Cancer Resources | OncoLink - The Web's First Cancer Resource

Cancer Resources | OncoLink - The Web's First Cancer Resource
 

 You may have come to OncoLink searching for information for your friend or family member who has a diagnosis of cancer. At the same time you may be wondering about your own risk of cancer. Why them? Could it be me? What can I do differently to lower my risk of developing cancer?

What's My Risk? is a comprehensive program designed to help the user learn about factors that determine their personal risk of many types of cancer and what they can do to decrease that risk.

We collect the answers people provide to be used in future development of the program and research related to use of such a program. Your use of the program is completely voluntary. We will not ask you for any personally identifiable information. We collect internet protocol (IP) addresses (a numerical label assigned to each device (e.g., computer, printer) in a computer network using the Internet) in order to remove duplicate entries from our data analysis. However, the IP address is removed from the data after duplicates are removed and is not linked to the responses of a user. If you choose to email your report to yourself, be advised that we do not store your email address or use it for anything other than delivering the report. Because of this, we cannot respond to any questions submitted in the user satisfaction survey at the end of the program. If you require assistance, please:

• visit our contact page or
• send us your comment or question.

Due to the sensitive nature of the medical information provided in this tool, this program is meant for use only by persons over the age of 18.

 What's My Risk? Questionnaire

The following questionnaire is comprehensive and asks about your habits, lifestyle and health history. Please be aware that your answers will be kept private. We do not ask for your name, address or date of birth. The more accurately you answer the questions, the more complete your What's My Risk? profile will be.

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abstract: Too Early To Determine Cancer Risk from Infertility Treatments

Too Early To Determine Cancer Risk from Infertility Treatments

As more and more women wait to have children, the use of fertility drugs is rapidly rising, along with concerns about the possible association with increased risk of certain cancers, primarily of the breast, ovary, and uterus.

Such interest was on display when Elizabeth Edwards, the wife of former Sen. John Edwards, died from a recurrence of breast cancer in 2010, years after she had used fertility treatments. Researchers agree that the issue is important, given the millions of women who have been treated with fertility drugs. By one estimate, that number will climb to 7 million by 2025. 

But the findings from the few studies that have tried to address the issue have been mixed. Most have been conducted outside the U.S., primarily in European countries with centralized health care systems that can track pharmacy and cancer registries. These studies can have methodological limitations, but researchers say the largest drawback is that, usually, it is too early to tell whether an association exists, especially for drugs used for in vitro fertilization (IVF). 

“We are just really now getting into an era where we have enough women who are in the right age range to be able to evaluate their cancer risk,” said Louise Brinton, Ph.D., M.P.H., chief of the hormonal and reproductive epidemiology branch of the Division of Cancer Epidemiology and Genetics at the National Cancer Institute.

But it won’t ever be completely clear whether these drugs cause even a slight increase in cancer risk, says Jennifer Litton, M.D., an assistant professor in the department of breast medical oncology at the University of Texas M. D. Anderson Cancer Center in Houston. “Infertility itself is a risk factor for increases in breast and ovarian cancers, so it is going to be difficult, if …(Blogger's Note: to read further subscription required $$$)

abstract: Time-varying incidence of cancer after the onset of type 2 diabetes: evidence of potential detection bias British Columbia, Canada

Time-varying incidence of cancer after the onset of type 2 diabetes: evidence of potential detection bias.:

Diabetologia. 2011 Sep;54(9):2263-71

Abstract

AIMS/HYPOTHESIS:
Despite the vast body of epidemiological literature on the risk of cancer in people with diabetes, few studies have examined the pattern of cancer risk during different time windows following diabetes onset. The objective of the study was to examine the risks of site-specific cancer in people with incident type 2 diabetes during different time windows following diabetes onset.

METHODS: 

This was a population-based retrospective cohort study. The study period was 1 April 1994 to 31 March 2006; censoring occurred at 31 March 2006, at death or on departure from British Columbia, Canada. Using linked health databases, we identified incident cohorts with and without diabetes, who were matched by age, sex and index year. Following a minimum 2-year cancer washout period, first site-specific cancers were identified prospectively in both cohorts.

RESULTS: 

Within 3 months following diabetes onset, participants with diabetes had significantly increased risks of colorectal, lung, liver, cervical, endometrial, ovarian, pancreatic and prostate cancers. After the initial 3-month period, the risks for colorectal (HR 1.15, 95% CI 1.05, 1.25), liver (HR 2.53, 95% CI 1.93, 3.31) and endometrial (HR 1.58, 95% CI 1.28, 1.94) cancers remained significantly elevated compared with those without diabetes.

The diabetes cohort remained at increased risk of pancreatic cancer in later years, but followed a different pattern: HR 3.71 at 3 months-1 year, 2.94 at 1-2 years, 1.78 at 2-3 years and 1.65 at 3-10 years (p value for all <0.01). After an initial period of elevated risk, men with type 2 diabetes subsequently had a decreased risk of prostate cancer (HR 0.82, 95% CI 0.76, 0.88).

CONCLUSIONS/INTERPRETATION: 

People with type 2 diabetes are at increased risk of select cancers; this risk is particularly elevated at the time of diabetes onset, which is likely to be due to increased ascertainment.

open access: PLoS Medicine: Injectable and Oral Contraceptive Use and Cancers of the Breast, Cervix, Ovary, and Endometrium in Black South African Women: Case–Control Study

Background

Oral contraceptives are known to influence the risk of cancers of the female reproductive system. Evidence regarding the relationship between injectable contraceptives and these cancers is limited, especially in black South Africans, among whom injectable contraceptives are used more commonly than oral contraceptives.

Study Sample

The Johannesburg Cancer Case Control Study is a large ongoing case–control study recruiting self-defined black (not mixed race/ancestry) male and female cancer patients with all cancer types, conducted at the greater Johannesburg public referral hospitals that offer cancer treatment. Female patients recruited from 8 March 1995 to 31 December 2006 were included in the present analysis.

Table 1. Demographic and risk factor characteristics of case and control participants, according to use of hormonal contraceptives.
doi:10.1371/journal.pmed.1001182.t001
Table 2. Frequencies and adjusted odds ratios for breast, cervical, ovarian, and endometrial cancer according to ever/never oral and injectable contraceptive use combinations.
doi:10.1371/journal.pmed.1001182.t002
Figure 2. Odds ratio for ovarian and endometrial cancer in relation to use of hormonal contraceptives, according to duration of use.
Adjusted OR (95% CI) for (A) ovarian cancer and (B) endometrial cancer in relation to use of oral and injectable contraceptives, adjusted for age at diagnosis, year of diagnosis, education, tobacco smoking, alcohol consumption, parity/age at first birth, number of sexual partners, urban/rural residence, and province of birth. Squares represent ORs, and horizontal lines indicate 95% CI. Diamonds represent the ORs and confidence intervals for the group comprising women from all three exposure categories immediately above.
doi:10.1371/journal.pmed.1001182.g002

  
Conclusions

In this study, use of oral and of injectable hormonal contraceptives was associated with a transiently increased risk of breast and cervical cancer and, for long durations of use, with a reduced risk of ovarian and endometrial cancer. The observed effects of injectable and of oral contraceptives on cancer risk in this study did not appear to differ substantially.

open access: Fruit and vegetables and cancer risk - UKPMC Article - UK PubMed Central

Blogger's note: the article/reference(s) does not include ovarian cancer research on this issue

The possibility that fruit and vegetables may help to reduce the risk of cancer has been studied for over 30 years, but no protective effects have been firmly established..........

FDA Alert: Angiotensin Receptor Blockers (ARBs): Ongoing Safety Review for Cancer Risk

BACKGROUND: ARBs are used in patients with high blood pressure and other conditions. Brand names include Atacand, Avapro, Benicar, Cozaar, Diovan, Micardis, and Teveten

Read more: http://www.drugs.com/fda/angiotensin-receptor-blockers-arbs-ongoing-safety-review-cancer-risk-12762.html#ixzz0tnuJNnYt

Hormonal contraception and risk of cancer

free full access: Diabetes and Cancer: A Consensus Report -- A Cancer Journal for Clinicians

"Because specific antihyperglycemic medications are associated with cancer risk factors, confounding by unmeasured or incompletely measured risk factors may explain at least in part the previously reported associations between medications and cancer. To our knowledge, few studies to date have examined the risk associated with the dose, duration, or recency of medication use, which might inform the biologic plausibility of observed associations. Many agents that affect carcinogenesis have long latencies or require a minimum exposure level, and the risk associated with some agents may return to baseline after the exposure has been terminated for a period of time. Some diabetes medications have only recently come on the market (eg, TZDs, insulin analogs, and incretin-based therapies), and therefore, studies of these agents will only assess the cancer risk associated with relatively short-term use.

It is unlikely that the effect of diabetes therapies on cancer risk and progression, particularly at specific cancer sites, will be fully addressed with randomized controlled clinical trials, due to both cost and follow-up time limitations.

JNCI Editorial: Fruits, Vegetables, and Cancer Prevention: Turmoil in the Produce Section

Some key excerpts - full text of Editorial available without cost:

•  In this issue of the Journal, Boffetta et al. (6) report findings from a European cohort of nearly 400 000 men and women who developed approximately 30 000 cancers at all sites combined over nearly 9 years of follow-up. After accounting for measurement error, a very weak but statistically significant inverse association was seen—a 4% lower incidence of all cancers combined for an increment of 200 g of total fruits and vegetables per day, which corresponds to about two extra servings per day.

• Most fundamentally, this study strongly confirms the findings from other prospective studies that the results of case–control studies were overly optimistic and that any association of intake of fruits and vegetables with risk of cancer is weak at best.

• Their more detailed analyses suggesting a stronge rbenefit among heavier consumers of alcohol lend some weight to a causal interpretation because other studies (7,8) have suggested that folate, primarily from fruits and vegetables,may be more beneficial in the context of regular alcohol consumption.

• A very weak or undetectable association between fruits and vegetables and risk of cancer does not exclude the possibility that oneor a small group of fruits or vegetables, or a specific substance in some of these foods, has an important protective effect.

• Even if we assume that the weak association seen in the EPIC cohort represents a true protective effect of fruits and vegetables,the question would still remain whether an effect of this magnitude should lead to clinical interventions or public health actions.Conveniently, although the evidence for benefits of fruits and vegetables against cancer was waning, data supporting benefits for cardiovascular disease were accumulating.

•  In summary, the findings from the EPIC cohort add further evidence that a broad effort to increase consumption of fruits and vegetables will not have a major effect on cancer incidence.

Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) - JNCI abstract

Abstract:
Conclusions: A very small inverse association between intake of total fruits and vegetables and cancer risk was observed in this study. Given the small magnitude of the observed associations, caution should be applied in their interpretation.

CONTEXT AND CAVEATS
Prior knowledge
The association between high intake of fruits and vegetables and reduction in overall cancer risk is not conclusively established.
Study design
European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study was conducted between 1992 and 2000. Diet and lifestyle data were self-reported by the participants. Cancer incidence and mortality data were obtained from country-specific national and regional registries. Association between overall cancer risk and high intake of total fruits, total vegetables, and total fruits and vegetables combined was assessed. Estimated cancer risks were adjusted for smoking, alcohol consumption, and many other variables.
Contribution
High intake of vegetables, and fruits and vegetables combined, was associated with a small reduction in overall cancer risk. The association was stronger in heavy alcohol drinkers but was restricted to cancers caused by smoking and drinking.
Implications
This study reveals a very modest association between high intake of fruits and vegetables and reduced risk of cancer.
Limitations
The inverse association between overall cancer risk and high intake of fruits and vegetables was weak. Errors inherent to self-reported dietary habits may have resulted in bias.
From the Editors