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1.
Int J Cancer ; 147(3): 876-886, 2020 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-31837003

RESUMEN

Laboratory studies have observed chemopreventive effects of black and green tea on breast cancer development, but few epidemiologic studies have identified such effects. We investigated the association between tea consumption and breast cancer risk using data from 45,744 U.S. and Puerto Rican women participating in the Sister Study. Frequency and serving size of black and green tea consumption were measured at cohort enrollment. Breast cancer diagnoses were reported during follow-up and confirmed by medical record review. Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). We further investigated potential variation according to estrogen receptor (ER) status, menopausal status and body mass index (BMI). Overall, 81.6 and 56.0% of women drank black or green tea, respectively. A total of 2,809 breast cancer cases were identified in the cohort. The multivariable model suggested an inverse association between black (≥5 vs. 0 cups/week: HR = 0.88, 95% CI 0.78, 1.00, p-trend = 0.08) and green tea (≥5 vs. 0 cups/week: HR = 0.82, 95% CI 0.70, 0.95, p-trend < 0.01) consumption and breast cancer risk. We did not observe differences by ER characteristics, menopausal status or BMI. In conclusion, our study suggests drinking at least five cups of green or black tea per week may be associated with decreased breast cancer risk.


Asunto(s)
Neoplasias de la Mama/epidemiología , Hispánicos o Latinos/estadística & datos numéricos , Menopausia/metabolismo , Receptores de Estrógenos/metabolismo , , Adulto , Anciano , Índice de Masa Corporal , Neoplasias de la Mama/metabolismo , Femenino , Humanos , Anamnesis , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Estados Unidos/etnología
2.
Am J Clin Nutr ; 107(5): 799-807, 2018 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-29722851

RESUMEN

Background: Calcium and dairy product intakes have been positively associated with prostate cancer risk. An imbalance in concentrations of calcium and magnesium has been associated with multiple chronic diseases, although few studies have examined the relation with prostate cancer aggressiveness. Objective: The goal of this study was to examine the association between dietary intakes of calcium and magnesium, the calcium-to-magnesium ratio (Ca:Mg), and dairy products and prostate cancer aggressiveness. Design: Dietary intake was assessed with the use of an interviewer-administered modified National Cancer Institute Diet History Questionnaire in 996 African American and 1064 European American men with a recent histologically confirmed diagnosis of prostate cancer from the North Carolina-Louisiana Prostate Cancer Project (PCaP). High-aggressive disease was defined as Gleason sum ≥8, or prostate-specific antigen (PSA) >20 ng/mL, or Gleason score ≥7 and clinical stage T3-T4. The comparison group was all other prostate cancer cases. Logistic regression was used to determine the adjusted ORs and 95% CIs for high-aggressive prostate cancer by tertile of diet and supplement exposures. Results: There was a positive association across tertiles of dietary Ca:Mg intake, with odds of high-aggressive prostate cancer in the upper tertiles as follows-OR for tertile 2 compared with tertile 1: 1.38 (95% CI: 1.01, 1.88); OR for tertile 3 compared with tertile 1: 1.46 (95% CI: 1.06, 2.02). When stratified by race, the positive association was more pronounced in African American men (OR for tertile 3 compared with tertile 2: 1.62; 95% CI: 1.04, 2.53). Men who reported the highest daily consumption of whole-fat milk had a 74% increased odds of high-aggressive prostate cancer compared with non-whole-fat milk drinkers, which was attenuated after adjustment for potential mediating factors, such as saturated fat and Ca:Mg intake. Conclusions: Among both African American and European American men diagnosed with prostate cancer, a higher Ca:Mg and whole-milk intake were associated with higher odds of high-aggressive prostate cancer. This study was registered at www.clinicaltrials.gov as NCT03289130.


Asunto(s)
Calcio de la Dieta/administración & dosificación , Calcio/administración & dosificación , Dieta , Magnesio/administración & dosificación , Leche , Neoplasias de la Próstata/etiología , Adulto , Anciano , Animales , Humanos , Louisiana/epidemiología , Masculino , Persona de Mediana Edad , North Carolina/epidemiología , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/patología , Grupos Raciales , Factores de Riesgo
3.
Prostate ; 76(12): 1053-66, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27271547

RESUMEN

BACKGROUND: Associations between carotenoid intake and prostate cancer (CaP) incidence have varied across studies. This may result from combining indolent with aggressive disease in most studies. This study examined whether carotenoid intake and adipose tissue carotenoid levels were inversely associated with CaP aggressiveness. METHODS: Data on African-American (AA, n = 1,023) and European-American (EA, n = 1,079) men with incident CaP from North Carolina and Louisiana were analyzed. Dietary carotenoid intake was assessed using a detailed-food frequency questionnaire (FFQ), and abdominal adipose tissue samples were analyzed for carotenoid concentrations using high-performance liquid chromatography. Multivariable logistic regression was used in race-stratified analyses to calculate odds ratios (ORs) and 95% confidence intervals (95%CI) comparing high aggressive CaP with low/intermediate aggressive CaP. RESULTS: Carotenoid intake differed significantly between AAs and EAs, which included higher intake of lycopene among EAs and higher ß-cryptoxanthin intake among AAs. Comparing the highest and lowest tertiles, dietary lycopene was associated inversely with high aggressive CaP among EAs (OR = 0.55, 95%CI: 0.34-0.89, Ptrend = 0.02), while an inverse association was observed between dietary ß-cryptoxanthin intake and high aggressive CaP among AAs (OR = 0.56, 95%CI: 0.36-0.87, Ptrend = 0.01). Adipose tissue α-carotene and lycopene (cis + trans) concentrations were higher among EAs than AAs, and marginally significant inverse linear trends were observed for adipose α-carotene (Ptrend = 0.07) and lycopene (Ptrend = 0.11), and CaP aggressiveness among EAs only. CONCLUSIONS: These results suggest that diets high in lycopene and ß-cryptoxanthin may protect against aggressive CaP among EAs and AAs, respectively. Differences in dietary behaviors may explain the observed racial differences in associations. Prostate 76:1053-1066, 2016. © 2016 Wiley Periodicals, Inc.


Asunto(s)
Tejido Adiposo/química , Negro o Afroamericano , Carotenoides/administración & dosificación , Carotenoides/análisis , Neoplasias de la Próstata/epidemiología , Población Blanca , Anciano , beta-Criptoxantina/administración & dosificación , Dieta , Preferencias Alimentarias , Humanos , Louisiana/epidemiología , Licopeno , Masculino , Persona de Mediana Edad , Clasificación del Tumor , North Carolina/epidemiología , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/prevención & control , Estados Unidos/epidemiología
4.
Int Urogynecol J ; 27(9): 1409-14, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26872646

RESUMEN

INTRODUCTION AND HYPOTHESIS: Understanding of pelvic floor disorders among women with gynecological cancer is limited. The objective of this study was to describe the prevalence of pelvic floor disorders in women with suspected gynecological malignancy before surgery. METHODS: A cross-sectional study was performed of women aged ≥18 with a suspected gynecological malignancy who enrolled in the University of North Carolina Health Registry/Cancer Survivorship Cohort (HR/CSC) from August 2012 to June 2013. Demographics were obtained from the HR/CSC self-reported data; clinical data were abstracted from the electronic medical record. Subjects completed validated questionnaires (Rotterdam Symptom Checklist and the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms) to assess bladder and bowel function. RESULTS: Among 186 women scheduled for surgery for gynecological malignancy, 152 (82 %) completed baseline assessments before surgery. Mean age was 58.1 ± 13.3 years, and mean BMI was 33.6 ± 8.8 kg/m(2). The majority of subjects had uterine cancer (61.8 %), followed by ovarian (17.1 %) and cervical (11.1 %). At baseline, the rate of urinary incontinence (UI) was 40.9 %. A third of subjects reported stress UI, and one quarter reported urge UI. The overall rate of fecal incontinence was 3.9 %, abdominal pain was 47.4 %, constipation was 37.7 %, and diarrhea was 20.1 %. When comparing cancer types, there were no differences in pelvic floor symptoms. CONCLUSION: Pelvic floor disorders are common in women with suspected gynecological malignancy at baseline before surgery. Recognizing pelvic floor disorders in the preoperative setting will allow for more individualized, comprehensive care for these women.


Asunto(s)
Neoplasias de los Genitales Femeninos/complicaciones , Trastornos del Suelo Pélvico/complicaciones , Trastornos del Suelo Pélvico/epidemiología , Dolor Abdominal/complicaciones , Dolor Abdominal/epidemiología , Anciano , Estreñimiento/complicaciones , Estreñimiento/epidemiología , Estudios Transversales , Incontinencia Fecal/complicaciones , Incontinencia Fecal/epidemiología , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Sistema de Registros , Encuestas y Cuestionarios , Incontinencia Urinaria/complicaciones , Incontinencia Urinaria/epidemiología
5.
Nutr Cancer ; 68(2): 214-24, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26847416

RESUMEN

The purpose of this study was to determine the relationship between total antioxidant capacity (TAC) from diet and supplements and prostate cancer aggressiveness among 855 African Americans (AA) and 945 European Americans (EA) in the North Carolina-Louisiana Prostate Cancer Project (PCaP). Cases were classified as either high aggressive, low aggressive, or intermediate aggressive. TAC was calculated from the vitamin C equivalent antioxidant capacity of 42 antioxidants measured via food frequency questionnaire. EA reported greater dietary TAC from diet and supplements combined (P < 0.0001). In both minimally and fully adjusted logistic regression models, TAC from diet and supplements combined was associated with a reduced odds of high aggressive prostate cancer in all men, AA and EA: odds ratios for highest vs. lowest level (>1500 vs. <500 mg vitamin C equivalent/day): 0.31 [95% confidence interval (CI): 0.15, 0.67; P-trend < 0.01], 0.28 (95% CI: 0.08, 0.96; P-trend < 0.001), and 0.36 (95% CI: 0.15, 0.86; P-trend = 0.58), respectively. These associations did not appear to differ between AA and EA. These data suggest that greater intake of antioxidants is associated with less aggressive prostate cancer. Additional research is needed to confirm these results and determine the underlying mechanisms.


Asunto(s)
Antioxidantes/administración & dosificación , Neoplasias de la Próstata/patología , Adulto , Negro o Afroamericano , Anciano , Ácido Ascórbico/administración & dosificación , Suplementos Dietéticos , Conducta Alimentaria , Humanos , Modelos Logísticos , Louisiana , Masculino , Persona de Mediana Edad , North Carolina , Neoplasias de la Próstata/dietoterapia , Factores Socioeconómicos , Población Blanca
6.
Br J Nutr ; 115(1): 68-74, 2016 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-26521663

RESUMEN

Prostate cancer is the most common non-cutaneous cancer and the second leading cause of cancer-related mortality among men in the USA. Growing evidence suggests that oxidative stress is involved in the development and progression of prostate cancer. In this study, the association between antioxidants from diet and supplements and biomarkers of oxidative stress in blood (n 278), urine (n 298) and prostate tissue (n 55) were determined among men from the North Carolina-Louisiana Prostate Cancer Project. The association between antioxidant intake and oxidative stress biomarkers in blood and urine was determined using linear regression, adjusting for age, race, prostate cancer aggressiveness and smoking status. Greater antioxidant intake was found to be associated with lower urinary 8-isoprostane concentrations, with a 10% increase in antioxidant intake corresponding to an unadjusted 1·1% decrease in urinary 8-isoprostane levels (95% CI -1·7, -0·3%; P value<0·01) and an adjusted 0·6% decrease (95% CI -1·4, 0·2%; P value=0·16). In benign prostate tissue, thioredoxin 1 was inversely associated with antioxidant intake (P=0·02). No significant associations were found for other blood or urinary biomarkers or for malignant prostate tissue. These results indicate that antioxidant intake may be associated with less oxidative stress among men diagnosed with prostate cancer.


Asunto(s)
Antioxidantes/farmacología , Dieta , Suplementos Dietéticos , Dinoprost/análogos & derivados , Estrés Oxidativo/efectos de los fármacos , Neoplasias de la Próstata/metabolismo , Tiorredoxinas/metabolismo , Adulto , Anciano , Biomarcadores/metabolismo , Dinoprost/orina , Conducta Alimentaria , Humanos , Louisiana , Masculino , Persona de Mediana Edad , North Carolina , Próstata/metabolismo , Próstata/patología
7.
Prostate ; 75(13): 1419-35, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26053590

RESUMEN

BACKGROUND: Controversies remain over the safety and efficacy of vitamin E (i.e., α-tocopherol) supplementation use for the prevention of prostate cancer (CaP); however, associations of different tocopherol forms and CaP aggressiveness have yet to be examined. METHODS: This study examined whether food intake of tocopherols, vitamin E supplement use, and adipose tissue biomarkers of tocopherol were associated with CaP aggressiveness among African-American (AA, n = 1,023) and European-American (EA, n = 1,079) men diagnosed with incident CaP. Dietary tocopherols were estimated from a food frequency questionnaire, supplement use from questionnaire/inventory, and biomarkers from abdominal adipose samples measured using high-performance liquid chromatography. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated from logistic regression comparing high-aggressive CaP to low/intermediate aggressive CaP, adjusting for covariates. RESULTS: Dietary intakes of α-and δ-tocopherol were related inversely to CaP aggressiveness among EAs [OR (95%CI), highest versus lowest quartile: α-tocopherol, 0.34 (0.17-0.69), P(trend) = 0.006; δ-tocopherol, 0.45 (0.21-0.95) P(trend) = 0.007]. Inverse associations between dietary and supplemental α-tocopherol and CaP aggressiveness were observed among AAs, though these did not reach statistical significance [OR (95%CI), highest versus lowest quartile: dietary α-tocopherol, 0.58 (0.28-1.19), P(trend) = 0.20; supplemental α-tocopherol, 0.64 (0.31-1.21) P(trend) = 0.15]. No significant association was observed between adipose tocopherol levels and CaP aggressiveness [OR (95%CI), highest versus lowest quartiles of α-tocopherol for EAs 1.43 (0.66-3.11) and AAs 0.66 (0.27-1.62)]. CONCLUSIONS: The inverse associations observed between dietary sources of tocopherols and CaP aggressiveness suggests a beneficial role of food sources of these tocopherols in CaP aggressiveness.


Asunto(s)
Tejido Adiposo/metabolismo , Suplementos Dietéticos , Invasividad Neoplásica/patología , Neoplasias de la Próstata/metabolismo , Tocoferoles/metabolismo , Negro o Afroamericano , Anciano , Humanos , Louisiana , Masculino , Persona de Mediana Edad , North Carolina , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/prevención & control , Tocoferoles/administración & dosificación , Población Blanca
8.
Patient Educ Couns ; 97(3): 339-46, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25224313

RESUMEN

OBJECTIVE: To examine the association between socio-cultural factors and patient-provider communication and related racial differences. METHODS: Data analysis included 1854 men with prostate cancer from a population-based study. Participants completed an assessment of communication variables, physician trust, perceived racism, religious beliefs, traditional health beliefs, and health literacy. A multi-group structural equation modeling approach was used to address the research aims. RESULTS: Compared with African Americans, Caucasian Americans had significantly greater mean scores of interpersonal treatment (p<0.01), prostate cancer communication (p<0.001), and physician trust (p<0.001), but lower mean scores of religious beliefs, traditional health beliefs, and perceived racism (all p values <0.001). For both African and Caucasian Americans, better patient-provider communication was associated with more physician trust, less perceived racism, greater religious beliefs (all p-values <0.01), and at least high school education (p<0.05). CONCLUSION: Socio-cultural factors are associated with patient-provider communication among men with cancer. No evidence supported associations differed by race. PRACTICE IMPLICATION: To facilitate patient-provider communication during prostate cancer care, providers need to be aware of patient education levels, engage in behaviors that enhance trust, treat patients equally, respect religious beliefs, and reduce the difficulty level of the information.


Asunto(s)
Comunicación , Competencia Cultural , Alfabetización en Salud , Disparidades en Atención de Salud/etnología , Relaciones Médico-Paciente , Neoplasias de la Próstata/etnología , Negro o Afroamericano/estadística & datos numéricos , Distribución por Edad , Estudios de Cohortes , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Louisiana , Masculino , Persona de Mediana Edad , North Carolina , Vigilancia de la Población , Neoplasias de la Próstata/psicología , Factores Socioeconómicos , Confianza , Población Blanca/estadística & datos numéricos
9.
Cancer ; 119(12): 2282-90, 2013 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-23575751

RESUMEN

BACKGROUND: African Americans have a higher incidence of prostate cancer and experience poorer outcomes compared with Caucasian Americans. Racial differences in care are well documented; however, few studies have characterized patients based on their prostate cancer risk category, which is required to differentiate appropriate from inappropriate guideline application. METHODS: The medical records of a population-based sample of 777 North Carolina men with newly diagnosed prostate cancer were studied to assess the association among patient race, clinical factors, and National Comprehensive Cancer Network (NCCN) guideline-concordant prostate cancer care. RESULTS: African Americans presented with significantly higher Gleason scores (P = .025) and prostate-specific antigen levels (P = .008) than did Caucasian Americans. However, when clinical T stage was considered as well, difference in overall risk category only approached statistical significance (P = .055). Across risk categories, African Americans were less likely to have surgery (58.1% versus 68.0%, P = .004) and more likely to have radiation (39.0% versus 27.4%, P = .001) compared with Caucasian Americans. However, 83.5% of men received guideline-concordant care within 1 year of diagnosis, which did not differ by race in multivariable analysis (odds ratio = 0.83; 95% confidence interval = 0.54-1.25). Greater patient-perceived access to care was associated with greater odds of receiving guideline-concordant care (odds ratio = 1.06; 95% confidence interval = 1.01-1.12). CONCLUSIONS: After controlling for NCCN risk category, there were no racial differences in receipt of guideline-concordant care. Efforts to improve prostate cancer treatment outcomes should focus on improving access to the health care system.


Asunto(s)
Atención Integral de Salud/estadística & datos numéricos , Adhesión a Directriz/estadística & datos numéricos , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/terapia , Negro o Afroamericano , Disparidades en Atención de Salud , Humanos , Masculino , Persona de Mediana Edad , North Carolina/epidemiología , Oportunidad Relativa , Guías de Práctica Clínica como Asunto , Antígeno Prostático Específico/análisis , Neoplasias de la Próstata/epidemiología , Factores Socioeconómicos , Población Blanca
10.
Nutr Cancer ; 64(5): 637-42, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22564042

RESUMEN

This study evaluated the relationship between caffeinated and decaffeinated coffee and prostate cancer (CaP) aggressiveness using data from a population-based incident CaP study within the North Carolina-Louisiana Prostate Cancer Project (PCaP). Classification of CaP aggressiveness at diagnosis was based on clinical criteria for 1,049 African-American (AA) and 1,083 Caucasian-American (CA) research subjects. Coffee consumption was measured using a modified NCI Dietary History Questionnaire. No significant associations were found between CaP aggressiveness and consumption of either caffeinated or decaffeinated coffee. The OR for high aggressive CaP among consumers of more than 4 cups per day was 0.92 (95%CI = 0.61, 1.39), compared to non-coffee-drinkers. Results stratified by race found no significant associations and no noticeable trends in either AAs (P for trend = 0. 62) or CAs (P for trend = 0.42). In contrast to a recent report on a select population that has less complete information on CaP aggressiveness suggesting that coffee prevents aggressive CaP, this rapid case ascertainment population-based study, in a biracial population with differing risks of CaP did not demonstrate a protective relationship between high coffee consumption and risk of high aggressive CaP.


Asunto(s)
Adenocarcinoma/diagnóstico , Cafeína/efectos adversos , Café/efectos adversos , Neoplasias de la Próstata/diagnóstico , Adenocarcinoma/epidemiología , Adenocarcinoma/etnología , Adenocarcinoma/patología , Adulto , Negro o Afroamericano , Anciano , Cafeína/administración & dosificación , Cafeína/uso terapéutico , Dieta/efectos adversos , Dieta/etnología , Humanos , Louisiana/epidemiología , Masculino , Registros Médicos , Persona de Mediana Edad , Estadificación de Neoplasias , North Carolina/epidemiología , Pronóstico , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/patología , Riesgo , Encuestas y Cuestionarios , Población Blanca
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