| 51. |
- Genkinger, Jeanine M., et al.
(författare)
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Alcohol Intake and Pancreatic Cancer Risk : A Pooled Analysis of Fourteen Cohort Studies
- 2009
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Ingår i: Cancer Epidemiology, Biomarkers and Prevention. - 1055-9965 .- 1538-7755. ; 18:3, s. 765-776
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Forskningsöversikt (refereegranskat)abstract
- Background: Few risk factors have been implicated in pancreatic cancer etiology. Alcohol has been theorized to promote carcinogenesis. However, epidemiologic studies have reported inconsistent results relating alcohol intake to pancreatic cancer risk. Methods: We conducted a pooled analysis of the primary data from 14 prospective cohort studies. The study sample consisted of 862,664 individuals among whom 2,187 incident pancreatic cancer cases were identified. Study-specific relative risks and 95% confidence intervals were calculated using Cox proportional hazards models and then pooled using a random effects model. Results: A slight positive association with pancreatic cancer risk was observed for alcohol intake (pooled multivariate relative risk, 1.22; 95% confidence interval, 1.03-1.45 comparing >= 30 to 0 grams/day of alcohol; P value, test for between-studies heterogeneity = 0.80). For this comparison, the positive association was only statistically significant among women although the difference in the results by gender was not statistically significant (P value, test for interaction = 0.19). Slightly stronger results for alcohol intake were observed when we limited the analysis to cases with adenocarcinomas of the pancreas. No statistically significant associations were observed for alcohol from wine, beer, and spirits comparing intakes of >= 5 to 0 grams/day. A stronger positive association between alcohol consumption and pancreatic cancer risk was observed among normal weight individuals compared with overweight and obese individuals (P value, test for interaction = 0.01). Discussion: Our findings are consistent with a modest increase in risk of pancreatic cancer with consumption of 30 or more grams of alcohol per day. (Cancer Epidemiol Biomarkers Prev 2009;18(3):765-76)
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| 52. |
- Genkinger, Jeanine M., et al.
(författare)
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Coffee, Tea, and Sugar-Sweetened Carbonated Soft Drink Intake and Pancreatic Cancer Risk : A Pooled Analysis of 14 Cohort Studies
- 2012
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Ingår i: Cancer Epidemiology, Biomarkers and Prevention. - 1055-9965 .- 1538-7755. ; 21:2, s. 305-318
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Tidskriftsartikel (refereegranskat)abstract
- Background: Coffee has been hypothesized to have pro- and anticarcinogenic properties, whereas tea may contain anticarcinogenic compounds. Studies assessing coffee intake and pancreatic cancer risk have yielded mixed results, whereas findings for tea intake have mostly been null. Sugar-sweetened carbonated soft drink (SSB) intake has been associated with higher circulating levels of insulin, which may promote carcinogenesis. Few prospective studies have examined SSB intake and pancreatic cancer risk; results have been heterogeneous. Methods: In this pooled analysis from 14 prospective cohort studies, 2,185 incident pancreatic cancer cases were identified among 853,894 individuals during follow-up. Multivariate (MV) study-specific relative risks (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models and then pooled using a random-effects model. Results: No statistically significant associations were observed between pancreatic cancer risk and intake of coffee (MVRR = 1.10; 95% CI, 0.81-1.48 comparing >= 900 to <0 g/d; 237g approximate to 8oz), tea (MVRR = 0.96; 95% CI, 0.78-1.16 comparing >= 400 to 0 g/d; 237g approximate to 8oz), or SSB (MVRR = 1.19; 95% CI, 0.98-1.46 comparing >= 250 to 0 g/d; 355g approximate to 12oz; P value, test for between-studies heterogeneity > 0.05). These associations were consistent across levels of sex, smoking status, and body mass index. When modeled as a continuous variable, a positive association was evident for SSB (MVRR = 1.06; 95% CI, 1.02-1.12). Conclusion and Impact: Overall, no associations were observed for intakes of coffee or tea during adulthood and pancreatic cancer risk. Although we were only able to examine modest intake of SSB, there was a suggestive, modest positive association for risk of pancreatic cancer for intakes of SSB.
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| 53. |
- Gonzalez, Virginia, et al.
(författare)
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Impact of preoperative breast MRI on 10-year survival outcome of patients included in the Swedish randomized multicenter POMB trial
- 2021
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Ingår i: BJS Open. - : Oxford University Press. - 2474-9842. ; 5:5
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACTBackground: The value of preoperative breast magnetic resonance imaging (MRI) as an adjunct technique regarding its effect on re-excision rates has been a subject of discussion. No survival data regarding preoperative breast MRI are available from randomized studies. Methods: Ten-year follow-up of the previous randomized multicentre study (POMB) was reported, evaluating MRI and its effect on disease-free survival (DFS) and overall survival (OS). A total of 440 patients with newly diagnosed breast cancer were randomized to either preoperative MRI (n = 220) group or conventional imaging (n = 220; control) group. Kaplan–Meier plots were used to analyze DFS and OS. Cox regression was used to estimate hazard ratios (HRs). Results: The median follow-up time for each group was 10 years. DFS rates were 85.5% and 80.0% for the MRI and control groups, respectively (P = 0.099). The risk of relapse or death was 46% higher in the control group (HR 1.46, 95% confidence interval 0.93–2.29). OS rates after 10 years were 90.9% and 88.6% for the MRI and control groups, respectively (P = 0.427). The risk of death was 27% higher in the control group (HR 1.27, 95% confidence interval 0.71–2.29). Locoregional, distant, and contralateral recurrence outcomes combined, were increased in the control group (P = 0.048). A subgroup analysis of patients with breast cancer stages I–III showed that preoperative MRI improved DFS compared with conventional imaging but this did not reach statistical significance (P = 0.057). Conclusion: After 10 years of follow-up, preoperative breast MRI as an adjunct to conventional imaging resulted in slightly, but non-significantly, improved DFS and OS.ClinicalTrials.gov Identifier: POMB NCT01859936
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| 54. |
- Granstam Björneklett, Helena, et al.
(författare)
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A randomised controlled trial of support group intervention after breast cancer treatment : Results on anxiety and depression
- 2012
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 51:2, s. 198-207
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious studies have demonstrated that between 20 and 30% of women treated for breast cancer have measurable signs of anxiety and depression compared with 6% in a population of healthy women. Depression has been proposed as a predictive factor for recurrence and survival. The aim of the present study was to evaluate if psychosocial support intervention could influence anxiety and depression during the first year after diagnosis.Material and methodsNewly diagnosed breast cancer patients were randomised between April 2002 and November 2007 and stratified by adjuvant chemotherapy. Of 382 eligible patients, 191 + 191 patients were randomised to intervention group or control group, respectively. Control patients were subjected to standard follow-up routines. The Intervention group had support intervention at the Foundation Lustgarden Malardalen. The rehabilitation lasted one week on a residential basis followed by four days of follow-up two months later. We used the Swedish version of the HAD scale with a cut-off value greater than 10 for clinical symptoms of depression and anxiety.ResultsSupport group intervention lowered anxiety over time (p < 0.001) but depression was unaffected (p = 0.610).ConclusionThis prospective randomised trial of support group intervention in a large homogenous group of breast cancer women showed a statistically significant effect on lowering anxiety over time. No statistically significant effect of intervention could be seen on depression.
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| 55. |
- Granstam Björneklett, Helena, et al.
(författare)
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A randomized controlled trial of a support group intervention on the quality of life and fatigue in women after primary treatment for early breast cancer
- 2012
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 20:12, s. 3325-3334
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:When diagnosed with breast cancer, most women's lives change as well as their perspectives on and appreciation of life. The aim of the present study was to evaluate whether psychosocial support intervention could influence health-related quality of life (HRQOL) and fatigue during the first year after diagnosis.MATERIAL AND METHODS:Of 382 patients with newly diagnosed breast cancer, 191 patients were randomized to an intervention group and 191 patients were randomized to a routine control group. The intervention group received support intervention that lasted 1 week on a residential basis, followed by 4 days of follow-up 2 months later. The support intervention included informative educational parts, relaxation training, mental visualization, and nonverbal communication. HRQOL was measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-BR23 questionnaires and fatigue with the Norwegian version of the fatigue scale at baseline and at 2, 6, and 12 months after intervention.RESULT:There was a time-dependent improvement in both functional and symptom scales between baseline and 12 months as measured by the EORTC QLQ-C30 and BR23 questionnaires and there was a decrease in fatigue between baseline and after 2 months with further improvement up to 12 months in both groups, but there were no differences between the intervention and control groups at any point in time.CONCLUSION:HRQOL improves and symptoms of fatigue decrease over time, but we could not see any additional effect from the rehabilitation program in this setting.
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| 56. |
- Granstam Björneklett, Helena, 1962-, et al.
(författare)
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A randomized controlled trial of support group intervention after breast cancer treatment : Results on sick leave, health care utilization and health economy
- 2013
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 52:1, s. 38-47
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMore than 50% of breast cancer patients are diagnosed before the age of 65. Returning to work after treatment is, therefore, of interest for both the individual and society. The aim was to study the effect of support group intervention on sick leave and health care utilization in economic terms.Material and MethodsOf 382 patients with newly diagnosed breast cancer, 191 + 191 patients were randomized to an intervention group or to a routine control group respectively. The intervention group received support intervention on a residential basis for one week, followed by four days of follow-up two months later. The support intervention included informative-educational sections, relaxation training, mental visualization and non-verbal communication. Patients answered a questionnaire at baseline, 2, 6 and 12 months about sick leave and health care utilization.ResultThere was a trend towards longer sick leave and more health care utilization in the intervention group. The difference in total costs was statistically significantly higher in the intervention group after 12 months (p= 0.0036).Conclusion Costs to society were not reduced with intervention in its present form.
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| 57. |
- Granstam Björneklett, Helena, et al.
(författare)
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Long-term follow-up of a randomized study of support group intervention in women with primary breast cancer
- 2013
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Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 74:4, s. 346-353
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Tidskriftsartikel (refereegranskat)abstract
- Background:Despite a fairly good prognosis, many breast-cancer patients suffer from symptoms such as anxiety, depression and fatigue, which may affect health-related quality of life and may persist for several years. The aim of the present study was to perform a long-term follow-up of a randomized study of support group intervention in women after primary breast cancer treatment.Materials and methods:Three hundred and eighty two women with primary breast cancer were randomized to support group intervention or control group, 181 in each group. Women in the intervention group participated in 1 week of intervention followed by 4 days of follow-up 2 months later. This is a long-term follow-up undertaken, in average, 6.5. years after randomization. Patients answered the questionnaires the European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire (EORTC QLQ-C30) and the Breast Cancer Module questionnaire (BR23), the Hospital Anxiety and Depression Scale (HAD) and the Norwegian version of the fatigue scale (FQ).Results: After adjusting for treatment with chemotherapy, age, marriage, education and children at home, there was a significant improvement in physical, mental and total fatigue (FQ), cognitive function, body image and future perspective (EORTC QLQ C30 and BR23) in the intervention group compared with controls. The proportion of women affected by high anxiety and depression scores were not significantly different between the groups.Conclusion:Support intervention significantly improved cognitive function, body image, future perspective and fatigue, compared with to the findings in the control group.
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| 58. |
- Granstam Björneklett, Helena, 1962-
(författare)
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Support Group Intervention in Primary Breast Cancer : Health-Related Quality of Life, with Special Reference to Anxiety, Depression and Fatigue
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to investigate in a (RCT) the effect of support group intervention in women with primary breast cancer in the short term, and with a long-term follow-up. Women with primary breast cancer were randomized between April 2002 and November 2007 and stratified according to adjuvant treatment with chemotherapy. Of 382 eligible patients, 191+191 patients were randomized to intervention and control groups respectively. Control patients were subjected to standard follow-up procedures. Patients in the intervention group received support intervention at the Foundation of Lustgården Mälardalen during one week followed by four days of follow-up two months later. Patients in intervention and control groups filled in questionnaires at baseline, after 2, 6 and 12 months and in the long-term follow-up after a mean of 6.5 years. In paper I, we studied the effect of the intervention on anxiety and depression measured by the HAD scale and we could show that a significantly lower proportion of women in the intervention group had high anxiety scores compared with women in the control group after 12 months; however, the proportion of women with high depression scores were unaffected. In paper II, we studied the effect of the intervention on fatigue and health-related quality of life (HRQoL) measured by the Norwegian version of the fatigue questionnaire (FQ) and EORTC-QLQ 30 and BR 23.We could not demonstrate any significant effect of the intervention. In paper III, we studied the effect of the intervention on sick-leave, healthcare utilization and the effect of the intervention in economic terms. We used a specially formulated questionnaire. There was a trend towards longer sick leave and more health-care utilization in the intervention group. The difference in total costs was statistically significantly higher in the intervention group after 12 months (p= 0.0036). In paper IV, we studied the long-term effects of the support intervention on anxiety, depression, fatigue and HRQoL. We could show a significant effect of the intervention on cognitive function, body image, future perspective and fatigue, the largest effect was seen among women who received chemotherapy; however, no effects on anxiety and depression were demonstrated.
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| 59. |
- Harris, Holly R., et al.
(författare)
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Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations and breast cancer risk
- 2016
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 138:11, s. 2657-2664
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Tidskriftsartikel (refereegranskat)abstract
- The World Cancer Research Fund/American Association for Cancer Research (WCRF/AICR) has published eight nutrition-related recommendations for the prevention of cancer. However, few prospective studies have examined these recommendations by breast cancer hormone receptor subtype and only one case-control study has included the dietary supplements recommendation in their evaluation. We investigated whether adherence to the WCRF/AICR cancer prevention recommendations was associated with breast cancer incidence, overall and by hormone receptor subtype, in the Swedish Mammography Cohort. Among 31,514 primarily postmenopausal women diet and lifestyle factors were assessed with a self-administered food frequency questionnaire. A score was constructed based on adherence to the recommendations for body fatness, physical activity, energy density, plant foods, animal foods, alcoholic drinks and dietary supplements (score range 0-7). Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs). During 15 years of follow-up 1,388 cases of breast cancer were identified. Women who met six to seven recommendations had a 51% decreased risk of breast cancer compared to women meeting only zero to two recommendations (95% CI = 0.35-0.70). The association between each additional recommendation met and breast cancer risk was strongest for the ER-positive/PR-positive subtype (HR = 0.86; 95% CI = 0.79-0.94), while for the ER-negative/PR-negative subtype the individual recommendations regarding plant and animal foods were most strongly associated with reduced risk. Our findings support that adherence to the WCRF/AICR recommendations reduces breast cancer risk in a population of primarily postmenopausal women. Promoting these recommendations to the public could help reduce breast cancer incidence.
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| 60. |
- Harris, H. R., et al.
(författare)
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Alcohol intake and mortality among women with invasive breast cancer
- 2012
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Ingår i: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 106:3, s. 592-595
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Alcohol intake has consistently been associated with increased breast cancer incidence in epidemiological studies. However, the relation between alcohol and survival after breast cancer diagnosis is less clear.METHODS: We investigated whether alcohol intake was associated with survival among 3146 women diagnosed with invasive breast cancer in the Swedish Mammography Cohort. Alcohol consumption was estimated using a food frequency questionnaire. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs).RESULTS: From 1987 to 2008 there were 385 breast cancer-specific deaths and 860 total deaths. No significant association was observed between alcohol intake and breast cancer-specific survival. Women who consumed 10 g per day (corresponding to approximately 0.75 to 1 drinks) or more of alcohol had an adjusted HR (95% CI) of breast cancer-specific death of 1.36 (0.82-2.26; p(trend) = 0.47) compared with non-drinkers. A significant inverse association was observed between alcohol and non-breast cancer deaths. Those who consumed 3.4-9.9 g per day of alcohol had a 33% lower risk of death compared with non-drinkers (95% CI 0.50-0.90; p(trend) = 0.04).CONCLUSION: Our findings suggest that alcohol intake up to approximately one small drink per day does not negatively impact breast cancer-specific survival and a half drink per day is associated with a decreased risk of mortality from other causes.
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