Common Familial Factors Research Articles

Factors Associated with the Deterioration of Intrinsic Capacity among Older Adults in Mexico and Colombia.

Intrinsic capacity (IC) is defined as "all the physical and mental attributes possessed by the older person." This concept has gained momentum in recent years because it provides insights into the changes in the functional capacity of individuals during their life. This study examined common factors associated with IC decline among older adults in Mexico and Colombia. This cross-sectional, correlational study included 348 community-dwelling older adults. Sociodemographic, clinical, and family conditions were assessed as possible associated factors, and IC was analyzed across five domains: cognitive, locomotor, psychological, vitality (malnutrition through deficiency and excess), and sensory (visual and auditory). Parametric and non-parametric statistical analyses were performed. The common factors associated with impairment according to domain were family dysfunctionality (cognitive domain); myocardial infarction, family dysfunctionality, age >80 years, home occupation, and not having a partner (locomotor domain); dysfunctional family and risk of falls (psychological domain); age >80 years and not having a partner (malnutrition by deficiency domain); age 60-79 years, walking <7,500 steps/day, and peripheral vascular disease (malnutrition by excess domain); risk of falling and being female (visual sensory domain); risk of falling (auditory sensory domain); and dysfunctional family and risk of falling (total intrinsic capacity). Both populations had common sociodemographic, clinical, and familial factors that directly affected total IC stocks and their domains.

Comorbidity and familial aggregation of back/neck pain in the NIMH Family Study of Affective Spectrum Disorders

ObjectiveBack pain is associated with substantial Global Burden of Disease and is highly comorbid with mood and anxiety symptoms and syndromes. However, mechanisms underlying this association have not been well-elucidated. Here we apply data from the NIMH Family Study of Affective Spectrum Disorders to investigate the comorbidity, familial aggregation, and cross-aggregation of back/neck pain with mood disorder subtypes. MethodsThe sample includes 519 probands and 560 interviewed first-degree relatives. Lifetime DSM-IV Bipolar I, Bipolar II, and Major Depressive Disorder [MDD] were derived from semi-structured diagnostic interviews. Lifetime history of back or neck pain and its age of onset were self-reported retrospectively. Familial aggregation and cross-aggregation were estimated via mixed effects models in probands and interviewed first-degree relatives, while heritability and co-heritability (endophenotypic ranking value [ERV]) were estimated using full pedigrees. ResultsOver 45% of participants endorsed a history of back/neck pain. Back/neck pain was familial (adjusted odds ratio [aOR] 1.5, p = 0.04; h2 = 0.24, p = 0.009). Back/neck pain in probands was associated with MDD in relatives (aOR 1.5, p = 0.04; ERV = 0.17, p = 0.024), but not with bipolar disorder. Onset of back/neck pain occurred earlier in those with bipolar disorder compared to controls. ConclusionFindings suggest common familial risk factors underlying back/neck pain with MDD, whereas there was within-individual comorbidity of bipolar with back/neck pain. Future studies that identify common factors that lead to either back/neck pain or MDD can inform prevention and interventions.

Pediatric Chronic Orofacial Pain: A Narrative Review of Biopsychosocial Associations and Treatment Approaches.

Pediatric chronic orofacial pain (OFP) is an umbrella term which refers to pain associated with the hard and soft tissues of the head, face, and neck lasting >3 months in patients younger than 18 years of age. Common chronic pediatric OFP diagnoses include temporomandibular disorder, headaches, and neuropathic pain. Chronic OFP can adversely affect youth's daily functioning and development in many areas of well-being, and may be associated with emotional stress, depression, functional avoidance, and poor sleep, among other negative outcomes. In this mini-review, we will discuss common psychological comorbidities and familial factors that often accompany chronic pediatric OFP conditions. We will also discuss traditional management approaches for pediatric orofacial pain including education, occlusal appliances, and psychological treatments such as relaxation, mindfulness-based interventions, and cognitive-behavioral treatments. Finally, we highlight avenues for future research, as a better understanding of chronic OFP comorbidities in childhood has the potential to prevent long-term pain-related disability in adulthood.

Classifying terrorism: a latent class analysis of primary source socio-political and psychological data

ABSTRACT Attempts to define terrorist typologies often emphasise the importance of socio-political and psychological factors and the distinction between lone and group actors. However, these attempts are predominantly driven by theory or secondary data, and controversies still surround how much influence family, ideology, and personality factors exercise on terrorist behaviour. Using Latent Class Analysis (LCA), we developed a typology for terrorism utilising common social, family, childhood, ideology, and personality factors. The sample comprised 160 incarcerated offenders convicted of terrorism in Iraq. We applied LCA, including a total of 21 variables representing participant characteristics, attitudes, perceptions, and behaviours commonly identified in the literature. Analysis indicated a three-class model fit was better than two- and four-class models. The largest class in the LCA (40.6%, n = 65) was classified as ‘non-religious nationalists’ (class 1). The second largest class (40%, n = 64) was classified as ‘oppressed instrumentalists’ (class 2). The smallest class (19.4%, n = 31) was classified as ‘aggrieved antisocials’ (class 3). The new typology merits further investigation in different settings with a larger sample Although the widely supported distinction between lone and group actor terrorism was not borne out in this sample, the new categorisation can nonetheless offer opportunities for identifying those at risk and offering social interventions.

Victimization by Friends and Victimization by Other Peers: Common Risk Factors or Mutual Influence?

Much research effort has been placed on understanding peer victimization. However, few studies have focused on victimization within friendships, which affects up to half of adolescents and bears similar consequences as victimization by the larger peer group. This study examined the temporal stability and the risk factors of victimization within friendships and victimization by other peers. In regard to the first objective, moderate to high levels of stability over a one-year period were expected for victimization by friends and by other peers. In regard to the second objective, two - not necessarily mutual exclusive - hypotheses were tested. The Common Risk Factors Hypothesis postulated that victimization by friends and by other peers share common personal and familial risk factors. Alternatively, the Mutual Influence Hypothesis proposed that victimization within one relationship context may increase the risk of being victimized in the other relationship context. These hypotheses were tested with a sample of 878 adolescents (Mage = 15.08 years, range 14.50-15.75; 52% female) assessed in Grades 8 and 9. Structural equation modeling revealed moderate and weak one-year stability for victimization by friends and by other peers, respectively. No common risk factors emerged, but victimization within one relationship context increased the risk of victimization in the other relationship context one year later. These results are in line with the mutual influence hypothesis and provide evidence of a cross-context transfer of victimization in adolescence.

Associations between depressive symptom profiles and immunometabolic characteristics in individuals with depression and their siblings

Objectives The present study examined associations between immunometabolic characteristics (IMCs) and depressive symptom profiles (DSPs) in probands with lifetime diagnoses of depression and/or anxiety disorders and their siblings. Methods Data were from the Netherlands Study of Depression and Anxiety, comprising 256 probands with lifetime diagnoses of depression and/or anxiety and their 380 siblings. Measured IMCs included blood pressure, waist circumference, and levels of glucose, triglycerides, HDL cholesterol, CRP, TNF-α and IL-6. DSPs included mood, cognitive, somatic and atypical-like profiles. We cross-sectionally examined whether DSPs were associated with IMCs within probands and within siblings, and whether DSPs were associated with IMCs between probands and siblings. Results Within probands and within siblings, higher BMI and waist circumference were associated with higher somatic and atypical-like profiles. Other IMCs (IL-6, glucose and HDL cholesterol) were significantly related to DSPs either within probands or within siblings. DSPs and IMCs were not associated between probands and siblings. Conclusions The results suggest that there is a familial component for each trait, but no common familial factors for the association between DSPs and IMCs. Alternative mechanisms, such as direct causal effects or non-shared environmental risk factors, may better fit these results.

Negative social comparisons and psychosis proneness in a healthy adolescent population

There is growing evidence of an association between negative social comparisons (NSC) and both psychosis, and psychosis proneness. The majority of the work thus far, however, has focused largely on one type of NSC, namely, social rank. Whilst social rank is clearly an important factor, an individual's perception of belonging is likely also of importance; particularly, when considering individuals from collectivistic cultures such as China, where greater emphasis is placed on fitting into the group. There is also limited research investigating what factors may contribute towards the relationship between NSC and psychosis proneness, and to what extent this relationship may be due to common familial factors. To address these issues, we examined whether (1) Social rank and perceived belonging predict negative, positive and depressive psychotic experiences in a Chinese, adolescent, twin and sibling population, (2) coping styles moderate the impact of these relationships and (3), there is a familial association between NSC and psychosis proneness. Both social rank and perceived belonging were found to predict the negative and depressive dimensions of psychosis. These relationships were moderated by problem-focused coping styles. Interestingly, the association between perception of belonging, and negative psychotic experiences was familial—and stronger in Monozygotic twins—indicating perhaps shared aetiology due to common genes. Our findings highlight NSC as potential vulnerability markers for negative and depressive psychotic experiences, and suggest potentially different aetiological pathways amongst different NSC and different psychotic experiences. On a clinical level, our findings emphasize the need to consider coping styles when treating at-risk individuals.

Common familial risk factors for schizophrenia and diabetes mellitus.

The co-occurrence of type 2 diabetes and psychosis is an important form of medical comorbidity within individuals, but no large-scale study has evaluated comorbidity within families. The aim of this study was to determine whether there is evidence for familial comorbidity between type 2 diabetes and psychosis. Data were analysed from an observational study of a nationally representative sample of 1642 people with psychosis who were in contact with psychiatric services at the time of survey (The 2010 Australian National Survey of Psychosis). Participants were aged 18-64 years and met World Health Organization's International Classification of Diseases, 10th Revision diagnostic criteria for a psychotic disorder (857 with schizophrenia, 319 with bipolar disorder with psychotic features, 293 with schizoaffective disorder, 81 with depressive psychosis and 92 with delusional disorder or other non-organic psychoses). Logistic regression was used to estimate the association between a family history of diabetes and a family history of schizophrenia. A positive family history of diabetes was associated with a positive family history of schizophrenia in those with a psychotic disorder (odds ratio = 1.35, p = 0.01, adjusted for age and gender). The association was different in those with an affective versus non-affective psychosis (odds ratio = 0.613, p = 0.019, adjusted for age and gender) and was significant only in those with a non-affective psychosis, specifically schizophrenia (odds ratio = 1.58, p = 0.005, adjusted for age and sex). Adjustment for demographic factors in those with schizophrenia slightly strengthened the association (odds ratio = 1.74, p = 0.001, adjusted for age, gender, diagnosis, ethnicity, education, employment, income and marital status). Elevated risk for type 2 diabetes in people with schizophrenia is not simply a consequence of antipsychotic medication; type 2 diabetes and schizophrenia share familial risk factors.

Close To You? How Parent-Adult Child Contact Is Influenced by Family Patterns.

Intergenerational contacts occur in the context of other family relationships. We examine how in-person contacts among parents and all adult children affect each other, focusing on proximity and other predictors to assess whether and how visiting is correlated across adult children. We use a modeling approach derived from an adaptation of multilevel models to provide a convenient mechanism by which to write child-specific equations, each with its own set of predictors, and wherein one child's attribute values can be attached to other children's records. We find that parent-adult child visiting is positively correlated across siblings, but the frequency of visiting within families is not directly reciprocated. Rather, visiting responds to common family factors. Visiting declines with distance, but there are strong discontinuities in the effect. Distance between parents and a focal child is positively associated with visiting with other children. The empirical patterns we report can be framed within enhancement and compensation models. Positive correlations and cross-sibling interactions that juxtapose levels of visiting against not seeing a child in last 12 months are consistent with the enhancement model. The cross-sibling interaction for distance, whereby one child's farther distance leads to more visits reported with others, provides evidence of a countervailing, though, weaker, pattern of compensation for proximity.

Childhood trauma and personality disorder criterion counts: A co-twin control analysis.

Correlational studies consistently report relationships between childhood trauma (CT) and most personality disorder (PD) criteria and diagnoses. However, it is not clear whether CT is directly related to PDs or whether common familial factors (i.e., shared environment and/or genetic factors) better account for that relationship. The current study used a cotwin control design to examine support for a direct effect of CT on PD criterion counts. Participants were from the Norwegian Twin Registry (N = 2,780), including a subset (n = 898) of twin pairs (449 pairs, 45% monozygotic [MZ]) discordant for CT meeting DSM-IV Posttraumatic Stress Disorder Criterion A. All participants completed the Norwegian version of the Structured Interview for DSM-IV Personality. Significant associations between CT and all PD criterion counts were detected in the general sample; however, the magnitude of observed effects was small, with CT accounting for no more than approximately 1% of variance in PD criterion counts. A significant, yet modest, interactive effect was detected for sex and CT on Schizoid and Schizotypal PD criterion counts, with CT being related to these disorders among women but not men. After common familial factors were accounted for in the discordant twin sample, CT was significantly related to Borderline and Antisocial PD criterion counts, but no other disorders; however, the magnitude of observed effects was quite modest (r2 = .006 for both outcomes), indicating that the small effect observed in the full sample is likely better accounted for by common genetic and/or environmental factors. CT does not appear to be a key factor in PD etiology.

Exploring the relationships between tobacco smoking and schizophrenia in first-degree relatives

Up to 90% of individuals with schizophrenia suffer from nicotine dependence. Both schizophrenia and nicotine consumption have strong genetic components, which may overlap. The relationship between schizophrenia and nicotine dependence remains unclear, due in part to confounding factors. Studies of the relationship between nicotine consumption and milder schizophrenia-related phenotypes, such as schizotypy, in first-degree relatives of individuals with schizophrenia could help to better understand the relationship between smoking and schizophrenia while avoiding such confounders. We assessed the proportion of smokers, their level of nicotine dependence and their level of schizotypy in a sample of 98 first-degree relatives of schizophrenic subjects and 110 healthy controls. Partial correlation analysis was used to assess the relationship between schizotypal dimensions and smoking dependence. The prevalence of smoking and nicotine dependence levels were higher in the relatives than in the healthy control group. We found no relationship between nicotine dependence and the magnitude of schizotypal features in either group. Our results support the hypothesis that the relationship between schizophrenia and smoking is largely mediated by common familial factors, which may be genetic.

Deliberate self-harm in children and adolescents: an 11-year case note study.

To retrospectively examine the case-notes of all children and adolescents admitted with deliberate self-harm (DSH) or suicidal ideation during the study period 1993-2003. The study aimed to identify underlying reasons why children and adolescents engage in DSH, and to identify common psychiatric, psychosocial and familial factors which may predispose or contribute to an individual's engagement in such behaviour. All children presenting to the hospital with DSH or suicidal ideation were identified and data collected from their case notes. A study specific questionnaire was designed to collect demographic details, details on clinical presentation, past attempts, comorbid psychiatry disorders, family history and family circumstances. Information was also recorded on hospital stay and discharge planning. During the 11-year period, 231 children presented with suicidal ideation or behaviour. The mean age was 12.85 with an age range from 6-17 years, with a female:male ratio of 2.5:1. Overdose was the most common method (81.2%) and paracetamol most commonly the drug of choice. More than half of the group (55.7%) expressed a wish to die. More than half (51.8%) had expressed suicidal ideation in the past, 31% had made a previous attempt, and 11.7% had been previously admitted. Of the children 8% presented with suicidal behaviour more than once over the study period. There was a family history of completed suicide in 6.6%. Deliberate self-harm in young people is a significant public health problem in Ireland. During the period of this study, rates have continued to increase. There is an urgent need for national bodies such as the National Suicide Review Group to extend their focus to include those under age 18 and for services to be developed that might reduce DSH behaviours. More research is needed in the area of childhood suicidal behaviour.

Family History Study of the Familial Coaggregation of Borderline Personality Disorder With Axis I and Nonborderline Dramatic Cluster Axis II Disorders

The purpose of this study was to assess the familial coaggregation of borderline personality disorder (BPD) with a full array of axis I disorders and four axis II disorders (antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and sadistic personality disorder) in the first-degree relatives of borderline probands and axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial psychopathology using the Revised Family History Questionnaire-a semistructured interview of demonstrated reliability. Of these 445 subjects, 341 met both DIB-R and DSM-III-R criteria for BPD and 104 met DSM-III-R criteria for another type of personality disorder (and neither criteria set for BPD). The psychopathology of 1,580 first-degree relatives of borderline probands and 472 relatives of axis II comparison subjects was assessed. Using structural models for familial coaggregation, it was found that BPD coaggregates with major depression, dysthymic disorder, bipolar I disorder, alcohol abuse/dependence, drug abuse/dependence, panic disorder, social phobia, obsessive-compulsive disorder, generalized anxiety disorder, posttraumatic stress disorder, somatoform pain disorder, and all four axis II disorders studied. Taken together, the results of this study suggest that common familial factors, particularly in the areas of affective disturbance and impulsivity, contribute to borderline personality disorder.

Childhood mistreatment and adolescent and young adult depression

In this paper, I use a nationally representative sample of adolescents from the United States to examine the association between childhood mistreatment (sexual abuse and physical abuse) and depression during adolescence and young adulthood. Researchers have implicated childhood mistreatment as one of the most important predictors of depression. An alternative mechanism linking childhood mistreatment with adolescent and young adult depression is community and family disadvantage (or other factors) that affect both outcomes. Using data from the restricted version of the U.S. National Longitudinal Study of Adolescent Health (Add Health), this paper outlines several findings of the relationship between mistreatment and depression as well as the gender differences in depression. First, I find very limited evidence that controlling for common environmental factors at the school or neighborhood level explain the relationship between mistreatment and depression. Also, I show that controlling for common family factors decreases the predictive power of childhood mistreatment on depression. Results in this paper generally support previous research that shows the link between childhood mistreatment and depression is most important for females, even within families. Finally, results suggest that the effects of child mistreatment on depression may increase as individuals age.

Genetic Determination of Head-Size-Related Anthropometric Traits in an Ethnically Homogeneous Sample of 373 Indian Pedigrees of West Bengal

The substantial involvement of genetic factors in the determination of head-size and head-shape traits has been firmly established. However, there has been a lack of agreement on a number of specific issues concerning the pattern of inheritance of craniofacial features. In this study we examined some of these issues in a large, ethnically homogeneous sample of Indian pedigrees. The data included 1,263 individuals belonging to 373 nuclear families. Eleven raw head-size traits and two synthetic phenotypes, interpreted as horizontal and vertical head-size components (HOC and VEC, respectively), were used in the analysis. To establish the pattern of inheritance of head traits, we carried out univariate and bivariate analyses. Maximum heritability estimates ranged from 0.41 to 0.83 for the studied head-size phenotypes. The portion of the total residual variance attributable to putative additive genetic factors was 68.3% and 70.3% for HOC and VEC, respectively, and common familial factor effects were found to be nonsignificant. The extent of genetic influences did not differ significantly with respect to sex or between HOC and VEC. The results of bivariate variance decomposition analysis strongly suggest the existence of common genetic factors simultaneously affecting HOC and VEC; 41.8% of the two traits' total residual variance was attributable to the effect of these common genetic factors.

Genetic and environmental influences on dimensional representations of DSM-IV cluster C personality disorders: a population-based multivariate twin study

The DSM-IV cluster C Axis II disorders include avoidant (AVPD), dependent (DEPD) and obsessive-compulsive (OCPD) personality disorders. We aimed to estimate the genetic and environmental influences on dimensional representations of these disorders and examine the validity of the cluster C construct by determining to what extent common familial factors influence the individual PDs. PDs were assessed using the Structured Interview for DSM-IV Personality (SIDP-IV) in a sample of 1386 young adult twin pairs from the Norwegian Institute of Public Health Twin Panel (NIPHTP). A single-factor independent pathway multivariate model was applied to the number of endorsed criteria for the three cluster C disorders, using the statistical modeling program Mx. The best-fitting model included genetic and unique environmental factors only, and equated parameters for males and females. Heritability ranged from 27% to 35%. The proportion of genetic variance explained by a common factor was 83, 48 and 15% respectively for AVPD, DEPD and OCPD. Common genetic and environmental factors accounted for 54% and 64% respectively of the variance in AVPD and DEPD but only 11% of the variance in OCPD. Cluster C PDs are moderately heritable. No evidence was found for shared environmental or sex effects. Common genetic and individual environmental factors account for a substantial proportion of the variance in AVPD and DEPD. However, OCPD appears to be largely etiologically distinct from the other two PDs. The results do not support the validity of the DSM-IV cluster C construct in its present form.

Is the association between posttraumatic stress disorder symptoms and poor health due to a common familial or genetic factor?

Objective The objective of this study was to identify genetic, familial and environmental contributions to the association between posttraumatic stress disorder (PTSD) symptoms and poor health. Methods A community sample of 1852 twin pairs was assessed for symptoms of PTSD [with the Impact of Events Scale (IES)] and self-reported global health status using a single five-level question. An ordinal logistic regression model estimated odds ratio/s (OR) for the association between PTSD and health status. Within-pair analysis assessed confounding by familial and genetic factors and adjusted for the possible confounding influence of age, sex, race, education and self-reported physician diagnosis of depression. Results The IES was strongly and significantly associated with self-reported health [OR=1.8; 95% confidence interval (95% CI)=1.5–2.2; highest quartile vs. lowest quartile]. This association remained significant in within-pair analysis (OR=1.3; 95% CI=1.0–1.7), but after further adjustment for sociodemographics and depression, it was no longer significant ( P trend=.17). Separate analysis by zygosity did not show differential effect in monozygotic or dizygotic pairs. Conclusion These findings suggest that the association between PTSD symptoms and poor health is, in part, due to familial confounding and sociodemographic factors. Little evidence of confounding by genetic factors was found. These findings suggest that early prevention efforts would have the greatest potential for improving poor health in PTSD-prone patients, whereas later intervention efforts directed at treating PTSD may have a more limited impact on improving poor health.

Early Onset Cannabis Use and Progression to other Drug Use in a Sample of Dutch Twins

One possible explanation of the commonly reported associations between early onset cannabis use and elevated risks of other illicit drug use is that early onset cannabis use increases access and availability to other drugs. It was this argument that in part motivated policy changes in the Netherlands that led to the de facto legalization of cannabis there. This study examines, using a co-twin control design, whether previously observed associations between early onset cannabis use and elevated lifetime rates of other illicit drug use would also be observed in a sample of 219 same sex Dutch twin pairs discordant for cannabis use before age 18. After adjustment for covariates, rates of lifetime party drug use (OR=7.4, 95% CI=2.3-23.4), hard drug use (OR=16.5, 95% CI=2.4-111.3), but not regular cannabis use (OR=1.3, 95% CI=0.3-5.1) were significantly elevated in individuals who reported early onset cannabis use, relative to their co-twin who had not used cannabis by age 18. The elevated odds of subsequent illicit drug use in early cannabis users relative to their non early using co-twins suggests that this association could not be explained by common familial risk factors, either genetic or environmental, for which our co-twin methodology provided rigorous control.

Genetic regulation of the variation of circulating insulin-like growth factors and leptin in human pedigrees

Recent literature has shown that circulating levels of insulin-like growth factor I (IGF-I) and/or IGF binding proteins (IGF-BPs) may be of importance in the risk assessment of several chronic diseases including cancer, cardiovascular disease, diabetes mellitus and so on. The present study examined the extent of genetic and environmental influences on the populational variation of circulating IGF-I and IGF-BP-1 in apparently healthy and ethnically homogeneous white families. The plasma levels of each of the studied biochemical indices were determined by enzyme-linked immunoassay in 563 individuals aged 18 to 80 years. Quantitative genetic analysis showed that the IGF-I variation was appreciably attributable to genetic effects (47.1% ± 9.0%), whereas for IGF-BP-1, only 23.3% ± 7.8% of the interindividual variation was explained by genetic determinants. Common familial environment factors contributed significantly only to IGF-BP-1 variation (23.3% ± 7.8%). In addition, we examined the covariations between these molecules and between them and IGF-BP-3 and leptin that were previously studied in the same sample. The analysis revealed that the pleiotropic genetic effects were significant for 2 pairs of traits, namely for IGF-I and IGF-BP-3, and for IGF-BP-1 and leptin. The bivariate heritability estimates were 0.21 ± 0.04 and 0.15 ± 0.05. The common environmental factors were consistently a significant source of correlation between all pairs (barring IGF-I and leptin) of the studied molecules; they were the sole predictors of correlation between IGF-I and IGF-BP-1, and between IGF-BP-1 and IGF-BP-3. Our results affirm the existence of specific and common genetic pathways that in combination determine a substantial proportion of the circulating variation of these molecules.

Common risk factors of breast and ovarian cancer: recent view.

Clinicians, epidemiologists, and public health specialists tend to examine breast and ovarian cancer separately. Although this seems fairly rational and expected, both malignancies are estrogen related and thus share many risk factors. In this review, we investigate the common familial, reproductive, anthropometric, nutritional, and lifestyle risk factors of breast and ovarian cancer. We believe that the parallel examination of the two cancer types could significantly contribute to an improved prevention of "gynecological cancer" as a whole.