Search

Purpose The aim of this study was to examine whether use of regular aspirin and/or other non-steroidal anti-inflammatory drugs (NSAIDs) is associated with the development of age-related macular degeneration (AMD). Methods In the California Teachers Study cohort (N = 88,481) we identified diagnoses of AMD up to December 31, 2012 by linkage to statewide hospital discharge records. Aspirin, ibuprofen, other NSAIDs, and acetaminophen use and comprehensive risk factor information were collected via self-administered questionnaires at baseline in 1995–1996 and a follow-up questionnaire in 2005–2006. We employed Cox proportional hazard regression to model AMD risk. Results We did not find any associations between AMD and frequency and duration of aspirin or ibuprofen use reported at baseline. In the subsample with more specific information on medication use, we observed a 20% decrease in risk of AMD among low-dose aspirin users (HR 0.81, 95% CI 0.70–0.95) and a 55% decrease among cyclooxygenase-2 (COX-2) inhibitor users (HR 0.45, 95% CI 0.26–0.78) during 6.3 years of average follow-up. Conclusion The decrease in risk of intermediate- or late-stage AMD among women who reported regular use of low-dose aspirin or specific COX-2 inhibitors suggests a possible protective role for medications with COX-2 inhibitory properties or aspirin at doses used for cardiovascular disease prevention.

Sustained and inadequately controlled hypertension can promote the development of age-related macular degeneration (AMD) through multiple biologic pathways. Epidemiologic studies of high blood pressure, antihypertensive therapies, and the risk of AMD thus far have been inconclusive. However, few studies evaluated risks according to the use of different classes of antihypertensive drugs or took combinations of use into account. We performed a prospective cohort study by linking the California Teachers Study (CTS) cohort (N = 88 481) to statewide hospital discharge records up to December 31, 2012. History of high blood pressure, regular use of antihypertensive medications, and comprehensive risk factor information was collected via self-administered questionnaires at baseline in 1995-1996, and information on specific classes of antihypertensive drugs was provided by a subsample of CTS participants who completed a follow-up questionnaire in 2000. We identified 1762 female teachers with AMD during 14.8 years of follow-up on average. Applying Cox proportional hazard regression, we estimated increased risks of AMD among women treated for hypertension at baseline (HR = 1.15, 95% CI: 1.03, 1.30); the magnitude of the association increased with longer duration of antihypertensive treatment. In the subsample with more specific information on type of medication use, we estimated a 45% increased risk of AMD among women receiving diuretics as monotherapy compared to women with medications more potent than diuretics (HR = 1.45, 95% CI 1.10, 1.90). In women treated with a combination of antihypertensive drugs, we observed no increased risk of AMD for any individual class of drugs.

Parkinson's disease (PD) is consistently observed to occur less frequently in women than men, prompting investigation into whether estrogen protects against neurodegeneration of dopaminergic neurons.We used baseline data in the California Teachers Study, a prospective cohort of women, to investigate whether reproductive factors indicating higher long-term estrogen levels are associated with PD using a nested case-control approach. We identified 228 PD cases and 3349 unaffected controls frequency matched by age and race.Women who reported using combined estrogen/progesterone therapy or progesterone only formulations had a 57% increase in PD risk (OR = 1.57, 95% CI = 1.06, 2.34) compared to never having used HT. Compared to women with menopause at 50-52 years, menopause at younger (35-46 years: OR = 0.59, 95% CI = 0.37, 0.94) and older ages (≥53 years: OR = 0.54, 95% CI = 0.36, 0.83) had lower PD risk. A derived composite estrogen summary score for women's exposure to both endogenous and exogenous estrogens throughout life indicated that women with presumed higher cumulative lifetime levels of estrogen (a score of 3-5) had a significantly reduced PD risk [(OR = 0.57, 95% CI = 0.35, 0.91) relative to those with lower lifetime estrogen exposure or a composite estrogen summary score of 0-1].These results provide some support for the hypothesis that lifelong high estrogen is protective in PD, suggesting that the level and persistence of exposure over the long term may be important in PD risk reduction.

Background: A recent association study identified a common variant (rs9790517) at 4q24 to be associated with breast cancer risk. Independent association signals and potential functional variants in this locus have not been explored. Methods: We conducted a fine-mapping analysis in 55,540 breast cancer cases and 51,168 controls from the Breast Cancer Association Consortium. Results: Conditional analyses identified two independent association signals among women of European ancestry, represented by rs9790517 [conditional P = 2.51 × 10−4; OR, 1.04; 95% confidence interval (CI), 1.02–1.07] and rs77928427 (P = 1.86 × 10−4; OR, 1.04; 95% CI, 1.02–1.07). Functional annotation using data from the Encyclopedia of DNA Elements (ENCODE) project revealed two putative functional variants, rs62331150 and rs73838678 in linkage disequilibrium (LD) with rs9790517 (r2 ≥ 0.90) residing in the active promoter or enhancer, respectively, of the nearest gene, TET2. Both variants are located in DNase I hypersensitivity and transcription factor–binding sites. Using data from both The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC), we showed that rs62331150 was associated with level of expression of TET2 in breast normal and tumor tissue. Conclusion: Our study identified two independent association signals at 4q24 in relation to breast cancer risk and suggested that observed association in this locus may be mediated through the regulation of TET2. Impact: Fine-mapping study with large sample size warranted for identification of independent loci for breast cancer risk. Cancer Epidemiol Biomarkers Prev; 24(11); 1680–91. ©2015 AACR.

OBJECTIVE: To describe factors associated with vitamin supplement use in a large cohort of adult women.

Background This study evaluates linkage algorithms used in 1997 for Los Angeles County by the AIDS-Cancer Match Registry to estimate the risk of cancer among people with HIV/AIDS. Methods In 2001, a linkage between the Los Angeles County cancer and AIDS registries using a five-pass algorithm was compared with the 1997 linkage results that used a two-pass algorithm. Results The five-pass linkage detected all of the previously identified matches (6571) as well as another 431 (6.2%), which had been missed. Conclusions Record linkage methodologic decisions can markedly affect matching sensitivity and specificity. It is probable that the AIDS-Cancer Match Registry two-pass linkage has underestimated the risks of some cancers among people with AIDS.

Objective: Whether alcohol consumption influences ovarian cancer risk is unclear. Therefore, we investigated the association between alcohol intake at various ages and risk of ovarian cancer. Methods: Among 90,371 eligible members of the California Teachers Study cohort who completed a baseline alcohol assessment in 1995-1996, 253 women were diagnosed with epithelial ovarian cancer by the end of 2003. Multivariate Cox proportional hazards regression analysis was performed to estimate relative risks (RRs) and 95% confidence intervals (CIs). Results: Consumption of total alcohol, beer, or liquor in the year prior to baseline, at ages 30-35 years, or at ages 18-22 years was not associated with risk of ovarian cancer. Consumption of at least one glass per day of wine, compared to no wine, in the year before baseline was associated with increased risk of developing ovarian cancer: RR = 1.57 (95% CI 1.11-2.22), Ptrend= 0.01. The association with wine intake at baseline was particularly strong among peri-/post-menopausal women who used estrogen-only hormone therapy and women of high socioeconomic status. Conclusions: Alcohol intake does not appear to affect ovarian cancer risk. Constituents of wine other than alcohol or, more likely, unmeasured determinants of wine drinking were associated with increased risk of ovarian cancer. © 2006 Springer Science+Business Media B.V.

This study evaluates linkage algorithms used in 1997 for Los Angeles County by the AIDS-Cancer Match Registry to estimate the risk of cancer among people with HIV/AIDS.In 2001, a linkage between the Los Angeles County cancer and AIDS registries using a five-pass algorithm was compared with the 1997 linkage results that used a two-pass algorithm.The five-pass linkage detected all of the previously identified matches (6571) as well as another 431 (6.2%), which had been missed.Record linkage methodologic decisions can markedly affect matching sensitivity and specificity. It is probable that the AIDS-Cancer Match Registry two-pass linkage has underestimated the risks of some cancers among people with AIDS.

Author(s): Marshall, Sarah F; Bernstein, Leslie; Anton-Culver, Hoda; Deapen, Dennis; Horn-Ross, Pamela L; Mohrenweiser, Harvey; Peel, David; Pinder, Rich; Purdie, David M; Reynolds, Peggy; Stram, Dan; West, Dee; Wright, William E; Ziogas, Argyrios; Ross, Ronald K | Abstract: BackgroundEpidemiologic studies of the association between nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, and breast cancer risk have yielded inconsistent results. We investigated the association of NSAID use with risk of breast cancer in the California Teachers Study cohort, with special attention to risk of specific breast cancer subtypes and to type of NSAID used.MethodsWe analyzed data on 114 460 women in the California Teachers Study cohort who were aged 22 to 85 years and free of breast cancer at baseline in 1995 to 1996. Information on frequency and duration of NSAID use was collected through a self-administered questionnaire. A total of 2391 women were diagnosed with breast cancer during the follow-up period from 1995 to 2001. We used Cox proportional hazards regression to estimate relative risks (RR) and 95% confidence intervals (CI) of breast cancer subtypes with NSAID use.ResultsNeither regular use (more than once a week) of any NSAID (aspirin and ibuprofen combined) nor regular use of aspirin was associated with breast cancer risk (RR = 1.09, 95% CI = 0.97 to 1.21 for daily versus no regular use of NSAIDs and RR = 0.98, 95% CI = 0.86 to 1.13 for daily versus no regular use of aspirin). However, long-term (g or = 5 years) daily aspirin users had a non-statistically significant decreased risk of estrogen receptor and progesterone receptor (ER/PR)-positive breast cancer (RR = 0.80, 95% CI = 0.62 to 1.03). In contrast, we observed a statistically significantly increased risk of ER/PR-negative breast cancer with long-term daily use of aspirin (RR = 1.81, 95% CI = 1.12 to 2.92). In this population, 11 fewer ER/PR-positive breast cancer cases and seven excess ER/PR-negative breast cancer cases may be due to daily long-term aspirin use among 2391 breast cancer cases observed over 6 years if the association were proven to be causal. Long-term daily use of ibuprofen was also associated with an increased risk of breast cancer (RR = 1.51, 95% CI = 1.17 to 1.95), particularly of nonlocalized tumors (RR = 1.92, 95% CI = 1.24 to 2.97). If causality were subsequently proven, 16 of the observed 2391 breast cancer cases and 8 of the 713 non-localized breast cancer cases would be attributable to long-term daily use of ibuprofen.ConclusionsLong-term daily use of NSAIDs was not associated with breast cancer risk overall. Ibuprofen use was associated with an increased risk of breast cancer, and long-term daily aspirin use was associated with an increased risk of ER/PR-negative breast cancer. However, it is not clear if the observed association is causal.

Determining an accurate method of obtaining complete morbidity data is a long-standing challenge for epidemiologists. The authors compared the accuracy and completeness of existing California hospital discharge data with self-reports of recent hospitalizations and surgeries from participants in the California Teachers Study. Self-reports were collected by questionnaire in 1997 from 91433 female teachers and administrators residing in California. Of the 13430 hospital discharge diagnoses identified for these women, cohort members reported 58%. Self-reporting was highest for neoplasms and musculoskeletal and connective tissue diseases and was most accurate for scheduled admissions, more recent admissions, longer lengths of stay, and less severe disorders. Hospitalizations for mental health and infectious disease were not as well reported. Among the 26383 self-reports-including outpatient surgeries, which are not captured by the hospital discharge database-confirmation was lower, as expected, especially for disorders of the nervous system and sense organs and skin and subcutaneous tissue. Confirmation was highest for childbirth admissions. The hospital discharge database was more specific, but the self-reports were more comprehensive, since many conditions are now treated in outpatient settings. The combination of self-reports and secondary medical records provides more accurate and complete morbidity data than does use of either source alone.

Cancer epidemiology cohorts (CECs) make vital contributions to molecular epidemiology and translational research. Large, well-annotated CECs require many years and substantial resources to build, mature, and maintain, but many CECs use inefficient legacy methods to collect and manage data. CECs must become more cost-efficient and find better ways to gather, store, and share data, and declining response rates suggest CEC participants increasingly require more personal and engaging methods. The California Teachers Study (CTS) is a CEC that has followed 133,479 female public school professionals since 1995-1996. We implemented a cloud-based customer relationship management (CRM) solution from Salesforce.com for a 4-year project (2012-2016), funded by the NCI and NIEHS, that is collecting 21,722 blood or saliva samples from CTS participants for use in future biomarker discovery and validation research. Phlebotomists at 3 sites (COH, CPIC, & UCI) visit participants in-person, conduct interviews, collect blood, and ship samples overnight to Fisher BioServices in Maryland for processing and storage. Our cloud-based system uses the web, smartphones, and tablets to recruit participants; schedule appointments; aggregate questionnaire data; and automate specimen collection, shipping, and tracking. Phlebotomists use a custom-built mobile app to scan consent forms, blood tubes, and FedEx shipping labels. The app includes a smart e-questionnaire that is customized for each person based on her answers to previous CTS questionnaires. Each night, the system automatically assembles and transmits a detailed shipping manifest directly to Fisher BioServices. All data are available for immediate access via a secure, CTS-specific Salesforce.com instance, in which we can track multiple progress and performance metrics on demand. Extensive security and validations protect data privacy and confidentiality. By using mobile technology to automate the study protocol across all sites, eliminating manual data entry during collection appointments, and removing data silos, our innovative approach increases productivity, ensures protocol compliance across study sites, and reduces data management costs. The Salesforce.com system is easily scalable for additional types of data collection and is an excellent tool for improving CEC infrastructure. Citation Format: Jennifer L. Benbow, Christina A. Clarke, Hannah L. Park, Christine N. Duffy, Nadia T. Chung, Amy E. Brankin, Karen Angell-Mendez, Argyrios Ziogas, Rich Pinder, Dennis Deapen, Hoda Anton-Culver, Susan L. Neuhausen, Leslie Bernstein, Sophia S. Wang, James V. Lacey. Novel implementation of cloud computing and mobile technology to transform data collection and management in cancer epidemiology. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 302. doi:10.1158/1538-7445.AM2014-302