Diabetes Medication Use in Association with Survival among Patients of Breast, Colorectal, Lung, or Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Studies suggest that regular use of metformin may decrease cancer mortality. We investigated the association between diabetes medication use and cancer survival. MATERIALS AND METHODS: The current study includes 633 breast, 890 colorectal, 824 lung, and 543 gastric cancer cases identified from participants of two population-based cohort studies in Shanghai. Information on diabetes medication use was obtained by linking to electronic medical records. The associations between diabetes medication use (metformin, sulfonylureas, and insulin) and overall and cancer-specific survival were evaluated using time-dependent Cox proportional hazards models. RESULTS: After adjustment for clinical characteristics and treatment factors, use of metformin was associated with better overall survival among colorectal cancer patients (hazards ratio [HR], 0.55; 95% confidence interval [CI], 0.34 to 0.88) and for all four types of cancer combined (HR, 0.75; 95% CI, 0.57 to 0.98). Ever use of insulin was associated with worse survival for all cancer types combined (HR, 1.89; 95% CI, 1.57 to 2.29) and for the four cancer types individually. Similar associations were seen for diabetic patients. Sulfonylureas use was associated with worse overall survival for breast or gastric cancer (HR, 2.87; 95% CI, 1.22 to 6.80 and HR, 2.05; 95% CI, 1.09 to 3.84, respectively) among diabetic patients. Similar association patterns were observed between diabetes medication use and cancer-specific survival. CONCLUSION: Metformin was associated with improved survival among colorectal cancer cases, while insulin use was associated with worse survival among patients of four major cancers. Further investigation on the topic is needed given the potential translational impact of these findings.

The joint effects of major lifestyle factors on stomach cancer risk among Chinese men: a prospective cohort study / 中华预防医学杂志

Objective@#To investigate the combined impact of lifestyle factors on stomach cancer risk.@*Methods@#We analyzed the data from the Shanghai Men's Health Study (SMHS) (2002-2013). The SMHS was conducted in eight neighborhood communities of urban Shanghai. From 2002 through June 2006, 61 480 residents aged 40 to 74 years old with no history of cancer were recruited. Failure time was the date of stomach cancer incidence, death or date of the last follow-up (December 31, 2013). The first two in-person follow-up surveys were conducted in 2004-2008, and 2008-2011, respectively. Using data on lifestyle, the healthy lifestyle index (HLI) was developed. The following lifestyle factors were included: smoking, alcohol consumption, diet habit, overweighted and physical activity. Cox proportional hazard models were used to evaluate the association of stomach cancer risk with lifestyle factors and HLI.@*Results@#Over 9.28 years' follow-up, 477 incident cases of stomach cancer were identified from 59 503 study participants. Participants with zero, one, two, three, four, and five favorable lifestyle behaviors accounted for 3.44% (n=2 045), 18.14% (n=10 793), 33.68% (n=20 041), 29.43% (n=17 511), 12.82% (n=7 627), and 2.50% (n=1 486), respectively. Among all the five lifestyle factors, smoking and alcohol use were significantly related to stomach cancer risk. The relative risk of stomach cancer was 0.71 (95%CI: 0.57-0.87) for those who never smoked or quitted smoking for no less than 10 years and 0.70 (95%CI: 0.55-0.90) for those who consumed alcohol no more than 14 drinks per week. For each increment of healthy lifestyle index, the relative risk of stomach cancer was 0.86 (95%CI: 0.79-0.95). Compared to men with none or one healthy lifestyle factor, the relative risk for those with four or five was 0.62 (95%CI: 0.46-0.83). When we rebuilt HLI using more categories of each lifestyle factors, the HLI ranged from 0 to 11. For each point increase, the relative risk of stomach cancer was 0.93 (95%CI: 0.89-0.97). Compared those with 0 to 3 points, the relative risk of those with 8 to 11 points was 0.64 (95%CI: 0.47-0.87).@*Conclusion@#In the SMHS, only a small proportion of men adhered to all the five healthy lifestyle factors. Compared to those with none or one healthy lifestyle behaviors, those with five may prevent about 1/3 stomach cancer incidence and the HLI was inversely associated with stomach cancer risk.

Lifestyle-related factors and cancer incidence in men: a public health assessment based on a 'healthy lifestyle score' / 中华流行病学杂志

Objective To evaluate the effects of combined lifestyle-related factors and risk of cancer incidence among adult men in urban Shanghai.Methods Information was obtained from 60 817 men in the Shanghai Men' s Health Study (2002-2006) program and 2033 incident cancers who were confirmed at the end of 2009.A healthy lifestyle score (HLS) system was developed,based on five lifestyle-related factors,and participants were scored one point for each of the healthy behaviour:never smoked,alcohol intake less than 1 drink/day,under normal weight range (18.5-27.9 kg/m2),physical activity (≥ 54 Met-hours/week),fruit and vegetable intake ≥451 g/day,the else would score as zero.The total score would range from zero to five.Cox regression model was used to evaluate the associations between combined lifestyle-related factors and the cancer incidence.Results Compared to men having scores as zero or one,the hazard ratios (95％ confidence intervals) for men with two,three,four,five health behaviour scores were 0.77 (95％CI:0.66,0.90),0.67 (95％CI:0.58,0.78),0.56(95％ CI:0.47,0.65),0.51 (95％ CI:0.42,0.62),respectively.The population attributable risks for cancer incidence was 10.4％ for those having scores less than 3 items.Conclusion Never smoked,moderate alcohol intake,maintaining normal weight,being physically fit,and having enough daily fruit and vegetable intake were associated with lower risk of total cancer incidence in men.Our data showed that healthy lifestyle could significantly benefit the public health programs of the population.

Association of a single nucleotide polymorphism at 6q25.1,rs2046210, with endometrial cancer risk among Chinese women / 癌症

A recent genome-wide association study identified a new susceptibility locus for breast cancer, rs2046210, which is a single nucleotide polymorphism (SNP) located upstream of the estrogen receptor α(ESR1) gene on chromosome 6q25.1. Given that endometrial cancer shares many risk factors with breast cancer and both are related to estrogen exposure and that rs2046210 is in close proximity to the ESR1 gene, we evaluated the association of SNP rs2046210 with endometrial cancer risk among 953 cases and 947 controls in a population-based, case-control study conducted in Shanghai, China. Logistic regression models were used to derive odds ratios (ORs) and 95% confidence intervals (95% CIs) after adjusting for potential confounders. We found that the A allele of rs2046210, linked to an increased risk of breast cancer, was associated with increased but not statistically significant risk of endometrial cancer (OR = 1.16, 95% CI = 0.96-1.41 for the GA and AA genotypes compared with the GG genotype); the association was stronger among post-menopausal women (OR = 1.28, 95% CI = 1.00-1.65). The association tended to be stronger among women with higher or longer estrogen exposure than among women with relatively lower or shorter exposure to estrogen. Our study suggests that rs2046210 may play a role in the etiology of endometrial cancer. Additional studies are needed to confirm our findings.

ABO blood type is associated with endometrial cancer risk in Chinese women / 癌症

ABO blood type has been associated with risk of several malignancies. However, results are not consistent. In this population-based case-control study including 1204 incident endometrial cancer cases and 1212 population controls, we examined the association of self-reported serologic blood type with endometrial cancer risk using a logistic regression model. Women with endometrial cancer were more likely to have blood type A. Compared to women with blood type O, the adjusted odds ratios for endometrial cancer were 1.00 [95% confidence interval (CI), 0.79-1.28] for type B, 1.24 (95% CI, 0.90-1.69) for type AB, and 1.50 (95% CI, 1.19-1.90) for type A. A significant dose-response relationship was observed for cancer risk and level of antigen A (P for trend = 0.0003). The positive association of blood type A with cancer risk was observed regardless of menopausal status, body mass index, oral contraceptive use, or family cancer history. Our results suggest that ABO blood type may be involved in the development of endometrial cancer.

Epidemiological characteristics of obesity and its relation to chronic diseases among middle aged and elderly men / 中华流行病学杂志

Objective To investigate the epidemiological characteristics of obesity and how they related to chronic diseases among middle aged and elderly men in urban Shanghai.Methods A cross-sectional analysis was conducted using data from a baseline survey from an on-going cohort study of 61 500 men between 40-74 of age in urban Shanghai.Study subjects were recruited from 8 communities of an urban district in Shanghai during 2002 to 2006.General obesity was measured by body mass index (BMI≥28) and,central obesity by waist to hip ratio (WHR≥0.9).Unconditional logistic regression model was used to estimate the odds ratio and 95% confidence interval of chronic diseases associated with obesity after adjustment for potential confounding factors.Results The aged-adjusted prevalence rates of overweight,overall obesity and central obesity were 36.8%,7.7% and 49.7% respectively.In this population,66.7% subjects had ever been diagnosed with one or more kinds of chronic diseases,in which hypertension ranked first with an age-adjusted prevalence rate of 26.5%.After mutual adjustment for WHR and BMI,obesity (BMI≥28) appeared to be associated with increased prevalence rates of hypertension,coronary heart disease,gallstone,urinary tract calculus and stroke comparing to men having normal BMI (18.5≤BMI＜24) with ORs ranged from 1.16 to 3.13.However,to the lowest quartile,the ORs associated with the highest WHR were between 1.20 and 1.69 for these 5 diseases.All P values for trend tests were less than 0.05.WHR was positively associated with diabetes,with OR as 2.40 (95% CI:2.14-2.70) for the highest quartile comparing to the lowest quartile.BMI was unrelated to the diabetes prevalence.Prevalence of chronic obstructive pulmonary disease decreased with increasing BMI,but increased with WHR.The corresponding OR was 0.87 (95% CI:0.77-0.98)for the obese men compared to those with normal BMI while 1.26(95%CI:1.14-1.40) for the subjects with the highest WHR comparing to those with the lowest WHR.Conclusion The prevalence rates of hypertension,gallstone,urinary tract calculus,cardiovascular and cerebrovascular diseases were higher in obesity men.Central obesity seemed to be related to high prevalence of diabetes.

A case-control study on genetic polymorphism of CYP17 MspA(1)I and its association with endometrial cancer risk / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To assess whether the polymorphisms of CYP17 MspA(1)I are associated with the susceptibility of endometrial cancer.</p><p><b>METHODS</b>The allelic discrimination of the CYP17A1 gene polymorphisms were assessed with the ABI PRISM 7900 Sequence Detection Systems using TaqMan genotyping assay. Unconditional logistic regression was applied to assess odds ratio and 95% CI and evaluate the association between different genotypes and endometrial cancer development.</p><p><b>RESULTS</b>The frequencies of wild-type, heterozygote and homozygote for the CYP17 MspA(1)I in control women in Shanghai were 17.8%, 49.3% and 32.9%, respectively. No significant difference was found in the distribution of various genotypes of CYP17 MspA(1)I between patients and controls. Pregnancy was associated with reduced risk of endometrial cancer in pre-menopausal women with A2 allele, OR = 0.66, 95% CI: 0.44 approximately 0.99. In post-menopausal women with A2 allele, more pregnancies ( > 2) and shorter time of menstruation ( < or = 32 yrs) were associated with reduced risk of endometrial cancer.</p><p><b>CONCLUSION</b>No significant relationship was found between CYP17 MspA(1)I genotypes and endometrial cancer risk.</p>

Green tea consumption and the risk of endometrial cancer: a population-based case-control study in urban Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To assess the effect of tea consumption on the risk of endometrial cancer.</p><p><b>METHODS</b>In a population based case-control study conducted in urban Shanghai, face-to-face interviews were completed for 995 incidence cases aged 30 - 69 from January 1997 to December 2002 and 1087 controls that frequency-matched to cases on age. Unconditional logistic model was used for analysis.</p><p><b>RESULTS</b>An inverse association was observed in tea drinking and endometrial cancer risk. Compared to non-tea drinkers, regular tea drinkers had reduced risk of endometrial cancer (OR = 0.74; 95% CI: 0.54 - 1.01) in premenopausal women. Green tea had a protective effect on endometrial cancer among non-smoking or non-alcohol drinking women (OR = 0.77, P = 0.0199) and the ORs reduced with the increasing concentration of tea being served (P for trend = 0.0493). The multivariate ORs for drinking green tea < 7 times/week and >or= 7 times/week were 0.90 (95% CI: 0.53 - 1.54) and 0.76 (95% CI: 0.60 - 0.95) with the trend test of P = 0.0163.</p><p><b>CONCLUSION</b>Tea drinking, with green tea in particurlar, seemed to have weak but inverse association with endometrial cancer risk, but this effect of protection might only limit to premenopausal women.</p>