Explore the vast range of titles available.

Background: The association between coffee intake, tea intake and cancer has been extensively studied, but associations are not established for many cancers. Previous studies are not consistent on whether caffeine may be the source of possible associations between coffee and cancer risk. Methods: In the Prostate, Lung, Colorectal, and Ovarian cancer screening trial, of the 97 334 eligible individuals, 10 399 developed cancer. Cancers included were 145 head and neck, 99 oesophageal, 136 stomach, 1137 lung, 1703 breast, 257 endometrial, 162 ovarian, 3037 prostate, 318 kidney, 398 bladder, 103 gliomas, and 106 thyroid. Results: Mean coffee intake was higher in lower education groups, among current smokers, among heavier and longer duration smokers, and among heavier alcohol drinkers. Coffee intake was not associated with the risk of all cancers combined (RR=1.00, 95% confidence interval (CI)=0.96–1.05), whereas tea drinking was associated with a decreased risk of cancer overall (RR=0.95, 95% CI=0.94–0.96 for 1+ cups per day vs <1 cup per day). For endometrial cancer, a decreased risk was observed for coffee intake (RR=0.69, 95% CI=0,52–0.91 for ⩾2 cups per day). Caffeine intake was not associated with cancer risk in a dose–response manner. Conclusions: We observed a decreased risk of endometrial cancer for coffee intake, and a decreased risk of cancer overall with tea intake.

Rural areas of the U.S. experience disproportionate colorectal cancer (CRC) death compared to urban areas. The authors aimed to analyze differences in CRC survival between rural and urban Utah men and investigate potential prognostic factors for survival among these men. A cohort of Utah men diagnosed with CRC between 1997 and 2013 was identified from the Utah Cancer Registry. Survival and prognostic factors were analyzed via 5-year CRC survival and Cox proportional hazards models, stratified by rural/urban residence. Among 4,660 men diagnosed with CRC, 15.3% were living in rural Utah. Compared with urban men, rural CRC patients were diagnosed at older ages and in different anatomic subsites; more were overweight, and current smokers. Differences in stage and treatment were not apparent between rural and urban CRC patients. Compared with urban counterparts, rural men experienced a lower CRC survival (Hazard Ratio 0.55, 95% CI 0.53, 0.58 vs. 0.58, 95% CI 0.56, 0.59). Race and cancer treatment influenced CRC survival among men living in both urban and rural areas. Factors of CRC survival varied greatly among urban and rural men in Utah. The influence of social and environmental conditions on health behaviors and outcomes merits further exploration.

Cancer disparities in rural and frontier communities are an important issue in Utah because much of Utah is sparsely populated. The aims of this study were to investigate whether there are differences in the cancer incidence and 5‐year survival rates in Utah by metropolitan/rural residence and to investigate disparities in distributions of cancer risk factors. We used cancer registry records to identify patients diagnosed with a first primary cancer in Utah between 2004 and 2008. We estimated 5‐year survival and incidence rates. The Cox proportional hazards model was used to estimate hazard ratios (HRs) for the risk of death. There were 32,498 (86.9%) patients with cancer who lived in metropolitan counties and 4906 (13.1%) patients with cancer who lived in rural counties at the time of cancer diagnosis. Patients with cancer from rural counties were more likely to be older, American Indian/Alaskan Native, non‐Hispanic, male, and diagnosed at higher stage. Rural residents had a five‐year relative survival that was 5.2% lower than metropolitan residents and a 10% increase in risk of death (HR = 1.10, 95% CI = 1.03, 1.18) after adjustment for multiple factors. Overall, the cancer incidence rates in rural counties were lower by 11.9 per 100,000 per year (449.2 in rural counties vs. 461.1 in metropolitan counties). Cancer patients living in rural counties of Utah had different demographic characteristics as well as differences in incidence and survival rates. Further studies with individual‐level data are necessary to investigate the reasons behind these differences in cancer incidence and survival to reduce disparities. Cancer disparities in rural and frontier communities are an important issue in Utah because much of Utah is sparsely populated. Patients with cancer from rural counties in Utah were more likely to be older, American Indian/Alaskan Native, non‐Hispanic, male, and diagnosed at higher stage. Rural residents had a five‐year relative survival that was 5.2% lower than metropolitan residents and a 10% increase in risk of death (HR = 1.10, 95% CI = 1.03, 1.18) after adjustment for multiple factors.

Background Ovarian cancer is the fifth most common female cancer in the United States. There have been very few studies investigating mental health diagnoses among ovarian cancer survivors with long‐term follow up. The aim of this study is to examine the incidence of mental illness among ovarian cancer survivors compared to a general population cohort. A secondary aim is to investigate risk factors for mental illnesses among ovarian cancer survivors. Patients and methods Cohorts of 1689 ovarian cancer patients diagnosed between 1996 and 2012 and 7038 women without cancer matched by age and birth state from the general population were identified. Mental health diagnoses were identified from electronic medical records and statewide healthcare facilities data. Cox proportional hazard models were used to estimate hazard ratios (HRs). Results Ovarian cancer survivors experienced increased risks of mental illnesses within the first 2 years after cancer diagnosis (HR = 3.55, 95% CI = 3.04–4.14). The risks of depression among ovarian cancer survivors were nearly 3‐fold within the first 2 years of cancer diagnosis (HR = 2.59, 95% CI = 1.94–3.47), and 1.69‐fold at 2–5 years after cancer diagnosis (HR = 1.69, 95% CI = 1.18–2.42). Ovarian cancer survivors experienced an 80% increased risk of death with a mental illness diagnosis (HR = 1.80, 95% CI = 1.48–2.18) and a 94% increased risk of death with a depression diagnosis (HR = 1.94, 95% CI = 1.56–2.40). Conclusions Higher risks of mental illnesses were observed among ovarian cancer survivors throughout the follow‐up periods of 0–2 years and 2–5 years after cancer diagnosis. Multidisciplinary care is needed to monitor and treat mental illnesses among ovarian cancer survivors.

Background Among Asian, Native Hawaiian, and Pacific Islanders (ANHPI) in the United States, cancer and cardiovascular disease are the leading causes of death. Colorectal cancer (CRC) is the third most common cancer among ANHPIs, with improving survival rates. However, the risk of cardiovascular disease (CVD) events among ANHPI CRC survivors is unknown, especially within disaggregated ANHPI race and ethnicity groups. Methods We estimated the risk of CVD events among ANHPI CRC survivors within the SEER-Medicare database. Composite CVD, heart failure, ischemic heart disease, and stroke/transient ischemic attack were identified using International Classification of Diseases (ICD) diagnostic codes. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for CVD events among ANHPI regional subgroups. Results Compared to non-Hispanic White (NHW) CRC survivors, the risk of composite CVD was lower among East and Southeast Asian CRC survivors at > 1 years after initial cancer diagnosis. The risk of composite CVD, heart failure, and ischemic heart disease were lower among East and Southeast Asians for follow-up > 5 years. When compared to East Asians, NHW and Southeast Asian CRC survivors had a higher risk of composite CVD, heart failure, and ischemic heart disease where South Asians had a higher risk of ischemic heart disease. Conclusions Within the disaggregated ANHPI race and ethnicity groups of CRC survivors, our results support heterogeneity of incident CVD events. Further research is needed to develop public health interventions to address the disparities in CVD risk, especially among the high-risk groups of South Asian and Southeast Asian CRC survivors.

Purpose Advancing therapies have increased B‐cell Non‐Hodgkin's Lymphoma (B‐NHL) patient survival. However, data are limited on the risk of type II diabetes mellitus (type II DM) in adult survivors following treatment. This study examines the risk of type II DM among a Utah population of B‐NHL survivors, compared to the general population. Methods A cohort of 3529 adult survivors diagnosed with B‐NHL in Utah between 1997 and 2013 in the Utah Cancer Registry and 13,339 individuals from the general population were identified using the Utah Population Database (UPDB). Multivariate Cox Proportional Hazard models were used to estimate adjusted hazard ratios (aHR) for developing type II DM, stratified for time post‐diagnosis. Results Compared to the cancer‐free population, B‐NHL survivors had an overall increased risk of developing type II DM (HR: 1.49; 95% CI: 1.32, 1.69), largely within the first year (HR: 4.41; 95% CI: 3.52, 5.52) following diagnosis. Older B‐NHL survivors were more likely to develop type II DM at any time compared to survivors < 40 years [40–65 years (HR: 2.66; 95% CI 1.48–4.79); ≥ 65 years (HR: 3.77; 95% CI 2.09–6.78)]. Obese (BMI > 30 kg/m2) survivors had a 4.06‐fold increase in the risk of type II DM compared to normal BMI (18–24.9 kg/m2) cancer survivors. Cancer treatment did not increase the risk of type II DM compared to no treatment. Conclusions Adult B‐NHL cancer survivors were at an overall increased risk of developing type II DM compared to the general population, within the first year and overall, following a cancer diagnosis. This study provides evidence suggesting the importance of obesity prevention and improvement in care management oversight for B‐NHL survivorship and DM outcomes.

Evidence for the human carcinogenic effects of alcohol consumption on the risk of cancers of the oral cavity and pharynx has been considered sufficient in the International Agency for Research on Cancer Monograph 44 on alcohol and cancer in 1988. We evaluated human carcinogenic evidence related to the risk of oral and pharyngeal cancers based on cohort and case–control studies published from 1988 to 2009. A large body of evidence from epidemiological studies of different designs and conducted in different populations has consistently supported the fact that alcohol consumption is strongly associated with an increase in the risk of oral and pharyngeal cancers. The relative risks are 3.2–9.2 for more than 60 g/day (or more than four drinks/day) when adjusted for tobacco smoking and other potential confounders. A strong dose–response effect on the intensity of alcohol use is reported in most of the studies. However, no apparent association is observed for the duration of alcohol use. Compared with current alcoholics, a decreased risk of approximately 10 to 15 years is associated with alcohol cessation. Similar associations have been observed among nonsmokers in over 20 studies. In general, the dominant type of alcohol consumption in each population is associated with the greatest increase in risk. A large number of studies on joint exposure to alcohol and tobacco consumption show a greater than multiplicative synergistic effect.

Background:Although low levels of folate leads to disturbances in DNA replication, DNA methylation and DNA repair, the association between dietary folate intake and head and neck cancer (HNC) risk remains unclear.Methods:We evaluated the association between folate intake and HNC risk using prospective cohort data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. This study included 101 700 participants and 186 cases with confirmed incident HNC. The median follow-up was 12.5 years. We estimated hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) using Cox proportional hazard model including age, sex, body mass index, education, race, tobacco smoking, alcohol drinking and total fruit and vegetable intake.Results:Higher intake of food folate and fortified folic acid in foods was associated with a decreasing HNC risk in a dose-response manner. The HRs of highest vs the lowest quartile of intake were 0.35 (95%CI: 0.18-0.67) for food folate, and 0.49 (95%CI: 0.30-0.82) for fortified folic acid. Intakes of total folate, natural folate and supplemental folic acid were not associated with the risk of HNC and its subsites. We did not detect any interaction between smoking, drinking and food folate intake on HNC risk.Conclusions:These findings provide evidence of the protective role of dietary folate intake on HNC risk.

Objective Rural–urban disparities in cancer care are well documented. However, research on rural–urban disparities regarding patient‐reported outcomes (PROs) is still developing. This study analyzed rural–urban disparities in patients with cancer with respect to anxiety, depression, fatigue, pain interference, and physical function. Methods This study was conducted at the University of Utah Huntsman Cancer Institute. We integrated data from electronic health records, Cancer Registry, and PRO questionnaires. We assessed the association between rurality status (rural vs. urban) in patients with cancer and PRO scores using multiple linear regression models and t‐tests. Results The cohort included 7271 patients. The mean age was 59.1 years at cancer diagnosis and 48.2% (n = 3505) were female. Across all cancer types, significant differences (Rural vs. Urban) were found for fatigue (53.6 vs. 54.1; p < 0.05) and physical function (45.5 vs. 45.1; p < 0.05). With respect to specific cancer types, there were differences in patients with oral cavity and pharynx cancer for depression (47.9 vs. 50.6; p < 0.01), fatigue (51.6 vs. 54.8; p < 0.05), pain interference (52.8 vs. 55.4; p < 0.05), and physical function (48.0 vs. 44.6; p < 0.01), colorectal cancer for fatigue (56.8 vs. 54.7; p < 0.05), pain interference (56.0 vs. 53.7; p < 0.05), and physical function (42.2 vs. 44.4; p < 0.05), uterus cancer for depression (47.5 vs. 50.5; p < 0.05) and fatigue (51.6 vs. 54.7; p < 0.05), and lung cancer for physical function (37.6 vs. 39.3; p < 0.05). Conclusions Across all cancer types, as well as specific cancers, this study found mostly limited rural–urban differences regarding PROs. Except for colorectal and lung/bronchus cancer, patients living in rural areas reported similar or better PRO scores for all cancer types. Results support the hypothesis that improving access can help to level rural–urban disparities regarding cancer care outcomes, because all patients were treated in the same comprehensive cancer center, had similar access to care, and had similar PRO scores.

IntroductionOesophageal cancer is a highly lethal malignancy with geographic disparity and a heavy burden in developing countries. While smoking and alcohol are established risk factors, emerging evidence suggests that indoor air pollution (IAP) may also play a role through the inhalation of aerosols along the aerodigestive tract, but its relationship with oesophageal cancer remains poorly understood. Previous studies have focused on how IAP is associated with lung cancer, and evidence on oesophageal cancer is sparse, underpowered and inconclusive.MethodsThis population-based case–control study was conducted in the Jiangsu Province, China, from 2003 to 2010. We analysed 2969 cases and 8019 controls using unconditional logistic regression, adjusting for potential confounders. In addition to the six individual household air pollution sources, we also studied their combined effect by calculating the unweighted and weighted sum of these IAP sources to improve comparability. Furthermore, we conducted subgroup analyses by sex and smoking status, as well as by sex exclusively among non-smokers.ResultsIn both the overall sample and subgroups, higher exposure to various individual or combined IAP sources was associated with a dose-response increase in oesophageal cancer risk (weighted risk score (WRS) semi-Bayesian (SB)-adjusted OR (aOR): 2.70; 95% CI 2.36 to 3.07). Solid fuels appeared to have the strongest association (SB-aOR: 1.76; 95% CI 1.56 to 1.98), followed by coal used for cooking, passive smoking and poor ventilation in the kitchen and bedrooms. The vulnerability to different sources varied by sex and smoking status, and females among non-smokers consistently experienced a more profound impact from combined IAP exposure using WRS.ConclusionsExposure to common IAP is associated with an increased risk of oesophageal cancer among the Chinese population, with variations in susceptibility observed across sex and depending on smoking status.