1,746 results on '"Thomson, Cynthia"'
Search Results
2. SWOG S1820: A pilot randomized trial of the Altering Intake, Managing Bowel Symptoms Intervention in Survivors of Rectal Cancer
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Sun, Virginia, Guthrie, Katherine A, Crane, Tracy E, Arnold, Kathryn B, Colby, Sarah, Freylersythe, Sarah G, Braun‐Inglis, Christa, Topacio, Roxanne, Messick, Craig A, Carmichael, Joseph C, Muskovitz, Andrew A, Nashawaty, Mohammed, Bajaj, Madhuri, Cohen, Stacey A, Flaherty, Devin C, O’Rourke, Mark A, Jones, Lee, Krouse, Robert S, and Thomson, Cynthia A
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Health Services and Systems ,Nursing ,Health Sciences ,Rare Diseases ,Clinical Trials and Supportive Activities ,Behavioral and Social Science ,Colo-Rectal Cancer ,Clinical Research ,Cancer ,Digestive Diseases ,Health Disparities ,Women's Health ,Nutrition ,Prevention ,Management of diseases and conditions ,7.1 Individual care needs ,Oral and gastrointestinal ,Humans ,Rectal Neoplasms ,Middle Aged ,Female ,Male ,Pilot Projects ,Cancer Survivors ,Quality of Life ,Aged ,Adult ,bowel dysfunction ,low anterior resection syndrome ,quality of life ,rectal cancer ,Oncology and Carcinogenesis ,Public Health and Health Services ,Oncology & Carcinogenesis ,Oncology and carcinogenesis ,Public health - Abstract
BackgroundSurvivors of rectal cancer experience persistent bowel dysfunction after treatments. Dietary interventions may be an effective approach for symptom management and posttreatment diet quality. SWOG S1820 was a pilot randomized trial of the Altering Intake, Managing Symptoms in Rectal Cancer (AIMS-RC) intervention for bowel dysfunction in survivors of rectal cancer.MethodsNinety-three posttreatment survivors were randomized to the AIMS-RC group (N = 47) or the Healthy Living Education attention control group (N = 46) after informed consent and completion of a prerandomization run-in. Outcome measures were completed at baseline and at 18 and 26 weeks postrandomization. The primary end point was total bowel function score, and exploratory end points included low anterior resection syndrome (LARS) score, quality of life, dietary quality, motivation, self-efficacy, and positive/negative affect.ResultsMost participants were White and college educated, with a mean age of 55.2 years and median time since surgery of 13.1 months. There were no statistically significant differences in total bowel function score by group, with the AIMS-RC group demonstrating statistically significant improvements in the exploratory end points of LARS (p = .01) and the frequency subscale of the bowel function index (p = .03). The AIMS-RC group reported significantly higher acceptability of the study.ConclusionsSWOG S1820 did not provide evidence of benefit from the AIMS-RC intervention relative to the attention control. Select secondary end points did demonstrate improvements. The study was highly feasible and acceptable for participants in the National Cancer Institute Community Oncology Research Program. Findings provide strong support for further refinement and effectiveness testing of the AIMS-RC intervention.
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- 2024
3. Baseline characteristics and recruitment for SWOG S1820: altering intake, managing bowel symptoms in survivors of rectal cancer (AIMS-RC)
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Sun, Virginia, Thomson, Cynthia A, Crane, Tracy E, Arnold, Kathryn B, Guthrie, Katherine A, Freylersythe, Sarah G, Braun-Inglis, Christa, Jones, Lee, Carmichael, Joseph C, Messick, Craig, Flaherty, Devin, Ambrale, Samir, Cohen, Stacey A, and Krouse, Robert S
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Health Services and Systems ,Nursing ,Health Sciences ,Behavioral and Social Science ,Clinical Trials and Supportive Activities ,Cancer ,Colo-Rectal Cancer ,Prevention ,Clinical Research ,Nutrition ,Digestive Diseases ,Rare Diseases ,Oral and gastrointestinal ,Good Health and Well Being ,Humans ,Rectal Neoplasms ,Male ,Female ,Middle Aged ,Cancer Survivors ,Aged ,Quality of Life ,Adult ,Patient Selection ,Self Efficacy ,Feasibility Studies ,Bowel dysfunction ,Diet modification ,Intervention ,Quality of life ,Self-management ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Oncology & Carcinogenesis ,Biomedical and clinical sciences ,Health sciences ,Psychology - Abstract
PurposeMany survivors of rectal cancer experience persistent bowel dysfunction. There are few evidence-based symptom management interventions to improve bowel control. The purpose of this study is to describe recruitment and pre-randomization baseline sociodemographic, health status, and clinical characteristics for SWOG S1820, a trial of the Altering Intake, Managing Symptoms in Rectal Cancer (AIMS-RC) intervention.MethodsSWOG S1820 aimed to determine the preliminary efficacy, feasibility, and acceptability of AIMS-RC, a symptom management intervention for bowel health, comparing intervention to attention control. Survivors with a history of cancers of the rectosigmoid colon or rectum, within 6-24 months of primary treatment completion, with a post-surgical permanent ostomy or anastomosis, and over 18 years of age were enrolled. Outcomes included total bowel function, low anterior resection syndrome, quality of life, motivation for managing bowel health, self-efficacy for managing symptoms, positive and negative affect, and study feasibility and acceptability.ResultsThe trial completed accrual over a 29-month period and enrolled 117 participants from 34 institutions across 17 states and one US Pacific territory. At baseline, most enrolled participants reported self-imposed diet adjustments after surgery, persistent dietary intolerances, and bowel discomfort post-treatment, with high levels of constipation and diarrhea (grades 1-4).ConclusionsSWOG S1820 was able to recruit, in a timely manner, a study cohort that is demographically representative of US survivors of rectal cancer. Baseline characteristics illustrate the connection between diet/eating and bowel symptoms post-treatment, with many participants reporting diet adjustments and persistent inability to be comfortable with dietary intake.ClinicaltrialsGov registration date12/19/2019.ClinicaltrialsGov identifierNCT#04205955.
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- 2024
4. Development and Evaluation of an Accelerometer-Based Protocol for Measuring Physical Activity Levels in Cancer Survivors: Development and Usability Study
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Crane, Tracy E, Skiba, Meghan B, Miller, Austin, Garcia, David O, and Thomson, Cynthia A
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Information technology ,T58.5-58.64 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundThe collection of self-reported physical activity using validated questionnaires has known bias and measurement error. ObjectiveAccelerometry, an objective measure of daily activity, increases the rigor and accuracy of physical activity measurements. Here, we describe the methodology and related protocols for accelerometry data collection and quality assurance using the Actigraph GT9X accelerometer data collection in a convenience sample of ovarian cancer survivors enrolled in GOG/NRG 0225, a 24-month randomized controlled trial of diet and physical activity intervention versus attention control. MethodsFrom July 2015 to December 2019, accelerometers were mailed on 1337 separate occasions to 580 study participants to wear at 4 time points (baseline, 6, 12, and 24 months) for 7 consecutive days. Study staff contacted participants via telephone to confirm their availability to wear the accelerometers and reviewed instructions and procedures regarding the return of the accelerometers and assisted with any technology concerns. ResultsWe evaluated factors associated with wear compliance, including activity tracking, use of a mobile app, and demographic characteristics with chi-square tests and logistic regression. Compliant data, defined as ≥4 consecutive days with ≥10 hours daily wear time, exceeded 90% at all study time points. Activity tracking, but no other characteristics, was significantly associated with compliant data at all time points (P
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- 2020
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5. Mobile Ecological Momentary Diet Assessment Methods for Behavioral Research: Systematic Review
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Schembre, Susan M, Liao, Yue, O'Connor, Sydney G, Hingle, Melanie D, Shen, Shu-En, Hamoy, Katarina G, Huh, Jimi, Dunton, Genevieve F, Weiss, Rick, Thomson, Cynthia A, and Boushey, Carol J
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Information technology ,T58.5-58.64 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundNew methods for assessing diet in research are being developed to address the limitations of traditional dietary assessment methods. Mobile device–assisted ecological momentary diet assessment (mEMDA) is a new dietary assessment method that has not yet been optimized and has the potential to minimize recall biases and participant burden while maximizing ecological validity. There have been limited efforts to characterize the use of mEMDA in behavioral research settings. ObjectiveThe aims of this study were to summarize mEMDA protocols used in research to date, to characterize key aspects of these assessment approaches, and to discuss the advantages and disadvantages of mEMDA compared with the traditional dietary assessment methods as well as implications for future mEMDA research. MethodsStudies that used mobile devices and described mEMDA protocols to assess dietary intake were included. Data were extracted according to Preferred Reporting of Systematic Reviews and Meta-Analyses and Cochrane guidelines and then synthesized narratively. ResultsThe review included 20 studies with unique mEMDA protocols. Of these, 50% (10/20) used participant-initiated reports of intake at eating events (event-contingent mEMDA), and 50% (10/20) used researcher-initiated prompts requesting that participants report recent dietary intake (signal-contingent mEMDA). A majority of the study protocols (60%, 12/20) enabled participants to use mobile phones to report dietary data. Event-contingent mEMDA protocols most commonly assessed diet in real time, used dietary records for data collection (60%, 6/10), and provided estimates of energy and nutrient intake (60%, 6/10). All signal-contingent mEMDA protocols used a near real-time recall approach with unannounced (ie, random) abbreviated diet surveys. Most signal-contingent protocols (70%, 7/10) assessed the frequency with which (targeted) foods or food groups were consumed. Relatively few (30%, 6/20) studies compared mEMDA with the traditional dietary assessment methods. ConclusionsThis review demonstrates that mEMDA has the potential to reduce participant burden and recall bias, thus advancing the field beyond current dietary assessment methods while maximizing ecological validity.
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- 2018
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6. Infertility and risk of postmenopausal breast cancer in the women’s health initiative
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Farland, Leslie V., Lind, Kimberly E., Thomson, Cynthia A., Saquib, Nazmus, Shadyab, Aladdin H., Schnatz, Peter F., Robles-Morales, Rogelio, Qi, Lihong, Strickler, Howard, Lane, Dorothy S., Murugappan, Gayathree, Roe, Denise J., and Harris, Holly R.
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- 2024
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7. Pre-diagnosis lipid levels and mortality after obesity-related cancer diagnosis in the Womens Health Initiative cardiovascular disease biomarker cohort.
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Hovsepyan, Gayane, Barac, Ana, Brasky, Theodore, Lehman, Amy, McLaughlin, Eric, Saquib, Nazmus, Iyengar, Neil, Wild, Robert, Caan, Bette, Desai, Pinkal, Beebe Dimmer, Jennifer, Thomson, Cynthia, Simon, Michael, and Shadyab, Aladdin
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lipids ,obesity related cancer ,survival ,womens health initiative ,Female ,Humans ,Cardiovascular Diseases ,Risk Factors ,Womens Health ,Obesity ,Biomarkers ,Cholesterol ,Multiple Myeloma ,Cholesterol ,HDL - Abstract
BACKGROUND: Published studies have demonstrated inconclusive relationships between serum lipid levels and mortality after cancer. METHODS: The primary objective was to evaluate the relationship between fasting lipid levels and mortality after cancer. Data were obtained on baseline lipids and outcomes after cancer from 1263 postmenopausal women diagnosed with 13 obesity-related cancers who were part of the Womens Health Initiative (WHI) lipid biomarkers cohort. Obesity-related cancers included incident invasive cancers of the breast, colorectum, endometrium, esophagus (adenocarcinoma), kidney, liver, gallbladder, pancreas, ovaries, small intestine, thyroid, stomach, as well as multiple myeloma. Baseline lipid measurements included high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, and non-HDL-cholesterol. Outcomes were all cause, cancer-specific, and CVD mortality. Multivariable Cox proportional hazards models were used to measure associations between lipid levels and mortality (all cause, cancer, and CVD) after a cancer diagnosis, with lipids analyzed as continuous variables. RESULTS: Among women with obesity-related cancer, there were 707 deaths, of which 379 (54%) were due to cancer and 113 (16%) were due to CVD. Mean time from blood draw to cancer diagnosis was 5.1 years (range: 0.05-10 years). LDL-C values above the 95th percentile were associated with higher risk of all-cause mortality (p
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- 2023
8. Loneliness, Spirituality, and Health-Related Quality of Life in Hispanic English-Speaking Cancer Caregivers: A Qualitative Approach
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King, Jennifer J., Badger, Terry A., Segrin, Chris, and Thomson, Cynthia A.
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- 2024
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9. Quantifying structural racism in cohort studies to advance prospective evidence.
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Follis, Shawna, Breathett, Khadijah, Garcia, Lorena, Jimenez, Monik, Cené, Crystal W, Whitsel, Eric, Hedlin, Haley, Paskett, Electra D, Zhang, Shiqi, Thomson, Cynthia A, and Stefanick, Marcia L
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Cohort study ,Disparities ,Ethnicity ,Health ,Office of management and budget ,Race ,Social determinants of health ,Social epidemiology ,Structural racism ,Basic Behavioral and Social Science ,Behavioral and Social Science ,Generic health relevance ,Good Health and Well Being ,Public Health and Health Services - Abstract
Calls-to-action in health research have described a need to improve research on race, ethnicity, and structural racism. Well-established cohort studies typically lack access to novel structural and social determinants of health (SSDOH) or precise race and ethnicity categorization, contributing to a loss of rigor to conduct informative analyses and a gap in prospective evidence on the role of structural racism in health outcomes. We propose and implement methods that prospective cohort studies can use to begin to rectify this, using the Women's Health Initiative (WHI) cohort as a case study. To do so, we evaluated the quality, precision, and representativeness of race, ethnicity, and SSDOH data compared with the target US population and operationalized methods to quantify structural determinants in cohort studies. Harmonizing racial and ethnic categorization to the current standards set by the Office of Management and Budget improved measurement precision, aligned with published recommendations, disaggregated groups, decreased missing data, and decreased participants reporting "some other race". Disaggregation revealed sub-group disparities in SSDOH, including a greater proportion of Black-Latina (35.2%) and AIAN-Latina (33.3%) WHI participants with income below the US median compared with White-Latina (42.5%) participants. We found similarities in the racial and ethnic patterning of SSDOH disparities between WHI and US women but less disparity overall in WHI. Despite higher individual-level advantage in WHI, racial disparities in neighborhood resources were similar to the US, reflecting structural racism. Median neighborhood income was comparable between Black WHI ($39,000) and US ($34,700) women. WHI SSDOH-associated outcomes may be generalizable on the basis of comparing across race and ethnicity but may quantitatively (but not qualitatively) underestimate US effect sizes. This paper takes steps towards data justice by implementing methods to make visible hidden health disparity groups and operationalizing structural-level determinants in prospective cohort studies, a first step to establishing causality in health disparities research.
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- 2023
10. Association between urinary phthalate biomarker concentrations and adiposity among postmenopausal women.
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Vieyra, Gabriela, Hankinson, Susan, Oulhote, Youssef, Vandenberg, Laura, Tinker, Lesley, Manson, JoAnn, Thomson, Cynthia, Bao, Wei, Reeves, Katherine, Odegaard, Andrew, Allison, Matthew, and Shadyab, Aladdin
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Biomarkers ,Phthalates ,Postmenopausal ,Subcutaneous adiposity ,Visceral adiposity ,Humans ,Female ,Adiposity ,Postmenopause ,Obesity ,Biomarkers ,Intra-Abdominal Fat - Abstract
BACKGROUND: Obesity is a leading risk factor for chronic diseases, potentially related to excess abdominal adiposity. Phthalates are environmental chemicals that have been suggested to act as obesogens, driving obesity risk. For the associations between phthalates and adiposity, prior studies have focused primarily on body mass index. We hypothesize that more refined measures of adiposity and fat distribution may provide greater insights into these associations given the role of central adiposity in chronic disease risk. OBJECTIVES: To evaluate associations between urinary phthalate biomarkers and both visceral and subcutaneous adipose tissue (VAT and SAT) among postmenopausal women enrolled in the Womens Health Initiative (WHI). METHODS: We included 1125 WHI participants with available, coincident measurements of urinary phthalate biomarkers (baseline, year 3) and VAT and SAT (baseline, year 3, year 6). VAT and SAT measurements were estimated from DXA scans. Multilevel mixed-effects models estimated the prospective associations between urinary phthalate biomarkers at baseline and VAT and SAT three years later. RESULTS: In multivariable adjusted models, we observed positive associations between some phthalate biomarkers, including the sum of di-isobutyl phthalate (ΣDiBP) biomarkers, MCNP, and ΣDEHP, with VAT three years later. For example, we observed positive associations between concentrations of ΣDiBP and VAT (Q4 vs Q1 β = 7.15, 95% CI -1.76-16.06; Q3 vs Q1 β = 10.94, 95% CI 3.55-18.33). Associations were generally attenuated but remained significant after additional adjustment for SAT. MBzP was positively associated with SAT. Other phthalate biomarkers investigated (MEP, MCOP, MCPP, ΣDBP) were not significantly associated with VAT or SAT. DISCUSSION: Based on robust measures of adiposity, this study provides supportive evidence that higher urinary concentrations of select phthalate compounds were associated with higher VAT levels over time in postmenopausal women. Efforts to replicate these findings are needed.
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- 2023
11. Frequency of Consuming Breakfast Meals and After-Dinner Snacks Is not Associated with Postmenopausal Breast Cancer Risk: Womens Health Initiative Observational Study.
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Elahy, Valeria, Thomson, Cynthia, Neuhouser, Marian, Pan, Kathy, Vitolins, Mara, Chlebowski, Rowan, Lane, Dorothy, Jiang, Luohua, Odegaard, Andrew, and Lee, Sunmin
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after-dinner snack ,breakfast ,breast cancer ,cancer ,circadian rhythm ,meal timing ,Humans ,Female ,Breakfast ,Snacks ,Breast Neoplasms ,Postmenopause ,Feeding Behavior ,Meals ,Energy Intake ,Womens Health - Abstract
BACKGROUND: There has been little investigation into how the timing of meals and eating occasions associates with postmenopausal breast cancer risk. OBJECTIVE: We examined the association between the frequency of consuming breakfast meals and after-dinner snacks with the risk for postmenopausal breast cancer. METHODS: A prospective analysis of 74,825 postmenopausal women aged 49 to 81 y from the Womens Health Initiative Observational Study cohort. Breakfast and after-dinner snack intake were assessed at year 1 examination. Risk for invasive and in situ breast cancer diagnosed before 28 February 2020 was modeled with multivariable Cox proportional hazards regression models according to breakfast and after-dinner snack consumption frequencies. The models were adjusted for age, self-identified race/ethnicity, education, income, physical activity, smoking, alcohol intake, diet quality score (Healthy Eating Index 2015), energy intake, diabetic status, hormone therapy, and BMI. RESULTS: During the follow-up period, 5313 participants were diagnosed with invasive breast cancer and 1197 participants with in situ breast cancer. Compared with participants who did not eat breakfast, those with daily breakfast consumption was not associated with invasive breast cancer (HR: 1.04; 95% CI: 0.9, 1.19) nor in situ (HR: 1.25; 95% CI: 0.91, 1.74) breast cancer. There were monotonic higher point estimates of in situ breast cancer for each higher category of breakfast intake from 0 to 7 times per week (P-trend = 0.04, Wald test). Compared with consumption of daily after-dinner snacks, avoidance of after-dinner snacks was not associated with invasive breast cancer (HR: 0.97; 95% CI: 0.87, 1.08) nor in situ (HR: 1.12; 95% CI: 0.89, 1.42) breast cancer. CONCLUSIONS: There was no association between intake frequency of breakfast meals or after-dinner snack habits and with risk of breast cancer in postmenopausal women.
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- 2023
12. Re-visiting the call for translation of cancer survivorship research: collaborative multidisciplinary approaches to improve translation and dissemination
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Risendal, Betsy, Thomson, Cynthia A., Seaman, Aaron, Hirschey, Rachel, and Overholser, Linda
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- 2023
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13. Mixed methods evaluation of the inaugural year of the Cancer Prevention and Control Research Network’s (CPCRN) scholars program
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Escoffery, Cam, Petagna, Courtney N., Wangen, Mary, Flicker, Kimberly J., Noblet, Samuel B., Sakhuja, Mayank, Thomson, Cynthia A., Morrato, Elaine H., Adams, Swann, Leeman, Jennifer, and Friedman, Daniela B.
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- 2023
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14. Cardiometabolic risk factors, physical activity, and postmenopausal breast cancer mortality: results from the Women’s Health Initiative
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Dieli-Conwright, Christina M, Nelson, Rebecca A, Simon, Michael S, Irwin, Melinda L, Neuhouser, Marian L, Reding, Kerryn W, Crane, Tracy E, Manson, JoAnn E, Nassir, Rami, Shadyab, Aladdin H, LaMonte, Michael, Qi, Lihing, Thomson, Cynthia A, Kroenke, Candyce H, Pan, Kathy, Chlebowski, Rowan T, and Mortimer, Joanne
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Biomedical and Clinical Sciences ,Health Services and Systems ,Health Sciences ,Public Health ,Oncology and Carcinogenesis ,Nutrition ,Aging ,Cardiovascular ,Prevention ,Cancer ,Breast Cancer ,Aetiology ,2.1 Biological and endogenous factors ,Metabolic and endocrine ,Good Health and Well Being ,Breast Neoplasms ,Cardiometabolic Risk Factors ,Exercise ,Female ,Humans ,Metabolic Syndrome ,Postmenopause ,Proportional Hazards Models ,Risk Factors ,Women's Health ,Physical activity ,Metabolic syndrome ,Breast cancer ,Nursing ,Paediatrics and Reproductive Medicine ,Public Health and Health Services ,Obstetrics & Reproductive Medicine ,Reproductive medicine ,Midwifery ,Public health - Abstract
BackgroundHigher physical activity levels are associated with lower breast cancer-specific mortality. In addition, the metabolic syndrome is associated with higher breast cancer-specific mortality. Whether the physical activity association with breast cancer mortality is modified by number of metabolic syndrome components (cardiometabolic risk factors) in postmenopausal women with early-stage breast cancer remains unknown.MethodsCardiovascular risk factors included high waist circumference, hypertension, high cholesterol, and diabetes. Breast cancers were verified by medical record review. Mortality finding were enhanced by serial National Death Index queries. Cox proportional hazards regression models were used to estimate associations between baseline physical activity and subsequent breast cancer-specific and overall mortality following breast cancer diagnosis in Women's Health Initiative participants. These associations were examined after stratifying by cardiometabolic risk factor group.ResultsAmong 161,308 Women's Health Initiative (WHI) participants, 8543 breast cancers occurred after 9.5 years (median) follow-up in women, additionally with information on cardiometabolic risk factors and physical activity at entry. In multi-variable analyses, as measured from cancer diagnosis, higher physical activity levels were associated with lower all-cause mortality risk (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.78-0.95, trend P
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- 2022
15. Correction: Taking action to advance the study of race and ethnicity: the Women’s Health Initiative (WHI)
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Garcia, Lorena, Follis, Shawna, Thomson, Cynthia A, Breathett, Khadijah, Cené, Crystal Wiley, Jimenez, Monik, Kooperberg, Charles, Masaki, Kamal, Paskett, Electra D, Pettinger, Mary, Aragaki, Aaron, Dilworth-Anderson, Peggye, and Stefanick, Marcia L
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Biomedical and Clinical Sciences ,Applied and Developmental Psychology ,Clinical Sciences ,Psychology ,Reproductive Medicine ,Clinical sciences ,Reproductive medicine ,Applied and developmental psychology - Published
- 2022
16. Characterization and efficacy of lifestyle behavior change interventions among adult rural cancer survivors: a systematic review
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Werts, Samantha J., Robles-Morales, Rogelio, Bea, Jennifer W., and Thomson, Cynthia A.
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- 2023
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17. Early-Onset Colorectal Cancer: A Call for Greater Rigor in Epidemiologic Studies
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Molmenti, Christine Louise S, Jacobs, Elizabeth T, Gupta, Samir, and Thomson, Cynthia A
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Colo-Rectal Cancer ,Cancer ,Prevention ,Digestive Diseases ,Clinical Research ,Good Health and Well Being ,Colorectal Neoplasms ,Epidemiologic Studies ,Humans ,Incidence ,Risk Factors ,United States ,Medical and Health Sciences ,Epidemiology - Abstract
The rates of early-onset colorectal cancer (EO-CRC) have been rising by 0.5% to 2.4% annually for three decades, accounting for an estimated 12% of all colorectal cancer diagnosed in the United States in 2020. Enhancing the rigor and comprehensiveness of the epidemiology in terms of the exposures and prognostic biomarkers is essential if we are to modify risk factors and underlying mechanisms, ultimately arresting this unduly trend. This commentary serves to describe the disease trend, postulate underlying risk factors and mechanisms driving disease incidence, and proposes a call to action for cancer epidemiologists to promote increased and timely opportunities to intervene on this trend.
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- 2022
18. Social Isolation and Incident Heart Failure Hospitalization in Older Women: Women’s Health Initiative Study Findings
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Cené, Crystal W, Leng, Xiaoyan Iris, Faraz, Khushnood, Allison, Matthew, Breathett, Khadijah, Bird, Chloe, Coday, Mace, Corbie‐Smith, Giselle, Foraker, Randi, Ijioma, Nkechinyere N, Rosal, Milagros C, Sealy‐Jefferson, Shawnita, Shippee, Tetyana P, Kroenke, Candyce H, Rossouw, Jacques, Ludlam, Shari, McGowan, Joan, Ford, Leslie, Geller, Nancy, Anderson, Garnet, Prentice, Ross, LaCroix, Andrea, Kooperberg, Charles, Manson, JoAnn E, Howard, Barbara V, Stefanick, Marcia L, Jackson, Rebecca, Thomson, Cynthia A, Wactawski‐Wende, Jean, Limacher, Marian, Robinson, Jennifer, Kuller, Lewis, Shumaker, Sally, and Brunner, Robert
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Cardiovascular ,Heart Disease ,Behavioral and Social Science ,Prevention ,Depression ,Aging ,Clinical Research ,Mental Health ,Good Health and Well Being ,Aged ,Female ,Heart Failure ,Hospitalization ,Humans ,Incidence ,Postmenopause ,Risk Factors ,Social Isolation ,Women's Health ,heart failure ,older adults ,social isolation ,women ,Cardiorespiratory Medicine and Haematology ,Cardiovascular medicine and haematology - Abstract
Background The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. Methods and Results This study included 44 174 postmenopausal women of diverse race and ethnicity from the WHI (Women's Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993-1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES-D (Center for Epidemiology Studies-Depression). Over a median follow-up of 15.0 years, we analyzed data from 36 457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08-1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07-1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. Conclusions Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT00000611.
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- 2022
19. Adiposity and breast, endometrial, and colorectal cancer risk in postmenopausal women: Quantification of the mediating effects of leptin, C‐reactive protein, fasting insulin, and estradiol
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Dashti, S Ghazaleh, Simpson, Julie A, Viallon, Vivian, Karahalios, Amalia, Moreno‐Betancur, Margarita, Brasky, Theodore, Pan, Kathy, Rohan, Thomas E, Shadyab, Aladdin H, Thomson, Cynthia A, Wild, Robert A, Wassertheil‐Smoller, Sylvia, Ho, Gloria YF, Strickler, Howard D, English, Dallas R, and Gunter, Marc J
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Biomedical and Clinical Sciences ,Oncology and Carcinogenesis ,Clinical Trials and Supportive Activities ,Nutrition ,Prevention ,Breast Cancer ,Digestive Diseases ,Aging ,Clinical Research ,Colo-Rectal Cancer ,Cancer ,Obesity ,Adiposity ,Body Mass Index ,Breast Neoplasms ,C-Reactive Protein ,Case-Control Studies ,Cohort Studies ,Colorectal Neoplasms ,Endometrial Neoplasms ,Estradiol ,Fasting ,Female ,Humans ,Insulin ,Leptin ,Postmenopause ,Risk Factors ,breast cancer ,causal mediation analysis ,colorectal cancer ,endometrial cancer ,estrogens ,inflammation ,insulin ,Biochemistry and Cell Biology ,Oncology and carcinogenesis - Abstract
BackgroundMechanisms underlying the adiposity-cancer relationship are incompletely understood. We quantified the mediating roles of C-reactive protein (CRP), leptin, fasting insulin, and estradiol in the effect of adiposity on estrogen receptor (ER)-positive breast, endometrial, and colorectal cancer risk in postmenopausal women.MethodsWe used a case-cohort study within the Women's Health Initiative Observational Study, analyzed as a cumulative sampling case-control study. The study included 188 breast cancer cases, 98 endometrial cancer cases, 193 colorectal cancer cases, and 285 controls. Interventional indirect and direct effects on the risk ratio (RR) scale were estimated using causal mediation analysis.ResultsFor breast cancer, the total effect RR for BMI ≥30 versus ≥18.5-
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- 2022
20. Effects of sleep on breakfast behaviors in recently unemployed adults
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Callovini, Leah C., Rojo-Wissar, Darlynn M., Mayer, Candace, Glickenstein, David A., Karamchandani, Avinash J., Lin, Kevin K., Thomson, Cynthia A., Quan, Stuart F., Silva, Graciela E., and Haynes, Patricia L.
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- 2024
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21. Taking action to advance the study of race and ethnicity: the Women’s Health Initiative (WHI)
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Garcia, Lorena, Follis, Shawna, Thomson, Cynthia A, Breathett, Khadijah, Cené, Crystal Wiley, Jimenez, Monik, Kooperberg, Charles, Masaki, Kamal, Paskett, Electra D, Pettinger, Mary, Aragaki, Aaron, Dilworth-Anderson, Peggye, and Stefanick, Marcia L
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Biomedical and Clinical Sciences ,Applied and Developmental Psychology ,Clinical Sciences ,Psychology ,Reproductive Medicine ,Behavioral and Social Science ,Clinical Research ,Basic Behavioral and Social Science ,Good Health and Well Being ,Reduced Inequalities ,Social determinants of health ,Structural racism ,Women’s health ,Clinical sciences ,Reproductive medicine ,Applied and developmental psychology - Abstract
"Race" and "ethnicity" are socially constructed terms, not based on biology - in contrast to biologic ancestry and genetic admixture - and are flexible, contested, and unstable concepts, often driven by power. Although individuals may self-identify with a given race and ethnic group, as multidimensional beings exposed to differential life influencing factors that contribute to disease risk, additional social determinants of health (SDOH) should be explored to understand the relationship of race or ethnicity to health. Potential health effects of structural racism, defined as "the structures, policies, practices, and norms resulting in differential access to goods, services, and opportunities of society by "race," have been largely ignored in medical research. The Women's Health Initiative (WHI) was expected to enroll a racially and ethnically diverse cohort of older women at 40 U.S. clinical centers between 1993 and 1998; yet, key information on the racial and ethnic make-up of the WHI cohort of 161,808 women was limited until a 2020-2021 Task Force was charged by the WHI Steering Committee to better characterize the WHI cohort and develop recommendations for WHI investigators who want to include "race" and/or "ethnicity" in papers and presentations. As the lessons learned are of relevance to most cohorts, the essence of the WHI Race and Ethnicity Language and Data Interpretation Guide is presented in this paper. Recommendations from the WHI Race and Ethnicity Language and Data Interpretation Guide include: Studies should be designed to include all populations and researchers should actively, purposefully and with cultural-relevance, commit to recruiting a diverse sample; Researchers should collect robust data on race, ethnicity and SDOH variables that may intersect with participant identities, such as immigration status, country of origin, acculturation, current residence and neighborhood, religion; Authors should use appropriate terminology, based on a participant's self-identified "race" and "ethnicity", and provide clear rationale, including a conceptual framework, for including race and ethnicity in the analytic plan; Researchers should employ appropriate analytical methods, including mixed-methods, to study the relationship of these sociocultural variables to health; Authors should address how representative study participants are of the population to which results might apply, such as by age, race and ethnicity.
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- 2022
22. Dietary Advanced Glycation End-Products and Mortality after Breast Cancer in the Women's Health Initiative
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Omofuma, Omonefe O, Peterson, Lindsay L, Turner, David P, Merchant, Anwar T, Zhang, Jiajia, Thomson, Cynthia A, Neuhouser, Marian L, Snetselaar, Linda G, Caan, Bette J, Shadyab, Aladdin H, Saquib, Nazmus, Banack, Hailey R, Uribarri, Jaime, and Steck, Susan E
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Aging ,Cancer ,Nutrition ,Breast Cancer ,Prevention ,Aetiology ,2.4 Surveillance and distribution ,Cardiovascular ,Good Health and Well Being ,Aged ,Breast Neoplasms ,Diet ,Female ,Glycation End Products ,Advanced ,Humans ,Middle Aged ,Postmenopause ,Proportional Hazards Models ,Risk Assessment ,Women's Health ,Medical and Health Sciences ,Epidemiology - Abstract
BackgroundAdvanced glycation end-products (AGE) are formed through nonenzymatic glycation of free amino groups in proteins or lipid. They are associated with inflammation and oxidative stress, and their accumulation in the body is implicated in chronic disease morbidity and mortality. We examined the association between postdiagnosis dietary Nε-carboxymethyl-lysine (CML)-AGE intake and mortality among women diagnosed with breast cancer.MethodsPostmenopausal women aged 50 to 79 years were enrolled in the Women's Health Initiative (WHI) between 1993 and 1998 and followed up until death or censoring through March 2018. We included 2,023 women diagnosed with first primary invasive breast cancer during follow-up who completed a food frequency questionnaire (FFQ) after diagnosis. Cox proportional hazards (PH) regression models estimated adjusted hazard ratios (HR) and 95% confidence intervals (CI) of association between tertiles of postdiagnosis CML-AGE intake and mortality risk from all causes, breast cancer, and cardiovascular disease.ResultsAfter a median 15.1 years of follow-up, 630 deaths from all causes were reported (193 were breast cancer-related, and 129 were cardiovascular disease-related). Postdiagnosis CML-AGE intake was associated with all-cause (HRT3vsT1, 1.37; 95% CI, 1.09-1.74), breast cancer (HRT3vsT1, 1.49; 95% CI, 0.98-2.24), and cardiovascular disease (HRT3vsT1, 1.91; 95% CI, 1.09-3.32) mortality.ConclusionsHigher intake of AGEs was associated with higher risk of major causes of mortality among postmenopausal women diagnosed with breast cancer.ImpactOur findings suggest that dietary AGEs may contribute to the risk of mortality after breast cancer diagnosis. Further prospective studies examining dietary AGEs in breast cancer outcomes and intervention studies targeting dietary AGE reduction are needed to confirm our findings.
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- 2021
23. Dietary Patterns of Insulinemia, Inflammation and Glycemia, and Pancreatic Cancer Risk: Findings from the Women's Health Initiative
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Jin, Qi, Hart, Phil A, Shi, Ni, Joseph, Joshua J, Donneyong, Macarius, Conwell, Darwin L, Clinton, Steven K, Cruz-Monserrate, Zobeida, Brasky, Theodore M, Tinker, Lesley F, Liu, Simin, Shadyab, Aladdin H, Thomson, Cynthia A, Qi, Lihong, Rohan, Thomas, and Tabung, Fred K
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Health Services and Systems ,Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Health Sciences ,Nutrition ,Aging ,Digestive Diseases ,Prevention ,Diabetes ,Obesity ,Rare Diseases ,Pancreatic Cancer ,Cancer ,Metabolic and endocrine ,Aged ,Blood Glucose ,Diabetes Mellitus ,Type 2 ,Diet Surveys ,Feeding Behavior ,Female ,Follow-Up Studies ,Glycemic Index ,Glycemic Load ,Humans ,Hyperinsulinism ,Inflammation ,Insulin ,Middle Aged ,Pancreatic Neoplasms ,Risk Assessment ,Risk Factors ,United States ,Women's Health ,Medical and Health Sciences ,Epidemiology ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundPancreatic cancer risk is increasing in countries with high consumption of Western dietary patterns and rising obesity rates. We examined the hypothesis that specific dietary patterns reflecting hyperinsulinemia (empirical dietary index for hyperinsulinemia; EDIH), systemic inflammation (empirical dietary inflammatory pattern; EDIP), and postprandial glycemia [glycemic index (GI); glycemic load (GL)] are associated with pancreatic cancer risk, including the potential modifying role of type 2 diabetes (T2D) and body mass index (BMI).MethodsWe calculated dietary scores from baseline (1993-1998) food frequency questionnaires among 129,241 women, 50-79 years-old in the Women's Health Initiative. We used multivariable-adjusted Cox regression to estimate HRs and 95% confidence intervals (95% CI) for pancreatic cancer risk.ResultsDuring a median 19.9 years of follow-up, 850 pancreatic cancer cases were diagnosed. We observed no association between dietary scores and pancreatic cancer risk overall. However, risk was elevated among participants with longstanding T2D (present >3 years before pancreatic cancer diagnosis) for EDIH. For each 1 SD increment in dietary score, the HRs (95% CIs) were: EDIH, 1.33 (1.06-1.66); EDIP, 1.26 (0.98-1.63); GI, 1.26 (0.96-1.67); and GL, 1.23 (0.96-1.57); although interactions were not significant (all P interaction >0.05). Separately, we observed inverse associations between GI [0.86 (0.76-0.96), P interaction = 0.0068] and GL [0.83 (0.73-0.93), P interaction = 0.0075], with pancreatic cancer risk among normal-weight women.ConclusionsWe observed no overall association between the dietary patterns evaluated and pancreatic cancer risk, although women with T2D appeared to have greater cancer risk.ImpactThe elevated risk for hyperinsulinemic diets among women with longstanding T2D and the inverse association among normal-weight women warrant further examination.
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- 2021
24. Associations of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use with Colorectal Cancer Risk in the Women's Health Initiative.
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Brasky, Theodore M, Flores, Katrina F, Larson, Joseph C, Newton, Alison M, Shadyab, Aladdin H, Watanabe, Jonathan H, Lane, Dorothy S, Thomson, Cynthia A, and LaCroix, Andrea Z
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Humans ,Colorectal Neoplasms ,Hypertension ,Angiotensin-Converting Enzyme Inhibitors ,Risk Assessment ,Prospective Studies ,Aged ,Middle Aged ,Female ,Angiotensin Receptor Antagonists ,Aging ,Cancer ,Prevention ,Digestive Diseases ,Colo-Rectal Cancer ,Medical and Health Sciences ,Epidemiology - Abstract
BackgroundUse of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) has been postulated to reduce cancer risk by inhibition of tumor progression, vascularization, and metastasis. The renin-angiotensin system is upregulated in colorectal cancers; however, the association of ACEi and ARB use with colorectal cancer risk is not well understood.MethodsThe study population was 142,812 Women's Health Initiative participants free of colorectal cancer who reported on ACEi and ARB use at baseline; 2,216 incident colorectal cancers were diagnosed during 10 years of follow-up. Cox regression models estimated adjusted HRs and 95% confidence intervals for associations relative to nonuse among normotensive women, untreated hypertensive women, and hypertensive women treated with other antihypertensive medications.ResultsHRs among women who used any ACEi or ARB compared with nonuse in the three referent groups ranged between 0.97 and 1.01. Findings were similar for increased ACEi/ARB duration and for medications examined as separate classes or individually.ConclusionsIn this large prospective study of women, no associations of ACEi or ARB use with colorectal cancer risk were observed.ImpactChoice of drug in the large population of aging women who will be prescribed ACEi and ARB should be made without factoring in any benefit on colorectal cancer risk.
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- 2021
25. Cardiometabolic risk factors and survival after cancer in the Womens Health Initiative.
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Simon, Michael, Hastert, Theresa, Barac, Ana, Banack, Hailey, Caan, Bette, Chlebowski, Rowan, Foraker, Randi, Hovsepyan, Gayane, Liu, Simin, Luo, Juhua, Manson, JoAnn, Neuhouser, Marian, Okwuosa, Tochukwu, Pan, Kathy, Thomson, Cynthia, Wactawski-Wende, Jean, Waheed, Nida, Beebe-Dimmer, Jennifer, Ruterbusch, Julie, Qi, Lihong, and Shadyab, Aladdin
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Womens Health Initiative ,cancer ,cardiometabolic risk factors ,survival ,Aged ,Breast Neoplasms ,Cardiometabolic Risk Factors ,Cardiovascular Diseases ,Cause of Death ,Diabetes Mellitus ,Type 2 ,Endometrial Neoplasms ,Female ,Follow-Up Studies ,Humans ,Kidney Neoplasms ,Middle Aged ,Obesity ,Ovarian Neoplasms ,Pancreatic Neoplasms ,Postmenopause ,Proportional Hazards Models ,Risk Factors ,Waist Circumference ,Womens Health - Abstract
BACKGROUND: Cardiometabolic abnormalities are a leading cause of death among women, including women with cancer. METHODS: This study examined the association between prediagnosis cardiovascular health and total and cause-specific mortality among 12,076 postmenopausal women who developed local- or regional-stage invasive cancer in the Womens Health Initiative (WHI). Cardiovascular risk factors included waist circumference, hypertension, high cholesterol, and type 2 diabetes. Obesity-related cancers included breast cancer, colorectal cancer, endometrial cancer, kidney cancer, pancreatic cancer, ovarian cancer, stomach cancer, liver cancer, and non-Hodgkin lymphoma. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for important predictors of survival. RESULTS: After a median follow-up of 10.0 years from the date of the cancer diagnosis, there were 3607 total deaths, with 1546 (43%) due to cancer. Most participants (62.9%) had 1 or 2 cardiometabolic risk factors, and 8.1% had 3 or 4. In adjusted models, women with 3 to 4 risk factors (vs none) had a higher risk of all-cause mortality (HR, 1.99; 95% CI, 1.73-2.30), death due to cardiovascular disease (CVD) (HR, 4.01; 95% CI, 2.88-5.57), cancer-specific mortality (HR, 1.37; 95% CI, 1.1-1.72), and other-cause mortality (HR, 2.14; 95% CI, 1.70-2.69). A higher waist circumference was associated with greater all-cause mortality (HR, 1.17; 95% CI, 1.06-1.30) and cancer-specific mortality (HR, 1.22; 95% CI, 1.04-1.42). CONCLUSIONS: Among postmenopausal women diagnosed with cancer in the WHI, cardiometabolic risk factors before the cancer diagnosis were associated with greater all-cause, CVD, cancer-specific, and other-cause mortality. These results raise hypotheses regarding potential clinical intervention strategies targeting cardiometabolic abnormalities that require future prospective studies for confirmation. LAY SUMMARY: This study uses information from the Womens Health Initiative (WHI) to find out whether cardiac risk factors are related to a greater risk of dying among older women with cancer. The WHI is the largest study of medical problems faced by older women in this country. The results show that women who have 3 or 4 risk factors are more likely to die of any cause, heart disease, or cancer in comparison with women with no risk factors. It is concluded that interventions to help to lower the burden of cardiac risk factors can have an important impact on survivorship among women with cancer.
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- 2021
26. Green Exercise as an Opportunity to Promote Equity in Physical Activity Engagement Across Diverse Populations.
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Lesser, Iris, Thomson, Cynthia, and Lem, Melissa
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PHYSICAL activity ,SHARED virtual environments ,OUTDOOR recreation - Abstract
The article discusses the potential of hiking as a means to promote equity in physical activity engagement across diverse populations. It highlights the barriers that underserved populations face in accessing physical activity opportunities and emphasizes the need for affordable and accessible options. The authors argue that hiking, as a form of "green exercise," can provide numerous health benefits and address some of the barriers to physical activity. They suggest that with support from local municipalities and health providers, it is feasible to provide equitable opportunities for individuals to engage in hiking and receive its health-promoting benefits. [Extracted from the article]
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- 2024
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27. Surgical versus non-surgical management for patients with malignant bowel obstruction (S1316): a pragmatic comparative effectiveness trial
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Krouse, Robert S, Anderson, Garnet L, Arnold, Kathryn B, Thomson, Cynthia A, Nfonsam, Valentine N, Al-Kasspooles, Mazin F, Walker, Joan L, Sun, Virginia, Alvarez Secord, Angeles, Han, Ernest S, Leon-Takahashi, Alberto M, Isla-Ortiz, David, Rodgers, Phillip, Hendren, Samantha, Sanchez Salcedo, Marco, Laryea, Jonathan A, Graybill, Whitney S, Flaherty, Devin C, Mogal, Harveshp, Miner, Thomas J, Pimiento, Jose M, Kitano, Mio, Badgwell, Brian, Whalen, Giles, Lamont, Jeffrey P, Guevara, Oscar A, Senthil, Maheswari S, Dewdney, Summer B, Silberfein, Eric, Wright, Jason D, Friday, Bret, Fahy, Bridget, Anantha Sathyanarayana, Sandeep, O'Rourke, Mark, Bakitas, Marie, Sloan, Jeff, Grant, Marcia, Deutsch, Gary B, and Deneve, Jeremiah L
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- 2023
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28. A Low-Glucose Eating Pattern Improves Biomarkers of Postmenopausal Breast Cancer Risk: An Exploratory Secondary Analysis of a Randomized Feasibility Trial
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Schembre, Susan M, Jospe, Michelle R, Giles, Erin D, Sears, Dorothy D, Liao, Yue, Basen-Engquist, Karen M, and Thomson, Cynthia A
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Biomedical and Clinical Sciences ,Health Services and Systems ,Health Sciences ,Nutrition and Dietetics ,Oncology and Carcinogenesis ,Clinical Trials and Supportive Activities ,Breast Cancer ,Prevention ,Nutrition ,Aging ,Clinical Research ,Obesity ,Cancer ,Metabolic and endocrine ,Biomarkers ,Blood Glucose ,Breast ,Breast Neoplasms ,Diet ,Fasting ,Feasibility Studies ,Feeding Behavior ,Female ,Humans ,Insulin Resistance ,Middle Aged ,Postmenopause ,eating physiology ,food intake regulation ,blood glucose ,metabolism ,weight management ,obesity ,adherence ,Food Sciences ,Clinical sciences ,Nutrition and dietetics ,Public health - Abstract
Postmenopausal breast cancer is the most common obesity-related cancer death among women in the U.S. Insulin resistance, which worsens in the setting of obesity, is associated with higher breast cancer incidence and mortality. Maladaptive eating patterns driving insulin resistance represent a key modifiable risk factor for breast cancer. Emerging evidence suggests that time-restricted feeding paradigms (TRF) improve cancer-related metabolic risk factors; however, more flexible approaches could be more feasible and effective. In this exploratory, secondary analysis, we identified participants following a low-glucose eating pattern (LGEP), defined as consuming energy when glucose levels are at or below average fasting levels, as an alternative to TRF. Results show that following an LGEP regimen for at least 40% of reported eating events improves insulin resistance (HOMA-IR) and other cancer-related serum biomarkers. The magnitude of serum biomarkers changes observed here has previously been shown to favorably modulate benign breast tissue in women with overweight and obesity who are at risk for postmenopausal breast cancer. By comparison, the observed effects of LGEP were similar to results from previously published TRF studies in similar populations. These preliminary findings support further testing of LGEP as an alternative to TRF and a postmenopausal breast cancer prevention strategy. However, results should be interpreted with caution, given the exploratory nature of analyses.
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- 2021
29. Circulating vitamin D and breast cancer risk: an international pooling project of 17 cohorts
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Visvanathan, Kala, Mondul, Alison M., Zeleniuch-Jacquotte, Anne, Wang, Molin, Gail, Mitchell H., Yaun, Shiaw-Shyuan, Weinstein, Stephanie J., McCullough, Marjorie L., Eliassen, A. Heather, Cook, Nancy R., Agnoli, Claudia, Almquist, Martin, Black, Amanda, Buring, Julie E., Chen, Chu, Chen, Yu, Clendenen, Tess, Dossus, Laure, Fedirko, Veronika, Gierach, Gretchen L., Giovannucci, Edward L., Goodman, Gary E., Goodman, Marc T., Guénel, Pascal, Hallmans, Göran, Hankinson, Susan E., Horst, Ronald L., Hou, Tao, Huang, Wen-Yi, Jones, Michael E., Joshu, Corrine E., Kaaks, Rudolf, Krogh, Vittorio, Kühn, Tilman, Kvaskoff, Marina, Lee, I-Min, Mahamat-Saleh, Yahya, Malm, Johan, Manjer, Jonas, Maskarinec, Gertraud, Millen, Amy E., Mukhtar, Toqir K., Neuhouser, Marian L., Robsahm, Trude E., Schoemaker, Minouk J., Sieri, Sabina, Sund, Malin, Swerdlow, Anthony J., Thomson, Cynthia A., Ursin, Giske, Wactawski-Wende, Jean, Wang, Ying, Wilkens, Lynne R., Wu, Yujie, Zoltick, Emilie, Willett, Walter C., Smith-Warner, Stephanie A., and Ziegler, Regina G.
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- 2023
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30. Eating Pattern Response to a Low-Fat Diet Intervention and Cardiovascular Outcomes in Normotensive Women: The Women's Health Initiative.
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Van Horn, Linda, Aragaki, Aaron K, Howard, Barbara V, Allison, Matthew A, Isasi, Carmen R, Manson, JoAnn E, Neuhouser, Marian L, Mossavar-Rahmani, Yasmin, Thomson, Cynthia A, Vitolin, Mara Z, Wallace, Robert B, Prentice, Ross L, and WHI Investigators
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WHI Investigators ,cardiovascular outcomes ,food choices ,low-fat diet ,normotensive women ,self-selected dietary change ,vegetable protein - Abstract
BackgroundWomen without cardiovascular disease (CVD) or hypertension at baseline assigned to intervention in the Women's Health Initiative Dietary Modification (DM) trial experienced 30% lower risk of coronary heart disease (CHD), whereas results in women with hypertension or prior CVD could have been confounded by postrandomization use of statins.ObjectivesIntervention participants reported various self-selected changes to achieve the 20% total fat goals. Reviewed are intervention compared with comparison group HRs for CHD, stroke, and total CVD in relation to specific dietary changes in normotensive participants.MethodsDietary change was assessed by comparing baseline with year 1 FFQ data in women (n = 10,371) without hypertension or CVD at baseline with intake of total fat above the median to minimize biases due to use of the FFQ in trial eligibility screening.ResultsIntervention participants self-reported compensating reduced energy intake from total fat by increasing carbohydrate and protein. Specifically they increased plant protein, with those in the upper quartile (increased total protein by ≥3.3% of energy) having a CHD HR of 0.39 (95% CI: 0.22, 0.71), compared with 0.92 (95% CI: 0.57, 1.48) for those in the lower quartile of change (decreased total protein ≥0.6% of energy), with P-trend of 0.04. CHD HR did not vary significantly with change in percentage energy from carbohydrate, and stroke HR did not vary significantly with any macronutrient changes. Scores reflecting adherence to recommended dietary patterns including the Dietary Approaches to Stop Hypertension Trial and the Healthy Eating Index showed favorable changes in the intervention group.ConclusionsIntervention group total fat reduction replaced with increased carbohydrate and some protein, especially plant-based protein, was related to lower CHD risk in normotensive women without CVD who reported high baseline total fat intake. This trial was registered at clinicaltrials.gov as NCT00000611. Link to the WHI trial protocol: https://www.whi.org/about/SitePages/Dietary%20Trial.aspx.
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- 2020
31. The Association between Prebiotic Fiber Supplement Use and Colorectal Cancer Risk and Mortality in the Women's Health Initiative
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Skiba, Meghan B, Kohler, Lindsay N, Crane, Tracy E, Jacobs, Elizabeth T, Shadyab, Aladdin H, Kato, Ikuko, Snetselaar, Linda, Qi, Lihong, and Thomson, Cynthia A
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Biomedical and Clinical Sciences ,Epidemiology ,Health Services and Systems ,Health Sciences ,Public Health ,Oncology and Carcinogenesis ,Clinical Research ,Nutrition ,Aging ,Prevention ,Digestive Diseases ,Colo-Rectal Cancer ,Cancer ,Good Health and Well Being ,Colorectal Neoplasms ,Dietary Supplements ,Female ,Humans ,Longitudinal Studies ,Prebiotics ,Risk Factors ,Women's Health ,Medical and Health Sciences ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundFiber-based prebiotic supplements are marketed for maintaining bowel health and promoting beneficial gut bacteria. However, the association between prebiotic supplement use and colorectal cancer risk and mortality is unknown.MethodsThe association between prebiotic use and colorectal cancer risk and mortality was evaluated in postmenopausal women in the Women's Health Initiative study. Self-reported prebiotic use was documented at study enrollment. Adjudicated colorectal cancer cases and mortality were captured using medical and death records. Cox proportional hazards models were used to estimate the HR related to prebiotic use and colorectal cancer risk and mortality.ResultsIn total, 3,032 colorectal cancer cases were diagnosed during an average 15.4 years of follow-up. Overall, 3.7% of women used a prebiotic with psyllium, the major fiber type. Use of any prebiotic supplement was not associated with colorectal cancer risk or mortality. The type of prebiotic supplement (none vs. insoluble or soluble) was not associated with colorectal cancer risk; however, use of insoluble fiber prebiotics compared with none was associated with higher colorectal cancer mortality [HR, 2.79; 95% confidence interval (CI), 1.32-5.90; P = 0.007]. Likelihood ratio tests indicated no significant interactions between prebiotic use and other colorectal cancer risk factors, including metabolic syndrome.ConclusionsPrebiotic fiber supplement use was not associated with colorectal cancer risk. Insoluble, but not soluble, prebiotic fiber use was associated with higher colorectal cancer mortality. These findings do not support the promotion of prebiotic fiber supplements to reduce colorectal cancer risk or colorectal cancer mortality.ImpactFurther investigation is warranted for findings regarding insoluble prebiotic fiber and higher colorectal cancer mortality in postmenopausal women.
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- 2019
32. Lifestyle intervention in ovarian cancer enhanced survival (LIVES) study (NRG/GOG0225): Recruitment, retention and baseline characteristics of a randomized trial of diet and physical activity in ovarian cancer survivors
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Thomson, Cynthia A., Crane, Tracy E., Miller, Austin, Gold, Michael A., Powell, Matthew, Bixel, Kristin, Van Le, Linda, DiSilvestro, Paul, Ratner, Elena, Lele, Shashikant, Guntupalli, Saketh, Huh, Warner, Robertson, Sharon E., Modesitt, Susan, Casey, A. Catherine, Basen-Engquist, Karen, Skiba, Meghan, Walker, Joan, Kachnic, Lisa, and Alberts, David S.
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- 2023
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33. Long-term dietary intervention influence on physical activity in the Women’s Health Initiative Dietary Modification randomized trial
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Pan, Kathy, Aragaki, Aaron K., Michael, Yvonne, Thomson, Cynthia A., Snetselaar, Linda G., Wactawski-Wende, Jean, Garcia, David O., Dieli-Conwright, Christina M., Shadyab, Aladdin H., Saquib, Nazmus, and Chlebowski, Rowan T.
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- 2022
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34. History of infertility and risk of colorectal cancer
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Farland, Leslie V., primary, Lind, Kimberly E., additional, Roe, Denise J., additional, Saquib, Nazmus, additional, Strickler, Howard D., additional, Qi, Lihong, additional, Thomson, Cynthia A., additional, and Harris, Holly R., additional
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- 2024
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35. Identifying the Leading Sources of Saturated Fat and Added Sugar in U.S. Adults
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Taylor, Christopher A, primary, Madril, Peter, additional, Weiss, Rick, additional, Thomson, Cynthia A, additional, Dunton, Genevieve F, additional, Jospe, Michelle R, additional, Richardson, Kelli M, additional, Bedrick, Edward J, additional, and Schembre, Susan M, additional
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- 2024
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36. Low macular pigment optical density is associated with manifest primary open-angle glaucoma in older women
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Liu, Yao, primary, Lawler, Thomas, additional, Liu, Zhe, additional, Thuruthumaly, Catherine, additional, Vajaranant, Thasarat, additional, Wallace, Robert, additional, Tinker, Lesley, additional, Nalbandyan, Marine, additional, Mares, Julie, additional, Anderson, Garnet, additional, Prentice, Ross, additional, LaCroix, Andrea, additional, Kooperberg, Charles, additional, Blodi, Barbara, additional, Liu, Yao, additional, Domalpally, Amitha, additional, Engelman, Corinne, additional, Gangnon, Ronald, additional, Sarto, Gloria, additional, Bailey, Steven, additional, LeBlanc (Kaiser-Permanente), Erin, additional, Gehrs, Karen, additional, Robinson, Jennifer, additional, Snodderly, D. Max, additional, Hammond, Randy, additional, Millen, Amy, additional, Wooten, Bill, additional, Johnson, Elizabeth, additional, Jennifer Maykoski, B.S., additional, Lundquist, Ann, additional, Chris Smith, B.S., additional, Wood, Kim, additional, Perry-Raymond, Jennie, additional, Heather Stockman, B.S., additional, Walshire, Jean, additional, Sinkey, Christine, additional, Manson, JoAnn E., additional, Howard, Barbara V., additional, Stefanick, Marcia L., additional, Jackson, Rebecca, additional, Thomson, Cynthia A., additional, Wactawski-Wende, Jean, additional, Limacher, Marian, additional, Kuller, Lewis, additional, Shumaker, Sally, additional, Brunner, Robert, additional, Courtney Blomme, M.S., additional, Hall, Kristen, additional, Pauk, Diane, additional, Mezhibovsky, Esther, additional, Christensen, Krista, additional, Espeland, Mark, additional, Rossouw, Jacques, additional, Ludlam, Shari, additional, McGowan, Joan, additional, Ford, Leslie, additional, and Geller, Nancy, additional
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- 2024
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37. The Women’s Health Initiative Randomized Trials and Clinical Practice
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Manson, JoAnn E., primary, Crandall, Carolyn J., additional, Rossouw, Jacques E., additional, Chlebowski, Rowan T., additional, Anderson, Garnet L., additional, Stefanick, Marcia L., additional, Aragaki, Aaron K., additional, Cauley, Jane A., additional, Wells, Gretchen L., additional, LaCroix, Andrea Z., additional, Thomson, Cynthia A., additional, Neuhouser, Marian L., additional, Van Horn, Linda, additional, Kooperberg, Charles, additional, Howard, Barbara V., additional, Tinker, Lesley F., additional, Wactawski-Wende, Jean, additional, Shumaker, Sally A., additional, and Prentice, Ross L., additional
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- 2024
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38. Exploring the relationship between loneliness, spirituality, and health-related quality of life in Hispanic cancer caregivers
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King, Jennifer J., Segrin, Chris, Badger, Terry A., and Thomson, Cynthia A.
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- 2022
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39. Stylists' and Clients’ perspectives of the black salon-a qualitative study guided by the settings approach theory
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Palmer, Kelly N.B., Okechukwu, Abidemi, Mantina, Namoonga M., Melton, Forest L., Kram, Nidal A-Z, Hatcher, Jennifer, Marrero, David G., Thomson, Cynthia A., and Garcia, David O.
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- 2022
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40. Menopausal Estrogen-Alone Therapy and Health Outcomes in Women With and Without Bilateral Oophorectomy: A Randomized Trial.
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Manson, JoAnn E, Aragaki, Aaron K, Bassuk, Shari S, Chlebowski, Rowan T, Anderson, Garnet L, Rossouw, Jacques E, Howard, Barbara V, Thomson, Cynthia A, Stefanick, Marcia L, Kaunitz, Andrew M, Crandall, Carolyn J, Eaton, Charles B, Henderson, Victor W, Liu, Simin, Luo, Juhua, Rohan, Thomas, Shadyab, Aladdin H, Wells, Gretchen, Wactawski-Wende, Jean, and Prentice, Ross L
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Reproductive Medicine ,Biomedical and Clinical Sciences ,Clinical Sciences ,Aging ,Estrogen ,Clinical Trials and Supportive Activities ,Contraception/Reproduction ,Clinical Research ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Good Health and Well Being ,Age Factors ,Aged ,Breast Neoplasms ,Cause of Death ,Colorectal Neoplasms ,Coronary Disease ,Estrogen Replacement Therapy ,Estrogens ,Conjugated (USP) ,Female ,Follow-Up Studies ,Hip Fractures ,Humans ,Incidence ,Menopause ,Middle Aged ,Ovariectomy ,Pulmonary Embolism ,Stroke ,United States ,WHI Investigators ,Medical and Health Sciences ,General & Internal Medicine ,Clinical sciences - Abstract
BackgroundWhether health outcomes of menopausal estrogen therapy differ between women with and without bilateral salpingo-oophorectomy (BSO) is unknown.ObjectiveTo examine estrogen therapy outcomes by BSO status, with additional stratification by 10-year age groups.DesignSubgroup analyses of the randomized Women's Health Initiative Estrogen-Alone Trial. (ClinicalTrials.gov: NCT00000611).Setting40 U.S. clinical centers.Participants9939 women aged 50 to 79 years with prior hysterectomy and known oophorectomy status.InterventionConjugated equine estrogens (CEE) (0.625 mg/d) or placebo for a median of 7.2 years.MeasurementsIncidence of coronary heart disease and invasive breast cancer (the trial's 2 primary end points), all-cause mortality, and a "global index" (these end points plus stroke, pulmonary embolism, colorectal cancer, and hip fracture) during the intervention phase and 18-year cumulative follow-up.ResultsThe effects of CEE alone did not differ significantly according to BSO status. However, age modified the effect of CEE in women with prior BSO. During the intervention phase, CEE was significantly associated with a net adverse effect (hazard ratio for global index, 1.42 [95% CI, 1.09 to 1.86]) in older women (aged ≥70 years), but the global index was not elevated in younger women (P trend by age = 0.016). During cumulative follow-up, women aged 50 to 59 years with BSO had a treatment-associated reduction in all-cause mortality (hazard ratio, 0.68 [CI, 0.48 to 0.96]), whereas older women with BSO had no reduction (P trend by age = 0.034). There was no significant association between CEE and outcomes among women with conserved ovaries, regardless of age.LimitationsThe timing of CEE in relation to BSO varied; several comparisons were made without adjustment for multiple testing.ConclusionThe effects of CEE did not differ by BSO status in the overall cohort, but some findings varied by age. Among women with prior BSO, in those aged 70 years or older, CEE led to adverse effects during the treatment period, whereas women randomly assigned to CEE before age 60 seemed to derive mortality benefit over the long term.Primary funding sourceThe WHI program is funded by the National Heart, Lung, and Blood Institute; National Institutes of Health; and U.S. Department of Health and Human Services. Wyeth Ayerst donated the study drugs.
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- 2019
41. The relationship between sleep and weight change among women diagnosed with breast cancer participating in the Women’s Health Initiative
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Donzella, Sidney M., Lind, Kimberly E., Skiba, Meghan B., Farland, Leslie V., Thomson, Cynthia A., Werts, Samantha J., Bell, Melanie L., LeBlanc, Erin, Weitlauf, Julie C., Hery, Chloe M. Beverly, Naughton, Michelle J., Mortimer, Joanne, and Crane, Tracy E.
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- 2022
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42. Ethnicity, socioeconomic status, income inequality, and colorectal cancer outcomes: evidence from the 4C2 collaboration
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Bradley, Cathy J., Anderson-Mellies, Amy, Borrayo, Evelinn A., Doherty, Jennifer Anne, Escontrías, Omar A., Garcia, David O., Mishra, Shiraz I., Sussman, Andrew L., Thomson, Cynthia A., Wetter, David W., and Cook, Linda S.
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- 2022
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43. Role of dietary patterns and acculturation in cancer risk and mortality among postmenopausal Hispanic women: results from the Women’s Health Initiative (WHI)
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Lopez-Pentecost, Melissa, Crane, Tracy E., Garcia, David O., Kohler, Lindsay N., Wertheim, Betsy C., Hebert, James R., Steck, Susan E., Shivappa, Nitin, Santiago-Torres, Margarita, Neuhouser, Marian L., Hatsu, Irene E., Snetselaar, Linda, Datta, Mridul, Kroenke, Candyce H., Sarto, Gloria E., and Thomson, Cynthia A.
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- 2022
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44. Optimal Pair Matching Combined with Machine Learning Predicts a Significant Reduction in Myocardial Infarction Risk in African Americans Following Omega-3 Fatty Acid Supplementation.
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Sun, Shudong, Hara, Aki, Johnstone, Laurel, Hallmark, Brian, Watkins, Joseph C., Thomson, Cynthia A., Schembre, Susan M., Sergeant, Susan, Umans, Jason G., Yao, Guang, Zhang, Hao Helen, and Chilton, Floyd H.
- Abstract
Conflicting clinical trial results on omega-3 highly unsaturated fatty acids (n-3 HUFA) have prompted uncertainty about their cardioprotective effects. While the VITAL trial found no overall cardiovascular benefit from n-3 HUFA supplementation, its substantial African American (AfAm) enrollment provided a unique opportunity to explore racial differences in response to n-3 HUFA supplementation. The current observational study aimed to simulate randomized clinical trial (RCT) conditions by matching 3766 AfAm and 15,553 non-Hispanic White (NHW) individuals from the VITAL trial utilizing propensity score matching to address the limitations related to differences in confounding variables between the two groups. Within matched groups (3766 AfAm and 3766 NHW), n-3 HUFA supplementation's impact on myocardial infarction (MI), stroke, and cardiovascular disease (CVD) mortality was assessed. A weighted decision tree analysis revealed belonging to the n-3 supplementation group as the most significant predictor of MI among AfAm but not NHW. Further logistic regression using the LASSO method and bootstrap estimation of standard errors indicated n-3 supplementation significantly lowered MI risk in AfAm (OR 0.17, 95% CI [0.048, 0.60]), with no such effect in NHW. This study underscores the critical need for future RCT to explore racial disparities in MI risk associated with n-3 HUFA supplementation and highlights potential causal differences between supplementation health outcomes in AfAm versus NHW populations. [ABSTRACT FROM AUTHOR]
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- 2024
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45. Identifying the Leading Sources of Saturated Fat and Added Sugar in U.S. Adults.
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Taylor, Christopher A., Madril, Peter, Weiss, Rick, Thomson, Cynthia A., Dunton, Genevieve F., Jospe, Michelle R., Richardson, Kelli M., Bedrick, Edward J., and Schembre, Susan M.
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The 2020–2025 Dietary Guidelines for Americans recommend limiting intakes of saturated fat and added sugars (SF/AS) to <10% total energy. Data-driven approaches to identify sources of SF/AS are needed to meet these goals. We propose using a population-based approach to identify the leading food and beverage sources of SF/AS consumed by US adults. Foods and beverages reported as consumed were assessed from two, 24 h dietary recalls (24HRDR) from 36,378 adults aged 19 years and older from the 2005–2018 National Health and Nutrition Examination Survey. Intakes of SF/AS were aggregated across both 24HRDR to identify What We Eat in America food categories accounting for ≥90% of SF/AS, respectively, by the total population and within population subgroups. Data were weighted to estimate a nationally representative sample. Ninety-five discrete food categories accounted for ≥90% of the total SF/AS intakes for >88% of the representative sample of U.S. adults. The top sources of SF were cheese, pizza, ice cream, and eggs. The leading sources of AS were soft drinks, tea, fruit drinks, and cakes and pies. This analysis reflects a parsimonious approach to reliably identify foods and beverages that contribute to SF/AS intakes in U.S. adults. [ABSTRACT FROM AUTHOR]
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- 2024
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46. A randomized controlled trial of metformin in women with components of metabolic syndrome: intervention feasibility and effects on adiposity and breast density
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Tapia, Edgar, Villa-Guillen, Diana Evelyn, Chalasani, Pavani, Centuori, Sara, Roe, Denise J., Guillen-Rodriguez, Jose, Huang, Chuan, Galons, Jean-Phillippe, Thomson, Cynthia A., Altbach, Maria, Trujillo, Jesse, Pinto, Liane, Martinez, Jessica A., Algotar, Amit M., and Chow, H-H. Sherry
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- 2021
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47. The Influence of Physical Activity and Sedentary Behavior on Living to Age 85 Years Without Disease and Disability in Older Women
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Rillamas-Sun, Eileen, LaMonte, Michael J, Evenson, Kelly R, Thomson, Cynthia A, Beresford, Shirley A, Coday, Mathilda C, Manini, Todd M, Li, Wenjun, and LaCroix, Andrea Z
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Clinical Sciences ,Aging ,Clinical Research ,Rehabilitation ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Prevention of disease and conditions ,and promotion of well-being ,Generic health relevance ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Body Mass Index ,Chronic Disease ,Exercise ,Female ,Health Status ,Healthy Aging ,Humans ,Longitudinal Studies ,Middle Aged ,Mobility Limitation ,Mortality ,Racial Groups ,Sedentary Behavior ,Gerontology ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundWhether physical activity (PA) and sedentary behavior influence the odds of women living to age 85 years without chronic disease or disability is not well described.MethodsParticipants of the Women's Health Initiative (n = 49,612) were categorized based on health status by age 85 years: (i) lived without developing major chronic disease or mobility disability ("healthy"); (ii) lived and developed mobility disability with or without disease; (iii) lived and developed major chronic disease, but not mobility disability; and (iv) died before their 85th birth year. Multinomial logistic regression models that adjusted for covariates such as age, race/ethnicity, and body size estimated associations of self-reported PA and sitting time on developing major disease or mobility disability or dying before age 85 relative to being healthy.ResultsMean ± SD baseline age was 70.2 ± 3.6 years. Distributions were: 22% healthy, 23% had mobility disability, 26% had major disease, and 29% died. Relative to those with high total PA, the adjusted odds ratios (OR) (confidence intervals [CI]) for mobility disability was 1.6 (1.4-1.7), 1.2 (1.1-1.3), and 1.1 (1.0-1.2) for women with no, low, and moderate total PA, respectively (p-trend < .001). The corresponding covariate-adjusted OR (CI) for mortality was 1.7 (1.5-1.8), 1.2 (1.1-1.3), and 1.0 (1.0-1.1) (p-trend < .001). Total PA was not associated with developing chronic disease before age 85 years. Sitting ≥10 relative to
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- 2018
48. A Low-Fat Dietary Pattern and Diabetes: A Secondary Analysis From the Women’s Health Initiative Dietary Modification Trial
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Howard, Barbara V, Aragaki, Aaron K, Tinker, Lesley F, Allison, Matthew, Hingle, Melanie D, Johnson, Karen C, Manson, JoAnn E, Shadyab, Aladdin H, Shikany, James M, Snetselaar, Linda G, Thomson, Cynthia A, Zaslavsky, Oleg, and Prentice, Ross L
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Public Health ,Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Health Sciences ,Diabetes ,Clinical Trials and Supportive Activities ,Clinical Research ,Nutrition ,Aging ,Complementary and Integrative Health ,Obesity ,Prevention ,Metabolic and endocrine ,Reproductive health and childbirth ,Cancer ,Aged ,Diabetes Mellitus ,Type 2 ,Diet Therapy ,Diet ,Fat-Restricted ,Dietary Fats ,Feeding Behavior ,Female ,Follow-Up Studies ,Fruit ,Humans ,Incidence ,Insulin ,Middle Aged ,Postmenopause ,Risk Factors ,Vegetables ,Medical and Health Sciences ,Endocrinology & Metabolism ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveWe performed a secondary analysis to evaluate the effect of the Women's Health Initiative dietary intervention on incident diabetes and diabetes treatment in postmenopausal women.Research design and methodsA total of 48,835 women were randomized to a comparison group or an intervention group that underwent a behavioral/nutritional modification program to decrease fat and increase vegetable, fruit, and grain intake for an average of 8.1 years. Ninety-three percent of participants completed the intervention, and 71% participated in active follow-up through 30 September 2015 (median 17.3 years). We measured time to development of treated diabetes and progression from oral antihyperglycemic agents to insulin. Serum glucose and insulin were measured in a subsample of women (N = 2,324) at baseline and years 1, 3, and 6.ResultsDuring the trial, intervention group women had lower rates of initiation of insulin therapy (hazard ratio [HR] 0.74 [95% CI 0.59, 0.94]; P = 0.01). Moreover, women with baseline waist circumference ≥88 cm (P interaction = 0.01) and worse metabolic syndrome scores (P interaction = 0.02) had the greatest reduction in risk of initiating insulin therapy. The decreased risk from the intervention was present during the cumulative follow-up (HR 0.88 [95% CI 0.78, 0.99]; P = 0.04). In participants with measured biomarkers (5.8% subsample) who had baseline glucose
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- 2018
49. 36‐Item Short Form Survey (SF‐36) Versus Gait Speed As Predictor of Preclinical Mobility Disability in Older Women: The Women's Health Initiative
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Laddu, Deepika R, Wertheim, Betsy C, Garcia, David O, Woods, Nancy F, LaMonte, Michael J, Chen, Bertha, Anton‐Culver, Hoda, Zaslavsky, Oleg, Cauley, Jane A, Chlebowski, Rowan, Manson, JoAnn E, Thomson, Cynthia A, Stefanick, Marcia L, and Investigators, the Women's Health Initiative
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Clinical Research ,Aging ,Aged ,Female ,Gait ,Geriatric Assessment ,Humans ,Mobility Limitation ,Self Report ,Surveys and Questionnaires ,Walking ,Women's Health ,physical function ,performance ,disability ,prevention ,geriatric assessment ,Women's Health Initiative Investigators ,Medical and Health Sciences ,Geriatrics ,Biomedical and clinical sciences ,Health sciences ,Psychology - Abstract
OBJECTIVES:To compare the value of clinically measured gait speed with that of the self-reported Medical Outcomes Study 36-item Short-Form Survey Physical Function Index (SF-36 PF) in predicting future preclinical mobility disability (PCMD) in older women. DESIGN:Prospective cohort study. SETTING:Forty clinical centers in the United States. PARTICIPANTS:Women aged 65 to 79 enrolled in the Women's Health Initiative Clinical Trials with gait speed and SF-36 assessed at baseline (1993-1998) and follow-up Years 1, 3, and 6 (N = 3,587). MEASUREMENTS:Women were categorized as nondecliners or decliners based on changes (from baseline to Year 1) in gait speed and SF-36 PF scores. Logistic regression models were used to estimate incident PCMD (gait speed
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- 2018
50. Association between Dietary Energy Density and Obesity-Associated Cancer: Results from the Women’s Health Initiative
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Thomson, Cynthia A, Crane, Tracy E, Garcia, David O, Wertheim, Betsy C, Hingle, Melanie, Snetselaar, Linda, Datta, Mridul, Rohan, Thomas, LeBlanc, Erin, Chlebowski, Rowan T, and Qi, Lihong
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Public Health ,Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Health Sciences ,Cancer ,Clinical Trials and Supportive Activities ,Nutrition ,Clinical Research ,Prevention ,Obesity ,Aging ,Cardiovascular ,Metabolic and endocrine ,Oral and gastrointestinal ,Stroke ,Aged ,Body Mass Index ,Clinical Trials as Topic ,Diet ,Energy Intake ,Female ,Humans ,Middle Aged ,Neoplasms ,Observational Studies as Topic ,Postmenopause ,Prospective Studies ,Risk Factors ,Waist Circumference ,Weight Gain ,Women's Health ,Energy density ,Postmenopausal women ,Clinical Sciences ,Anthropology ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundDietary energy density (DED) is the ratio of energy (kilocalories or kilojoules) intake to food weight (grams) and is a measure of diet quality. Consumption of foods high in DED has been associated with weight gain in adults.ObjectiveTo investigate the association between baseline DED and incident obesity-associated cancers in the Women's Health Initiative.DesignProspective cohort study of clinical trial and observational study participants.Participants/settingPostmenopausal women aged 50 to 79 years (N=92,295) enrolled in the observational study or the calcium and vitamin D trial and hormone replacement therapy trials of the Women's Health Initiative.Main outcome measuresIncident, medical record-adjudicated, obesity-related cancers during follow-up. Exposure variable was DED (kilocalories per gram for the total diet) from self-reported dietary intake at baseline using a food frequency questionnaire.Statistical analysesThe associations between DED and each incident cancer, or any obesity-related cancer, were examined using competing-risks regression models, with death as a competing risk. Body mass index-stratified models were generated to investigate body mass index as a potential modifying factor.ResultsDED was associated with higher body mass index (28.9±6.0 vs 26.3±4.9) and waist circumference (89.3±14.2 vs 82.4±12.4 cm) for DED quintiles 5 vs 1, respectively. DED was associated with a 10% increased risk of any obesity-related cancer (subhazard ratioQ5 vs Q1: 1.1, 95% CI 1.03 to 1.2; P=0.004). This increased risk appeared limited to women who were normal weight at enrollment.ConclusionsHigher DED may be a contributing factor for obesity-related cancers, especially among normal-weight postmenopausal women and, as such, could serve as a modifiable behavior for dietary interventions to reduce obesity-associated cancer risk.
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- 2018
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