Predictors of genetic beliefs toward cancer risk perceptions among adults in the United States: Implications for prevention or early detection.

The objective of this study is to assess predictors of genetic beliefs toward cancer risk perceptions among adults, aged 18 years and over, in the United States (US). Data were obtained from the National Cancer Institute's (NCI) Health Information National Trends Survey 2014 (HINTS) 4 Cycle 4. Bivariate and multivariable logistic regression analyses were conducted to assess factors associated with an individual's beliefs about genetic and cancer risk perceptions. The results showed that African Americans, Non-White Hispanics, Non-Hispanic Asians, individuals with a high school education or less, and annual household incomes less than $20,000 and do not believe that health behaviors play some role in determining whether a person will develop cancer was significantly less likely to report that genetics plays at least some role in whether a person will develop cancer. Findings of this study provide an opportunity for genetic counselors to address beliefs about genetics and cancer risk perceptions among minority populations and promote health equity.

Use of consumer wearable devices to promote physical activity among breast, prostate, and colorectal cancer survivors: a review of health intervention studies.

PURPOSE: A growing amount of research has successfully incorporated Fitbit devices and other wearable activity trackers into technology-oriented lifestyle interventions to increase physical activity among cancer survivors. METHODS: The present review of this literature is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from January 1, 2009, through October 16, 2019, were considered. RESULTS: A total of 1726 article citations were identified in PubMed and non-duplicates in CINAHL. After screening the abstracts or full texts of these articles and reviewing the references of previous review articles, we found 13 studies that met the eligibility criteria. Of these, 8 were randomized controlled trials, one was a pre-post-test trial, and 4 were qualitative studies (focus groups, in-depth interviews). The studies focused on breast cancer (n = 8), prostate cancer (n = 2), and colorectal cancer (n = 1), and the remainder focused on more than one cancer site. CONCLUSIONS: Additional research is needed to examine the efficacy of consumer wearable devices in promoting physical activity and weight management among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Cancer survivors show an increase in physical activity when using consumer wearable activity trackers. Increased physical activity plays an important role in alleviating many adverse effects of breast cancer therapy as well as improving morbidity and mortality. Additional research such as clinical trials focused on the development of successful interventions utilizing these devices is warranted.

Home-based physical activity interventions for breast cancer patients receiving primary therapy: a systematic review.

PURPOSE: Breast cancer continues to be the leading cause of cancer in women in the US, so it is important to provide these women with good therapies. However, there are adverse effects to these therapies. Physical activity plays an important role in alleviating these adverse effects of breast cancer therapy. However, the effectiveness of home-based physical activity interventions such as walking programs has not been detailed by prior reviews. METHODS: This article reviews articles published to date to examine whether home-based physical activity interventions are effective in improving physical activity and other outcomes among breast cancer patients who are undergoing primary therapy for the disease. The present review is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from 1980 through February 28, 2019 were identified. A total of 360 article citations were identified in PubMed and non-duplicates in CINAHL. RESULTS: After screening the abstracts or full texts of these articles and reviewing the references of previous review articles, we found 15 studies that met the eligibility criteria. Four of the studies were pre/post-test trials, 10 were randomized controlled trials, and one study was an observational study. CONCLUSION: Results from studies published to date indicate that among women receiving primary breast cancer therapy, home-based physical activity programs have positive effects on physical functioning and symptoms such as fatigue. Among women receiving adjuvant chemotherapy or radiation therapy, home-based physical activity programs are effective in reducing symptoms and improving physical functioning. Additional studies are needed to clarify the impact of home-based physical therapy interventions on other outcomes including quality-of-life, bone mineral density, cognitive functioning, and chemotherapy-induced peripheral neuropathy.

Electronic Nicotine Delivery Systems or E-cigarettes: American College of Preventive Medicine's Practice Statement.

INTRODUCTION: E-cigarettes or or electronic nicotine delivery systems (ENDS) have rapidly gained popularity in the U.S. Controversy exists about the safety and efficacy of ENDS. The American College of Preventive Medicine's Prevention Practice Committee undertook a consensus-based evidence review process to develop a practice statement for the American College of Preventive Medicine. METHODS: A rapid review of the literature was performed through June 2017 to identify efficacy, patient-oriented harms, and the impact on population health. RESULTS: On an individual level, limited evidence suggests that ENDS may be effective at reducing cigarette use among adult smokers intending to quit. There is insufficient evidence addressing potential long-term harms of ENDS, and limited evidence is available about short-term harms of ENDS and the impact of secondhand exposure. Although ENDS appear safer than combustible cigarettes, they are not without risk. Among youth there is no known benefit and significant concern for harm. On a population level, there may be significant harms associated with ENDS, particularly among youth nonsmokers. The long-term balance of potential benefits versus harms from the individual and population perspectives are unclear. CONCLUSIONS: The American College of Preventive Medicine developed practice recommendations that include encouraging screening for ENDS use, strategies to prevent the initiation of ENDS use in nonsmokers, particularly in youth, adoption of a harm reduction model for smokers intending to quit in those who refuse or fail to quit with evidence-based smoking-cessation methods, recommendations on policy and regulatory strategies to decrease public use of ENDS and regulation of their components, and future research needs.

Reducing Disparities by way of a Cancer Disparities Research Training Program.

BACKGROUND: For minority populations, there is a continuing disparity in the burden of death and illness from cancer. Research to address this disparity should be conducted by investigators who can best understand and address the needs of culturally diverse communities. However, minorities are under-represented in health-related research. The goal of this project was to develop and evaluate an approach to motivating and preparing master's degree students for careers dedicated to cancer disparities research. METHOD: A Cancer Disparities Research Training Program (CDRTP) was initiated in 2010. The program consists of coursework, practicum experiences, and research opportunities. Assessment of the curriculum is based on monitoring achievement of evaluation indicators and included a mixed-method approach with included both quantitative and qualitative approach. RESULTS: In its first three years, the program graduated 20 trainees, all of whom were minorities (18 African Americans and two Asians). When asked about career goals, two-thirds of the trainees indicated interest in pursuing careers in research in cancer prevention and control. The trainees expressed high satisfaction with the courses, instructor, materials, and curriculum. Although trainees had suggestions about course details, evaluations overall were positive. Across focus groups, three recurrent themes emerged regarding activities to enhance the trainee experience: having a wider variety of topics, more guest speakers, and field trips. CONCLUSION: The CDRTP was intended to recruit students - primarily African Americans - into research on prevention and control of cancer disparities. Although final evaluation of the program's overall outcome will not be available for several years, this preliminary evaluation indicates early program success.

Religiosity and Function Among Community-Dwelling Older Adult Survivors of Cancer.

Aspects of religiosity/spirituality are important to health and quality of life of cancer patients. The three components of religiosity of the Duke Religiosity Scale: organizational (religious affiliation and attendance); non-organizational (prayer, meditation, and private study); and intrinsic religiosity (identification with a higher power and integration of spiritual belief into daily life) are used to determine whether religiosity was associated with physical and/or mental functioning among older cancer survivors of the UAB Study of Aging. Church attendance was independently associated with lower ADL and IADL difficulty and fewer depressive symptoms, while intrinsic religiosity was independently associated with lower depression scores.

Geographic distribution of liver and stomach cancers in Thailand in relation to estimated dietary intake of nitrate, nitrite, and nitrosodimethylamine.

It is our working hypothesis that the high rate of the liver and gastric cancers in North and Northeast Thailand is associated with increased daily dietary intake of nitrate, nitrite, and nitrosodimethylamine (NDMA). Samples of fresh and preserved Thai foods were systematically collected and analyzed from 1988 to 1996 and from 1998 to 2005. Consumption frequencies of various food items were determined on the basis of a dietary questionnaire given to 467 adults (212 males and 255 females) from 1998 to 2005. Food consumption data for the preceding and current year were collected and intakes (day, week, and month) of nitrate, nitrite, and NDMA were calculated. The trends in liver and stomach cancer age-standardized incidence rates (ASR) in four regions of Thailand were compared with the dietary intake of nitrate, nitrite, and NDMA in those same geographic regions. Mean daily intakes of nitrate of 155.7 mg/kg, of nitrite of 7.1 mg/kg, and of NDMA of 1.08 microg/kg per day were found. Significant differences in dietary nitrate, nitrite, and NDMA intakes were seen between various Thai regions (P < 0.0001), and these corresponded to the variations in liver and stomach cancer ASR values between the regions. Dietary factors are likely to play key roles in different stages of liver and stomach carcinogenesis in Thailand.

Abnormal mammogram follow-up: do community lay health advocates make a difference?

This pilot study evaluates a community lay health advocate (CLHA) intervention in promoting follow-up for abnormal mammograms among African American women. A controlled trial was implemented at an urban hospital in Atlanta, with 48 women in a CLHA intervention group and 35 in a usual care group. Participants were 25 or older and had an abnormal mammogram between March 25, 2002, and May 2, 2003. Intervention group women received CLHA support including encouragement of timely abnormal mammogram follow-up, reminders of follow-up appointments, identification and removal of barriers to follow-up, and accompaniment to follow-up appointments. Women in the intervention group were significantly more likely to keep their first abnormal mammogram follow-up appointment, all of their scheduled follow-up appointments, and their biopsy or fine needle aspiration appointment. CLHAs are effective in promoting abnormal mammogram followup among African American women and may be an important resource in reducing racial disparities in breast cancer mortality.

Cigarette smoking and primary liver cancer: a population-based case-control study in US men.

OBJECTIVE: Using the case-control data from the Selected Cancers Study, the authors assessed whether cigarette smoking increases the risk of primary liver cancer in the US. METHODS: Cases were men who were pathologically diagnosed with primary liver cancer during 1984-1988, were 31-59 years old, and lived in the areas covered by eight US cancer registries (n=168). Controls were men without a history of primary liver cancer who were selected by random-digit telephone dialing (n=1910). RESULTS: Relative to non-smokers, the risks of liver cancer were 1.85 (95% confidence interval (CI), 1.05-3.25) and 1.49 (95% CI, 0.83-2.68) for former and current smokers, respectively. The adjusted odds ratio (OR) estimates were 0.96, 1.43, 1.80, and 1.87 for smoking for less than 15, 15-24, 25-34 and 35 or more years, respectively (p for trend=0.039). The OR estimates were 1.41 (95% CI, 0.74-2.68), 1.67 (95% CI, 0.93-2.98), and 1.83 (95% CI, 0.89-3.76) for less than 1, 1-2, and 2 or more packs smoked per day (p for trend=0.068). CONCLUSIONS: Cigarette smoking may be a factor that contributes somewhat to the occurrence of primary liver cancer among men in the United States, a country with low risk of liver cancer.

The American College of Radiology's BI-RADS 3 Classification in a Nationwide Screening Program: current assessment and comparison with earlier use.

The Breast Imaging Reporting and Data System allows radiologists to classify lesions as "probably benign-short interval follow-up suggested" (category 3). The purpose of this study is to evaluate the recent use of the category 3 designation in a national cancer detection program. We analyzed data from the National Breast and Cervical Cancer Early Detection Program, a nationwide collaboration between the Centers for Disease Control and Prevention (CDC) and local health agencies that provides cancer screening for low-income, uninsured women. The study population included all women at least 40 years old who had mammograms in the program through September 1999 (n = 826,424). Of the 826,424 mammograms, the percentage classified as category 3 in the initial phase (1991-1996, previously reported, n = 372,760) was 7.7%; of the most recent 453,664 mammograms (1996-1999), 6.0% were given this designation. During the same periods, the percentage of abnormal mammograms decreased from 2.6% to 2.1% and those needing "additional imaging" (category 0) increased from 5.0% to 6.9%. The percentage receiving a category 3, category 0, or abnormal designation decreased with increasing age for each classification. The percentage of category 3 mammograms varied by site from 1.1% to 12.2%. Overall the proportions of category 3 mammograms decreased over time, while requests for additional examinations increased. This suggests that patients were more likely than before to receive additional examinations prior to their final designation. The persistent wide variability in category 3 indicates further education and attention to the use of this category is warranted.

Validity of women's self-reports of cancer screening test utilization in a managed care population.

This study was undertaken to examine the validity of self-reported data on breast and cervical cancer screening behavior. An abbreviated version of the Behavioral Risk Factor Surveillance System telephone survey, including questions on mammography, clinical breast examination (CBE), and Papanicolaou test utilization, was administered to a sample of 480 women aged 40-74 years, enrolled in Kaiser Permanente Colorado for at least 5 years. Screening information reported in the telephone interview was compared with that abstracted from respondents' medical records. The vast majority of women had a mammogram, CBE, and Pap test according to both self-report and medical record. Sensitivity for determining whether her last test was within 2 years (3 years for Pap test) exceeded 95% for all, whereas specificities were <55%. The percentage of overall agreement between self-reported and recorded information was 88.4% (kappa = 0.62) for mammography, 87.9% (kappa = 0.45) for CBE, and 87.2% (kappa = 0.54) for Pap test. Pearson correlations between self-reported and recorded information for specific time interval since most recent mammogram, CBE, and Pap test were 0.72, 0.58, and 0.65, respectively. Correlation increased greatly when time interval was allowed to vary by +/-1 year. In most cases of disagreement, the self-report underestimated the time since last screening. These results suggest that self-reporting of breast and cervical cancer screening is fairly accurate in this managed care population, although women tend to underestimate the time since their last screening.

Breast cancer knowledge, beliefs, and screening behaviors among low-income, elderly black women.

This cross-sectional study explored whether there are age-specific differences in breast cancer-related knowledge, beliefs, and screening behaviors among low-income, elderly black women. Data were collected at senior citizen facilities from 214 black women aged 65 and older. Differences in knowledge, beliefs, and screening practices across three age groups were assessed by chi-square tests. Logistic regression modeling was used to determine the effect of these factors on compliance with American Cancer Society (ACS) screening guidelines. Age was inversely associated with knowledge and screening practices. The youngest group (65-74) was about twice as likely as the oldest group (85 and over) to correctly recognize breast cancer risk factors. About 50% of the oldest women compared to about 20% of the youngest women believed their risk for breast cancer was nil. The oldest group was also least likely to have had a mammogram or clinical breast examination within the past year, as recommended by the ACS. Our results suggest that educating elderly women, especially those 85 and over, about breast cancer and screening may lead to higher compliance with ACS recommendations.

Racial/ethnic differences in the self-reported use of screening mammography.

The efficacy of mammography in reducing breast cancer mortality among women 50-69 years of age has been demonstrated in randomized controlled studies, but many women, especially ethnic minorities, have not been receiving regular mammographic screening. The current study investigated racial/ethnic differences in mammography use and their association with demographic characteristics and other factors. The study population consisted of 4,444 women aged 40 years and older who participated in the 1996 Medical Expenditure Panel Survey. Outcome measures studied included the self-reporting of mammography within the past two years and past year. Multivariate logistic regression modeling was used to examine the effect of race while controlling for other factors. In the univariate analysis, there was virtually no difference between white, black, and Hispanic women in mammography rates within either one or two years. However, multivariate logistic regression suggested that both blacks and Hispanics were more likely than whites to have received recent mammography, as black women were 31% and Hispanic women were 43% more likely than white women to have had a mammogram within the previous two years. Our results suggest that white women are no longer more likely to receive periodic screening mammography than black and Hispanic women, and in fact, might even be less likely to undergo the procedure. This reversal might indicate, at least in part, that programs and other activities to promote screening mammography among ethnic minority women have been successful and should now be expanded to include other women.

Validity of self-reported mammography: examining recall and covariates among older women in a Health Maintenance Organization.

Self-reports of screening are frequently used in place of chart abstraction, particularly in outpatient settings, because they are generally less expensive and frequently provide the only information available. The authors expanded the literature on validation of self-reported mammography by including the validity of recall and by assessing covariates in a setting where women were examined more than once. In 1995, this study validated mammography use in a sample of 949 women aged 50-80 years who were members of a health maintenance organization with centralized automated records of mammographic examinations. The majority of women had had a mammogram within the previous 2 years according to self-reports and records, but self-reported rates exceeded record rates by 8.2%. Sensitivity was high (93.8%), whereas specificity was low (53.6%). The overall agreement between self-reports and records was 82.7%. The kappa value was 0.52, indicating fair agreement beyond chance. Modeling with logistic regression revealed that being a college graduate and having a first-degree relative with breast cancer were significantly associated with accurate recall. Comparison of actual time interval data revealed that disagreements consisted largely of women's underestimates of time since their last screening. These results add to knowledge about the validity of self-reported mammographic screening data in settings where women are screened more than once.

Paternal age and preeclampsia.

BACKGROUND: Paternal aging is associated with premeiotic damage to spermatogonia, a mechanism by which new point mutations are introduced into the gene pool. We hypothesized that paternal age might contribute to preeclampsia. METHODS: We studied the incidence of preeclampsia in 81,213 deliveries surveyed in 1964-1976 in the Jerusalem Perinatal Study. We controlled for maternal age, parity and other risk factors using logistic regression. RESULTS: Preeclampsia was reported in 1303 deliveries (1.6%). Compared with fathers age 25-34 years, the odds ratios (ORs) for preeclampsia were 1.24 (95% confidence interval = 1.05-1.46) for age 35-44 and 1.80 (1.40-2.31) for age 45+. For fathers age <25, the OR was 1.25 (1.04-1.51). Although weaker than maternal age effects, paternal effects were consistent within subgroups of other variables. CONCLUSIONS: These findings support the hypothesis that a modest proportion of preeclampsia might be explained by new mutations acquired from fathers and add to a growing body of evidence for paternal age effects in birth defects, neuropsychiatric disease and neoplasia.

Case-control study evaluating the homogeneity and heterogeneity of risk factors between sinonasal and nasopharyngeal cancers.

Sinonasal cancer and nasopharyngeal cancer may share some risk factors because both are located within the upper aerodigestive tract. They may also have different etiological profiles because of anatomic or pathologic differences. However, the similarities and differences in risk factors have rarely been studied within the same population. We assessed the risk factor profiles of sinonasal and nasopharyngeal cancers, using data from a case-control study. The 2 case groups consisted of men aged 31-59 and diagnosed pathologically with sinonasal cancer (n=70) and nasopharyngeal cancer (n=113), respectively. Controls were men without these cancers and selected from the same areas (n=1910). Logistic regression analysis showed that smoking was a risk factor for both sinonasal [odds ratio (OR)=2.5, 95% confidence interval (CI) 1.1-5.4] and nasopharyngeal cancer (OR=1.8, 95%CI 1.1-3.0). However, ever use of barbiturates without a prescription (OR=4.9, 95%CI 1.7-13.8), working with or around cutting oils on a job (OR=1.9, 95%CI 1.1-3.1) and ever having had sinus infections (OR=2.3, 95%CI 1.1-4.6) were associated with nasopharyngeal cancer only. Having received blood products other than a transfusion (OR=9.1, 95%CI 2.2-37.4) and exposure to a pesticide containing 2,4,5-T (OR=5.9, 95%CI 1.5-23.7) were related to sinonasal cancer only. When data analyses were confined to squamous cell type, smoking and exposure to chlorophenols were related to squamous cell tumors at both sites. However, use of barbiturates and sinus problems other than infection only increased the risk of nasopharyngeal carcinoma. Our study suggests that except for smoking and chlorophenol exposure, which are associated with both sites, the risk factor profiles may differ between sinonasal and nasopharyngeal cancers.

Cervical cancer screening in the workplace. Research review and evaluation.

1. The workplace has become an increasingly important site for disseminating health information and implementing health promotion activities, including cancer screening. 2. Few studies have focused on the benefits and effectiveness of worksite programs for Pap tests. 3. It is unclear from studies conducted to date if cervical cancer screening in the workplace is more likely to prevent cervical cancer than alternative approaches outside the workplace. 4. The occupational and environmental health nurse has an important role to play in worksite cancer screening programs.