Proportion of U.S. Trends in Breast Cancer Incidence Attributable to Long-term Changes in Risk Factor Distributions.
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ABSTRACT:
SUBMITTER: Pfeiffer RM
PROVIDER: S-EPMC8423092 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Many studies have documented long-term changes in adult marine fish distributions and linked these changes to climate change and multi-decadal climate variability. Most marine fish, however, have complex life histories with morphologically distinct stages, which use different habitats. Shifts in distribution of one stage may affect the connectivity between life stages and thereby impact population processes including spawning and recruitment. Specifically, many marine fish species have a planktonic larval stage, which lasts from weeks to months. We compared the spatial distribution and seasonal occurrence of larval fish in the Northeast U.S. Shelf Ecosystem to test whether spatial and temporal distributions changed between two decades. Two large-scale ichthyoplankton programs sampled using similar methods and spatial domain each decade. Adult distributions from a long-term bottom trawl survey over the same time period and spatial area were also analyzed using the same analytical framework to compare changes in larval and adult distributions between the two decades. Changes in spatial distribution of larvae occurred for 43% of taxa, with shifts predominately northward (i.e., along-shelf). Timing of larval occurrence shifted for 49% of the larval taxa, with shifts evenly split between occurring earlier and later in the season. Where both larvae and adults of the same species were analyzed, 48% exhibited different shifts between larval and adult stages. Overall, these results demonstrate that larval fish distributions are changing in the ecosystem. The spatial changes are largely consistent with expectations from a changing climate. The temporal changes are more complex, indicating we need a better understanding of reproductive timing of fishes in the ecosystem. These changes may impact population productivity through changes in life history connectivity and recruitment, and add to the accumulating evidence for changes in the Northeast U.S. Shelf Ecosystem with potential to impact fisheries and other ecosystem services.
| S-EPMC4580593 | biostudies-literature
Project description:Black-white differences in U.S. adult mortality have narrowed over the past five decades, but whether this narrowing unfolded on a period or cohort basis is unclear. The distinction has important implications for understanding the socioeconomic, public health, lifestyle, and medical mechanisms responsible for this narrowing. We use data from 1959 to 2009 and age-period-cohort (APC) models to examine period- and cohort-based changes in adult mortality for U.S. blacks and whites. We do so for all-cause mortality among persons aged 15-74 as well as for several underlying causes of death more pertinent for specific age groups. We find clear patterns of cohort-based reductions in mortality for both black men and women and white men and women. Recent cohort-based reductions in heart disease, stroke, lung cancer, female breast cancer, and other cancer mortality have been substantial and, save for breast cancer, have been especially pronounced for blacks. Period-based changes have also occurred and are especially pronounced for some causes of death. Period-based reductions in blacks' and whites' heart disease and stroke mortality are particularly impressive, as are recent period-based reductions in young men's and women's mortality from infectious diseases and homicide. These recent period changes are more pronounced among blacks. The substantial cohort-based trends in chronic disease mortality and recent period-based reductions for some causes of death suggest a continuing slow closure of the black-white mortality gap. However, we also uncover troubling signs of recent cohort-based increases in heart disease mortality for both blacks and whites.
| S-EPMC4420626 | biostudies-literature
Project description:ImportanceMany established breast cancer risk factors are used in clinical risk prediction models, although the proportion of breast cancers explained by these factors is unknown.ObjectiveTo determine the population-attributable risk proportion (PARP) for breast cancer associated with clinical breast cancer risk factors among premenopausal and postmenopausal women.Design, setting, and participantsCase-control study with 1:10 matching on age, year of risk factor assessment, and Breast Cancer Surveillance Consortium (BCSC) registry. Risk factor data were collected prospectively from January 1, 1996, through October 31, 2012, from BCSC community-based breast imaging facilities. A total of 18 437 women with invasive breast cancer or ductal carcinoma in situ were enrolled as cases and matched to 184 309 women without breast cancer, with a total of 58 146 premenopausal and 144 600 postmenopausal women enrolled in the study.ExposuresBreast Imaging Reporting and Data System (BI-RADS) breast density (heterogeneously or extremely dense vs scattered fibroglandular densities), first-degree family history of breast cancer, body mass index (>25 vs 18.5-25), history of benign breast biopsy, and nulliparity or age at first birth (≥30 years vs <30 years).Main outcomes and measuresPopulation-attributable risk proportion of breast cancer.ResultsOf the 18 437 women with breast cancer, the mean (SD) age was 46.3 (3.7) years among premenopausal women and 61.7 (7.2) years among the postmenopausal women. Overall, 4747 (89.8%) premenopausal and 12 502 (95.1%) postmenopausal women with breast cancer had at least 1 breast cancer risk factor. The combined PARP of all risk factors was 52.7% (95% CI, 49.1%-56.3%) among premenopausal women and 54.7% (95% CI, 46.5%-54.7%) among postmenopausal women. Breast density was the most prevalent risk factor for both premenopausal and postmenopausal women and had the largest effect on the PARP; 39.3% (95% CI, 36.6%-42.0%) of premenopausal and 26.2% (95% CI, 24.4%-28.0%) of postmenopausal breast cancers could potentially be averted if all women with heterogeneously or extremely dense breasts shifted to scattered fibroglandular breast density. Among postmenopausal women, 22.8% (95% CI, 18.3%-27.3%) of breast cancers could potentially be averted if all overweight and obese women attained a body mass index of less than 25.Conclusions and relevanceMost women with breast cancer have at least 1 breast cancer risk factor routinely documented at the time of mammography, and more than half of premenopausal and postmenopausal breast cancers are explained by these factors. These easily assessed risk factors should be incorporated into risk prediction models to stratify breast cancer risk and promote risk-based screening and targeted prevention efforts.
| S-EPMC5540816 | biostudies-literature
Project description:Although ever-smokers make up the majority of the older adult population in the USA, they are often excluded from studies examining the impact of obesity on mortality. Understanding how smoking and obesity interact is critical to assessing the proportion of deaths attributable to obesity.Nationally representative sample of the non-institutionalised population of the USA. Baseline data were drawn from the National Health and Nutrition Examination Survey, 1988-1994 and 1999-2004.US adults aged 50-74 (n=9835).We used Cox models to estimate the mortality risks of obesity by smoking status. All-cause mortality was assessed prospectively through 31 December 2006 (n=1243 deaths). Maximum body mass index (BMI) was specified as the key exposure variable. We also calculated population attributable fractions (PAFs) by smoking status and investigated differences in PAFs in a decomposition analysis.The HR associated with a one-unit increment in BMI beyond 25.0 kg/m(2) was 1.057 for never-smokers (95% CI 1.033 to 1.082; p<0.001), 1.036 for former smokers (95% CI 1.015 to 1.059; p<0.01) and 1.024 for current smokers (95% CI 0.997 to 1.052).We estimated that 19.8% of deaths were attributable to excess weight. The PAFs were 31.9, 20.4 and 11.3 for never-smokers, former and current smokers, respectively. The difference in PAFs between never-smokers and current smokers was almost entirely explained by the difference in HRs.The proportion of deaths attributable to obesity is nearly 3 times as high among never-smokers compared with current smokers. This finding is consistent with the fact that smokers are subject to significant competing risks. Analyses that exclude smokers are likely to substantially overestimate the proportion of deaths attributable to obesity in the USA.
| S-EPMC4769428 | biostudies-other
Project description:ObjectiveThe Centers for Medicare and Medicaid Services' National Partnership to Improve Dementia Care in Nursing Homes focuses on but is not limited to long-term care (LTC) residents with dementia; the potential impact on residents with other diagnoses is unclear. We sought to determine whether resident subpopulations experienced changes in antipsychotic and mood stabilizer prescribing.DesignRepeated cross-sectional analysis of a 20% Medicare sample, 2011-2014.Setting and participantFee-for-service Medicare beneficiaries with Part D coverage in LTC (n = 562,485) and a secondary analysis limited to persons with depression or bipolar disorder (n = 139,071).MethodsMain outcome was quarterly predicted probability of treatment with an antipsychotic or mood stabilizer.ResultsFrom 2011 to 2014, the adjusted predicted probability (APP) of antipsychotic treatment fell from 0.120 [95% confidence interval (CI) 0.119-0.121] to 0.100 (95% CI 0.099-0.101; P < .001). Use decreased for all age, sex, and racial/ethnic groups; the decline was larger for persons with dementia (P < .001). The APP of mood stabilizer use grew from 0.140 (95% CI 0.139-0.141) to 0.185 (95% CI 0.184-0.186), growth slightly larger among persons without dementia (P < .001). Among persons with depression or bipolar disorder, the APP of antipsychotic treatment increased from 0.081 (95% CI 0.079-0.082) to 0.087 (95% CI 0.085-0.088; P < .001); APP of mood stabilizer treatment grew more, from 0.193 (95% CI 0.190-0.196) to 0.251 (0.248-0.253; P < .001). Quetiapine was the most commonly prescribed antipsychotic. The most widely prescribed mood stabilizer was gabapentin, prescribed to 70.5% of those who received a mood stabilizer by the end of 2014.Conclusions and implicationsThe likelihood of antipsychotic and mood stabilizer treatment did not decline for residents with depression or bipolar disorder, for whom such prescribing may be appropriate but who were not excluded from the Partnership's antipsychotic quality measure. Growth in mood stabilizer use was widespread, and largely driven by growth in gabapentin prescribing.
| S-EPMC7641905 | biostudies-literature
Project description:Excess deposition (including both wet and dry deposition) of nitrogen and sulfur are detrimental to ecosystems. Recent studies have investigated the spatial patterns and temporal trends of nitrogen and sulfur wet deposition, but few studies have focused on dry deposition due to the scarcity of dry deposition measurements. Here, we use long-term model simulations from the coupled WRF-CMAQ model covering the period from 1990 to 2010 to study changes in spatial distribution as well as temporal trends in total (TDEP), wet (WDEP) and dry deposition (DDEP) of total inorganic nitrogen (TIN) and sulfur (TSO4). We first evaluate the model's performance in simulating WDEP over the U.S. by comparing the model results with observational data from the U.S. National Atmospheric Deposition Program. The coupled model generally underestimates the WDEP of both TIN (including both the oxidized nitrogen deposition-TNO3, and the reduced nitrogen deposition-NHX) and TSO4, with better performance in the eastern U.S. than the western U.S. TDEP of both TIN and TSO4 show significant decreases over the U.S., especially in the east due to the large emission reductions that occurred in that region. The decreasing trends of TIN TDEP are caused by decrease of TNO3, and the increasing trends of TIN deposition over the Great Plains and Tropical Wet Forests regions are caused by increases in NH3 emissions although it should be noted that these increasing trends are not significant. TIN WDEP shows decreasing trends throughout the U.S., except for the Marine West Coast Forest region. TIN DDEP shows significant decreasing trends in the region of Eastern Temperate Forests, Northern Forests, Mediterranean California and Marine West Coast Forest, and significant increasing trends in the region of Tropical Wet Forests, Great Plains and Southern Semi-arid Highlands. For the other three regions (North American Deserts, Temperate Sierras and Northwestern Forested Mountains), the decreasing or increasing trends were not significant. Both the WDEP and DDEP of TSOx have decreases across the U.S., with a larger decreasing trend in the DDEP than that in the WDEP. Across the U.S. during the 1990-2010 period, DDEP of TIN accounted for 58-65% of TDEP of TIN. TDEP of TIN over the U.S. was dominated by deposition of TNO3 during the first decade, which then shifts to reduced nitrogen (NHX) dominance after 2003 resulting from combination of NOx emission reductions and NH3 emission increases. The sulfur DDEP is usually higher than the sulfur WDEP until recent years, as the sulfur DDEP has a larger decreasing trend than WDEP.
| S-EPMC6069975 | biostudies-literature
Project description:We aimed to estimate the proportion of Dutch postmenopausal breast cancer cases in 2010 that is attributable to lifestyle-related risk factors. We calculated population attributable fractions (PAFs) of potentially modifiable risk factors for postmenopausal breast cancer in Dutch women aged >50 in 2010. First, age-specific PAFs were calculated for each risk factor, based on their relative risks for postmenopausal breast cancer (from meta-analyses) and age-specific prevalence in the population (from national surveys) around the year 2000, assuming a latency period of 10 years. To obtain the overall PAF, age-specific PAFs were summed in a weighted manner, using the age-specific breast cancer incidence rates (2010) as weights. 95 % confidence intervals for PAF estimates were derived by Monte Carlo simulations. Of Dutch women >40 years, in 2000, 51 % were overweight/obese, 55 % physically inactive (<5 days/week 30 min activity), 75 % regularly consumed alcohol, 42 % ever smoked cigarettes and 79 % had a low-fibre intake (<3.4 g/1000 kJ/day). These factors combined had a PAF of 25.7 % (95 % CI 24.2-27.2), corresponding to 2,665 Dutch postmenopausal breast cancer cases in 2010. PAFs were 8.8 % (95 % CI 6.3-11.3) for overweight/obesity, 6.6 % (95 % CI 5.2-8.0) for alcohol consumption, 5.5 % (95 % CI 4.0-7.0) for physical inactivity, 4.6 % (95 % CI 3.3-6.0) for smoking and 3.2 % (95 % CI 1.6-4.8) for low-fibre intake. Our findings imply that modifiable risk factors are jointly responsible for approximately one out of four Dutch postmenopausal breast cancer cases. This suggests that incidence rates can be lowered substantially by living a more healthy lifestyle.
| S-EPMC4469298 | biostudies-literature
Project description:Although HIV caused one of the worst epidemics since the late twentieth century, China and the U.S. has made substantial progress to control the spread of HIV/AIDS. However, the trends of HIV/AIDS incidence remain unclear in both countries. Therefore, this study aimed to highlight the long-term trends of HIV/AIDS incidence by gender in China and the U.S. population. The data were retrieved from the Global Burden of Disease (GBD) database since it would be helpful to assess the impact/role of designed policies in the control of HIV/AIDS incidence in both countries. The age-period-cohort (APC) model and join-point regression analysis were employed to estimate the age-period-cohort effect and the average annual percentage change (AAPC) on HIV incidence. Between 1994 and 2019, we observed an oscillating trend of the age-standardized incidence rate (ASIR) in China and an increasing ASIR trend in the U.S. Despite the period effect in China declined for both genders after peaked in 2004, the age effect in China grew among the young (from 15-19 to 25-29) and the old age groups (from 65-69 to 75-79). Similarly, the cohort effect increased among those born in the early (from 1924-1928 to 1934-1938) and the latest birth groups (from 1979-1983 to 2004-2009). In the case of the U.S., the age effect declined after it peaked in the 25-29 age group. People born in recent birth groups had a higher cohort effect than those born in early groups. In both countries, women were less infected by HIV than men. Therefore, besides effective strategies and awareness essential to protect the young age groups from HIV risk factors, the Chinese government should pay attention to the elderly who lacked family support and were exposed to HIV risk factors.
| S-EPMC8634360 | biostudies-literature
Project description:BackgroundA report of multiple cases of bile duct cancer at a Japanese printing company raised concern about such cancers. We examined long-term trends in bile duct cancer in Japan.MethodsData from 4 population-based cancer registries were used to calculate incidence between 1985 and 2007, and vital statistics were used to estimate mortality between 1985 and 2011. Age-standardized rates were calculated and analyzed using a joinpoint regression model.ResultsAmong men, the incidence rate of intrahepatic bile duct cancer increased throughout the observation period; among women, it increased until 1996-1998 and remained stable thereafter. The incidence rate of extrahepatic bile duct cancer was stable in men and decreased from 1993-1995 in women. In people aged 30 to 49 years, the incidence rates of intra- and extrahepatic bile duct cancer remained stable or decreased. The mortality rate of intrahepatic bile duct cancer increased in both sexes and in all age groups since 1996, while that of extrahepatic bile duct cancer decreased since 1992. In people aged 30 to 49 years, the mortality rates of intra- and extrahepatic bile duct cancer remained stable and decreased, respectively.ConclusionsThe incidence and mortality rates of intrahepatic bile duct cancer remained stable or increased throughout the observation period. The incidence rate of extrahepatic bile duct cancer remained stable or decreased, and the mortality rate decreased since 1992. In people aged 30 to 49 years, the incidence and mortality rates of intra- and extrahepatic bile cancer remained stable or decreased.
| S-EPMC4000766 | biostudies-literature
Project description:BackgroundTo address the lack of knowledge regarding the long-term risk of intracranial hemorrhage (ICH) after acute myocardial infarction (AMI), the aims of this study were to: (1) investigate the incidence, time trends, and predictors of ICH in a large population within 1 year of discharge after AMI; (2) investigate the comparative 1-year risk of ICH in AMI patients and a reference group; and (3) study the impact of previous ischemic stroke on ICH risk in patients treated with various antithrombotic therapies.Methods and resultsData about patients whose first AMI occurred between 1998 and 2010 were collected from the Swedish Register of Information and Knowledge about Swedish Heart-Intensive-Care Admissions (RIKS-HIA). Patients with an ICH after discharge were identified in the National Patient Register. Risk was compared against a matched reference population. Of 187 386 patients, 590 had an ICH within 1 year. The 1-year cumulative incidence (0.35%) was approximately twice that of the reference group, and it did not change significantly over time. Advanced age, previous ischemic or hemorrhagic stroke, and reduced glomerular filtration rate were associated with increased ICH risk, whereas female sex was associated with a decreased risk. Previous ischemic stroke did not increase risk of ICH associated with single or dual antiplatelet therapy, but increased risk with anticoagulant therapy.ConclusionThe 1-year incidence of ICH after AMI remained stable, at ?0.35%, over the study period. Advanced age, decreased renal function, and previous ischemic or hemorrhagic stroke are predictive of increased ICH risk.
| S-EPMC4845264 | biostudies-literature