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Treatment options, selection, and satisfaction among african american and white men with prostate carcinoma in north carolina

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cancer 2000年第2期83卷 320-330页

作者： Wendy Demark-Wahnefried Ph.D. Joellen M. Schildkraut Ph.D. Christophe E. Iselin M.D. Elizabeth Conlisk Ph.D. Andrew Kavee M.A. Tim E. Aldrich Ph.D. Eugene J. Lengerich V.M.D., M.S. Philip J. Walther M.D., Ph.D. David F. Paulson M.D. Division of Urology Duke University Medical Center Durham North Carolina Program of Cancer Prevention Detection and Control Research Duke University Medical Center Durham North Carolina Office of Epidemiology North Carolina Division of Health Promotion Raleigh North Carolina Department of Epidemiology University of North Carolina at Chapel Hill Chapel Hill North Carolina Division of Epidemiology and Statistics University of Utah School of Medicine Salt Lake City Utah

BACKGROUND In the U.S., prostate carcinoma mortality is greatest among African Americans. In North Carolina, the state with the fourth largest population of African Americans, the prostate carcinoma mortality rate is 2.5 times greater among African Americans than among whites and is the highest reported rate for any state in the nation. To explore potential reasons for the racial differential in mortality, a study was undertaken to determine whether differences related to treatment existed between African American and white men who were diagnosed with prostate carcinoma during the period 1994-1995. METHODS Cases were selected from 16 institutions within a region comprising 63 contiguous counties where the overall population was >20% African American. A stratified design was employed to accrue subjects into groups of even size according to race and disease stage (n = 231). A telephone survey was conducted, which assessed treatment options discussed by patients with their physicians, treatment(s) received, factors influencing treatment, satisfaction with treatments discussed and options given, and sociodemographic information. RESULTS All measures related to treatment were consistently associated with stage at diagnosis ( P < 0.001) rather than other variables measured (i.e., race, age, income, comorbidity, education, and residential status). Furthermore, most subjects reported that their physicians presented several treatment options (65%), that they were satisfied with the options presented (90%), and that the physician was the most important factor influencing their treatment decision (57%). CONCLUSIONS These data suggest that African American and white men in North Carolina receive comparable treatment for prostate carcinoma. Therefore, efforts to reduce the racial disparity in mortality should be directed toward lessening the high incidence of later stage disease at diagnosis and exploring potential biologic differences that may increase the risk of more aggressi

关键词： Prostate prostatic neoplasms disease management patient satisfaction African Americans whites

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A field experiment using the foot-in-the-door technique to recruit teen smokers to smoking cessation programs

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Social Marketing Quarterly 1998年第4期4.0卷 61-63页

作者： Bloom, Paul N. Lipkus, Isaac Schwartz-Bloom, Rochelle D. McBride, Colleen Feaganes, John Faculty of Marketing Kenan-Flagler Business School University of North Carolina Chapel Hill United States Department of Psychiatry Program of Cancer Prevention Detection and Control Research Duke University Medical Center United States Duke University Medical Center United States Program of Cancer Prevention Detection and Control Research Duke University Medical Center United States Behavioral Medicine Research Center Duke University Medical Center United States

Behavioral compliance approaches such as the foot-in-the-door technique (Freedman & Fraser, 1966;Pliner, Hart, Kohl & Saari, 1974) have been tested and used in several social marketing programs (Scott, 1977;Ford & Spekman, 1981). However, much more needs to be learned about where and how to use these approaches most effectively. Little is known about the usefulness of these approaches for facilitating changes in behavior within highly resistant target markets. We conducted a field experiment to evaluate the promise of the foot-in-the-door technique (FITD) as a tool for addressing a very troublesome public health problem - how to recruit teenagers into a smoking cessation program. Previous recruitment efforts that have targeted teen smokers without using FITD have had very little success;only 2 to 6 % have agreed to enter programs (Peltier, Telch, & Coates, 1982). We examined whether the FITD approach of requesting teens to engage in a small behavior first, before asking them to engage in larger behaviors (i.e., agreeing to receive and/or help prepare smoking cessation materials), increased the likelihood that they would engage in the larger behaviors.

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Serum Androgens: Associations With Prostate cancer Risk and Hair Patterning

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The Journal of Urology 1998年第1期160卷 266-267页

作者： W. Demark-Wahnefried S.M. Lesko M.R. Conaway C.N. Robertson R.V. Clark B. Lobaugh B.J. Mathias T.S. Strigo D.F. Paulson Divisions of Urology Biometry and Endocrinology Metabolism and Nutrition Program of Cancer Prevention Detection and Control Research Duke University Medical Center Durham North Carolina and School of Public Health Boston University School of Medicine Boston Massachusetts

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Behavioral research contributions and needs in cancer prevention and control: Dietary change

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PREVENTIVE MEDICINE 1997年第5期26卷 S43-S55页

作者： Glanz, K Prevention and Control Program Cancer Research Center of Hawaii University of Hawaii

This paper summarizes key behavioral research contributions to the promotion of healthful diets and identifies the outstanding behavioral research needs that could lead to positive dietary changes in the United States. Nutrition plays an important role in the initiation, promotion, and progression of cancer. Dietary guidelines for health promotion and cancer prevention recommend diets that are lower in fat and higher in fiber, fruits, and vegetables, Behavioral research on dietary change has become more rigorous and sophisticated in the past decade, with noteworthy contributions in four areas: behavioral research within clinical trials, self-help or minimal contact intervention strategies, school nutrition programs and services, and advances in the development of measures. Work in progress includes large-scale randomized intervention trials, with the majority of funding for studies to increase fruit and vegetable consumption. There are many needs for further research. Six priority areas for behavioral research are identified and discussed: (1) determinants of dietary behavior and change processes;(2) policy, environmental, and organizational interventions;(3) studies of dietary change and exercise and interventions with persons at high risk for diet-related cancers;(4) methodological research;(5) research on diffusion and dissemination;and (6) systematic behavioral research on dietary change in clinical trials. A concerted research effort in the area of dietary change has great potential benefits for cancer prevention and control and for public health in general. (C) 1997 Academic Press.

关键词： dietary change nutrition intervention nutrition education behavioral research cancer prevention and control

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A conversation with William M. Haenszel

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STATISTICAL SCIENCE 1997年第2期12卷 108-112页

作者： Hankey, B Cancer Statistics Branch Cancer Control Research Program Division of Cancer Prevention and Control National Cancer Institute National Institutes of Health Rockville MD 20892 United States

William M. Haenszel was born on June 19, 1910, in Rochester, New York. He received a B.A. degree in 1931 and an M.A. degree in 1932, both from the University of Buffalo. He is an elected Fellow of the American Statistical Association, the American Public Health Association and the American Association For the Advancement of Science. He has been awarded a Doctor Honoris Causa en Salud Publica from the Universidad del Valle in Colombia. He has held positions as Secretary of the Statistics Section and member of the governing Council of the American Public Health Association, Chair of the Biometrics Section of the American Statistical Association and member of the Regional Advisory Board of the Eastern North Atlantic Region of the International Biometric Society. During his tenure at the National Institutes of Health (NIH) from 1952 through 1976, he served as Head of the Biometric Section and the Chief of the Biometry Branch at the National cancer Institute. Since leaving the National Institutes of Health he was on staff at the Illinois cancer Council, Professor of Epidemiology at the University of Illinois (he is currently Professor Emeritus) and a consultant to the World Health Organization.

关键词： Biometrics Military recruitment Medical specialists Clinical trials cancer incidence Mammography

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Review of nutritional attitudes and counseling practices of primary care physicians

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AMERICAN JOURNAL OF CLINICAL NUTRITION 1997年第6期65卷 2016-2019页

作者： Glanz, K Prevention and Control Program Cancer Research Center of Hawai''i University of Hawai''i Honolulu 96813 USA

I review major issues covered at the International Workshop on Nutritional Attitudes and Practices of Primary Care Physicians and synthesize some of the key findings presented at this workshop and found in the scientific Literature. After presenting the rationale for managing nutritional problems in primary health care, I discuss the extent of both practice and international differences. Next, the determinants of attitudes and practices, in terms of both individual and system-level factors, are examined. Various types of interventions and the available data regarding their efficacy are reviewed. I then raise a variety of considerations regarding research methodologies and describe work in progress. Finally, suggestions are advanced regarding opportunities for increasing and improving physician efforts to manage nutritional concerns and for pursuing promising future directions for better health through nutrition.

关键词： nutrition counseling nutrition attitudes primary care physicians nutrition education international nutrition

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Use of gene tests to detect hereditary predisposition to cancer: What do we know about cost effectiveness?

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INTERNATIONAL JOURNAL OF cancer 1996年第1期69卷 55-57页

作者： Brown, ML Kessler, LG Applied Research Branch Surveillance Program Division of Cancer Prevention and Control National Cancer Institute Bethesda MD 20892 USA

Mutations in 4 genes associated with DNA repair have been shown to be associated with hereditary non-polyposis colon cancer (HNPCC) in families which display unusually high risk for colorectal cancer. laboratory tests for mutations in these genes will soon be commercially available, raising the possibility that population-wide gene testing to identify individuals with an inherited susceptibility to colorectal cancer could be conducted. The purpose of our report is to explore the economic implications of conducting a program of population-wide screening for HNPCC compared with alternative programs which would be restricted to families already known to be at high risk for HNPCC. Rather than provide a definitive answer to these questions, our purpose is to indicate priority areas of research which need to be conducted before such a definitive analysis can be done. An exploratory analysis has been conducted to determine which factors are most important in determining the cost-effectiveness of a genetic testing program for HNPCC. The base case analysis focuses on current uncertainty about the population prevalence of the HNPCC genotype and phenotype, factors which are central to the cost-effectiveness of population-wide screening. Uncertainty in parameters related to the cost and effectiveness of screening and preventive interventions for HNPCC were explored using additional sensitivity analyses. Favorable levels of cost-effectiveness for population-wide screening are achieved only when the most favorable assumptions about HNPCC prevalence and the cost and effectiveness of screening and preventive interventions are made. (C) 1996 Wiley-Liss, Inc.*

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Corrigendum to “induction of NAD(P)H:quinone reductase by vitamins A, E and C in Colo205 colon cancer cells”

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cancer Letters 1996年第2期101卷 265-265页

作者： Weiqun Wang Carl M. Higuchi Prevention and Control Program Cancer Research Center of Hawaii University of Hawaii 1236 Lauhala Street Honolulu HI 96813 USA

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COMODULATION OF CELLULAR POLYAMINES AND PROLIFERATION - BIOMARKER APPLICATION TO COLORECTAL MUCOSA

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JOURNAL OF CELLULAR BIOCHEMISTRY 1995年第2期57卷 256-261页

作者： HIGUCHI, CM WANG, WQ Prevention and Control Program Cancer Research Center of Hawaii University of Hawaii Honolulu Hawaii 96813

Polyamines are low molecular weight aliphatic amines required for normal cellular growth which are ubiquitously found in all living tissues. Polyamine biosynthesis is known to increase with mitogenesis, and elevated polyamine concentrations are found in hyperproliferative tissues. Quantitation of tissue polyamine content may thus provide a biochemical measure of proliferation, with potential biomarker application to the colonic mucosa where dysregulated epithelial proliferation is associated with cancer risk. This study was performed to validate polyamine analyses as a measure of cellular proliferation, and to preliminarily assess polyamine assay characteristics when applied to clinical samples. Using FHC, a human colonic epithelial cell line, for in vitro experimentation, deoxycholic acid or retinol was added to freshly passaged cultures to either stimulate or inhibit proliferation, respectively. Parallel cultures were then assayed for (1) proliferation by sulforhodamine B staining;and (2) polyamine content by a high-performance liquid chromatographic method. Deoxycholic acid stimulated, and retinol inhibited proliferation in dose-dependent fashion. Polyamine content, specifically the spermidine content and the spermidine/spermine ratio, also increased or decreased in response to culture with deoxycholic acid or retinol, respectively. Significant linear correlations between proliferation and spermidine (r = 0.858, P < 0.001), and with the spermidine/spermine ratio (r = 0.574, P < 0.05) were observed. When quantitative polyamine analyses were applied to human colonic specimens, replicate mucosal sampling revealed a high degree of intra-individual variability, indicating a heterogeneous distribution of polyamines within anatomically confined colonic segments. The results support a role for quantitative polyamine analyses as a correlative measure of colonic epithelial proliferation;however, intraindividual variability may limit the utility of colorectal biomarker meas

关键词： POLYAMINES PROLIFERATION COLORECTAL cancer BIOMARKERS MUCOSA

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Induction of NAD(P)H:quinone reductase by vitamins A, E and C in colo205 colon cancer cells

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cancer LETTERS 1995年第1期98卷 63-69页

作者： Wang, WQ Higuchi, CM Prevention and Control Program Cancer Research Center of Hawaii University of Hawaii 1236 Lauhala Street Honolulu HI 96813 USA

High consumption of fruits and vegetables which are abundant in dietary antioxidants has been linked to a reduced incidence of colorectal cancer. A potential mechanism of dietary anticarcinogenesis involves the induction of detoxifying phase II enzymes, including NAD(P)H:quinone reductase (QR) and glutathione-S-transferase (GST). This study therefore examined the ability of the dietary antioxidant vitamins beta-carotene, alpha-tocopherol and ascorbic acid to induce cellular expression of QR and GST activities in human colon cancer cells. Colo205 cells were cultured in the presence or absence of various concentrations (10(-10) to 10(-5) M) of each antioxidative micronutrient, then assessed for cytosolic QR and GST activities and cell growth. beta-carotene, alpha-tocopherol and ascorbic acid each resulted in dose-dependent increases in QR activity, without adverse effects upon cell proliferation, To investigate whether the ability of beta-carotene to induce QR may be attributable to its conversion to vitamin A and/or to its antioxidant capacity as a carotenoid, retinol, retinoic acid, and lycopene were similarly tested for their capacity for enzyme induction. Although retinol and retinoic acid were both noted to be antiproliferative at higher concentrations (10(-6) to 10(-5) M), both retinoids stimulated QR at physiological concentrations. Lycopene, a carotenoid which is not converted to vitamin A, was devoid of biologic activity. By contrast with the effects upon QR, GST activity was unaffected by treatment with any of the micronutrients tested in this in vitro model. The results support a hypothesis that a high dietary consumption of vitamins A, E and C may confer partial protection against colorectal cancer by the induction of specific detoxifying enzymes. The antioxidant capacity of beta-carotene appears to have less biologic impact vis-a-vis QR induction than its function as a non-toxic reservoir of vitamin A. Measurements of QR activity within the colorectal muc

关键词： induction of phase II detoxifying enzymes NAD(P)H:quinone reductase glutathione-S-transferase antioxidants vitamins colon cancer cells

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