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Background: Night-shift work (NSW) has been suggested as a possible cause of breast cancer, and its association with mammographic density (MD), one of the strongest risk factors for breast cancer, has been scarcely addressed. This study examined NSW and MD in Spanish women.Methods: The study covered 2,752 women aged 45–68 years recruited in 2007–2008 in 7 population-based public breast cancer screening centers, which included 243 women who had performed NSW for at least one year. Occupational data and information on potential confounders were collected by personal interview. Two trained radiologist estimated the percentage of MD assisted by a validated semiautomatic computer tool (DM-scan). Multivariable mixed linear regression models with random screening center–specific intercepts were fitted using log-transformed percentage of MD as the dependent variable and adjusting by known confounding variables.Results: Having ever worked in NSW was not associated with MD [{e^\beta }$:0.96; 95% confidence interval (CI), 0.86–1.06]. However, the adjusted geometric mean of the percentage of MD in women with NSW for more than 15 years was 25% higher than that of those without NSW history (MD>15 years:20.7% vs. MDnever:16.5%;{e^\beta }$:1.25; 95% CI,1.01–1.54). This association was mainly observed in postmenopausal participants ({e^\beta }$:1.28; 95% CI, 1.00–1.64). Among NSW-exposed women, those with ≤2 night-shifts per week had higher MD than those with 5 to 7 nightshifts per week ({e^\beta }$:1.42; 95% CI, 1.10–1.84).Conclusions: Performing NSW was associated with higher MD only in women with more than 15 years of cumulated exposure. These findings warrant replication in futures studies.Impact: Our findings suggest that MD could play a role in the pathway between long-term NSW and breast cancer. Cancer Epidemiol Biomarkers Prev; 26(6); 905–13. ©2017 AACR.

Supplementary table S1. Association of current or recent (stopped NSW

Supplementary Figure 1. Graphic esqueme summarizing the proposed pathways of the association between night-shift work and mammographic density.

Conceptualization, B.P.-G., C.S. and A.M.P.-F.; methodology, B.P.-G., A.M.P.-F. and C.S. validation, B.P.-G., N.F.d.L., R.P.-B. and V.L; formal analysis, A.M.P.-F., R.P.-B. and C.S.; investigation, A.M.P.-F., R.P.-B. and C.S. resources, B.P.-G. and M.P., data curation, A.M.P.-F. and C.S.; writing—original draft preparation, C.S. and B.P.-G.; writing—review and editing R.P.-B., V.L., N.F.d.L., J.J.J.-M. and M.P.; visualization, A.M.P.-F., B.P.-G., R.P.-B. and C.S.; supervision, B.P.-G., M.P. and J.J.J.-M.; project administration, B.P.-G. All authors have read and agreed to the published version of the manuscript., This systematic review discusses long-term NSW and female BC risk, with special attention to differences between pre-and postmenopausal BC, to test the association with recent NSW. The review follows PRISMA guidelines (Prospero registry: CRD42018102515). We searched PubMed, Embase, and WOS for case–control, nested case–control, and cohort studies addressing long-term NSW (≥15 years) as risk exposure and female BC as outcome until 31 December 2020. Risk of bias was evaluated with the Newcastle–Ottawa scale. Eighteen studies were finally in-cluded (eight cohorts; five nested case–control; five case–control). We performed meta-analyses on long-term NSW and BC risk; overall and by menopausal status; a subanalysis on recent long-term NSW, based on studies involving predominantly women below retirement age; and a dose– response meta-analysis on NSW duration. The pooled estimate for long-term NSW and BC was 1.13 (95%CI = 1.01–1.27; 18 studies, I2 = 56.8%, p = 0.002). BC risk increased 4.7% per 10 years of NSW (95%CI = 0.94–1.09; 16 studies, I2 = 33.4%, p = 0.008). The pooled estimate for premenopausal BC was 1.27 (95%CI = 0.96–1.68; six studies, I2 = 32.0%, p = 0.196) and for postmenopausal BC 1.05 (95%CI = 0.90–1.24, I2 = 52.4%; seven studies, p = 0.050). For recent long-term exposure, the pooled estimate was 1.23 (95%CI = 1.06–1.42; 15 studies; I2 = 48.4%, p = 0.018). Our results indicate that long-term NSW increases the risk for BC and that menopausal status and time since exposure might be relevant.

Purpose: The aim of this study was to identify the informational needs of cancer patients and caregivers among a diverse population in Colombia to inform the development of Cancer Navigator, a video-based tool to help cancer patients and their families understand and navigate their treatment. Methods: Seven focus group discussions (FGDs) with n=47 participants and n=80 in-depth interviews (IDIs) were conducted to understand the needs of cancer patients and caregivers regarding their cancer diagnosis, treatment and rehabilitation in the Colombian healthcare system. The information was analyzed using thematic analysis, and informed the development of a series of 18 short infographic and personal narrative videos covering different cancer topics, delivered by local clinicians and survivors; along with a resource guide of local services for food, housing and transportation. A pilot study was conducted to evaluate pre-post depression and anxiety among 22 caregivers and 18 cancer patients at Hospital Méderi (Bogotá, Colombia). Results: Themes/topics identified from the interviews included: treatment effects; cancer etiology; nutrition, physical activity recommendations; psychological/spiritual/emotional support; alternative therapies; warning signs; self-learning cancer tools and administrative procedures. The pilot study showed a mild decrease in anxiety and distress immediately after viewing three videos. The proportion of patients with anxiety levels above normal (>7 on Hospital Anxiety and Depression Scale, HADS) changed from 27% to 15% after viewing (p=0.17), and distress (score >5 on the distress thermometer) decreased from 35% to 22% (p=0.22). Conclusion: The Cancer Navigator video-based educational/support tool shows promise for reducing anxiety and distress among cancer patients and caregivers in Colombia. Next steps will be to test the feasibility and acceptability of the videos among patients, caregivers and healthcare providers at three additional oncology hospitals in Bogotá in 2021. Citation Format: Ana Pedraza-Flechas, Carolyn Taylor, Erika Barrera-Suárez, Luis Perez, Jesica Soto, Alejandra Arias, Andres Patiño, Vera Perales, Ángela Pinzón-Rondon, Ángela Ruíz-Sternberg, Anna Cabanes, Phuongthao Le. Cancer Navigator: A Video-Based Support and Education Tool for Cancer Patients and Their Caregivers [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 60.

[EN] Objectives: The association between breast cancer (BC) and thyroid disorders has been widely explored with unclear results. Mammographic density (MD) is one of the strongest risk factor for BC. This study explores the relationship between thyroid diseases and MD in Spanish women. Materials & methods: This cross-sectional study covered 2883 women aged 47-71 years participating in 7 BC screening programs in 2010. They allowed access to their mammograms, had anthropometrical-measures taken, and answered a telephonic epidemiological interview which included specific questions on thyroid diseases. Percentage of MD was assessed with a semiautomatic-computer tool (DM-scan) by two trained radiologists. We calculated the geometric mean of MD percentages (mean MD). Multivariable mixed linear regression models with random screening-center-specific intercepts were fitted, using log-transformed percentage of MD as dependent variable and adjusting for age, body mass index, menopausal status and other confounders. e(beta) represents the relative increase of mean MD. Results: 13.9% of the participants reported personal history of thyroid disease. MD was not associated to hyperthyroidism (e(beta): 1.05, 95%CI: 0.82-1.36), hypothyroidism (e(beta):1.02, 95%CI: 0.75-1.38), thyroid nodules (e(beta):1.01, 95%CI: 0.85-1.19) or thyroid cancer (e(beta):1.03, 95%CI: 0.56-1.92). However, women with goiter had lower MD (mean MDno-goiter: 13.4% vs mean MDgoiter: 10.6%; e(beta):0.79, 95%CI: 0.64-0.98) and those with Hashimoto thyroiditis had higher MD (mean MDno-thyroiditis: 13.3% vs mean MDthyroidits: 25.8%; e(beta) 95%CI: 1.00-3.77). Conclusion: Functional thyroid disorders were not related to MD. However, MD was lower in women with goiter and higher in those reporting Hashimoto's thyroiditis. These relationships should be confirmed in future studies. (C) 2017 Elsevier Ltd. All rights reserved., This work was supported by the Spanish Ministry of Economy and Competitiveness - Carlos III Institute of Health (ISCIII) (FI14CIII/00013, FIS PI060386 & PS09/0790); the Spanish Federation of Breast Cancer Patients (FECMA 485 EPY 1170-10); the Gent per Gent Fund (EDEMAC Project); and the EPY1306/06 collaboration agreement between Astra-Zeneca and the ISCIII and partially funded by the European Regional Development Fund. None of these funding sources had any role in the study design, in the collection, analysis or interpretation of data. Other members of DDM-Spain/Var-DDM: María Casals, Inmaculada Martínez, María Ederra and Jesús Vioque.

Night shift work can affect hormonal balance, and so might be a risk factor for gynaecological malignancies. This report presents a systematic review on the association between this occupational exposure and the incidence of gynaecological cancers other than breast cancer. We searched for original articles addressing this issue in PubMed/MEDLINE, EMBASE and Web of Science, and used the Newcastle–Ottawa Quality Index to evaluate the methodological quality of those reports selected for review. Globally, we found only six articles, which provided the results of just six research studies: four examined ovarian cancer, two endometrial tumours and two cervical cancer. Our results show that this matter has received scant attention from the research community, and that the little evidence available does not show any clear relationship between night shift work and ovarian, endometrial or cervical cancer. More prospective rigorous studies are needed to evaluate these associations. © 2018 Elsevier B.V.

[EN] Objectives The association between occupational exposures and mammographic density (MD), a marker of breast cancer risk, has not been previously explored. Our objective was to investigate the influence of occupational exposure to chemical, physical and microbiological agents on MD in adult women. Methods This is a population-based cross-sectional study based on 1476 female workers aged 45-65 years from seven Spanish breast cancer screening programmes. Occupational history was surveyed by trained staff. Exposure to occupational agents was assessed using the Spanish job-exposure matrix MatEmESp. Percentage of MD was measured by two radiologists using a semiautomatic computer tool. The association was estimated using mixed log-linear regression models adjusting for age, education, body mass index, menopausal status, parity, smoking, alcohol intake, type of mammography, family history of breast cancer and hormonal therapy use, and including screening centre and professional reader as random effects terms. Results Although no association was found with most of the agents, women occupationally exposed to perchloroethylene (e(beta)=1.51; 95% CI 1.04 to 2.19), ionising radiation (e(beta)=1.23; 95% CI 0.99 to 1.52) and mould spores (e(beta)=1.44; 95% CI 1.01 to 2.04) tended to have higher MD. The percentage of density increased 12% for every 5 years exposure to perchloroethylene or mould spores, 11% for every 5 years exposure to aliphatic/alicyclic hydrocarbon solvents and 3% for each 5 years exposure to ionising radiation. Conclusions Exposure to perchloroethylene, ionising radiation, mould spores or aliphatic/alicyclic hydrocarbon solvents in occupational settings could be associated with higher MD. Further studies are needed to clarify the accuracy and the reasons for these findings., This study was funded by the Spanish Ministry of Economy and Competitiveness - Carlos II Institute of Health (ISCI) (AESI PI15CI/00013); the Scientific Foundation of the Spanish Association Against Cancer (Fundacion Cientifica de la Asociacion Espanola Contra el Cancer (AEC) - EVP-1178/14); the Spanish Public Health Research Fund (FIS PI060386 & PS09/0790); the collaboration agreement between Astra-Zeneca and the ISCI (EPY1306/06) and a grant from the Spanish Federation of Breast Cancer Patients (FECMA 485 EPY 1170-10).

a b s t r a c t Objective: To estimate the prevalence of hepatitis B virus (HBV) infection and vaccine-induced immunity in the region of Madrid, and to analyze their evolution over time. Methods: An observational, analytical, cross-sectional study was carried out in the population aged 16- 80 years between 2008 and 2009. This was the last of four seroprevalence surveys in the region of Madrid. The prevalence of HBV infection and vaccine-induced immunity was estimated using multivariate logistic models and were compared with the prevalences in the 1989, 1993 and 1999 surveys. Results: In the population aged 16-80 years, the prevalence of HBV infection was 11.0% (95% CI: 9.8-12.3) and that of chronic infection was 0.7% (95% CI: 0.5-1.1). The prevalence of vaccine-induced immunity in the population aged 16-20 years was 73.0% (95% CI: 70.0-76.0). Compared with previous surveys, there was a decrease in the prevalence of HBV infection. Conclusions: Based on the prevalence of chronic infection (

[EN] We explored the relationship between sleep patterns and sleep disorders and mammographic density (MD), a marker of breast cancer risk. Participants in the DDM-Spain/var-DDM study, which included 2878 middle-aged Spanish women, were interviewed via telephone and asked questions on sleep characteristics. Two radiologists assessed MD in their left craneo-caudal mammogram, assisted by a validated semiautomatic-computer tool (DM-scan). We used log-transformed percentage MD as the dependent variable and fitted mixed linear regression models, including known confounding variables. Our results showed that neither sleeping patterns nor sleep disorders were associated with MD. However, women with frequent changes in their bedtime due to anxiety or depression had higher MD (e¿:1.53;95%CI:1.04¿2.26)., This work was supported by grants from the Spanish Ministry of Economy and Competitiveness - Carlos III Institute of Health (ISCIII) (FI14CIII/00013, FIS PI060386 & PS09/0790), from the Spanish Federation of Breast Cancer Patients (FECMA 485 EPY 1170-10), Gent per Gent Fund (EDEMAC Project), the EPY1306/06 collaboration agreement between Astra-Zeneca and the ISCIII and partially funded by the European Regional Development Fund (FEDER)

Objetivo: Evaluar la efectividad clínica de intervenciones preventivas sistémicas o tópicas para la mucositis oral secundaria a tratamientos antineoplásicos en adultos con cáncer.Materiales y métodos: Se realizaron búsquedas en Cochrane, MEDLINE, LILACS y SCIELO. Fueron seleccionados ensayos clínicos controlados aleatorizados. Las medidas preventivas debían ser iniciadas el mismo día del inicio del tratamiento antineoplásico. Se incluyeron límites de tiempo en la búsqueda. Inicialmente se revisaron título y resumen de todos los estudios resultantes de la búsqueda y posteriormente en texto completo, la extracción de resultados se realizó por duplicado y las diferencias fueron resueltas por discusión. Se hizó un metanálisis con los estudios que fueron comparables en los programas EPIDAT y REVMAN 5.Resultados: Cuarenta y seis estudios fueron elegibles de los cuales se excluyeron 24. Se evaluaron 15 intervenciones preventivas, de ellas, nueve presentaron algún beneficio, tres intervenciones se presentaron en más de un estudio y fueron comparables para la realización de metanálisis: el amifostine, láser He/Ne y zinc. El zinc fue el único que mostró beneficio; el riesgo de desarrollar mucositis grado 2 en los pacientes que recibieron zinc fue 20% menor que en el grupo control y 73% menor para desarrollar mucositis grado 3.Conclusiones: La administración del zinc, la miel y el sucralfate han mostrado algún beneficio en la prevención o la reducción de la severidad de la mucositis asociada con el tratamiento del cáncer. La calidad y el tamaño de la muestra de estos estudios no son suficientes para recomendar estas intervenciones específicas.[Otero JA, Torres H, Pedraza AM, González AE. Prevención de la mucositis oral secundaria a tratamientos oncológicos en adultos con cáncer: revisión sistemática. Ustasalud 2011; 10: 11 - 28] Objective: To evaluate the effectiveness of interventions for the prevention of oral mucositis in cancer patients antineoplasic treated.Methods: The Cochrane Oral Health Group Trials Register, MEDLINE LILACS y SCIELO were searched. Randomized clinical trials were selected. The preventive measures must have been begun the first day of the antineoplasic treatment. Only were include the studies publish in the last 10 years. Review the title and abstract of each result of the search and extracted the outcome measures and results in duplicate. Meta-analysis was performed when two or more studies use the same intervention and was comparable. The statistical analysis was made by EPIDAT y RevMan 5.Results: Forty six studies were eligible, 24 were excluded. Fifteen interventions were evaluated, of the included interventions in this study nine showed evidence of some benefit for either preventing or reducing the severity of mucositis, three interventions were present in more than one study and comparable for performing meta-analysis: amifostine, laser He/Ne y zinc. The meta-analysis of zinc was the only one that showed beneficial effect in preventing moderate and severe mucositis.Conclusions: Especially administration of zinc, honey and sucralfate had showed some benefit at preventing or reducing the severity of mucositis associated with cancer treatment. Nevertheless the quality and the sample size of these studies are not enough for recommend and specific intervention instead of another.