Cancer Epidemiology Unit

About: Cancer Epidemiology Unit is a based out in . It is known for research contribution in the topics: Population & Cancer. The organization has 669 authors who have published 1725 publications receiving 93979 citations.

Clinicians’ concerns about decision support interventions for patients facing breast cancer surgery options: understanding the challenge of implementing shared decision‐making

Abstract: Background:There is interest in interventions that provide support for patients facing challenging decisions, such as the choice between mastectomy and breast conservation surgery for breast cancer. However, it is difficult to implement these interventions. One potential source of resistance is the attitudes of clinicians. Objective: To examine specialist breast clinicians’ opinions about the provision of decision support interventions (DesIs) for patients. Methods: As part of the development of a web-based DesI (BresDex), semi-structured interviews were conducted with specialist clinicians [breast surgeons, breast care nurses (BCNs) and oncologists] from four breast units in a UK region, and speciality national opinion leaders. Interviews were recorded, transcribed and analysed using the Framework approach. Results: A majority of the 24 clinicians interviewed did not have a working knowledge of DesIs and were ambivalent or sceptical. Many expressed conflicting opinions: they noted the potential benefits, but at the same time expressed reservations about information overlap, overload and about content that they considered inappropriate. Many wanted access to DesIs to be always under clinical supervision. In particular, they were uncertain as regards how DeSIs could be tailored to individual patients’ needs and also accommodate clinical practice variation. BCNs were particularly concerned that DesIs might induce patient anxiety and replace their role. Conclusions: The concept of providing interventions to support patients in decision-making tasks generated concern, defensiveness and scepticism. These attitudes will be a significant barrier. Implementation efforts will need to recognize and address these issues if these interventions are to become embedded in clinical practice.

Adipokines and inflammation markers and risk of differentiated thyroid carcinoma: The EPIC study

Abstract: Other than the influence of ionizing radiation and benign thyroid disease, little is known about the risk factors for differentiated thyroid cancer (TC) which is an increasing common cancer worldwi ...

Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition.

Abstract: Previously, a lower risk of colorectal cancer was observed with fruit and vegetable consumption in the European Prospective Investigation into Cancer and Nutrition within a follow-up period of 9 years which was not fully supported by a recent meta-analysis. Therefore, we were interested in the relation with extended follow-up, also focusing on single subtypes and a variety of intake of fruit and vegetables. Fruit and vegetable consumption was assessed at baseline. After an average of 13 years of follow-up, 3,370 participants were diagnosed with colon or rectal cancer. Diet diversity scores were constructed to quantify variety in fruit and vegetable consumption. A lower risk of colon cancer was observed with higher self-reported consumption of fruit and vegetable combined (HR Q4 vs. Q1 0.87, 95% CI 0.75-1.01, p for trend 0.02), but no consistent association was observed for separate consumption of fruits and vegetables. No associations with risk of rectal cancer were observed. The few observed associations for some fruit and vegetable subtypes with colon cancer risk may have been due to chance. Variety in consumption of fruits and vegetables was not associated with a lower risk of colon or rectal cancer. Although a lower risk of colon cancer is suggested with high consumption of fruit and vegetables, this study does not support a clear inverse association between fruit and vegetable consumption and colon or rectal cancer beyond a follow-up of more than 10 years. Attenuation of the risk estimates from dietary changes over time cannot be excluded, but appears unlikely.

Characteristics of the Million Women Study participants who have and have not worked at night.

Abstract: Objectives The aim of this study was to compare the characteristics of women who had and had not worked at night in terms of their risk factors for common disease, indicators of general health, social activities, employment, and sleep behavior. Methods The Million Women Study is a large prospective cohort study of women’s health in the United Kingdom with 1.3 million women recruited during 1996–2001 (aged 50–64 years) through 66 National Health Service breast screening centers. We analyzed the data from a random sample of 41 652 participants who, in 2009–2010, reported their history of night work. Results Of the participants, 1 in 8 women (13%) reported that they had ever worked at night and 1 in 50 (2%) reported working at night for ≥20 years. For 33 sociodemographic, behavioral, reproductive, and hormonal factors examined, 20 showed highly significant differences between “ever” and “never” night workers (P<0.0001); 12 showed significant trends by duration of night work (P<0.01). In particular, compared to women who had never worked at night, women who had worked at night were more likely to (i) be of lower socioeconomic status [the odds ratio (OR) for ever versus never night workers of being in the lowest third of socioeconomic status was 1.15, 99% confidence interval (95% CI) 1.06–1.25]; (ii) have ever used hormone replacement therapy (HRT) for the menopause (OR 1.43, 99% CI 1.33–1.55); (iii) be current smokers (OR 1.37, 99% CI 1.19–1.58); and (iv) be obese (OR 1.26, 99% CI 1.15–1.37). Compared to women who had never worked at night, women who had worked at night for ≥20 years were more likely to be (i) of lower socioeconomic status (OR 1.28, 99% CI 1.04–1.57); (ii) nulliparous (OR 1.47, 99% CI 1.12–1.91); (iii) current smokers (OR 1.63, 99% CI 1.18–2.25); and (iv) obese (OR 1.55, 99% CI 1.25–1.93). Former night workers were more likely than never night workers to report a range of sleep disturbances, including poor quality of sleep (OR 1.15, 99% CI 1.01–1.31) and having to take medication to sleep (OR 1.35, 99% CI 1.15–1.60). Conclusions Women who reported having worked at night were substantially different from those who reporting never having worked at night and many of the differences would put “ever night workers” at increased risks of cancer, vascular disease, and many other common conditions.