Dissertations / Theses on the topic 'Cancer in children Epidemiology'
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KRALLMAN, KELLI ALICIA. "The Cancerogenic Effects of Exposure to Uranium: Are Children More At Risk?" University of Cincinnati / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1218647724.
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Davis, Jonathan. "Cancer risk in children of agricultural health study participants." Diss., University of Iowa, 2017. https://ir.uiowa.edu/etd/5926.
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This study examines the risk of cancer in children of pesticide applicators from the Agricultural Health Study. The study includes 36,537 children of Iowa participants who were evaluated for cancer incidence during 1975 through 2013 from birth through the age of seventeen. Standard incidence rates for any cancer and specific groups of cancers classified using the International Classification of Childhood Cancer was calculated using rates from the general population of Iowa controlling for year of follow, age, sex, and race. Hazard ratios for Group I-III cancers and paternal exposure to specific pesticides were calculated using exposure information collected on 50 pesticides during phase 1 and 2 of the Agricultural Health Study. The exposure information allowed for calculation of intensity-weighted days of exposure to pesticides using the Agricultural Health Study exposure algorithm. Additionally, maternal ever exposure to specific pesticides was used to evaluate risk of childhood cancer.
There were 118 cancers identified in children of Agricultural Health Study participants. The all-cancer standardized incidence ratio was significantly elevated (SIR = 1.27 95% CI: 1.04-1.50). The most common groups of cancers were Group I leukemia, myeloproliferative disease, and myelodysplastic disease (n=34) followed by Group III central nervous system (CNS) and miscellaneous intracranial and intraspinal neoplasms (n=25).
For paternal intensity-weighted days of exposure, there were 31 of 50 specific pesticides that had sufficient cases of cancer to investigate using Cox proportional hazard models. The herbicide trifluralin significantly increased the risk for Group I childhood cancers for any parental pesticide exposure 2 years before birth through birth when compared to children with no paternal exposure (HR = 2.72 95% CI: 1.15, 6.44). This was consistent with results found from analyzing exposure split into two quantiles based on median exposure of exposed children with a Group I cancer. Parental use of the herbicide S-Ethyl-dipropylthiocarbamate (EPTC) did not result in a sufficient number of Group III cancer cases to look at levels of exposure to EPTC, but ever exposure showed an increased hazard ratio when compared to children with unexposed fathers (HR = 2.56 95% CI: 1.06, 6.20). Other pesticides (dicamba, cyanazine, and terbufos) showed mixed evidence of an association with specific childhood cancers, but were either under powered to evaluate with sensitivity analysis or showed inconsistent risk across exposure levels. Less extensive exposure information was available for mothers of children of the Agricultural Health Study, so analysis was restricted to ever or never exposure to pesticides during a mother’s lifetime. Additionally, there were a limited number of cases of cancer for which maternal exposure to specific pesticides was reported resulting in only 4 pesticides being evaluated for childhood cancer risk (glyphosate, 2,4-dichlorophenoxyacetic acid (2,4-D), carbaryl, and malathion). For these four pesticides, this study did not detect any increased risk of childhood cancer from maternal exposure.
In summary, this study provides the first epidemiological evidence of an increased risk of childhood cancer for trifluralin and EPTC. Since this study provides the first evidence of this increased risk, additional analysis is needed to validate the results. This study demonstrates how pesticide exposure information from participants of the AHS can be used in the evaluation of their children’s cancer risk. Additional follow-up and analysis of this cohort beyond the age of 17 would provide further insight into cancer risk during early adulthood from early life pesticide exposure.
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Dang-Tan, Tam 1976. "Epidemiology of delays in care of children and adolescents diagnosed with cancer in Canada." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=115664.
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Background: Although rare relative to adult cancers, cancer is still the leading cause of disease-related death in children in developed countries, including Canada. Few studies have specifically examined the epidemiology and public health significance of diagnosis and treatment delays in childhood cancer. This study aimed to investigate the nature of delays in care for children and adolescents with cancer in Canada and to assess the potential impact of such delays on clinical outcomes.Study Design: I conducted a prospective cohort study to investigate the delays of cancer symptoms reporting, diagnosis, and treatment in children between 0-19 years of age in Canada. This study used a database from Health Canada's Treatment and Outcomes component of the Canadian Childhood Cancer Surveillance and Control Program.
Methodology: Patients were identified from 17 paediatric cancer centres across Canada. Subjects included in this study were residents of Canada, aged less than 20 years, diagnosed with a malignant tumour and had information on date of first symptoms, diagnosis, treatment and outcome available. Descriptive statistics and regression techniques (linear, logistic and Cox regression) were used as appropriate. I measured the individual impact of patient and provider delays on disease severity and prognosis by using judicious control for potential confounding mechanisms and mediating factors.
Study Findings and Significance: By measuring various types of delays in Canada, I found that varying lengths of patient and referral delay, across age groups, types of cancers, and Canadian settings, are the main contributors to diagnosis, HCS and overall delay. Factors relating to the patients, the parents, healthcare and the cancer may all exert different influences on different segments of cancer care. I also found a negative association between diagnosis delay and disease severity for lymphoma and CNS tumour patients. Furthermore, I found that diagnosis and physician delay had a negative effect, while patient delay had a positive effect, on survival for patients diagnosed with CNS tumours. The information provided from this study may form the basis for new effective policies aimed at eliminating obstacles in cancer the diagnostic and care trajectories for Canadian children with cancer and for improving their prognosis.
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Oliveira, Friestino Jane Kelly 1984. "Panorama do câncer em crianças e adolescentes sob a perspectiva da Saúde Coletiva = Overview of cancer among children and adolescents in the perspective of Collective Health." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312569.
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Orientador: Djalma de Carvalho Moreira FilhoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-27T20:51:08Z (GMT). No. of bitstreams: 1 OliveiraFriestino_JaneKelly_D.pdf: 2892489 bytes, checksum: fdc2a35ce3e46aaf292c913864bc673d (MD5) Previous issue date: 2015
Resumo: A assistência à saúde da criança e adolescente necessita contemplar as particularidades e características intrínsecas a essa fase da vida. Os cânceres que acometem crianças e adolescentes têm fatores de riscos e características que diferem daqueles que acometem a população adulta. No Brasil, pouco se conhece a respeito da magnitude das neoplasias no universo infanto-juvenil, bem como as características da população acometida. Objetivou-se estudar o panorama do câncer em crianças e adolescentes sob a perspectiva da Saúde Coletiva, e neste âmbito, apontar ferramentas de monitoramento; conhecer as dificuldades e percepções dos profissionais de saúde que atuam na atenção básica, em relação a suspeita e diagnóstico de câncer em crianças; e, analisar os padrões de distribuição espacial das incidências e sobrevivências de crianças diagnosticadas com neoplasias. Para atender aos objetivos, foram utilizados métodos qualitativos e quantitativos com dados obtidos em Registros de Câncer de Base Populacional e também em Grupos Focais realizados com trabalhadores da Atenção Primária à Saúde. Os resultados foram apresentados em capítulos correspondentes a três artigos. No primeiro artigo, "Câncer Infantil: monitoramento da informação através dos Registros de Câncer de Base Populacional RCBP", realizou-se uma pesquisa bibliográfica da incidência de tumores raros em menores de 20 anos, em três países. Nesta busca identificou-se que a primeira publicação específica sobre câncer em crianças e adolescentes no Brasil foi divulgada em 2008. As publicações do Brasil, Alemanha e Estados Unidos apresentam as informações com critérios heterogêneos, tanto em relação ao modo como a incidência é apresentada, quanto em relação à faixa etária adotada. No segundo trabalho, "Suspeita e Diagnóstico de Câncer em Crianças e Adolescentes na Atenção Primária à Saúde", foram identificados pontos fortes e fragilidades no que concerne ao sentimento dos profissionais; a suspeita e diagnóstico na rede de cuidados primários e a relação dos profissionais e a família. Em todas as categorias de profissionais, as percepções foram negativas com demonstração de insegurança em relação ao tema na atenção básica. No terceiro estudo, "Câncer em crianças e adolescentes: incidência e sobrevivência no município de Campinas-SP, Brasil", os resultados apontaram taxa de incidência global para os grupos de Leucemias (Grupo I); Linfomas (Grupo II); Tumores do Sistema Nervoso Central (Grupo III) e Sarcomas de Partes Moles (Grupo IX) de 54,2 por milhão, com uma incidência padronizada de 59,1 por milhão (Grupo I¿28,8; Grupo II-11,6; Grupo III-7.5 e Grupo IX-4,3). Diferenças nos padrões espaciais não foram encontradas. Diferenças significativas em tempos de sobrevivência foram verificadas por Grupos de diagnóstico ajustados para idade e sexo (p=0,001). Os achados desse estudo demonstraram diferentes possibilidades de abordagem do câncer infantil utilizando o saber científico da Epidemiologia. Os resultados apontam para a necessidade de uma sistematização das informações de tumores raros na infância e na adolescência, e uma inclusão do tema câncer infantil aos profissionais de saúde que atuam na Atenção Primária à Saúde. A utilização de metodologias epidemiológicas como análise da incidência, uso da estatística espacial e análises de sobrevivência contribuem para a construção do panorama do câncer infantil na Saúde Coletiva.
Abstract: The health care to the children and adolescents needs to contemplate the particularities and intrinsic characteristics of this phase of life. Occurrences of childhood cancer have risk factors and specific characteristics that differ from tumours in adults. In Brazil, little is known about the magnitude of childhood cancer, as well as the characteristics of the affected population. Our goal to study cancer among children and adolescents in the perspective of Collective Health, and in this context, point monitoring tools in the health information systems; identify the difficulties and perceptions of workers in primary health care, in relation to suspicion and diagnosis of childhood cancer; and finally analyse the distribution patterns of spatial incidence and survival of children who have been diagnosed with cancer. To achieve the objectives, we used qualitative and quantitative methods with data by Population-based Cancer Registries and also in focus groups conducted with workers of Primary Health Care. Results are presented in three articles on chapters. In the first article, "Childhood Cancer: Information Followed in Population-Based Cancer Registry", we conducted a literature search of tumours incidence in children under 20 years of age in three countries. This research identified that first specific publication about cancer among children and adolescents in Brazil was released in 2008. Publications of Brazil, Germany and the United States have the information with heterogeneous criteria, both in relation to how the incidence is presented and in relation to age adopted, being difficult to compare. In the second study, "Suspicion and Diagnosis of Cancer among Children and Adolescents in Primary Health Care", were identified strong points and weaknesses concerning regarding feeling of professionals, suspicion and diagnosis the primary care network and relationship between professionals and family. In all professional¿s categories perceptions were negative with demonstration of insecurity in primary care. In the study, "Cancer Incidence and survival among children and adolescents in Campinas ¿ SP, Brazil", the results showed overall crude incidence rate for Leukaemia (Group I); Lymphomas (Group II); CNS neoplasms (Group III), and Soft tissue sarcomas (Group IX) was 54.2 per million and standardized incidence rates was 59.1 (Group I-28.8, Group II-11.6, Group III-7.5 and Group IX-4.3). Spatial differences were not found. Significant differences in survival times were found by diagnostic Groups adjusted for age and sex (p=0.001). In conclusion, higher incidence was found in Group-I and 5-year survival is higher in children than in adolescents similar to the findings reported in the literature. The findings of this study showed different approach possibilities of childhood cancer using scientific knowledge of collective health. The results indicate the need for systematic information of rare tumours in childhood, and including the theme to health professionals working in primary health care. The use of such epidemiological methods analysis of incidence, use of spatial statistics and survival analyses contribute to the construction of the panorama of childhood cancer in Collective Health
Doutorado
Epidemiologia
Doutora em Saúde Coletiva
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Kroll, Mary Eileen. "Time trends in childhood cancer : Britain 1966-2005." Thesis, University of Oxford, 2009. http://ora.ox.ac.uk/objects/uuid:8be887be-36e7-4b77-a7af-5887f3a1df8c.
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Increasing time trends in the recorded incidence of childhood cancer have been reported in many different settings. The extent to which these trends reflect real changes in incidence, rather than improvements in methods for diagnosis and registration, is controversial. Using data from the National Registry of Childhood Tumours (NRCT), this thesis investigates time trends in cancer diagnosed under age 15 in residents of Britain during 1966-2005 (54650 cases), and considers potential sources of artefact in detail. Several different methods are used to estimate completeness of NRCT registration. The history of methods for diagnosis and registration of childhood cancers in Britain is described, and predictions are made for effects on recorded incidence. For each of the 12 main diagnostic groups, Poisson regression is used to fit continuous time trends and ‘step’ models to the annual age-sex-standardised rates by year of birth and year of diagnosis. Age-specific rates by period, and quinquennial standardised rates for diagnostic subgroups, are shown graphically. For three broad groups (leukaemia, CNS tumours and other cancer), geographical variation is compared by period of diagnosis. The results of these analyses are discussed in relation to the predicted artefacts. The evidence for a positive association between affluence and recorded incidence of childhood leukaemia is briefly reviewed. A special form of diagnostic artefact, the ‘fatal infection’ hypothesis, is proposed as an explanation of both this association and the leukaemia time trend. This hypothesis is examined in a novel test based on clinical data. The recorded incidence of childhood cancer in Britain increased in each of 12 diagnostic groups during 1966-2005 (from 0.5% per year for bone cancer to 2.5% for hepatic cancer, with 0.7% for leukaemia). Evidence presented here suggests that these increases are probably artefacts of diagnosis and registration. The potential implications for epidemiological studies of childhood cancer should be considered.
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Tanaka, Luana Fiengo. "A epidemiologia do câncer em crianças e adolescentes com Aids no Município de São Paulo: um estudo de base populacional." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-18042017-150014/.
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Introdução: A associação entre a infecção pelo vírus da imunodeficiência humana (HIV) e o câncer tem sido documentada desde os primórdios da epidemia da síndrome da imunodeficiência adquirida (Aids). A introdução da highly active antirretroviral therapy (HAART) alterou, profundamente, o curso da epidemia da Aids, reduzindo, drasticamente, a incidência de manifestações definidoras da síndrome, incluindo cânceres. No entanto, existem informações limitadas sobre a incidência de câncer em crianças e adolescentes com Aids vivendo em países em desenvolvimento. Objetivo: Descrever a epidemiologia do câncer em crianças e adolescentes com Aids no Município de São Paulo, no período de 1997 a 2012. Métodos: Trata-se de um estudo de base populacional, utilizando as bases de dados do Registro de Câncer de Base Populacional do Município de São Paulo e do Sistema de Informações de Agravos de Notificação (SINAN). As crianças e adolescentes (< 20 anos) com Aids e câncer foram identificadas por meio de um processo de linkage probabilístico entre as bases de dados supracitadas. Foram calculadas as taxas de incidência brutas e ajustadas por milhão de habitantes. Para comparar a incidência de câncer na população com Aids e a população geral foi calculada a razão de incidência padronizada (RIP) e respectivos intervalos de confiança de 95 por cento (IC 95 por cento ). A análise de tendência foi feita por meio do cálculo do annual percent change (APC) e IC 95 por cento correspondentes. A análise da sobrevida global de cinco anos após o câncer entre pacientes com Aids e na população geral foi calculada por meio do estimador produto limite de Kaplan-Meier e modelos univariados de riscos proporcionais de Cox. Mapas coropléticos em escalas monocromáticas foram gerados para descrever a distribuição de casos no Município. Resultados: Foram identificados 24 casos de câncer em pacientes com Aids menores de 20 anos, sendo 62,5 por cento cânceres definidores de Aids. Os cânceres mais incidentes foram o linfoma não Hodgkin, incluindo o linfoma de Burkitt (12; 50,0 por cento ), o linfoma de Hodgkin (6; 25,0 por cento ) e o sarcoma de Kaposi (3; 12,5 por cento ). A taxa bruta de incidência foi de 1.461,3 casos/milhão. A análise de tendência revelou redução significativa da incidência para todos os cânceres (APC= -14,5), influenciada pela queda nos cânceres definidores de Aids (APC= -17,0). O risco para câncer se mostrou aumentado (RIP= 3,9), sobretudo para o linfoma não Hodgkin, excluindo linfoma de Burkitt (RIP= 22,5), linfoma de Burkitt (RIP= 29,7) e linfoma de Hodgkin (RIP= 18,7). A probabilidade acumulada de sobrevida aos cinco anos foi de 56,3 por cento em crianças e adolescentes com Aids versus 87,5 por cento na população geral. A hazard ratio para óbito foi 5,2 (IC 95 por cento = 2,0; 13,6). O mapa da distribuição geográfica mostrou concentração dos casos nas áreas de classes sociais mais baixas do Município. Conclusão: Houve redução acentuada da incidência de cânceres definidores de Aids, como provável resultado da introdução da HAART. No entanto, crianças e adolescentes com Aids permanecem sob risco aumentado para o desenvolvimento de câncer quando comparadas à população geral. Para aquelas que desenvolveram câncer, o risco para óbito também se mostrou substancialmente elevadoIntroduction: The association between human immunodeficiency virus (HIV) infection and cancer has been documented since the beginning of the epidemic of the acquired immunodeficiency syndrome (AIDS). The introduction of the highly active antiretroviral therapy (HAART) has profoundly altered the course of the AIDS epidemic, drastically reducing the incidence of AIDS-defining manifestations, including cancers. Nevertheless, there is limited information on the incidence of cancer in children and adolescents with AIDS living in developing countries. Objective: To describe the cancer epidemiology in children and adolescents with AIDS in the Municipality of São Paulo from 1997 to 2012. Methods: It is a population-based study, using the databases of the Population-based Cancer Registry of São Paulo and the Notifiable Diseases Information System (SINAN). Children and adolescents (< 20 years) with AIDS and cancer have been identified by means of a probabilistic record linkage process between the aforementioned databases. Crude and age-standardized incidence rates per million inhabitants were calculated. To compare the incidence of cancer in people with AIDS and that of the general population, standardized incidence ratio (SIR) and respective 95 per cent confidence intervals (95 per cent CI) were calculated. We examined trends by calculating the annual percent change (APC) and corresponding 95 per cent CI. The analyses of the overall five-year survival after cancer diagnosis among children and adolescents with AIDS and that of the general population were based on the Kaplan-Meier product limit estimator and univariate Cox proportional hazards models. Choropleth maps on monochromatic scales were generated to describe the distribution of cases across the Municipality. Results: We identified 24 cases of cancer in patients with AIDS aged 20 years and younger, of which, 62.5 per cent were AIDS-defining malignancies. The most incident cancers were non-Hodgkin\'s lymphoma, including Burkitt\'s lymphoma (12; 50.0 per cent ), Hodgkin\'s lymphoma (6; 25.0 per cent ) and Kaposi sarcoma (3; 12.5 per cent ). The age-standardized incidence rate was 1,461.3 cases/million. The trend analyses revealed a significant reduction in the incidence of all cancers (APC= -14.5), driven by the decrease in AIDS-defining cancers (APC= -17.0). The overall risk for cancer was significantly increased (SIR= 3.9), especially for non-Hodgkin lymphoma, excluding Burkitts lymphoma (SIR= 22.5), Burkitt\'s lymphoma (SIR= 29.7) and Hodgkin\'s lymphoma (SIR= 18.7). The overall probability of survival at five years after cancer was 56.3 per cent in children and adolescents with AIDS versus 87.5 per cent in the general population. The hazard ratio for death was 5.2 (95 per cent CI= 2.0, 13.6). The map of the geographical distribution showed a concentration of cases in the low-income areas of the Municipality. Conclusion: There was a marked reduction in the incidence of AIDS-defining cancers, likely to be a result of the introduction of HAART. However, children and adolescents with AIDS remain at increased risk for the development of cancer when compared to the general population. For those who developed cancer, the risk of death was also significantly higher
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Wiklund, Fredrik. "Genetic epidemiology of prostate cancer." Doctoral thesis, Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-281.
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Cheng, Kar Keung. "The epidemiology of oesophageal cancer." Thesis, University of Cambridge, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309275.
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Rigby, Janette Elizabeth. "An epidemiology of breast cancer." Thesis, Lancaster University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.311870.
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Macfarlane, Gary John. "The epidemiology of oral cancer." Thesis, University of Bristol, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.357309.
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Gandini, Sara. "Meta-analysis in cancer epidemiology." Thesis, University of Birmingham, 2004. http://etheses.bham.ac.uk//id/eprint/251/.
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A published meta-analysis on breast cancer and vegetables and fruit consumption was described to present a methodology used on meta-analysis in Epidemiology. Meta-analysis confirmed the association between intake of vegetables (RR=0.74; 95%CI 0.65-0.84) and, to a lesser extent, fruit and breast cancer risk (RR=0.93; 95%CI 0.79-1.09). Using this methodology, present in a peer-reviewed journal, a systematic meta-analysis on melanoma was conducted extracting RRs from published studies. Fully adjusted estimates were obtained from those studies, when available; RRs adjusted for confounders not related to sun exposure, such as naevi, were considered for sun exposure and sunburns pooled estimates. Pooled estimates were obtained for all main risk factors for melanoma: sun exposure (total, intermittent and chronic), sunburns (in childhood and in adulthood), indicators of actinic damage, family history of melanoma and phenotype characteristics. Investigation of biases and inconsistencies among studies was one of the key phases of the meta-analysis to look for patterns among studies that might explain discrepant findings. The analyses on pigmented lesions and sun exposure showed that the choice of sources of cases and controls influenced significantly the estimate. An indication of a protective effect of chronic sun exposure came from studies that did not include subjects with dermatological problems (significantly different from the other studies: p=0.01). Publication year was an important factor for total sun exposure (p=0.005). Latitude of the study seemed to be an important factor for sunburns (p=0.002) and for high density of freckles (p=0.04). Estimates for hair colour and eye colour adjusted for phenotype and/or photo-type were significantly lower than unadjusted ones (p=0.06 and p=0.06, respectively). This study highlighted how several features of study design, type of analysis, categorization of exposures, study location and populations significantly explained between-study heterogeneity.
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Kho, Pik Fang. "Genetic epidemiology of endometrial cancer." Thesis, Queensland University of Technology, 2021. https://eprints.qut.edu.au/211383/1/Pik%20Fang_Kho_Thesis.pdf.
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Endometrial cancer is the fifth most common cancer diagnosed in women in developed countries. This research used genetics to assess relationships between endometrial cancer and, previously identified and novel, risk factors. This work brings new insights by providing evidence that HDL and LDL cholesterol levels are linked to endometrial cancer risk. Further, I have shown that two gynaecological diseases, which are comorbid with endometrial cancer, also share genetic risk architecture with endometrial cancer. This work also advances the understanding of biological mechanisms of endometrial cancer by identifying candidate susceptibility genes.
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Ji, Jia. "Translational Research in Cancer: Preclinical Pharmacodynamics and Cancer Epidemiology." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1250092164.
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Plummer, Kathleen Hope. "Cancer and Infection." Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5293.
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E. coli is the most frequently isolated Gram negative pathogen from bacteremia in cancer patients and is repeatedly recovered from many other extraintestinal illnesses. These infections are commonly endogenous in nature and interfere with the treatment of cancer resulting in increased healthcare costs, morbidity, and mortality rates. Cancer and the treatments related to cancer cause alterations in the microbiome of the gut and other organs. Despite this point, there is a serious lack of knowledge about the genetic types of E. coli infecting cancer patients. This gap results in vague prevention strategies and limited treatment options for cancer patients. Multi Locus Sequence Typing (MLST) was used to successfully genotype 105 sequentially collected E. coli isolates from patients admitted to H. Lee Moffitt Cancer Center (HLMCC, Tampa, FL) with confirmed extraintestinal infections between 2010 and 2012. In total, 24 distinct genotypes (STs) have been identified in this dataset using EcMLST (STEC Reference Center). Of these, ST34 constituted 39% of the isolates and may represent a disseminating clone at HLMCC. Furthermore, 17 isolates not found in the EcMLST database have been identified. Importantly, phylogenetic analysis of DNA sequence data for MLMCC E. coli revealed only 22% of HLMCC E. coli clustered with ECOR reference strains commonly attributed to the B2 phylogroup of extraintestinal pathogenic E. coli (ExPEC). Four HLMCC E. coli belonging to ST171 and attributed to life-threatening blood infections clustered with Shiga toxin (Stx) producing E. coli (STEC) strain TW06296. HLMCC E. coli belonging to ST34 clustered with enteroaggregative E. coli (EAEC) strain TW10263. Importantly, these non-B2 phylogroup strains demonstrated more pathogenic potential than HLMCC E. coli clustered with B2 ExPEC,which included a higher incidence of bacteremia and sepsis, as well as resistance to first-line antibiotics. Upon further investigation, ST34 may equate to ST131 by another MLST database. These findings suggest that isolates previously characterized as commensal and intestinal pathogenic E. coli have an increased ability to cause infection outside of the gastrointestinal tract in cancer patients and that selective pressures are contributing to increased antibiotic resistance. These findings may change the approach to clinical management of E. coli infections at cancer centers.
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Lubbe, Steven John. "The genetic epidemiology of colorectal cancer." Thesis, Institute of Cancer Research (University Of London), 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.538696.
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Michelin, Ruel Slyfield. "The Effect of Phytoestrogen Chemoprevention of Prostate Cancer." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1064.
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Prostate cancer (CaP) remains the most commonly diagnosed cancer and second leading cause of cancer mortality among men in several ethnic groups in the United States. Lower CaP incidence among Asian men has been attributed to increased intake of soy derived phytoestrogens (SDPs); however, its association has not been extensively explored in U.S. men. The purpose of this study was to determine the effect size of serum prostate specific antigen (sPSA) and serum estradiol (sE2) following dietary SDP intervention. The study was based on an original conceptual model that aims to avert early prostate tissue damage through identification of critical prevention endpoints. Research questions examined the correlation between dietary SDPs and sPSA and sE2 levels. This quantitative meta-analysis study used data abstracted from 8 randomized controlled trials yielding 530 participants ages 50-85. Outcome specific meta-analysis using the random effect model adjusted for heterogeneity and determined cumulative effect size that favored intervention. Odds ratios established a positive correlation between intake of dietary SDP and detection of serum SDP (sSDP) among treated groups. Positive correlations between both dietary and sSDP with sE2 levels, and inverse correlations between both dietary and sSDP with sPSA levels, were indicated among treated compared to placebo groups. Hedges' g, correlation, and standardized mean difference statistics confirmed analyses. Implications for positive social change include developing professional dietary standards to use SDPs for CaP chemoprevention among U.S. and other men, as well as a medical option for treatment of CaP. Further research exploring mechanisms of SDP action on hormones may be beneficial to men at risk for CaP and individuals at risk for other cancers linked to changes in hormonal levels.
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Persson, Eva-Karin. "Hydrocephalus in children : epidemiology and outcome /." Göteborg : Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at Göteborg University, 2007. http://hdl.handle.net/2077/2556.
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Olsen, Jonathan Robin. "Epidemiology of molluscum contagiosum in children." Thesis, Cardiff University, 2015. http://orca.cf.ac.uk/70412/.
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Molluscum contagiosum (MC) is a common skin condition in children presenting to primary care in the United Kingdom (UK) and is typically diagnosed based on its distinct appearance. There are limited data on the epidemiology of MC in UK children. Little is known about its presenting symptoms, time to resolution, likelihood of transmission and impact on quality of life (QoL), highlighted within a systematic review of the epidemiology of childhood MC presented early in this thesis. This thesis aimed to address this gap in evidence. A retrospective longitudinal cohort of 9,245,847 children registered at primary care centres in the UK extracted routinely collected data from the Clinical Practice Research Datalink (CPRD). The study highlighted decreasing trends in consultation rates for MC by 50% during the 10 year study period 2004-13. Children who were previously diagnosed with atopic eczema were more likely to have a future MC consultation than controls. The ‘Molluscum Contagiosum Diagnostic Tool for Parents’ (MCDTP) was developed to aid parents in diagnosing spots, lumps or bumps on a child’s skin as being MC or not. The MCDTP was assessed in primary care centres to measure its diagnostic accuracy (n=203, sensitivity=92%, specificity=88%), and used to recruit a prospective community cohort of 306 UK children with MC. Results showed that MC lesions were most common on legs and arms, and nearly 70% of children had lesions in more than one site. The average time to resolution was 12 months, however over a quarter still had lesions after 18 months and 12% after 24 months. Nearly half of households reported transmission to one or more children from an index case. Overall MC had a small effect on QoL however, 1 in 10 children experienced a very severe effect on QoL. The findings presented in this thesis can facilitate self-care of MC in the community where parents can self-diagnose their child’s spot, lumps or bumps on the skin as MC or not using the MCDTP. These data can provide parents, and other interested stakeholders, with accurate information of the epidemiology of the condition to aid the management in both clinical and community settings.
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Tran, Sinh. "Tuberculosis in children : diagnosis and epidemiology." Thesis, Open University, 2017. http://oro.open.ac.uk/48426/.
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Globally, an estimated one-million new tuberculosis (TB) cases occurred in children in 2014. For a long time, research of TB in children has been neglected. Most research and surveillance of TB is performed in adults, and the resulting lack of evidence in children is a major barrier for implementation of rational control strategies for children, including diagnosis. More research on TB in children is of importance as children are more susceptible to developing severe extrapulmonary TB, children require different approaches to both diagnosis and treatment and paediatric TB reflects the ongoing transmission of TB in the population. This research gap on the epidemiology of tuberculosis in children, especially in high burden countries, should be addressed in order to better understand the dynamics of TB transmission in both adults and children. Accurate data are the basis for establishment of effective control strategies. This thesis aims to assess the diagnostic role of microscopic observation drug susceptibility (MODS) and mycobacterial blood culture for diagnosis of TB in children as well as to present the epidemiological characteristics of paediatric TB in northern Vietnam with regard to drug resistance and genotypes of Mycobacterium tuberculosis (MTB), the causative agent of TB, isolated from them. MODS is a low cost non-commercial liquid culture assay to detect MTB by microscopy. MODS was compared with conventional assays including Ziehl-Neelsen smear (ZN) and Löwenstein-Jensen culture (LJ) in a study conducted from 2009 to 2010 at the National Hospital for Paediatrics, a general paediatric hospital, in Hanoi, Vietnam. In suspected paediatric TB cases, the MODS test was shown to be significantly more sensitive than both smear (46.0% vs. 8.8%) and LJ (46.0% vs. 38.9%), and significantly faster than LJ with a median time difference of 28 days in favour of MODS (7 days vs. 35 days). The findings suggest that MODS is a rapid low-cost diagnostic tool for TB diagnosis in the paediatric population. The additional yield of mycobacterial blood culture was assessed in comparison to routine detection methods for TB diagnosis in children in two hospitals in Vietnam. The findings show that mycobacterial blood culture detected an additional six TB cases of which 5 cases were negative with other tests and in the remaining case no other tests were done. All six cases were susceptible to rifampicin and isoniazid. The overall performance of TB blood culture was poor as compared to routine culture with regard to detection rate (2.9%, 16/554 vs. 16.6%, 92/554) and turnaround time (26 days vs. 14 days). The incremental cost for adding one additional TB case is substantial. Therefore, addition of mycobacterial blood culture into routine diagnostics has limited utility in resource limited settings. To assess the molecular epidemiology of paediatric TB in northern Vietnam, a collection of 125 MTB isolates from children with TB admitted to NHP during 2009 to 2013 was analysed. Drug susceptibility testing results from 121 isolates and genotypes from 120 isolates were generated. The phenotypic drug susceptibility testing showed that 20.7% was resistant to isoniazid (25/121), 3.3% resistant to rifampicin (4/121), 28.1% resistant to streptomycin (34/121) and 2.5% resistant to ethambutol (1/121). There were 4 cases with multidrug resistant TB. The high frequency of resistance to isoniazid and streptomycin are consistent with data from adults in Vietnam, suggesting the ongoing transmission of drug resistant MTB in the community. MIRU typing patterns showed that the Beijing genotype was predominant in this population (63.3%, 76/120), which is in agreement with various prior studies in adults in Vietnam. These findings provide more evidence to support the hypothesis of the epidemic spread of the Beijing genotype in Vietnam. In this study, an association between Beijing genotype and drug resistance to streptomycin and isoniazid was observed. The number of MDR isolates was too small to draw conclusions regarding association of MDR and Beijing genotype. Collectively, these results demonstrate that liquid culture can improve the yield of TB diagnosis in Vietnam and mycobacterial blood culture should not be routinely performed for paediatric cases. The molecular epidemiology study also showed that the Beijing genotype is the predominant lineage among actively transmitted strains in Vietnam and that it is associated with both isoniazid and streptomycin resistance. Paediatric TB remains a significant cause of morbidity and mortality in Vietnamese children and sustained political and social commitment from all stakeholders, including governments, funders, academics and the medical community will be needed to improve diagnosis, treatment and prevention of TB in children globally.
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Stella, Achimole. "Epidemiology peculiarities of poisoning of children." Thesis, Сумський державний університет, 2013. http://essuir.sumdu.edu.ua/handle/123456789/32300.
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Acute poisoning play a significant role in the pathology of childhood. Among the accidents they occupy fourth place, behind in the number of injuries, burns and drowning. Currently, there are over 10 million different chemicals that can affect the human body.
When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/32300
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Watson, Joanna. "Studies in the epidemiology of colorectal cancer." Thesis, University of Oxford, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.534176.
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Ford, Deborah. "Genetic epidemiology of breast and ovarian cancer." Thesis, Institute of Cancer Research (University Of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367527.
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Bolton, Kelly. "The genetic epidemiology of ovarian cancer survival." Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610071.
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Macdonald, Sara. "An exploration of lay epidemiology and cancer." Thesis, University of Glasgow, 2011. http://theses.gla.ac.uk/2583/.
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Some estimates suggest that as much as 70% of cancer is preventable by disease modification alone (Peto 1991). Disease prevention via behavioural change is a challenging endeavour. There is widespread recognition that for behaviour to be better understood there is a need to understand the context in which it occurs, and the beliefs that underpin it. Lay epidemiology illustrates the sophistication of belief formation. The arrival at a coronary candidate provides according to Davison, Frankel and Davey Smith (1991), a cultural mechanism that aids the estimation of risk as observed from known cases in the family and wider society. Consequently, the estimate provides the potential motivation for behavioural choices. Other studies that followed the original model of lay epidemiology have similarly described the coronary candidate (Preston 1997; Emslie, Hunt & Watt 2001a; Frich, Malterud & Fugelli 2007; Weiner 2009) and suggest that the lay public have an understanding of the risk profile for Coronary Heart Disease. This study aimed to explore the utility of the elements held within lay epidemiology in cancer beliefs. Do the lay public recognise a ‘cancer candidate’? Method: A series of 31 in-depth semi-structured interviews were conducted between November 2007 and October 2008. Interviews took place in two communities in Glasgow, Scotland – one affluent, one deprived. The sample was drawn from a number of community organisations and leisure clubs in the communities to facilitate accessing an ‘ordinary’ view. Cancer sufferers were excluded from the study. A topic guide was used to ensure consistency throughout interviews and focused on participants’ experience of cancer. Although the study did not adhere to a strict grounded theory approach, the analytic method of constant comparative analysis was followed. Findings: The complexity of the scheme described by Davison, where a wide range of sources of knowledge to inform beliefs resonated. Sophisticated and complex explanatory models of cancer were described. Cancer inhabited an important cultural position and was most commonly associated with fear and dread. Possible aetiological explanations included behavioural, environmental, biological and psychological factors. Smoking was the most widely recognised risk factor. Knowledge of other risk factors for individual cancers was patchy. Candidacy therefore was not as unequivocal for cancer. Many ‘anomalous cases’ (those without obvious explanation) were proffered. Ultimately the randomness of cancer was emphasised. Conclusion: Cancer is a more complex disease than CHD, both culturally and biomedically and this is reflected in the beliefs voiced by participants in this study. This complexity is a barrier to the adoption of a cancer candidate.
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Mungai, Mary Wairimu. "The epidemiology of atopy in Kenyan children." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ29756.pdf.
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Mungai, Mary. "The epidemiology of atopy in Kenyan children /." Thesis, McGill University, 1997. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=27381.
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This thesis investigated the epidemiology of atopy in Kenyan children. Analysis was based on data gathered on 599 rural and 567 urban children, as part of a research program on childhood asthma focussing on the impact of urbanization. Atopy was more frequent in urban than rural children (22.9% vs 14.7%). The unadjusted odds ratio for urban rural differences in atopy was 1.75, 95% CI 1.30 to 2.36. Urban children were also younger, taller, weighed more and were breastfed for shorter periods compared to rural children. They were also more likely to have a family history of allergic disease but were less likely to share their bed, use allergenic mattresses and live in homes with pets and smokers.When the urban rural differences were adjusted for these differences in the distribution of personal, environmental and socio economic characteristics, the odds ratio fell to 0.81 and became nonsignificant (95% CI 0.50 to 1.33). Therefore, the urban rural difference in the prevalence of atopy in Kenyan children appear to be due to the differences in the distribution of the relevant risk factors.
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Hemingway, Jennifer M. "Low Level Lead Exposure and Postural Balance in Children." University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353099859.
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Theodoratou, Evropi. "Colorectal cancer and diet in Scotland." Thesis, University of Edinburgh, 2008. http://hdl.handle.net/1842/3287.
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Introduction Colorectal cancer is a cancer that forms in the tissues of the colon and/ or rectum and more than 95% of colorectal cancers are adenocarcinomas. It is the third most common cancer in incidence and mortality rates, accounting for 9% of all cancer cases and for 8% of all cancer related deaths (2002). The established risk factors of colorectal cancer include personal or family history of previous colorectal cancer or adenomatous polyps, chronic bowel inflammatory disease and presence of any of the hereditary syndromes. In addition, due to the fact that the majority of colorectal cancer cases (approximately 90%) occur after the age of 50, advanced age is also considered as a risk factor. Finally, evidence for significant associations between colorectal cancer and other risk factors, including diet, body weight, physical activity, smoking, alcohol intake, NSAIDs intake and HRT in post-menopausal women, is promising and increasing. Aims and objectives The main aims of this project were: 1) to investigate the associations between colorectal cancer and specific nutrients, including flavonoids, fatty acids, folate, vitamin B2, vitamin B6, vitamin B12, alcohol, vitamin D and calcium (prior hypotheses 1-4) and 2) to conduct an overall as well as forward and backward stepwise regression analyses of demographic, lifestyle and dietary risk factors. Methods The analysis of this thesis was based on a population-based case-control study of colorectal cancer (Scottish Colorectal Cancer Study; SOCCS). In total 3,417 colorectal cancer cases and 3,396 controls were recruited in the study. Dietary and lifestyle data were collected by two questionnaires (Lifestyle & Cancer and Food Frequency Questionnaire) and were available for 2,061 cases and 2,776 controls. For the analysis of the first two hypotheses (flavonoids and fatty acids) a matched dataset of 1,489 casecontrol pairs was used and conditional logistic regression models were applied, whereas for the analysis of the last two hypotheses (folate, vitamin B2, vitamin B6, vitamin B12, alcohol, vitamin D and calcium) an unmatched dataset including 2,061 cases and 2,776 v controls was used and unconditional logistic regression models were applied. For the overall and stepwise regression analyses the unmatched dataset was used (2,061 cases and 2,776 controls). Forward and backward stepwise regression was applied on three different sets of variables and the stability of the resultant models was checked in 100 bootstrap samples. Results Regarding the first two hypotheses, statistically significant odds ratios (ORs) (matched on sex, age and health board are and adjusted for family history of cancer, BMI, physical activity, smoking, and intakes of total energy, fibre, alcohol and NSAIDs) for highest versus lowest intakes (quartiles) were observed for flavonols OR (95% CI), p-value for trend: 0.78 (0.60, 0.99), 0.08) and for the individual flavonoid compounds quercetin and catechin (OR (95% CI), p-value for trend: 0.77 (0.60, 0.99), 0.04; 0.75 (0.58-0.97), 0.02; respectively); for the 3PUFAs fatty acids (OR (95% CI), p-value for trend: 0.75 (0.59, 0.97), 0.01) and for the individual fatty acids stearic acid, EPA and DHA (OR (95% CI), p-value for trend: 1.46 (1.11, 1.91), 0.01; 0.74 (0.58, 0.95), 0.02; 0.74 (0.58, 0.95), 0.02; respectively). Regarding the last two hypotheses, statistically significant odds ratios (ORs) (adjusted for age, sex, deprivation score, family history of cancer, BMI, physical activity, smoking, and intakes of total energy, fibre, alcohol and NSAIDs) for highest versus lowest intakes (quartiles) were observed for vitamin B6, vitamin B12 and alcohol (OR (95% CI), p-value for trend: 0.86 (0.72, 1.03), 0.08; 0.80 (0.67, 0.97), 0.05; 0.83 (0.68, 1.00), 0.03); and for vitamin D (OR (95% CI), p-value for trend: 0.83 (0.69, 0.99), 0.03). Regarding the second aim of the project, several risk factors were found to be significantly associated with colorectal cancer in the overall analysis including demographic and lifestyle factors (family history of cancer, NSAIDs intake, dietary energy intake, HRT intake and physical activity), food group variables (vegetables, eggs, sweets, fruit/ vegetable juice, oily fish, coffee, fruit, savoury foods and white fish) and nutrient variables (tMUFAs, 3PUFAs, SFAs, tFAs, MUFAs, quercetin, catechin, phytoestrogen, cholesterol, fibre, protein, starch, magnesium, potassium, manganese, copper, iron, zinc, phosphorus, selenium, niacin, vitamin B6, carotenes, vitamin C, vi vitamin A, potential niacin, biotin, folate, pantothenic acid, vitamin D, vitamin B1 and vitamin B12). In addition, the variables that were selected to be included in 100% of the models after applying forward and backward stepwise regression analyses were family history, NSAIDs, sweets and fruit/ vegetable juice. Finally according to the findings from the bootstrap analysis, the variables that were selected to be included in models for the majority of the bootstrap samples (more than 90%) were family history, NSAIDs, dietary energy, eggs, sweets, fruit/ vegetable juice and white fish. Discussion The particular dietary factors that were found to be inversely associated with colorectal cancer after applying several multivariable logistic regression models were: flavonols, quercetin, catechin, 3PUFAs, EPA, DHA, vitamin B6, vitamin B12 and vitamin D. In addition, high intakes of stearic acid were found to be positively associated with colorectal cancer. In contrast, high intakes of dietary and total folate were associated with a decreased colorectal cancer risk in the energy-adjusted model, but this inverse association was attenuated after further adjustment for several confounding factors including fibre. Regarding alcohol intake, when it was divided into quartiles, high alcohol consumption was associated with a statistically significant and dose-dependent decreased colorectal cancer risk. However, when alcohol intake was divided in categories an increased colorectal cancer risk for intakes of higher than 60 g/day was observed. Intakes of 3PUFAs, vitamin D and vitamin B12 were highly correlated due to having the same food source (oily fish) and therefore it is difficult to draw specific conclusions regarding which nutrient is truly associated with colorectal cancer and which not. Finally, it was observed that for calcium intakes to be inversely associated with colorectal cancer, a dosage of 1500mg/day or higher was necessary. The majority of these results are in accordance with results of previous epidemiological and laboratory studies; however their confirmation in further large-scale studies is required. Results from the overall and stepwise regression analysis supported previous findings of an increased colorectal cancer risk due to a high or moderate family history risk. In addition, high intakes of dietary energy were found to be positively associated with increased colorectal cancer risk in the overall analysis and in addition dietary energy was vii selected to be included in the majority of the stepwise regression models. On the other hand, regular intake of NSAIDs was found to be inversely associated with colorectal cancer risk in the overall analysis and in the majority of the stepwise regression models. Finally, the overall and stepwise regression analyses generated a few new hypotheses suggesting that low intakes of fruit/ vegetable juice, eggs, white fish and sweets (a combined variable of high-fat and high-sugar foods) and high intakes of coffee and magnesium were associated with a decreased colorectal cancer. These findings, though interesting and important for generation of new hypotheses, need further investigation (as prior hypotheses) in large-scale observational studies.
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MacLeod, Kendra D. "Emotional well-being in children experiencing cancer and children whose mother experiences cancer /." Cincinnati, Ohio University of Cincinnati, 2005. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=ucin1128615655.
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Puig, Vives Montserrat. "Breast cancer epidemiology: mammographic screening and molecular subtypes." Doctoral thesis, Universitat de Girona, 2015. http://hdl.handle.net/10803/289426.
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The aim of this thesis is to carry out an in-depth study of various aspects of breast cancer epidemiology. Firstly, we have confirmed that DCIS incidence in Girona has increased over recent decades. Proportions of screen-detected cancers, interval cancers and non-screen-detected cancers during the start-up phase of the mammographic screening programme were found to be 42.2%, 5.8% and 52.2%, respectively. Secondly, we have found that luminal A-like was the most frequent subtype associated with the best survival rate, while triple-negative breast cancer was related to the lowest survival rate. Importantly, we have concluded that breast cancer molecular subtype defined by IHC biomarkers provides prognostic value, regardless of age, tumour size, histological grade, lymph node involvement and method of detection. Finally, we have demonstrated that method of detection also provides prognostic value regardless of age, tumour size, histological grade, lymph node involvement and breast cancer molecular subtype defined by IHC biomarkers.L’objectiu d’aquesta tesi és realitzar aprofundir en diversos aspectes de l'epidemiologia del càncer de mama. Hem confirmat que la incidència del DCIS a Girona ha augmentat en les últimes dècades. Les proporcions dels càncers detectats mitjançant el programa de cribratge, fora d’aquest i els càncers d'interval van ser del 42,2%, 52,2% i 5,8%, respectivament. Per altra banda, el subtipus amb la supervivència més elevada i més baixa van ser el luminal A-like i el triple negatiu, respectivament. És important destacar que el subtipus molecular de càncer de mama definit per biomarcadors determinats amb tècniques d’IHC proporciona valor pronòstic, independentment de l'edat, la mida, el grau histològic, l’afectació dels ganglis i el mètode de detecció. Finalment, hem demostrat que el mètode de detecció del càncer també proporciona valor pronòstic independentment de l'edat, la mida, el grau histològic, l'afectació dels ganglis i el subtipus molecular.
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Sak, Sei Chung. "Molecular epidemiology of DNA repair and bladder cancer." Thesis, University of Leeds, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.446441.
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Kellier, Nicole. "The Epidemiology of Prostate Cancer Among Multiethnic Men." FIU Digital Commons, 2011. http://digitalcommons.fiu.edu/etd/534.
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The research goal was to document differences in the epidemiology of prostate cancer among multicultural men [non-Hispanic White (NHW), Hispanic (H), non-Hispanic Black (NHB)], and Black subgroups, particularly among NHB subgroups [US-born (USB) and Caribbean-born (CBB)]. Study findings will be useful in supporting further research into Black subgroups. Aim 1 explored changes over time in reported prostate cancer prevalence, by race/ethnicity and by birthplace (within the Black subgroups). Aim 2 investigated relationships between observed and latent variables. The analytical approaches included confirmatory factor analysis (CFA for measurement models) and structural equation modeling (SEM for regression models).
National Center for Health Statistics, National Health Interview Survey (NHIS) data from 1999 – 2008 were used. The study sample included men aged 18 and older, grouped by race/ethnicity. Among the CBB group, survey respondents were limited to the English-speaking Caribbean.
Prostate cancer prevalence, by race showed a higher trend among NHB men than NHW men overall, however differences over time were not significant. CBB men reported a higher proportion of prostate cancer among cancers diagnosed than USB men overall. Due to small sample sizes, stable prostate cancer prevalence trends could not be assessed over time nor could trends in the receipt of a PSA exam among NHB men when stratified by birthplace.
USB and CBB men differ significantly in their screening behavior. The effect of SES on PSA screening adjusted for risk factors was statistically significant while latent variable lifestyle was not. Among risk factors, family history of cancer exhibited a consistent positive effect on PSA screening for both USB and CBB men. Among the CBB men, the number of years lived in the US did not significantly affect PSA screening behavior.
When NHB men are stratified by birthplace, CBB men had a higher overall prevalence of prostate cancer diagnoses than USB men although not statistically significant. USB men were 2 to 3 times more likely to have had a PSA exam compared to CBB men, but among CBB men birthplace did not make a significant difference in screening behavior. Latent variable SES, but not lifestyle, significantly affected the likelihood of a PSA exam.
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Siliņš, Ilvars. "Molecular epidemiology of human papillomavirus and cervical cancer /." Stockholm : [Karolinska institutets bibl.], 2001. http://diss.kib.ki.se/2001/91-7349-091-1/.
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Magnusson, Cecilia. "Breast cancer epidemiology : influence of hormone-related factors /." Stockholm, 1998. http://diss.kib.ki.se/1998/91-628-2870-3.
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Bashash, Morteza. "Molecular epidemiology of gastric and esophageal cancer survival." Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/30666.
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Introduction: Gastric and esophageal cancers are among the deadliest forms of cancer. Studies of human cancer susceptibility examine factors associated with the incidence of disease. Studies of human cancer prognosis and prediction examine factors associated with disease outcomes. This dissertation is about molecular and other factors that affect survival of gastric and esophageal cancer patients. Methods: Population-based registry data linked with patient outcome data was used to describe the epidemiology of gastric and esophageal cancers in BC; to compare survival of cancer patients in BC, and Ardabil, Iran and to describe differences in survival of BC patients of different ethnicity. The ethnicity of patients was determined based on lists of names corresponding to each ethnic group. A prospective cohort study was conducted to examine the effect of genetic polymorphisms in TIMP (1-4) and MMP (2, 7 and 9) genes. Results: Analysis of cancer registry data points to several factors associated with gastric and esophageal cancer survival. Patients with gastric cardia experience worse survival compared to other gastric cancers. Ethnicity of gastric and esophageal cancer patients is associated with their survival. Gastric and esophageal cancer patients diagnosed in British Columbia have better survival compared to those daignosed in Adabil, Iran. Genetic polymorphisms are also associated with survival. My prospective study identified 4 genetic polymorphisms at TIMP-3 associated with survival of esophageal adenocarcinoma and gastroesophageal junction (GEJ). Conclusion: Besides established prognostic indicators, other factors affect survival of gastric and esophageal cancers. Differences in survival by ethnicity support the importance of ethnicity as a prognostic factor. Survival differences between BC and Ardabil are likely due to disease characteristics and patient factors, in addition to differences in healthcare systems. TIMP3 genetic polymorphisms are promising prognostic factors for adenocarcinoma of esophagus and GEJ. Modeling prognosis based on host factors, including ethnicity and genetic polymorphisms, is an emerging field of translational cancer research. More research is needed to fully explore the functional effects of TIMP3 polymorphisms, and to identify both genetic and lifestyle factors underlying the effect ethnicity on survival.
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Webb, Penelope M. "The epidemiology of Helicobacter pylori and gastric cancer." Thesis, University of Oxford, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259836.
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Conway, David Ian. "Epidemiology of oral cancer from a socioeconomic perspective." Thesis, University of Glasgow, 2008. http://theses.gla.ac.uk/154/.
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Tackling health inequalities is a policy priority. Research on cancer and particularly oral cancer aetiology has somewhat overlooked this area, in favour of pursuing genetic and 'lifestyle' risk factors. The over-arching aim of this thesis was to investigate the epidemiology of oral cancer in relation to individual socioeconomic status (SES), area-based socioeconomic circumstances, and socioeconomic inequalities. Descriptive epidemiology studies undertaken demonstrated that the burden of oral cancer was increasing across the UK, especially in Scotland, and a socioeconomic gap was widening with those from more deprived communities having significantly greater and increasing incidence of the disease. A systematic review and meta-analysis of the world literature showed that low compared to high SES was associated with significantly elevated risk of oral cancer independent of behavioural factors. A local case-control study provided unclear findings when individual- and area-based socioeconomic factors were explored together; however, a framework for future analyses was developed. In totality, this thesis suggests that public health policy to address the overall rising incidence and widening inequalities of oral cancer needs to acknowledge the complexity of the risk factors; in addition, the findings provide evidence to steer policy, which focus on lifestyles factors towards an integrated approach incorporating measures designed to tackle the root causes of disadvantage.
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Franklin, Jarrod Peter. "Epidemiology of cancer in patients with inflammatory polyarthritis." Thesis, University of Manchester, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517729.
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Price, Alison Jane. "Nutritional and hormonal biomarkers in prostate cancer epidemiology." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:8d96d746-7c87-4133-b873-e9a8426da953.
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Evidence from international comparisons and migrant studies suggest that environmental factors, such as a Western diet, may be important in prostate cancer development, possibly through effects on hormone and growth factor secretion and metabolism. However, despite considerable research, convincing associations between diet and risk for prostate cancer have not been established. Random and systematic measurement error in dietary assessment using traditional survey methods may contribute to inconsistent findings, particularly as they may not capture adequately specific nutritional constituents of the diet that may be associated with risk, such as fatty acids or vitamins. Validated biomarkers of nutritional factors and hormonal activity, as used in this thesis, provide more precise, objective and integrated measures of exposure, with the capacity to clarify potential mechanisms in the causal pathway of prostate cancer development. Nutritional and hormonal biomarkers investigated for their potential role in the development of prostate cancer include: folate and vitamin B12, which are essential for DNA methylation, repair and synthesis; phytanic acid, obtained predominantly from ruminant fat intake and associated with an enzyme (α-Methylacyl-Coenzyme A Racemase (AMACR)) that is consistently over-expressed in prostate cancer tissue; and insulin-like growth factor (IGF-I), a growth factor influenced by diet and involved in the regulation of cell proliferation, differentiation, and apoptosis. All work presented in this thesis is from the European Prospective Investigation into Cancer and Nutrition (EPIC) study of 500,000 European men and women, using prospectively collected diet and lifestyle data and biological samples. The large number of prostate cancer cases diagnosed during long-term follow-up of EPIC participants enabled investigation of heterogeneity in risk for prostate cancer by time from recruitment to diagnosis (of particular importance for a disease with a long pre-clinical phase) and cancer characteristics such as disease grade and stage. Plasma phytanic acid concentration was highly correlated with dietary intake of fat from dairy products (r = 0.46) and beef (r = 0.30); capturing differences between countries in consumption of fat from these foods. Although phytanic acid is a useful biomarker of ruminant fat consumption, there was little evidence to support the hypothesis that the association between dairy products and prostate cancer risk (as suggested by previous work in EPIC and other studies) is mediated by phytanic acid (OR for doubling in concentration 1.05; 95%CI 0.91 – 1.21; P trend = 0.53). There was strong evidence for an association between higher circulating IGF-I concentration and risk for prostate cancer (OR for highest versus lowest fourth 1.69; 95% CI: 1.35, 2.13; P trend = 0.0002). Furthermore, the positive association observed among men diagnosed with advanced stage disease and among men diagnosed more than seven years after blood collection, supports the hypothesis that high IGF-I concentration is associated with clinically significant prostate cancer many years before diagnosis. There was no evidence of an association between prostate cancer risk and dietary folate or vitamin B12 intake, or between circulating levels of folate (OR for doubling in concentration 1.05; 95%CI 0.95 – 1.15;
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Schmidt, Julie Andersen. "Epidemiology of metabolite profile and prostate cancer risk." Thesis, University of Oxford, 2017. http://ora.ox.ac.uk/objects/uuid:468ca322-16a3-4f61-8fcc-bac9b918300c.
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Insulin-like growth factor-I (IGF-I) is the only known potentially modifiable risk factor for prostate cancer. Intake of dietary protein, especially from dairy products, might also be associated with risk and with circulating IGF-I, but it is not clear if amino acids play a role in these relationships. Moreover, investigations of circulating concentrations of metabolites might reveal novel risk factors for prostate cancer. This thesis investigates plasma concentrations of amino acids and other metabolites in relation to protein intake, IGF-I, and prostate cancer risk using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). To characterise plasma metabolite profile in men consuming markedly different amounts and types of animal products (meat-eaters, fish-eaters, vegetarians and vegans), cross-sectional analyses of 392 men in the EPIC-Oxford sub-cohort were conducted. Of 21 amino acids, six varied significantly by diet group, and the metabolite profile of vegans was different from those of other diet groups owing to lower concentrations of several glycerophospholipids and sphingolipids. In a case-control study nested within EPIC, with a mean follow-up time of seven years, the relationship of plasma metabolites with risk of prostate cancer overall, by time to diagnosis, by tumour characteristics, and with risk of prostate cancer death, was investigated. Data from 1,077 matched sets suggested that seven metabolites, from various classes, were associated with risk of prostate cancer overall (p < 0.05). After correction for multiple testing, 12 glycerophospholipids were inversely associated with risk of advanced prostate cancer (the strongest OR1SD = 0.54; 95%CI: 0.40-0.72). In multivariate analyses, including data from 1,593 matched sets, principal component analysis (PCA) and treelet transform (TT) were used to identify patterns in metabolite profile, five of which were associated with risk of more aggressive tumour sub-types (high grade, advanced and aggressive disease) and/or prostate cancer death. There was a ≈ 50% lower risk of advanced and high grade prostate cancer in men with metabolite profiles characterised by high glycerophospholipids and sphingolipids (for advanced ORTT, top vs bottom third = 0:48; 95%CI: 0:31-0:74), with similar results for high grade and PCA). To investigate if associations between protein intake and circulating IGF-I may be mediated by plasma amino acid concentrations, cross-sectional analyses of amino acid concentrations with protein intake and IGF-I concentrations were carried out in 1,697 and 1,142 control participants, respectively, from the nested case-control study. Dairy protein intake was positively associated with concentrations of branched-chain amino acids and several other essential amino acids, while plant protein intake was strongly associated only with histidine. Serum IGF-I was positively associated with arginine and inversely with ornithine and certain amino acid ratios. In conclusion, men with different dietary habits with respect to the consumption of protein types have different amino acid and metabolite profiles, and metabolite concentrations may be associated with risk of more high-risk prostate cancer sub-types (high grade, advanced and aggressive disease) and prostate cancer death. Further large-scale studies are needed to determine if metabolites play a role in aetiology or are markers of sub-clinical prostate cancer.
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Akre, Olof. "Etiological insights into the testicular cancer epidemic /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3689-7/.
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Mytton, Julie Ann. "Epidemiology of injuries in primary school aged children." Thesis, University of the West of England, Bristol, 2011. http://eprints.uwe.ac.uk/20897/.
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Background Injuries remain one of the leading causes of death and disability for children over the age of one year in the UK and socioeconomic differences persist in injury occurrence. Policy makers need to understand the distribution of injuries and their associated risk factors to address the issue. This thesis aims to summarise the evidence from cohort studies of injury occurrence and risk factors for injury in school aged children, to describe the injuries occurring to primary school aged children in an area of England, and to explore the relationship between secondary care attended injuries in those children and risk factors in the child, their family, their home and their neighbourhood. Methods A systematic literature review of cohort studies reporting injuries in school- aged children was undertaken. Data on injuries and risk factors was used from the Avon Longitudinal Study of Parents and Children (ALSPAC). Parent reported injury data collected four times between the ages of five and 11 years were coded and described. Multivariable logistic regression analyses of risk factors for secondary care attended injury were undertaken on the observed data and repeated on a dataset where missing values had been imputed. Results The review identified 44 papers from 18 cohort studies. Risk factors for injury were identified, and equivalent variables from ALSPAC included in analyses where possible. The distribution of 12,421 injury events in 5752 children in ALSPAC illustrated trends in injuries by type of injury, age and sex. Child factors such as male sex, having a previous injury treated in secondary care and behavioural problems were associated with increased risk of injury. Mothers with many life events and children living in privately rented accommodation had increased risks of injury. Children with two or more younger siblings had reduced risks of injury. Conclusions Few cohort studies have reported trends in child injury with age, collected information on the child's environment or reported associations between the environment and injury. This study addressed these issues. Limited evidence of environmental predictors for child injury were found, but factors in the child, their family and their home may usefully inform prevention initiatives.
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Hijazi, Nariman. "Epidemiology of asthma among children in Saudi Arabia." Thesis, University of Aberdeen, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.322584.
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Northam, Emma J. K. "The epidemiology of diabetes in very young children." Thesis, University of Bristol, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.284899.
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Chen, Maxine M. "Genetics and Genomics of Endometrial Cancer." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:27201719.
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Endometrial cancer (EC) is the most common gynecological cancer among women in the developed world and is hypothesized to arise from excess estrogen exposure from established risk factors like estrogen-only hormone therapy and obesity. EC is divided into the common “estrogen-dependent” endometrioid subtype and the rare “estrogen-independent” non- endometrioid subtype. However, this broad categorization of EC is not sufficient based on evidence for EC heterogeneity. Furthermore, family history and hereditary syndromes also increase risk, suggesting a genetic component. This dissertation examines the genetic and genomic architecture of EC to provide insight into its etiology and heterogeneity.
In Chapter 1, a four-study EC meta-analysis of 4,907 cases and 11,645 controls in women of European ancestry is presented. Four loci reached genome-wide significance. One novel susceptibility locus at 6p22.3 was identified and two previously discovered loci at 6q22.31 and 13q22.1 were confirmed. Genes near the 6p22.3 locus are implicated in malignancy and poor prognosis in many cancers, highlighting the potential importance of this region to general cancer susceptibility.
In Chapter 2, we conduct an exome-wide association study of EC. Using a new, commercially-developed exome array comprising ~260,000 putative functional exonic variants, we genotyped a multiethnic population of 3,067 women (1,169 EC cases and 1,898 controls) from the Epidemiology of Endometrial Cancer Consortium to test whether rare variants in coding regions are associated with endometrial cancer risk. No variants reached global significance in this study. Larger studies are needed to detect associations between rare exonic variants and EC.
In Chapter 3, we combined targeted next-generation sequencing from archival EC tissue with clinical, immunohistochemical, and epidemiologic data for a comprehensive characterization of EC in 37 women from the Nurses’ Health Study. Mutations most frequently occurred in TP53, PTEN, and PIK3CA. TP53 mutations were seen in the majority of tumors that were p53 abnormal. Low grade correlated with frequency of PTEN and PIK3CA mutation. The archival EC tissue had mutation profiles consistent with previous studies, supporting use of targeted sequencing panels on archival tissue for mutation detection. Our comprehensive annotation of EC tumors demonstrates the utility of integrating many data types to reveal differences between tumors.
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Garrett, Amy. "Characteristics of Death Certificate Only Cases in the Cancer Registry." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1405704511.
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Lewis, Sylvester. "Dissertation: Sociodemographics and Pancreatic Cancer Survival Rate." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5745.
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Pancreatic carcinoma or pancreatic cancer (PaCa) is an insidious disease with a prognosis of 6- to 12-month survival time for a late stage diagnosis. This problem has become crucial given that no study to date had been able to establish a definitive association between independent factors (other than a few diseases) and the survival rate of pancreatic cancer. The purpose of this quantitative, cross-sectional study was to determine whether an association exists between the independent, sociodemographic variables (marital status, age, education, income, and employment) and the outcome variable of survival rate. The social cognitive theory was the framework that provided the blueprint throughout the development of this study and helped guide the analysis of the secondary data, which was procured from the surveillance, epidemiology, and end results program. The sample of 56,166 participants was collected from 2009 to 2013 and Cox proportional hazard was used to analyze the data and arrive at the answers to the research hypotheses. A Cox proportional hazard model was used to analyze whether an association existed between each of the independent variables and the outcome variable. The analysis showed significant association between age, education, income, and employment and survival rate. It was not the same for marital status. These findings could stimulate social change by allowing stakeholders and other policy makers to become aware of the role that sociodemographic factors can play in health care. In addition, a need exists for effective research to be undertaken in the prevention and intervention of this disease. This could then lead to private and public health innovations and procedures to benefit patients with PaCa.
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Ndui, Mary K. "Epidemiology of oral cancer in South Africa 1996-2002." Thesis, University of the Western Cape, 2011. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8665_1367481245.
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Oral cancer is characterised by marked geographical differences in frequency and site preference as reported by various studies. In South Africa, a few studies have been reported on the patterns and aetiology of oral cancer, and age standardised incidence rates (ASIR). Studies in several countries have shown an increase in oral cancer incidence among younger people. Title:
Epidemiology of oral cancer in South Africa 1996-2002.
Aim and Objective: The aim of this study was to determine the age standardised incidence rates (ASIR) of oral cancer by age, gender, race
and site in South Africa for a consecutive period of seven years. Method: Pathology case records of oral cancer diagnosed over a seven-year period from 1996 to 2002 and reported to the National
Cancer Registry (NCR) were analysed for age, sex, race, and date of diagnosis, basis of diagnosis, topography and tumour type. The data was tabulated and categorised using Microsoft Excel. The South African population size for each year of the study was estimated by linear extrapolation using the 1996 and 2001 census results. Age standardisation incidence rates against the world
population were calculated by the standard direct method. Results: The total number of oral squamous cell carcinoma cases over the 7-year period was 9702. The majority of cases (34%) were
on the tongue. The male to female ratio was 1:3. The age standardized incidence rates in this study was lower among African women
(0.640 per 100000 per year) and the highest was 13.40 new cases per 100000 per year (coloured males). Lip cancer was highest among both males and females of the white population. The cumulative rate of developing oral cancer was 1:83 and 1:32 for males and females respectively.
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Key, Timothy J. A. "Studies in the epidemiology of sex hormones and cancer." Thesis, University of Oxford, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.238136.
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Porter, Daniel Edward. "Studies on the genetic epidemiology of heritable breast cancer." Thesis, University of Edinburgh, 1995. http://hdl.handle.net/1842/21467.
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Pedigrees with two or more cases of breast cancer were collected from southeast Scotland. Data were corroborated from the Registrar General for Scotland's records. Constitutional DNA from members of 15 pedigrees, each containing between 3 and 8 cases of breast cancer, was extracted from blood lymphocytes and paraffin-embedded material. Polymorphic markers on chromosome 17 were screened to locate a putative breast cancer susceptibility gene by means of linkage analysis in these families. Pairwise Lod scores were calculated at 5 loci. The maximal summated Lod was +5.62 at hypothetical genetic distance theta = 2.5cM from marker 42D6. A genetic exclusion map of critical recombinants in five linked pedigrees suggested that the susceptibility gene (BRCA1) could be flanked by markers 42D6 and MFD188 (D17S579); a region 5 - 10 cM in length mapping to chrosome 17q12-21. In eight pedigrees a posterior probability of linkage to BRCA1 was calculated as greater than 75% (range 79.2% - 99.9%) and a total of 102 female relatives from these families were typed with one or both of adjacent markers 42D6 and MFD188. Lifetime disease penetrance of BRCA1 gene mutation was calculated to be 88%. The survival curve in probable BRCA1 mutation carriers who developed breast cancer appeared to be less steep than in the general population. Two breast cancer pedigrees were found to contain individuals in which specific p53 point mutations could be identified as important heritable susceptibility factors for breast and other tumours. These studies have enabled high-risk women from both BRCA1 and p53 gene mutation carrying families to be identified and discriminated from their low-risk, non-gene carrying relatives; an important prerequisite for improved survival in familial breast cancer.