Chinese Women In Taiwan Research Articles

How Far Can Chicken Feet Travel?

Abstract This article analyses Chinese women's e-entrepreneurship of trading nostalgic and/or contested goods in the disputed sovereign borders and virtual marketplace in the borderland between China and Taiwan. Using physical and digital ethnography, and drawing on the case study of the journey of chicken feet and other goods traded through WeChat by Chinese women in Taiwan, this article shows how the online and offline trails of these goods and the virtual marketplace generate new forms of transnationalism and connectedness between the two rivaling societies. Calling attention to Chinese women's emotions and nostalgia embedded in their e-entrepreneurship, their goods’ geographical movements, and their social networks, these findings enrich our understanding of transnational entrepreneurship as well as migrants’ agency-making and digital connectivity. However, highlighting how the worsening Taiwan-China relationship has diminished micro e-entrepreneurship, this article also reveals the vulnerability, instability, and uncertainty of the virtual marketplace, which is threatened by the politics of sovereignty contestation.

Immigration and inequality: Analysis of Mainland Chinese spouses during the early stages of their time in Taiwan

AbstractIn this study on Mainland Chinese women in Taiwan, I examined the effect of immigration‐related disruption on the assimilation of these women into the Taiwanese labour market during 2005–2015. Accordingly, I used a unique dataset obtained by linking three administrative registers to measure the assimilation process. In addition, I employed the nearest‐neighbour matching estimator to assess heterogeneous effects on each Mainland Chinese woman. The results indicated narrowing immigrant–native gaps in labour supply (full‐time employment rates) and real monthly insured wages for their first traceable job in favour of Mainland Chinese women. In general, I found that Mainland Chinese women assimilated into the Taiwanese workforce at levels comparable with those of Taiwanese women.

Abstract P2-02-05: Combined Ultrasound/MRI for Breast Cancer Screening in Asian Women of Average Cancer Risk

Abstract Background and purpose: MRI is not recommended for screening women at average risk because it is associated with substantial numbers of false-positive results and cost. MRI as a screening tool for breast cancer, however, involves a complexity of cancer epidemiology, socio-economic situation, healthcare policy, and awareness and compliance of general population. Breast MRI may be particularly beneficial as a screening tool for Asian women due to their dense breast. In this study we reported the breast MRI screening results in Chinese women in Taiwan. Materials and Methods: In a period of 8 years, 3681 women underwent breast MRI examination in our imaging center. Of them, 95 women were known to have prior histories of cancers and were excluded from this study. The remaining breast MR images from 3,586 asymptomatic healthy women (mean age, 45.3 years) were retrospectively analyzed in this study. All subjects came to our imaging center for screening breast MR studies by self-referral due to high concern of cancer. All subjects were examined at a 1.5T scanner. The imaging interpretation was based on the criteria of ACR BI-RADS lexicon. After the breast MRI examination, complementary US was performed. If suspicious lesions were detected on MRI but showed negative results on US, double check with targeted US were done by the same radiologist immediately. US was also used to guide needle biopsy when in need. Results: Overall, among 3,586 cases, totally 115 subjects were suspected to have malignant lesions and ultrasound-guided biopsy (N=106) and/or aspiration cytology study (N=122) was performed in all these 115 subjects. 47 were proved to have malignant lesions in pathology (35 invasive cancers — 27 IDC, 7 ILC, and one apocrine carcinoma; and 12 cases of carcinoma in situ). 31 additional cases of pre-cancerous lesions were found. The mean age in cancer group was 49 y/o and 52.2 y/o in CIS group. Subjects at age 41-50 group had the highest incidence of cancer detection, including 6 in situ lesions and 19 invasive cancers. Five cases were found to have breast cancers 1 or 2 years later. The incidence for malignancy in our asymptomatic group was about 1.31% (47/3586) and increased to 2.2% (78/3586) if precancerous lesions were included. The overall sensitivity of combined US/MRI was 94% and specificity was 99%. Conclusions: Breast MRI can be an option for Asian women of average risk, who usually have dense breast, at their own cost. From our results, it was shown that combined ultrasound and MRI can achieve high sensitivity and specificity for women of average risk. The unnecessary biopsy due to the false positive diagnosis of breast MRI can also be reduced remarkably. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-02-05.

Abstract 1870: Genotype polymorphisms of DNA repair genes interact with estrogen exposure to breast cancer susceptibility

Abstract Endogenous estrogen is suggested to initiate cell proliferation and cause oxidative DNA damage during breast tumorigenesis. Cells eliminate DNA damages by repair enzymes. Genotypic variants of DNA damage repair genes, participating base excision repair (BER) and nucleotide excision repair (NER) pathways, may act as modifiers that affect the association between estrogen exposure and breast cancer. In a hospital-based case-control study of female breast cancer, DNA samples from 401 cases and 533 healthy controls were enrolled among Chinese women in Taiwan. Genotyping polymorphisms of XRCC1 (Arg194Trp and Arg399Gln), OGG1 (Ser326Cys and Arg229Gln), ERCC2 Lys751Gln, ERCC4 Pro662Ser, and ERCC5 His1104Asp were determined and used to evaluate breast cancer susceptibility. Of these non-synonymous polymorphisms, ERCC5 1104Asp variant was significantly associated with breast cancer (OR=1.42; 95%CI=1.08-1.97), and this was more pronounced in women with prolonged estrogen exposure. A trend toward an increased risk of developing breast cancer was observed in women who carried greater numbers of combined high-risk genotypes of BER and NER genes (Ptrend = 0.038). The synergistic effect of multiple genes on risk elevation was significant in women having a longer period of estrogen exposure (>26 years), a longer menarche-to-FFTP interval (>11 years), greater age at the first full-term pregnancy (>26 years), and higher body mass index (>22) (all P<0.05). In conclusion, this study demonstrates that genotype polymorphisms for the DNA damage repair confer higher risk in individual susceptibility to endogenous estrogen on female breast cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1870.

Synergistic Effects of Polymorphisms in DNA Repair Genes and Endogenous Estrogen Exposure on Female Breast Cancer Risk

Endogenous estrogen is suggested to initiate cell proliferation and cause oxidative DNA damage during breast tumorigenesis. Cells eliminate DNA damage by means of repair enzymes. Genotypic variants of DNA damage repair genes, participating in base excision repair (BER) and nucleotide excision repair (NER) pathways, may act as modifiers that affect the association between estrogen exposure and breast cancer. In a hospital-based case-control study of female breast cancer, DNA samples were obtained from 401 cases and 533 enrolled healthy controls, all of whom were Chinese women in Taiwan. Genotyping of polymorphisms of XRCC1 (Arg194Trp and Arg399Gln), OGG1 (Ser326Cys and Arg229Gln), ERCC2 Lys751Gln, ERCC4 Ser662Pro, and ERCC5 His1104Asp was performed and used to evaluate breast cancer susceptibility. Of the nonsynonymous polymorphisms, the ERCC5 1104Asp variant was significantly associated with breast cancer (odds ratio = 1.42; 95% confidence interval = 1.08-1.97), and this association was more pronounced in women with lengthy estrogen exposure. A trend toward an increased risk of developing breast cancer was observed in women who carried greater numbers of combined high-risk genotypes of BER and NER genes (P(trend) = .038). The synergistic effect of multiple genes on the increase of risk was significant in women with a longer period of estrogen exposure (>26 years), greater age at first full-term pregnancy (>26 years), a longer menarche-to-first full-term pregnancy interval (>11 years), and higher body mass index (>22) (all P<.05). This study demonstrates that genotype polymorphisms related to DNA damage repair confer greater susceptibility to endogenous estrogen in the development of breast cancer in women.

Polymorphism of cytosolic serine hydroxymethyltransferase, estrogen and breast cancer risk among Chinese women in Taiwan

Cytosolic serine hydroxymethyltransferase (cSHMT) is key to intersection of folate-metabolic pathway, participating in the pyrimidine synthesis for DNA repair. Based on the hypothesis that variants of the cSHMT C1420T together with methionine synthase (MS A2756G) and 5,10-methylenetetrahydrofolate reductase (MTHFR C677T and A1298C) are associated with breast cancer, we performed a multigenic case-control study of the effects to breast cancer risk of four polymorphisms of folate-metabolizing genes against duration of estrogen exposure. Support of our hypothesis came from the following observations: (i) Allelic frequency of cSHMT C1420T was higher in the controls than in the cases, manifesting a 0.56-fold risk reduction in breast cancer (95%CI = 0.39-0.80); and this association was more significant in those women are susceptible to time of estrogen exposure. (ii) A joint effect of the cSHMT and MS polymorphisms significantly reduced susceptibility to breast cancer (aOR = 0.55; 95%CI = 0.34-0.88). (iii) There was a trend toward a reduced risk of breast cancer in women carrying a greater number of putative low-risk genotypes (Ptrend = 0.048). (iv) This synergistic effects on risk reduction was significantly interacted with length of estrogen exposure, exhibiting a longer time of estrogen exposure (> or =30 years), menarche-to-FFTP interval (>11 years), age at the first full-term pregnancy (< or =25 years), and body mass index (< or =24). In conclusion, our study provides support to account for the preferential role of cSHMT polymorphism to lower risk of female breast cancer, and such reduced risk would be more significant in carriers with the polymorphisms of MS and MTHFR genes.

Psychometric Properties of the Cervical Smear Belief Inventory for Chinese Women

This study examines the reliability and validity of the scores of Cervical Smear Belief Inventory (CSBI) among Chinese women in Taiwan. Women who were nonadherent to cervical screening guidelines were recruited (N = 424). Reliabilities showed good internal consistency for the perceived Pros, Cons, and Susceptibility scales (a ranged from .78 to .87). Factor analysis showed good construct validity of the scores of CSBI that revealed concordant patterns with existing social and behavioral theories, except that the Norms scale was loaded with the Pros scale. Moreover, two items in the Cons scale appeared to be "cultural belief toward virginity." Item-discrimination analysis showed that all items in the CSBI successfully discriminated women with favorable cervical smear beliefs from those with unfavorable beliefs (p < .001). In summary, many psychometric properties of the CSBI showed that the scores of the inventory were reliable and valid to assess belief toward cervical smear among Chinese women.

Hormonal and Body-Size Factors in Relation to Breast Cancer Risk: A Prospective Study of 11,889 Women in a Low-Incidence Area

This prospective cohort study of 11,889 women was conducted to determine significant factors associated with the risk of breast cancer among Chinese women in Taiwan, a low-incidence area. In-person interviews were completed for subjects to solicit information on hormonal factors. Measurements of height, weight, and waist-and- hip circumferences were performed by well-trained assistants using standardized techniques. Cox proportional hazards models were employed to estimate relative risks (RRs) and 95% confidence intervals (CIs). During an average follow-up time of 10.3 years (range: 1 to 11 years) with an accumulation of 134,063 person-years, 104 incident breast cancer cases were identified through data linkage with national cancer registry profile. There was a significant elevation in breast-cancer risk with increasing duration of the interval between age at menarche and age at first full-term pregnancy (FFTP). Additionally, central adiposity reflected by hip circumference was a significant predictor of breast cancer in this Chinese female population. The findings of this study indicated common mechanisms responsible for the higher incidence of breast cancer in Western populations may also explain the risk of breast cancer development in Taiwan, a low-incidence area.

Effect of conjugated equine estrogen in combination with two different progestogens on the risk factors of coronary heart disease in postmenopausal Chinese women in Taiwan: a randomized one-year study

Effect of conjugated equine estrogen in combination with two different progestogens on the risk factors of coronary heart disease in postmenopausal Chinese women in Taiwan: a randomized one-year study

CORRELATES OF CERVICAL CANCER SCREENING AMONG WOMEN IN TAIWAN

In this study we examine several theory-based psychosocial factors on cervical cancer screening among Chinese women in Taiwan (N = 125). The reliabilities of the scales showed good internal consistence (Chronbach alpha ranged from 0.68 to 0.88). We found that 30% of the women had never received a Papanicolaou (Pap) test, and only 58% reported a screening in the past 3 years (adherent). Intention to have a Pap test in the coming year was higher among screening adherence women (90%) than nonadherents (58%). Multiple logistic regression analysis revealed significant associations between screening adherence and women's knowledge (p = 0.034), perceived pros (p = 0.041), cons (p = 0.000), and norms (p = 0.019) of a Pap test. In addition to identifying screening associated factors, we also provided a basis for measuring important theory-based constructs. Although we developed some scale items for Chinese culture, data showed that psychosocial factors were universally relevant. Future intervention efforts tailoring these factors could potentially impact cancer screening for women internationally.

Relation of BsmI vitamin D receptor gene polymorphism to bone mineral density and occurrence of osteoporosis in postmenopausal Chinese women in Taiwan.

Osteoporosis is a common disorder with a strong genetic component. Our aim was to evaluate the correlation of the vitamin D receptor gene intron 8 BsmI polymorphism with bone mineral density (BMD) and their relationship to osteoporosis. We determined the vitamin D receptor gene intron 8 BsmI polymorphfsm using polymerase chain reaction-based restriction analysis in 171 postmenopausal Chinese women in Taiwan. The polymorphism was detected using the restriction enzyme BsmI, where the B allele indicated absence of the cuttable site and the b allele its presence. BMD of the lumbar spine and proximal femur were measured using dual-energy X-ray absorptiometry. The allelic frequencies for postmenopausal Chinese women in Taiwan were 12.3% for B and 87.7% for b in BsmI restriction fragment length polymorphisms. The prevalence of each genotype in the study population was: 6.4% BB, 11.7% Bb and 81.9% bb. The three genotypic groups differed significantly in BMD at the lumbar spine and the femoral neck. These differences corresponded to significant gene-dose effects at the lumbar spine and femoral neck (p<0.001 for both sites). The relative risk for the development of osteoporosis was about 2-3 times as great as that predicted by the differences between genotypes in BMD, and remained significant even after adjustment for age, height and weight. The vitamin D receptor gene intron 8 BsmI polymorphism is associated with reduced BMD and predisposes women to osteoporosis.

Relation of the estrogen receptor α gene microsatellite polymorphism to bone mineral density and the susceptibility to osteoporosis in postmenopausal Chinese women in Taiwan

Objective: Osteoporosis is a common disorder with a strong genetic component. Our aim was to investigate the correlation of the estrogen receptor α gene microsatellite polymorphism (TA dinucleotide repeat polymorphism 5′ upstream of exon 1) with bone mineral density and their relationship to osteoporosis. Methods: We determined the estrogen receptor α gene microsatellite polymorphism using polymerase chain reaction-based microsatellite analysis in postmenopausal Chinese women in Taiwan. Bone mineral density of the lumbar spine and proximal femur were measured using dual-energy X-ray absorptiometry. Results: The ERα genotype was classified into ‘12’ through ‘27’ according to the number of TA dinucleotide repeats they contained, as a ‘signpost’. After adjustment for potential confounding factors including age, height, and weight, subjects with genotype 18+ ( n=4) had lower bone mineral density values and a 54.5 times greater risk for osteoporosis when compared with subjects with genotype 18− ( n=170) at the lumbar spine. This should be interpreted with caution because of the small number of subjects with the unfavorable genotype 18+. According to mean number of TA dinucleotide repeats, women with a high number of repeats (TA≧20) ( n=38) had the lowest bone mineral density and a 6.1 times greater risk for osteoporosis than women with a low number of repeats (TA≦15) ( n=61) at the femoral neck, after adjustment for potential confounding factors such as age, height, and weight. Conclusion: The present study suggests that the estrogen receptor α gene microsatellite polymorphism may be a candidate genetic marker for risk of osteoporosis in postmenopausal Chinese women in Taiwan.

Breast Cancer Screening in Taiwan and China

In contrast to incidence rates prevailing in women in Western countries, Chinese women in Taiwan and China are considered to have the lowest incidence of breast cancer in the world. However, in the past 20 years, breast cancer incidence in Chinese women has seen a dramatic increase of 50-100%, which strongly supports the need for breast cancer prevention and screening programs. It is also important to indicate that breast cancer in Chinese women is characterized by younger age at tumor onset. More than 50% of the total breast cancer diagnosed annually is found in premenopausal patients, creating the need to initiate breast cancer screening programs in this population. Initially, the breast cancer screening program depended on breast self-examination. Since Chinese women have relatively small breasts, it was assumed that breast cancer was easier to detect by self-examination. However, this strategy has failed. The dilemma of breast cancer screening can be summarized by the fact that Chinese have a rapidly increasing incidence of premenopausal breast cancer, while the overall incidence is still low. Therefore, since premenopausal women have denser breasts than postmenopausal women, and Chinese women have smaller breasts and a higher percentage of dense breasts, increased mammography screening frequency may be not the sole solution to increase detection in this age group. In our experience in Taiwan, the addition of breast ultrasound may be helpful. Nearly all the nonpalpable cancers detected by mammography in our women are due to microcalcifications, and ultrasound is more sensitive in detecting nonpalpable cancers; Therefore, we suggest that a screening program, based on ultrasound to detect nonpalpable cancers not associated with microcalcifications, along with mammography within a long period, may provide more effective protection for Taiwanese and Chinese women against breast cancer.

Validation of the Chinese version of the Edinburgh Postnatal Depression Scale: detecting postnatal depression in Taiwanese women.

The Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was revalidated among Chinese women in Taiwan during the fourth week postpartum. One hundred and twenty primiparas completed the EPDS and the Beck Depression Inventory (BDI) four weeks after giving birth. The concurrent validity of the EPDS evaluated against the BDI scores was r = 0.79. The internal consistency (Cronbach's alpha) of the EPDS was 0.87. Results showed that the Chinese version of the EPDS has appropriate reliability and validity and a cut-off score of 9/10 is recommended for screening postnatal depression among Taiwanese women.

Relation of polymorphism in the promotor region for the human osteocalcin gene to bone mineral density and occurrence of osteoporosis in postmenopausal Chinese women in Taiwan.

Osteoporosis is a common disorder with a strong genetic component. Our aim was to evaluate the correlation of the HindIII osteocalcin gene polymorphism to bone mineral density (BMD) and their relationship to osteoporosis. We determined the HindIII osteocalcin gene polymorphism using polymerase chain reaction (PCR)-based restriction analysis in postmenopausal Chinese women in Taiwan. The osteocalcin gene polymorphism was detected by the restriction enzyme HindIII, where the H allele indicated the absence of the cuttable site and the h allele indicated its presence. We then related the genotypes to BMD and occurrence of osteoporosis in these women. The allelic frequencies for postmenopausal Chinese women in Taiwan were 64% for h and 36% for H in HindIII restriction fragment length polymorphisms. The prevalence of each genotype in the study population was 37.7% hh, 52.6% Hh, and 9.7% HH. The subjects with genotype hh had the greatest BMD at the lumbar spine and the femoral neck, and those with HH had the smallest BMD at the femoral neck, but these differences did not reach statistical significance. The HindIII osteocalcin genotype showed a significant effect on the prevalence of osteoporosis in the subjects at the femoral neck, that is, women with genotype HH had a 6.4 times greater risk for osteoporosis (P < 0.05), and those with genotype Hh had a 1.2 times greater risk than women with genotype hh. In conclusion, the HindIII osteocalcin gene polymorphism is associated with reduced BMD and predisposes women to osteoporosis at the femoral neck.

Proximal femoral dimension in elderly Chinese women with hip fractures in Taiwan.

To investigate the relationship between proximal femoral geometry and the occurrence of hip fracture, we compared the geometry of contralateral normal hips of 120 elderly Chinese women with hip fractures, including 63 femoral neck fractures (group A) and 57 intertrochanteric fractures (group B) due to minor trauma, with that of 72 normal elderly Chinese women (group C). The mean ages for group A, B and C subjects were 77.3, 79.7 and 72.9 years, respectively. The femoral neck length (NL), neck width (NW), diameter of femoral head, femoral shaft width just below the lesser trochanter, and neck-shaft angle (theta;) were measured on the anteroposterior plain pelvic radiographs. The mean +/- SD of NL for group A was 50.4 +/- 3.3 mm; for group B, 50.6 +/- 3.1 mm; and for group C, 48.8 +/- 3.6 mm. Statistical analysis by ANOCOVA and regression showed that only NL of women with hip fractures was significantly longer than controls after correction for age, body height and weight (p <0.01). However, the difference in NL between group A and group B was not significant. By linear regression, the probability of fracture increased only with older age (p <0.001), longer NL (p <0.005) and lighter body weight (p <0.05). By logistic regression, each standard deviation increase in NL increased the risk of hip fracture (age-adjusted odds ratio 1.84; 95% CI, 1.11-3.06). The results confirm the relationship between proximal femoral geometry and the occurrence of hip fracture in elderly Chinese women in Taiwan.

Association between N-acetyltransferase 2 (NAT2) genetic polymorphism and development of breast cancer in post-menopausal Chinese women in Taiwan, an area of great increase in breast cancer incidence

The incidence of breast cancer has increased greatly in Taiwan over the past 2 decades. Increased exposure to environmental carcinogens, including aryl aromatic amines, as a result of the economic boom, is suspected to be one factor contributing to this increase. The enzyme N-acetyltransferase 2 (NAT2) determines the rate of metabolism of aryl aromatic amines, and therefore the NAT2 slow acetylator genotype is associated with an increased risk of cancer. Our present case-control study of 150 breast cancer patients and 150 healthy controls in Taiwan was performed to explore the association between NAT2 genetic polymorphism and individual susceptibility to breast cancer. A structured questionnaire was used to collect relevant information regarding all known or suspected risk factors of breast cancer. The NAT2 genotype was determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay in 139 cases and 133 controls, and 28.8% and 21.1%, respectively, were found to have slow acetylator genotypes. Multivariate analysis, simultaneously considering other risk factors, including age at menarche, nulliparity or age at first full-term pregnancy, body mass index (BMI), hormone replacement therapy (HRT) and smoking status, showed that the NAT2 slow acetylator genotype was associated with an increased risk with borderline significance (Odds Ratio, 1.81; 95% CI, 1.01–3.31). Interestingly, this association was not significant in premenopausal women, but was significant in post-menopausal women. Further stratification of our study subjects based on different risk factor status showed that the increased risk for an NAT2 slow acetylator was more marked in post-menopausal women who were not using HRT or who had a lower BMI. Our findings suggest that NAT2 polymorphism is a susceptibility factor for breast cancer in Taiwanese women, and that NAT2-metabolized carcinogens are probably present in the environment and may be associated with induction of breast cancer. Int. J. Cancer 82:175–179, 1999. © 1999 Wiley-Liss, Inc.

Association between N-acetyltransferase 2 (NAT2) genetic polymorphism and development of breast cancer in post-menopausal Chinese women in Taiwan, an area of great increase in breast cancer incidence.

The incidence of breast cancer has increased greatly in Taiwan over the past 2 decades. Increased exposure to environmental carcinogens, including aryl aromatic amines, as a result of the economic boom, is suspected to be one factor contributing to this increase. The enzyme N-acetyltransferase 2 (NAT2) determines the rate of metabolism of aryl aromatic amines, and therefore the NAT2 slow acetylator genotype is associated with an increased risk of cancer. Our present case-control study of 150 breast cancer patients and 150 healthy controls in Taiwan was performed to explore the association between NAT2 genetic polymorphism and individual susceptibility to breast cancer. A structured questionnaire was used to collect relevant information regarding all known or suspected risk factors of breast cancer. The NAT2 genotype was determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay in 139 cases and 133 controls, and 28.8% and 21.1%, respectively, were found to have slow acetylator genotypes. Multivariate analysis, simultaneously considering other risk factors, including age at menarche, nulliparity or age at first full-term pregnancy, body mass index (BMI), hormone replacement therapy (HRT) and smoking status, showed that the NAT2 slow acetylator genotype was associated with an increased risk with borderline significance (Odds Ratio, 1.81; 95% CI, 1.01-3.31). Interestingly, this association was not significant in premenopausal women, but was significant in post-menopausal women. Further stratification of our study subjects based on different risk factor status showed that the increased risk for an NAT2 slow acetylator was more marked in post-menopausal women who were not using HRT or who had a lower BMI. Our findings suggest that NAT2 polymorphism is a susceptibility factor for breast cancer in Taiwanese women, and that NAT2-metabolized carcinogens are probably present in the environment and may be associated with induction of breast cancer.

Cytochrome P4501A1 polymorphism as a susceptibility factor for breast cancer in postmenopausal Chinese women in Taiwan.

The incidence of breast cancer has been greatly increasing in Taiwan over the past two decades. Since cytochrome P4501A1 (CYP1A1) is involved in the metabolism of environmental carcinogens or oestrogen, we hypothesized that CYP1A1 genetic polymorphism may be a susceptibility factor for breast cancer. This hypothesis was evaluated in this case control study of 150 breast cancer patients and 150 healthy controls among Chinese women. Two CYP1A1 polymorphisms were studied, one containing a new Msp1 site and the other located in axon 7 and resulting in the replacement of an isoleucine (Ile) residue by a valine (Val). After simultaneously considering the known or significant risk factors for breast cancer, including the age of study participants, positive family history of breast cancer, early menarche (≤ 13 years), nulliparity and late first full-term pregnancy (≥ 30 years), hormone replacement therapy and smoking, the CYP1A1 Msp1 polymorphism was found to be a significant factor in determining the risk of breast cancer. The homozygous variant was the most susceptible genotype with an adjusted odds ratio of 1.98 (95% confidence interval (CI) = 1.01–3.99) compared with the non-homozygous variants (the homozygous wild-type and the heterozygous variant). In contrast, the CYP1A1 Ile/Val polymorphism was not significantly associated with breast cancer development (adjusted OR = 1.07, 95% CI = 0.64–1.78). Interestingly, the Msp1 polymorphism was especially significant in postmenopausal women, but not in premenopausal women. Further stratification analysis in postmenopausal women who were non-smokers and with no history of hormone replacement therapy showed the cancer risk due to the Msp1 variant to be more significant in women with early menarche. We conclude that CYP1A1 polymorphism is a susceptibility factor for breast cancer in postmenopausal Chinese women in Taiwan. Further study with a large sample size should be considered to address issues of interactions between CYP1A1 and other risk factors. © 1999 Cancer Research Campaign

Chinese Midlife Women??s Perceptions and Attitudes About Menopause

The purpose of this research was to discover and describe the meaning of and attitudes toward menopause in midlife Chinese women in Taiwan. How these women learned about menopause was also explored. Questionnaires were distributed to a convenience sample of 208 Chinese women aged 35 to 55 living in Taiwan; 168 responded. Qualitative data were analyzed using content analysis. Percentage and chi-square were used to examine the quantitative data. The findings revealed that 154 (91.7%) women perceived menopause as a natural phenomenon. No statistically significant differences in attitude toward menopause were found between women grouped by different menopausal levels, by use or not use of hormones, or by religious preference. Some women described menopause as, "no longer young, getting old." Others described menopause as, "wisdom and maturation," "a symbol of achievement," and "a time to start enjoying life." Sixty-eight (40.5%) of the sample indicated they obtained menopausal information from friends and printed materials such as books, newspapers, and magazines. Study findings indicate that Chinese women in Taiwan perceive menopause in a positive and holistic way. Culturally sensitized Western practitioners can utilize this study's findings to more appropriately individualize care for Chinese midlife women.