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Multilevel research and the challenges of implementing genomic medicine

Journal of the National cancer Institute - Monographs 2012年第44期2012卷 112-120页

作者： Khoury, Muin J. Coates, Ralph J. Fennell, Mary L. Glasgow, Russell E. Scheuner, Maren T. Schully, Sheri D. Williams, Marc S. Clauser, Steven B. Office of Public Health Genomics Centers for Disease Control and Prevention Atlanta GA United States Epidemiology and Genomics Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD United States Implementation Science Team Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD United States Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD United States Department of Sociology Department of Health Services Policy and Practice Brown University Providence RI United States Veterans Administration Greater Los Angeles Healthcare System Los Angeles CA United States Clinical Genetics Institute Intermountain Healthcare Salt Lake City UT United States

Advances in genomics and related fields promise a new era of personalized medicine in the cancer care continuum. Nevertheless, there are fundamental challenges in integrating genomic medicine into cancer practice. We explore how multilevel research can contribute to implementation of genomic medicine. We first review the rapidly developing scientific discoveries in this field and the paucity of current applications that are ready for implementation in clinical and public health programs. We then define a multidisciplinary translational research agenda for successful integration of genomic medicine into policy and practice and consider challenges for successful implementation. We illustrate the agenda using the example of Lynch syndrome testing in newly diagnosed cases of colorectal cancer and cascade testing in relatives. We synthesize existing information in a framework for future multilevel research for integrating genomic medicine into the cancer care continuum. © The Author 2012. Published by Oxford University Press. All rights reserved.

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Multicenter study of human papillomavirus and the human papillomavirus vaccine: Knowledge and attitudes among people of African descent

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Infectious Diseases in Obstetrics and Gynecology 2013年第1期2013卷 1-8页

作者： Blackman, Elizabeth Thurman, Natalie Halliday, Darron Butler, Raleigh Francis, Dorita Joseph, Madeline Thompson, Jahzreel Akers, Aletha Andraos-Selim, Cecile Bondzi, Cornelius Taioli, Emanuela Hagan, Kourtney L. Jones, Erin A. Jones, Jade Moss, Cierra M. Smith, Ar'Lena C. Ashing, Kimlin Tam Ragin, Camille C. Cancer Prevention and Control Program Fox Chase Cancer Center 333 Cottman Avenue Philadelphia PA 19111 United States African Caribbean Cancer Consortium United States Department of Epidemiology University of Pittsburgh Graduate School of Public Health Pittsburgh PA United States Department of Obstetrics and Gynecology Princess Margaret Hospital Nassau Bahamas Department of Family Medicine Princess Margaret Hospital Nassau Bahamas Division of Gynecologic Specialties Department of Obstetrics Gynecology and Reproductive Sciences University of Pittsburgh Pittsburgh PA United States Department of Biological Sciences Hampton University Hampton VA United States North Shore Long Island Jewish Health System Feinstein Institute for Medical Research Manhasset NY 350 Community Drive United States Division of Cancer Prevention and Population Science University of Pittsburgh Cancer Institute Pittsburgh PA United States Center of Community Alliance for Research and Education Department of Population Science City of Hope Medical Center Duarte CA United States

Objective. To compare knowledge and attitudes of human papillomavirus (HPV) and the vaccine between different cultures of African descent. Methods. A cross-sectional survey of 555 African-Americans and Afro-Caribbeans residing in the US and the Bahamas (BHM) was conducted. Results. General knowledge about HPV and the HPV vaccine differed between the two countries significantly. Bahamian respondents were less likely to have higher numbers of correct knowledge answers when compared to Americans (Adjusted Odds Ratio [Adj. OR] 0.47, 95% Confidence Interval [CI] 0.30-0.75). Older age, regardless of location, was also associated with answering fewer questions correctly (Adj. OR 0.61, 95% CI 0.40-0.92). Attitudes related to HPV vaccination were similar between the US and BHM, but nearly 80% of BHM respondents felt that children should not be able to receive the vaccine without parental consent compared to 57% of American respondents. Conclusions. Grave lack of knowledge, safety and cost concerns, and influence of parental restrictions may negatively impact vaccine uptake among African-American and Afro-Caribbean persons. Interventions to increase the vaccine uptake in the Caribbean must include medical provider and parental involvement. Effective strategies for education and increasing vaccine uptake in BHM are crucial for decreasing cervical cancer burden in the Caribbean. © 2013 Elizabeth Blackman et al.

关键词： TRANSMISSION of papillomavirus diseases ATTITUDES toward health HUMAN Papillomavirus vaccination CROSS-sectional method HEALTH of African Americans THERAPEUTIC use

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Serum Androgens: Associations With Prostate cancer Risk and Hair Patterning

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Journal of Andrology 2013年第5期18卷

作者： WENDY DEMARK-WAHNEFRIED Ph.D., R.D., L.D.N. SAMUEL M. LESKO MARK R. CONAWAY CARY N. ROBERTSON RICHARD V. CLARK BRUCE LOBAUGH BARBARA J. MATHIAS TARA SMITH STRIGO DAVID F. PAULSON Division of Urology Duke University Medical Center Durham North Carolina School of Public Health Boston University School of Medicine Boston Massachusetts Division of Biometry Duke University Medical Center Durham North Carolina Division of Endocrinology Metabolism and Nutrition Duke University Medical Center Durham North Carolina Program of Cancer Prevention Detection and Control Research Duke University Medical Center Durham North Carolina

ABSTRACT: cancer of the prostate is the leading cancer among American men, yet few risk factors have been established. Hair growth and development are influenced by androgens, and it has long been suspected that prostate cancer also is responsive to these hormones. A blinded, case-control study was undertaken to determine if hair patterning is associated with risk of prostate cancer, as well as specific hormonal profiles. The study accrued 315 male subjects who were stratified with regard to age, race, and case-control status (159 prostate cancer cases/156 controls). Hair-patterning classification and serum levels of total and free testosterone (T), sex hormone binding globulin, and dihydrotestosterone (DHT) were performed. Data indicate that hair patterning did not differ between prostate cancer cases and controls; however, significant hormonal differences were detected between the two groups. Free T was greater among cases than in controls (16.4 ± 6.1 vs. 14.9 ± 4.8 pg/ml, P = 0.02). Conversely, DHT-related ratios were greater among controls ( P = 0.03 for DHT/T and P = 0.01 for DHT/free T). Several strong associations also were found between hormone levels and hair patterning. Men with vertex and frontal baldness had higher levels of free T (16.5 ± 5.5 and 16.2 ± 8.0 pg/ml, respectively) when compared to men with either little or no hair loss (14.8 ± 4.7 pg/ml) ( P = 0.01). Data suggest that increased levels of free T may be a risk factor for prostatic carcinoma. In addition, although no differences in hair patterning were detected between cases and controls within this older population, further research (i.e., prospective trials or case-control studies among younger men) may be necessary to determine if hair patterning serves as a viable biomarker for this disease, especially given the strong association between free T levels and baldness.

关键词： Prostatic neoplasms hormones testosterone baldness

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Regional, provider, and economic factors associated with the choice of active surveillance in the treatment of men with localized prostate cancer

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Journal of the National cancer Institute - Monographs 2012年第45期2012卷 213-220页

作者： Hamilton, Ann S. Wu, Xiao-Cheng Lipscomb, Joseph Fleming, Steven T. Lo, Mary Wang, Dian Goodman, Michael Ho, Alex Owen, Jean B. Rao, Chandrika German, Robert R. Keck School of Medicine University of Southern California Los Angeles CA United States Epidemiology Program School of Public Health LSU Health Sciences Center New Orleans LA United States Department of Health Policy and Management Rollins School of Public Health Emory University Atlanta GA United States Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA United States College of Public Health University of Kentucky Lexington KY United States Department of Radiation Oncology Medical College of Wisconsin Milwaukee WI United States Clinical Research Center American College of Radiology Philadelphia PA United States North Carolina Central Cancer Registry State Center for Health Statistics Raleigh NC United States Division of Cancer Prevention and Control Centers for Disease Control and Prevention Atlanta GA United States

Data on initial treatment of 8232 cases of localized prostate cancer diagnosed in 2004 were obtained by medical record abstraction (including hospital and outpatient locations) from seven state cancer registries participating in the Centers for Disease control and prevention's Breast and Prostate cancer Data Quality and Patterns of Care Study. Distinction was made between men receiving no therapy with no monitoring plan (no therapy/no plan [NT/NP]) and those receiving active surveillance (AS). Overall, 8.6% received NT/NP and 4.7% received AS. Older age at diagnosis, lower clinical risk group, and certain registry locations were significant predictors of use of both AS and NT/NP. AS was also related to having more severe comorbidities, whereas nonwhite race was predicted receiving NT/NP. Men receiving AS lived in areas with a higher number of urologists per 100 000 men than those receiving NT/NP. In summary, physician and clinical factors were stronger predictors of AS, whereas demographic and regional factors were related to receiving NT/NP. Physicians appear reluctant to recommend AS for younger patients with no comorbidities. © The Author 2012. Published by Oxford University Press. All rights reserved.

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Correlates of cervical cancer screening among Vietnamese American women

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Infectious Diseases in Obstetrics and Gynecology 2012年第1期2012卷 617234页

作者： Ma, Grace X. Fang, Carolyn Y. Feng, Ziding Tan, Yin Gao, Wanzhen Ge, Shaokui Nguyen, Cuc Department of Public Health College of Health Professions Temple University Philadelphia PA 19122 1301 Cecil B Moore Avenue 913 Ritter Annex United States Center for Asian Health College of Health Professions Temple University Philadelphia PA 19122 1415 N. Broad Street United States Fox Chase Cancer Center Cancer Prevention and Control Program Philadelphia PA 19111 333 Cottman Avenue United States Department of Biostatistics Fred Hutchinson Cancer Research Center University of Washington Seattle WA 98109 P.O. Box 19024 United States Asian Community Health Coalition Unit A Philadelphia PA 19123 1106 Buttonwood Street United States Vietnamese Women Association of Eastern Region Marlton NJ 08053 3 Coventry Circle East United States

Objective. Vietnamese American women are at the greatest risk for cervical cancer but have the lowest cervical cancer screening rates. This study was to determine whether demographic and acculturation, healthcare access, and knowledge and beliefs are associated with a prior history of cervical cancer screening among Vietnamese women. Methods. Vietnamese women (n = 1450) from 30 Vietnamese community-based organizations located in Pennsylvania and New Jersey participated in the study and completed baseline assessments. Logistic regression analyses were performed. Results. Overall levels of knowledge about cervical cancer screening and human papillomavirus (HPV) are low. Factors in knowledge, attitude, and beliefs domains were significantly associated with Pap test behavior. In multivariate analyses, physician recommendation for screening and having health insurance were positively associated with prior screening. Conclusion. Understanding the factors that are associated with cervical cancer screening will inform the development of culturally appropriate intervention strategies that would potentially lead to increasing cervical cancer screening rates among Vietnamese women. © 2012 Grace X. Ma et al.

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Validation of actigraphy to assess circadian organization and sleep quality in patients with advanced lung cancer

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Journal of Circadian Rhythms 2011年第1期9卷 1-12页

作者： Grutsch, James F. Wood, Patricia A. Du-Quiton, Jovelyn Reynolds, Justin L. Lis, Christopher G. Levin, Robert D. Ann Daehler, Mary Gupta, Digant Quiton, Dinah F.T. Hrushesky, William J.M. Cancer Treatment Centers of America at Midwestern Regional Medical Center Zion IL United States Medical Chronobiological Laboratory Dorn Research Institute WJB Dorn VA Medical Center Columbia SC United States School of Medicine University of South Carolina Columbia SC United States School of Public Health Cancer Prevention and Control Program University of South Carolina Columbia SC United States School of Engineering and Information Technology University of South Carolina Columbia SC United States University of Illinois School of Public Health Chicago IL United States

Background: Many cancer patients report poor sleep quality, despite having adequate time and opportunity for sleep. Satisfying sleep is dependent on a healthy circadian time structure and the circadian patterns among cancer patients are quite abnormal. Wrist actigraphy has been validated with concurrent polysomnography as a reliable tool to objectively measure many standard sleep parameters, as well as daily activity. Actigraphic and subjective sleep data are in agreement when determining activity-sleep patterns and sleep quality/quantity, each of which are severely affected in cancer patients. We investigated the relationship between actigraphic measurement of circadian organization and self-reported subjective sleep quality among patients with advanced lung ***: This cross-sectional and case control study was conducted in 84 patients with advanced non-small cell lung cancer in a hospital setting for the patients at Midwestern Regional Medical Center (MRMC), Zion, IL, USA and home setting for the patients at WJB Dorn Veterans Affairs Medical Center (VAMC), Columbia, SC, USA. Prior to chemotherapy treatment, each patient's sleep-activity cycle was measured by actigraphy over a 4-7 day period and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) ***: The mean age of our patients was 62 years. 65 patients were males while 19 were females. 31 patients had failed prior treatment while 52 were newly diagnosed. Actigraphy and PSQI scores showed significantly disturbed daily sleep-activity cycles and poorer sleep quality in lung cancer patients compared to healthy controls. Nearly all actigraphic parameters strongly correlated with PSQI self-reported sleep quality of inpatients and ***: The correlation of daily activity/sleep time with PSQI-documented sleep indicates that actigraphy can be used as an objective tool and/or to complement subjective assessments of sleep quality in patients with advanced

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Altered host immunity, human T lymphotropic virus type I replication, and risk of adult T-cell leukemia/lymphoma: a prospective analysis from the ATL Cohort Consortium

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Retrovirology 2011年第1期8卷 1-2页

作者： Brenda M Birmann Catherine A Suppan Akihiko Okayama Norma Kim Kokichi Arisawa Elizabeth C Breen Anna B F Carneiro-Proietti Kerstin I Falk Barrie Hanchard Manami Inoue Shoichiro Tsugane Otoniel Martínez-Maza Edward L Murphy Ruth M Pfeiffer Michie Hisada Takashi Sawada Sherri O Stuver Hongchuan Li Nancy E Mueller Channing Laboratory Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Boston Massachusetts 02115 USA Department of Rheumatology Infectious Diseases and Laboratory Medicine University of Miyazaki Miyazaki Japan RTI International Rockville Maryland 20852 USA Department of Preventive Medicine Institute of Health Biosciences Tokushima University Tokushima Japan Cousins Center for Psychoneuroimmunology Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine at UCLA University of California Los Angeles Los Angeles California 90095 USA Hemominas Foundation Belo Horizonte Minas Gerais Brazil Department of Preparedness Swedish Institute for Communicable Disease Control and MTC Karolinska Institute Stockholm Sweden Department of Pathology University of the West Indies Mona Kingston Jamaica Research Center for Cancer Prevention and Screening National Cancer Center Japan Departments of Obstetrics and Gynecology and Microbiology Immunology and Molecular Genetics David Geffen School of Medicine at UCLA and Department of Epidemiology UCLA School of Public Health University of California Los Angeles Los Angeles California 90095 USA Departments of Laboratory Medicine and Epidemiology/Biostatistics University of California San Francisco and Blood Systems Research Institute San Francisco California 94118 USA Division of Cancer Epidemiology and Genetics National Cancer Institute NIH DHHS Bethesda Maryland 20892 USA Current affiliation: Takeda Global Research and Development Center Inc Deerfield Illinois 60015 USA Department of Clinical Development Oncology Product Creation Unit Eisai Co. Ltd Tokyo Japan Department of Epidemiology Boston University School of Public Health Boston Massachusetts 02118 USA Laboratory of Experimental Immunology Cancer and Inflammation Program Center for Cancer Research National Cancer Institute NIH DHHS Frederick MD 21702 USA Basic Research Program SAIC-Frederick In

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Can we use biomarkers in combination with self-reports to strengthen the analysis of nutritional epidemiologic studies?

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Epidemiologic Perspectives and Innovations 2010年第1期7卷 1-9页

作者： Freedman, Laurence S Kipnis, Victor Schatzkin, Arthur Tasevska, Nataa Potischman, Nancy Biostatistics Unit Gertner Institute for Epidemiology Tel Hashomer 52161 Israel Division of Cancer Prevention National Cancer Institute Bethesda MD 20892-7354 6130 Executive Boulevard EPN-3131 United States Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda MD 20892-7232 6120 Executive Boulevard EPS-3040 United States Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda MD 20892-7344 6130 Executive Boulevard EPN-4008 United States

Identifying diet-disease relationships in nutritional cohort studies is plagued by the measurement error in self-reported intakes. The authors propose using biomarkers known to be correlated with dietary intake, so as to strengthen analyses of diet-disease hypotheses. The authors consider combining self-reported intakes and biomarker levels using principal components, Howe's method, or a joint statistical test of effects in a bivariate model. They compared the statistical power of these methods with that of conventional univariate analyses of self-reported intake or of biomarker level. They used computer simulation of different disease risk models, with input parameters based on data from the literature on the relationship between lutein intake and age-related macular degeneration. The results showed that if the dietary effect on disease was fully mediated through the biomarker level, then the univariate analysis of the biomarker was the most powerful approach. However, combination methods, particularly principal components and Howe's method, were not greatly inferior in this situation, and were as good as, or better than, univariate biomarker analysis if mediation was only partial or non-existent. In some circumstances sample size requirements were reduced to 20-50% of those required for conventional analyses of self-reported intake. The authors conclude that (i) including biomarker data in addition to the usual dietary data in a cohort could greatly strengthen the investigation of diet-disease relationships, and (ii) when the extent of mediation through the biomarker is unknown, use of principal components or Howe's method appears a good strategy. © 2010 Freedman et al;licensee BioMed Central Ltd.

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Strengthening the reporting of Genetic RIsk Prediction Studies (GRIPS): Explanation and elaboration

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Journal of Clinical Epidemiology 2011年第8期64卷 e1-e22页

作者： Janssens, A. Cecile J.W. Ioannidis, John P.A. Bedrosian, Sara Boffetta, Paolo Dolan, Siobhan M. Dowling, Nicole Fortier, Isabel Freedman, Andrew N. Grimshaw, Jeremy M. Gulcher, Jeffrey Gwinn, Marta Hlatky, Mark A. Janes, Holly Kraft, Peter Melillo, Stephanie Pencina, Michael J. Ransohoff, David Schully, Sheri D. Seminara, Daniela Winn, Deborah M. Wright, Caroline F. Van Duijn, Cornelia M. Little, Julian Khoury, Muin J. Department of Epidemiology Erasmus University Medical Center 3000 CA Rotterdam PO Box 2040 Netherlands Department of Hygiene and Epidemiology University of Ioannina School of Medicine Ioannina Greece Biomedical Research Institute Foundation for Research and Technology Ioannina Greece Department of Medicine Tufts University School of Medicine Boston MA United States Center for Genetic Epidemiology and Modeling and Tufts CTSI Institute for Clinical Research and Health Policy Studies Tufts Medical Center Boston MA United States Stanford Prevention Research Center Stanford University School of Medicine Stanford CA United States Office of Public Health Genomics Centers for Disease Control and Prevention Atlanta GA United States Tisch Cancer Institute Mount Sinai School of Medicine New York NY United States International Prevention Research Institute Lyon France Department of Obstetrics and Gynecology and Women's Health Albert Einstein College of Medicine Montefiore Medical Center Bronx NY United States Public Population Project in Genomics (P3G) Montreal QC Canada Division of Cancer Control and Population Sciences National Cancer Institute National Institutes of Health Bethesda MD United States Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa ON Canada Department of Medicine University of Ottawa Ottawa ON Canada DeCODE Genetics Reykjavik Iceland Department of Health Research and Policy Stanford University Palo Alto CA United States Fred Hutchinson Cancer Research Center Vaccine and Infectious Disease Institute Division of Public Health Sciences Seattle WA United States Department of Epidemiology Harvard School of Public Health Boston MA United States National Heart Lung and Blood Institute (NHLBI) NHLBI's Framingham Heart Study Framingham MA United States Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA United States Department of Biostatistics Boston University Boston MA United S

The rapid and continuing progress in gene discovery for complex diseases is fuelling interest in the potential application of genetic risk models for clinical and public health practice. The number of studies assessing the predictive ability is steadily increasing, but they vary widely in completeness of reporting and apparent quality. Transparent reporting of the strengths and weaknesses of these studies is important to facilitate the accumulation of evidence on genetic risk prediction. A multidisciplinary workshop sponsored by the Human Genome Epidemiology Network developed a checklist of 25 items recommended for strengthening the reporting of Genetic RIsk Prediction Studies (GRIPS), building on the principles established by prior reporting guidelines. These recommendations aim to enhance the transparency, quality and completeness of study reporting, and thereby to improve the synthesis and application of information from multiple studies that might differ in design, conduct or analysis.

关键词： AUC Area Under the receiver operating characteristic Curve CONSORT Consolidated Standard of Reporting Trials dbGaP Database of Genotype and Phenotype EQUATOR Enhancing the QUAlity and Transparency Of health research GAIN Genetic Association Information Network GRIPS Genetic RIsk Prediction Studies HuGENet Human Genome Epidemiology Network IDI Integrated Discrimination Improvement MeSH Medical Subject Headings REMARK Guidelines for Reporting of tumor MARKer studies SNP single nucleotide polymorphism STARD STAndards for Reporting Diagnostic accuracy STREGA STrenghtening the REporting of Genetic Association studies STROBE Strengthening the Reporting of OBservational studies in Epidemiology

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cancer Survivorship: Today and Tomorrow

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European Journal of cancer Care 2010年第3期19卷

作者： CAROLYN GOTAY Professor Director Prevention and Control Program Cancer Research Center of Hawaii</br>Honolulu HI USA</br>(e-mail: cgotay@crch.hawaii.edu)

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