and to identify factors related to the method of detection. During the period 1988–90, 3,197 women with invasive breast cancer, identified through the Wisconsin (United States) tumor registry, were interviewed. The method of cancer detection (classified as self, screening mammography, or clinical breast examination [CBE]) was analyzed using polychotomous logistic regression. Fifty-five percent (1,754/3,197) of the women found their own cancers, while 35 percent (1,122/3,197) were detected by screening mammography. Compared with self-detection, the likelihood of non-localized disease was significantly lower for tumors detected by mammography (odds ratio [OR]=0.3, 95 percent confidence interval [CI]=0.2–0.4) and CBE (OR=0.6, CI=0.4–0.7). The likelihood of cancer being detected by screening mammography increased with increasing age, education, number of prior mammograms, family history, and body mass index (weight/height2) (BMI). Women in the highest BMI quintile were 2.3 times (CI=1.7–3.0) more likely than women in the lowest BMI quintile to have their cancers diagnosed by mammography. This association most likely results from breast tumors being more difficult to palpate in heavier women.
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  • 9
    ISSN: 1573-7225
    Keywords: Breast cancer ; physical activity ; United States ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have used data from a large population-based case-control study inthe United States to evaluate the effect of occupational physical activity onbreast cancer risk. Women diagnosed with breast cancer identified from fourstate cancer registries, and controls randomly selected from lists oflicensed drivers or Medicare beneficiaries, were interviewed by telephone forinformation on usual occupation and other factors. We classified usualoccupation into one of four categories of physical activity. After excludingsubjects for whom a strength rating could not be assigned, we had a finalsample size of 4,863 cases and 6,783 controls. Using conditional logisticregression models, we calculated adjusted odds ratios (OR) and 95 percentconfidence intervals (CI) for occupations having light, medium, and heavyactivity compared with sedentary ones. Women with heavy-activity occupationshad a lower risk of breast cancer than women with sedentary jobs (OR = 0.82,CI = 0.63-1.08), as di d women with jobs with medium activity (OR = 0.86, CI= 0.77-0.97) or light activity (OR = 0.92, CI = 0.84-1.01). There was asignificant decreasing trend in the ORs from sedentary to heavy work (P =0.007). Although limited by exposure misclassification, these data areconsistent with the hypothesis that physical activity reduces the risk ofbreast cancer.
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  • 10
    ISSN: 1573-7225
    Keywords: Breast cancer ; oral contraceptives ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: We examined the association between recent oral contraceptive (OC) use and the risk of breast cancer in data from a large population-based case-control study in the United States. Cases (n=6,751) were women less than 75 years old who had breast cancer identified from statewide tumor registries in Wisconsin, Massachusetts, Maine, and New Hampshire. Controls (n=9,311) were selected randomly from lists of licensed drivers (if aged under 65 years) and from lists of Medicare beneficiaries (if aged 65 through 74 years). Information on OC use, reproductive experiences, and family and medical history was obtained by telephone interview. After adjustment for parity, age at first delivery, and other risk factors, women who had ever used OCs were at similar risk of breast cancer as never-users (relative risk [RR]=1.1, 95 percent confidence interval [CI]=10–1.2). Total duration of usealso was not related to risk. There was a suggestion that more recent use was associated with an increased risk of breast cancer; use less than two years ago was associated with an RR of 1.3 (CI=0.9–1.9). However, only among women aged 35 to 45 years at diagnosis was the increase in risk among recent users statistically significantly elevated (RR=2.0, CI=1.1–3.9). Use prior to the first pregnancy or among nulliparous women was not associated with increased risk. Among recent users of OCs, the risk associated with use was greatest among non-obese women, e.g., among women with body mass index (kg/m2) less than 20.4, RR=1.7, CI=1.1–2.8. While these results suggest that, in general, breast cancer risk is not increased substantially among women who have used OCs, they also are consistent with a slight increased risk among subgroups of recent users.
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