sodium-ethylxanthate and Colorectal-Neoplasms

To assess whether timing of initial post-diagnosis cancer care differs between American Indian and Alaska Native (AI/AN) and non-Hispanic White (NHW) patients, we accessed SEER-Medicare data for breast, colorectal, lung, and prostate cancers (2001-2007). Medicare claims data were examined for initiation of cancer-directed treatment. Overall, AI/ANs experienced longer median times to starting treatment than NHWs (45 and 39 days, p < .001) and lower rates of treatment initiation (HR[95%CI]: 0.86[0.79-0.93]). Differences were largest for prostate (HR: 0.80[0.71-0.89]) and smallest for breast cancer (HR: 0.96[0.83-1.11]). American Indians / Alaska Natives also had elevated odds of greater than 10 weeks between diagnosis and treatment compared with NHWs (OR[95% CI]: 1.37[1.16-1.63]), especially for prostate cancer (OR: 1.41[1.14-1.76]). Adjustment for comorbidity and socio-demographic factors attenuated associations except for prostate cancer. In this insured population, we observed evidence that AI/ANs start cancer therapy later than NHWs. The modest magnitude of delays suggests that they are unlikely to be a determinant of survival disparities.

Topics: Age Factors; Age of Onset; Aged; Aged, 80 and over; Alaska; Alaskan Natives; Breast Neoplasms; Colorectal Neoplasms; Comorbidity; Female; Humans; Indians, North American; Lung Neoplasms; Male; Medicare; Neoplasm Grading; Neoplasms; Prostatic Neoplasms; Residence Characteristics; SEER Program; Sex; Socioeconomic Factors; Time-to-Treatment; United States; United States Indian Health Service; White People

Using a case-control design, we evaluated differences in risk factors for colorectal polyps according to histological type, anatomical site, and severity. Participants were enrollees in the Group Health Cooperative aged 20-79 years who underwent colonoscopy in Seattle, Washington, between 1998 and 2007 and comprised 628 adenoma cases, 594 serrated polyp cases, 247 cases with both types of polyps, and 1,037 polyp-free controls. Participants completed a structured interview, and polyps were evaluated via standardized pathology review. We used multivariable polytomous logistic regression to compare case groups with controls and with the other case groups. Factors for which the strength of the association varied significantly between adenomas and serrated polyps were sex (P < 0.001), use of estrogen-only postmenopausal hormone therapy (P = 0.01), and smoking status (P < 0.001). For lesion severity, prior endoscopy (P < 0.001) and age (P = 0.05) had significantly stronger associations with advanced adenomas than with nonadvanced adenomas; and higher education was positively correlated with sessile serrated polyps but not with other serrated polyps (P = 0.02). Statistically significant, site-specific associations were observed for current cigarette smoking (P = 0.05 among adenomas and P < 0.001 among serrated polyps), postmenopausal estrogen-only therapy (P = 0.01 among adenomas), and obesity (P = 0.01 among serrated polyps). These findings further illustrate the epidemiologic heterogeneity of colorectal neoplasia and may help elucidate carcinogenic mechanisms for distinct pathways.

Topics: Adenoma; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Body Mass Index; Case-Control Studies; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Estrogen Replacement Therapy; Female; Health Behavior; Humans; Logistic Models; Male; Middle Aged; Obesity; Risk Factors; Severity of Illness Index; Sex; Smoking; Socioeconomic Factors

Genome-wide association studies have identified several common single nucleotide polymorphisms (SNP) associated with an increased risk of colorectal cancer (CRC), although they have failed to identify any recessively acting alleles that contribute to disease risk. However, two recent studies have suggested that inbreeding and runs of homozygosity (ROH) increase the risk of developing cancer, perhaps by exposing recessive alleles as a result of autozygosity. To examine these results in a relatively large case-control series, we analyzed samples from a cohort in the United Kingdom comprising 921 colorectal tumor cases and 929 controls. Individuals were genotyped using a 550,000 tagging SNP panel. Additionally, we identified from these SNPs a set of approximately 30,000 SNPs in low pairwise linkage disequilibrium. To determine whether homozygosity was associated with CRC, we performed multiple tests to assess homozygosity at individual SNPs and ROHs in cases and controls. No association was found between CRC and (i) homozygosity at any individual SNP, (ii) overall homozygosity or level of inbreeding, (iii) total length or number of ROHs per individual, or (iv) a ROH at any particular genomic location. In conclusion, our results from a large case-control series do not replicate those of previous studies and suggest that homozygosity/autozygosity is not a major risk factor for CRC in an outbred population.

Topics: Adult; Aged; Case-Control Studies; Cohort Studies; Colorectal Neoplasms; Female; Genetic Predisposition to Disease; Genome, Human; Homozygote; Humans; Male; Middle Aged; Polymorphism, Single Nucleotide; Sex; United Kingdom

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Carcinoma; Colorectal Neoplasms; Ethnicity; Female; Humans; Male; Middle Aged; Sex

To explore gender differences and similarities in the dimensions of quality of life (QOL).. Secondary analysis of the Multidimensional Quality of Life Scale--Cancer Version (MQOLS--CA) data from two different research studies.. Multiple outpatient oncology sites.. The typical female participant (n = 254) was 58 years old (SD +/- 11.3) with 14 years of education, married/partnered (64%), Caucasian (88%), and diagnosed with breast (47%) or colorectal (16%) cancer. The typical male participant (n = 222) was 60 years old (SD +/- 14) with 14.3 years of education, married/partnered (69%), Caucasian (85%), and diagnosed with colorectal (31%) or prostate (13%) cancer.. Factor analytic procedures and reliability testing.. QOL as measured by the MQOLS-CA, gender.. For women, two factors emerged from the analysis procedures-psychosocial well-being (7 items) and physical competence (6 items). For the men, two different factors emerged--vitality (8 items) and personal resources (4 items). None of the cancer-specific items from the MQOLS-CA loaded on any of the factors for either gender.. Measurement of QOL requires gender-specific questions to accurately address the dimensions of the concept of QOL in females and males.. Additional research is warranted to replicate these findings. Gender-specific interventions could then be developed and tested to maximize the QOL of all patients.

Topics: Adaptation, Psychological; Breast Neoplasms; California; Colorectal Neoplasms; Factor Analysis, Statistical; Female; Humans; Male; Middle Aged; Neoplasms; Pain; Prostatic Neoplasms; Psychometrics; Quality of Life; Sex; Surveys and Questionnaires