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Open Access Publications from the University of California

Scholarly Works (45 results)

  • Article
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UC Irvine Previously Published Works (1995)
We present a model to plan a rational strategy for cancer prevention that has two main functions--assessment and intervention. The assessment function includes three main components: to identify populations at high cancer risk, which may be due to their ethnic group, occupational and environmental exposures, family history, cigarette smoking, or other risk factors; to assess exposure to known carcinogens through the general and occupational environments, lifestyle factors, and the home as well as to document known carcinogens using human tissue banks and develop and validate questionnaires to target known risk factors for each of the most common cancers; and to conduct research studies of high-risk populations, including studies on mechanism and genetic testing. The intervention function includes three components: development of population-based intervention programs using the results from the research studies; evaluation of intervention programs; and modification of existing intervention programs and implementation of new ones. The above-proposed prevention strategy depends to a great extent on population-based cancer registries. Existing cancer registries around the United States should be strengthened and other dimensions should be added to their charge to augment their function in prevention research. To convert existing population-based cancer registries, particularly those that serve multiethnic and multicultural populations, into Cancer Prevention Research Registries (CPRRs), three types of data in addition to their existing required data complement should be incorporated. These are exposure information including occupational history, host factors information, and information about family history of cancer and associated conditions. The primary goal of the CPRRs should be to support cancer prevention research in its widest sense. Future research needs must be designed to investigate each of the components of the prevention strategy as well as its integrated performance. Regardless of what we do in the future, we must now promote healthier lifestyles, prevent exposure to known carcinogens, and improve early detection procedures.
    Cover page: Cancer prevention strategies: use of cancer prevention research registries.
    • Article
    • Peer Reviewed
    UC Irvine Previously Published Works (2011)
      Cover page: Adenosquamous versus Andocarcinoma of the Pancreas: A Population-Based Outcomes AnalysisCreative Commons 'BY' version 4.0 license
      • Article
      • Peer Reviewed
      UC Irvine Previously Published Works (2010)
      Purpose We sought to compare the quality of life (QOL), characteristics, and survival of patients with non-Hodgkin lymphoma (NHL) with and without human immunodeficiency virus (HIV) infection. Methods Using the population-based cancer registry for Orange and San Diego Counties, We recruited 50 patients with HIV and systemic NHL (cases) and 50 age, sex and race-matched NHL patients without HIV (controls) diagnosed with NHL during 2002-2006. Patients completed a medical history survey and QOL instrument, the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) for cases and Functional Assessment of Cancer Therapy-General (FACT G) for controls. Results HIV-infected patients had worse overall QOL and survival than uninfected patients. QOL differences were more marked in the areas of functional, physical and social well-being than in the area of emotional well-being. HIV-infected patients had lower income and were less likely to have private insurance and more likely to have diffuse large B cell histology than uninfected patients. Conclusion HIV-infected NHL patients had worse QOL and survival than uninfected patients, due to a combination of co-morbidity, aggressive histology and lack of social support. However, their emotional well-being was comparable to that of uninfected NHL patients and better than historical norms for the HIV-infected.
        Cover page: Quality of life, characteristics and survival of patients with HIV and lymphomaCreative Commons 'BY' version 4.0 license
        • Article
        • Peer Reviewed
        UC Irvine Previously Published Works (2013)
          Cover page: NCCN treatment guidelines for ovarian cancer: A population-based vali- dation study of structural and process quality measuresCreative Commons 'BY' version 4.0 license
          • Article
          • Peer Reviewed
          UC Irvine Previously Published Works (2014)
            Cover page: Spatial analysis of geographic location and adherence to treatment guidelines for advanced-stage ovarian cancer: Impact of race and socioeconomic statusCreative Commons 'BY' version 4.0 license
            • Article
            • Peer Reviewed
            UC Irvine Previously Published Works (2001)
            The majority of renal cell carcinomas (RCCs) are sporadic, and increasing incidence rates suggest that such environmental risk factors as smoking play a role in the etiology of the disease. Cases with RCC were selected from the population-based cancer registry of Orange County, California, between 1994 and 1997; controls were recruited by telephone using random digit dialing. A total of 115 case and 259 control subjects were genotyped for N-acetyltransferase 2 (NAT2), which codes for a polymorphic enzyme involved in tobacco-carcinogen metabolism. Subjects with slow acetylator genotypes were found to be at twofold increased risk (odds ratio (OR) = 1.8; 95 percent confidence interval (CI): 1.1, 2.9) of RCC. Although cancer risk doubled among smokers (OR = 2.2; 95 percent CI: 1.3, 3.7), stratified analysis revealed gene-environment interaction among slow acetylators that smoked (OR = 3.2; 95 percent CI: 1.7, 6.1) compared with rapid acetylators that smoked (OR = 1.4; 95 percent CI: 0.7, 2.9). A dose response was found for pack-years among slow acetylators (p < 0.01) but not among rapid acetylators (p = 0.06). Although smoking is a well-established risk factor of RCC, our data suggest that the risk is pronounced among slow rather than rapid acetylators.
              Cover page: Gene-Environment Interactions in Renal Cell CarcinomaCreative Commons 'BY' version 4.0 license
              • Article
              • Peer Reviewed
              UC Irvine Previously Published Works (2005)

              Purpose Classification changes for bronchioloalveolar carcinoma (BAC) by the WHO in May 1999 narrowed its definition. This study was undertaken in an attempt to characterize the impact of these changes on the epidemiology of BAC. Patients and Methods This retrospective study involves data analysis from the population-based Cancer Surveillance Programs of three Southern California counties from 1995 to 2003. BAC cases diagnosed after May 1999 are compared with BAC cases before that time by clinicopathologic variables including survival. Results Incident cases (11,969) of non-small-cell lung cancer (NSCLC) were analyzed, including 626 cases of BAC (5.2%). Median overall survival (OS) for BAC patients diagnosed after May 1999 (> 53 months) was significantly improved over median OS for BAC patients before May 1999 (32 months; P = .012). This survival benefit remained after adjustment for sex, smoking status, and stage at presentation (hazard ratio for time of diagnosis before May 1999 compared with a diagnosis after May 1999 = 1.43; P = .015). Median CS for non-BAC NSCLC patients diagnosed before May 1999 (9 months) did not differ from the median OS of such patients afterwards (110 months; P = .09). Conclusion This epidemiologic study is the first to demonstrate a survival advantage for BAC patients diagnosed after May 1999 compared with BAC patients diagnosed before this time-a finding that persists after adjustment for sex, smoking status, and stage at presentation. We believe that this observed survival benefit likely reflects changes in the revised 1999 WHO classification.

                Cover page: Epidemiology of bronchioloalveolar carcinoma: Improvement in survival after release of the 1999 WHO classification of lung tumors
                • Article
                • Peer Reviewed
                UC Irvine Previously Published Works (1995)
                Human tissue banking could provide a tool to address a number of public health concerns. We can potentially use it to monitor trends in human exposures, serve as an early warning system for new environmental exposures, assess low-level exposures around hazardous waste and other point sources of pollutants, evaluate the effectiveness of regulatory programs, and study etiologies of diseases (e.g., childhood cancer and birth defects) that are likely to be related to the environment. This article discusses opportunities to establish human tissue banks in connection with pre-existing public health surveillance programs for cancer and adverse reproductive outcomes. This is a cost-effective way to conduct surveillance and enhances the ability to carry out epidemiologic studies. The article also discusses ethical issues that are particularly important for public health practice. One is the issue of risk communication and the need to explain risks in a way that provides people with the information they need to determine appropriate action on the individual and community levels. Second is the issue of environmental justice. We recommend early involvement of communities that are likely to be involved in tissue-banking projects and full explanation of individual and group social risks from their participation.
                  Cover page: Banking of human tissue for biomonitoring and exposure assessment: utility for environmental epidemiology and surveillance.Creative Commons 'BY' version 4.0 license
                  • Article
                  • Peer Reviewed
                  UC Irvine Previously Published Works (2009)
                  OBJECTIVE: In California, leukemia represents ~35, 5, and 2% of all cancers in children (aged 0-14), adolescents (15-29), and young adults (30-39), respectively. Poorer survival has been previously noted in individuals residing in lower socioeconomic status (SES) neighborhoods. We explored the relationship between SES and survival as modified by age and race/ethnicity using data from the California Cancer Registry. METHODS: A total of 7,688 incident cases of first primary leukemia diagnosed during 1996-2005 in individuals aged 0-39 at diagnosis were included in this study. Univariate analyses of overall survival were conducted using the Kaplan-Meier method and multivariate survival analyses were performed using Cox proportional hazard regression to estimate hazard ratios. RESULTS: Multivariate analyses showed that overall survival and lymphoid cancer-specific survival was reduced in those individuals aged 15-39 compared to children aged 0-14. Although shorter survival was observed in non-whites, an association between lower-SES neighborhood and shorter survival was significant only for non-Hispanic whites (NHWs) (p value for trend <0.05). Lack of insurance was significantly associated with shorter survival for all race/ethnicities examined except Asian/Pacific Islanders (p value < 0.05). CONCLUSION: Lower survival in individuals diagnosed with leukemia was observed in adolescents and young adults compared to children and in non-whites compared to NHWs. Further, the independent effects on survival of both low SES and lack of insurance at diagnosis persisted after adjustment for demographic variables and varied across race/ethnicities.
                    Cover page: Leukemia survival in children, adolescents, and young adults: influence of socioeconomic status and other demographic factors.Creative Commons 'BY' version 4.0 license
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                    • Peer Reviewed
                    UC Irvine Previously Published Works (2006)

                    Objectives. Some risk factors for cervical cancer in situ convey risk for malignancies of the cervix and other sites. We estimate risk of several malignancies following in situ cancer of the cervix for Hispanic Americans and non-Hispanic Whites. Methods. Using California Cancer Registry data (1988-1999) we identify 56,020 women with cervical cancer in situ and observe subsequent malignancies in that cohort, with over three million woman-months of follow-up, We focus on cancers of the reproductive system and cancers related to smoking. Risk estimates are standardized incidence ratios, accounting for age, time at risk, cancer type, and race/ethnicity. Results. There is elevated risk for invasive cervical cancer (SIR=4.1, 95% Cl: 3.5-4.7), which is significantly higher for Hispanics than for non-Hispanic Whites (SlRs = 5.2 and 3.2, respectively, X-2(l)=7.66, P=0.006). Excluding cervix, non-Hispanic Whites show elevated risk for a pool of reproductive cancers (SIR= 1.8, 95% Cl: 1.4-2.4). While both groups show elevated risk for a pool of smoking-related cancers, only non-Hispanic Whites show significant risk specifically for lung cancer (SIR= 1.7, 95% CI: 1.4-2.1). Non-Hispanic Whites show elevated risk for ovarian cancer (SIR = 1.8, 95% CI: 1.3-2.4). Ovarian cancer following in situ cervical cancer is disproportionately of borderline histology (G(2)(l)=7.43, P=0.006). Conclusions. These results have implications for public health planning for women, as well as better understanding of disparities in care or biologic paths to malignancies in women with in situ cancer of the cervix. (c) 2006 Elsevier Inc. All rights reserved.

                      Cover page: Malignancies following in situ cervical cancer in Hispanic Americans and non-Hispanic Whites
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