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The article presents the study conducted regarding the role of progesterone receptor (PGR) gene in endometrial cancer risk development in China. The study which collected DNA samples and information from Shanghai Endometrial Cancer Study aims to determine the association of PGR with the cancer risk in the Chinese population. The result shows that the gene is associated with the risk due to the polymorphism in the PGR region.

Green tea is a commonly consumed beverage in China. Epidemiological and animal data suggest tea and tea polyphenols may be preventive against various cancers, including breast cancer. Catechol-O-methyltransferase (COMT) catalyzes catechol estrogens and tea polyphenols. The COMT rs4680 AA genotype leads to lower COMT activity, which may affect the relationship between green tea consumption and breast cancer risk. We evaluated whether regular green tea consumption was associated with breast cancer risk among 3454 incident cases and 3474 controls aged 20-74 y in a population-based case-control study conducted in Shanghai, China during 1996-2005. All participants were interviewed in person about green tea consumption habits, including age of initiation, duration of use, brew strength, and quantity of tea. Odds ratios (OR) and 95% Cl were calculated for green tea consumption measures and adjusted for age and other confounding factors. Compared with nondrinkers, regular drinking of green tea was associated with a slightly decreased risk for breast cancer (OR, 0.88; 95% Cl, 0.79-0.98). Among premenopausal women, reduced risk was observed for years of green tea drinking (P-trend = 0.02) and a dose-response relationship with the amount of tea consumed per month was also observed (P-trend = 0.046). COMT rs4680 genotypes did not have a modifying effect on the association of green tea intake with breast cancer risk. Drinking green tea may be weakly associated with a decreased risk of breast cancer. [ABSTRACT FROM AUTHOR]

Background: Obesity is a major risk factor for endometrial cancer. Obesity, particularly central obesity, is considered as a systemic inflammatory condition and is related strongly to insulin resistance. C-reactive protein (CRP) is the most recognized biologic marker of chronic systematic inflammation, and it is conceivable that the CRP gene may work together with obesity in the development of endometrial cancer.Methods: On the basis of a population-based case-control study in a Chinese population, the authors obtained obesity measurements and data on 6 CRP single-nucleotide polymorphisms (SNPs) from 1046 patients with newly diagnosed endometrial cancer (cases) and from 1035 age frequency-matched controls. The association of the CRP SNPs with endometrial cancer risk and their modification on the association between obesity and endometrial cancer risk were evaluated.Results: Although CRP SNPs alone were not associated with endometrial cancer, the associations of endometrial cancer with central obesity, measured as the waist-to-hip ratio (WHR) and the waist circumference, seemed to be stronger in women who were homozygous for the major allele of reference SNP (rs)1130864 (cytidine [C]/C) than in women who had the C/thymidine (T) and T/T genotypes (interaction test: P = .013 for WHR; P = .083 for waist circumference). When the women were stratified further by menopausal status, the observed interactions persisted mainly in premenopausal women (interaction test: P < .001 for WHR; P = .002 for waist circumference).Conclusions: The current results suggested that, in the Chinese population that was studied, obesity-related insulin resistance and proinflammatory effects may play an important role in endometrial cancer risk, and these effects were modified significantly by the CRP SNP rs1130864. [ABSTRACT FROM AUTHOR]

Abstract Background  Dietary fats and other constituents have been studied extensively in relation to breast cancer risk. Iron, an essential micronutrient with pro-oxidant properties, has received little attention, and specific fats may augment its toxicity. We investigated the effects of iron and fats from various food sources on the risk of breast cancer. Methods  Participants in a population-based case–control study, 3,452 breast cancer cases, and 3,474 age-frequency-matched controls, completed in-person interviews, including a detailed food-frequency questionnaire. Plant- and animal-derived iron and fat intakes were derived from dietary intake data and food composition tables. Unconditional logistic regression models were used to study the independent and interactive effects of different forms of iron and fats on breast cancer risk. Results  Animal-derived (largely heme) iron intake was positively associated with breast cancer risk (P trend P  Conclusions  A high intake of animal-derived (heme) iron may be associated with an increased risk of primary breast cancer in Chinese women, and saturated and mono-unsaturated fats that are also derived from animal sources may augment this effect. Combined reductions in animal-derived iron and fat consumption have the potential to reduce breast cancer risk. [ABSTRACT FROM AUTHOR]

Background Adult obesity is a well-established risk factor for endometrial cancer. However, little is known about the association of endometrial cancer risk with body size early in life and weight change during adulthood. We investigated whether women with greater early-age body size or with greater weight change during adulthood have an increased risk of endometrial cancer.Methods We analysed data from a population-based case–control study of endometrial cancer conducted between 1997 and 2001 in Shanghai, China. Included in this analysis were 832 endometrial cancer cases aged 30–69 years and 846 population controls. Information on weight and height history from adolescence through adulthood was obtained via structured in-person interviews. A logistic regression model was used to derive odds ratios (ORs) and 95% confidence intervals (CIs) for endometrial cancer in association with adolescent and adult adiposity, as well as adult body weight change. All ORs were adjusted for age, education, menstrual status, duration of menstruation, number of pregnancies, oral contraceptive use, and family history of cancer.Results Perceived weights and heights during puberty that were greater than average were associated with a modestly increased risk of cancer. The association for perceived weight was substantially weakened after adjustment for current body mass index (BMI). High BMI at all adult ages significantly predicted endometrial cancer risk, with recent BMI being the strongest predictor. Further analyses disclosed that weight gain during adulthood, particularly during the peri-menopausal period (age 40–50 years), was associated with a significantly elevated risk of endometrial cancer, even among currently non-obese women. Gaining >5 kg between age 40 and 50 was related to ORs of 2.3 (95% CI 1.4–3.9) for women with a BMI < 25 kg/m2 and 2.0 (95% CI 1.3–3.0) for women with BMI ≥ 25 kg/m2.Conclusions Adult weight gain, particularly during the peri-menopausal period, plays a significant role in the development of endometrial cancer risk. [ABSTRACT FROM AUTHOR]

The authors investigated the association between overweight at the time of or soon after cancer diagnosis and survival in a cohort of 1,455 breast cancer patients aged 2564 years. The patients were recruited into the Shanghai Breast Cancer Study (Shanghai, China), a population-based case-control study, between August 1996 and March 1998. The median follow-up time for this cohort was 5.1 years (19962002) after breast cancer diagnosis, and 240 deaths were identified. Being overweight at cancer diagnosis or soon afterward, as measured by body mass index (BMI; weight (kg)/height (m)2), was associated with poorer overall survival and disease-free survival. Five-year survival rates were 86.5%, 83.8%, and 80.1% for subjects whose BMIs were <23.0, 23.024.9, and =25.0, respectively (p = 0.02); the corresponding 5-year disease-free survival rates were 81.9%, 78.1%, and 76.6% (p = 0.05). The inverse association between BMI and survival persisted after adjustment for age at diagnosis and other known prognostic factors for breast cancer, including disease stage. The authors found neither waist:hip ratio nor waist circumference to be independently associated with overall survival or disease-free survival. These results suggest that excess weight may be an independent predictor of breast cancer survival among Chinese women. [ABSTRACT FROM AUTHOR]

Abstract Soy and its constituents have been shown in many in vivo and in vitro studies and in some epidemiological studies to have anti-cancer effects. Some soy constituents, however, also stimulate cell proliferation, which has raised concerns in promoting soy intake among breast cancer survivors. To investigate whether soy intake may be associated with breast cancer survival, we evaluated data from a cohort of 1459 breast cancer patients who participated in the Shanghai Breast Cancer Study between 1996 and 1998. Usual soy food intake was assessed using a validated food frequency questionnaire at baseline. The median follow-up time for this cohort of women was 5.2?years. We found that soy intake prior to cancer diagnosis was unrelated to disease-free breast cancer survival (adjusted hazard ratio [HR]=0.99, 95% confidence interval [CI], 0.731.33 for the highest tertile compared to the lowest tertile). The association between soy protein intake and breast cancer survival did not differ according to ER/PR status, tumor stage, age at diagnosis, body mass index (BMI), waist to hip ratio (WHR), or menopausal status. Additionally, the soy-survival association did not appear to vary according to XbaI or PvuII polymorphisms in ER-alpha, or C(14206)T, G(25652)A, or A(50766)G polymorphisms in ER-beta. These data suggest that soyfoods do not have an adverse effect on breast cancer survival. [ABSTRACT FROM AUTHOR]

The authors conducted a population-based case-control study of 832 endometrial cancer cases and 846 frequency-matched controls in Shanghai, China (1997–2001), to examine the association of overall adiposity and body fat distribution with disease risk. Overall adiposity was estimated using weight and body mass index (BMI); upper body fat distribution was evaluated using waist circumference and waist:hip ratio. Overall and upper-body obesity were both associated with an elevated risk of endometrial cancer. Adjusted odds ratios and 95% confidence intervals for highest-versus-lowest quartile comparisons were 2.6 (95% confidence interval (CI): 2.0, 3.5) for weight, 2.9 (95% CI: 2.2, 3.9) for BMI, 4.7 (95% CI: 3.4, 6.4) for waist circumference, and 3.5 (95% CI: 2.6, 4.8) for waist:hip ratio. The positive associations with weight and BMI vanished after results were controlled for waist circumference, while associations with waist circumference and waist:hip ratio persisted after adjustment for BMI. The positive association with upper-body obesity was more pronounced among younger women, women who had never used oral contraceptives, and women with a history of diabetes mellitus (p for multiplicative interaction < 0.05). Upper-body obesity was related to increased risk among women with low BMI. These results suggest that obesity, particularly upper-body fat deposition, is associated with an increased risk of endometrial cancer. [ABSTRACT FROM AUTHOR]

Summary Methylenetetrahydrofolate reductase (MTHFR) regulates the intracellular folates pool for DNA synthesis and methylation. Sequence variations in MTHFR (nucleotides 677 (C?T) and 1298 (A?C)) result in allozymes with decreased activity. The 677TT genotype is associated with increased toxicity of methotrexate and increased clinical response to 5-fluorouracil in treatment of cancers including breast cancer. We evaluated MTHFR genotypes and breast cancer survival in a cohort of 1067 Chinese women diagnosed with breast cancer between 1996 and 1998 who received surgery and chemotherapy. Life table method was used to calculate 5-year survival rates. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) after adjusting for potential confounding factors. Median follow-up time was 5.2 years; 5-year survival was 84.6%. Sixty-six percent carried a 677T allele and 31% carried a 1298 C allele. We found that overall 5-year breast cancer survival did not differ significantly across all genotypes (85.3% for 677 CC and 83.8% for 677TT; 83.8% for 1298 AA and 79.1% for 1298 CC). However, carrying the 677T allele was associated with non-significant increased risk of death for subjects with late stage disease (stages III–IV) (HR=1.80, 95% CI: 0.79–4.14 for TT vs. CC, p for trend=0.15), particularly among those who had survived past the second year (HR=2.97, 95% CI: 1.10–7.98, p for trend=0.04). The A1298C genotypes were not significantly associated with risk of death. This study suggests that the MTHFR C677T polymorphisms may affect long-term survival from advanced breast cancer. [ABSTRACT FROM AUTHOR]

Quality of life (QOL) has become an integral part of the modern assessment of cancer treatment in Western society. However, little is known about the QOL of Chinese breast cancer survivors. To evaluate the long-term impact of medical and socio-demographic factors on survivors' QOL, we conducted a population-based study of 1065 breast cancer survivors in Shanghai, China. The mean age at diagnosis was 48.1 years and the median survival time was 4.3 years for the study participants. The Generic Quality of Life Inventory was used to assess survivors' QOL. Multiple linear regression models were employed to analyze the associations of QOL outcomes with socio-demographic and medical factors. The results revealed that recurrence status, time since diagnosis, marital status, income and education all had an independent, significant association with overall QOL and differential domains of QOL. Age at diagnosis exhibited a dual effect on QOL, positively associated with material well-being and negatively associated with physical well-being. Stage of disease was only associated with social well-being, while the type of surgery was related to material well-being alone. No associations between QOL and chemotherapy or radiotherapy were found. Further, analyses by survival intervals suggested a domain-specific order of recovery of QOL after cancer treatment. These results fill gaps in the limited literature, and provide valuable information for physicians to target the specific needs of Chinese women with breast cancer, choose appropriate interventions at the optimal time, and develop strategies accordingly in terms of improvement of patient's QOL. [ABSTRACT FROM AUTHOR]

The use of complementary and alternative medicine (CAM) has been rapidly increasing among cancer patients. The aim of this study is to evaluate the prevalence and patterns of CAM use, particularly patients’ intentions and their perceived effectiveness of using Chinese herbal medicine (CHM), as well as the relations between the herbal medicine use and demographic and clinical factors among Chinese women with breast cancer. We analyzed the data from a population-based sample of 1065 breast cancer women in urban Shanghai. Patients’ average age at diagnosis was 48.1 years and the median time from the initial diagnosis to the follow-up survey was 4.3 years. Overall, 98% of patients had used at least one form of CAM therapy after diagnosis of breast cancer. The most popular CAM modality was traditional Chinese medicine (86.7%), followed by the use of supplements (84.8%), physical exercises (65.5%), and support group attendance (16.6%). CHM was used by 86.4% of patients, while acupuncture was used only by 4.9% of patients. Treating cancer (81.5%) was the most common intentions of using CHM. Other cited intentions included enhancing the immune system (12%), preventing metastasis of cancer or managing other discomforts (7.9%), and lessening menopausal symptoms (4.7%). The majority of patients reported that they had benefited from the use of CHM. Patients who were younger, married, had higher education or income, received chemotherapy or radiotherapy, or had recurrence/metastasis of cancer tended to use CHM more frequently than other patients. The relations between patient characteristics and use of CHMs varied with users’ intentions. Given the high prevalence of CAM use among breast cancer patients, research is urgently needed to systematically evaluate the efficacy and safety of CAM use, particularly use of herbal medicines. [ABSTRACT FROM AUTHOR]

The purpose of our study was to evaluate the association of menstrual and reproductive factors with the risk of endometrial cancer. In a population-based case-control study conducted in urban Shanghai, in-person interviews were completed for 833 women aged 30–69 years and an equal number of controls frequency-matched to cases by age. All cases were newly diagnosed with endometrial cancer between January 1, 1997 and December 31, 2001. The unconditional logistic regression model was employed to derive the adjusted odds ratios (ORs) of endometrial cancer and 95% confidence intervals (CIs) in relation to menstrual and reproductive factors. Earlier menarche age, particularly among premenopausal women, and later menopausal age were associated with an elevated risk of endometrial cancer. A clear dose-response relation between endometrial cancer risk and years of menstruation was observed (p for trend < 0.01). Compared to women ever having a pregnancy and women ever having had a live birth, respectively, nulligravity and nulliparity were both associated with a more than one-fold elevated risk of endometrial cancer. Both completed (OR = 3.02, 95% CI 1.10–8.32 for women never having a complete pregnancy) and incomplete pregnancy (OR = 0.69, 95%CI 0.55–0.87) conferred a protective effect against endometrial cancer, and the protective effect appeared to increase with total number of pregnancies (p for trend = 0.01). The effect of pregnancy on endometrial cancer remained unchanged with increasing time since the last pregnancy. Stillbirth and age at first pregnancy was unrelated to endometrial cancer risk. Our study suggests that prolonged menstruation was related to an increased risk of endometrial cancer while pregnancy, including induced abortion, reduced the risk of endometrial cancer. © 2003 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Certain polyphenols inhibit the activity of aromatase, a critical enzyme in estrogen synthesis that is coded by the CYP19A1 gene. Consumption of polyphenol-rich foods and beverages, thus, may interact with CYP19A1 genetic polymorphisms in the development of endometrial cancer. The authors tested this hypothesis in the Shanghai Endometrial Cancer Study (1997–2003), a population-based case-control study of 1,204 endometrial cancer cases and 1,212 controls. Dietary information was obtained by use of a validated food frequency questionnaire. Genotypes of CYP19A1 at rs28566535, rs1065779, rs752760, rs700519, and rs1870050 were available for 1,042 cases and 1,035 controls. Unconditional logistic regression models were used to calculate odds ratios and their 95% confidence intervals after adjustment for potential confounding factors. Higher intake of soy foods and tea consumption were both inversely associated with the risk of endometrial cancer, with odds ratios of 0.8 (95% confidence interval: 0.6, 1.0) for the highest versus the lowest tertiles of intake of soy and 0.8 (95% confidence interval: 06, 0.9) for ever tea consumption. The association of single nucleotide polymorphisms rs1065779, rs752760, and rs1870050 with endometrial cancer was modified by tea consumption (pinteraction CYP19A1 genetic polymorphisms on the development of endometrial cancer. [ABSTRACT FROM AUTHOR]