Bladder cancer - Race differences in extent of disease at diagnosis
bacillus-calmette-guerin; biologic implications; black-white; bladder cancer; cancer; carcinoma insitu; differences; grade; Oncology; race; registry; risk-factors; sociodemographic factors; stage; survival; transitional-cell neoplasms; urinary-bladder
BACKGROUND. Blacks are less likely than whites to develop bladder cancer; although once diagnosed, blacks experience poorer survival. This study sought to examine multiple biological and behavioral factors and their influence on extent of disease. METHODS. A population-based cohort of black bladder cancer patients and a random sample of frequency-matched white bladder cancer patients, stratified by age, gender, and race were identified through cancer registry systems in metropolitan Atlanta, New Orleans, and the San Francisco/Oakland area. Patients were ages 20-79 years at bladder cancer diagnosis from 1985-1987, and had no previous cancer history. Medical records were reviewed at initial diagnosis. Of the patients selected for study, a total of 77% of patients was interviewed. Grade, stage, and other variables (including age, socioeconomic status, symptom duration, and smoking history) were recorded. Extent of disease was modeled in 497 patients with urothelial carcinoma using logistic regression. RESULTS. Extent of disease at diagnosis was significantly greater in Blacks than in Whites. Older age group, higher tumor grade, larger tumors, and presence of carcinoma in situ were related to greater extent of disease in blacks and in whites. Large disparities between blacks and whites were found for socioeconomic status and source of care. Blacks had greater symptom duration and higher grade. Black women were more likely to have invasive disease than white women; this difference was not seen among men. Blacks in unskilled occupational categories, perhaps reflecting socioeconomic factors, were at much higher risk for muscle invasion than whites. CONCLUSIONS. While specific relationships between variables were noted, an overall pattern defining black and white differences in stage did not emerge. Future studies should examine the basis upon which occupation and life style factors operate by using biochemical and molecular methods to study the genetic factors involved. Published 2000 by the American Cancer Society.*.
Prout G R; Wesley M N; Greenberg R S; Chen V W; Brown C C; Miller A W; Weinstein R S; Robboy S J; Haynes M A; Blacklow R S; Edwards B K
Cancer
2000
2000-09
Journal Article
<a href="http://doi.org/10.1002/1097-0142(20000915)89:6%3C1349::aid-cncr20%3E3.0.co;2-d" target="_blank" rel="noreferrer noopener">10.1002/1097-0142(20000915)89:6%3C1349::aid-cncr20%3E3.0.co;2-d</a>
Correlation of menstrual cycle at time of breast cancer surgery to disease-free and overall survival
carcinoma; General & Internal Medicine; killer cell-activity; mastectomy; operation; phase; premenopausal women; prognosis; receptor; stage; status; surgical cure
The timing of surgery during the menstrual cycle of premenopausal breast cancer patients was correlated with their disease-free survival (DFS) and overall survival (OS). The study included 150 premenopausal patients treated for breast cancer between 1977 and 1992. The data were analyzed using three different menstrual cycle phase categorization schemes: (1) days 0 to 6 and 21 to 32 vs 7 to 20; (2) days 0 to 2 and 19 to 32 vs 3 to 12; and (3) days 0 to 14 vs 14 to 32, Two different surgery dates used for analysis were biopsy date and definitive surgery date. There was no association of the timing of surgery with OS. Only one categorization scheme correlated with DFS (scheme No, 2), and this correlation was significant using either surgery or biopsy dates, Thus, premenopausal breast cancer patients who have biopsy and/or definitive surgery during their perimenstrual phase (days 0 to 2 or after day 13) of the menstrual cycle may have a longer DFS than patients operated on during their midcycle phase (days 3 to 13); however, this may not affect overall survival.
Vanek V W; Kadivar T F; Bourguet C C
Southern Medical Journal
1997
1997-08
Journal Article
<a href="http://doi.org/10.1097/00007611-199708000-00003" target="_blank" rel="noreferrer noopener">10.1097/00007611-199708000-00003</a>
Differences between black and white patients with cancer of the uterine corpus in interval from symptom recognition to initial medical consultation (United states)
diagnosis; race; Environmental & Occupational Health; Public; disease; survival; women; Oncology; breast-cancer; stage; health behavior; determinants; blacks; delay; health services accessibility; seeking care; States; United; uterine neoplasms
To determine whether Black women with symptoms of uterine corpus cancer had longer times from symptom recognition to initial medical consultation than did White women in the United States, 331 newly diagnosed patients living in Atlanta (GA), New Orleans (LA), and San Francisco/Oakland (CA) during 1985-87 were interviewed to collect information on symptoms, dates of recognition and consultation, and other factors that might affect the interval. Data were analyzed to estimate medical consultation rates and rate ratios following symptom recognition. Median recalled times between symptom recognition and consultation were 16 days for Black women and 14 days for White women. Although poverty, having no usual source of healthcare, and other factors were associated with lower consultation rates, the adjusted rate among Black women was only somewhat lower (0.87) than among White women, and the 95 percent confidence interval (CI = 0.58-1.31) was consistent with no true difference between the races. In addition, the median time to consultation for women with stage IV cancer was only 15 days longer than the time (14 days) for the women with stage I cancer. These results suggest that time from symptom recognition to initial medical consultation does not contribute importantly to the more advanced stage cancer of the uterine corpus commonly found among Black women.
Coates R J; Click L A; Harlan L C; Robboy S; Barrett R J; Eley J W; Reynolds P; Chen V W; Darity W A; Blacklow R S; Edwards B K
Cancer Causes & Control
1996
1996-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/bf00052938" target="_blank" rel="noreferrer noopener">10.1007/bf00052938</a>
Obesity And Breast Cancer Prognosis: An Expanding Body Of Evidence
mass; Oncology; receiving adjuvant chemotherapy; risk; size; stage; weight; women
Dignam J J; Mamounas E P
Annals of Oncology
2004
2004-06
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1093/annonc/mdh241" target="_blank" rel="noreferrer noopener">10.1093/annonc/mdh241</a>
Racial-differences In Survival From Breast-cancer - Results Of The National-cancer-institute Black/white Cancer Survival Study
black-white differences; delay; estrogen; experience; General & Internal Medicine; project; race; socioeconomic-status; stage; women
Eley J W; Hill H A; Chen V W; Austin D F; Wesley M N; Muss H B; Greenberg R S; Coates R J; Correa P; Redmond C K; Hunter C P; Herman A A; Kurman R; Blacklow R; Shapiro S; Edwards B K
Jama-Journal of the American Medical Association
1994
1994-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1001/jama.272.12.947" target="_blank" rel="noreferrer noopener">10.1001/jama.272.12.947</a>
Widespread Metastases After Resection Of Noninvasive Thymoma
carcinoma; expression; Oncology; organization histologic classification; relevance; stage; thymic epithelial tumors
Gamboa E O; Sawhney V; Lanoy R S; Haller N A; Powell A T; Hazra S V
Journal of Clinical Oncology
2008
2008-04
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1200/jco.2007.14.5656" target="_blank" rel="noreferrer noopener">10.1200/jco.2007.14.5656</a>
Gonadal Hormones And Frontocortical Expression Of Vascular Endothelial Growth Factor In Male Stroke-prone, Spontaneously Hypertensive Rats, A Model For Attention-deficit/hyperactivity Disorder
aged female rats; animal-model; central-nervous-system; cerebral-blood-flow; computed tomography; deficit-hyperactivity-disorder; emission; Endocrinology & Metabolism; estrogen-receptor-alpha; in-situ hybridization; insulin-resistant; messenger-ribonucleic-acid; stage
Attention-deficit/hyperactivity disorder (AD/HD) is a common pediatric behavioral disorder associated, in part, with male preponderance and reduced regional cerebral blood flow (rCBF). However, mechanism(s) underlying male preponderance and reduced rCBF in AD/HD are unclear. The present study profiles the expression of angiogenic and hormonal factors likely to underlie these symptoms using a recently characterized AD/HD animal model, juvenile male stroke-prone spontaneously hypertensive rats (SHRSP). Because vascular endothelial growth factor (VEGF) signaling cascade and gonadal steroids are key regulators of angiogenesis and gender-based behavior, respectively, we profiled their patterns of expression in the frontal cortex of SHRSP to elucidate their roles in the genesis of AD/HD male preponderance and rCBF. Interestingly, levels of VEGF, VEGF receptors (KDR, Flt-1), endothelial nitric oxide synthase, phosphorylated. Akt (pAkt), estrogen receptor-alpha, aromatase, and capillary density in sham-operated SHRSP were remarkably down-regulated, whereas androgen receptor levels were up-regulated, compared with age-matched genetic control, Wistar-Kyoto rats. Castration, estrogen, and androgen receptor antagonist (flutamide) counteracted these effects. Dihydrotestosterone, but not testosterone, reversed the beneficiary effects of castration. Estrogen receptor-beta levels remained unchanged in all groups examined. We postulate that changes in androgen metabolism that tend to up-regulate local dihydrotestosterone concentration and diminish estrogen synthesis, in the frontal cortex of juvenile male SHRSP, may lower levels and/or activity of VEGF and its signaling cascade and, subsequently, reduce rCBF. These findings could, in part, help explain the pathogenesis of reduced rCBF and male preponderance in AD/HD.
Jesmin S; Togashi H; Sakuma I; Mowa C N; Ueno K I; Yamaguchi T; Yoshioka M; Kitabatake A
Endocrinology
2004
2004-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1210/en.2004-0487" target="_blank" rel="noreferrer noopener">10.1210/en.2004-0487</a>