scholarly journals Timing of aspirin use in colorectal cancer chemoprevention: a prospective cohort study

2021 ◽  
Author(s):  
Yin Zhang ◽  
Andrew T Chan ◽  
Jeffrey A Meyerhardt ◽  
Edward L Giovannucci
Keyword(s):  
Colorectal Cancer ◽  
Total Duration ◽  
Cancer Chemoprevention ◽  
Health Study ◽  
Average Dose ◽  
Recent Period ◽  
Cox Models ◽  
Hazard Ratios ◽  
Independent Effects

Abstract Background Prior epidemiological and intervention studies have not been able to separate independent effects of dose, timing and duration of aspirin use in colorectal cancer (CRC) chemoprevention. We examined aspirin-based CRC chemoprevention according to timing in the Nurses’ Health Study and Health Professionals Follow-Up Study. Methods The exposures include cumulative average dose and total duration of aspirin use in > 10 years before follow-up started (remote period), and in the immediate 10 years before follow-up started (recent period). Cox models were used to estimate hazard ratios (HR) and 95% confidence intervals for exposures and CRC risk. Results Aspirin use >10 years before follow-up started (HR = 0.88, 95% CI = 0.83 to 0.94) per 5 year increment) and immediate 10 years before follow-up started (HR = 0.90, 95% CI = 0.84 to 0.96) were similarly important in CRC chemoprevention, though a 5-year lag was required for a clear benefit in the recent period. In the remote period, the association was not dose-dependent; compared to < 0.5 standard (325 mg)-dose tablets/week; hazard ratios were HR = 0.78, 95% CI = 0.63 to 0.98, HR = 0.81, 95% CI = 0.72 to 0.91, and HR = 0.74, 95% CI = 0.64 to 0.86 for doses of 0.5 to < 1.5, 1.5 to < 5, ≥5 tablets/week, respectively. However, there was dose dependency in the recent period (with respective HR = 0.91, 95% CI = 0.79 to 1.06; HR = 0.87, 95% CI = 0.77 to 0.98; and HR = 0.76, 95% CI = 0.64 to 0.91). Conclusion A suggestive benefit necessitates at least 6–10 years and most clearly after approximately 10 years since initiation of aspirin. Remote use and use within the previous 10 years both contribute independently to decreased risk, though a lower dose may be required for a benefit with longer term use.

Abstract MP27: Weight Change, BMI, and Mortality Among Survivors of Myocardial Infarction: Analysis of Two Prospective US Cohort Studies

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Laila Al-Shaar ◽  
Yanping Li ◽  
Eric Rimm ◽  
JoAnn E Manson ◽  
Frank Hu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Weight Change ◽  
Normal Weight ◽  
Health Study ◽  
Obese Patients ◽  
Cox Models ◽  
Hazard Ratios ◽  
Before And After ◽  
Cvd Mortality

Background: The relation between BMI, weight change and mortality among survivors of Myocardial Infarction (MI) remains controversial, with some studies reporting favorable survival outcomes among overweight and obese patients, as compared to those with normal weight. We aim to examine the relationship between BMI reported shortly before and after MI diagnosis in addition to weight change with all-cause and cardiovascular disease (CVD) mortality among MI survivors. Methods: Using the data from Nurses’ Health Study (NHS) and Health Professionals Follow up Study (HPFS) cohorts, we studied 4278 participants who were free of CVD and cancer before their MI. Weight change (in BMI units) was categorized as loss of (> 4, 2-4, <2-0 (reference)), or gain of (0.1-2, or >2) units. Multivariable Cox models were used to estimate hazard ratios and 95 % confidence interval for mortality across BMI/weight change categories. Results: During up to 36 (NHS) and 28 (HPFS) years of follow-up post-MI, there were 2071 all-cause and 835 CVD deaths. Overweight patients with BMI before or after MI of 25-27.49 kg/m 2 had decreased mortality as compared to normal weight patients (22.5-24.9 kg/m 2 ). All-cause mortality increased progressively with higher BMI. Obese patients (BMI≥30) had the highest risk of CVD mortality (HR=1.35; 95% CI, 1.06-1.73). Among MI patients who had never smoked (N=1484) or were younger than 65 years of age at the time of diagnosis (N=1873), no survival advantage was observed for overweight/obese patients. Compared to stable weight (a BMI reduction of 0-1.99 units) from before to after MI, a reduction of 2-4 or >4 BMI units was associated with increased mortality (HR=1.12; 95% CI, 0.96-1.29 and 1.42; 95% CI, 1.17-1.71 respectively, Figure). Conclusions: We observed a J-shaped association between BMI and mortality among all MI patients, but not among those who had never smoked or were younger than 65 years of age. Weight loss associated with acute MI, potentially related to disease severity, is an important predictor of higher mortality.

scholarly journals A Prospective Analysis of Meat Mutagens and Colorectal Cancer in the Nurses’ Health Study and Health Professionals Follow-up Study

2016 ◽  
Vol 124 (10) ◽  
pp. 1529-1536 ◽  
Author(s):  
Ngoan Tran Le ◽  
Fernanda Alessandra Silva Michels ◽  
Mingyang Song ◽  
Xuehong Zhang ◽  
Adam M. Bernstein ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Professionals ◽  
Health Study ◽  
Prospective Analysis ◽  
Follow Up Study

Abstract P382: Fried Food Consumption is Associated with a Higher Risk of Heart Failure among US Male Physicians

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Luc Djousse ◽  
Andrew Petrone ◽  
John M Gaziano
Keyword(s):  
Heart Failure ◽  
Food Intake ◽  
Food Consumption ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Health Study ◽  
Median Frequency ◽  
Fried Food ◽  
Hazard Ratios

Background: While previous studies have reported a positive relation of fried food consumption with type 2 diabetes, hypertension, and obesity, no previous study has examined the relation of total fried food intake with risk of heart failure (HF) in a prospective cohort. Objective: To test the hypothesis that fried food consumption is positively associated with risk of HF in male physicians. Methods: A prospective cohort of 19,968 participants from the Physicians’ Health Study. Frequency of fried food consumption was assessed between 1999 and 2002 using a food frequency questionnaire and HF was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted hazard ratios of HF. Results: During a median follow-up of 10.6 years, 862 cases of HF occurred. The mean age at baseline was 66.4 ± 9.2 years. Median frequency of fried food consumption was <1 time per week. Multivariable adjusted hazard ratios (95% CI) were: 1.0 (ref), 1.18 (1.01-1.37), 1.25 (1.02-1.54), and 1.68 (1.19-2.36) for fried food consumption of <1/week, 1-3/week, 4-6/week, and 7+/week, respectively (p for linear trend: 0.0004), after adjustment for age, alcohol use, smoking, exercise, and history of myocardial infarction, coronary artery bypass graph or angioplasty (Fig). Additional adjustment of total trans fats did not alter the findings. In a secondary analysis, body mass index did not modify the relation of fried foods with HF risk. Conclusions: Our data show a positive association between fried food intake and risk of HF in US male physicians.

scholarly journals Cardiovascular Health and Stroke in Older British Men

Stroke ◽  
2020 ◽  
Vol 51 (11) ◽  
pp. 3286-3294
Author(s):  
Ayesha Ahmed ◽  
Snehal M. Pinto Pereira ◽  
Lucy Lennon ◽  
Olia Papacosta ◽  
Peter Whincup ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cardiovascular Health ◽  
Population Attributable Fraction ◽  
Cox Models ◽  
Population Attributable Fractions ◽  
Hazard Ratios ◽  
Attributable Fractions ◽  
Time Point

Background and Purpose: Research exploring the utility of cardiovascular health (CVH) and its Life’s Simple 7 (LS7) components (body mass index, blood pressure [BP], glucose, cholesterol, physical activity, smoking, and diet) for prevention of stroke in older adults is limited. In the British Regional Heart Study, we explored (1) prospective associations of LS7 metrics and composite CVH scores with, and their impact on, stroke in middle and older age; and (2) if change in CVH was associated with subsequent stroke. Methods: Men without cardiovascular disease were followed from baseline recruitment (1978–1980), and again from re-examination 20 years later, for stroke over a median period of 20 years and 16 years, respectively. LS7 were measured at each time point except baseline diet. Cox models estimated hazard ratios (95% CI) of stroke for (1) ideal and intermediate versus poor levels of LS7; (2) composite CVH scores; and (3) 4 CVH trajectory groups (low-low, low-high, high-low, high-high) derived by dichotomising CVH scores from each time point across the median value. Population attributable fractions measured impact of LS7. Results: At baseline (n=7274, mean age 50 years), healthier levels of BP, physical activity, and smoking were associated with reduced stroke risk. At 20-year follow-up (n=3798, mean age 69 years) only BP displayed an association. Hazard ratios for intermediate and ideal (versus poor) levels of BP 0.65 (0.52–0.81) and 0.40 (0.24–0.65) at baseline; and 0.84 (0.67–1.05) and 0.57 (0.36–0.90) at 20-year follow-up. With reference to low-low trajectory, the low-high trajectory was associated with 40% reduced risk, hazard ratio 0.60 (0.44–0.83). Associations of CVH scores weakened, and population attributable fractions of LS7 reduced, from middle to old age; population attributable fraction of nonideal BP from 53% to 39%. Conclusions: Except for BP, CVH is weakly associated with stroke at older ages. Prevention strategies for older adults should prioritize BP control but also enhance focus beyond traditional risk factors.

scholarly journals Menstrual cycle regularity and length across the reproductive lifespan and risk of premature mortality: prospective cohort study

BMJ ◽  
2020 ◽  
pp. m3464 ◽  
Author(s):  
Yi-Xin Wang ◽  
Mariel Arvizu ◽  
Janet W Rich-Edwards ◽  
Jennifer J Stuart ◽  
JoAnn E Manson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cycle Length ◽  
Premature Mortality ◽  
Health Study ◽  
Menstrual Cycles ◽  
Hazard Ratios

AbstractObjectiveTo evaluate whether irregular or long menstrual cycles throughout the life course are associated with all cause and cause specific premature mortality (age <70 years).DesignProspective cohort study.SettingNurses’ Health Study II (1993-2017).Participants79 505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes and who reported the usual length and regularity of their menstrual cycles at ages 14-17 years, 18-22 years, and 29-46 years.Main outcome measuresHazard ratios and 95% confidence intervals for all cause and cause specific premature mortality (death before age 70 years) were estimated from multivariable Cox proportional hazards models.ResultsDuring 24 years of follow-up, 1975 premature deaths were documented, including 894 from cancer and 172 from cardiovascular disease. Women who reported always having irregular menstrual cycles experienced higher mortality rates during follow-up than women who reported very regular cycles in the same age ranges. The crude mortality rate per 1000 person years of follow-up for women reporting very regular cycles and women reporting always irregular cycles were 1.05 and 1.23 for cycle characteristics at ages 14-17 years, 1.00 and 1.37 for cycle characteristics at ages 18-22 years, and 1.00 and 1.68 for cycle characteristics at ages 29-46 years. The corresponding multivariable adjusted hazard ratios for premature death during follow-up were 1.18 (95% confidence interval 1.02 to 1.37), 1.37 (1.09 to 1.73), and 1.39 (1.14 to 1.70), respectively. Similarly, women who reported that their usual cycle length was 40 days or more at ages 18-22 years and 29-46 years were more likely to die prematurely than women who reported a usual cycle length of 26-31 days in the same age ranges (1.34, 1.06 to 1.69; and 1.40, 1.17 to 1.68, respectively). These relations were strongest for deaths related to cardiovascular disease. The higher mortality associated with long and irregular menstrual cycles was slightly stronger among current smokers.ConclusionsIrregular and long menstrual cycles in adolescence and adulthood are associated with a greater risk of premature mortality (age <70 years). This relation is slightly stronger among women who smoke.

scholarly journals Intake of whole grain foods and risk of type 2 diabetes: results from three prospective cohort studies

BMJ ◽  
2020 ◽  
pp. m2206 ◽  
Author(s):  
Yang Hu ◽  
Ming Ding ◽  
Laura Sampson ◽  
Walter C Willett ◽  
JoAnn E Manson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Brown Rice ◽  
Whole Grains ◽  
Health Study ◽  
Whole Grain ◽  
Breakfast Cereal ◽  
Hazard Ratios ◽  
Grain Foods

Abstract Objective To examine the associations between the intake of total and individual whole grain foods and the risk of type 2 diabetes. Design Prospective cohort studies. Setting Nurses’ Health Study (1984-2014), Nurses’ Health Study II (1991-2017), and Health Professionals Follow-Up Study (1986-2016), United States. Participants 158 259 women and 36 525 men who did not have type 2 diabetes, cardiovascular disease, or cancer at baseline. Main outcome measures Self-reports of incident type 2 diabetes by participants identified through follow-up questionnaires and confirmed by a validated supplementary questionnaire. Results During 4 618 796 person years of follow-up, 18 629 participants with type 2 diabetes were identified. Total whole grain consumption was categorized into five equal groups of servings a day for the three cohorts. After adjusting for lifestyle and dietary risk factors for diabetes, participants in the highest category for total whole grain consumption had a 29% (95% confidence interval 26% to 33%) lower rate of type 2 diabetes compared with those in the lowest category. For individual whole grain foods, pooled hazard ratios (95% confidence intervals) for type 2 diabetes in participants consuming one or more servings a day compared with those consuming less than one serving a month were 0.81 (0.77 to 0.86) for whole grain cold breakfast cereal, 0.79 (0.75 to 0.83) for dark bread, and 1.08 (1.00 to 1.17) for popcorn. For other individual whole grains with lower average intake levels, comparing consumption of two or more servings a week with less than one serving a month, the pooled hazard ratios (95% confidence intervals) were 0.79 (0.75 to 0.83) for oatmeal, 0.88 (0.82 to 0.94) for brown rice, 0.85 (0.80 to 0.90) for added bran, and 0.88 (0.78 to 0.98) for wheat germ. Spline regression showed a non-linear dose-response association between total whole grain intake and the risk of type 2 diabetes where the rate reduction slightly plateaued at more than two servings a day (P<0.001 for curvature). For whole grain cold breakfast cereal and dark bread, the rate reduction plateaued at about 0.5 servings a day. For consumption of popcorn, a J shaped association was found where the rate of type 2 diabetes was not significantly raised until consumption exceeded about one serving a day. The association between higher total whole grain intake and lower risk of type 2 diabetes was stronger in individuals who were lean than in those who were overweight or obese (P=0.003 for interaction), and the associations did not vary significantly across levels of physical activity, family history of diabetes, or smoking status. Conclusion Higher consumption of total whole grains and several commonly eaten whole grain foods, including whole grain breakfast cereal, oatmeal, dark bread, brown rice, added bran, and wheat germ, was significantly associated with a lower risk of type 2 diabetes. These findings provide further support for the current recommendations of increasing whole grain consumption as part of a healthy diet for the prevention of type 2 diabetes.

scholarly journals Farming tasks and the development of rheumatoid arthritis in the agricultural health study

2019 ◽  
pp. oemed-2018-105361 ◽  
Author(s):  
Christine G Parks ◽  
Armando Meyer ◽  
Laura E Beane Freeman ◽  
Jonathan Hofmann ◽  
Dale P Sandler
Keyword(s):  
Rheumatoid Arthritis ◽  
Self Report ◽  
Health Study ◽  
Proportional Hazard ◽  
Agricultural Health ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Models ◽  
Agricultural Health Study

ObjectivesFarming has been associated with rheumatoid arthritis (RA). Some studies have evaluated the effects of pesticides, but other agricultural exposures may also affect immune response.MethodsWe investigated non-pesticide agricultural exposures in relation to RA in licensed pesticide applicators (n=27 175, mostly male farmers) and their spouses (n=22 231) in the Agricultural Health Study (AHS) cohort (1993–1997) who completed at least one follow-up survey through 2015. Incident RA cases (n=229 applicators and 249 spouses) were identified based on self-report confirmed by use of disease-modifying antirheumatic drugs or medical records. Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) were estimated by Cox proportional hazard models adjusting for applicator status, state, smoking, education and specific pesticide use, allowing estimates to vary by median age when hazards assumptions were not met.ResultsOverall, RA was associated with regularly applying chemical fertilisers (HR=1.50; 95% CI 1.11 to 2.02), using non-gasoline solvents (HR=1.40; 95% CI 1.09 to 1.80), and painting (HR=1.26; 95% CI 1.00 to 1.59). In older applicators (>62 years), RA was associated with driving combines (HR=2.46; 95% CI 1.05 to 5.78) and milking cows (HR=2.56; 95% CI 1.01 to 6.53). In younger participants (≤62 years), RA was inversely associated with raising animals as well as crops (HR=0.68; 95% CI 0.51 to 0.89 vs crops only). Associations with specific crops varied by age: some (eg, hay) were inversely associated with RA in younger participants, while others (eg, alfalfa) were associated with RA in older participants.ConclusionThese findings suggest several agricultural tasks and exposures may contribute to development of RA.

Headache as a risk factor for dementia: A prospective population-based study

Cephalalgia ◽  
2013 ◽  
Vol 34 (5) ◽  
pp. 327-335 ◽  
Author(s):  
Knut Hagen ◽  
Eystein Stordal ◽  
Mattias Linde ◽  
Timothy J Steiner ◽  
John-Anker Zwart ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Cox Regression ◽  
Subsequent Development ◽  
Population Based ◽  
Health Study ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Increased Risk

Background Headache has not been established as a risk factor for dementia. The aim of this study was to determine whether any headache was associated with subsequent development of vascular dementia (VaD), Alzheimer’s disease (AD) or other types of dementia. Methods This prospective population-based cohort study used baseline data from the Nord-Trøndelag Health Study (HUNT 2) performed during 1995–1997 and, from the same Norwegian county, a register of cases diagnosed with dementia during 1997–2010. Participants aged ≥20 years who responded to headache questions in HUNT 2 were categorized (headache free; with any headache; with migraine; with nonmigrainous headache). Hazard ratios (HRs) for later inclusion in the dementia register were estimated using Cox regression analysis. Results Of 51,383 participants providing headache data in HUNT 2, 378 appeared in the dementia register during the follow-up period. Compared to those who were headache free, participants with any headache had increased risk of VaD ( n = 63) (multivariate-adjusted HR = 2.3, 95% CI 1.4–3.8, p = 0.002) and of mixed dementia (VaD and AD ( n = 52)) (adjusted HR = 2.0, 95% CI 1.1–3.5, p = 0.018). There was no association between any headache and later development of AD ( n = 180). Conclusion In this prospective population-based cohort study, any headache was a risk factor for development of VaD.

scholarly journals Coffee Intake and Colorectal Cancer Incidence According to T-Cell Response

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Tomotaka Ugai ◽  
Koichiro Haruki ◽  
Juha P Väyrynen ◽  
Rong Zhong ◽  
Jennifer Borowsky ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
T Cell ◽  
Cell Subset ◽  
T Cell Response ◽  
Health Study ◽  
Sufficient Evidence ◽  
Coffee Intake ◽  
T Cell Subset ◽  
Cell Densities

Abstract We hypothesized that the associations between coffee intake and colorectal cancer (CRC) incidence might differ by immune cell densities in CRC tissue. Using the Nurses’ Health Study and the Health Professionals Follow-up Study, we examined the association of coffee intake with incidence of CRC classified by intraepithelial or stromal T-cell subset densities by multiplex immunofluorescence assay for CD3, CD4, CD8, CD45RO (PTPRC), and FOXP3. We applied an inverse probability-weighted Cox proportional hazardsregression model to control for selection bias and potential confounders. During follow-up of 133 924 participants (3 585 019 person-years), we documented 3161 incident CRC cases, including 908 CRC cases with available data on T-cell densities in tumor tissue. The association between coffee intake and CRC was not statistically significantly different by intraepithelial or stroma T-cell subset (Pheterogeneity &gt; .38). Hence, there is no sufficient evidence for differential effect of coffee intake on incidence of CRC subtypes classified by T-cell infiltrates.

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