Multivariate Unconditional Logistic Regression Research Articles

LIG3 gene polymorphisms and risk of gastric cancer in a Southern Chinese population

DNA ligase III (LIG3) has been implicated in the etiology of cancer. However, few studies have accessed the association of LIG3 single nucleotide polymorphisms (SNPs) with gastric cancer risk, especially in Chinese population. The current study was undertaken to investigate contribution of LIG3 gene polymorphisms to gastric cancer risk. We first applied TaqMan assay to genotype three LIG3 gene SNPs (rs1052536 C > T, rs3744356 C > T, rs4796030 A > C) in 1142 patients with gastric cancer and 1173 healthy controls. And then, we adopted unconditional multivariate logistic regression analysis to estimate the association between LIG3 SNP genotypes and gastric cancer risk. In all, no positive association was found between the three LIG3 SNPs and gastric cancer risk in single locus analysis or combined risk genotypes analysis. However, compared with participants with rs4796030 AA genotype, participants with the AC/CC had a decreased risk of developing tumors from cardia at an adjusted OR of 0.68 (95% CI = 0.48–0.96, P = 0.026). In addition, we found that participants harboring 2–3 risk genotypes were at a significantly increased risk of developing tumor from cardia (adjusted OR = 1.63, 95% CI = 1.16–2.28, P = 0.005). These results suggest that genetic variations in LIG3 gene may play a weak role in modifying the risk of gastric cancer. Future functional studies should be performed to elucidate the biological role of LIG3 polymorphisms in gastric cancer carcinogenesis.

Moderate-to-vigorous intensity physical activity in early pregnancy reduces risk of gestational diabetes mellitus

Objective To investigate the effects of moderate-to-vigorous intensity physical activity (MVPA) in early pregnancy on the onset of gestational diabetes mellitus (GDM) in Sichuan Province. Methods A case-control study was performed on 1 508 gravidas at 8-14 gestational weeks in Sichuan Provincial Hospital for Women and Children from February to July, 2017. Baseline information during early pregnancy was collected through questionnaires. Information on time and intensity of physical activity were collected through pregnancy physical activity questionnaire. The time spent in MVPA was calculated and was categorized as active (≥3.5 h/week) or inactive MVPA (<3.5 h/week). Based on self-reported pre-pregnancy weights collected by questionnaire as well as the measured heights, body mass index (BMI) before pregnancy was calculated. After a 75 g oral glucose tolerance test (OGTT) at 24-28 gestational weeks, all subjects were divided into GDM (n=561) or non-GDM group (n=947), according to the GDM diagnostic criteria of the Guidelines for the Diagnosis and Treatment of Pregnancy Diabetes in China (2014). Mann-Whitney U test and Chi-square test were used for statistical analysis. Multivariate unconditional logistic regression model was used to analyze the association between the time of MVPA in early pregnancy and GDM incidence. Results The median time spent in MVPA [M(P25-P75)] in early pregnancy was 3.00 (0.50-3.12) h/week, and 345 gravidas (22.9%) were classified as active in MVPA. After the control of confounding factors such as age, gravidity and parity history, and pre-pregnancy BMI, the multivariate unconditional logistic regression analysis showed that compared with the inactive group, the risk of GDM of active MVPA gravidas was reduced by 26.1% (OR=0.739, 95%CI: 0.553-0.989, P=0.042). Among primigravidas and primiparae, the risk of GDM in active MVPA gravidas was decreased by 47.6% and 44.3% than the inactive ones, respectively (primigravidas: OR=0.524, 95%CI: 0.297-0.925, P=0.026; primiparae: OR=0.557, 95%CI: 0.357-0.868, P=0.010). Conclusions Insufficient physical activity in early pregnancy is common in gravidas in Sichuan, China. The risk of GDM could be reduced if the frequency of MVPA during early pregnancy is no less than 3.5 h/week, especially in primigravidas and primiparae. Key words: Diabetes, gestational; Exercise; Pregnancy trimester, first

Plasma B-vitamins and one-carbon metabolites and the risk of breast cancer in younger women.

We examined the association of plasma B-vitamins and metabolites, and related genetic variants, with risk of breast cancer among predominantly premenopausal women. We conducted a nested case-control study within the Nurses' Health Study II. From blood samples collected in 1996-1999 and follow-up through 2007, plasma measures were available for 610 cases and 1207 controls. Unconditional multivariable logistic regression was used to estimate relative risks (RR) of breast cancer and 95% confidence intervals (CIs). We examined whether associations varied by methylenetetrahydrofolate reductase (MTHFR) and dihydrofolate reductase polymorphisms, breast cancer risk factors, or tumor characteristics. Plasma vitamin B12 was associated with a 64% higher risk of breast cancer comparing the highest versus lowest quintile (95% CI 1.17-2.29, p-trend = 0.02). Plasma folate (comparable RR = 1.18, 95% CI 0.84-1.66), pyridoxal 5'-phosphate (RR = 1.18, 95% CI 0.85-1.64), homocysteine (RR = 0.93, 95% CI 0.67-1.28), cysteine (RR = 1.14, 95% CI 0.81-1.62), and cysteinylglycine (RR = 0.93, 95% CI 0.66-1.31) were not associated with overall breast cancer risk. Folate was significantly positively associated with invasive and estrogen receptor-positive/progesterone receptor-positive breast cancer, and this association was suggestively stronger for bloods collected post-fortification. Several nutrient/breast cancer associations varied across subgroups defined by age, smoking, alcohol, multivitamin use, and MTHFR status (p-interaction < 0.05). Overall, plasma B-vitamins and metabolites were not associated with lower breast cancer risk. Plasma vitamin B-12 was positively associated with higher risk of overall breast cancer, and plasma folate was positively associated with risk of invasive breast cancer. Additionally, there may be associations in subgroups defined by related genetic variants, breast cancer risk factors, and tumor factors. Further studies in younger women and in the post-fortification era are needed to confirm these findings.

Tobacco Smoking Modifies the Association between Hormonal Factors and Lung Cancer Occurrence among Post-Menopausal Chinese Women

Inconsistent evidence has been reported on the role of female hormonal factors in the development of lung cancer. This population-based case–control study evaluated the main effect of menstrual/reproductive factors on the risk of lung cancer, and the effect modification by smoking status. Multivariable unconditional logistic regression models were applied adjusted for age, income, education, county of residence, body mass index, smoking status, pack-years of smoking, and family history of lung cancer. Among 680 lung cancer cases and 1,808 controls, later menopause (at >54 vs. <46 years old) was associated with increased risk of lung cancer (SBOR, semi-Bayes adjusted odds ratio = 1.61, 95% PI, posterior interval = 1.10–2.36). More pregnancies (2 or 3 vs. 0 or 1) was associated with decreased risk (SBOR = 0.71, 95% PI = 0.53, 0.95). Ever being a smoker and having two or fewer pregnancies in one's lifetime could jointly increase the odds of lung cancer (RERI, relative excess risk due to interaction = 1.71, 95% CI = 0.03, 3.38). An increased number of ovulatory cycles was associated with increased risk of lung cancer (SBOR for 13 ovulatory cycles = 1.02, 95% CI = 1.00+, 1.04).

Household fuel use and latent tuberculosis infection in a Nepali population

BackgroundThe risk of developing latent tuberculosis infection (LTBI) associated with cooking with solid fuels is unknown. This study examined the relationship between household fuel uses and LTBI in adults living in Nepal, a country with a high incidence of tuberculosis. MethodsParticipants were 1088 adults aged 18–70 years, members of the control group of a population-based case-control study of pulmonary TB (PTB) in people without previous TB, living in Kaski and neighboring districts of Nepal. Participants were interviewed in their homes with a standardized questionnaire. Blood samples were tested for LTBI using an interferon-gamma release assay. Multivariate unconditional logistic regression was used to examine associations between household fuel sources and LTBI. ResultsThe overall prevalence of LTBI in the study population was 36%. Using liquefied petroleum gas (LPG) as the baseline cooking fuel type, the adjusted odds ratio (aOR) for using a primary wood cookstove was 1.13 (95%CI: 0.73,1.77) for all participants and, in women only, 1.14 (0.62, 2.09). Corresponding figures for biogas stoves were 0.64 (0.34,1.20) and 0.59 (0.24,1.45), respectively. Household sources of air pollution positively associated with LTBI included traditional oil lamps (diyos) used during power outages, for which the aOR in all participants was 2.53 (1.20, 5.31), although the number of users was small. Use of candles for lighting was also associated with increased risk of LTBI among men (aOR = 1.61, 95% CI:1.01, 2.56). ConclusionsNo association was found between use of wood for cooking and LTBI. However, there was some evidence that biogas cookstoves were associated with reduced odds of LTBI. Some exposures at the time of actual infection will have been different than the current exposures used in the analysis, biasing results towards the null. Results are sufficient for the use of diyos to be discouraged for lighting purposes. Overall, results suggest that household cooking fuel use is likely to have more effect on moving from the infected state to PTB than on becoming infected with the M. tuberculosis complex. Further research, including longitudinal studies with serial LTBI testing would be useful to more accurately assess the relationships between exposures and infection.

The characteristics of recent HIV-1 infection and associated factors in Tianjin

The newly reported HIV infected cases was collected, and HIV blood samples were detected to identify recent HIV infection in Tianjin during 2008-2015. Factors associated with HIV-1 infection were analyzed by the univariate and multivariate unconditional logistic regression. The recent HIV-1 infection proportion of homosexuals increased from 37.70% in 2008 to 83.68% in 2015. Those cases who aged ≤30 years (OR=1.53, 95%CI: 1.30-1.79), in han ethnic group (OR=1.40, 95%CI: 1.02-1.91), students (OR=1.79, 95%CI: 1.28-2.51) were more likely to be recent infected. The cases who had a high school education (OR=1.28, 95%CI: 1.05-1.56) or collage education (OR=1.23, 95%CI: 1.00-1.50) were more likely to be recent infected than those who had a primary school education. Compared with patients identified by hospitals, the recent HIV infections were more likely to be found through voluntary counseling and testing (VCT), STD outpatients, men who have sex with men (MSM) investigation and unpaid blood donors. Homosexual transmission has become the major route of HIV-1 recent infection in Tianjin.

Empirical Analysis of the Status and Influencing Factors of Catastrophic Health Expenditure of Migrant Workers in Western China.

Objective: To understand the current situation and influencing factors of catastrophic health expenditure (CHE) of migrant workers in Western China. Method: Sample data were obtained by cluster random sampling. Data were entered and sorted using Epidata 3.1 and SPSS 21.0. The statistical analysis involved a descriptive analysis, chi-square tests, multivariate unconditional logistic regression, and multiple correspondence analysis (MCA). Results: A total of 1271 households were surveyed, and the incidence of CHE was 12.5% (159/1271). The multivariate logistic regression showed that households with elderly people over 65 years old (0R = 2.05, 95% CI = 1.42–2.97), children under five years old (0R = 2.61, 95% CI = 1.53–4.48), at least one person with no basic medical insurance (0R = 2.96, 95% CI = 2.08–4.23), chronically ill patients (0R = 1.85, 95% CI = 1.23–2.77), and hospitalized patients (0R = 3.61, 95% CI = 2.31–5.62) contributed to the risk of CHE. Compared to migrant workers in the >30,000 Yuan household per capita annual income group, the 10,001–20,000 Yuan income group (0R = 2.35, 95% CI = 1.44–3.82) and ≤10,000 Yuan income group (0R = 3.72, 95% CI = 2.09–6.62) had a higher risk of CHE occurrence. Compared to migrant workers in the university and above head-of-household education group, those in the primary level or below education group (0R = 5.90, 95% CI = 3.02–11.5) had a higher risk of CHE occurrence. MCA revealed a strong interrelationship between the following risk factors and CHE: household per capita annual income ≤10,000 Yuan, primary school education level or below for the head of the household, and having at least one person in the household with no basic medical insurance. Conclusions: CHE incidence amongst migrant workers in Western China is a serious issue, and policymakers should pay more attention to these migrant workers’ households that are more prone to CHE than others, so as to decrease the incidence of CHE in this group.

Comparison of medical comorbidity between patients with primary angle-closure glaucoma and a control cohort: a population-based study from Taiwan

ObjectiveTo determine the prevalence and risk of systemic comorbidities in primary angle-closure glaucoma in Taiwan population.MethodsWe included 3322 primary angle-closure glaucoma (PACG) subjects and randomly selected patients without PACG from...

Transcranial Doppler Ultrasonography for the Management of Severe Traumatic Brain Injury After Decompressive Craniectomy

Cerebral hemodynamic transformation is a relatively common finding in patients with traumatic brain injury (TBI). Knowledge of cerebral hemodynamic disturbance may assist in predicting the management outcome. Transcranial Doppler ultrasonography (TCD) monitoring of patients with TBI can be used to reveal various pathologic hemodynamic changes. The objective of this study was to compare the clinical outcomes of postoperative routine intracranial pressure (ICP) monitoring versus ICP monitoring combined with TCD monitoring in patients with brain trauma after decompressive craniectomy. This was a retrospective study of 30 patients with TBI who underwent ICP combined with TCD monitoring (after 2015) compared with a historical control group of 30 patients who only underwent routine ICP monitoring (in 2013-2014). ICP, partial pressure of carbon dioxide, hemoglobin, and hematocrit values were monitored and recorded on a daily basis for 7 days after operation. Neuroimaging was also performed at admission. Neurologic outcome was assessed at 2 weeks and 6 months after operation using the Glasgow Outcome Score Extended (GOS-E). Unconditional multivariable logistic regression was conducted to analyze the factors for favorable clinical outcome. Two weeks after operation, there were no differences in mortality rate between the 2 groups (P=0.643). When considering the GOS-E score at 6 months, there were no differences in clinical prognosis between the 2 groups (P= 0.101), but the ICP combined with TCD monitoring group showed a higher frequency of patients with favorable outcome compared with the routine ICP monitoring group (P= 0.043). Unconditional multivariable logistic regression results showed that no factor was independently associated with GOS-E at 6 months. TCD could be helpful for the serial monitoring of cerebral hemodynamic changes after decompressive craniectomy for TBI, which could be beneficial for neurologic outcome improvement.

Germline BRCA2 K3326X and CHEK2 I157T mutations increase risk for sporadic pancreatic ductal adenocarcinoma.

Rare truncating BRCA2 K3326X (rs11571833) and pathogenic CHEK2 I157T (rs17879961) variants have previously been implicated in familial pancreatic ductal adenocarcinoma (PDAC), but not in sporadic cases. The effect of both mutations in important DNA repair genes on sporadic PDAC risk may shed light on the genetic architecture of this disease. Both mutations were genotyped in germline DNA from 2,935 sporadic PDAC cases and 5,626 control subjects within the PANcreatic Disease ReseArch (PANDoRA) consortium. Risk estimates were evaluated using multivariate unconditional logistic regression with adjustment for possible confounders such as sex, age and country of origin. Statistical analyses were two-sided with p values <0.05 considered significant. K3326X and I157T were associated with increased risk of developing sporadic PDAC (odds ratio (ORdom ) = 1.78, 95% confidence interval (CI) = 1.26-2.52, p = 1.19 × 10-3 and ORdom = 1.74, 95% CI = 1.15-2.63, p = 8.57 × 10-3 , respectively). Neither mutation was significantly associated with risk of developing early-onset PDAC. This retrospective study demonstrates novel risk estimates of K3326X and I157T in sporadic PDAC which suggest that upon validation and in combination with other established genetic and non-genetic risk factors, these mutations may be used to improve pancreatic cancer risk assessment in European populations. Identification of carriers of these risk alleles as high-risk groups may also facilitate screening or prevention strategies for such individuals, regardless of family history.

Breastfeeding factors and risk of epithelial ovarian cancer

ObjectivePrevious studies suggest that breastfeeding reduces epithelial ovarian cancer (EOC) risk. However, the effects of age, timing and episode details on the EOC-breastfeeding relationship have not been examined. The objective of this study was to examine the association between breastfeeding factors and epithelial ovarian cancer. MethodsWe examined breastfeeding factors among parous women in a population-based, case-control study conducted in Pennsylvania, Ohio, and New York from 2003 to 2008. We compared 689 incident EOC cases to 1572 community controls. Multivariable unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) associated with breastfeeding patterns adjusting for potential confounders. ResultsCompared to never breastfeeding, breastfeeding any offspring was associated with a 30% reduction in EOC risk (OR = 0.70; 95%CI = 0.58–0.85). That association lasted more than 30 years (OR = 0.69, 95%CI = 0.53–0.88). An average breastfeeding episode of 3 months was also associated with reduced risk (OR = 0.73, 95%CI = 0.58–0.80). A greater number of breastfeeding episodes was associated with greater risk reduction (OR = 0.78, 95%CI = 0.64–0.96 and OR = 0.49, 95%CI = 0.36–0.68 1–2 and 3+ episodes, respectively, compared to never breastfed, trend p = 0.01). Longer breastfeeding duration was also associated with reduced risk (OR = 0.75 and 0.62 for less than and greater than 1-year total duration, respectively, compared to never breastfed). An earlier age at first breastfeeding was further associated with increased protection (OR = 0.50–0.80, for first episode at age <25, 25–29, and 30+, respectively, trend p = 0.001). ConclusionsBreastfeeding for as few as 3 months is associated with reduced EOC risk. Although this association decreases over time, it persists for more than 30 years. Longer cumulative duration, increasing number of breastfeeding episodes, and earlier age at first breastfeeding episode are each associated with increased benefit.

ECG conduction disturbances and ryanodine receptor expression levels in occupational lead exposure workers

ObjectivesA significant number of researches have evidenced that occupational lead (Pb) exposure increased risks of cardiovascular disease. However, evidences about the potential effects of Pb on the cardiac conduction system...

Higher frequency of dairy intake is associated with a reduced risk of breast cancer: Results from a case-control study in Northern and Eastern China.

The association between dairy intake and breast cancer risk has not been well investigated, especially in the Chinese population. This study aimed to examine the association between the weekly frequency of dairy intake and the risk of breast cancer among women in Northern and Eastern China, and to investigate whether the association varied by hormone receptor status. A total of 1,286 cases of breast cancer and 1,461 controls were enrolled in this study. Dairy intake was obtained using a food-frequency questionnaire (FFQ). Frequency of dairy intake per week was divided into four categories (<1 day/week, 1–2 days/week, 3–4 days/week and 5–7 days/week). Unconditional multivariate logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI). Stratified analyses were performed by residence, age, and education level. Separate analyses were also conducted for different estrogen receptor (ER) and progesterone receptor (PR) status. This analysis revealed that weekly frequency of dairy intake was strongly inversely associated with breast cancer risk, with an adjusted OR for intake 5–7 days/week of 0.53 (95% CI=0.39–0.72, P<0.001 for trend). In the stratified analyses, women who consumed dairy 5–7 days/week had a lower risk of breast cancer in urban areas (OR=0.45, 95% CI=0.30–0.66, P<0.001 for trend), in the group 45–59 years old (OR=0.39, 95% CI=0.26–0.60, P<0.001 for trend), and in the group educated to senior high school or above (OR=0.39, 95% CI=0.25–0.59, P<0.001 for trend). There was an inverse association between the weekly frequency of dairy intake and the risk of ER+, PR+, and ER+PR+ breast cancer (all P<0.001 for trend). These results indicated that the weekly frequency of dairy intake was inversely associated with the risk of breast cancer among women in Northern and Eastern China.

Poor Sleep Quality Is Associated with a Higher Risk of Pulmonary tuberculosis in Patients with a Type 2 Diabetes Mellitus Course for More than 5 Years.

A case-control study was conducted in Shandong from January to December 2017 to explore the relationship between sleep quality and the risk of active pulmonary tuberculosis (PTB). Seventy-nine patients with type 2 diabetes mellitus coincident with newly diagnosed pulmonary tuberculosis (DM-PTB) and 169 age, sex, and DM course frequency-matched controls (DM alone) were enrolled. Univariate and multivariable unconditional logistic regression analyses were conducted. We further conducted subgroup analyses to explore the relationship between sleep quality and PTB risk, including DM course (≤5 and ＞5 years), age, sex, and the presence of overweight or obesity (body mass index (BMI) ＞ 24 kg/m2). Multivariate logistic regression demonstrated that poor sleep quality had a borderline negative association with the odds of PTB (P ＝ 0.065). Subgroup multivariate analyses showed that poor sleep quality increased the risk of PTB to more than 3 times among patients with a DM course ＞ 5 years (odds ratio 3.31, 95% confidence interval: 1.08-10.13; P ＝ 0.036) after adjusting for potential confounding factors including residential area, educational level, BMI, history of contact with tuberculosis patients, smoking, alcohol consumption, physical exercise, immune status, and frequency of blood glucose monitoring. In conclusion, poor sleep quality is an independent risk factor of PTB among DM patients with a course of ＞ 5 years, which indicates significant epidemiological implications for PTB control.

What Is the Role for Metronidazole in the Treatment of Clostridium difficile Infection? Results From a National Cohort Study of Veterans With Initial Mild Disease

Metronidazole may still be an appropriate therapeutic option for mild Clostridium difficile infection (CDI) in select patients, but data are limited to guide clinicians in identifying these patients. Our 2-stage study included a national cohort of Veterans with a first episode of mild CDI (2010-2014). First, among those treated with metronidazole, we identified predictors of success, defined as absence of all-cause mortality or recurrence 30 days posttreatment, using multivariable unconditional logistic regression. Second, among a subgroup of patients with characteristics predictive of success identified in the first stage, we compared clinical outcomes among those treated with metronidazole compared with vancomycin, using Cox proportional hazards models for time to 30-day all-cause mortality, CDI recurrence, and failure. Among 3656 patients treated with metronidazole, we identified 3282 patients with success and 374 patients without success (failure). Younger age was the only independent predictor of success. Age ≤65 years was associated with an odds of success 1.63 times higher (95% confidence interval [CI], 1.29-2.06) than age >65 years. Among 115 propensity score-matched pairs ≤65 years of age, no significant differences were observed between metronidazole and vancomycin (reference) for all-cause mortality (hazard ratio [HR], 0.29 [95% CI, .06-1.38]), CDI recurrence (HR, 0.62 [95% CI, .26-1.49]), or failure (HR, 0.50 [95% CI, .23-1.07]). Among patients ≤65 years of age with initial mild CDI, clinical outcomes were similar with metronidazole and vancomycin. These data suggest that metronidazole may be considered for the treatment of initial mild CDI among patients 65 years of age or younger.

Smoking and Other Risk Factors in Individuals With Synchronous Conventional High-Risk Adenomas and Clinically Significant Serrated Polyps.

Serrated polyps (SPs) and conventional high-risk adenomas (HRAs) derive from two distinct biological pathways but can also occur synchronously. Adults with synchronous SPs and adenomas have been shown to be a high-risk group and may have a unique risk factor profile that differs from adults with conventional HRAs alone. We used the population-based New Hampshire Colonoscopy Registry (NHCR) to examine the risk profile of individuals with synchronous conventional HRAs and SPs. Our study population included 20,281 first time screening colonoscopies from asymptomatic NHCR participants 40 years or older between 2004-15. Exams were categorized by findings: (1) normal, (2) HRA only (adenomas ≥ 1 cm, villous, high grade dysplasia, multiple adenomas ( > 2) and adenocarcinoma), (3) clinically significant SP (CSSP) only (any hyperplastic polyp ≥ 1 cm, sessile serrated adenomas/polyps or traditional serrated adenomas), and (4) synchronous HRA + CSSP. Risk factors examined included exposure of interest, smoking (never, past, and current/pack years), as well as age, sex, alcohol, education, and family history of colorectal cancer (CRC). Multivariable unconditional logistic regression tested the relation of risk factors with having synchronous HRA + CSSP versus having a normal exam or HRA alone. Among NHCR participants with 18,354 screening colonoscopies (with complete smoking, sex, bowel preparation data, and adequate preparation) there were 16,495 normal; 1309 HRA alone; 461 CSSP alone, and 89 synchronous HRA + CSSP. Current smoking was associated with an almost threefold increased risk for HRA or CSSP, and an eightfold risk for synchronous HRA + CSSP (aOR = 8.66; 95% CI: 4.73-15.86) compared to normal exams. Adults with synchronous HRA + CSSP were threefold more likely to be current smokers than those with HRA alone (aOR = 3.27; 95% CI:1.74-6.16). Our data suggest that current smokers may be at a higher risk for synchronous CSSP + HRA even when compared to having HRA alone.

Cell phone use and risk of thyroid cancer: a population-based case–control study in Connecticut

PurposeThis study aims to investigate the association between cell phone use and thyroid cancer. MethodsA population-based case–control study was conducted in Connecticut between 2010 and 2011 including 462 histologically confirmed thyroid cancer cases and 498 population-based controls. Multivariate unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations between cell phone use and thyroid cancer. ResultsCell phone use was not associated with thyroid cancer (OR: 1.05, 95% CI: 0.74–1.48). A suggestive increase in risk of thyroid microcarcinoma (tumor size ≤10 mm) was observed for long-term and more frequent users. Compared with cell phone nonusers, several groups had nonstatistically significantly increased risk of thyroid microcarcinoma: individuals who had used a cell phone >15 years (OR: 1.29, 95% CI: 0.83–2.00), who had used a cell phone >2 hours per day (OR: 1.40, 95% CI: 0.83–2.35), who had the most cumulative use hours (OR: 1.58, 95% CI: 0.98–2.54), and who had the most cumulative calls (OR: 1.20, 95% CI: 0.78–1.84). ConclusionsThis study found no significant association between cell phone use and thyroid cancer. A suggestive elevated risk of thyroid microcarcinoma associated with long-term and more frequent uses warrants further investigation.

Prediction of individuals at high absolute risk of esophageal squamous cell carcinoma

This study aimed to develop a prediction model for identifying individuals at high absolute risk of esophageal squamous cell carcinoma (ESCC) for endoscopic screening at a curable stage based on readily identifiable risk factors. This was a nationwide Swedish population-based, case-control study, including 167 new cases of ESCC and 820 randomly selected control participants. Odds ratios with 95% confidence intervals (CI) were assessed by using multivariable unconditional logistic regression. The discriminative accuracy of the model was assessed by the area under the receiver operating characteristic curve (AUC) with leave-1-out cross validation. Models for projecting individuals' absolute 5-year risk of ESCC were developed by incorporating the age-specific and sex-specific incidence rates and competing risk of death from other causes. A model including the risk factors age, sex, tobacco smoking, alcohol overconsumption, education, duration of living with a partner, and place of residence during childhood generated an AUC of 0.81 (95% CI, 0.77-0.84). A model based only on age, sex, tobacco smoking, and alcohol overconsumption obtained a similar AUC (0.79; 95% CI, 0.75-0.82). A 5-year follow-up of 355 men aged 70 to 74 years with over 35 years' smoking and alcohol overconsumption history is needed to detect 1 ESCC case. The estimated individuals' absolute 5-year risk of ESCC varied according to the combinations of risk factors. This easy-to-use risk prediction model showed a good discriminative accuracy and had the potential to identify individuals at high absolute risk of ESCC who might benefit from tailored endoscopic screening and surveillance.

Predictors of male condom use among sexually active heterosexual young women in South Africa, 2012

BackgroundIn South Africa, young women are at disproportionate risk of HIV infection with about 2363 new infections per week in 2015. Proper condom use is one of the most effective HIV/AIDS prevention strategies among sexually active persons. Understanding factors associated with male condom use in this key population group is important to curb the spread of HIV. This study determined practices and predictors of male condom use among sexually active young women in South Africa.MethodsThe 2012 National HIV Communication Survey measured the extent of exposure to communication activities for HIV prevention among men and women aged 16–55 years in South Africa. We performed a secondary data analysis on a subset of this survey, focussing on 1031 women aged 16–24 years who reported having had sex in the past 12 months. We determined predictors of male condom use using the unconditional multivariable logistic regression model.ResultsOf the 1031 young women, 595 (57.8%) reported using a male condom at last sex, 68.4% in women aged 16–19 years and 54.5% in women aged 20–24 years (p < 0.001). Delayed sexual debut [20 years or above] (Adjusted Odds Ratio [aOR] 2.1, 95% CI: 1.2 to 3.7, p = 0.006); being a student (aOR 1.6, 95% CI: 1.2 to 2.3, p = 0.005); and exposure to HIV communication programmes (aOR 3.1, 95% CI: 1.2 to 8.6, p = 0.025) were significantly associated with male condom use at last sex.ConclusionMale condom use was a common practice among young women and was associated with delayed sexual debut and exposure to HIV communication programmes. Behavioral interventions and HIV communication programmes should therefore encourage young women to delay initiation of sex and promote usage of male condoms.

Abstract PR10: Breastfeeding protects against epithelial ovarian cancer: Results of the HOPE Study

Abstract Objective: to examine the association between breastfeeding patterns and risk of epithelial ovarian cancer. Methods: We examined duration, age, and timing factors related to breastfeeding episodes among parous women in a population-based case-control study conducted in western PA, eastern OH, and southwestern NY from 2003-2008 (the HOPE Study). We compared 689 incident cases of epithelial ovarian cancer (EOC) to 1572 community controls frequency-matched to cases by age and three-digit telephone exchange. Multivariable unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for EOC associated with breastfeeding patterns adjusting for age, race, parity, duration of oral contraceptive use, education, tubal ligation, hysterectomy, talc use, and family history of breast or ovarian cancer. Results: Compared to never breastfeeding, breastfeeding any offspring was associated with a significant 28% reduction in EOC risk (OR=0.72; 95% CI=0.58-0.90). That protection appeared to last more than 30 years (OR=0.70, 95%CI=0.54-0.92), although the magnitude of the protection decreased over time (OR=0.54, 0.74, 0.83 and 0.70 for &amp;lt;10, 10-19, 20-19, and 30+ years since last breastfeeding episode, trend p=0.013). Greater number of offspring nursed provided increased protection (OR=0.75, 95%CI=0.60-0.93 and OR=0.44, 95%CI=0.28-0.63 for nursing 1-2 and 3+ offspring, respectively, compared to never breastfed, trend p&amp;lt;0.001). Longer total breastfeeding duration also provided increased protection (OR=0.74 and 0.58 for less than and greater than 1 year total duration, respectively, compared to never breastfed, trend p=0.002). Although there did not appear to be any benefit from longer average duration per episode (OR=0.73 and OR=0.70 for 1-3 and 4 or more months average per episode, respectively), longer duration for both the first (OR=0.75 and OR=0.67 for 1-3 and 4 or more months, respectively, trend p=0.004) and last (OR=0.76 and OR=0.65 for 1-3 and 4 or more months, respectively, trend p=0.003) breastfeeding episode provided greater protection. Earlier age at first breastfeeding episode appeared more protective than a later age of first breastfeeding (OR=0.65, 0.73,0.94, for first episode at age &amp;lt;25, 25-29, and 30+, respectively). Age at last breastfeeding episode did not appear to have a substantial impact on risk (OR=0.67, 0.78, 0.74, for last episode at age &amp;lt;25, 25-29, and 30+, respectively). Conclusions: Breastfeeding is protective against EOC. Although this protection decreases over time, it persists for more than 30 years. Longer total duration and increasing number of offspring nursed increase the protective effect, as does an earlier age at first breastfeeding episode. Impact: Interventions to encourage and support women in breastfeeding can reduce EOC risk. This abstract is also being presented as Poster B18. Citation Format: Danielle Wallack, Clareann H. Bunker, Robert P. Edwards, Joseph L. Kelley, Kunle Odunsi, Kirsten Moysich, Roberta B. Ness, Maria Mori Brooks, Francesmary Modugno. Breastfeeding protects against epithelial ovarian cancer: Results of the HOPE Study. [abstract]. In: Proceedings of the AACR Conference: Addressing Critical Questions in Ovarian Cancer Research and Treatment; Oct 1-4, 2017; Pittsburgh, PA. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(15_Suppl):Abstract nr PR10.