Roy E Shore, Ph.D.

Low-dose radiation knowledge worth the cost
Barcellos-Hoff, Mary Helen; Brenner, David J; Brooks, Antone L; Formenti, Silvia; Hlatky, Lyn; Locke, Paul A; Shore, Roy; Tenforde, Thomas; Travis, Elizabeth L; Williams, Jacqueline
2011 Apr 15;332(6027):305-306, Science
— id: 140490, year: 2011, vol: 332, page: 305, stat: Journal Article,

Endogenous hormones and coronary heart disease in postmenopausal women
Chen, Yu; Zeleniuch-Jacquotte, Anne; Arslan, Alan A; Wojcik, Oktawia; Toniolo, Paolo; Shore, Roy E; Levitz, Mortimer; Koenig, Karen L
2011 Jun;216(2):414-419, Atherosclerosis
The association between serum levels of endogenous estrogens in postmenopausal women and the subsequent risk of coronary heart disease (CHD) was examined in a prospective case-control study nested within the New York University Women's Health Study (NYUWHS). The NYUWHS is a prospective cohort study of 14,274 healthy women enrolled between 1985 and 1991. A total of 99 women who were postmenopausal and free of cardiovascular disease at enrollment and who subsequently experienced CHD, defined as non-fatal myocardial infarction (MI), fatal CHD, percutaneous transluminal coronary angioplasty (PTCA), or coronary artery bypass grafting (CABG), were matched 1:2 by baseline age, blood sampling date, and postmenopausal status to controls who remained free of CHD as of the date of diagnosis of the matching case. Biochemical analyses for total estradiol, estrone, percent free estradiol, percent estradiol bound to sex hormone-binding globulin (SHBG), and SHBG were performed on pre-diagnostic stored serum samples. Participants had not used any hormone medications in the 6 months prior to blood collection. In the model adjusting only for matching factors, the risk of CHD in the top tertile of calculated bioavailable estradiol was elevated compared with the bottom tertile (OR=2.10; 95% CI=1.13-3.90, P for trend=0.03), and the risk in the top tertile of SHBG was reduced (OR=0.50, 95% CI=0.28-0.92, P for trend<0.01). However, these associations disappeared after adjusting for baseline hypertension status, body mass index, and serum cholesterol levels. These findings suggest that circulating estradiol and SHBG are not associated with CHD risk in postmenopausal women beyond what can be explained by the variation in hypertension status, BMI, and cholesterol
— id: 134306, year: 2011, vol: 216, page: 414, stat: Journal Article,

Circulating Inflammation Markers and Risk of Epithelial Ovarian Cancer
Clendenen TV; Lundin E; Zeleniuch-Jacquotte A; Koenig KL; Berrino F; Lukanova A; Lokshin AE; Idahl A; Ohlson N; Hallmans G; Krogh V; Sieri SA; Muti P; Marrangoni AM; Nolen B; Liu M; Shore RE; Arslan AA
2011 May;20(5):799-810, Cancer epidemiology biomarkers & prevention
BACKGROUND: Factors contributing to chronic inflammation appear to be associated with increased risk of ovarian cancer. The purpose of this study was to assess the association between circulating levels of inflammation mediators and subsequent risk of ovarian cancer.METHODS: We conducted a case-control study of 230 cases and 432 individually-matched controls nested within three prospective cohorts to evaluate the association of pre-diagnostic circulating levels of inflammation-related biomarkers (IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p40, IL-12p70, IL-13, TNFalpha, IL-1Ra, sIL-1RII, sIL-2Ra, sIL-4R, sIL-6R, sTNF-R1, and sTNF-R2) measured using Luminex xMap technology with risk of ovarian cancer. RESULTS: We observed a trend across quartiles for IL-2 (OR(Q4 vs. Q1): 1.57, 95% CI: 0.98, 2.52, p= 0.07), IL-4 (OR(Q4 vs. Q1): 1.50, 95% CI: 0.95, 2.38, p= 0.06), IL-6 (OR(Q4 vs. Q1): 1.63, 95% CI: 1.03, 2.58, p= 0.03), IL-12p40 (OR(Q4 vs. Q1): 1.60, 95% CI: 1.02, 2.51, p= 0.06), and IL-13 (OR(Q4 vs. Q1): 1.42, 95% CI: 0.90, 2.26, p= 0.11). Trends were also observed when cytokines were modeled on the continuous scale for IL-4 (p-trend=0.01), IL-6 (p-trend=0.01), IL-12p40 (p-trend=0.01), and IL-13 (p-trend=0.04). Odds ratios were not materially different after excluding cases diagnosed less than five years after blood donation or when limited to serous tumors.Conclusions and Impact: This study provides the first direct evidence that multiple inflammation markers, specifically IL-2, IL-4, IL-6, IL-12, and IL-13, may be associated with risk of epithelial ovarian cancer, and adds to the evidence that inflammation is involved in the development this disease
— id: 131785, year: 2011, vol: 20, page: 799, stat: Journal Article,

Factors associated with inflammation markers, a cross-sectional analysis
Clendenen, Tess V; Koenig, Karen L; Arslan, Alan A; Lukanova, Annekatrin; Berrino, Franco; Gu, Yian; Hallmans, Goran; Idahl, Annika; Krogh, Vittorio; Lokshin, Anna E; Lundin, Eva; Muti, Paola; Marrangoni, Adele; Nolen, Brian M; Ohlson, Nina; Shore, Roy E; Sieri, Sabina; Zeleniuch-Jacquotte, Anne
2011 Dec;56(3):769-778, Cytokine
Epidemiological studies have reported associations between circulating inflammation markers and risk of chronic diseases. It is of interest to examine whether risk factors for these diseases are associated with inflammation. We conducted a cross-sectional analysis to evaluate whether reproductive and lifestyle factors and circulating vitamin D were associated with inflammation markers, including C-reactive protein, cytokines (IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p40, IL-12p70, IL-13, TNFalpha), and cytokine modulators (IL-1RA, sIL-1RII, sIL-2Ra, sIL-4R, sIL-6R, sTNF-R1/R2), among 616 healthy women. We confirmed associations of several inflammation markers with age and BMI. We also observed significantly higher levels of certain inflammation markers in postmenopausal vs. premenopausal women (TNFalpha, sIL-1RII, sIL-2Ra), with increasing parity (IL-12p40), and with higher circulating 25(OH) vitamin D (IL-13) and lower levels among current users of non-steroidal anti-inflammatory drugs (NSAIDs) (IL-1beta, IL-2, IL-10, IL-12p70, and IL-12p40), current smokers (IL-4, IL-13, IL-12p40), and women with a family history of breast or ovarian cancer (IL-4, IL-10, IL-13). Our findings suggest that risk factors for chronic diseases (age, BMI, menopausal status, parity, NSAID use, family history of breast and ovarian cancer, and smoking) are associated with inflammation markers in healthy women
— id: 141702, year: 2011, vol: 56, page: 769, stat: Journal Article,

Circulating sex hormones and breast cancer risk factors in postmenopausal women: reanalysis of 13 studies
Key, T J; Appleby, P N; Reeves, G K; Roddam, A W; Helzlsouer, K J; Alberg, A J; Rollison, D E; Dorgan, J F; Brinton, L A; Overvad, K; Kaaks, R; Trichopoulou, A; Clavel-Chapelon, F; Panico, S; Duell, E J; Peeters, P H M; Rinaldi, S; Fentiman, I S; Dowsett, M; Manjer, J; Lenner, P; Hallmans, G; Baglietto, L; English, D R; Giles, G G; Hopper, J L; Severi, G; Morris, H A; Hankinson, S E; Tworoger, S S; Koenig, K; Zeleniuch-Jacquotte, A; Arslan, A A; Toniolo, P; Shore, R E; Krogh, V; Micheli, A; Berrino, F; Barrett-Connor, E; Laughlin, G A; Kabuto, M; Akiba, S; Stevens, R G; Neriishi, K; Land, C E; Cauley, J A; Lui, Li Yung; Cummings, Steven R; Gunter, M J; Rohan, T E; Strickler, H D
2011 Aug 23;105(5):709-722, British journal of cancer
BACKGROUND: Breast cancer risk for postmenopausal women is positively associated with circulating concentrations of oestrogens and androgens, but the determinants of these hormones are not well understood. METHODS: Cross-sectional analyses of breast cancer risk factors and circulating hormone concentrations in more than 6000 postmenopausal women controls in 13 prospective studies. RESULTS: Concentrations of all hormones were lower in older than younger women, with the largest difference for dehydroepiandrosterone sulphate (DHEAS), whereas sex hormone-binding globulin (SHBG) was higher in the older women. Androgens were lower in women with bilateral ovariectomy than in naturally postmenopausal women, with the largest difference for free testosterone. All hormones were higher in obese than lean women, with the largest difference for free oestradiol, whereas SHBG was lower in obese women. Smokers of 15+ cigarettes per day had higher levels of all hormones than non-smokers, with the largest difference for testosterone. Drinkers of 20+ g alcohol per day had higher levels of all hormones, but lower SHBG, than non-drinkers, with the largest difference for DHEAS. Hormone concentrations were not strongly related to age at menarche, parity, age at first full-term pregnancy or family history of breast cancer. CONCLUSION: Sex hormone concentrations were strongly associated with several established or suspected risk factors for breast cancer, and may mediate the effects of these factors on breast cancer risk
— id: 137962, year: 2011, vol: 105, page: 709, stat: Journal Article,

Postmenopausal circulating levels of 2- and 16alpha-hydroxyestrone and risk of endometrial cancer
Zeleniuch-Jacquotte, A; Shore, R E; Afanasyeva, Y; Lukanova, A; Sieri, S; Koenig, K L; Idahl, A; Krogh, V; Liu, M; Ohlson, N; Muti, P; Arslan, A A; Lenner, P; Berrino, F; Hallmans, G; Toniolo, P; Lundin, E
2011 Oct 25;105(9):1458-1464, British journal of cancer
Background:It has been suggested that the relative importance of oestrogen-metabolising pathways may affect the risk of oestrogen-dependent tumours including endometrial cancer. One hypothesis is that the 2-hydroxy pathway is protective, whereas the 16alpha-hydroxy pathway is harmful.Methods:We conducted a case-control study nested within three prospective cohorts to assess whether the circulating 2-hydroxyestrone : 16alpha-hydroxyestrone (2-OHE1 : 16alpha-OHE1) ratio is inversely associated with endometrial cancer risk in postmenopausal women. A total of 179 cases and 336 controls, matching cases on cohort, age and date of blood donation, were included. Levels of 2-OHE1 and 16alpha-OHE1 were measured using a monoclonal antibody-based enzyme assay.Results:Endometrial cancer risk increased with increasing levels of both metabolites, with odds ratios in the top tertiles of 2.4 (95% CI=1.3, 4.6; P(trend)=0.007) for 2-OHE1 and 1.9 (95% CI=1.1, 3.5; P(trend)=0.03) for 16alpha-OHE1 in analyses adjusting for endometrial cancer risk factors. These associations were attenuated and no longer statistically significant after further adjustment for oestrone or oestradiol levels. No significant association was observed for the 2-OHE1 : 16alpha-OHE1 ratio.Conclusion:Our results do not support the hypothesis that greater metabolism of oestrogen via the 2-OH pathway, relative to the 16alpha-OH pathway, protects against endometrial cancer
— id: 139737, year: 2011, vol: 105, page: 1458, stat: Journal Article,

Radiation exposure, the ATM Gene, and contralateral breast cancer in the women's environmental cancer and radiation epidemiology study
Bernstein, Jonine L; Haile, Robert W; Stovall, Marilyn; Boice, John D Jr; Shore, Roy E; Langholz, Bryan; Thomas, Duncan C; Bernstein, Leslie; Lynch, Charles F; Olsen, Jorgen H; Malone, Kathleen E; Mellemkjaer, Lene; Borresen-Dale, Anne-Lise; Rosenstein, Barry S; Teraoka, Sharon N; Diep, Anh T; Smith, Susan A; Capanu, Marinela; Reiner, Anne S; Liang, Xiaolin; Gatti, Richard A; Concannon, Patrick
2010 Apr 7;102(7):475-483, Journal of the National Cancer Institute
BACKGROUND: Ionizing radiation is a known mutagen and an established breast carcinogen. The ATM gene is a key regulator of cellular responses to the DNA damage induced by ionizing radiation. We investigated whether genetic variants in ATM play a clinically significant role in radiation-induced contralateral breast cancer in women. METHODS: The Women's Environmental, Cancer, and Radiation Epidemiology Study is an international population-based case-control study nested within a cohort of 52,536 survivors of unilateral breast cancer diagnosed between 1985 and 2000. The 708 case subjects were women with contralateral breast cancer, and the 1397 control subjects were women with unilateral breast cancer matched to the case subjects on age, follow-up time, registry reporting region, and race and/or ethnicity. All women were interviewed and underwent full mutation screening of the entire ATM gene. Complete medical treatment history information was collected, and for all women who received radiotherapy, the radiation dose to the contralateral breast was reconstructed using radiotherapy records and radiation measurements. Rate ratios (RRs) and corresponding 95% confidence intervals (CIs) were estimated by using multivariable conditional logistic regression. All P values are two-sided. RESULTS: Among women who carried a rare ATM missense variant (ie, one carried by <1% of the study participants) that was predicted to be deleterious, those who were exposed to radiation (mean radiation exposure = 1.2 Gy, SD = 0.7) had a statistically significantly higher risk of contralateral breast cancer compared with unexposed women who carried the wild-type genotype (0.01-0.99 Gy: RR = 2.8, 95% CI = 1.2 to 6.5; > or =1.0 Gy: RR = 3.3, 95% CI = 1.4 to 8.0) or compared with unexposed women who carried the same predicted deleterious missense variant (0.01-0.99 Gy: RR = 5.3, 95% CI = 1.6 to 17.3; > or =1.0 Gy: RR = 5.8, 95% CI = 1.8 to 19.0; P(trend) = .044). CONCLUSIONS: Women who carry rare deleterious ATM missense variants and who are treated with radiation may have an elevated risk of developing contralateral breast cancer. However, the rarity of these deleterious missense variants in human populations implies that ATM mutations could account for only a small portion of second primary breast cancers
— id: 133494, year: 2010, vol: 102, page: 475, stat: Journal Article,

DNA methylation in pre-diagnostic serum samples of breast cancer cases: Results of a nested case-control study
Brooks, Jennifer D; Cairns, Paul; Shore, Roy E; Klein, Catherine B; Wirgin, Isaac; Afanasyeva, Yelena; Zeleniuch-Jacquotte, Anne
2010 Dec;34(6):717-723, Cancer Epidemiology
Background: Promoter methylation of tumor suppressor genes is a frequent and early event in breast carcinogenesis. Paired tumor tissue and serum samples from women with breast cancer show that promoter methylation is detectable in both sample types, with good concordance. This suggests the potential for these serum markers to be used for breast cancer detection. Methods: The current study was a case-control study nested within the prospective New York University Women's Health Study cohort aimed to assess the ability of promoter methylation in serum to detect pre-clinical disease. Cases were women with blood samples collected within the 6 months preceding breast cancer diagnosis (n=50). Each case was matched to 2 healthy cancer-free controls and 1 cancer-free control with a history of benign breast disease (BBD). Results: Promoter methylation analysis of four cancer-related genes: -RASSF1A, GSTP1, APC and RARbeta2, - was conducted using quantitative methylation-specific PCR. Results showed that the frequency of methylation was lower than expected among cases and higher than expected among controls. Methylation was detected in the promoter region of: RASSF1A in 22.0%, 22.9% and 17.2% of cases, BBD controls and healthy controls respectively; GSTP1 in 4%, 10.4% and 7.1% respectively; APC in 2.0%, 4.4% and 4.2% respectively and RARbeta2 in 6.7%, 2.3% and 1.1% respectively. Conclusion: Methylation status of the four genes included in this study was unable to distinguish between cases and either control group. This study highlights some methodological issues to be addressed in planning prospective studies to evaluate methylation markers as diagnostic biomarkers
— id: 114817, year: 2010, vol: 34, page: 717, stat: Journal Article,

Circulating cytokines and risk of B-cell non-Hodgkin lymphoma: a prospective study
Gu, Yian; Shore, Roy E; Arslan, Alan A; Koenig, Karen L; Liu, Mengling; Ibrahim, Sherif; Lokshin, Anna E; Zeleniuch-Jacquotte, Anne
2010 Aug;21(8):1323-1333, Cancer causes & control. ccc
Cytokines play important roles in B-cell activation, proliferation, and apoptosis, thus may be etiologically related to risk of B-cell non-Hodgkin lymphoma (B-NHL). However, the association between circulating levels of cytokines and B-NHL risk has not been prospectively studied in non-HIV populations. The objective of this study was to assess this association by conducting a case-control study nested within a prospective cohort of non-HIV-infected, healthy women. Fifteen cytokines were measured in samples collected a median of 8.2 years prior to diagnosis in 92 cases and two matched controls per case. Only cytokines that showed adequate temporal reproducibility over a two-year period were included. The odds ratio (OR) for the highest tertile relative to the lowest was elevated for soluble IL-2 receptor (sIL-2R) (OR = 2.5, 95% CI = 1.4-4.7, p (trend) < 0.01) and decreased for IL-13 (OR = 0.5, 95% CI = 0.2-1.0, p (trend) = 0.05). Three other cytokines were marginally associated with risk of B-NHL: TNF-alpha (OR = 1.7, 95% CI = 0.9-3.3, p (trend) = 0.11), sTNF-R2 (OR = 1.9, 95% CI = 0.9-3.5, p (trend) = 0.06), and IL-5 (OR = 0.5, 95% CI = 0.3-1.0, p (trend) = 0.06). No association was observed between B-NHL risk and levels of the other cytokines measured (IL-1beta, IL-1RA, IL-2, IL-4, IL-6, IL-10, IL-12, IL-12p70, CRP and sTNF-R1). This study suggests that dysregulated cytokines may be involved in B-NHL development
— id: 138134, year: 2010, vol: 21, page: 1323, stat: Journal Article,

Cox regression model with time-varying coefficients in nested case-control studies
Liu, Mengling; Lu, Wenbin; Shore, Roy E; Zeleniuch-Jacquotte, Anne
2010 Oct;11(4):693-706, Biostatistics (Oxford, England)
The nested case-control (NCC) design is a cost-effective sampling method to study the relationship between a disease and its risk factors in epidemiologic studies. NCC data are commonly analyzed using Thomas' partial likelihood approach under Cox's proportional hazards model with constant covariate effects. Here, we are interested in studying the potential time-varying effects of covariates in NCC studies and propose an estimation approach based on a kernel-weighted Thomas' partial likelihood. We establish asymptotic properties of the proposed estimator, propose a numerical approach to construct simultaneous confidence bands for time-varying coefficients, and develop a hypothesis testing procedure to detect time-varying coefficients. The proposed inference procedure is evaluated in simulations and applied to an NCC study of breast cancer in the New York University Women's Health Study
— id: 138187, year: 2010, vol: 11, page: 693, stat: Journal Article,

Circulating vitamin d and risk of epithelial ovarian cancer
Arslan, Alan A; Clendenen, Tess V; Koenig, Karen L; Hultdin, Johan; Enquist, Kerstin; Agren, Asa; Lukanova, Annekatrin; Sjodin, Hubert; Zeleniuch-Jacquotte, Anne; Shore, Roy E; Hallmans, Goran; Toniolo, Paolo; Lundin, Eva
2009 ;2009:672492-672492, Journal of oncology
We conducted a nested case-control study within two prospective cohorts, the New York University Women's Health Study and the Northern Sweden Health and Disease Study, to examine the association between prediagnostic circulating levels of 25-hydroxy vitamin D (25(OH)D) and the risk of subsequent invasive epithelial ovarian cancer (EOC). The 25(OH)D levels were measured in serum or plasma from 170 incident cases of EOC and 373 matched controls. Overall, circulating 25(OH)D levels were not associated with the risk of EOC in combined cohort analysis: adjusted OR for the top tertile versus the reference tertile, 1.09 (95% CI, 0.59-2.01). In addition, there was no evidence of an interaction effect between VDR SNP genotype or haplotype and circulating 25(OH)D levels in relation to ovarian cancer risk, although more complex gene-environment interactions may exist
— id: 101966, year: 2009, vol: 2009, page: 672492, stat: Journal Article,

Circulating estrogen metabolites and risk for breast cancer in premenopausal women
Arslan, Alan A; Shore, Roy E; Afanasyeva, Yelena; Koenig, Karen L; Toniolo, Paolo; Zeleniuch-Jacquotte, Anne
2009 Aug;18(8):2273-2279, Cancer epidemiology biomarkers & prevention
BACKGROUND: It has been proposed that a shift toward 2-hydroxyestrone from 16alpha-hydroxyestrone metabolic pathway may be inversely associated with breast cancer risk because 2-hydroxyestrone is thought to be less genotoxic and estrogenic than 16alpha-hydroxyestrone. METHODS: We examined the associations of invasive breast cancer risk with circulating 2-hydroxyestrone, 16alpha-hydroxyestrone, and the 2-hydroxyestrone:16alpha-hydroxyestrone ratio in a case-control study on premenopausal women nested within a prospective cohort the New York University Women's Health Study. The serum levels of 2-hydroxyestrone and 16alpha-hydroxyestrone were measured in 377 incident premenopausal breast cancer cases and 377 premenopausal controls, who were matched on age at enrollment, number and dates of blood donations, and day and phase of menstrual cycle. RESULTS: Overall, no significant associations were observed between breast cancer risk and serum levels of 2-hydroxyestrone, 16alpha-hydroxyestrone, or their ratio. The 2-hydroxyestrone:16alpha-hydroxyestrone ratio was positively associated with risk for estrogen receptor-positive breast cancer in the analyses controlling for matching factors. However, the association was attenuated and not significant after adjustment for potential confounders (odds ratio for the highest versus the lowest quartile, 2.15; 95% CI, 0.88-5.27; P(trend) = 0.09). CONCLUSIONS: The results of the current study do not support the hypothesis that a metabolic shift from 16alpha-hydroxyestrone toward 2-hydroxyestrone in premenopausal women is associated with reduced risk for breast cancer. The association between the 2-hydroxy:16alpha-hydroxyestrone ratio and estrogen receptor-positive breast cancer needs to be explored in future studies
— id: 101449, year: 2009, vol: 18, page: 2273, stat: Journal Article,

Postmenopausal levels of endogenous sex hormones and risk of colorectal cancer
Clendenen, Tess V; Koenig, Karen L; Shore, Roy E; Levitz, Mortimer; Arslan, Alan A; Zeleniuch-Jacquotte, Anne
2009 Jan;18(1):275-281, Cancer epidemiology biomarkers & prevention
Observational epidemiologic studies and randomized trials have reported a protective effect of oral hormonal replacement therapy on risk of colorectal cancer. Only one previous prospective study, the Women's Health Initiative Observational Study, has reported on the relationship between endogenous hormones and incident colorectal cancer. Contrary to expectation, the investigators found that women with higher circulating estradiol levels were at increased risk of developing colorectal cancer. We conducted a case-control study nested within the New York University Women's Health Study prospective cohort to evaluate the association between endogenous levels of estrone, estradiol, and sex hormone-binding globulin (SHBG) with risk of colorectal cancer. We measured hormones and SHBG in serum samples collected at enrollment from a total of 148 women who subsequently developed colorectal cancer and 293 matched controls. Circulating estrone levels were positively associated with risk of colorectal cancer: The odds ratio for the highest versus lowest quartile of estrone was 1.8 (95% confidence interval, 1.0-3.3). We found a nonsignificant inverse association between SHBG and colorectal cancer, which disappeared after adjusting for body mass index. We did not find an association between estradiol and colorectal cancer risk, but we cannot rule out a potential association because of substantial laboratory error in the measurement. Our results suggest that endogenous estrone is associated with increased risk of colorectal cancer in postmenopausal women
— id: 92142, year: 2009, vol: 18, page: 275, stat: Journal Article,

Reproducibility of serum cytokines and growth factors
Gu, Yian; Zeleniuch-Jacquotte, Anne; Linkov, Faina; Koenig, Karen L; Liu, Mengling; Velikokhatnaya, Lyudmila; Shore, Roy E; Marrangoni, Adele; Toniolo, Paolo; Lokshin, Anna E; Arslan, Alan A
2009 Jan;45(1):44-49, Cytokine
BACKGROUND: In most studies, circulating biomarkers are usually assessed from a single sample, assuming that this single measurement represents the long-term biomarker status of the individual. Such an assumption is rarely tested although it may not be valid for all biomarkers. The objective of this study was to investigate the temporal reproducibility of a panel of cytokines and growth factors. METHODS: Thirty-five postmenopausal women with two annual visits and 30 premenopausal women with three annual visits were randomly selected from the participants in an existing prospective cohort. A total of 23 serum cytokines, nine growth factors and C-reactive protein (CRP) were measured using the Luminex xMap technology. In addition, for eight biomarkers, regular and high sensitivity (hs) assays were compared. RESULTS: The biomarkers with adequate (>60%) detection rates and acceptable (> or =0.55) intra-class correlation coefficients (ICCs) were: hsIL-1beta, IL-1RA, hsIL-2, hsIL-4, hsIL-5, hsIL-6, hsIL-10, IL-12p40, hsIL-12p70, hsTNF-alpha, TNF-R1, TNF-R2, CRP, HGF, NGF, and EGFR. The remaining biomarkers either had low temporal reproducibility or were undetectable in more than 40% of samples. CONCLUSIONS: The results suggest that 16 of the 41 biomarkers measured with Luminex technology showed sufficient sensitivity and temporal reproducibility in sera
— id: 92177, year: 2009, vol: 45, page: 44, stat: Journal Article,

Reliability of tumor markers, chemokines, and metastasis-related molecules in serum
Linkov, Faina; Gu, Yian; Arslan, Alan A; Liu, Mengling; Shore, Roy E; Velikokhatnaya, Lyudmila; Koenig, Karen L; Toniolo, Paolo; Marrangoni, Adele; Yurkovetsky, Zoya; Zeleniuch-Jacquotte, Anne; Lokshin, Anna E
2009 Mar;20(1):21-26, European cytokine network
There is a growing interest in the role that cancer biomarkers, metastasis-related molecules, and chemokines may play in the development and progression of various cancers. However, few studies have addressed the reliability of such biomarkers in healthy individuals over time. The objective of this study was to investigate the temporal reliability of multiple proteins in serum samples from healthy women who donated blood over successive years. Thirty five, postmenopausal women with two, repeated annual visits, and thirty, premenopausal women with three, repeated annual visits were randomly selected among eligible subjects from an existing, prospective cohort. Multiplexing Luminex xMAPTM technology was used to measure the levels of 55 serum proteins representing cancer antigens, chemokines, angiogenic and anti-angiogenic factors, proteases, adipokines, apoptotic molecules, and other markers in these women. The biomarkers with high detection rates (> 60%) and acceptable reliability (intraclass correlation coefficient, ICCs > or = 0.55) using xMAPTM method were: cancer antigens: AFP, CA 15-3, CEA, CA-125, SCC, SAA; growth factors/related molecules: ErbB2, IGFBP-1; proteases and adhesion molecules: MMP-1, 8, 9, sE-selectin, human kallikreins (KLK) 8,10, ICAM-1, VCAM-1, chemokines: fractalkine, MCP-1,2, RANTES, MIP-1alpha, MIP-1beta, Eotaxin, GRO-alpha, IP-10; inhibitors of angiogenesis: angiostatin and endostatin; adipokines leptin and resistin; apoptotic factor: Fas, and other proteins mesothelin, myeloperoxidase (MPO), and PAI-1. The rest of the biomarkers under investigation either had ICCs less than 0.55 or had low levels of detection (< 60%). These included cancer antigens: CA 19-9, CA 72-4, MICA, S100, TTR, ULBP1, ULBP2, ULBP3; proteases: MMP 2, 3, 7, 12, 13; chemokines: MCP-3, MIF, MIG; adipokines: leptin and resistin; apoptotic factors: FasL, DR5, Cyfra 21-1; and inhibitors of angiogenesis and other markers: thrombospondin and heat shock protein (HSP) 27. In conclusion, 34 out of the 55 biomarkers investigated were present in detectable levels in > 60% of the samples, and with an ICC > or = 0.55, indicating that a single serum measurement can be used in prospective epidemiological studies using the xMAPTM method
— id: 126591, year: 2009, vol: 20, page: 21, stat: Journal Article,

Reproducibility of serum pituitary hormones in women
Arslan, Alan A; Gu, Yian; Zeleniuch-Jacquotte, Anne; Koenig, Karen L; Liu, Mengling; Velikokhatnaya, Lyudmila; Shore, Roy E; Toniolo, Paolo; Linkov, Faina; Lokshin, Anna E
2008 Aug;17(8):1880-1883, Cancer epidemiology biomarkers & prevention
Endogenous pituitary hormones are commonly used in clinical and epidemiologic studies and some of them are thought to influence the risk of several diseases in women. In most studies, endogenous levels of pituitary hormones are usually assessed at a single point in time, assuming that this single measurement represents the long-term biomarker status of the individual. Such an assumption is rarely tested and may not always be valid. This study examined the reproducibility of the following pituitary hormones: adrenocorticotropic hormone (ACTH), growth hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin, measured using the Luminex xMap method in sera of healthy premenopausal and postmenopausal women. The study included 30 premenopausal women with three yearly samples and 35 postmenopausal women with two repeated yearly samples randomly selected from an existing prospective cohort. Analysis of intraclass correlation coefficients suggested higher reproducibility in postmenopausal women compared with premenopausal women for the following hormones: FSH (0.72 and 0.37, respectively), LH (0.83 and 0.44, respectively), and growth hormone (0.60 and 0.35, respectively). The intraclass correlation coefficients were relatively high and similar between postmenopausal and premenopausal women for ACTH (0.95 and 0.94, respectively), TSH (0.85 and 0.85, respectively), and prolactin (0.72 and 0.69, respectively). This study found that serum concentrations of FSH, LH, and growth hormone are stable in postmenopausal women and that ACTH, TSH, and prolactin are stable in both premenopausal and postmenopausal women, suggesting that a single measurement may reliably categorize average levels over at least a 2-year period
— id: 91436, year: 2008, vol: 17, page: 1880, stat: Journal Article,

Effect of systemic adjuvant treatment on risk for contralateral breast cancer in the Women's Environment, Cancer and Radiation Epidemiology Study
Bertelsen, Lisbeth; Bernstein, Leslie; Olsen, Jorgen H; Mellemkjaer, Lene; Haile, Robert W; Lynch, Charles F; Malone, Kathleen E; Anton-Culver, Hoda; Christensen, Jane; Langholz, Bryan; Thomas, Duncan C; Begg, Colin B; Capanu, Marinela; Ejlertsen, Bent; Stovall, Marilyn; Boice, John D Jr; Shore, Roy E; Bernstein, Jonine L
2008 Jan 2;100(1):32-40, Journal of the National Cancer Institute
BACKGROUND: Results from randomized trials indicate that treatment with tamoxifen or chemotherapy for primary breast cancer reduces the risk for contralateral breast cancer. However, less is known about how long the risk is reduced and the impact of factors such as age and menopausal status. METHODS: The study included 634 women with contralateral breast cancer (case patients) and 1158 women with unilateral breast cancer (control subjects) from the Women's Environment, Cancer and Radiation Epidemiology Study. The women were younger than age 55 when they were first diagnosed with breast cancer during 1985-1999. Rate ratios (RRs) and 95% confidence intervals (CIs) for contralateral breast cancer after treatment with chemotherapy or tamoxifen were assessed by multivariable adjusted conditional logistic regression analyses. RESULTS: Chemotherapy was associated with a lower risk for contralateral breast cancer (RR = 0.57, 95% CI = 0.42 to 0.75) than no chemotherapy. A statistically significant association between chemotherapy and reduced risk for contralateral breast cancer persisted up to 10 years after the first breast cancer diagnosis and was stronger among women who became postmenopausal within 1 year of the first breast cancer diagnosis (RR = 0.28, 95% CI = 0.11 to 0.76). Tamoxifen use was also associated with reduced risk for contralateral breast cancer (RR = 0.66, 95% CI = 0.50 to 0.88) compared with no use, and the association was statistically significant for 5 years after the first diagnosis. CONCLUSION: The associations between chemotherapy and tamoxifen treatment and reduced risk for contralateral breast cancer appear to continue for 10 and 5 years, respectively, after the initial breast cancer is diagnosed. Ovarian suppression may have a role in the association between chemotherapy and reduced risk for contralateral breast cancer
— id: 135318, year: 2008, vol: 100, page: 32, stat: Journal Article,

Polymorphisms in RAD51, XRCC2, and XRCC3 are not related to breast cancer risk
Brooks, Jennifer; Shore, Roy E; Zeleniuch-Jacquotte, Anne; Currie, Diane; Afanasyeva, Yelena; Koenig, Karen L; Arslan, Alan A; Toniolo, Paolo; Wirgin, Isaac
2008 Apr;17(4):1016-1019, Cancer epidemiology biomarkers & prevention
— id: 80287, year: 2008, vol: 17, page: 1016, stat: Journal Article,

Vitamin D receptor polymorphisms and risk of epithelial ovarian cancer
Clendenen, Tess V; Arslan, Alan A; Koenig, Karen L; Enquist, Kerstin; Wirgin, Isaac; Agren, Asa; Lukanova, Annekatrin; Sjodin, Hubert; Zeleniuch-Jacquotte, Anne; Shore, Roy E; Hallmans, Goran; Toniolo, Paolo; Lundin, Eva
2008 Feb 18;260(1-2):209-215, Cancer letters
The vitamin D receptor (VDR) is a critical mediator of the cellular effects of vitamin D. The associations between four common VDR polymorphisms (BSMI, APAI, TAQI, and FOKI) and risk of epithelial ovarian cancer (EOC) were assessed in a case-control study nested within two prospective cohorts. One hundred seventy incident cases of EOC and 323 individually matched controls were genotyped. Overall, no associations were observed in genotype analyses. Haplotypes combining three SNPs in high linkage disequilibrium (BSMI, APAI, and TAQI) were also not associated with risk. These observations do not support a role for BSMI, APAI, TAQI, and FOKI polymorphisms in epithelial ovarian cancer in a predominantly Caucasian population
— id: 76858, year: 2008, vol: 260, page: 209, stat: Journal Article,

Risk for contralateral breast cancer among carriers of the CHEK2*1100delC mutation in the WECARE Study
Dahl C.; Christensen J.; Borresen-Dale A.-L.; Langholz B.; Andersson M.; Concannon P.; Olsen J.H.; Bernstein J.L.; Borresen-Dale A.L.; Borg A.; Bertelsen L.; Mellemkjaer L.; Guldberg P.; Liang X.; Wolitzer A.; Seminara D.; Haile R.W.; Diep A.T.; Zhou N.; Liu Y.; Ter-Karapetova E.; Hernandez A.; Orlow I.; Bernstein L.; Donnelly-Allen L.; Lynch C.F.; DeWall J.; Malone K.E.; Epstein N.; Anton-Culver H.; Largent J.; Stovall M.; Smith S.; Shore R.E.; Boice Jr. J.D.; Langholz B.M.; Thomas D.C.; Begg C.; Capanu M.; Thompson W.D.
2008 ;98(4):728-733, British journal of cancer
The protein encoded by the CHEK2 gene is involved in cellular repair of DNA damage. The truncating mutation, CHEK2*1100delC, seems to increase the risk for breast cancer. We investigated whether the CHEK2*1100delC mutation carrier status increases the risk for asynchronous contralateral breast cancer (CBC) and whether it interacts with radiation therapy (RT) or chemotherapy in regard to CBC risk. The germline mutation frequency was assessed in 708 women with CBC and 1395 women with unilateral breast cancer (UBC) in the Women's Environment, Cancer and Radiation Epidemiology (WECARE) Study whose first primary breast cancer was diagnosed before age 55 years and during 1985-1999. Seven women with CBC (1.0%) and 10 women with UBC (0.7%) were CHEK2*1100delC variant carriers (rate ratio (RR)=1.8, 95% confidence interval (CI)=0.6-5.4 for CBC vs UBC). Carriers who received RT for their first breast cancer, compared with non-carriers not treated with RT, had an RR of developing CBC of 2.6 (95% CI=0.8-8.7). We found no significant associations between the CHEK2*1100delC mutation and CBC overall or among those treated with RT. However, the sampling variability was such that modest increases in risk could not be excluded. Nonetheless, because this is a rare mutation, it is unlikely to explain a major fraction of CBC in the population. copyright 2008 Cancer Research UK All rights reserved
— id: 76162, year: 2008, vol: 98, page: 728, stat: Journal Article,

Polymorphisms in XPC and ERCC2 genes, smoking and breast cancer risk
Shore, Roy E; Zeleniuch-Jacquotte, Anne; Currie, Diane; Mohrenweiser, Harvey; Afanasyeva, Yelena; Koenig, Karen L; Arslan, Alan A; Toniolo, Paolo; Wirgin, Isaac
2008 May 1;122(9):2101-2105, International journal of cancer
To evaluate the associations of breast cancer risk with polymorphisms in the XPC and XPD/ERCC2 DNA nucleotide excision repair genes, a case-control study nested within a prospective cohort of 14,274 women was conducted. Genotypes were characterized for 612 incident, invasive breast cancer cases and their 1:1 matched controls. The homozygous variant of a poly(AT) insertion/deletion polymorphism in intron 9 of the XPC gene (XPC-PAT+/+), was associated with breast cancer risk [odds ratio (OR) = 1.45, 95% confidence interval: 1.07-1.97], after adjustment for other breast cancer risk factors. The breast cancer risk associated with XPC-PAT+/+ did not differ by age at diagnosis. There was an indication of an interaction (p = 0.08) between the XPC-PAT+/+ genotype and cigarette smoking. Ever smokers with the XPC-PAT+/+ genotype were at elevated risk of breast cancer (OR = 1.56, CI: 0.95-2.58), but no differences were observed among never smokers. Analyses of the ERCC2 Lys751Gln polymorphism did not show an association with breast cancer risk, either overall or at younger ages. The results suggest that breast cancer risk is related to the XPC haplotype tagged by the XPC-PAT+/+ insertion-deletion polymorphism in intron 9. Further study of the XPC haplotypes and their interactions with smoking in relation to breast cancer risk is needed
— id: 76390, year: 2008, vol: 122, page: 2101, stat: Journal Article,

Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study
Stovall, Marilyn; Smith, Susan A; Langholz, Bryan M; Boice, John D Jr; Shore, Roy E; Andersson, Michael; Buchholz, Thomas A; Capanu, Marinela; Bernstein, Leslie; Lynch, Charles F; Malone, Kathleen E; Anton-Culver, Hoda; Haile, Robert W; Rosenstein, Barry S; Reiner, Anne S; Thomas, Duncan C; Bernstein, Jonine L
2008 Nov 15;72(4):1021-1030, International journal of radiation oncology biology physics
PURPOSE: To quantify the risk of second primary breast cancer in the contralateral breast (CB) after radiotherapy (RT) for first breast cancer. METHODS AND MATERIALS: The study population included participants in the Women's Environmental, Cancer, and Radiation Epidemiology study: 708 cases (women with asynchronous bilateral breast cancer) and 1399 controls (women with unilateral breast cancer) counter-matched on radiation treatment. Participants were <55 years of age at first breast cancer. Absorbed doses to quadrants of the CB were estimated. Rate ratios (RR) and 95% confidence intervals (CI) were calculated using multivariable-adjusted conditional logistic regression models. RESULTS: Across all patients, the mean radiation dose to the specific quadrant of the CB tumor was 1.1 Gy. Women <40 years of age who received >1.0 Gy of absorbed dose to the specific quadrant of the CB had a 2.5-fold greater risk for CB cancer than unexposed women (RR = 2.5, 95% CI 1.4-4.5). No excess risk was observed in women >40 years of age. Women <40 years of age with follow-up periods >5 years had a RR of 3.0 (95% CI 1.1-8.1), and the dose response was significant (excess RR per Gy of 1.0, 95% CI 0.1-3.0). CONCLUSIONS: Women <40 years of age who received a radiation dose >1.0 Gy to the CB had an elevated, long-term risk of developing a second primary CB cancer. The risk is inversely related to age at exposure and is dose dependent
— id: 143385, year: 2008, vol: 72, page: 1021, stat: Journal Article,

Re: C-reactive protein and risk of breast cancer
Zeleniuch-Jacquotte, Anne; Gu, Yian; Bruning, Peter F; Bonfrer, Johannes M G; Koenig, Karen L; Arslan, Alan A; Toniolo, Paolo; Shore, Roy E
2008 Mar 19;100(6):443-444, Journal of the National Cancer Institute
— id: 93619, year: 2008, vol: 100, page: 443, stat: Journal Article,

Dosimetry for a study of low-dose radiation cataracts among Chernobyl clean-up workers
Chumak, V V; Worgul, B V; Kundiyev, Y I; Sergiyenko, N M; Vitte, P M; Medvedovsky, C; Bakhanova, E V; Junk, A K; Kyrychenko, O Y; Musijachenko, N V; Sholom, S V; Shylo, S A; Vitte, O P; Xu, S; Xue, X; Shore, R E
2007 May;167(5):606-614, Radiation research
A cohort of 8,607 Ukrainian Chernobyl clean-up workers during 1986-1987 was formed to study cataract formation after ionizing radiation exposure. Study eligibility required the availability of sufficient exposure information to permit the reconstruction of doses to the lens of the eye. Eligible groups included civilian workers, such as those who built the 'sarcophagus' over the reactor, Chernobyl Nuclear Power Plant Workers, and military reservists who were conscripted for clean-up work. Many of the official doses for workers were estimates, because only a minority wore radiation badges. For 106 military workers, electron paramagnetic resonance (EPR) measurements of extracted teeth were compared with the recorded doses as the basis to adjust the recorded gamma-ray doses and provide estimates of uncertainties. Beta-particle doses to the lens were estimated with an algorithm devised to take into account the nature and location of Chernobyl work, time since the accident, and protective measures taken. A Monte Carlo routine generated 500 random estimates for each individual from the uncertainty distributions of the gamma-ray dose and of the ratio of beta-particle to gamma-ray doses. The geometric mean of the 500 combined beta-particle and gamma-ray dose estimates for each individual was used in the data analyses. The median estimated lens dose for the cohort was 123 mGy, while 4.4% received >500 mGy
— id: 133538, year: 2007, vol: 167, page: 606, stat: Journal Article,

Analysis of radiation dose response with tumor location and location-specific dose in the WECARE study of second breast cancer
Langholz B.; Thomas D.C.; Stovall M.; Smith S.; Boice Jr. J.D.; Shore R.E.; Bernstein J.L.
2007 ;167(3):358-359, Radiation research
— id: 76785, year: 2007, vol: 167, page: 358, stat: Journal Article,

Cataracts among Chernobyl clean-up workers: Implications regarding permissible eye exposures
Woraul, BV; Kundiyev, YI; Sergiyenko, NM; Chumak, VV; Vitte, PM; Medvedovsky, C; Bakhanova, EV; Junk, AK; Kyrychenko, OY; Musijachenko, NV; Shylo, SA; Vitte, OP; Xu, S; Xue, X; Shore, RE
2007 FEB ;167(2):233-243, Radiation research
The eves of a prospective cohort of 8,607 Chernobyl cleanup workers (liquidators) were assessed for cataract at 12 and 14 years after exposure. The prevalence of strictly age-related cataracts was low, as expected (only 3.9% had nuclear cataracts at either examination), since 90% of the cohort was younger than 55 years of age at first examination. However, posterior subcapsular or cortical cataracts characteristic of radiation exposure were present in 25% of the subjects. The data for Stage I cataracts, and specifically for posterior subcapsular cataracts, revealed a significant dose response. When various cataract end points were analyzed for dose thresholds, the confidence intervals all excluded values greater than 700 mGy. Linear-quadratic dose-response models yielded mostly linear associations, with weak evidence of upward curvature. The findings do not support the ICRP 60 risk guideline assumption of a 5-Gy threshold for 'detectable opacities' from protracted exposures but rather point to a dose-effect threshold of under I Gy. Thus, given that cataract is the dose-limiting ocular pathology in current eye risk guidelines, revision of the allowable exposure of the human visual system to ionizing radiation should be considered. (c) 2007 by Radiation Research Society
— id: 70614, year: 2007, vol: 167, page: 233, stat: Journal Article,

Cox regression analysis in presence of collinearity: an application to assessment of health risks associated with occupational radiation exposure
Xue, Xiaonan; Kim, Mimi Y; Shore, Roy E
2007 Sep;13(3):333-350, Lifetime data analysis
This paper considers the analysis of time to event data in the presence of collinearity between covariates. In linear and logistic regression models, the ridge regression estimator has been applied as an alternative to the maximum likelihood estimator in the presence of collinearity. The advantage of the ridge regression estimator over the usual maximum likelihood estimator is that the former often has a smaller total mean square error and is thus more precise. In this paper, we generalized this approach for addressing collinearity to the Cox proportional hazards model. Simulation studies were conducted to evaluate the performance of the ridge regression estimator. Our approach was motivated by an occupational radiation study conducted at Oak Ridge National Laboratory to evaluate health risks associated with occupational radiation exposure in which the exposure tends to be correlated with possible confounders such as years of exposure and attained age. We applied the proposed methods to this study to evaluate the association of radiation exposure with all-cause mortality
— id: 149905, year: 2007, vol: 13, page: 333, stat: Journal Article,

Reliability of serum assays of iron status in postmenopausal women
Zeleniuch-Jacquotte, Anne; Zhang, Qi; Dai, Jisen; Shore, Roy E; Arslan, Alan A; Koenig, Karen L; Karkoszka, Jerzy; Afanasyeva, Yelena; Frenkel, Krystyna; Toniolo, Paolo; Huang, Xi
2007 May;17(5):354-358, Annals of epidemiology
PURPOSE: The aim of the study is to determine the reliability during a 2-year period of several newly developed iron-related assays to assess their potential for use in prospective epidemiologic studies. METHODS: We assessed the temporal reliability of several iron-related assays by using three serum samples collected at yearly intervals from 50 postmenopausal participants in a large prospective study. RESULTS: We observed high reliability coefficients for ferritin (0.78; 95% confidence interval [CI], 0.67-0.86), soluble transferrin receptor (sTfR; 0.79; 95% CI, 0.69-0.87), sTfR/ferritin ratio (0.74; 95% CI, 0.62-0.83), and hepcidin (0.89; 95% CI, 0.84-0.94). In a subset of 30 women, lower reliability was observed for serum iron (0.50; 95% CI, 0.29-0.70), unsaturated iron-binding capacity (0.55; 95% CI, 0.34-0.73), total iron-binding capacity (0.60; 95% CI, 0.40-0.76), and serum transferrin saturation rate (0.44; 95% CI, 0.22-0.65). The reliability of anti-5-hydroxymethyl-2'-deoxyuridine autoantibody titers, a biomarker of oxidized DNA damage, one of the mechanisms by which iron is thought to impact disease risk, was very high (0.97, 95% CI, 0.5-0.99). CONCLUSIONS: Our results show that some newly developed iron-related assays could be useful tools to assess iron-disease associations in prospective cohorts that collect a single blood sample
— id: 73252, year: 2007, vol: 17, page: 354, stat: Journal Article,

Cancer consequences of the Chernobyl accident: 20 years on
Cardis, Elisabeth; Howe, Geoffrey; Ron, Elaine; Bebeshko, Vladimir; Bogdanova, Tetyana; Bouville, Andre; Carr, Zhanat; Chumak, Vadim; Davis, Scott; Demidchik, Yuryi; Drozdovitch, Vladimir; Gentner, Norman; Gudzenko, Natalya; Hatch, Maureen; Ivanov, Victor; Jacob, Peter; Kapitonova, Eleonora; Kenigsberg, Yakov; Kesminiene, Ausrele; Kopecky, Kenneth J; Kryuchkov, Victor; Loos, Anja; Pinchera, Aldo; Reiners, Christoph; Repacholi, Michael; Shibata, Yoshisada; Shore, Roy E; Thomas, Gerry; Tirmarche, Margot; Yamashita, Shunichi; Zvonova, Irina
2006 Jun;26(2):127-140, Journal of radiological protection
26 April 2006 marks the 20th anniversary of the Chernobyl accident. On this occasion, the World Health Organization (WHO), within the UN Chernobyl Forum initiative, convened an Expert Group to evaluate the health impacts of Chernobyl. This paper summarises the findings relating to cancer. A dramatic increase in the incidence of thyroid cancer has been observed among those exposed to radioactive iodines in childhood and adolescence in the most contaminated territories. Iodine deficiency may have increased the risk of developing thyroid cancer following exposure to radioactive iodines, while prolonged stable iodine supplementation in the years after exposure may reduce this risk. Although increases in rates of other cancers have been reported, much of these increases appear to be due to other factors, including improvements in registration, reporting and diagnosis. Studies are few, however, and have methodological limitations. Further, because most radiation-related solid cancers continue to occur decades after exposure and because only 20 years have passed since the accident, it is too early to evaluate the full radiological impact of the accident. Apart from the large increase in thyroid cancer incidence in young people, there are at present no clearly demonstrated radiation-related increases in cancer risk. This should not, however, be interpreted to mean that no increase has in fact occurred: based on the experience of other populations exposed to ionising radiation, a small increase in the relative risk of cancer is expected, even at the low to moderate doses received. Although it is expected that epidemiological studies will have difficulty identifying such a risk, it may nevertheless translate into a substantial number of radiation-related cancer cases in the future, given the very large number of individuals exposed
— id: 72191, year: 2006, vol: 26, page: 127, stat: Journal Article,

Dairy products and ovarian cancer: a pooled analysis of 12 cohort studies
Genkinger, Jeanine M; Hunter, David J; Spiegelman, Donna; Anderson, Kristin E; Arslan, Alan; Beeson, W Lawrence; Buring, Julie E; Fraser, Gary E; Freudenheim, Jo L; Goldbohm, R Alexandra; Hankinson, Susan E; Jacobs, David R Jr; Koushik, Anita; Lacey, James V Jr; Larsson, Susanna C; Leitzmann, Michael; McCullough, Marji L; Miller, Anthony B; Rodriguez, Carmen; Rohan, Thomas E; Schouten, Leo J; Shore, Roy; Smit, Ellen; Wolk, Alicja; Zhang, Shumin M; Smith-Warner, Stephanie A
2006 Feb;15(2):364-372, Cancer epidemiology biomarkers & prevention
BACKGROUND: Dairy foods and their constituents (lactose and calcium) have been hypothesized to promote ovarian carcinogenesis. Although case-control studies have reported conflicting results for dairy foods and lactose, several cohort studies have shown positive associations between skim milk, lactose, and ovarian cancer. METHODS: A pooled analysis of the primary data from 12 prospective cohort studies was conducted. The study population consisted of 553,217 women among whom 2,132 epithelial ovarian cases were identified. Study-specific relative risks and 95% confidence intervals were calculated by Cox proportional hazards models and then pooled by a random-effects model. RESULTS: No statistically significant associations were observed between intakes of milk, cheese, yogurt, ice cream, and dietary and total calcium intake and risk of ovarian cancer. Higher lactose intakes comparing > or = 30 versus <10 g/d were associated with a statistically significant higher risk of ovarian cancer, although the trend was not statistically significant (pooled multivariate relative risk, 1.19; 95% confidence interval, 1.01-1.40; P(trend) = 0.19). Associations for endometrioid, mucinous, and serous ovarian cancer were similar to the overall findings. DISCUSSION: Overall, no associations were observed for intakes of specific dairy foods or calcium and ovarian cancer risk. A modest elevation in the risk of ovarian cancer was seen for lactose intake at the level that was equivalent to three or more servings of milk per day. Because a new dietary guideline recommends two to three servings of dairy products per day, the relation between dairy product consumption and ovarian cancer risk at these consumption levels deserves further examination
— id: 72192, year: 2006, vol: 15, page: 364, stat: Journal Article,

Methods for pooling results of epidemiologic studies: the Pooling Project of Prospective Studies of Diet and Cancer
Smith-Warner, Stephanie A; Spiegelman, Donna; Ritz, John; Albanes, Demetrius; Beeson, W Lawrence; Bernstein, Leslie; Berrino, Franco; van den Brandt, Piet A; Buring, Julie E; Cho, Eunyoung; Colditz, Graham A; Folsom, Aaron R; Freudenheim, Jo L; Giovannucci, Edward; Goldbohm, R Alexandra; Graham, Saxon; Harnack, Lisa; Horn-Ross, Pamela L; Krogh, Vittorio; Leitzmann, Michael F; McCullough, Marjorie L; Miller, Anthony B; Rodriguez, Carmen; Rohan, Thomas E; Schatzkin, Arthur; Shore, Roy; Virtanen, Mikko; Willett, Walter C; Wolk, Alicja; Zeleniuch-Jacquotte, Anne; Zhang, Shumin M; Hunter, David J
2006 Jun 1;163(11):1053-1064, American journal of epidemiology
With the growing number of epidemiologic publications on the relation between dietary factors and cancer risk, pooled analyses that summarize results from multiple studies are becoming more common. Here, the authors describe the methods being used to summarize data on diet-cancer associations within the ongoing Pooling Project of Prospective Studies of Diet and Cancer, begun in 1991. In the Pooling Project, the primary data from prospective cohort studies meeting prespecified inclusion criteria are analyzed using standardized criteria for modeling of exposure, confounding, and outcome variables. In addition to evaluating main exposure-disease associations, analyses are also conducted to evaluate whether exposure-disease associations are modified by other dietary and nondietary factors or vary among population subgroups or particular cancer subtypes. Study-specific relative risks are calculated using the Cox proportional hazards model and then pooled using a random- or mixed-effects model. The study-specific estimates are weighted by the inverse of their variances in forming summary estimates. Most of the methods used in the Pooling Project may be adapted for examining associations with dietary and nondietary factors in pooled analyses of case-control studies or case-control and cohort studies combined
— id: 72085, year: 2006, vol: 163, page: 1053, stat: Journal Article,

Estimation of health risks associated with occupational radiation exposure: addressing measurement error and minimum detectable exposure level
Xue, Xiaonan; Kim, Mimi Y; Shore, Roy E
2006 Dec;91(6):582-591, Health physics
Occupational exposures are subject to several types of measurement errors. This paper considers two of the most common types of measurement error associated with occupational exposures: the error due to below minimum detection level and doses due to random measurement error. Doses are often recorded as zero when the exposure is below the minimum detection level. Values that are below the minimum detection level and are entered as zero lead to underestimation of the true exposure and can result in either an overestimate or underestimate of risk associated with the exposure. Random measurement error leads to an inefficient and attenuated estimate of risk associated with exposure. However, the levels of bias and inefficiency that can result from the simultaneous presence of both types of measurement error have not previously been studied. In addition, the impact of these measurement errors on the type I error and type II error for an exposure-response effect is unclear. Since the magnitude of the random error associated with cumulative exposure may vary with individuals and across time within an individual, traditional methods to correct for random measurement errors are not applicable here. Further, correcting errors for minimum detectable levels and random errors simultaneously is too complex for analytical solutions. Therefore, this paper uses simulation studies to quantitatively evaluate the magnitude of the bias, inefficiency, and type I and type II errors associated with them. The simulation results are applied to a sample of historical occupational radiation exposure data from the Oak Ridge National Laboratory. We conclude that after taking into consideration random measurement error and missed doses due to falling below the minimum detection level, radiation exposure is not significantly associated with all-cause mortality in that cohort
— id: 72190, year: 2006, vol: 91, page: 582, stat: Journal Article,

Circulating enterolactone and risk of endometrial cancer
Zeleniuch-Jacquotte, Anne; Lundin, Eva; Micheli, Andrea; Koenig, Karen L; Lenner, Per; Muti, Paola; Shore, Roy E; Johansson, Ingegerd; Krogh, Vittorio; Lukanova, Annekatrin; Stattin, Par; Afanasyeva, Yelena; Rinaldi, Sabina; Arslan, Alan A; Kaaks, Rudolf; Berrino, Franco; Hallmans, Goran; Toniolo, Paolo; Adlercreutz, Herman
2006 Nov 15;119(10):2376-2381, International journal of cancer
It has been suggested that phytoestrogens protect against hormone-dependent cancers. Lignans are the main class of phytoestrogens in Western diets. We conducted a prospective study of endometrial cancer and circulating levels of the main human lignan, enterolactone. The design was a case-control study nested within 3 prospective cohort studies, in New York, Sweden and Italy. Serum or plasma samples had been collected at enrollment and stored at -80 degrees C. A total of 153 cases, diagnosed a median of 5.3 years after blood donation, and 271 matched controls were included. No difference in circulating enterolactone was observed between cases (median, 19.2 nmol/L) and controls (18.5 nmol/L). Adjusting for body mass index, the odds ratio for the top tertile of enterolactone, as compared to the lowest was 1.2 (95% CI, 0.7-2.0; p for trend = 0.53). Lack of association was observed in both pre- and postmenopausal women. No correlation was observed between enterolactone and circulating estrogens or SHBG in healthy postmenopausal women. These results do not support a protective role of circulating lignans, in the range of levels observed, against endometrial cancer
— id: 69245, year: 2006, vol: 119, page: 2376, stat: Journal Article,

Personal and occupational exposure to organic solvents and risk of non-Hodgkin's lymphoma (NHL) in women (United States)
Kato, Ikuko; Koenig, Karen L; Watanabe-Meserve, Hiroko; Baptiste, Mark S; Lillquist, Patricia P; Frizzera, Glauco; Burke, Jerome S; Moseson, Miriam; Shore, Roy E
2005 Dec;16(10):1215-1224, Cancer causes & control. ccc
OBJECTIVES: The authors assessed whether home and occupational exposure to organic solvents is associated with risk of NHL in women. METHODS: A population-based, incidence case-control study was conducted in upstate New York, involving 376 NHL cases and 463 population controls selected from the Medicare beneficiary files and State driver's license records. Exposure information was obtained by telephone interview. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using an unconditional logistic regression model, adjusting for a number of risk factors for NHL. RESULTS: Overall, history of exposure to organic solvents was not associated with the risk of NHL. A statistically significant increase in risk associated with occupational exposure was observed only for the subjects whose first exposure occurred before 1970 (OR=1.87, 95% CI 1.03-3.40). When occupational and home exposures to paint thinners/turpentine were combined and analyzed together, the risk of NHL associated with any exposure, compared to no exposure at either job or home, was a statistically significantly increased (OR=1.46, 95% CI: 1.05-2.03). This observation was more pronounced for B-cell lymphoma and for low-grade lymphoma with ORs of 1.52 (95 CI: 1.08-2.14) and 2.20 (95% CI; 1.42-3.41), respectively. CONCLUSIONS: The results of this case-control study do support of a major role of organic solvents in the development of NHL among women currently living in the US. However, relatively intensive exposure in past occupations and use of paint thinners/turpentine may deserve further investigation
— id: 72139, year: 2005, vol: 16, page: 1215, stat: Journal Article,

Biomarkers of benzene: Urinary metabolites in relation to individual genotype and personal exposure
Qu, Qingshan; Shore, Roy; Li, Guilan; Su, Lin; Jin, Ximei; Melikian, Asseih A; Roy, Nirmal; Chen, Lung Chi; Wirgin, Isaac; Cohen, Beverly; Yin, Songnian; Li, Yuying; Mu, Ruidong
2005 May 30;153-154:85-95, Chemico-biological interactions
This report is part of an extensive biomarker study conducted in a Chinese occupational population with benzene exposures ranging from 0.06 to 122ppm (median exposure of 3.2ppm). All urinary benzene metabolites measured in this study were significantly elevated after exposure to benzene at or above 5ppm. Among these metabolites, however, only S-phenylmercapturic acid (S-PMA) and trans,trans-muconic acid (t,t-MA) showed a significant exposure-response trend over the exposure range from 0 to 1ppm (for S-PMA, p<0.0001 and for t,t-MA, p=0.006). For benzene exposure monitoring, both S-PMA and t,t-MA were judged to be good and sensitive markers, which detected benzene exposure at around 0.1 and 1ppm, respectively. Polymorphisms of the metabolic genes, including CYP2E1, quinone oxidoreductase (NQO1), GSTT1, and myeloperoxidase (MPO), were identified and did not show significant effects on the formation of metabolites, except GSTT1 on S-PMA. The production rate of S-PMA from benzene in exposed workers with GSTT1 null alleles (24.72+/-32.48mug/g creatinine/ppm benzene) was significantly lower than that in subjects with the wild type of GSTT1 (59.84+/-47.66mug/g creatinine/ppm benzene, p<0.0001). Further regression analysis of S-PMA production rate on GSTT1 genotype with adjustment of sex, age, benzene exposure, and cotinine levels indicated that the genotype of GSTT1 plays a critical role in determining the inter-individual variations of S-PMA formation from benzene exposure. Therefore, the individual genotype of GSTT1 needs to be identified and considered while using S-PMA as a marker to estimate the personal exposure levels of benzene in future population studies
— id: 56002, year: 2005, vol: 153-154, page: 85, stat: Journal Article,

Protein adducts as biomarkers of human benzene metabolism
Rappaport, Stephen M; Waidyanatha, Suramya; Yeowell-O'Connell, Karen; Rothman, Nathaniel; Smith, Martyn T; Zhang, Luoping; Qu, Qingshan; Shore, Roy; Li, Guilan; Yin, Songnian
2005 May 30;153-154:103-109, Chemico-biological interactions
We used cysteinyl adducts of serum albumin (Alb) to investigate the production of two reactive benzene metabolites, namely, benzene oxide (BO) and 1,4-benzoquinone (1,4-BQ) in workers exposed to benzene. Adducts were measured in 160 benzene-exposed workers who did not use respiratory protection (based upon individual geometric mean benzene exposure levels: median=5.27 ppm, interquartile range=2.14-13.4 ppm, range=0.074-328 ppm) and 101 local controls, from populations in Shanghai and Tianjin, China. After isolation of Alb, these adducts (designated as BO-Alb and 1,4-BQ-Alb) were cleaved from the protein with methanesulfonic acid and trifluoroacetic anhydride and measured by gas chromatography-mass spectrometry. Although BO-Alb and 1,4-BQ-Alb were measured in all subjects, levels of both adducts were 2.4-fold greater (median value) in exposed subjects than in controls (interquartile-fold range=1.63-4.05 for BO-Alb and 1.64-3.69 for 1,4-BQ-Alb). Log-log plots of the individual adduct levels versus exposure were quasi-linear with straight-line slopes of about 0.3 for both BO-Alb and 1,4-BQ-Alb. Since these log-space slopes were significantly less than one, we infer that adduct production was nonlinear, i.e., less-than proportional to benzene exposure, over the indicated range. This behavior points to saturation of CYP2E1 as a critical metabolic consequence of high exposure to benzene in humans. Thus, the biologically effective dose of BO and 1,4-BQ should be proportionally greater in persons exposed to low rather than high levels of benzene
— id: 72193, year: 2005, vol: 153-154, page: 103, stat: Journal Article,

Insulin-like growth factor-I, IGF binding protein-3, and breast cancer in young women: a comparison of risk estimates using different peptide assays
Rinaldi, Sabina; Kaaks, Rudolf; Zeleniuch-Jacquotte, Anne; Arslan, Alan A; Shore, Roy E; Koenig, Karen L; Dossus, Laure; Riboli, Elio; Stattin, Par; Lukanova, Annekatrin; Toniolo, Paolo
2005 Jan;14(1):48-52, Cancer epidemiology biomarkers & prevention
Circulating insulin-like growth factor-I (IGF-I) and its major binding protein IGF binding protein-3 (IGFBP-3) have been associated with increased risk of premenopausal breast cancer, although risk estimates varied broadly. An extension of a case-control study (138 cases, 259 matched controls) on IGF-I and breast cancer in premenopausal women nested in the New York University Women's Health Study cohort offered the opportunity to address the hypothesis that such variability may have been the result of variations in the ability of different IGFBP-3 assays to specifically measure intact/functional forms of the protein. IGF-I and IGFBP-3 had originally been measured using in-house RIAs. These measurements were repeated using commercially available ELISAs [Diagnostic System Laboratories (DSL), Webster, Texas], and a third ELISA with greater specificity for active forms for IGFBP-3. Pearson's correlations between IGF-I concentrations in the original study and DSL ELISA were very high [r = 0.92; 95% CI, 0.90-0.94]. Correlations with DSL ELISA were much lower for IGFBP-3 (r = 0.58; 0.49-0.66) and even lower still with the assay for functional IGFBP-3 (r = 0.33; 0.20-0.44). IGF-I and IGFBP-3 measurements by the DSL ELISA methods showed statistically significant relationships with risk. The odds ratios (OR) for top versus bottom quartiles were 1.93 (1.00-3.72; P = 0.02) and 2.03 (1.09-3.76; P = 0.02), respectively, in agreement with the original observations. In contrast, measurements of functional IGFBP-3 tended to be unrelated to risk [ORs for the top versus bottom quartile, 0.97 (0.44-2.11)]. The association with IGF-I became substantially weaker and lost statistical significance after adjustment for IGFBP-3 using DSL ELISA, but became considerably stronger when adjusting for the functional IGFBP-3 measurements [OR = 2.43 (1.21-4.90); P = 0.005], or when considering the molar ratio of IGF-I to IGFBP-3 [OR = 2.37 (1.13-5.00); P = 0.02]. These results are consistent with an association of breast cancer risk in young women with elevated IGF-I and IGFBP-3, and show that for IGFBP-3, the strength of such an association could vary substantially depending on the assay used
— id: 72082, year: 2005, vol: 14, page: 48, stat: Journal Article,

IGF-I, IGFBP-3 and breast cancer in young women: a pooled re-analysis of three prospective studies
Rinaldi, Sabina; Toniolo, Paolo; Muti, Paola; Lundin, Eva; Zeleniuch-Jacquotte, Anne; Arslan, Alan; Micheli, Andrea; Lenner, Per; Dossus, Laure; Krogh, Vittorio; Shore, Roy E; Koenig, Karen L; Riboli, Elio; Stattin, Par; Berrino, Franco; Hallmans, Goran; Lukanova, Annekatrin; Kaaks, Rudolf
2005 Dec;14(6):493-496, European journal of cancer prevention
Prospective cohort studies on breast cancer risk among premenopausal women and insulin-like growth factor I (IGF-I) concentrations have so far included only few cases, and have shown inconsistent relative risk estimates. We pooled 220 cases of breast cancer diagnosed before age 50, and 434 control subjects, from three prospective studies in New York (USA), Umea (Northern Sweden) and Milan (Italy), and we measured IGF-I and insulin-like growth factor binding protein 3 (IGFBP-3) with common enzyme-linked immunosorbent assays. Overall, IGF-I and IGFBP-3 measurements obtained by the common method showed a positive but not significant relationship with breast cancer risk (odds ratios (ORs) 0.90 [95% confidence intervals (95% CI) 0.50-1.62], 1.63 [0.89-2.97], 1.46 [0.78-2.73] and 1.41 [0.75-2.63] for quintiles of IGF-I, and ORs 0.98 [0.54-1.75], 1.06 [0.59-1.91], 1.04 [0.58-1.87] and 1.77 [0.97-3.24] for quintiles of IGFBP-3). Our results give only moderate support for an association of blood IGF-I with breast cancer risk in young women
— id: 72088, year: 2005, vol: 14, page: 493, stat: Journal Article,

Postmenopausal levels of sex hormones and risk of breast carcinoma in situ: results of a prospective study
Zeleniuch-Jacquotte, Anne; Gu, Yian; Shore, Roy E; Koenig, Karen L; Arslan, Alan A; Kato, Ikuko; Rinaldi, Sabina; Kaaks, Rudolf; Toniolo, Paolo
2005 Mar 20;114(2):323-327, International journal of cancer
We report on a prospective study to assess the association of postmenopausal serum levels of sex hormones with subsequent risk of breast carcinoma in situ. We conducted a case-control study nested within the cohort of the New York University Women's Health Study, a large prospective study documenting a positive association of circulating levels of estrogens and androgens with invasive breast cancer. The study included 69 cases of incident in situ carcinoma and 134 individually matched controls. No statistically significant trend of increasing risk with increasing level of any of the hormones was observed. Odds ratios (95% CIs) for the highest tertile relative to the lowest were 1.10 (0.51-2.39) for estradiol, 0.95 (0.41-2.19) for estrone, 1.63 (0.69-3.88) for testosterone, 0.99 (0.44-2.24) for androstenedione, 0.99 (0.45-2.20) for dehydroepiandrosterone sulfate and 0.81 (0.38-1.74) for sex hormone-binding globulin. Adjusting for potential confounders did not materially affect the results, nor did limiting the analysis to the 59 cases of ductal carcinoma in situ, the lesion thought to be the direct precursor of most invasive breast cancers. Our results are at variance with the positive associations observed in this same cohort with risk of invasive breast cancer. Possible explanations for our results include lack of power, an effect of sex hormones limited to the progression from in situ to invasive tumors, overrepresentation of indolent tumors or an effect of sex hormones on the induction of only a subset of in situ tumors, those that would develop into invasive tumors
— id: 51094, year: 2005, vol: 114, page: 323, stat: Journal Article,

A case-control study of workplace exacerbation of asthma symptoms
Berger, Z; Kim, M; Reibman, J; Shore, R; Friedman-Jimenez, G
2004 JUN 1 ;159(11):S78-S78, American journal of epidemiology
— id: 46558, year: 2004, vol: 159, page: S78, stat: Journal Article,

Study design: evaluating gene-environment interactions in the etiology of breast cancer - the WECARE study
Bernstein, Jonine L; Langholz, Bryan; Haile, Robert W; Bernstein, Leslie; Thomas, Duncan C; Stovall, Marilyn; Malone, Kathleen E; Lynch, Charles F; Olsen, Jorgen H; Anton-Culver, Hoda; Shore, Roy E; Boice, John D Jr; Berkowitz, Gertrud S; Gatti, Richard A; Teitelbaum, Susan L; Smith, Susan A; Rosenstein, Barry S; Borresen-Dale, Anne-Lise; Concannon, Patrick; Thompson, W Douglas
2004 ;6(3):R199-R214, Breast cancer research
INTRODUCTION: Deficiencies in cellular responses to DNA damage can predispose to cancer. Ionizing radiation can cause cluster damage and double-strand breaks (DSBs) that pose problems for cellular repair processes. Three genes (ATM, BRCA1, and BRCA2) encode products that are essential for the normal cellular response to DSBs, but predispose to breast cancer when mutated. DESIGN: To examine the joint roles of radiation exposure and genetic susceptibility in the etiology of breast cancer, we designed a case-control study nested within five population-based cancer registries. We hypothesized that a woman carrying a mutant allele in one of these genes is more susceptible to radiation-induced breast cancer than is a non-carrier. In our study, 700 women with asynchronous bilateral breast cancer were individually matched to 1400 controls with unilateral breast cancer on date and age at diagnosis of the first breast cancer, race, and registry region, and counter-matched on radiation therapy. Each triplet comprised two women who received radiation therapy and one woman who did not. Radiation absorbed dose to the contralateral breast after initial treatment was estimated with a comprehensive dose reconstruction approach that included experimental measurements in anthropomorphic and water phantoms applying patient treatment parameters. Blood samples were collected from all participants for genetic analyses. CONCLUSIONS: Our study design improves the potential for detecting gene-environment interactions for diseases when both gene mutations and the environmental exposures of interest are rare in the general population. This is particularly applicable to the study of bilateral breast cancer because both radiation dose and genetic susceptibility have important etiologic roles, possibly by interactive mechanisms. By using counter-matching, we optimized the informativeness of the collected dosimetry data by increasing the variability of radiation dose within the case-control sets and enhanced our ability to detect radiation-genotype interactions
— id: 72195, year: 2004, vol: 6, page: R199, stat: Journal Article,

Effect of acculturation on objective measures of oral health in Haitian immigrants in New York City
Cruz, G D; Shore, R; Le Geros, R Z; Tavares, M
2004 Feb;83(2):180-184, Journal of dental research
Acculturation is a complex phenomenon that can serve as a proxy for cultural norms and behaviors affecting care-seeking, prevention behaviors, and, ultimately, health outcomes. The purpose of this study was to assess the effect of acculturation on the oral health of Haitian immigrants in New York City. We hypothesized that acculturation would be a predictor of the oral health status of the participating individuals. An acculturation scale was specifically developed and validated for this study. A sample of 425 adult Haitian immigrants living in NYC was obtained through outreach activities. Oral health examinations were conducted, and a questionnaire was administered to the participants. After adjustment for age, sex, education, income, and marital status, acculturation was negatively associated with measures of decayed teeth, periodontal attachment loss of > or = 4 mm, and the number of missing teeth. Results suggest a positive impact of acculturation on the oral health status of these individuals
— id: 147025, year: 2004, vol: 83, page: 180, stat: Journal Article,

Pesticide product use and risk of non-hodgkin lymphoma in women
Kato, Ikuko; Watanabe-Meserve, Hiroko; Koenig, Karen L; Baptiste, Mark S; Lillquist, Patricia P; Frizzera, Glauco; Burke, Jerome S; Moseson, Miriam; Shore, Roy E
2004 Sep;112(13):1275-1281, Environmental health perspectives
A population-based, incidence case-control study was conducted among women in upstate New York to determine whether pesticide exposure is associated with an increase in risk of non-Hodgkin lymphoma (NHL) among women. The study involved 376 cases of NHL identified through the State Cancer Registry and 463 controls selected from the Medicare beneficiary files and state driver's license records. Information about history of farm work, history of other jobs associated with pesticide exposure, use of common household pesticide products, and potential confounding variables was obtained by telephone interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using an unconditional logistic regression model. The risk of NHL was doubled (OR = 2.12; 95% CI, 1.21-3.71) among women who worked for at least 10 years at a farm where pesticides were reportedly used. When both farming and other types of jobs associated with pesticide exposure were combined, there was a progressive increase in risk of NHL with increasing duration of such work ((italic)p(/italic) = 0.005). Overall cumulative frequency of use of household pesticide products was positively associated with risk of NHL ((italic)p(/italic) = 0.004), which was most pronounced when they were applied by subjects themselves. When exposure was analyzed by type of products used, a significant association was observed for mothballs. The associations with both occupational and household pesticides were particularly elevated if exposure started in 1950-1969 and for high-grade NHL. Although the results of this case-control study suggest that exposure to pesticide products may be associated with an increased risk of NHL among women, methodologic limitations related to selection and recall bias suggest caution in inferring causation. Key words: case-control study, mothballs, NHL, pesticides
— id: 44747, year: 2004, vol: 112, page: 1275, stat: Journal Article,

Funding crisis at the Radiation Effects Research Foundation
Little, Mark P; Blettner, Maria; Boice, John D Jr; Bridges, Bryn A; Cardis, Elisabeth; Charles, Monty W; de Vathaire, Florent; Doll, Richard; Fujimoto, Kenzo; Goodhead, Dudley T; Grosche, Bernd; Hall, Per; Heidenreich, Wolfgang F; Jacob, Peter; Moolgavkar, Suresh H; Muirhead, Colin R; Niwa, Ohtsura; Paretzke, Herwig G; Richardson, Richard B; Samet, Jonathan M; Sasaki, Yasuhito; Shore, Roy E; Straume, Tore; Wakeford, Richard
2004 Sep;24(3):195-197, Journal of radiological protection
— id: 72194, year: 2004, vol: 24, page: 195, stat: Journal Article,

Potential funding crisis for the Radiation Effects Research Foundation
Little, Mark P; Blettner, Maria; Boice, John D Jr; Bridges, Bryn A; Cardis, Elisabeth; Charles, Monty W; de Vathaire, Florent; Doll, Richard; Fujimoto, Kenzo; Goodhead, Dudley; Grosche, Bernd; Hall, Per; Heidenreich, Wolfgang F; Jacob, Peter; Moolgavkar, Suresh H; Muirhead, Colin R; Niwa, Ohtsura; Paretzke, Herwig G; Richardson, Richard B; Samet, Jonathan M; Sasaki, Yasuhito; Shore, Roy E; Straume, Tore; Wakeford, Richard
2004 Aug 14;364(9434):557-558, Lancet
— id: 44992, year: 2004, vol: 364, page: 557, stat: Journal Article,

Body mass index, circulating levels of sex-steroid hormones, IGF-I and IGF-binding protein-3: a cross-sectional study in healthy women
Lukanova, A; Lundin, E; Zeleniuch-Jacquotte, A; Muti, P; Mure, A; Rinaldi, S; Dossus, L; Micheli, A; Arslan, A; Lenner, P; Shore, R E; Krogh, V; Koenig, K L; Riboli, E; Berrino, F; Hallmans, G; Stattin, P; Toniolo, P; Kaaks, R
2004 Feb;150(2):161-171, European journal of endocrinology
OBJECTIVE: Excess weight has been associated with increased risk of cancer at several organ sites. In part, this effect may be modulated through alterations in the metabolism of sex steroids and IGF-I related peptides. The objectives of the study were to examine the association of body mass index (BMI) with circulating androgens (testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEAS)), estrogens (estrone and estradiol), sex hormone-binding globulin (SHBG), IGF-I and IGF-binding protein (IGFBP)-3, and the relationship between sex steroids, IGF-I and IGFBP-3. DESIGN AND METHODS: A cross-sectional analysis was performed using hormonal and questionnaire data of 620 healthy women (177 pre- and 443 post-menopausal). The laboratory measurements of the hormones of interest were available from two previous case-control studies on endogenous hormones and cancer risk. RESULTS: In the pre-menopausal group, BMI was not related to androgens and IGF-I. In the post-menopausal group, estrogens, testosterone and androstenedione increased with increasing BMI. The association with IGF-I was non-linear, with the highest mean concentrations observed in women with BMI between 24 and 25. In both pre- and post-menopausal subjects, IGFBP-3 did not vary across BMI categories and SHBG decreased with increasing BMI. As for the correlations between peptide and steroid hormones, in the post-menopausal group, IGF-I was positively related to androgens, inversely correlated with SHBG, and not correlated with estrogens. In the pre-menopausal group, similar but weaker correlations between IGF-I and androgens were observed. CONCLUSIONS: These observations offer evidence that obesity may influence the levels of endogenous sex-steroid and IGF-related hormones in the circulation, especially after menopause. Circulating IGF-I, androgens and SHBG appear to be related to each other in post-menopausal women
— id: 44748, year: 2004, vol: 150, page: 161, stat: Journal Article,

Circulating levels of sex steroid hormones and risk of endometrial cancer in postmenopausal women
Lukanova, Annekatrin; Lundin, Eva; Micheli, Andrea; Arslan, Alan; Ferrari, Pietro; Rinaldi, Sabina; Krogh, Vittorio; Lenner, Per; Shore, Roy E; Biessy, Carine; Muti, Paola; Riboli, Elio; Koenig, Karen L; Levitz, Mortimer; Stattin, Par; Berrino, Franco; Hallmans, Goran; Kaaks, Rudolf; Toniolo, Paolo; Zeleniuch-Jacquotte, Anne
2004 Jan 20;108(3):425-432, International journal of cancer
Experimental and epidemiological data support a role for sex steroid hormones in the pathogenesis of endometrial cancer. The associations of pre-diagnostic blood concentrations of estradiol, estrone, testosterone, androstenedione, DHEAS and SHBG with endometrial cancer risk were investigated. A case-control study was nested within 3 cohorts in New York (USA), Umea (Sweden) and Milan (Italy). Cases were 124 postmenopausal women with invasive endometrial cancer. For each case, 2 controls were selected, matching the case on cohort, age and date of recruitment. Only postmenopausal women who did not use exogenous hormones at the time of blood donation were included. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated by conditional logistic regression. ORs (95% CI) for endometrial cancer for quartiles with the highest hormone levels, relative to the lowest were as follows: 4.13 (1.76-9.72), p(trend) = 0.0008 for estradiol, 3.67 (1.71-7.88), p(trend) = 0.0007 for estrone, 2.15 (1.05-4.40), p(trend) = 0.04 for androstenedione, 1.74 (0.88-3.46), p(trend) = 0.06 for testosterone, 2.90 (1.42-5.90), p(trend) = 0.002 for DHEAS and 0.46 (0.20-1.05), p(trend) = 0.01 for SHBG after adjustment for body mass index, use of oral contraceptives and hormone replacement therapy. The results of our multicenter prospective study showed a strong direct association of circulating estrogens, androgens and an inverse association of SHBG levels with endometrial cancer in postmenopausal women. The effect of elevated androstenedione and testosterone levels on disease risk seems to be mediated mainly through their conversion to estrogens, although an independent effect of androgens on tumor growth cannot be ruled out, in particular in the years close to diagnosis
— id: 44750, year: 2004, vol: 108, page: 425, stat: Journal Article,

Prediagnostic levels of C-peptide, IGF-I, IGFBP -1, -2 and -3 and risk of endometrial cancer
Lukanova, Annekatrin; Zeleniuch-Jacquotte, Anne; Lundin, Eva; Micheli, Andrea; Arslan, Alan A; Rinaldi, Sabina; Muti, Paola; Lenner, Per; Koenig, Karen L; Biessy, Carine; Krogh, Vittorio; Riboli, Elio; Shore, Roy E; Stattin, Par; Berrino, Franco; Hallmans, Goran; Toniolo, Paolo; Kaaks, Rudolf
2004 Jan 10;108(2):262-268, International journal of cancer
Conditions related to chronic hyperinsulinemia, such as obesity, noninsulin dependent diabetes mellitus and polycystic ovary syndrome, are associated with an increased risk of endometrial cancer. Elevated plasma IGF-I and decreased levels of IGF-binding proteins have been shown to be associated with increased risk of several cancer types that are frequent in affluent societies. We investigated for the first time in a prospective study the association of pre-diagnostic blood concentrations of C-peptide (a marker of pancreatic insulin production), IGF-I, IGFBP-1, -2 and -3 with endometrial cancer risk. A case-control study was nested within 3 cohorts in New York (USA), Umea (Sweden) and Milan (Italy). It included 166 women with primary invasive endometrial cancer and 315 matched controls, of which 44 case and 78 control subjects were premenopausal at recruitment. Endometrial cancer risk increased with increasing levels of C-peptide (ptrend = 0.0002), up to an odds ratio (OR) of 4.76 [95% confidence interval (CI) = 1.91-11.8] for the highest quintile. This association remained after adjustment for BMI and other confounders [OR for the top quintile = 4.40 (1.65-11.7)]. IGFBP-1 levels were inversely related to endometrial cancer [ptrend = 0.002; OR in the upper quintile = 0.30 (0.15-0.62)], but the association was weakened and lost statistical significance after adjustment for confounders [ptrend = 0.06; OR in the upper quintile = 0.49 (0.22-1.07)]. Risk was unrelated to levels of IGF-I, IGFBP-2 and IGFBP-3. Chronic hyperinsulinemia, as reflected by increased circulating C-peptide, is associated with increased endometrial cancer risk. Decrease in the prevalence of chronic hyperinsulinemia, through changes in lifestyle or medication, is expected to prevent endometrial cancer
— id: 44751, year: 2004, vol: 108, page: 262, stat: Journal Article,

Estimating the dose response relationship for occupational radiation exposure measured with minimum detection level
Xue, Xiaonan; Shore, Roy E; Ye, Xiangyang; Kim, Mimi Y
2004 Oct;87(4):397-404, Health physics
Occupational exposures are often recorded as zero when the exposure is below the minimum detection level (BMDL). This can lead to an underestimation of the doses received by individuals and can lead to biased estimates of risk in occupational epidemiologic studies. The extent of the exposure underestimation is increased with the magnitude of the minimum detection level (MDL) and the frequency of monitoring. This paper uses multiple imputation methods to impute values for the missing doses due to BMDL. A Gibbs sampling algorithm is developed to implement the method, which is applied to two distinct scenarios: when dose information is available for each measurement (but BMDL is recorded as zero or some other arbitrary value), or when the dose information available represents the summation of a series of measurements (e.g., only yearly cumulative exposure is available but based on, say, weekly measurements). Then the average of the multiple imputed exposure realizations for each individual is used to obtain an unbiased estimate of the relative risk associated with exposure. Simulation studies are used to evaluate the performance of the estimators. As an illustration, the method is applied to a sample of historical occupational radiation exposure data from the Oak Ridge National Laboratory
— id: 44991, year: 2004, vol: 87, page: 397, stat: Journal Article,

Circulating enterolactone and risk of breast cancer: a prospective study in New York
Zeleniuch-Jacquotte, A; Adlercreutz, H; Shore, R E; Koenig, K L; Kato, I; Arslan, A A; Toniolo, P
2004 Jul 5;91(1):99-105, British journal of cancer
It has been proposed that phyto-oestrogens protect against breast cancer. Lignans are the main class of phyto-oestrogens in Western diets. We conducted a case-control study of breast cancer and serum levels of the main human lignan, enterolactone, nested within a prospective cohort study, the New York University Women's Health Study. Serum samples collected at enrollment and stored at -80 degrees C were used. Among 14 275 participants, 417 incident breast cancer cases were diagnosed a median of 5.1 years after enrollment. Cohort members individually matched to the cases on age, menopausal status at enrollment, serum storage duration and, if premenopausal, day of menstrual cycle were selected as controls. No difference in serum enterolactone was observed between postmenopausal cases (median, 14.3 nmol l(-1)) and controls (14.5 nmol l(-1)), whereas premenopausal cases had higher levels (13.9 nmol l(-1)) than their matched controls (10.9 nmol l(-1), P-value=0.01). In the latter group, the odds ratio for the highest vs the lowest quintile of enterolactone was 1.7 (95% confidence interval (CI), 0.8-3.4; P-value for trend=0.05) and after adjustment for known risk factors for breast cancer was 1.6 (95% CI, 0.7-3.4; P-value for trend=0.13). We observed a moderate positive correlation between serum enterolactone and serum sex hormone-binding globulin in postmenopausal women (r=0.29 in controls (P<0.001) and r=0.14 in cases (P=0.04)), but no correlation with oestrogens or androgens. These results do not support a protective role of circulating lignans, in the range of levels observed, in the development of breast cancer.British Journal of Cancer (2004) 91, 99-105. doi:10.1038/sj.bjc.6601893 www.bjcancer.com
— id: 43220, year: 2004, vol: 91, page: 99, stat: Journal Article,

Postmenopausal levels of oestrogen, androgen, and SHBG and breast cancer: long-term results of a prospective study
Zeleniuch-Jacquotte, A; Shore, R E; Koenig, K L; Akhmedkhanov, A; Afanasyeva, Y; Kato, I; Kim, M Y; Rinaldi, S; Kaaks, R; Toniolo, P
2004 Jan 12;90(1):153-159, British journal of cancer
We assessed the association of sex hormone levels with breast cancer risk in a case-control study nested within the cohort of 7054 New York University (NYU) Women's Health Study participants who were postmenopausal at entry. The study includes 297 cases diagnosed between 6 months and 12.7 years after enrollment and 563 controls. Multivariate odds ratios (ORs) (95% confidence interval (CI)) for breast cancer for the highest quintile of each hormone and sex-hormone binding globulin (SHBG) relative to the lowest were as follows: 2.49 (1.47-4.21), P(trend)=0.003 for oestradiol; 3.24 (1.87-5.58), P(trend)<0.001 for oestrone; 2.37 (1.39-4.04), P(trend)=0.002 for testosterone; 2.07 (1.28-3.33), P(trend)<0.001 for androstenedione; 1.74 (1.05-2.89), P(trend)<0.001 for dehydroepiandrosterone sulphate (DHEAS); and 0.51 (0.31-0.82), P(trend)<0.001 for SHBG. Analyses limited to the 191 cases who had donated blood five to 12.7 years prior to diagnosis showed results in the same direction as overall analyses, although the tests for trend did not reach statistical significance for DHEAS and SHBG. The rates of change per year in hormone and SHBG levels, calculated for 95 cases and their matched controls who had given a second blood donation within 5 years of diagnosis, were of small magnitude and overall not different in cases and controls. The association of androgens with risk did not persist after adjustment for oestrone (1.08, 95% CI=0.92-1.26 for testosterone; 1.15, 95% CI=0.95-1.39 for androstenedione and 1.06, 95% CI=0.90-1.26 for DHEAS), the oestrogen most strongly associated with risk in our study. Our results support the hypothesis that the associations of circulating oestrogens with breast cancer risk are more likely due to an effect of circulating hormones on the development of cancer than to elevations induced by the tumour. They also suggest that the contribution of androgens to risk is largely through their role as substrates for oestrogen production
— id: 42623, year: 2004, vol: 90, page: 153, stat: Journal Article,

Mortality of nuclear submariners in the US Navy
Friedman-Jimenez, G; Kato, I; Afanasyeva, Y; Shore, R
2003 JUN 1 ;157(11):S80-S80, American journal of epidemiology
— id: 55531, year: 2003, vol: 157, page: S80, stat: Journal Article,

Relationship between low doses of ionizing radiation and mortality of nuclear submariners in the US Navy
Friedman-Jimenez, G; Kato, I; Afanasyeva, Y; Shore, R
2003 JUN 1 ;157(11):S10-S10, American journal of epidemiology
— id: 55530, year: 2003, vol: 157, page: S10, stat: Journal Article,

History of antibiotic use and risk of non-Hodgkin's lymphoma (NHL)
Kato, Ikuko; Koenig, Karen L; Baptiste, Mark S; Lillquist, Patricia P; Frizzera, Glauco; Burke, Jerome S; Watanabe, Hiroko; Shore, Roy E
2003 Oct 20;107(1):99-105, International journal of cancer
A population-based, incidence case-control study was conducted among women in upstate New York to determine whether histories of certain infections and antibiotic use are associated with risk of non-Hodgkin's lymphoma (NHL). Our study involved 376 cases of NHL identified through the New York State Cancer Registry and 463 controls selected from the Medicare beneficiary files and state driver's license records. Information about use of common medications including antibiotics, history of selected infectious diseases and potential confounding variables was obtained by telephone interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using an unconditional logistic regression model. There was a progressive increase in risk of NHL with increasing frequency and duration of systemic antibiotic use, as assessed over the period of 2-20 years before the interview. The ORs for the highest exposure categories, >/=36 episodes and >/=366 days of use, were 2.56 (95% CI 1.33-4.94) and 2.66 (95% CI 1.35-5.27), respectively. These associations were primarily due to antibiotic use against respiratory infections and dental conditions. Moreover, the association with frequency of antibiotic use for respiratory infections was pronounced for marginal zone B-cell lymphoma and for respiratory tract lymphoma. Analyses by class of antibiotics did not suggest that a general cytotoxic effect of antibiotics was responsible for these increased risks. Although recall bias and selection bias remain potential concerns in our study, the results are generally consistent with the hypothesis that persistent infection/inflammation predisposes individuals to the development of NHL. However, a direct role of antibiotics in NHL induction has not been ruled out
— id: 38443, year: 2003, vol: 107, page: 99, stat: Journal Article,

Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women
Key, T J; Appleby, P N; Reeves, G K; Roddam, A; Dorgan, J F; Longcope, C; Stanczyk, F Z; Stephenson, H E Jr; Falk, R T; Miller, R; Schatzkin, A; Allen, D S; Fentiman, I S; Key, T J; Wang, D Y; Dowsett, M; Thomas, H V; Hankinson, S E; Toniolo, P; Akhmedkhanov, A; Koenig, K; Shore, R E; Zeleniuch-Jacquotte, A; Berrino, F; Muti, P; Micheli, A; Krogh, V; Sieri, S; Pala, V; Venturelli, E; Secreto, G; Barrett-Connor, E; Laughlin, G A; Kabuto, M; Akiba, S; Stevens, R G; Neriishi, K; Land, C E; Cauley, J A; Kuller, L H; Cummings, S R; Helzlsouer, K J; Alberg, A J; Bush, T L; Comstock, G W; Gordon, G B; Miller, S R; Longcope, C
2003 Aug 20;95(16):1218-1226, Journal of the National Cancer Institute
BACKGROUND: Obesity is associated with increased breast cancer risk among postmenopausal women. We examined whether this association could be explained by the relationship of body mass index (BMI) with serum sex hormone concentrations. METHODS: We analyzed individual data from eight prospective studies of postmenopausal women. Data on BMI and prediagnostic estradiol levels were available for 624 case subjects and 1669 control subjects; data on the other sex hormones were available for fewer subjects. The relative risks (RRs) with 95% confidence intervals (CIs) of breast cancer associated with increasing BMI were estimated by conditional logistic regression on case-control sets, matched within each study for age and recruitment date, and adjusted for parity. All statistical tests were two-sided. RESULTS: Breast cancer risk increased with increasing BMI (P(trend) =.002), and this increase in RR was substantially reduced by adjustment for serum estrogen concentrations. Adjusting for free estradiol reduced the RR for breast cancer associated with a 5 kg/m2 increase in BMI from 1.19 (95% CI = 1.05 to 1.34) to 1.02 (95% CI = 0.89 to 1.17). The increased risk was also substantially reduced after adjusting for other estrogens (total estradiol, non-sex hormone-binding globulin-bound estradiol, estrone, and estrone sulfate), and moderately reduced after adjusting for sex hormone-binding globulin, whereas adjustment for the androgens (androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and testosterone) had little effect on the excess risk. CONCLUSION: The results are compatible with the hypothesis that the increase in breast cancer risk with increasing BMI among postmenopausal women is largely the result of the associated increase in estrogens, particularly bioavailable estradiol
— id: 38442, year: 2003, vol: 95, page: 1218, stat: Journal Article,

Free estradiol and breast cancer risk in postmenopausal women: Comparison of measured and calculated values
Key, TJ; Appleby, PN; Reeves, GK; Roddam, AW; Dorgan, JF; Longcope, C; Stanczyk, FZ; Stephenson, HE; Falk, RT; Miller, R; Schatzkin, A; Allen, DS; Fentiman, IS; Key, TJ; Wang, DY; Thomas, HV; Hankinson, SE; Toniolo, P; Akhmedkhanov, A; Koenig, K; Shore, RE; Zeleniuch-Jacquotte, A; Berrino, F; Muti, P; Krogh, AMV; Sieri, S; Pala, V; Venturelli, E; Secreto, G; Barrett-Connor, E; Laughlin, GA; Kabuto, M; Stevens, RG; Neriishi, K; Land, CE; Cauley, JA; Kuller, LH; Helzlsouer, KJ; Alberg, AJ; Bush, TL; Comstock, GW; Gordon, GB; Miller, SR; Longcope, C
2003 DEC ;12(12):1457-1461, Cancer epidemiology biomarkers & prevention
Mathematical methods exist to determine the fractions of sex hormones bound to albumin, bound to sex hormone binding globulin (SHBG), or unbound, using total hormone concentration and SHBG concentration. We used data from eight prospective studies of postmenopausal women to assess the validity of these estimates for fractions of estradiol (E2) and to investigate the impact of using calculated values in breast cancer relative risk (RR) models. Comparisons were made between measured and calculated concentrations of free and non-SHBG-bound E2 in four studies. Relationships between the hormone fractions were investigated and a sensitivity analysis of the calculation performed. Breast cancer RRs were estimated using conditional logistic regression by quintiles of free E2. There is a high correlation (r > 0.91) between calculated and measured values of both free and non-SHBG-bound E2. The calculation is highly sensitive to total hormone concentration but is relatively insensitive to SHBG concentration. In studies with both measured and calculated values, the RRs of breast cancer by quintile of free E2 were almost identical for both estimates; using calculated values in all possible studies the RR in the highest compared with the lowest quintile of free E2 was 2.29 (95% confidence interval, 1.65-3.19). The mathematical method used to calculate fractions of E2 is valid, and RR analyses using calculated values produce similar results to those using measured values. This suggests that for epidemiological studies, it is only necessary to measure total E2 concentration and SHBG concentration, with hormone fractions being obtained by calculation, producing savings in cost, time, and serum
— id: 42543, year: 2003, vol: 12, page: 1457, stat: Journal Article,

Benzene exposure measurement in shoe and glue manufacturing: a study to validate biomarkers
Qu, Qingshan; Cohen, Beverly S; Shore, Roy; Chen, Lung Chi; Li, Guilan; Jin, Ximei; Melikian, Assieh A; Yin, Songnian; Yan, Huifang; Xu, Bohong; Li, Yuying; Mu, Ruidong; Zhang, Xiaoling; Li, Keqi
2003 Dec;18(12):988-998, Applied occupational & environmental hygiene
This article reports an extensive program to monitor individual personal exposures of subjects recruited for a study conducted in a Chinese occupational population to determine whether selected biological markers of exposure to benzene are reliable and sensitive enough to detect low-level benzene exposure in people. The monitoring program reported here was to assure an appropriate range of exposure for subject selection as well as to provide data for the exposure response assessment. The overall study resulted in correlation of the measured exposures with the measured concentrations of two minor urinary benzene metabolites, trans,trans-muconic acid and S-phenylmercapturic acid. The study design and evaluation of biological end points are presented in separate publications. Recruitment of 130 exposed subjects was based on personal exposure measurements collected with passive organic vapor monitors at weekly intervals for 3 to 4 weeks prior to collection of biological samples. Two monitors, side by side, were used for all of the personal monitoring in the first year of the study and about 10 percent of subsequent monitoring. One of each pair was analyzed immediately in Beijing at the Institute of Occupational Medicine, and the other was shipped to the United States and analyzed at the New York University Institute of Environmental Medicine. Exposure concentrations measured over 4-5 weeks were reasonably stable with average coefficients of variation of 0.58, 0.59, and 0.46 for benzene, toluene, and xylene, respectively. Benzene exposure averaged 10 +/- 13 ppm benzene with a median of 3.8 ppm for the recruited exposed workers. Excellent correlation was obtained between samples analyzed for benzene at the two laboratories. The extensive effort to document exposures was important to the exposure-response relationship demonstrated in the full study, which concluded that S-phenylmercapturic acid appears to be a good biomarker for detecting and evaluating benzene exposure at concentrations less than 0.25 ppm
— id: 38997, year: 2003, vol: 18, page: 988, stat: Journal Article,

Validation and evaluation of biomarkers in workers exposed to benzene in China
Qu, Qingshan; Shore, Roy; Li, Guilan; Jin, Ximei; Chen, Lung Chi; Cohen, Beverly; Melikian, Assieh A; Eastmond, David; Rappaport, Stephen; Li, Heyi; Rupa, Doppalapudi; Waidyanatha, Suramya; Yin, Songnian; Yan, Huifang; Meng, Min; Winnik, Witold; Kwok, Eric S C; Li, Yuying; Mu, Ruidong; Xu, Bohong; Zhang, Xiaoling; Li, Keqi
2003 Jun;23(115):1-72, Research report (Health Effects Institute)
This study was conducted to validate biomarkers for early detection of benzene exposure and effect in 2 phases. The main purpose of phase 1 was to determine whether these biomarkers could reliably detect differences between workers with high exposure levels and unexposed subjects, which is the minimal screening criterion for a biomarker assay. Phase 2 of the study mainly focused on evaluating the exposure-response relation, confounding factors, and sensitivities of biomarkers for low benzene exposures. The Chinese occupational population studied had a broad range of benzene exposures. On the day of biological sample collection, exposures ranged from 0.06 to 122 ppm with a median exposure of 3.2 ppm. The median of the 4-week mean benzene exposures was 3.8 ppm, and the median lifetime cumulative exposure was 51.1 ppm-years. Compared with benzene levels in collected samples, toluene levels were relatively high, with a median of 12.6 ppm (mean, 26.3 ppm), but xylene levels were low, with a median of 0.30 ppm (mean, 0.40 ppm). The biomarkers evaluated were urinary metabolites S-phenylmercapturic acid (S-PMA*), trans,trans-muconic acid (t,t-MA), hydroquinone (HQ), catechol (CAT), and phenol; albumin adducts of benzene oxide and 1,4-benzoquinone (BO-Alb and 1,4-BQ-Alb, respectively) in blood; blood cell counts; and chromosomal aberrations. Blood cell counts in this population, including red blood cells (RBCs), white blood cells (WBCs), and neutrophils, decreased significantly with increased exposures but remained in normal ranges. Chromosomal aberration data showed significant increases of chromatid breaks and total chromosomal aberrations in exposed subjects compared with unexposed subjects. Among the urinary metabolites, the levels of S-PMA and t,t-MA were significantly elevated after benzene exposures. Both markers showed significant exposure-response trends even over the exposure range from 0 to 1 ppm. However, HQ, CAT, and phenol showed significant increases only for benzene exposure levels above 5 ppm. Multiple regression analyses of these urinary metabolites on benzene exposure indicated that toluene exposure, smoking status, and cotinine levels had no significant effects on urinary metabolite levels. A time-course study estimated the half-lives of S-PMA, t,t-MA, HQ, CAT, and phenol to be 12.8, 13.7, 12.7, 15.0, and 16.3 hours, respectively. Both BO-Alb and 1,4-BQ-Alb showed strong exposure-response associations with benzene. Regression analyses showed that after adjustment for potential confounding by smoking, there was still a strong association between benzene exposure and these markers. Furthermore, the analyses for correlations among biomarkers revealed that the urinary metabolites correlated substantially with each other. The albumin adducts also correlated well with the urinary biomarkers, especially with S-PMA. BO-Alb and 1,4-BQ adducts also correlated well with each other (r = 0.74). For benzene exposure monitoring, both S-PMA and t,t-MA were judged to be good and sensitive markers, which detected benzene exposures at around 0.1 ppm and 1 ppm, respectively. But S-PMA was clearly superior to t,t-MA as a biomarker for low levels of benzene exposure
— id: 39100, year: 2003, vol: 23, page: 1, stat: Journal Article,

Human carcinogenic risk from in utero irradiation
Shore RE
Biological effects after prental irradiation (embryo and fetus) Oxford : Pergamon, 2003,
— id: 3107, year: 2003, vol: , page: 153, stat: Chapter,

Breast cancer susceptibility and DNA demage/repair
Shore, Roy E
[S.l.] : Ft. Belvoir Defense Technical Information Center, 2003,
The specific hypothesis was that women who have selected polymorphic variants in genes that predispose them to poorer repair of DNA damage will have greater breast cancer risk. Polymorphisms in base excision repair (xRCCl), nucleotide excision repair (XPD, XPC), double-strand break repair (XRCC3, Rad5l, LIG4) and checkpoint-control (CDKN2A) genes were investigated. A secondary hypothesis was that risk may be further accentuated by lifestyle-related exposures to carcinogens or oxidants. A nested case control study of 612 matched pairs was conducted within the NYU Women's Health Study, a prospective study of over 14,000 healthy women aged 35-65 who were enrolled in the study during 1985-91. Genotyping was performed using RFLP. Statistical analyses were controlled for ethnicity, age, and various risk factors for breast cancer. There was a statistically significant increase in breast cancer risk for women who had the homozygous variant genotype for the XPC-PAT+ polymorphism (OR=l.41, 95% CI: 1.04-1.91). Further analyses suggested that women with the variant allele had an 80% greater (p=O.09) breast cancer risk associated with smoking and 70% greater (p=O.06) for alcohol consumption than those who were wild type. The XRCC3 Thr24l-Met substitution also showed a suggestive association with breast cancer risk
— id: 1233, year: 2003, vol: , page: , stat: ,

Tumors and other diseases following childhood x-ray treatment for ringworm of the scalp (Tinea capitis)
Shore, Roy E; Moseson, Miriam; Harley, Naomi; Pasternack, Bernard S
2003 Oct;85(4):404-408, Health physics
The objective of the study is to characterize the risk of tumors from radiation exposure to the head and neck. A cohort of 2,224 children given x-ray treatment and 1,380 given only topical medications for ringworm of the scalp (tinea capitis) during 1940-1959 have been followed up for a median of 39 y to determine tumor incidence. Follow-ups were by mail/telephone questionnaire, with 84-88% of the original cohort followed and with medical verification of diseases of interest. Sixteen intracranial tumors [7 brain cancers, 4 meningiomas, and 5 acoustic neuromas (vestibular schwannomas)] occurred in the x-irradiated group following an average brain dose of about 1.4 Gy, compared to 1 acoustic neuroma in the control group. The standardized incidence ratio (SIR) for brain cancer was 3.0 [95% confidence interval (CI): 1.3, 5.9]. Even though the dose to the thyroid gland was only about 60 mGy, 2 thyroid cancers were found in the irradiated group vs. none among controls, and 11 vs. 1 thyroid adenomas were found in the respective groups. Following an average dose of about 4 Gy to cranial marrow, 8 cases of leukemia (SIR = 3.2, CI: 1.5, 6.1) were observed in the irradiated group and 1 in the control group. There was also a suggestive excess of blood dyscrasias. There was no difference between the groups in the frequency of other cancers of the head and neck (excluding nonmelanoma skin cancer) or in total mortality
— id: 38441, year: 2003, vol: 85, page: 404, stat: Journal Article,

A method for estimating occupational radiation doses subject to minimum detection levels
Xue, Xiaonan; Shore, Roy E
2003 Jan;84(1):61-71, Health physics
Occupational radiation exposure is often coded as zero when the exposure dose is below the minimum detection level. This leads to an underestimation of the doses received by individuals and can lead to overestimates of risk in occupational epidemiologic studies. The extent of the dose underestimation is increased with the magnitude of the minimum detection level and the frequency of monitoring. The paper proposes a Bayesian approach to estimate the actual dose and the dose distribution parameter when the observed dose is subject to censoring due to minimum detection level. A Gibbs sampling algorithm is developed to implement the method. Simulation studies are used to evaluate the performance of the estimators. The method is applied to a sample of historical occupational radiation exposure data from the Oak Ridge National Laboratory
— id: 38445, year: 2003, vol: 84, page: 61, stat: Journal Article,

Exposure of the American population to radioactive fallout from nuclear weapons tests : a review of the CDC-NCI draft report on a feasibility study of the health consequences to the American population from nuclear weapons tests conducted by the United States and other nations
[Schull WJ; Boecker BB; Brill AB; Carter MW; Clark SB; Crouch EAC; Friedman SM; Higley KA; Lederer SE; Levenson M; Paretzke HG; Scott BR; Shore RE; Stram DO]
Washington DC : National Academies Press, 2003,
— id: 748, year: 2003, vol: , page: , stat: ,

Aspirin and lung cancer in women
Akhmedkhanov, A; Toniolo, P; Zeleniuch-Jacquotte, A; Koenig, K L; Shore, R E
2002 Jul 1;87(1):49-53, British journal of cancer
The association between aspirin use and lung cancer risk in women was examined in a case-control study nested in the New York University Women's Health Study, a large cohort in New York. Case subjects were all the 81 incident lung cancer cases who had provided information about aspirin use at enrollment and during the 1994-1996 follow up. Ten controls per case were randomly selected from among study participants who matched a case by age, menopausal status, and dates of enrollment and follow-up. Relative to no aspirin use, the odds ratio for lung cancer (all histological sub-types combined) among subjects who reported aspirin use three or more times per week for at least 6 months was 0.66 (95% confidence interval 0.34-1.28), after adjustment for smoking and education. A stronger inverse association was observed in analyses restricted to non-small cell lung cancer (adjusted odds ratio 0.39, 95% confidence interval 0.16-0.96). These results suggest that regular aspirin use might be inversely associated with risk of lung cancer in women, particularly the non-small cell sub-type
— id: 32489, year: 2002, vol: 87, page: 49, stat: Journal Article,

The development of a questionnaire to assess past year physical activity in a multi-ethnic/racial urban population
Britton, Julie A; Kushi, Lawrence H; Morabia, Alfredo; Bernstein, Jonine; Shore, Roy; Geringer, Wendy; Rohan, Tom
2002 ;47(3):178-194, Sozial- und Praventivmedizin
OBJECTIVES: Describe the development of a questionnaire to assess past year physical activity, including activities of daily living, in a multi-ethnic/racial cohort. Describe energy expenditure (EE) patterns in the sample used for questionnaire development. METHODS: 24-hour activity recalls were collected from a convenience sample (N = 367) at four New York City health agencies (October 1999-February 2000). EE was determined at the population, subgroup, and individual level. EE distributions were compared. RESULTS: Activities identified were similar to those on established questionnaires. Subgroup and individual EE differences were noted. Median EE at the Chinese and Puerto Rican sites were lower than those at the Caribbean or Dominican sites. No clear age pattern was apparent. Overall, a greater percentage of daily EE was spent in low intensity activities. The resultant 30-minute interviewer-administered questionnaire ascertains patterns (frequency and duration) of domain-specific (recreational, household, occupational, and transportation) activity. This information combined with published intensity levels provides summary EE measures. CONCLUSION: Variation in EE levels requires information on activity type and amount. Summary activity measures can be used to rank individuals analogous to nutrient food frequency measures
— id: 38472, year: 2002, vol: 47, page: 178, stat: Journal Article,

PTCH (patched) and XPA genes in radiation-induced basal cell carcinomas
Burns FJ; Shore RE; Roy N; Loomis C; Zhao P
Radiation and Homeostasis : proceedings of the International Symposium of Radiation and Homeostasis, held in Kyoto, Japan, 13-16 July 2001 Amsterdam ; Boston : Elsevier, 2002,
— id: 3100, year: 2002, vol: , page: 175, stat: Chapter,

Insulin-like growth factor II and colorectal cancer risk in women
Hunt, Kelly J; Toniolo, Paolo; Akhmedkhanov, Arslan; Lukanova, Annekatrin; Dechaud, Henri; Rinaldi, Sabina; Zeleniuch-Jacquotte, Anne; Shore, Roy E; Riboli, Elio; Kaaks, Rudolf
2002 Sep;11(9):901-905, Cancer epidemiology biomarkers & prevention
Recently, a number of prospective studies showed evidence that the growth hormone/insulin-like growth factor I (IGF-I) axis may be important in the development of colorectal cancer. However, only a few studies have reported on the possible relationship of colorectal cancer risk with circulating levels of IGF-II, which are not growth hormone dependent and which do not vary with alterations in energy balance. In a case-control study of 102 cases and 200 matched controls nested within a cohort of 14,275 women in New York, we examined the relationship between colorectal cancer risk and prediagnostic serum levels of IGF-II. Conditional logistic regression analysis showed an odds ratio (OR) for colorectal cancer of 2.02 (95% confidence interval (CI): 0.83-4.93), comparing the upper to lower quintile of IGF-II. This association was slightly attenuated after excluding IGF-II measurements in serum samples taken within 1 year before case diagnosis (OR of 1.81; 95% CI: 0.71-4.64) and moderately attenuated after excluding IGF-II measurements in serum samples taken within 2 years before case diagnosis (OR of 1.47; 95% CI: 0.56-3.91). Adjustment for IGF-1, IGF binding protein (BP)-1, IGFBP-3, smoking, or body mass index did not substantially alter the association, whereas adjustment for IGFBP-2 moderately attenuated the relationship. Our results confirm those of three recent case-control studies, and collectively these results suggest a possible increase in colorectal cancer risk among subjects with comparatively elevated serum IGF-II. Mechanisms that might cause the increase in IGF-II levels are unknown but may include loss of parental imprinting of the IGF-II gene
— id: 34544, year: 2002, vol: 11, page: 901, stat: Journal Article,

Use of anti-inflammatory and non-narcotic analgesic drugs and risk of non-Hodgkin's lymphoma (NHL) (United States)
Kato, Ikuko; Koenig, Karen L; Shore, Roy E; Baptiste, Mark S; Lillquist, Patricia P; Frizzera, Glauco; Burke, Jerome S; Watanabe, Hiroko
2002 Dec;13(10):965-974, Cancer causes & control. ccc
OBJECTIVE: To examine whether exposures to anti-inflammatory and non-narcotic analgesic drugs are associated with risk of non-Hodgkin's lymphoma (NHL). METHODS: A case-control study was conducted among women living in upstate New York. The study involved 376 cases of NHL identified through the New York State Cancer Registry and 463 controls randomly selected from the Medicare beneficiary files and New York State driver's license records. Information regarding use of common medications in the past 20 years and potential confounding variables was obtained by telephone interview. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using an unconditional logistic regression model. RESULTS: There were non-significant increases in risk associated with ever use of cortisone injections and oral cortisone (OR = 1.44 (CI 0.98-2.11) for injections and 1.21 (CI 0.73-2.00) for oral cortisone, although there was no clear dose-response relationship with either type. On the other hand, the risk of NHL progressively increased with the frequency of use of non-steroidal anti-inflammatory and non-narcotic analgesic drugs (NSAID/NNAD) (p-value for trend 0.008). Women who used any of these medications daily for more than 10 years had an OR of 1.90 (CI 1.01-3.57), compared with those who used it less than once a month on average. The risk associated with long-term use was most pronounced for ibuprofen, intermediate for aspirin, and least for acetaminophen. CONCLUSIONS: Because the population-attributable risk associated with NSAID/NNAD use is potentially large, our results need to be verified in further epidemiologic studies
— id: 38444, year: 2002, vol: 13, page: 965, stat: Journal Article,

Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies
Key, T; Appleby, P; Barnes, I; Reeves, G
2002 Apr 17;94(8):606-616, Journal of the National Cancer Institute
BACKGROUND: Reproductive and hormonal factors are involved in the etiology of breast cancer, but there are only a few prospective studies on endogenous sex hormone levels and breast cancer risk. We reanalyzed the worldwide data from prospective studies to examine the relationship between the levels of endogenous sex hormones and breast cancer risk in postmenopausal women. METHODS: We analyzed the individual data from nine prospective studies on 663 women who developed breast cancer and 1765 women who did not. None of the women was taking exogenous sex hormones when their blood was collected to determine hormone levels. The relative risks (RRs) for breast cancer associated with increasing hormone concentrations were estimated by conditional logistic regression on case-control sets matched within each study. Linear trends and heterogeneity of RRs were assessed by two-sided tests or chi-square tests, as appropriate. RESULTS: The risk for breast cancer increased statistically significantly with increasing concentrations of all sex hormones examined: total estradiol, free estradiol, non-sex hormone-binding globulin (SHBG)-bound estradiol (which comprises free and albumin-bound estradiol), estrone, estrone sulfate, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and testosterone. The RRs for women with increasing quintiles of estradiol concentrations, relative to the lowest quintile, were 1.42 (95% confidence interval [CI] = 1.04 to 1.95), 1.21 (95% CI = 0.89 to 1.66), 1.80 (95% CI = 1.33 to 2.43), and 2.00 (95% CI = 1.47 to 2.71; P(trend)<.001); the RRs for women with increasing quintiles of free estradiol were 1.38 (95% CI = 0.94 to 2.03), 1.84 (95% CI = 1.24 to 2.74), 2.24 (95% CI = 1.53 to 3.27), and 2.58 (95% CI = 1.76 to 3.78; P(trend)<.001). The magnitudes of risk associated with the other estrogens and with the androgens were similar. SHBG was associated with a decrease in breast cancer risk (P(trend) =.041). The increases in risk associated with increased levels of all sex hormones remained after subjects who were diagnosed with breast cancer within 2 years of blood collection were excluded from the analysis. CONCLUSION: Levels of endogenous sex hormones are strongly associated with breast cancer risk in postmenopausal women
— id: 38580, year: 2002, vol: 94, page: 606, stat: Journal Article,

Development and validation of a food frequency questionnaire for Korean Americans
Kim, Jeongseon; Chan, Mabel M; Shore, Roy E
2002 Mar;53(2):129-142, International journal of food sciences & nutrition
A food frequency questionnaire for Korean Americans (KFFQ) was developed by modifying Block's Health Habits and History Questionnaire (HHHQ). The final KFFQ contained 118 food items taking into account culturally specific dietary patterns. Validation of the KFFQ was conducted to compare the nutrient intakes assessed by the KFFQ against those measured by seven-day dietary records in 73 Korean Americans. The mean nutrient values from the KFFQ differed at most by 25% from those of the dietary records with the exception of vitamin A, and 70% of the nutrients (16 out of 23 nutrients) were within 15%. Adjusted Spearman rank-order correlation coefficients for nutrients ranged between 0.45 and 0.84. The overall degree of agreement between the KFFQ and the dietary records was 68% with a range 56% to 79%. This validation study indicates that the KFFQ gives reasonably accurate estimates of the usual dietary intakes among the study population. The results also verify that it is possible to use a FFQ that is both culturally specific and comprehensive with the benefit of being easy to self-administer. This high degree of correlation between the KFFQ and the dietary records demonstrates that the KFFQ provides an easier yet accurate method in large-scale epidemiological studies of relationships between nutrition intakes and diseases in Korean Americans
— id: 38447, year: 2002, vol: 53, page: 129, stat: Journal Article,

Personal exposure to different levels of benzene and its relationships to the urinary metabolites S-phenylmercapturic acid and trans,trans-muconic acid
Melikian, Assieh A; Qu, Qingshan; Shore, Roy; Li, Guilan; Li, Heyi; Jin, Ximei; Cohen, Beverly; Chen, Lungchi; Li, Yuying; Yin, Songnian; Mu, Reidong; Zhang, Xiaoling; Wang, Yuanxiang
2002 Oct 5;778(1-2):211-221, Journal of chromatography. B. Analytical technologies in the biomedical & life sciences
This report is part of an extensive study to verify the validity, specificity, and sensitivity of biomarkers of benzene at low exposures and assess their relationships with personal exposure and genetic damage. The study population was selected from benzene-exposed workers in Tianjin, China, based on historical exposure data. The recruitment of 130 exposed workers from glue-making or shoe-making plants and 51 unexposed subjects from nearby food factories was based on personal exposure measurements conducted for 3-4 weeks prior to collection of biological samples. In this report we investigated correlation of urinary benzene metabolites, S-phenylmercapturic acid (S-PMA) and trans,trans-muconic acid (t,t-MA) with personal exposure levels on the day of urine collection and studied the effect of dose on the biotransformation of benzene to these key metabolites. Urinary S-PMA and t,t-MA were determined simultaneously by liquid chromatography-tandem mass spectrometry analyses. Both S-PMA and t,t-MA, but specifically the former, correlated well with personal benzene exposure over a broad range of exposure (0.06-122 ppm). There was good correlation in the subgroup that had been exposed to <1 ppm benzene with both metabolites (P-trend <0.0001 for S-PMA and 0.006 for t,t-MA). Furthermore, the levels of S-PMA were significantly higher in the subgroup exposed to <0.25 ppm than that in unexposed subjects (n=17; P=0.001). There is inter-individual variation in the rate of conversion of benzene into urinary metabolites. The percentage of biotransformation of benzene to urinary S-PMA ranged from 0.005 to 0.3% and that to urinary t,t-MA ranged from 0.6 to approximately 20%. The percentage of benzene biotransformed into S-PMA and t,t-MA decreased with increasing concentration of benzene, especially conversion of benzene into t,t-MA. It appears that women excreted more metabolites than men for the same levels of benzene exposures. Our data suggest that S-PMA is superior to t,t-MA as a biomarker for low levels of benzene exposure
— id: 34386, year: 2002, vol: 778, page: 211, stat: Journal Article,

Handheld cellular telephones and risk of acoustic neuroma
Muscat, J E; Malkin, M G; Shore, R E; Thompson, S; Neugut, A I; Stellman, S D; Bruce, J
2002 Apr 23;58(8):1304-1306, Neurology
The hypothesis that intracranial energy deposition from handheld cellular telephones causes acoustic neuroma was tested in an epidemiologic study of 90 patients and 86 control subjects. The relative risk was 0.9 (p = 0.07) and did not vary significantly by the frequency, duration, and lifetime hours of use. In patients who used cellular telephones, the tumor occurred more often on the contralateral than ipsilateral side of the head. Further efforts should focus on potentially longer induction periods
— id: 38446, year: 2002, vol: 58, page: 1304, stat: Journal Article,

Radiation effects on breast cancer risk: a pooled analysis of eight cohorts
Preston, Dale L; Mattsson, Anders; Holmberg, Erik; Shore, Roy; Hildreth, Nancy G; Boice, John D Jr
2002 Aug;158(2):220-235, Radiation research
Breast cancer incidence rates after radiation exposure in eight large cohorts are described and compared. The nature of the exposures varies appreciably, ranging from a single or a small number of high-dose-rate exposures (Japanese atomic bomb survivors, U.S. acute post-partum mastitis patients, Swedish benign breast disease patients, and U.S. infants with thymic enlargement) to highly fractionated high-dose-rate exposures (two U.S. tuberculosis cohorts) and protracted low-dose-rate exposure (two Swedish skin hemangioma cohorts). There were 1,502 breast cancers among 77,527 women (about 35,000 of whom were exposed) with 1.8 million woman-years of follow-up. The excess risk depends linearly on dose with a downturn at high doses. No simple unified summary model adequately describes the excess risks in all groups. Excess risks for the thymus, tuberculosis, and atomic bomb survivor cohorts have similar temporal patterns, depending on attained age for relative risk models and on both attained age and age at exposure for excess rate models. Excess rates were similar in these cohorts, whereas, related in part to the low breast cancer background rates for Japanese women, the excess relative risk per unit dose in the bomb survivors was four times that in the tuberculosis or thymus cohorts. Excess rates were higher for the mastitis and benign breast disease cohorts. The hemangioma cohorts showed lower excess risks suggesting ameliorating dose-rate effects for protracted low-dose-rate exposures. For comparable ages at exposure (approximately 0.5 years), the excess risk in the hemangioma cohorts was about one-seventh that in the thymus cohort, whose members received acute high-dose-rate exposures. The results support the linearity of the radiation dose response for breast cancer, highlight the importance of age and age at exposure on the risks, and suggest a similarity in risks for acute and fractionated high-dose-rate exposures with much smaller effects from low-dose-rate protracted exposures. There is also a suggestion that women with some benign breast conditions may be at elevated risk of radiation-associated breast cancer
— id: 72196, year: 2002, vol: 158, page: 220, stat: Journal Article,

Hematological changes among Chinese workers with a broad range of benzene exposures
Qu, Qingshan; Shore, Roy; Li, Guilan; Jin, Ximei; Chen, Lung Chi; Cohen, Beverly; Melikian, Assieh A; Eastmond, David; Rappaport, Stephen M; Yin, Songnian; Li, Heyi; Waidyanatha, Suramya; Li, Yuying; Mu, Ruidong; Zhang, Xiaoling; Li, Keqi
2002 Oct;42(4):275-285, American journal of industrial medicine
BACKGROUND: Depression of peripheral blood cells is a well-known indicator of benzene hematotoxicity. Previous studies of its effects on specific types of blood cells have yielded inconsistent results. We examine hematological findings and their possible relations with exposure markers validated in a recent biomarker project conducted in Tianjin, China. METHODS: Personal benzene exposures were sampled with 3-M organic vapor monitors, and analyzed by gas chromatography. The peripheral blood cells were counted by a cell counter. The WBC differential was manually counted on a total of 900 cells by a US commercial laboratory. RESULTS: A total of 130 exposed workers and 51 age- and gender-matched unexposed subjects were recruited in this study. Benzene exposure levels monitored on the day of biological sample collection for exposed workers ranged from 0.06 to 122 ppm. Their 4-week average and cumulative benzene exposure levels were 0.08-54.5 ppm and 6.1-623.2 ppm-years, respectively. Significant decreases of red blood cells (RBC), white blood cells (WBC), and neutrophils were observed and correlated with both personal benzene exposures and levels of urinary metabolites (S-phenylmercapuric acid and t,t-muconic acid) and albumin adducts of benzene oxide and 1,4-benzeoquinone. CONCLUSIONS: The depressions in RBC, WBC, and neutrophils observed in this study are not only exposure dependent, but also significantly different in the lowest exposed group (at or below 0.25 ppm) compared with unexposed subjects. The results of the present study appear to suggest that lymphocytes may not be more sensitive to chronic benzene exposure than neutrophils
— id: 34387, year: 2002, vol: 42, page: 275, stat: Journal Article,

Albumin adducts of benzene oxide and 1,4-benzoquinone as measures of human benzene metabolism
Rappaport, Stephen M; Waidyanatha, Suramya; Qu, Qingshan; Shore, Roy; Jin, Ximei; Cohen, Beverly; Chen, Lung-Chi; Melikian, Assieh A; Li, Guilan; Yin, Songnian; Yan, Huifang; Xu, Bohong; Mu, Ruidong; Li, Yuying; Zhang, Xiaoling; Li, Keqi
2002 Mar 1;62(5):1330-1337, Cancer research
Albumin adducts of benzene oxide (BO-Alb) and 1,4-benzoquinone (1,4-BQ-Alb) were investigated among 134 workers exposed to benzene and 51 unexposed controls in Tianjin, China. Concentrations of both adducts increased with benzene exposure [range = 0.07-46.6 parts/million (ppm); median = 3.55 ppm] and with urinary cotinine. Adduct levels were less than proportional to benzene exposure, suggesting saturable CYP 2E1 metabolism of benzene. Because the transition from linear to saturable metabolism began at approximately 1 ppm, the common assumption of linear kinetics at much higher benzene exposures could lead to substantial underestimation of leukemia risks. Adduct levels were generally lower in older workers, indicating that CYP 2E1 metabolism diminished with age, at approximately 2%/year of life. The ratio of 1,4-BQ-Alb:BO-Alb decreased with age and coexposure to toluene, and increased with alcohol consumption. This indicates that factors affecting CYP 2E1 metabolism exerted a greater role on production of 1,4-BQ than BO, presumably because of the second oxidation step from phenol to hydroquinone. The adduct ratio was also positively associated with urinary cotinine, suggesting that both benzene and hydroquinone from cigarette smoke affected adduct levels. Results of a limited time course study of 11 subjects indicated moderate chemical instability of 1,4-BQ-Alb (half life = 13.5 days compared with 21 days for normal Alb turnover), whereas no evidence of instability of BO-Alb was observed. This study illustrates that Alb adducts can be used to investigate the dispositions of reactive metabolites of procarcinogens in humans, provided that exposures are adequately characterized in the month preceding blood collection
— id: 34388, year: 2002, vol: 62, page: 1330, stat: Journal Article,

Validity of free testosterone and free estradiol determinations in serum samples from postmenopausal women by theoretical calculations
Rinaldi, Sabina; Geay, Annabelle; Dechaud, Henri; Biessy, Carine; Zeleniuch-Jacquotte, Anne; Akhmedkhanov, Arslan; Shore, Roy E; Riboli, Elio; Toniolo, Paolo; Kaaks, Rudolf
2002 Oct;11(10 Pt 1):1065-1071, Cancer epidemiology biomarkers & prevention
In this study, we validated measurements of free testosterone (fT) and free estradiol (fE(2)) concentrations calculated from total serum concentrations of testosterone (T), estradiol (E(2)), and sex hormone-binding globulin (SHBG), measured by direct, commercial radioimmunoassays, by comparison with reference measurements obtained by dialysis plus an in-house radioimmunoassay after extraction and chromatographic purification. The study was conducted in serum samples from 19 postmenopausal women who were part of an ongoing prospective cohort study. We also performed sensitivity analyses to examine the robustness of the theoretical calculations. Sensitivity analyses showed that in this population, competitive binding of dihydrotestosterone and total T could be ignored in the calculation of fE(2), and competitive binding by dihydrotestosterone does not need to be taken into account for calculation of fT. Furthermore, variations in albumin and SHBG concentrations had negligible effects on fT and fE(2) calculations. Values of fT and fE(2), calculated from total T and E(2) concentrations obtained by the same in-house radioimmunoassay used for the dialysis method, correlated highly with the measurements by dialysis (Pearson's coefficients of correlation above 0.97). When calculating fT and fE(2) using total T and total E(2) concentrations obtained by different direct radioimmunoassays, almost all kits gave good correlations with the reference method for fT (Pearson's r > 0.83), but only a few gave good correlations for fE(2) (Diagnostic System Laboratories and DiaSorin; r > 0.80). The direct radioimmunoassays giving the best correlation for fT and fE(2) with the dialysis method were those that best measured total concentrations of T and E(2). Furthermore, mean values of fT and fE(2) corresponded well to mean values by the reference method if SHBG measurements were also well calibrated. We conclude that in postmenopausal women, theoretical calculations are valid for the determination of fT and fE(2) concentrations and can give reliable estimation of cancer risk in epidemiological studies when the total concentrations of T, E(2), and SHBG are measured accurately
— id: 34542, year: 2002, vol: 11, page: 1065, stat: Journal Article,

Breast cancer susceptibility and DNA damage/repair
Shore, Roy E
[S.l.] : Ft. Belvoir Defense Technical Information Center, 2002,
The study is based on breast cancer cases and matched controls from a cohort of women (New York University Women's Health Study-NYUWHS) who have been followed up for 7-13 years since they donated a blood sample and completed a health, lifestyle and dietary questionnaire to determine the incidence of breast cancer The original proposal was to genotype 6 polymorphisms in the genetic pathways for DNA repair or protection against DNA damage in 200 cases and 200 matched controls We expanded the study to 300 cases and 300 controls. For about 40% of subjects we had blood clots or cell aggregates (left after separating out the serum) from which to extract DNA, but for the remainder we had to extract it from the serum. There was abundant DNA in the clots and cell aggregates but much less in the serum
— id: 1232, year: 2002, vol: , page: , stat: ,

Skin cancer after X-ray treatment for scalp ringworm
Shore, Roy E; Moseson, Miriam; Xue, Xiaonan; Tse, Yardey; Harley, Naomi; Pasternack, Bernard S
2002 Apr;157(4):410-418, Radiation research
Some 2,224 children given X-ray therapy for tinea capitis (ringworm of the scalp) have been followed for up to 50 years to determine cancer incidence, along with a control group of 1,380 tinea capitis patients given only topical medications. The study found a relative risk (RR) of 3.6 (95% confidence interval, 2.3-5.9) for basal cell skin cancer (BCC) of the head and neck among irradiated Caucasians (124 irradiated cases and 21 control cases), in response to a scalp dose of about 4.8 Gy. No melanomas of the head and neck have been seen, and only a few squamous cell carcinomas. About 40% of irradiated cases have had multiple BCCs, for a total of 328 BCCs. Although 25% of both the irradiated and control groups are African-American, only 3 skin cancers have been seen among them, all in the irradiated group, indicating the importance of susceptibility to UV radiation as a cofactor. Light complexion, severe sunburning and North European ancestry were predictive of BCC risk in the irradiated group, but chronic sun exposure was not. Children irradiated at young ages had the highest BCC risk. The RR for BCC risk is approximately constant with time since exposure, suggesting that risk will probably last for a lifetime
— id: 29336, year: 2002, vol: 157, page: 410, stat: Journal Article,

Aspirin and epithelial ovarian cancer
Akhmedkhanov A; Toniolo P; Zeleniuch-Jacquotte A; Kato I; Koenig KL; Shore RE
2001 Dec;33(6):682-687, Preventive medicine
BACKGROUND: Epidemiological evidence suggests that chronic inflammation may influence ovarian carcinogenesis. The study objective was to examine the association between the commonly used anti-inflammatory drug aspirin and epithelial ovarian cancer. METHODS: The authors conducted a case-control study based in the New York University Women's Health Study cohort enrolled between 1985 and 1991 in New York City. After a median follow-up period of 12 years, 68 incident cases of epithelial ovarian cancer were identified. Data about regular aspirin use were collected during the 1994-1996 follow-up questionnaire. Using a case-control study design, 10 controls per case were randomly selected among study participants who matched the case by age and menopausal status. Conditional logistic regression analysis was used to study the relationships between aspirin and epithelial ovarian cancer by generating odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Relative to no aspirin use, the OR for epithelial ovarian cancer among women who reported aspirin use three or more times per week for a period of at least 6 months was 0.60 (95% CI 0.26, 1.38), after adjustment for age at menarche, parity, oral contraceptive use, and first-degree family history of breast cancer before age 50. Among recent, within the previous 5 years, users of aspirin, the adjusted OR was 0.36 (95% CI 0.11, 1.18). CONCLUSION: Although confidence intervals included unity, the observed risk estimates seem to be compatible with previous studies suggesting that regular aspirin use could be inversely associated with risk of epithelial ovarian cancer
— id: 26517, year: 2001, vol: 33, page: 682, stat: Journal Article,

Validation of an acculturation scale for Hatian Americans in New York City
Cruz GD; Shore R; Barrow SL; Tavares M; LeGeros RZ
2001 ;80(Special issue):668-668, Journal of dental research
— id: 147067, year: 2001, vol: 80, page: 668, stat: Journal Article,

A prospective study of insulin-like growth factor-I, IGF-binding proteins-1, -2 and -3 and lung cancer risk in women
Lukanova A; Toniolo P; Akhmedkhanov A; Biessy C; Haley NJ; Shore RE; Riboli E; Rinaldi S; Kaaks R
2001 Jun 15;92(6):888-892, International journal of cancer
Insulin-like growth factor-I (IGF-I) has mitogenic and anti-apoptotic properties and has been implicated in the development of breast, colorectum, prostate and lung cancer. IGF binding proteins (IGFBPs) are not only carrier proteins for IGFs but also hold a central position in IGF ligand-receptor interactions through influences on the bioavailability and distribution of IGFs in the extracellular environment. A case-control study nested within the New York University Women's Health Study Cohort included 93 women diagnosed with lung cancer at least 6 months after recruitment into the study. Two controls (n = 186) were matched to each case on age, date of blood sampling, menopausal status, day of menstrual cycle and questionnaire data of smoking status at the time of blood donation. Serum IGF-I, IGFBP-1, -2 and -3, insulin and cotinine were measured. Mean serum levels of IGF-I, IGFBP-1, -2 and -3 were not significantly different between the case and control groups. Univariate logistic regression analyses showed no association of lung cancer risk with serum levels of IGF-I or any of the IGFBPs. These results remained virtually the same in multivariate analyses, including adjustment for cotinine, time since last meal, BMI, IGF-I or IGFBP-3, respectively. Exclusion of cases diagnosed within 3 years of recruitment in the cohort, or restriction of the analyses to adenocarcinomas only, did not alter these results. Our study does not offer evidence in support of an association between prediagnostic serum levels of IGF-I or IGFBP-1, -2 and -3 and lung cancer risk in women
— id: 34549, year: 2001, vol: 92, page: 888, stat: Journal Article,

Reliability and validity of commercially available, direct radioimmunoassays for measurement of blood androgens and estrogens in postmenopausal women
Rinaldi S; Dechaud H; Biessy C; Morin-Raverot V; Toniolo P; Zeleniuch-Jacquotte A; Akhmedkhanov A; Shore RE; Secreto G; Ciampi A; Riboli E; Kaaks R
2001 Jul;10(7):757-765, Cancer epidemiology biomarkers & prevention
In large-scale epidemiological studies on endogenous sex steroids and cancer risk, direct immunoassays of circulating hormone levels have the advantage of being fast and comparatively inexpensive while requiring only small sample volumes. On the other hand, indirect assays after organic extraction and chromatographic prepurification have the advantage of reducing specific interferences and matrix effects and hence are thought to have better validity. We compared direct assays of testosterone (T, six different assays), Delta4-androstenedione (A, four assays), estrone (E(1), one assay), and 17beta-estradiol (E(2), five assays) with measurements obtained by an indirect assay in a representative subset of 20 postmenopausal women who were part of a large prospective cohort study. Within-batch reproducibilities of the subject rankings by relative hormone levels were good (intraclass correlations >0.89) for all direct assays tested. Between batches, reproducibilities generally were also acceptable (r > 0.80) to good (r > 0.90) in terms of Pearson's correlations. The between-batch reproducibility in terms of intraclass correlations was systematically lower in terms of Pearson's correlations, however, because of between-batch variations in the absolute scale of measurements. The relative validity of direct versus indirect assays in terms of the subjects' ranking by relative hormone levels was also high for most of the kits tested for T, A, and E(1) (Pearson's correlations between 0.70 and 0.89) but was high for only two kits of five tested for E(2) (correlations of 0.86 and 0.84). On an absolute scale, mean measurement values were generally higher for direct assays than for the indirect assay and, for each hormone, varied substantially, depending on the kit used. Overall, the results of this study show that, with careful selection, commercial kits for direct radioimmunoassays of steroid hormones in postmenopausal serum can be found that may allow a reliable estimation of relative risks in epidemiological studies. However, standardization of the absolute scale of assays remains problematic
— id: 34548, year: 2001, vol: 10, page: 757, stat: Journal Article,

Radiation-induced skin cancer in humans
Shore RE
2001 May;36(5):549-554, Medical & pediatric oncology
The principal epidemiologic studies of ionizing radiation and skin cancer have all shown that radiation causes basal cell carcinoma but have not found dose-related excesses of squamous cell carcinoma or malignant melanoma. The Japanese atomic bomb study indicates that doses of radiation under about 1 Gy confer less risk per unit dose than higher doses do. All available studies show that skin cancer risk is greater from radiation exposure at young ages than at older ages. Finding few excess skin cancers among irradiated African-Americans as compared to Caucasians with a comparable dose indicates that skin susceptibility to ultraviolet exposure modifies the excess risk from ionizing radiation. Available evidence indicates that the excess risk of skin cancer lasts for 45 years or more following irradiation. Several studies indicate a risk of nonmelanoma skin cancer (NMSC) following cancer therapy; however, most of the studies reporting on NMSC have not distinguished between patients who received radiotherapy versus chemotherapy. Some, but not all, follow-up studies of cancer patients have reported excesses of malignant melanoma as second malignant neoplasms. It is not clear from the studies how much, if any, of the excess melanoma risk is attributable to radiotherapy.
— id: 20683, year: 2001, vol: 36, page: 549, stat: Journal Article,

Serum carotenoids and breast cancer
Toniolo P; Van Kappel AL; Akhmedkhanov A; Ferrari P; Kato I; Shore RE; Riboli E
2001 Jun 15;153(12):1142-1147, American journal of epidemiology
The consumption of vegetables and fruit may protect against many types of cancer, but research evidence is not compelling for breast cancer. Carotenoids are pigments that are present in most plants and have known antioxidant properties. Blood concentrations of carotenoids have been proposed as integrated biochemical markers of vegetable, fruit, and synthetic supplements consumed. In a case-control study (270 cases, 270 controls) nested within a cohort in New York during 1985-1994, the carotenoids lutein, zeaxanthin, beta-cryptoxanthin, lycopene, alpha-carotene, and beta-carotene were measured in archived serum samples using liquid chromatography. There was an evident increase in the risk of breast cancer for decreasing beta-carotene, lutein, alpha-carotene, and beta-cryptoxanthin. The risk of breast cancer approximately doubled among subjects with blood levels of beta-carotene at the lowest quartile, as compared with those at the highest quartile (odds ratio = 2.21; 95% confidence interval (CI): 1.29, 3.79). The risk associated with the other carotenoids was similar, varying between 2.08 (95% CI: 1.11, 3.90) for lutein and 1.68 (95% CI: 0.99, 2.86) for beta-cryptoxanthin. The odds ratio for the lower quartile of total carotenoids was 2.31 (95% CI: 1.35, 3.96). These observations offer evidence that a low intake of carotenoids, through poor diet and/or lack of vitamin supplementation, may be associated with increased risk of breast cancer and may have public health relevance for people with markedly low intakes
— id: 21175, year: 2001, vol: 153, page: 1142, stat: Journal Article,

Assessing excess lifetime risk for disease after radiation exposure
Xue X; Shore RE
2001 May;80(5):462-469, Health physics
In this paper, we define the excess lifetime risk for a disease due to radiation exposure, and we evaluate the excess lifetime risk for an exposed group with the same age and with a mixture of ages. We propose two methods to estimate the excess lifetime risk: the standard maximum likelihood approach and a Monte-Carlo approach. Both approaches allow us to construct confidence intervals for the excess lifetime risk and perform hypothesis testing to compare two excess risks. The maximum likelihood approach is straightforward and computationally simple; however, it may not provide good approximations when the normality assumption is violated. The Monte-Carlo approach is always reliable, but often involves heavier computations and additional programming. These two approaches are illustrated and discussed based on a pooled analysis of five cohorts exposed to external radiation and followed up for subsequent thyroid cancer incidence
— id: 20713, year: 2001, vol: 80, page: 462, stat: Journal Article,

Postmenopausal endogenous oestrogens and risk of endometrial cancer: results of a prospective study
Zeleniuch-Jacquotte A; Akhmedkhanov A; Kato I; Koenig KL; Shore RE; Kim MY; Levitz M; Mittal KR; Raju U; Banerjee S; Toniolo P
2001 Apr 6;84(7):975-981, British journal of cancer
We assessed the association of postmenopausal serum levels of oestrogens and sex hormone-binding globulin (SHBG) with endometrial cancer risk in a case-control study nested within the NYU Women's Health Study cohort. Among 7054 women postmenopausal at enrolment, 57 cases of endometrial cancer were diagnosed a median of 5.5 years after blood donation. Each case was compared to 4 controls matched on age, menopausal status at enrolment, and serum storage duration. Endometrial cancer risk increased with higher levels of oestradiol (odds ratio = 2.4 in highest vs lowest tertile, P for trend = 0.02), percent free oestradiol (OR = 3.5, P< 0.001), and oestrone (OR = 3.9, P< 0.001). Risk decreased with higher levels of percent SHBG-bound oestradiol (OR = 0.43, P = 0.03) and SHBG (OR = 0.39, P = 0.01). Trends remained in the same directions after adjusting for height and body mass index. A positive association of body mass index with risk was substantially reduced after adjusting for oestrone level. Our results indicate that risk of endometrial cancer increases with increasing postmenopausal oestrogen levels but do not provide strong support for a role of body mass index independent of its effect on oestrogen levels.
— id: 21217, year: 2001, vol: 84, page: 975, stat: Journal Article,

Serum C-peptide, insulin-like growth factor (IGF)-I, IGF-binding proteins, and colorectal cancer risk in women
Kaaks R; Toniolo P; Akhmedkhanov A; Lukanova A; Biessy C; Dechaud H; Rinaldi S; Zeleniuch-Jacquotte A; Shore RE; Riboli E
2000 Oct 4;92(19):1592-1600, Journal of the National Cancer Institute
BACKGROUND: Leading a Western lifestyle, being overweight, and being sedentary are associated with an increased risk of colorectal cancer. Recent theories propose that the effects of these risk factors may be mediated by increases in circulating insulin levels and in the bioactivity of insulin-like growth factor (IGF)-I. To test this hypothesis, we conducted a case-control study nested within a cohort of 14 275 women in New York. METHODS: We used blood samples that had been obtained from these women from March 1985 through June 1991 and stored in a biorepository. C-peptide (a marker for insulin secretion), IGF-I, and IGF-binding proteins (IGFBPs)-1, -2, and -3 were assayed in the serum of 102 women who subsequently developed colorectal cancer and 200 matched control subjects. Logistic regression was used to relate cancer risk to these peptide levels, by adjustment for other risk factors. All statistical tests used are two-sided. RESULTS: Colorectal cancer risk increased with increasing levels of C-peptide (P:(trend) =.001), up to an odds ratio (OR) of 2. 92 (95% confidence interval [CI] = 1.26-6.75) for the highest versus the lowest quintiles, after adjustment for smoking. For colon cancer alone (75 case subjects and 146 control subjects), ORs increased up to 3.96 (95% CI = 1.49-10.50; P:(trend) <.001) for the highest versus the lowest quintiles. A statistically significant decrease in colorectal cancer risk was observed for increasing levels of IGFBP-1 (P:(trend) =.02; OR in the upper quintile = 0.48 [95% CI = 0.23-1. 00]), as well as for the highest quintile of IGFBP-2 levels (P:(trend) =.06; OR = 0.38 [95% CI = 0.15-0.94]). Colorectal cancer risk showed a modest but statistically nonsignificant positive association with levels of IGF-I and was statistically significantly increased for the highest quintile of IGFBP-3 (OR = 2.46 [95% CI = 1. 09-5.57]). CONCLUSIONS: Chronically high levels of circulating insulin and IGFs associated with a Western lifestyle may increase colorectal cancer risk, possibly by decreasing IGFBP-1 and increasing the bioactivity of IGF-I
— id: 34552, year: 2000, vol: 92, page: 1592, stat: Journal Article,

Risk of iron overload among middle-aged women
Kato I; Dnistrian AM; Schwartz M; Toniolo P; Koenig K; Shore RE; Zeleniuch-Jacquotte A; Akhmedkhanov A; Riboli E
2000 May;70(3):119-125, International journal for vitamin & nutrition research
Iron overload, expressed as increased body iron stores, has been recognized as a potential hazard because it promotes the generation of oxygen radicals. We analyzed factors associated with serum ferritin levels (an indicator of body iron stores) among middle-aged women with a high prevalence of nutrient supplement use. Serum ferritin concentrations were determined on automated immunoassay for 487 healthy women with the mean age of 57 years who participated in the New York University Women's Health Study. The mean serum ferritin concentration in postmenopausal women was more than twice that in premenopausal women. Serum ferritin concentrations progressively increased with advancing age, but adjustment for menopausal status considerably weakened this association. Among non-dietary factors, nonwhite ethnicity, obesity and cigarette smoking were positively associated with serum ferritin concentrations. After adjustment for these factors and for menopausal status, serum ferritin levels were positively associated with meat intake and multivitamin use and inversely associated with breakfast cereal consumption. However, none of these lifestyle factors positively associated with serum ferritin levels had a significant impact on serum ferritin levels above 100 ng/ml (approximately equal to median concentration). Our results suggest that iron overload seems unlikely among middle aged women through their diet and nutritional supplements
— id: 34554, year: 2000, vol: 70, page: 119, stat: Journal Article,

Diet, smoking and anthropometric indices and postmenopausal bone fractures: a prospective study
Kato I; Toniolo P; Zeleniuch-Jacquotte A; Shore RE; Koenig KL; Akhmedkhanov A; Riboli E
2000 Feb;29(1):85-92, International journal of epidemiology
OBJECTIVE: Bone fractures are an important cause of morbidity and mortality among the elderly in the US. The present study assesses the possible role of a number of risk factors for postmenopausal bone fractures. METHODS: We analysed the relationships of anthropometric, demographic and lifestyle factors with the risk of bone fracture among 6250 postmenopausal women in a prospective cohort study, the New York University Women's Health Study. RESULTS: After an average of 7.6 years of follow-up, 1025 new incident bone fractures were reported, including 34 hip and 159 wrist fractures (incidence rates; 71.6 and 334.7 per 105 woman-years, respectively). The risk of fracture increased with increasing age, body height and total fat intake, while it was significantly lower among obese and African American women. The relative risk among African Americans was 0.45 (95% CI: 0.32-0.63) compared with non-African Americans. Women taller than 170 cm had a 64% increase in risk of fractures, as compared with those under 155 cm. These associations were generally more pronounced when fractures were limited to those at the hip and wrist. CONCLUSIONS: The present study provides an indication for a potential role of dietary fat in the development of postmenopausal fractures and further evidence to support protective effects of obesity, short stature and African American ethnicity
— id: 10348, year: 2000, vol: 29, page: 85, stat: Journal Article,

Psychotropic medication use and risk of hormone-related cancers: the New York University Women's Health Study
Kato I; Zeleniuch-Jacquotte A; Toniolo PG; Akhmedkhanov A; Koenig K; Shore RE
2000 Jun;22(2):155-160, Journal of public health medicine
BACKGROUND: The use of psychotropic medications may increase the risk of hormone-related cancers in females through increased gonadotropin secretion, but the data from epidemiologic studies are limited to evaluate the hypothesis. METHODS: The association between the use of psychotropic medications and cancer incidence was studied in a prospective cohort study that involves 15,270 women who participated in mammographic screening. The relative risks (RR) and 95 per cent confidence intervals (CIs) for cancer associated with the use of psychotropic medications were estimated by the Cox's proportional hazard model. RESULTS: During an average of 7.3 years of follow-up, 1,130 incident cases of cancer were identified, including 566 breast, 67 endometrial and 47 ovarian cancers. The use of any type of psychotropic medication at baseline was associated with increased risks of breast [relative risk (RR) = 1.39, 95 per cent CI 1.11-1.74], endometrial (RR=1.71; 95 per cent CI 0.93-3.14) and ovarian (RR= 1.48, 95 per cent CI 0.69-3.16) cancers, whereas no increase in risk was observed for other cancers (RR = 1.06). When the subjects were divided by menopausal status at baseline, premenopausal women tended to have higher risk of all hormone-related cancers (RR = 1.73, 95 per cent CI 1.27-2.35) than postmenopausal women (RR=1.23, 95 per cent CI 0.94-1.62). The magnitude of the RR associated with the use of these medications did not change by length of follow-up. Analysis by type of medication did not find that the association was limited to specific types. CONCLUSION: The observed association needs to be confirmed in further studies based on more detailed medication history
— id: 34553, year: 2000, vol: 22, page: 155, stat: Journal Article,

Drug injection rates and needle-exchange use in New York City, 1991-1996 [In Process Citation]
Marmor M; Shore RE; Titus S; Chen X; Des Jarlais DC
2000 Sep;77(3):359-368, Journal of urban health
Objectives included (1) to develop methods for identifying injection drug users with accelerating injection habits so they might be referred to counseling and treatment and (2) to investigate behavioral correlates of accelerating injection habits, including syringe-exchange program utilization. Data on drug use, enrollment in methadone maintenance, and demographic variables were obtained from 328 subjects who were seronegative for human immunodeficiency virus (HIV) who attended anywhere from 4 to 11 quarterly study visits for interview, HIV pretest counseling and risk reduction counseling, and blood donation for HIV antibody testing. Subjects were recalled 2 weeks after each study visit to receive their results and post-test counseling. We characterized subjects according to their patterns of drug injection as accelerating, decelerating, or stable, using intraindividual regression analyses and categorization rules, and by syringe-exchange use as consistent users, sporadic users, or nonusers. The present subjects included 52% with decelerating, 29% with stable, and 19% with accelerating rates of drug injection. There were 128 subjects (39%) who were categorized as consistent users of syringe-exchange programs, 84 (25%) were categorized as sporadic users, and 116 (35%) were categorized as nonusers. All syringe-exchange groups showed significantly decelerating drug injection. Rates of decline were significantly less, however, among consistent syringe-exchange users than sporadic or nonusers of syringe exchanges. Categorical analysis also showed significant differences among groups, with 30% of consistent syringe-exchange program users having accelerating rates of drug injection compared to 9% of nonusers and 17% of sporadic users. That consistent syringe-exchange users included a larger proportion of individuals whose drug habits were accelerating than did sporadic users or nonusers of syringe exchanges suggests a need for improved identification and counseling of such subjects by syringe-exchange program staff. The present statistical approaches may be of value in targeting such efforts. The ability of a syringe-exchange program to attract a disproportionate share of drug users with accelerating rates of drug injection underscores the importance of these programs to HIV prevention efforts
— id: 9088, year: 2000, vol: 77, page: 359, stat: Journal Article,

Handheld cellular telephone use and risk of brain cancer
Muscat JE; Malkin MG; Thompson S; Shore RE; Stellman SD; McRee D; Neugut AI; Wynder EL
2000 Dec 20;284(23):3001-3007, JAMA
CONTEXT: A relative paucity of data exist on the possible health effects of using cellular telephones. OBJECTIVE: To test the hypothesis that using handheld cellular telephones is related to the risk of primary brain cancer. DESIGN AND SETTING: Case-control study conducted in 5 US academic medical centers between 1994 and 1998 using a structured questionnaire. PATIENTS: A total of 469 men and women aged 18 to 80 years with primary brain cancer and 422 matched controls without brain cancer. MAIN OUTCOME MEASURE: Risk of brain cancer compared by use of handheld cellular telephones, in hours per month and years of use. RESULTS: The median monthly hours of use were 2.5 for cases and 2.2 for controls. Compared with patients who never used handheld cellular telephones, the multivariate odds ratio (OR) associated with regular past or current use was 0.85 (95% confidence interval [CI], 0.6-1.2). The OR for infrequent users (<0. 72 h/mo) was 1.0 (95% CI, 0.5-2.0) and for frequent users (>10.1 h/mo) was 0.7 (95% CI, 0.3-1.4). The mean duration of use was 2.8 years for cases and 2.7 years for controls; no association with brain cancer was observed according to duration of use (P =.54). In cases, cerebral tumors occurred more frequently on the same side of the head where cellular telephones had been used (26 vs 15 cases; P =.06), but in the cases with temporal lobe cancer a greater proportion of tumors occurred in the contralateral than ipsilateral side (9 vs 5 cases; P =.33). The OR was less than 1.0 for all histologic categories of brain cancer except for uncommon neuroepitheliomatous cancers (OR, 2.1; 95% CI, 0.9-4.7). CONCLUSIONS: Our data suggest that use of handheld cellular telephones is not associated with risk of brain cancer, but further studies are needed to account for longer induction periods, especially for slow-growing tumors with neuronal features
— id: 38448, year: 2000, vol: 284, page: 3001, stat: Journal Article,

Validation of biomarkers in humans exposed to benzene: urine metabolites
Qu Q; Melikian AA; Li G; Shore R; Chen L; Cohen B; Yin S; Kagan MR; Li H; Meng M; Jin X; Winnik W; Li Y; Mu R; Li K
2000 May;37(5):522-531, American journal of industrial medicine
BACKGROUND: The present study was conducted among Chinese workers employed in glue- and shoe-making factories who had an average daily personal benzene exposure of 31+/-26 ppm (mean+/-SD). The metabolites monitored were S-phenylmercapturic acid (S-PMA), trans, trans-muconic acid (t,t-MA), hydroquinone (HQ), catechol (CAT), 1,2, 4-trihydroxybenzene (benzene triol, BT), and phenol. METHODS: S-PMA, t,t-MA, HQ, CAT, and BT were quantified by HPLC-tandem mass spectrometry. Phenol was measured by GC-MS. RESULTS: Levels of benzene metabolites (except BT) measured in urine samples collected from exposed workers at the end of workshift were significantly higher than those measured in unexposed subjects (P < 0.0001). The large increases in urinary metabolites from before to after work strongly correlated with benzene exposure. Concentrations of these metabolites in urine samples collected from exposed workers before work were also significantly higher than those from unexposed subjects. The half-lives of S-PMA, t,t-MA, HQ, CAT, and phenol were estimated from a time course study to be 12.8, 13.7, 12.7, 15.0, and 16.3 h, respectively. CONCLUSIONS: All metabolites, except BT, are good markers for benzene exposure at the observed levels; however, due to their high background, HQ, CAT, and phenol may not distinguish unexposed subjects from workers exposed to benzene at low ambient levels. S-PMA and t,t-MA are the most sensitive markers for low level benzene exposure.
— id: 10349, year: 2000, vol: 37, page: 522, stat: Journal Article,

Serum insulin-like growth factor-I and breast cancer
Toniolo P; Bruning PF; Akhmedkhanov A; Bonfrer JM; Koenig KL; Lukanova A; Shore RE; Zeleniuch-Jacquotte A
2000 Dec 1;88(5):828-832, International journal of cancer
Insulin-like growth factor I (IGF-I) is a systemic hormone with potent mitogenic and anti-apoptotic properties, which could influence the proliferative behavior of normal breast cells. Limited epidemiological observations suggest that the hormone may play a role in the etiology of breast cancer, especially at pre-menopausal ages. In a prospective case-control study nested within a cohort of New York City women, IGF-I, IGF-binding protein 3 (IGFBP-3) and C peptide were measured in frozen serum samples from 172 pre-menopausal and 115 post-menopausal subjects who were subsequently diagnosed with breast cancer. Subjects were eligible if diagnosed 6 months or more after recruitment into the study (7 to 120 months). Cohort members who matched the cases on age, menopausal status, date of blood sampling and day of menstrual cycle at blood collection served as controls. Post-menopausal breast cancer was not associated with serum IGF-I, IGFBP-3 or C-peptide levels. However, the risk of breast cancer increased with increasing serum concentrations of IGF-I in pre-menopausal women. The odds ratio (OR) for the highest quartile of IGF-I (>256 ng/ml) compared to the lowest (<168 ng/ml) was 1.60 [95% confidence interval (CI) 0.91-2. 81]. The OR decreased to 1.49 (95% CI 0.80-2.79) after adjustment for IGFBP-3. In analyses restricted to subjects who were pre-menopausal at the time of blood sampling and whose cancer was diagnosed before age 50, the top vs. bottom quartile OR increased appreciably to 2.30 (95% CI 1.07-4.94). Adjustment for IGFBP-3 reduced the OR to 1.90 (95% CI 0.82-4.42). There was no association between pre-menopausal breast cancer and IGFBP-3, IGF-I:IGFBP-3 ratio or non-fasting levels of C peptide. Elevated circulating levels of IGF-I may be an indicator of increased risk of breast cancer occurring before age 50
— id: 34550, year: 2000, vol: 88, page: 828, stat: Journal Article,

A continence index predicts the early return of urinary continence after radical retropubic prostatectomy
Twiss C; Martin S; Shore R; Lepor H
2000 Oct;164(4):1241-1247, Journal of urology
PURPOSE: We evaluated the ability of a newly developed continence index to predict the return of urinary continence 3 months after radical retropubic prostatectomy. MATERIALS AND METHODS: We developed and used a continence index to determine continence level after removal of the urinary catheter on postoperative day 15 in 145 men. A total of 20 patients were evaluated independently by 2 nurse specialists to assess continence index reliability. We evaluated continence level, pad use and degree of bothersomeness due to incontinence 3 months after catheter removal. The association of continence score with outcome variables was calculated using the Mantel-Haenszel trend test and the predictive ability of the continence score was determined by logistic regression to produce cumulative odds ratios. RESULTS: The intraclass correlation coefficient was 0.995 for the independently assessed continence index ratings and the Cronbach coefficient alpha was 0.65 for the 5 continence index parameters. Complete continence or continence with heavy activity but not always was achieved by 96%, 85% and 68% of the men in tertiles 1 (continence score 18), 2 (continence score 15 to 17) and 3 (continence score 14 or less), respectively. The cumulative odds ratio of 2.9 (95% confidence interval [CI] 1.9 to 4. 6) per tertile indicated a 2.9-fold increased chance of incontinence for each successively lower tertile. In addition, 96%, 82% and 68% of the men in tertiles 1 to 3, respectively, required no or 1 small pad daily. The cumulative odds ratio for pad use was 2.3 (95% CI 1.5 to 3.5) per tertile. Of the patients in tertiles 1 to 3 100%, 97% and 80%, respectively, had no or slight bothersomeness due to urinary incontinence. The cumulative odds ratio for bothersomeness level was 2.7 (95% CI 1.7 to 4.3) per tertile. The Mantel-Haenszel trend test showed a significant association of continence score with all 3 outcome variables (p < or =0.001). CONCLUSIONS: Our continence index is a simple and reliable instrument that provides useful prognostic information on the early return of continence after radical retropubic prostatectomy
— id: 32246, year: 2000, vol: 164, page: 1241, stat: Journal Article,

Serum folate, homocysteine and colorectal cancer risk in women: a nested case-control study
Kato I; Dnistrian AM; Schwartz M; Toniolo P; Koenig K; Shore RE; Akhmedkhanov A; Zeleniuch-Jacquotte A; Riboli E
1999 Apr;79(11-12):1917-1922, British journal of cancer
Accumulating evidence suggests that folate, which is plentiful in vegetables and fruits, may be protective against colorectal cancer. The authors have studied the relationship of baseline levels of serum folate and homocysteine to the subsequent risk of colorectal cancer in a nested case-control study including 105 cases and 523 matched controls from the New York University Women's Health Study cohort. In univariate analyses, the cases had lower serum folate and higher serum homocysteine levels than controls. The difference was more significant for folate (P < 0.001) than for homocysteine (P = 0.04). After adjusting for potential confounders, the risk of colorectal cancer in the subjects in the highest quartile of serum folate was half that of those in the lowest quartile (odds ratio, OR = 0.52, 95% confidence interval, CI = 0.27-0.97, P-value for trend = 0.04). The OR for the highest quartile of homocysteine, relative to the lowest quartile, was 1.72 (95% CI = 0.83-3.65, P-value for trend = 0.09). In addition, the risk of colorectal cancer was almost twice as high in subjects with below-median serum folate and above-median total alcohol intake compared with those with above-median serum folate and below-median alcohol consumption (OR = 1.99, 95% CI = 0.92-4.29). The potentially protective effects of folate need to be confirmed in clinical trials
— id: 6090, year: 1999, vol: 79, page: 1917, stat: Journal Article,

Epidemiologic correlates of serum folate and homocysteine levels among users and non-users of vitamin supplement
Kato I; Dnistrian AM; Schwartz M; Toniolo P; Koenig K; Shore RE; Zeleniuch-Jacquotte A; Akhmedkhanov A; Riboli E
1999 Sep;69(5):322-329, International journal for vitamin & nutrition research
Lower serum folate and higher serum homocysteine levels are known risk factors for various conditions. Thus, epidemiologic correlates with these measurements were studied for 256 multivitamin users and 230 non-users who were middle-aged women. Both serum folate and homocysteine levels increased with advancing age in both multivitamin users (P < 0.01 and P < 0.01) and non-users (P = 0.08 and P < 0.01). Among non-users, higher intake of vegetables, fruits, cold cereals and total protein were associated positively with serum folate and inversely with homocysteine levels. There were 25-74% increases in serum folate and 10-15% decreases in serum homocysteine between 1st and 4th quartiles of intake of these food/nutrients. In addition, 26% lower serum folate and 18% higher serum homocysteine were observed for those smoking 20 or more cigarettes per day compared with non-smokers. Among multivitamin users, body weight was correlated inversely with serum folate (P < 0.01) and positively with serum homocysteine levels (P = 0.04), while no correlates were found among lifestyle factors. Regular use of multivitamins increased serum folate about fourfold and decreased homocysteine twofold. These results suggest that multivitamin use can offset the effects of an unhealthy lifestyle on these serum markers, and that levels of serum folate and homocysteine can also be favorably influenced by healthier diet and abstinence from smoking
— id: 6221, year: 1999, vol: 69, page: 322, stat: Journal Article,

Iron intake, body iron stores and colorectal cancer risk in women: a nested case-control study
Kato I; Dnistrian AM; Schwartz M; Toniolo P; Koenig K; Shore RE; Zeleniuch-Jacquotte A; Akhmedkhanov A; Riboli E
1999 Mar 1;80(5):693-698, International journal of cancer
Accumulated evidence suggests that increased body iron stores may increase the risk of colorectal cancer, possibly via catalyzing oxidation reactions. We examined the relationship between iron status and colorectal cancer in a case-control study nested within the New York University Women's Health Study cohort. For 105 incident cases of colorectal cancer with an average follow-up of 4.7 years and 523 individually matched controls, baseline levels of serum iron, ferritin, total iron binding capacity (TIBC) and transferrin saturation were determined as indicators of body iron stores, and total iron intake was assessed based on their diet and supplement intake. Overall, there were no associations between the risk of colorectal cancer and any of these indices except for serum ferritin, which showed a significant inverse association. When analyzed by subsite, there was an increasing trend in risk of cancer of the proximal colon with increasing total iron intake (p-value for trend = 0.04). In addition, a significantly increased risk of colorectal cancer associated with higher total iron intake [odds ratio (OR) = 2.50; 95% confidence interval (CI): 1.06-5.87] was observed among subjects with higher intake of total fat. Our results do not support a role of increased body iron stores in the development of colorectal cancer, but suggest that luminal exposure to excessive iron may possibly increase the risk in combination with a high fat diet
— id: 7363, year: 1999, vol: 80, page: 693, stat: Journal Article,

Epidemiologic correlates with menstrual cycle length in middle aged women
Kato I; Toniolo P; Koenig KL; Shore RE; Zeleniuch-Jacquotte A; Akhmedkhanov A; Riboli E
1999 Oct;15(9):809-814, European journal of epidemiology
While irregular menstruations have been associated with lower cumulative exposure to the ovarian steroids, shorter regular cycles have been postulated to increase the cumulative exposure. Epidemiological correlates with menstrual patterns were analyzed among 4900 premenopausal women aged 45 or younger from the New York University Women's Health Study. The length of regular menstrual cycles increased with increasing age at menarche, body mass index and parity, but decreased with age, nonwhite racial background and current smoking. The likelihood of irregular cycles increased with increasing age, body mass index and number of cigarettes smoked per day. With adjustment for age, body mass index and number of cigarettes smoked per day, the risk of irregular cycles was marginally positively associated with total fat intake
— id: 10358, year: 1999, vol: 15, page: 809, stat: Journal Article,

Onset of natural menopause - Response
Kato, I; Toniolo, P; Akhmedkhanov, A; Koenig, KL; Shore, R; Zeleniuch-Jacquotte, A
1999 DEC ;52(12):1291-1292, Journal of clinical epidemiology
— id: 53844, year: 1999, vol: 52, page: 1291, stat: Journal Article,

Equivalence trials in SLE research: issues to consider
Kim MY; Buyon JP; Petri M; Skovron ML; Shore RE
1999 ;8(8):620-626, Lupus
In contrast to the objective of most clinical trials, which is to demonstrate superiority of an experimental treatment over a standard or placebo, the aim of an equivalence trial is to show that two treatments are equivalent in outcome or only marginally different. This would be of interest when an experimental treatment offers advantages such as reduced toxicity, ease of administration, or cost relative to the standard. Demonstrating equivalence may also be a goal when evaluating the safety of certain drugs because similarity in the risks of an adverse event in subjects exposed and unexposed to the drug is an indication of its safety. The classical formulation of the null hypothesis of treatment equality that is used in superiority trials is not applicable to equivalence trials because absolute equivalence between treatment groups cannot be proven. The strategy in equivalence trials is to define a maximum difference between treatment groups that is clinically acceptable and then assess whether there is sufficient evidence from the trial to conclude that the true treatment difference is within this acceptable range. In this paper, we discuss issues surrounding the planning, conduct, and analysis of equivalence trials in the context of SLE, with examples from the SELENA study
— id: 11928, year: 1999, vol: 8, page: 620, stat: Journal Article,

Body fat distribution and obesity in pre- and postmenopausal breast cancer
Sonnenschein E; Toniolo P; Terry MB; Bruning PF; Kato I; Koenig KL; Shore RE
1999 Dec;28(6):1026-1031, International journal of epidemiology
BACKGROUND: Excessive body weight is known to increase the risk of postmenopausal, but not premenopausal breast cancer. Some studies have suggested that being overweight is protective against premenopausal breast cancer, but the evidence is not compelling. Much less is known about the role of body fat distribution in either pre- or postmenopausal breast cancer. METHODS: Breast cancer risk was examined in relation to body weight, height, Quetelet index (kg/m2), and waist/hip ratio (WHR) in the New York University Women's Health Study, a prospective cohort study. Cases were 109 premenopausal and 150 postmenopausal women diagnosed with breast cancer between 1985 and 1994. Non-cases were 8,157 cohort members free of breast cancer. RESULTS: Among premenopausal women, there was an increasing risk of breast cancer with increasing WHR. The relative risk (RR) of breast cancer increased to 1.72 (95% confidence interval [CI]: 1.0-3.1) in the upper quartile of WHR. The association was limited to subjects who had elevated Quetelet index, but not among those with lower weight. Overall, Quetelet index itself was not related to breast cancer risk in the premenopausal group, but there was a protective association among those ranking below the median WHR. In postmenopausal women, the RR for breast cancer increased to 2.36 (95% CI: 1.4-3.9) in the upper quartile of Quetelet index, but there was no association with WHR. Height was not associated with breast cancer in this study. CONCLUSIONS: The study confirms that excessive body weight increases breast cancer risk in postmenopausal women. On the contrary, in premenopausal women, excessive body weight may be protective among women who have a lower-body type of fat accumulation (low WHR). An upper-body fat accumulation (high WHR) is a predictor of breast cancer risk in premenopausal women, and this effect is especially pronounced among subjects who are overweight
— id: 10351, year: 1999, vol: 28, page: 1026, stat: Journal Article,

XP-A mutations in basal cell carcinomas (BCCs) from X-irradiated tinea capitis patients with multiple BCCs
Zhao, P; Shore, R E; Roy, N; Burns, F
1999 Apr 10-14;40:283-283, Proceedings (American Association for Cancer Research)
— id: 15918, year: 1999, vol: 40, page: 283, stat: Journal Article,

Prospective study of factors influencing the onset of natural menopause
Kato I; Toniolo P; Akhmedkhanov A; Koenig KL; Shore R; Zeleniuch-Jacquotte A
1998 Dec;51(12):1271-1276, Journal of clinical epidemiology
Late or early menopause has been implicated in risk of several chronic diseases in women. To study factors influencing the onset of natural menopause, the authors analyzed the follow-up data of 4694 premenopausal women who enrolled in the New York University Women Study at ages 34-61. In an average of 5.4 years of observation, there were 2035 incidences of menopause, with the median age of 51.3 years. Current smokers experienced menopause 0.75 years earlier than never-smokers. Those who smoked more than 10 cigarettes per day had a 40% increase in risk of earlier menopause. In contrast, women who had three or more children experienced menopause 0.86 years later than nulliparous women, and Jewish women, 0.66 years later than Catholic women. There was also a modest increase in the age at menopause with increasing body mass index. This prospective study provides solid epidemiologic evidence that several factors other than cigarette smoking have impact on the onset of natural menopause
— id: 6062, year: 1998, vol: 51, page: 1271, stat: Journal Article,

Prospective study of diet and female colorectal cancer: the New York University Women's Health Study
Kato I; Akhmedkhanov A; Koenig K; Toniolo PG; Shore RE; Riboli E
1997 ;28(3):276-281, Nutrition & cancer
The relation between diet and female colorectal cancer was analyzed in a prospective study of 14,727 women aged 34-65 years, who were enrolled at mammographic screening clinics in New York and Florida from 1985 to 1991. They were followed through the end of 1994 (average 7.1 yrs) by a combination of direct contact through mail and telephone and record linkages with regional tumor registries, resulting in 100 incident cases of colorectal cancer. There was no overall positive or inverse association of colorectal cancer risk with intakes of total calories, total or subclasses of fat, carbohydrate, or dietary fiber, whereas there was an inverse association with total protein. Among major food groups, there was a progressive decline in risk of colorectal cancer with increasing intake of fish and shellfish (relative risk for 4th vs. 1st quartile = 0.49, 95% confidence interval = 0.27-0.89). A similar inverse association was also observed for consumption of dairy products, and this association was explained mainly by calcium, not by other nutrients, such as fat or protein. The results of the present study indicated that certain dietary components of fish or dairy products may protect against colorectal cancer, whereas the relations with red meat or total fat remained unclear
— id: 10362, year: 1997, vol: 28, page: 276, stat: Journal Article,

Sex hormone-binding globulin in estrogen-dependent cancer and estrogen replacement therapy
Levitz M; Banerjee S; Raju U; Toniolo PG; Shore RE; Nachtigall LE
1997 Sep 26;828:358-365, Annals of the New York Academy of Sciences
— id: 12252, year: 1997, vol: 828, page: 358, stat: Journal Article,

Reproducibility of a food frequency questionnaire used in the New York University Women's Health Study: effect of self-selection by study subjects
Riboli E; Toniolo P; Kaaks R; Shore RE; Casagrande C; Pasternack BS
1997 Jul;51(7):437-442, European journal of clinical nutrition
OBJECTIVE: The aim of the study was to investigate the reproducibility of a food frequency questionnaire (FFQ) used in a cohort of 14,290 women enrolled in the NYU Women's Health Study. DESIGN: A subset of 474 cohort subjects who completed the dietary questionnaire at baseline (FFQ-1) were approached again on the occasion of a second visit to the mammography study centre and asked to complete the questionnaire a second time (FFQ-2) two to four years after FFQ-1. Two to three months later the questionnaire was mailed to the subjects, and they were asked to complete it a third time (FFQ-3). SETTING: A breast cancer screening clinic. SUBJECTS: Of the 474 subjects selected, 100% completed the second questionnaire while only 56% completed and mailed back FFQ-3. This made it possible to compare the long-term reproducibility of dietary intake measurements and baseline dietary habits between the two groups of subjects 'respondents', who agreed to complete the questionnaire a third time, and 'non-respondents', who did not. RESULTS: Among respondents (56% of study subjects), energy-adjusted correlation coefficients for short-term reproducibility between FFQ-2 and FFQ-3 ranged from 0.50-0.64 for nutrients, and from 0.44-0.67 for foods. The long-term reproducibility was lower, ranging from 0.36-0.53 for nutrients, and from 0.31-0.48 for specific food groups. Among those who did not respond to FFQ-3, crude correlations for long-term reproducibility, unadjusted for energy intake, were generally lower than among respondents. Nevertheless, after adjustment for energy intake, correlations for long-term reproducibility (FFQ-2 to FFQ-1) were of similar magnitude in both groups. In addition, 'non-respondents' reported lower intake of fruit and vegetables and higher intake of meat. CONCLUSIONS: The results of this study suggest that subjects who volunteer to participate in substudies on the validity or reproducibility of dietary questionnaire measurements may tend to provide more accurate responses to the questionnaire. The phenomenon seems related more to accuracy of reporting of absolute intake levels than of the relative composition of diet, self-selection may be associated with differences in dietary habits
— id: 10263, year: 1997, vol: 51, page: 437, stat: Journal Article,

Relation of serum levels of testosterone and dehydroepiandrosterone sulfate to risk of breast cancer in postmenopausal women
Zeleniuch-Jacquotte A; Bruning PF; Bonfrer JM; Koenig KL; Shore RE; Kim MY; Pasternack BS; Toniolo P
1997 Jun 1;145(11):1030-1038, American journal of epidemiology
The authors examined the relation between postmenopausal serum levels of testosterone and dehydroepiandrosterone sulfate (DHEAS) and subsequent risk of breast cancer in a case-control study nested within the New York University Women's Health Study cohort. A specific objective of their analysis was to examine whether androgens had an effect on breast cancer risk independent of their effect on the biologic availability of estrogen. A total of 130 cases of breast cancer were diagnosed prior to 1991 in a cohort of 7,054 postmenopausal women who had donated blood and completed questionnaires at a breast cancer screening clinic in New York City between 1985 and 1991. For each case, two controls were selected, matching the case on age at blood donation and length of storage of serum specimens. Biochemical analyses were performed on sera that had been stored at -80 degrees C since sampling. The present report includes a subset of 85 matched sets, for whom at least 6 months had elapsed between blood donation and diagnosis of the case. In univariate analysis, testosterone was positively associated with breast cancer risk (odds ratio (OR) for the highest quartile = 2.7, 95% confidence interval (CI) 1.1-6.8, p < 0.05, test for trend). However, after including % estradiol bound to sex hormone-binding globulin (SHBG) and total estradiol in the statistical model, the odds ratios associated with higher levels of testosterone were considerably reduced, and there was no longer a significant trend (OR for the highest quartile = 1.2, 95% CI 0.4-3.5). Conversely, breast cancer risk remained positively associated with total estradiol levels (OR for the highest quartile = 2.9, 95% CI 1.0-8.3) and negatively associated with % estradiol bound to SHBG (OR for the highest quartile = 0.05, 95% CI 0.01-0.19) after adjustment for serum testosterone levels. These results are consistent with the hypothesis that testosterone has an indirect effect on breast cancer risk, via its influence on the amount of bioavailable estrogen. No evidence was found of an association between DHEAS and risk of breast cancer in postmenopausal women
— id: 7290, year: 1997, vol: 145, page: 1030, stat: Journal Article,

Weight loss associated with HIV seroconversion among injection-drug users
Marmor M; Titus S; Harrison C; Cord-Cruz EA; Shore RE; Vogler M; Krasinski K; Mildvan D; Des Jarlais DC
1996 Aug 15;12(5):514-518, Journal of acquired immune deficiency syndromes & human retrovirology
To describe symptoms associated with human immunodeficiency virus (HIV) seroconversion, we studied a cohort of 366 injection-drug users (IDUs) with a study design that included recall every 3 months to collect symptom histories using a structured questionnaire. Eleven HIV seroconversions were observed in 621.5 person years at risk (PYAR), equivalent to 1.8 seroconversions/100 PYAR. Cox regression analysis showed age < or = 35 years to be a significant risk factor for HIV seroconversion after controlling for gender, race, and the frequency of drug injection. An embedded case-control analysis then compared symptom histories of HIV seroconverters with those of age-(+/- 5 years) and visit number-matched controls who remained HIV seronegative for > or = 3 months longer than the HIV-seroconverters. Multivariate case-control analysis adjusted for injection frequency yielded significant associations of HIV seroconversion with histories of weight loss > or = 4.5 kg (seven of 11 cases; odds ratio [OR] = 11.6, 95% confidence interval [CI] 3.1, 43.1) and oral ulcers (three of 11 cases; OR = 7.6, 95% CI = 1.2, 48.2) in the 3 months before the subjects' first HIV-seropositive study visit. We conclude that histories of recent symptoms reported by HIV-seroconverting IDUs differ from those reported by non-HIV-seroconverting IDUs, and weight loss may be particularly common among IDUs experiencing primary HIV infection
— id: 9096, year: 1996, vol: 12, page: 514, stat: Journal Article,

Epidemiologic issues related to nasopharyngeal radium exposures
Shore RE
1996 Nov;115(5):422-428, Otolaryngology, head & neck surgery
A number of topics are discussed related to the potential for and pitfalls in undertaking epidemiologic studies of the late effects of nasopharyngeal radium irradiation. The available evidence indicates that linear extrapolation of risk estimates from high-dose studies is a reasonable basis for estimating risk from radium exposure or other situations in which the radiation exposures were fairly low and fractionated. Epidemiologic study of populations given nasopharyngeal radium irradiation is worthwhile scientifically if several criteria can be met. It is very important that any such study has adequate statistical power, which is a function of the doses to the organs of interest and the radiation risk coefficients for those organs, as well as the available sample size. If the organ doses are low, a prohibitively large sample size would be required. Other problems with low-dose studies include the likelihood of false-positive results when a number of health end points are evaluated and the impact of dose uncertainties, small biases, and confounding factors that make the interpretation uncertain. Cluster studies or studies of self-selected cohorts of irradiated patients are not recommended because of the potential for severe bias with such study designs. The ability to define subgroups of the population who have heightened genetic susceptibility may become a reality in the next few years as genes conferring susceptibility to brain cancers or other head and neck tumors are identified; this scientific advance would have the potential to alter greatly the prospects and approaches of epidemiologic studies
— id: 12505, year: 1996, vol: 115, page: 422, stat: Journal Article,

Methadone maintenance and other factors associated with intraindividual temporal trends in injection-drug use
Shore RE; Marmor M; Titus S; Des Jarlais DC
1996 May-Jun;13(3):241-248, Journal of substance abuse treatment
The objective of this study was to determine what sociodemographic, lifestyle, or drug-related characteristics predict temporal changes in self reported drug injection frequencies among HIV-seronegative injection-drug users (IDUs) who were being given HIV testing and risk reduction counseling. The 277 subjects were given 4-11 quarterly interviews including detailed history of drug use and other HIV risk factors, HIV risk reduction counseling, and venipuncture for HIV antibody testing. A regression slope of change over time in drug injection frequency was calculated for each subject, and categories were created of decreasing temporal slope, increasing slope, relapse (decrease initially, then increase), or no substantial change. Only 44% of subjects decreased their drug injection frequencies despite repetitive HIV testing and counseling. In multivariate logistic analyses, decreasing temporal trends were associated with consistent enrollment in methadone maintenance (p < .1), whereas increasing trends conversely were associated with inconsistent enrollment (p < .01) and also with an absence of crack use (p < .01). Relapses were significantly associated with needle sharing with multiple partners and a low frequency of smoking. The data suggest that methadone maintenance facilitates a positive response to HIV risk reduction counseling. However, the fact that only a minority of subjects displayed a decreasing temporal trend in drug injection frequencies emphasizes the need for improved therapeutic and counseling techniques
— id: 8429, year: 1996, vol: 13, page: 241, stat: Journal Article,

A PROSPECTIVE-STUDY OF ENDOGENOUS ESTROGENS AND BREAST-CANCER IN POSTMENOPAUSAL WOMEN - REPLY
LEVITZ, M; BANERJEE, S; KOENIG, K; SHORE, RE; TONIOLO, P; ZELENIUCHJACQUOTTE, A
1995 SEP 20 ;87(18):1414-1415, Journal of the National Cancer Institute
— id: 86758, year: 1995, vol: 87, page: 1414, stat: Journal Article,

RE - PREMENOPAUSAL ESTRADIOL LEVELS AND THE RISK OF BREAST-CANCER - A NEW METHOD OF CONTROLLING FOR DAY OF THE MENSTRUAL-CYCLE - REPLY
PASTERNACK, BS; SHORE, RE; KOENIG, KL; TONIOLO, PG; ROSENBERG, CR
1995 APR 15 ;141(8):789-790, American journal of epidemiology
— id: 87373, year: 1995, vol: 141, page: 789, stat: Journal Article,

Thyroid cancer after exposure to external radiation: a pooled analysis of seven studies
Ron E; Lubin JH; Shore RE; Mabuchi K; Modan B; Pottern LM; Schneider AB; Tucker MA; Boice JD Jr
1995 Mar;141(3):259-277, Radiation research
The thyroid gland of children is especially vulnerable to the carcinogenic action of ionizing radiation. To provide insights into various modifying influences on risk, seven major studies with organ doses to individual subjects were evaluated. Five cohort studies (atomic bomb survivors, children treated for tinea capitis, two studies of children irradiated for enlarged tonsils, and infants irradiated for an enlarged thymus gland) and two case-control studies (patients with cervical cancer and childhood cancer) were studied. The combined studies include almost 120,000 people (approximately 58,000 exposed to a wide range of doses and 61,000 nonexposed subjects), nearly 700 thyroid cancers and 3,000,000 person years of follow-up. For persons exposed to radiation before age 15 years, linearity best described the dose response, even down to 0.10 Gy. At the highest doses (> 10 Gy), associated with cancer therapy, there appeared to be a decrease or leveling of risk. For childhood exposures, the pooled excess relative risk per Gy (ERR/Gy) was 7.7 (95% CI = 2.1, 28.7) and the excess absolute risk per 10(4) PY Gy (EAR/10(4) PY Gy) was 4.4 (95% CI = 1.9, 10.1). The attributable risk percent (AR%) at 1 Gy was 88%. However, these summary estimates were affected strongly by age at exposure even within this limited age range. The ERR was greater (P = 0.07) for females than males, but the findings from the individual studies were not consistent. The EAR was higher among women, reflecting their higher rate of naturally occurring thyroid cancer. The distribution of ERR over time followed neither a simple multiplicative nor an additive pattern in relation to background occurrence. Only two cases were seen within 5 years of exposure. The ERR began to decline about 30 years after exposure but was still elevated at 40 years. Risk also decreased significantly with increasing age at exposure, with little risk apparent after age 20 years. Based on limited data, there was a suggestion that spreading dose over time (from a few days to > 1 year) may lower risk, possibly due to the opportunity for cellular repair mechanisms to operate. The thyroid gland in children has one of the highest risk coefficients of any organ and is the only tissue with convincing evidence for risk about 1.10 Gy
— id: 38450, year: 1995, vol: 141, page: 259, stat: Journal Article,

Height and mortality after myocardial infarction
Rosenberg CR; Shore RE; Pasternack BS
1995 Aug;20(4):335-343, Journal of community health
A case-control analysis was conducted to determine the relationship between height and mortality among patients enrolled in the already completed Beta Blocker Heart Attack Trial (BHAT). In a basic model including height (continuous) and relevant covariates the relative risk (RR) per 4-inch reduction in height (approximately 1 standard deviation) was 1.18 (95% confidence interval, 0.92 to 1.51). When sex was considered, the effect of short stature on mortality was found to be restricted to male subjects. The male RR per 4-inch reduction in height was 1.26 (0.96 to 1.63) whereas for women it was 0.89 (0.49 to 1.59). In males not randomized to propranolol (untreated) the effect was further modified with a RR per 4-inch reduction in height of 1.41 (1.00 to 1.99). It is hypothesized that short stature could be a marker for factors operating as far back as childhood that predispose males to mortality from coronary heart disease in later life
— id: 10265, year: 1995, vol: 20, page: 335, stat: Journal Article,

Epidemiologic data in risk assessment--imperfect but valuable
Shore RE
1995 Apr;85(4):474-476, American journal of public health. AJPH
— id: 38449, year: 1995, vol: 85, page: 474, stat: Journal Article,

A prospective study of endogenous estrogens and breast cancer in postmenopausal women
Toniolo PG; Levitz M; Zeleniuch-Jacquotte A; Banerjee S; Koenig KL; Shore RE; Strax P; Pasternack BS
1995 Feb 1;87(3):190-197, Journal of the National Cancer Institute
BACKGROUND: Circumstantial evidence links endogenous estrogens to increased risk of breast cancer in women, but direct epidemiologic support is limited. In particular, only a few small prospective studies have addressed this issue. PURPOSE: Our purpose was to assess breast cancer risk in relation to circulating levels of the two major endogenous estrogens, estrone and estradiol, measured before the clinical onset of the disease. METHODS: The association between serum levels of estrogens and the risk of breast cancer was examined in a prospective cohort study of 14,291 New York City women, 35-65 years of age, who received screening for breast cancer at the time of blood sampling and who had not been diagnosed with breast cancer. During the first 5 1/2 years of study, we identified 130 breast cancers among the postmenopausal group (7063 women, 35,509 person-years). The case subjects and twice as many postmenopausal control subjects were included in a case-control study nested within the cohort. Biochemical analyses for percent free estradiol, percent estradiol bound to sex hormone-binding globulin (SHBG), total estradiol, estrone, and follicle-stimulating hormone were performed on sera that had been kept at -80 degrees C since sampling. RESULTS: For increasing quartiles of total estradiol, the odds ratio (ORs) of breast cancer, as adjusted for Quetelet index (weight in kilograms divided by the square of the height in meters), were 1.0, 0.9, 1.8, and 1.8 (P value for trend = .06); the ORs for increasing quartiles of estrone were 1.0, 2.2, 3.7, and 2.5 (P value for trend = .06). For increasing quartiles of free estradiol, defined as the fraction of estradiol that is not bound to proteins, the Quetelet index-adjusted ORs of breast cancer were 1.0, 1.4, 3.0, and 2.9 (P value for trend < .01). When we considered the percent of estradiol bound to SHBG, the Quetelet index-adjusted ORs were 1.0, 0.70, 0.40, and 0.32 (P value for trend < .01), thus suggesting a strong protective effect. These associations persisted or became even stronger when analyses were restricted to women whose samples had been drawn 2 or more years before breast cancer diagnosis. CONCLUSIONS: These data represent the first confirmation in a large prospective epidemiologic study of a link between circulating estrogens and breast cancer risk. Although estrogen levels appeared to fall within the conventional limits of normality in all women under study, those who subsequently developed breast cancer tended to show higher levels of estrone, total estradiol, and free estradiol, and a lower percent of estradiol bound to SHBG than women who remained free of cancer. IMPLICATIONS: Factors that increase endogenous estrogen production or reduce the binding of estradiol to SHBG may increase a woman's risk of developing breast cancer later in life
— id: 57459, year: 1995, vol: 87, page: 190, stat: Journal Article,

LIMITATIONS OF NUTRITIONAL DATA - REPLY
TONIOLO, PG; SHORE, RE
1995 JAN ;6(1):90-91, Epidemiology
— id: 87473, year: 1995, vol: 6, page: 90, stat: Journal Article,

Endogenous estrogens and risk of breast cancer by estrogen receptor status: a prospective study in postmenopausal women
Zeleniuch-Jacquotte A; Toniolo P; Levitz M; Shore RE; Koenig KL; Banerjee S; Strax P; Pasternack BS
1995 Dec;4(8):857-860, Cancer epidemiology biomarkers & prevention
A positive association between postmenopausal serum levels of total estradiol, percentage of free estradiol, and percentage of estradiol not bound to sex hormone-binding globulin (SHBG) and breast cancer risk was recently reported by the New York University Women's Health Study (P. Toniolo et al., J. Natl. Cancer Inst., 87: 190-197, 1995). Data from this prospective study are used to assess whether the observed associations differ according to estrogen receptor (ER) status of the tumor. Between 1985 and 1991, 7063 postmenopausal women donated blood and completed questionnaires at a large breast cancer screening clinic in New York City. Before 1991, 130 cases of first primary breast cancer were identified by active follow-up of the cohort. For each case, two controls were selected, matching the case on age at first blood donation and length of storage of specimens. Biochemical analyses were performed on sera that had been stored at -80 degrees since sampling. ER information was abstracted from pathology reports. Separate statistical analyses were conducted of ER-positive, ER-negative, and ER-unknown groups (53, 23, and 54 matched sets, respectively). In each of the 3 groups, the mean estradiol and the mean percentage of free estradiol were greater (21-28% and 6-7%, respectively) in cases than in controls. Conversely, the mean percentage of estradiol bound to SHBG was 9-12% lower in cases than in controls. The logistic regression coefficients measuring the strength of the association between estradiol and its free and SHBG-bound fractions and breast cancer risk were similar in the ER-positive, ER-negative, and ER-unknown groups. These data suggest that in postmenopausal women, the association of endogenous estrogens with breast cancer risk is independent of the ER status of the tumor. This result is more compatible with the hypothesis of a progression from ER-positive to ER negative tumors than with the hypothesis that ER status identifies two distinct types of breast cancer
— id: 56859, year: 1995, vol: 4, page: 857, stat: Journal Article,

ENDOGENOUS ESTROGENS AND RISK OF BOAST CANCER BY ESTROGEN-RECEPTOR STATUS
ZELENIUCHJACQUOTTE, A; TONIOLO, P; LEVITZ, M; SHORE, R; KOENIG, K; BANERJEE, S; STRAX, P; PASTERNACK, B
1995 JUN 1 ;141(11):S15-S15, American journal of epidemiology
— id: 87280, year: 1995, vol: 141, page: S15, stat: Journal Article,

Second cancers following oral and pharyngeal cancers: role of tobacco and alcohol
Day GL; Blot WJ; Shore RE; McLaughlin JK; Austin DF; Greenberg RS; Liff JM; Preston-Martin S; Sarkar S; Schoenberg JB; et al.
1994 Jan 19;86(2):131-137, Journal of the National Cancer Institute
BACKGROUND: The exceptionally high rate of second primary cancers among patients with oral and pharyngeal cancers is well recognized, yet there has been limited epidemiologic study of risk factors for second tumors. PURPOSE: To evaluate the relation of smoking and alcohol consumption to the development of second cancers among this high-risk patient group, we conducted a nested case-control study. METHODS: A total of 1090 patients enrolled in a 1984-1985 population-based, case-control study of oral cancer in four areas of the United States were followed through June 1989 for the occurrence of second primary cancers. Information on tobacco and alcohol consumption was obtained from the original interviews and was updated by follow-up interviews obtained for 80 case patients with second cancers and 189 sex-, study area-, and survival-matched cancer patients free of second cancers (control subjects). RESULTS: Tobacco smoking and alcohol drinking each contributed to risk of second cancers, with the effects of smoking more pronounced than those of alcohol. The odds ratios (ORs) for smoking (adjusted for alcohol) rose with duration and intensity of smoking and were strongest for tumors of the aerodigestive tract (oral cavity, pharynx, esophagus, larynx, and lungs), with ORs reaching 4.7 (95% confidence interval [CI] = 1.4-16) among smokers of 40 or more cigarettes per day for 20 or more years. Current smokers as of the baseline survey experienced a fourfold increased risk of a second aerodigestive tract cancer relative to nonsmokers and former smokers. No reduction in risk was associated with cessation of smoking or drinking at or after the index diagnosis, although the short median interval (27 months) between tumor diagnoses limited observation of the effects due to recent cessation. Risk was significantly reduced, however, 5 years after smoking cessation. Among drinkers, second cancer risk was greatest for beer intake, with an OR for a second aerodigestive tract cancer of 3.8 (95% CI = 1.2-12) for 15 or more beers per week. CONCLUSIONS: Oral and pharyngeal cancer patients with the highest intakes of tobacco and alcohol are the ones most prone to develop second primary cancers. IMPLICATIONS: Avoidance of tobacco smoking and alcohol drinking is the most desirable way not only to prevent primary oral cancers, but also to reduce risk of second cancers of the aerodigestive system
— id: 38452, year: 1994, vol: 86, page: 131, stat: Journal Article,

Second cancers following oral and pharyngeal cancer: patients' characteristics and survival patterns
Day GL; Blot WJ; Shore RE; Schoenberg JB; Kohler BA; Greenberg RS; Liff JM; Preston-Martin S; Austin DF; McLaughlin JK; et al.
1994 Nov;30B(6):381-386, European journal of cancer. Pt. B. Oral oncology
A survey was made of second primary cancers among patients who were enrolled in a large case-control investigation of oral and pharyngeal cancer, hereafter called oral cancer, during 1984-1985 in four areas of the United States. Among the original 1090 patients with oral cancer (nearly all squamous cell carcinomas), 107 developed a second cancer (one-half of them squamous cell) by the end of follow-up in June 1989 (average follow-up 2.6 years), with 69% occurring in the oral cavity, pharynx, oesophagus, larynx or lung. Rates of second tumours varied by age and socioeconomic status, but not sex or race, and were higher among those whose initial cancer was localised, even after adjusting for their longer survival. Long-term survival was lower among those with second cancers. Conditional on surviving for 2 years, the survival at 5 years was under 50% and nearly 70%, respectively, for those with versus those without a second cancer in the first 2 years. These findings confirm the exceptionally high rate of second cancers (especially of the aerodigestive tract) following oral cancer, describe the clinical and pathological features of patients with multiple cancers and indicate the importance of preventive measures
— id: 38451, year: 1994, vol: 30B, page: 381, stat: Journal Article,

Dietary factors and second primary cancers: a follow-up of oral and pharyngeal cancer patients
Day GL; Shore RE; Blot WJ; McLaughlin JK; Austin DF; Greenberg RS; Liff JM; Preston-Martin S; Sarkar S; Schoenberg JB; et al.
1994 ;21(3):223-232, Nutrition & cancer
To investigate the possible relationship between dietary factors and the development of multiple primary cancer, a nested case-control study was carried out within a cohort of 1,090 oral and pharyngeal cancer patients. This patient group, enrolled in 1984-1985 in a population-based case-control study conducted in four areas of the United States, was followed up through June 1989 for the occurrence of second primary cancer. Information on a number of risk factors, including diet, ascertained from interviews conducted at baseline (1984-1985) and at follow-up were compared between 80 patients with histologically confirmed second primary cancers (39% in the upper aerodigestive tract, 32% in the lung, 29% elsewhere) and 189 sex- and survival-matched control patients free of second cancers. Although few significant trends emerged, the results were suggestive of a protective effect provided by higher intake of vegetables. Risk of second primary cancers was 40-60% lower among those with the highest levels of intake for total vegetables and most vegetable subgroups, including dark yellow, cruciferous, and green leafy vegetables and legumes. Risks were also nonsignificantly lower among those with high consumption of vitamin C and carotenoids, with the adverse effects of alcohol being most evident among heavy drinkers with low vitamin C or carotenoid intake. There was also some evidence of an interaction between smoking and vitamin C consumption, but numbers of nonsmokers were small. Among other dietary factors considered, positive associations were found with increasing consumption of meats, liver, and retinol. The findings suggest that dietary factors contribute along with alcohol and smoking to the excess risks of second primary cancers among patients with oral and pharyngeal cancers
— id: 38453, year: 1994, vol: 21, page: 223, stat: Journal Article,

PREDICTING LIKELIHOOD OF GASTROENTERITIS FROM SEA BATHING - RESULTS FROM RANDOMIZED EXPOSURE
KAY, D; FLEISHER, JM; SALMON, RL; JONES, F; WYER, MD; GODFREE, AF; ZELENAUCHJACQUOTTE, Z; SHORE, R
1994 OCT 1 ;344(8927):905-909, Lancet
The health effects of bathing in coastal waters is an area of scientific controversy. We conducted the first ever randomised ''trial'' of an environmental exposure to measure the health effects of this activity. The trial was spread over four summers in four UK resorts and 1216 adults took part. Detailed interviews were used to collect data on potential confounding factors and intensive water quality monitoring was used to provide more precise indices of exposure. 548 people were randomised to bathing, and the exposure included total immersion of the head. Crude rates of gastroenteritis were significantly higher in the exposed group (14.8 per 100) than the unexposed group (9.7 per 100; p=0.01). Linear trend and multiple logistic regression techniques were used to establish relations between gastroenteritis and microbiological water quality. Of a range of microbiological indicators assayed only faecal streptococci concentration, measured at chest depth, showed a significant dose-response relation with gastroenteritis. Adverse health effects were identified when faecal streptococci concentrations exceeded 32 per 100 mL. This relation was independent of non-water-related predictors of gastroenteritis. We do not suggest that faecal streptococci caused the excess of gastrointestinal symptoms in sea bathers but these microorganisms do seem to be a better indicator of water quality than the traditional coliform counts. Bathing water standards should be revised with these findings in mind
— id: 52354, year: 1994, vol: 344, page: 905, stat: Journal Article,

Premenopausal estradiol levels and the risk of breast cancer: a new method of controlling for day of the menstrual cycle [see comments]
Rosenberg CR; Pasternack BS; Shore RE; Koenig KL; Toniolo PG
1994 Sep 15;140(6):518-525, American journal of epidemiology
Levels of total estradiol in premenopausal women vary widely over the course of the menstrual cycle with a spike at the time of ovulation and dissimilar patterns pre- and post-ovulation. Evaluating the association between breast cancer and premenopausal measurements of total estradiol when the measurements cannot be taken on a uniform day of the cycle is therefore a difficult methodological challenge. In a matched case-control study of breast cancer nested within a prospective study, premenopausal serum samples obtained up to 7 years before breast cancer diagnosis were available for total estradiol assay. By fitting a three-piece spline model that regressed the logarithm of total estradiol (ln estradiol) on day of menstrual cycle, the authors were able to adjust the measurements for day of the cycle on which they were collected by expressing them in terms of the number of standard deviations above or below the fitted ln estradiol value for that day. Applying the adjusted measurements to the nested case-control study, they found evidence of a 1.5 to 2-fold risk for women in the upper two tertiles of ln estradiol relative to women in the lowest tertile. Conditional logistic regression analysis for day-of-cycle-adjusted ln estradiol treated as a continuous variable resulted in a relative risk estimate of 1.19 (95% confidence interval 0.91-1.55) per standard-deviation increase in adjusted ln estradiol
— id: 10268, year: 1994, vol: 140, page: 518, stat: Journal Article,

Reliability of measurements of total, protein-bound, and unbound estradiol in serum
Toniolo P; Koenig KL; Pasternack BS; Banerjee S; Rosenberg C; Shore RE; Strax P; Levitz M
1994 Jan-Feb;3(1):47-50, Cancer epidemiology biomarkers & prevention
Estradiol (E2) circulates in the blood in three states: unbound (U-E2), bound to sex-hormone binding globulin (SHBG-E2), and bound to albumin. There is evidence to support the concept that only U-E2 and albumin-bound E2, are bioavailable (i.e., rapidly extracted by tissues). A case-control study nested within a large cohort of women, in which we are examining the effect of estrogens on breast cancer risk, offered the opportunity to assess the reliability of measurements of E2, the percentage of SHBG-E2, and the percentage of U-E2 based on multiple annual serum specimens. Long-term (1-2 year) reliability, as estimated by the intraclass correlation coefficient, was assessed in a subgroup of 71 premenopausal and 77 postmenopausal controls for whom two or three serum specimens were assayed. In postmenopausal women the intraclass correlation coefficient for a single measurement of total E2 was only 0.51. As for the percentage of SHBG-E2, intraclass correlation coefficients were 0.83 and 0.94, and for U-E2, 0.72 and 0.77 in the premenopausal and postmenopausal groups, respectively. These data suggest that, whereas single determinations of total E2 are insufficient to reliably estimate a woman's true mean level, a single measurement of the percentage of SHBG-E2 or U-E2 is adequate to assess bioavailability of E2 in an epidemiological study, irrespective of day of the menstrual cycle
— id: 56598, year: 1994, vol: 3, page: 47, stat: Journal Article,

Consumption of meat, animal products, protein, and fat and risk of breast cancer: a prospective cohort study in New York
Toniolo P; Riboli E; Shore RE; Pasternack BS
1994 Jul;5(4):391-397, Epidemiology
Epidemiologic studies have focused on the association between diet and breast cancer with conflicting results. Whereas a majority of case-control studies indicate a role for the intake of total fat and saturated fat, most prospective cohort studies either are negative or indicate very modest associations. Only a few authors have examined the role of meat intake in relation to breast cancer risk. The aim of this study was to examine the relation between risk of breast cancer and dietary intake of meat, animal products, fat, and protein. Between 1985 and 1991, we recruited 14,291 New York City women in a prospective cohort study of endogenous hormones, diet, and cancer in which they reported on their recent diet using a food frequency questionnaire self-administered at enrollment. From the cohort, 180 invasive breast cancer cases diagnosed before December 1990 and five times as many controls, individually matched by age, calendar time at enrollment, menopausal status, and, if premenopausal, phase of menstrual cycle, were included in a nested case-control study. There was an evident increase in the relative risk (RR) of breast cancer for increasing consumption of meat. Women in the upper quintile of meat consumption, as compared with the lowest quintile, had an energy-adjusted RR of 1.87 (95% confidence interval = 1.09-3.21). There was a modest RR increase in the upper quintile of total and saturated fat and no apparent association for other types of fat, protein, dairy products, poultry, or fish.(ABSTRACT TRUNCATED AT 250 WORDS)
— id: 56722, year: 1994, vol: 5, page: 391, stat: Journal Article,

Reliability of serum prolactin measurements in women
Koenig KL; Toniolo P; Bruning PF; Bonfrer JM; Shore RE; Pasternack BS
1993 Sep-Oct;2(5):411-414, Cancer epidemiology biomarkers & prevention
Prolactin, a hormone indispensable for milk secretion, has been shown to enhance the development and growth of mammary tumors in rodents; however, its importance in human breast cancer is uncertain. Serum prolactin levels are known to fluctuate considerably under normal conditions, and lack of precision in the hormone measurements may have contributed to the largely negative findings in humans to date. The purpose of this study was to investigate the reliability of prolactin measurements in women using stored serum from an ongoing prospective study of breast cancer. Separate groups of postmenopausal and premenopausal women who donated multiple blood samples at approximately 1-year intervals were studied. The reliability of a single log prolactin determination, as measured by the intraclass correlation coefficient, was 0.76 for the postmenopausal women (95% confidence interval, 0.66-0.85) and 0.48 for the premenopausal women (95% confidence interval, 0.31-0.62). These findings suggest that a single measurement is sufficient to characterize the serum prolactin level of postmenopausal women for epidemiological research. For premenopausal women, however, multiple samples are desirable. Controlling for phase of the menstrual cycle does not appear to substantially improve the reliability of premenopausal measurements
— id: 6424, year: 1993, vol: 2, page: 411, stat: Journal Article,

PROSPECTIVE-STUDY OF SERUM PROLACTIN AND BREAST-CANCER
KOENIG, K; TONIOLO, P; BRUNING, P; BONFRER, J; SHORE, R; ZELENIUCHJACQUOTTE, A; PASTERNACK, B
1993 OCT 15 ;138(8):601-601, American journal of epidemiology
— id: 52160, year: 1993, vol: 138, page: 601, stat: Journal Article,

The influence of medical conditions associated with hormones on the risk of breast cancer [published erratum appears in Int J Epidemiol 1994 Dec;23(6):1330]
Moseson M; Koenig KL; Shore RE; Pasternack BS
1993 Dec;22(6):1000-1009, International journal of epidemiology
Medical conditions related to hormonal abnormalities were investigated in a case-control study of breast cancer among women who attended a screening centre. Information was obtained by telephone interview regarding physician-diagnosed medical conditions such as thyroid or liver diseases, diabetes, and hypertension, as well as hirsutism, acne, galactorrhoea, and reproductive, menstrual, and gynaecological factors. Results are presented for 354 cases and 747 controls. Women with fertility problems who never succeeded in becoming pregnant were at significantly increased breast cancer risk (adjusted odds ratio [OR] = 3.5; 95% confidence interval [CI]:1.1-10.9). An elevated cancer risk was also associated with having excess body hair (OR = 1.5; 95% CI:1.0-2.3), or having excess body hair in addition to persistent adult acne (OR = 6.8; 95% CI:1.7-27.1). Recurrent amenorrhea (OR = 3.5; 95% CI:1.1-11.5), and a treated hyperthyroid condition (OR = 2.2; 95% CI:1.1-4.4) were significantly associated with risk. A non-significant elevation of risk was present for endometrial hyperplasia (OR = 1.8; 95% CI: 0.8-4.0). There was a suggestion of an association between a history of galactorrhoea and breast cancer risk (OR = 2.0; 95% CI:0.8-4.9) among premenopausal women. No associations were found with other medical or gynaecological factors. The possibility that some of these findings are due to chance cannot be excluded because of the problem of multiple comparisons
— id: 6464, year: 1993, vol: 22, page: 1000, stat: Journal Article,

Ethylene oxide: an assessment of the epidemiological evidence on carcinogenicity
Shore RE; Gardner MJ; Pannett B
1993 Nov;50(11):971-997, British journal of industrial medicine
Mortality from cancer among workers exposed to ethylene oxide (EtO) has been studied in 10 distinct cohorts that include about 29,800 workers and 2540 deaths. This paper presents a review and meta-analysis of these studies, primarily for leukaemia, non-Hodgkin's lymphoma, stomach cancer, pancreatic cancer, and cancer of the brain and nervous system. The magnitude and consistency of the standardised mortality ratios (SMRs) were evaluated for the individual and combined studies, as well as trends by intensity or frequency of exposure, by duration of exposure, and by latency (time since first exposure). Exposures to other workplace chemicals were examined as possible confounder variables. Three small studies by Hogstedt initially suggested an association between EtO and leukaemia, but in seven subsequent studies the SMRs for leukaemia have been much lower. For the combined studies the SMR = 1.06 (95% confidence interval (95% CI) 0.73-1.48). There was a slight suggestion of a trend by duration of exposure (p = 0.19) and a suggested increase with longer latency (p = 0.07), but there was no overall trend in risk of leukaemia by intensity or frequency of exposure; nor did a cumulative exposure analysis in the largest study indicate a quantitative association. There was also an indication that in two studies with increased risks the workers had been exposed to other potential carcinogens. For non-Hodgkin's lymphoma there was a suggestive risk overall (SMR = 1.35, 95% CI 0.93-1.90). Breakdowns by exposure intensity or frequency, exposure duration, or latency did not indicate an association, but a positive trend by cumulative exposure (p = 0.05) was seen in the largest study. There was a suggested increase in the overall SMR for stomach cancer (SMR = 1.28, 95% CI 0.98-1.65 (CI 0.73-2.26 when heterogeneity among the risk estimates was taken into account)), but analyses by intensity or duration of exposure or cumulative exposure did not support a causal association for stomach cancer. The overall SMRs and exposure-response analyses did not indicate a risk from EtO for pancreatic cancer (SMR = 0.98), brain and nervous system cancer (SMR = 0.89), or total cancer (SMR = 0.94). Although the current data do not provide consistent and convincing evidence that EtO causes leukaemia or non-Hodgkin's lymphoma, the issues are not resolved and await further studies of exposed populations
— id: 56590, year: 1993, vol: 50, page: 971, stat: Journal Article,

Thyroid cancer among persons given X-ray treatment in infancy for an enlarged thymus gland
Shore RE; Hildreth N; Dvoretsky P; Andresen E; Moseson M; Pasternack B
1993 May 15;137(10):1068-1080, American journal of epidemiology
A cohort of 2,657 infants in Rochester, New York, who were given x-ray treatment for a purported enlarged thymus gland, along with 4,833 siblings, have been followed by mail surveys through about 1986, which represents an average of 37 years of follow-up, to determine their incidence of thyroid cancer. Estimated thyroid doses ranged from 0.03 to > 10 Gy, with 62% receiving > 0.5 Gy. There were 37 pathologically diagnosed thyroid cancers in the irradiated group and five in the sibling controls. The dose-response relation was essentially linear, with no evidence of an additional dose-squared component. The estimated relative risk at 1 Gy was 10 (90% confidence interval 5-23). Thyroid cancer rates were elevated even at low doses; i.e., a dose-response analysis over the range of 0-0.3 Gy showed a significant positive slope. The risk ratio was declining over time but was still highly elevated to at least 45 years after irradiation. An examination of potential risk factors showed that older age at first childbirth was significantly associated with thyroid cancer risk. An evaluation of interactions between possible risk factors and radiation suggested that Jewish subjects and women with older ages at menarche or at first childbirth were at greater risk for radiogenic thyroid cancer
— id: 13160, year: 1993, vol: 137, page: 1068, stat: Journal Article,

Benign thyroid adenomas among persons X-irradiated in infancy for enlarged thymus glands
Shore RE; Hildreth N; Dvoretsky P; Pasternack B; Andresen E
1993 May;134(2):217-223, Radiation research
Thyroid adenoma incidence in a cohort of 2657 infants given X-ray treatment for a supposedly enlarged thymus gland, along with 4833 unirradiated siblings, has been ascertained for an average of 37 years since irradiation. Estimated thyroid doses ranged from 0.03 to > 8 Gy, with 62% receiving < 0.5 Gy. After excluding 4 adenoma cases with concurrent or previous thyroid cancer, there were 86 cases with pathologically diagnosed thyroid adenomas in the irradiated group and 11 in the sibling controls. The estimated excess relative risk (ERR) was 6.3 per gray (90% CI = 3.7, 11.2). Once the dose group with > or = 6 Gy, which was producing downward curvature in the dose-response function, was removed, the curve was compatible with linearity and the ERR was 7.8 per gray. Thyroid adenoma rates were elevated even at low doses: the lowest dose group (< 0.25 Gy) showed a significant elevation in risk. The relative risk appeared to be constant over time and was comparable for both sexes. Excess adenoma risk was observed in the irradiated group to the maximum follow-up interval of about 50 years. A number of potential risk factors for thyroid adenoma were examined both as risk factors in their own right and as modifiers of the radiogenic risk. Parity and use of hormones in relation to menopause were significantly associated with thyroid adenoma risk in women, while education, Jewish origin, history of hyperthyroidism or hypothyroidism, and family history of cancer were also adenoma risk factors in both sexes. An examination of interactions between possible risk factors and radiation suggested that women with a history of oral contraceptive use or hysterectomy and persons with a family history of cancer may have greater risk (per unit dose) of radiogenic thyroid adenomas than their counterparts
— id: 13172, year: 1993, vol: 134, page: 217, stat: Journal Article,

Ethylene oxide : an assessment of the epidemiologic evidence on carcinogenicity
Shore, Roy E; Gardner, Martin J; Pannett, Brian
[S.l. : s.n.], 1993,
'[prepared] for the Ethylene Oxide Industry Council of the Chemical Manufacturers Association, Washington DC [...] June, 1993'
— id: 1235, year: 1993, vol: , page: , stat: ,

PROSPECTIVE-STUDY OF ENDOGENOUS ESTROGENS AND BREAST-CANCER
TONIOLO, P; LEVITZ, M; JACQUOTTE, A; KOENIG, K; SHORE, R; PASTERNACK, B
1993 OCT 15 ;138(8):601-601, American journal of epidemiology
— id: 52159, year: 1993, vol: 138, page: 601, stat: Journal Article,

Intermittent ST depression and mortality after myocardial infarction
Ruberman W; Crow R; Rosenberg CR; Rautaharju PM; Shore RE; Pasternack BS
1992 Apr;85(4):1440-1446, Circulation
BACKGROUND. We conducted a case-control analysis to determine the contribution made to mortality by intermittent ST depression (STD) among patients enrolled in the already completed Beta Blocker Heart Attack Trial. METHODS AND RESULTS. STD was determined by computer analysis of 24-hour ECG tapes as a change in ST level by +/- 0.1 mV or more from the median value of ST of all normally conducted complexes for greater than or equal to 1 minute. All computer-detected ST events were verified by trained readers. To estimate risk of dying associated with STD, 261 deaths were compared with controls matched for age, sex, drug status, and time elapsed since acute myocardial infarction. In a model including relevant covariates, STD had a relative risk (RR) of 1.73 (95% confidence interval, 1.09-2.73). The RR was 2.56 (1.39-4.71) in untreated patients and 0.98 (0.48-2.00) in propranolol-treated patients. A history of angina, although not independently significant, was found to enhance these RRs. A gradient of risk was shown in the placebo group by a RR of 1.91 in those with 1-30 minutes of STD and 4.33 in those with greater than 30 of STD (p = 0.001, trend test). CONCLUSIONS. The findings in this large study show a significant contribution to mortality among untreated early post-myocardial infarction survivors from transient STD on 24-hour monitoring. The absence or reduction of effect in the treated group also suggests an anti-ischemic mechanism by which propranolol exerts a protective effect on mortality. Trials to determine whether reduction of STD improves survival would be warranted
— id: 10270, year: 1992, vol: 85, page: 1440, stat: Journal Article,

Issues and epidemiological evidence regarding radiation-induced thyroid cancer
Shore RE
1992 Jul;131(1):98-111, Radiation research
The available information on the induction of thyroid cancer in humans by ionizing radiation is summarized and weaknesses or gaps in assessing risk are identified. Issues to be addressed include: average estimates of thyroid cancer risk from external irradiation, the effects of age on thyroid cancer induction, shape of the dose-response curve for acute irradiation, magnitude of risk at low doses, effects of dose fractionation or dose protraction, the relative effectiveness of iodine-131 (131I) in inducing thyroid cancer compared to external radiation, the temporal course of radiogenic thyroid cancer risk, mortality caused by thyroid cancer, host-susceptibility factors for radiogenic thyroid cancer, and biological factors in risk. It is concluded that the most important needs are to obtain more information on thyroid cancer risks following low-level or highly fractionated radiation exposures and following 131I exposure in children
— id: 13549, year: 1992, vol: 131, page: 98, stat: Journal Article,

Use of human data in quantitative risk assessment of carcinogens: impact on epidemiologic practice and the regulatory process
Shore RE; Iyer V; Altshuler B; Pasternack BS
1992 Apr;15(2 Pt 1):180-221, Regulatory toxicology & pharmacology
Epidemiologic data are increasingly being used to assess cancer risk from chemicals as their value is recognized and as more and better studies become available. Weight-of-evidence approaches are now available for classifying the experimental and epidemiological evidence regarding human carcinogenicity. When the human data are extensive and of good quality, they should be given substantial weight in assessing risk. Both the positive and the negative epidemiologic data should be used in a quantitative risk assessment (QRA), because only then can an unbiased risk assessment be derived. Good-quality epidemiological studies are those with sound methodology, lack of bias, long enough follow-up times to observe a carcinogenic response, adequate exposure information, and dose-response information. Before a lack of carcinogenicity can be inferred, it is essential that the exposures be of substantial duration and intensity, and that the number of exposed persons be reasonably large. Epidemiologists need to give more attention to exposure assessment, because lack of quantitative exposure information is often the limiting factor that prevents the use of epidemiologic data in QRA. Development of methods to estimate historical workplace exposure intensities from surrogate industrial hygiene variables should receive high research priority, since they have the potential to increase the usefulness in QRA of many epidemiologic studies that have limited exposure information. Several frequently used surrogates for exposure measurements have limitations or pitfalls in their use. In particular, the use of 'ever/never' exposed has a large potential to produce falsely negative results by means of a 'dilution' effect, especially in the common case where the exposure distribution is skewed. Duration of exposure (rather than duration x intensity) may also give misleading results. There is little information to suggest that synergistic exposures to multiple toxicants in an industrial environment are likely to invalidate QRAs, probably because few studies have identified a group of workers with major workplace exposures to multiple carcinogens that cause the same type of cancer. Most of the interactive effects which have been identified to date are between smoking and some occupational carcinogen, so this possibility needs careful evaluation for smoking-related diseases. It is important to evaluate dose-response gradients in a QRA to obtain maximum precision and accuracy in the resulting risk coefficient. The analysis should take into account an appropriate cancer induction period. Various methods to account for cancer induction times are compared; those that incorporate a lag period or model the induction-time distribution are superior to other methods.(ABSTRACT TRUNCATED AT 400 WORDS)
— id: 10269, year: 1992, vol: 15, page: 180, stat: Journal Article,

The health effects of low-level ionizing radiation
Upton AC; Shore RE; Harley NH
1992 ;13:127-150, Annual review of public health
— id: 13746, year: 1992, vol: 13, page: 127, stat: Journal Article,

Hair dye use and breast cancer: a case-control study among screening participants
Koenig KL; Pasternack BS; Shore RE; Strax P
1991 May 15;133(10):985-995, American journal of epidemiology
To investigate whether hair dye use increases the risk of breast cancer, a case-control study was conducted among patients attending a screening center in New York City. The study group consisted of 398 breast cancer cases identified at the screening center between 1977 and 1981, and 790 randomly selected controls screened during the same period. Subjects were interviewed by telephone to obtain information on known risk factors for breast cancer, along with a complete history of hair dye use detailing type of dye, color, duration, frequency, and temporal periods of use. Most subjects (77%) had used hair dye at least once, 38% of the subjects at least 100 times. However, little increased risk of breast cancer was found among hair dye users. The adjusted odds ratio for ever having used hair dye was 0.8 (95% confidence interval 0.6-1.1), and there was no evidence of a trend in risk with increasing number of hair dye uses. The results were the same whether all past exposures were considered or only exposures more than 10 years before disease. Breast cancer risk did not increase with increasing intensity of exposure, as measured by frequency of use or darkness of color. No effect was seen for different types or colors of dye, or for use during different periods of reproductive life. Although personal hair dye use was unrelated to breast cancer risk, there was an adjusted odds ratio of 3.0 (95% confidence interval 1.1-7.8) for 5 or more years of work as a beautician. Overall, the results of this study, taken in conjunction with the findings of other epidemiologic studies, do not implicate hair dye use as an important cause of human breast cancer
— id: 8284, year: 1991, vol: 133, page: 985, stat: Journal Article,

RELIABILITY OF SERUM PROLACTIN MEASUREMENTS
KOENIG, KL; TONIOLO, P; BONFRER, JMG; PASTERNACK, BS; SHORE, RE; BRUNING, PF
1991 OCT 1 ;134(7):753-753, American journal of epidemiology
— id: 51536, year: 1991, vol: 134, page: 753, stat: Journal Article,

Time variations in the risk of cancer following irradiation in childhood
Little MP; Hawkins MM; Shore RE; Charles MW; Hildreth NG
1991 Jun;126(3):304-316, Radiation research
The Japanese atomic bomb survivors and three other cohorts of children exposed to radiation are analyzed, and evidence is found for a reduction in the radiation-induced relative risk of cancers other than leukemia with time following exposure. Multiplicative adjustments to the excess risk either of the form exp[-delta.(time since exposure)] or of the form [time since exposure] gamma give equivalent goodness of fit. Using the former type of adjustment an annual overall reduction of 6.9-8.6% in excess relative risk is indicated (depending on the year after which this reduction might take effect). Using the second type of multiplier an adjustment to the excess relative risk varying between [time after exposure]-2.0 and [time after exposure]-3.2 fits best overall. All these reductions are statistically significant at the 5% level. There is no significant variation by cohort, by sex, by cancer type, or by age at exposure group in the degree of annual reduction in excess relative risk. Although time-adjusted relative and absolute risk models give equivalently good fits within each cohort, there is significant variation between cohorts in the degree of increase of risk with time in the absolute risk formulation, in contrast to the lack of such heterogeneity for the relative risk formulation. It is shown that if the range of observed reductions in relative risk is assumed to operate 40 or more years after exposure in the youngest age groups, the calculated UK population risks would be reduced by 30-45% compared to those based on a constant relative risk model
— id: 38454, year: 1991, vol: 126, page: 304, stat: Journal Article,

Endogenous hormones and breast cancer: a prospective cohort study [see comments]
Toniolo PG; Pasternack BS; Shore RE; Sonnenschein E; Koenig KL; Rosenberg C; Strax P; Strax S
1991 May;18 Suppl 1:S23-S26, Breast cancer research & treatment
A cohort study is under way in New York City to evaluate how levels of endogenous reproductive hormones influence the risk of breast cancer. The study, in which approximately 15,000 women are being recruited, utilizes a prospective design in which volunteers are asked to provide repeated specimens of serum during the period 1985-1992. A case-control study nested within the cohort is planned by which specimens from all cases arising in the population and from a randomly selected sample of time-matched controls will be analyzed and compared. As of December 31, 1989, 13,609 volunteers had donated blood specimens, about 50% of whom had already donated more than once. Of the 187 incident breast cancer cases who are expected to arise in the cohort before the end of 1992, 77 have been detected thus far
— id: 6539, year: 1991, vol: 18 Suppl 1, page: S23, stat: Journal Article,

RELIABILITY OF PERCENT ESTRADIOL BINDING TO PROTEINS - IMPLICATIONS FOR STUDY DESIGN
TONIOLO, P; PASTERNACK, B; KOENIG, K; ROSENBERG, C; SHORE, R; BANERJEE, S; LEVITZ, M
1991 OCT 1 ;134(7):774-775, American journal of epidemiology
— id: 51537, year: 1991, vol: 134, page: 774, stat: Journal Article,

Men assigned to ethylene oxide production or other ethylene oxide related chemical manufacturing: a mortality study
Greenberg HL; Ott MG; Shore RE
1990 Apr;47(4):221-230, British journal of industrial medicine
A retrospective cohort study was conducted to examine the mortality experience of 2174 men employed between 1940 and 1978 by a large chemical company and who had been assigned to a chemical production department that used or produced ethylene oxide (EO). Comparisons were made with the general United States population, the regional population, and with a group of 26,965 unexposed men from the same plants. Comparisons with general United States death rates showed fewer deaths than expected in the EO group due to all causes and for total cancers. There was no statistically significant excess of deaths due to any cause. Seven deaths each due to leukaemia and pancreatic cancer were observed with 3.0 and 4.1 deaths expected. Among the subcohort of men who worked where both average and peak exposure levels were probably highest, however, one death due to pancreatic cancer (0.9 expected) and no deaths due to leukaemia were observed. Four of the seven who died from leukaemia and six of the seven who died from pancreatic cancer had been assigned to the chlorohydrin department where the potential for exposure to EO is judged to have been low. The relative risk of death due to each disease was strongly related to duration of assignments to that department. When men who worked in the chlorohydrin department were excluded, there was no evidence for an association of exposure to EO with pancreatic cancer or leukaemia. Together with the failure to show independent EO associations, the chlorohydrin department results suggest that leukaemia and pancreatic cancer may have been associated primarily with production of ethylene chlorohydrin or propylene chlorohydrin, or both. These results emphasise the importance of examining additional concurrent/asynchronous exposures among human populations exposed to EO
— id: 38457, year: 1990, vol: 47, page: 221, stat: Journal Article,

Occupational radiation studies: status, problems, and prospects
Shore RE
1990 Jul;59(1):63-68, Health physics
At least 350,000 workers at U.S. radiation facilities are being followed up to monitor their mortality experience, with particular reference to cancer. Although these studies are expensive, they are needed from the standpoint of public health and radiation protection; they also provide a useful check that the risk extrapolation models based on high dose data are not seriously out of line. Unfortunately, there are a number of problems in interpreting radiation worker studies that stem mainly from the fact that the expected magnitude of effects is small because of the low doses. Problems of falsely positive effects caused by chance or by study biases are difficult to distinguish from real effects. Dose-effect analyses and pooled analyses from several studies offer some improvements in assessing the risk from low doses but do not obviate all the problems. Future studies should explore whether there are biological markers of exposure, damage, or susceptibility that would improve our power to assess individual risk
— id: 38456, year: 1990, vol: 59, page: 63, stat: Journal Article,

Overview of radiation-induced skin cancer in humans
Shore RE
1990 Apr;57(4):809-827, International journal of radiation biology
There are about a dozen studies of the incidence of skin cancer among irradiated populations with known skin doses that are available for estimating the risk of radiation-induced skin cancer. It is of note that they provide no evidence for a dose threshold and are compatible with a linear dose-response relationship, at least for ultraviolet radiation exposed skin. The studies also provide varying amounts of evidence concerning a number of other important issues in assessing skin cancer risk: types of skin cancer induced by ionizing radiation, the appropriateness of relative risk vs absolute risk models, combined effects of ionizing and UV radiations, and variations in sensitivity to skin cancer induction among demographic and genetic subgroups. Little epidemiological information is available on several factors, such as the RBE for high-LET radiation, the effects of dose protraction or fractionation, or variations in risk by age at irradiation. A reasonable estimate of skin cancer lethality was 0.2 per cent when weighted for the relative proportions of squamous cell and basal cell skin cancers. Average risk estimates of radiation-induced skin cancer incidence were: absolute risk (AR) of 8.5 X 10(-4) person-year-Sv and excess relative risk (RR) of 52 per cent/Sv. Lifetime skin cancer risk was calculated by life-table methods for males from exposures spread out over ages 20-60 years. The estimates for excess skin cancer incidence were 2 per cent and 11 per cent per Sv under the AR and RR models, respectively, while the corresponding mortality risks were 4 X 10(-5) and 2 X 10(-4) per Sv
— id: 38458, year: 1990, vol: 57, page: 809, stat: Journal Article,

Skin cancer susceptibility among irradiated patients
Shore, R; Harley, N; Pasternack, B; Gladstein, A H
1990 May;22(5 Pt 1):859-860, Journal of the American Academy of Dermatology
— id: 122382, year: 1990, vol: 22, page: 859, stat: Journal Article,

Second malignancies following radiotherapy for testicular seminoma
Steinfeld AD; Shore RE
1990 Sep;2(5):273-276, Clinical oncology (Royal College of Radiologists)
Traditional treatment for testicular seminoma produces excellent survival. We report five, second non-testicular malignancies which occurred in a group of seminoma patients. A total of 79 men with primary testicular seminoma were available for analysis. All underwent a radical inguinal orchiectomy. Those with Stage I disease received adjuvant radiation therapy to the para-aortic and ipsilateral iliac nodes. The usual dose was 2500 cGy in 15 treatments. Stage II patients also received prophylactic mediastinal radiation therapy to a dose of 2500 cGy. None of the 51 Stage II patients died of tumour, whereas four of the 28 Stage II patients died of their disease. The median follow-up was ten years (range 4-25 years). The second malignancies seen were melanoma (2), myeloma, caecal adenocarcinoma, and retroperitoneal fibrosarcoma. All but one tumour developed within the radiation fields. Based on US SEER data for white males, only 1.5 cancers were expected, giving significantly greater (P = 0.04) relative risk. This observation lends support to observation, rather than elective treatment, in patients with Stage I testicular cancer
— id: 38455, year: 1990, vol: 2, page: 273, stat: Journal Article,

A MORTALITY STUDY OF MEN ASSIGNED TO ETHYLENE-OXIDE PRODUCTION OR OTHER ETHYLENE OXIDE-RELATED CHEMICAL PRODUCTION
Greenberg, HL; Shore, RE; Ott, MG; Teta, MJ
1989 Oct;130(4):814-815, American journal of epidemiology
— id: 31668, year: 1989, vol: 130, page: 814, stat: Journal Article,

The risk of breast cancer after irradiation of the thymus in infancy
Hildreth NG; Shore RE; Dvoretsky PM
1989 Nov 9;321(19):1281-1284, New England journal of medicine
It is well established that exposure to ionizing radiation during or after puberty increases a woman's risk for breast cancer, but it is less clear whether exposure to ionizing radiation very early in life is also carcinogenic. We studied the incidence of breast cancer prospectively in a cohort of 1201 women who received x-ray treatment in infancy for an enlarged thymus gland and in their 2469 nonirradiated sisters. After an average of 36 years of follow-up, there were 22 breast cancers in the irradiated group and 12 among their sisters, yielding an adjusted rate ratio of 3.6 (95 percent confidence interval, 1.8 to 7.3). The estimated mean absorbed dose of radiation to the breast was 0.69 Gy. The first breast cancer was diagnosed 28 years after irradiation. The dose-response relation was linear (P less than 0.0001), with a relative risk of 3.48 for 1 Gy of radiation (95 percent confidence interval, 2.1 to 6.2) and an additive excess risk of 5.7 per 10(4) person-years per gray (95 percent confidence interval, 2.9 to 9.5). We conclude that exposure of the female breast to ionizing radiation in infancy increases the risk of breast cancer later in life
— id: 38459, year: 1989, vol: 321, page: 1281, stat: Journal Article,

The potential role of nutritional factors in the induction of immunologic abnormalities in HIV-positive homosexual men
Moseson M; Zeleniuch-Jacquotte A; Belsito DV; Shore RE; Marmor M; Pasternack B
1989 ;2(3):235-247, Journal of acquired immune deficiency syndrome
The literature is briefly summarized as to how several nutrients affect immune function, susceptibility to infection, and cancer susceptibility or progression. Nutritional deficiencies can impair immunity and so influence susceptibility to infectious agents, including ones that are common and relatively virulent in acquired immune deficiency syndrome (AIDS) patients. A variety of nutrients affect several of the immune functions that are defective in human immunodeficiency virus (HIV)-infected individuals. For example, beta-carotene increased the number of CD4+ cells; vitamin E decreased the number of CD8+ cells and increased the CD4+/CD8+ ratio; vitamin D decreased the CD4+/CD8+ ratio; and iron increased the number of peripheral lymphocytes in humans receiving supplementation. Furthermore, nutritional deficiencies can influence gastrointestinal function, while infectious diseases can influence nutrient requirements by altering the efficiency of absorption and the rate of tissue metabolism. Malnutrition, depressed serum zinc levels, and intestinal nutrient malabsorption have been found in AIDS patients. The above findings suggest that dietary manipulations might diminish the immune defects in HIV infection and enhance resistance to opportunistic infections. However, dietary alterations in immune defects are generally not well quantified and may be small relative to the magnitude of the defects observed in AIDS patients. Because conflicting or adverse effects have been reported for some nutrients, recommendations for dietary supplementation in HIV-infected individuals are premature and possibly hazardous. Further studies are much needed to relate dietary nutrient intakes to clinical outcomes
— id: 9114, year: 1989, vol: 2, page: 235, stat: Journal Article,

Radiation epidemiology: old and new challenges
Shore RE
1989 May;81:153-156, Environmental health perspectives
Over the last 40 years the amount of knowledge about human radiation effects has increased dramatically. During that interval, radiation epidemiologists have documented a number of additional types of radiation-induced cancer and have established rough estimates of the magnitude of cancer risks. Nevertheless, we currently have inadequate knowledge about a number of factors that help define the magnitude of radiation risks. These include questions of estimating risk over the lifetime, shapes of dose-effect curves, magnitude of risks at low doses, potentiation between radiation and other agents, and the nature and role of host susceptibility factors. Data from various studies are used to illustrate these questions
— id: 10627, year: 1989, vol: 81, page: 153, stat: Journal Article,

RISK OF THYROID-CANCER AFTER DIAGNOSTIC DOSES OF IODINE - RESPONSE
Shore, RE
1989 May 3;81(9):715-715, Journal of the National Cancer Institute
— id: 31794, year: 1989, vol: 81, page: 715, stat: Journal Article,

Electromagnetic radiations and cancer. Cause and prevention
Shore RE
1988 Oct 15;62(8 Suppl):1747-1754, Cancer
The various types of electromagnetic radiation differ considerably in their ability to induce cancer. The potential of radiofrequency or microwave radiation and low-frequency electromagnetic radiation to alter DNA is very limited, because their energy is too low to produce substantial ionizations. They are therefore unlikely to be carcinogenic by any direct mechanism. Epidemiologic studies of the carcinogenicity of microwave radiation are basically negative. Studies of workers with relatively high exposures to low-frequency electromagnetic fields have suggested that such persons may be at somewhat elevated risk for leukemia, especially of the acute myeloid type, but the studies have had methodologic weaknesses and mixed results. The association is not proven at this point, but neither can it be ruled out. For ionizing radiation, which is clearly carcinogenic, major questions pertain to how to define the magnitude of risk from low doses and low dose rates, how to identify subgroups of people who are especially susceptible to the effects of ionizing radiation, and how to minimize radiation exposure. When fortuitous radiation exposure from manmade sources, such as radioactive releases from nuclear power plants, are examined in the context of the total exposure people receive from natural sources, medical irradiation, etc., they are almost always found to be small by comparison. Quantitatively, two sources of radiation provide the greatest opportunities for exposure reduction: abatement of radon levels in homes, and reduction in medical radiation exposures
— id: 10930, year: 1988, vol: 62, page: 1747, stat: Journal Article,

An industry-wide study of respiratory cancer in chemical workers exposed to chloromethyl ethers
Collingwood KW; Pasternack BS; Shore RE
1987 Jun;78(6):1127-1136, Journal of the National Cancer Institute
An industry-wide retrospective cohort mortality study was conducted on 6,152 chemical workers (2,460 exposed and 3,692 nonexposed) engaged in chloromethyl ether manufacture at 7 major U.S. companies between 1948 and 1980. A previous study at 6 companies from 1948 through 1972 reported excess respiratory cancer (RC) mortality and significant exposure-response relationships in exposed workers at 1 company (company 2). The present study, which extended follow-up of an additional 7 years for companies 1-6 and included company 7 for follow-up from 1953 through 1980, found excess RC mortality in exposed workers at company 2 [observed (Obs) = 32, standardized mortality ratio (SMR) = 430] and company 7 (Obs = 9, SMR = 603). External comparisons of RC mortality at both companies showed significant exposure-response relationships with respect to cumulative time-weighted exposure. At company 2, where the greatest number of RC deaths occurred, external comparisons showed that RC risk remained constant in relation to age at first exposure and decreased with increasing time since last exposure. With the use of Mantel-Haenszel and relative risk (RR) regression methods, internal comparisons at company 2 demonstrated significant findings of increasing RR with cumulative duration of exposure and cumulative time-weighted exposure and with decreasing time since last exposure. No association was found between RR and age at first exposure. An interesting finding was a significant negative interaction between cumulative time-weighted exposure and age at risk. The best-fitting logistic regression model for the exposed group predicted RR at 2.79 (95% confidence interval = 1.66-4.69) for workers with the mean cumulative exposure score of the 32 RC deaths (lagged by 6 yr) compared with those with negligible exposure (assuming mean age at risk of the RC deaths, 51 years old, and time since last exposure held constant). Qualitative assessment of the results suggests that chloromethyl ether exposure affects both an early as well as a late stage of a putative multistage respiratory malignant process.
— id: 10274, year: 1987, vol: 78, page: 1127, stat: Journal Article,

RESPIRATORY CANCER MORTALITY AND EXPOSURE TO CHLOROMETHYL ETHER
Collingwood, KW; Pasternack, B; Shore, R
1987 Feb;91(2):301-301, Chest
— id: 31279, year: 1987, vol: 91, page: 301, stat: Journal Article,

CORRELATION OF TRACE-ELEMENTS IN HAIR OF PATIENTS WITH COLON CANCER
KWIATEK, WM; CHOLEWA, M; KAJFOSZ, J; JONES, KW; SHORE, RE; REDRICK, AL
1987 MAR ;22(1-3):166-171, Nuclear instruments & methods in physics research. Section B, Beam interactions with materials & atoms
— id: 41714, year: 1987, vol: 22, page: 166, stat: Journal Article,

Applications of epidemiologic methods to podiatric medicine
Shore RE
1987 Jul;4(3):593-604, Clinics in podiatric medicine & surgery
National statistics show that the burden of occupational foot problems is large. For example, over 20 per cent of work-related injuries occur in the lower extremities. However, to date few epidemiologic studies have been undertaken to document the nature, frequency, and causes of occupational foot problems. More are clearly needed. The results of such studies could profitably be disseminated among occupational health professionals to increase their awareness of this relatively neglected aspect of worker health
— id: 38460, year: 1987, vol: 4, page: 593, stat: Journal Article,

[I-129 as a health effect panel dosimetry tool]
Shore, Roy E; Conners, Daniel A
[S.l. : s.n.], 1987,
[Letter from Roy E. Shores to Daniel A. Connors at Rockwell Hanford Operations]
— id: 1236, year: 1987, vol: , page: , stat: ,

RESPIRATORY CANCER MORTALITY AMONG WORKERS EXPOSED TO CHLOROMETHYL METHYL-ETHER
COLLINGWOOD, KW; PASTERNACK, BS; SHORE, RE
1986 SEP ;124(3):530-530, American journal of epidemiology
— id: 41371, year: 1986, vol: 124, page: 530, stat: Journal Article,

Breast cancer among women given X-ray therapy for acute postpartum mastitis
Shore RE; Hildreth N; Woodard E; Dvoretsky P; Hempelmann L; Pasternack B
1986 Sep;77(3):689-696, Journal of the National Cancer Institute
Acute postpartum mastitis (APM) is an inflammatory-infectious condition of the breast, occurring commonly at childbirth or during lactation. A series of 601 women who received x-ray therapy for APM during the 1940's or 1950's have been followed up by mail questionnaire, with medical verification of pertinent conditions, to ascertain their incidences of breast cancer. Control subjects consisted of a series with APM who did not receive irradiation, plus the female siblings of both the APM groups, for a total of 1,239 controls. The groups have been followed up to 45 years; the average was 29 years. The relative risk (RR) for breast cancer, adjusted for age and interval since irradiation (or an equivalent entry definition for controls), was 3.2 for the irradiated breasts; the 90% confidence interval (CI) was 2.3-4.3. For a linear multiplicative model, the risk increased by 0.4% per rad (90% Cl of 0.2-0.7). The dose-response curve appeared to be essentially linear, except for a diminution of risk at high doses (greater than or equal to 700 rad). The fact that there were no treated breasts with doses between 0 and 60 rad, however, means that it was not possible to evaluate the curvature with the maximum contrast between low and high doses. The dose fractionation analyses showed that neither the number of dose fractions, the number of days between fractions, nor the dose per fraction had any apparent effect on breast cancer risk when the variables were analyzed separately. Similarly, when the fractionation variables were considered jointly in a Cox regression analysis, none was significant once total breast dose was controlled for. Analyses of age at irradiation did not show appreciable differences between age groups, although the numbers were too small to be clear-cut (only 64 women greater than 34 yr old at irradiation). Other studies have shown diminished risk associated with an older age at irradiation. The lack of diminished risk in this study may occur because during pregnancy and lactation the breasts are under increased proliferative stimulation by hormones, by comparison with the normal condition of breasts at older ages. An analysis of the temporal relationship of radiation to breast cancer showed that the RR did not vary systematically with interval since irradiation, but the absolute risk increased over time. This finding agrees with other studies that have also suggested a better fit for the multiplicative model
— id: 32499, year: 1986, vol: 77, page: 689, stat: Journal Article,

Radiation carcinogenesis
Upton, Arthur C.; Albert, Roy E.; Burns, Fredric J.; Shore, Roy E
New York : Elsevier, c1986,
— id: 417, year: 1986, vol: , page: , stat: ,

Risk of extrathyroid tumors following radiation treatment in infancy for thymic enlargement
Hildreth NG; Shore RE; Hempelmann LH; Rosenstein M
1985 Jun;102(3):378-391, Radiation research
Two thousand eight hundred and fifty-six individuals who received X-ray treatments in infancy for an enlarged thymus gland and their 5053 nonirradiated siblings have been followed prospectively since 1953 to evaluate the risk of radiation-induced neoplastic disease. The health status of the entire cohort has been ascertained periodically by mail questionnaire survey. Based on the cumulative experience of five surveys of this cohort, the irradiated group has a statistically significant increased risk for both benign and malignant extrathyroid tumors, the age-adjusted relative risks being 2.0 and 2.2, respectively. Benign tumors of the bone, nervous system, salivary gland, skin, and breast (females only) and malignant tumors of the skin and breast (females only) account for the excess incidence of extrathyroid tumors among the thymic-irradiated individuals. Although a radiation-induced excess of extrathyroid tumors was suggested in an earlier survey of this cohort, small numbers restricted attribution of this excess to specific sites. The implications of these findings are discussed. Thyroid tumors are addressed in a separate paper
— id: 38461, year: 1985, vol: 102, page: 378, stat: Journal Article,

Thyroid tumors following thymus irradiation
Shore RE; Woodard E; Hildreth N; Dvoretsky P; Hempelmann L; Pasternack B
1985 Jun;74(6):1177-1184, Journal of the National Cancer Institute
About 2,650 persons who received X-ray treatment for purported enlarged thymuses in infancy and 4,800 sibling controls have been followed by mail questionnaire for an average of 29 years to observe their incidence of thyroid tumors. The follow-up rate in the latest survey was 88% in both groups. The radiation doses to the thyroid gland ranged from 5 to over 1,000 rad, with 62% receiving less than 50 rad. To date 30 thyroid cancers and 59 benign thyroid adenomas have been detected in the irradiated group, as compared with 1 thyroid cancer and 8 adenomas in the control group. The relative risks in the irradiated group were about 45 for thyroid cancer and 15 for benign thyroid adenomas. The dose-response curve for thyroid cancer was essentially linear, although a linear-quadratic curve could not be ruled out. For thyroid adenomas the risk per rad was somewhat greater at lower doses than at high doses. For both thyroid cancers and adenomas the absolute excess risk per rad was two to three times as great in females as males. Within the limitations imposed by the treatment regimens and the sample size, there was no indication of a 'sparing' effect due to dose fractionation for either thyroid cancers or adenomas. There was an excess risk for both malignant and benign thyroid tumors for at least 40 years post irradiation. For thyroid cancer the radiogenic risk appeared to be additive with respect to time, rather than the age-specific natural rates of cancer being multiplied
— id: 32500, year: 1985, vol: 74, page: 1177, stat: Journal Article,

Hair dye use and breast cancer
Koenig KL; Pasternack BS; Shore RE
1984 Jun;72(6):1211-1212, Journal of the National Cancer Institute
— id: 10282, year: 1984, vol: 72, page: 1211, stat: Journal Article,

Radiation induced cancer: risk assessment and prevention
Shore RE
1984 ;7(3):181-190, Cancer detection & prevention
A number of factors have to be considered in defining the cancer risk from ionizing radiation. These include the radiation sensitivity of the target tissue(s), the temporal pattern of risk, the shape of the dose-incidence curve, the effects of low dose rates, host susceptibility factors, and synergism with other environmental exposures. For the population as a whole the largest sources of radiation exposure are natural background radiation and medical/dental radiation. Radiation exposures in the medical field make up the largest volume of occupational exposures as well. Although new technologies offer opportunities to lower exposures, worker training, careful exposure monitoring with remedial feedback, and monitoring to prevent unnecessary radiodiagnostic procedures may be even more important means of reducing radiation exposure. Screening of irradiated populations can serve a useful preventive function, but only for those who have received very high doses
— id: 38462, year: 1984, vol: 7, page: 181, stat: Journal Article,

Skin cancer incidence among children irradiated for ringworm of the scalp
Shore RE; Albert RE; Reed M; Harley N; Pasternack BS
1984 Oct;100(1):192-204, Radiation research
A series of about 2200 children who received X-ray treatment for ringworm of the scalp (tinea capitis) during the 1940s and 1950s, and a comparable group of 1400 treated without X ray, have been followed by mail questionnaire for an average of 26 years since treatment to tabulate the incidence of skin cancer. The X-ray treatment consisted of 300-380 R to five overlapping fields on the scalp, to cause complete depilation. This delivered doses of 300-600 rad to various portions of the scalp, with lower doses to the skin of the face and neck. In the irradiated group, 41 persons have had one or more basal cell carcinomas of the scalp or face while only three have been diagnosed in controls. There was a high prevalence of multiple skin cancers in the irradiated group (80 lesions among 41 cases). The minimum latent period for radiation-induced skin cancers was long--about 20 years--and this may be attributable to the young age of the population. The skin cancer risk was particularly pronounced on the face, where there would be more UVR exposure in addition to X-ray exposure. Lightness of complexion proved to be an important factor in the skin cancer risk. In addition, skin cancers were found only among caucasians, even though 25% of the study population were blacks. These findings suggest that UVR exposure levels or sensitivity to such exposure interact with ionizing radiation exposure in defining skin cancer risk.
— id: 10279, year: 1984, vol: 100, page: 192, stat: Journal Article,

The skin dose and response for the head and neck in patients irradiated with x-ray for tinea capitis: implications for environmental radioactivity
Harley HN; Kolber AB; Shore RE; Albert RE; Altman SM; Pasternack BS
Epidemiology applied to health physics : proceedings of the 16th Midyear Topical Meeting of the Health Physics Society, Albuquerque, New Mexico, January 9-13, 1983 Springfield, VA : National Technical Information Service, 1983,
— id: 2797, year: 1983, vol: , page: 125, stat: Chapter,

Risk of breast cancer among women receiving radiation treatment in infancy for thymic enlargement
Hildreth NG; Shore RE; Hempelmann LH
1983 Jul 30;2(8344):273-273, Lancet
— id: 38463, year: 1983, vol: 2, page: 273, stat: Journal Article,

Repeated pulmonary function evaluation following bleomycin treatment
Jaeger RJ; Sussman RG; Gearhart JM; Bowers AB; Shore RE; Sellakumar AR
1983 Mar;11(3):415-423, Journal of toxicology & environmental health
A computerized, nonsurgical, pulmonary function measurement method was tested for sensitivity and utility in detecting the development of fibrosis. Bleomycin, a fibrogenic agent, was intratracheally instilled into male Fisher 344 rats. Respiratory function was monitored in restrained, awake animals before treatment and for the subsequent 4 wk. In the first week, among responders, a significant (p less than 0.05) drop in body weight, tidal volume, and compliance was accompanied by a significant increase in respiratory frequency. Minute volume increased in the second week. Although body weight, tidal volume, and compliance returned to baseline values in the following weeks, respiratory frequency and minute volume remained significantly elevated. With the methods used here, respiratory rate change was the parameter most sensitive to the effects of bleomycin in vivo
— id: 38464, year: 1983, vol: 11, page: 415, stat: Journal Article,

Endocrine and environmental factors in breast cancer : the case for prospective studies
Shore RE; Pasternack BS; Bulbrook RD; Moseson M; Kwa HG; Wang D; et al
1983 ;3:1-31, Commentaries on research in breast disease
— id: 112083, year: 1983, vol: 3, page: 1, stat: Journal Article,

Effects of aircraft noise on hearing ability of school-age children
Green KB; Pasternack BS; Shore RE
1982 Sep-Oct;37(5):284-289, Archives of environmental health
Two hundred one cases with permanent bilateral high-frequency hearing loss and 208 controls with normal hearing were identified through the New York City hearing screening program. Aircraft noise exposure was estimated for the residences of cases and controls from Noise Exposure Forecast contour maps of the New York City airports. The noise exposure estimates had a correlation on 0.89 with noise level measurement made in the area. Birth certificates and questionnaires were used to provide additional information on other sources of noise exposure and potential confounders. The results showed a positive, but not statistically significant association between aircraft noise exposure and the risk of high-frequency hearing loss.
— id: 10286, year: 1982, vol: 37, page: 284, stat: Journal Article,

Effects of aircraft noise on reading ability of school-age children
Green KB; Pasternack BS; Shore RE
1982 Jan-Feb;37(1):24-31, Archives of environmental health
The percent of students reading below grade level from 1972 to 1976 was regressed on racial, socioeconomic, educational, and noise level variables for all elementary schools in Brooklyn and Queens, New York. Schools were assigned noise exposure scores based on Noise Exposure Forecast contours for New York City airports. The correlations between these noise scores and a variety of noise level metrics ranged from 0.74 to 0.97. The regression coefficients adjusted for confounding factors, indicated that an additional 3.6% of the students in the noisiest schools read at least 1 yr below grade level with 95% confidence limits from 1.5 to 5.8%. The dose-response relationship indicated that the percent reading below grade level increased as noise level increased.
— id: 10289, year: 1982, vol: 37, page: 24, stat: Journal Article,

Analysis of dichotomous response data from toxicological experiments involving stable laboratory mouse populations
Pasternack BS; Shore RE
1982 Dec;38(4):1057-1067, Biometrics
The comparability between an analysis of variance that employs untransformed proportions and one that employs two common arcsine transforms is assessed by using preweaning mouse litter survival data from a toxicological experiment that involves stable laboratory populations. The importance of controlling for litter order, litter size and birth cohort is demonstrated. An adaptation of a nonparametric method suggested by Mantel (1963, Journal of the American Statistical Association 58, 690-700) is proposed as an alternative procedure. Although the results indicate that the nonparametric method is modestly less powerful than the parametric approach, its use is recommended when the assumptions underlying the analysis of variance are questionable. A method for plotting the temporal pattern of the effect of continuous exposure to the toxicant (DDT) on preweaning survival is also presented.
— id: 10285, year: 1982, vol: 38, page: 1057, stat: Journal Article,

Group-sequential methods in the design and analysis of epidemiological studies
Pasternack BS; Shore RE
10a Conferencia Internacional de Biometrica : Regiao Brasileira da Sociedade Internacional de Biometria, Guaruja, SP, Brasil, Brasilia : EMBRAPA-DID, 1982,
— id: 2838, year: 1982, vol: , page: 469, stat: Chapter,

Sample sizes for individually matched case-control studies: a group sequential approach
Pasternack BS; Shore RE
1982 May;115(5):778-784, American journal of epidemiology
This paper proposes the use of group sequential methods to calculate sample sizes for individually matched case-control study designs. A table is presented in which the average sample size required for a group sequential (i.e., multistage) matched pair design is compared to that of the conventional matched pair fixed sample size plan for the usual constant relative risk situation. The table shows that group sequential designs are in general more efficient than fixed sample size plans. Computer simulations showed that group sequential methods yield the appropriate type I and type II error rates not only for matching on a one-to-one basis, but also more generally with multiple matched controls per case. Further simulation studies indicated that there may be only a small loss of power when the matching variable(s) is associated with the probability of exposure but not with the disease. This is shown for both the multistage and fixed sample tests.
— id: 10288, year: 1982, vol: 115, page: 778, stat: Journal Article,

A follow-up study of children given x-ray treatment for ringworm of the scalp (Tinea Capitis)
Shore, Roy E
[S.l. : s.n.], 1982,
Thesis (Doctorate) -- Columbia University, 1982
— id: 1237, year: 1982, vol: , page: , stat: ,

Sample sizes for group sequential cohort and case-control study designs
Pasternack BS; Shore RE
1981 Feb;113(2):182-191, American journal of epidemiology
This paper proposes the use of group sequential methods of calculate sample sizes for cohort and case-control study designs. The methods are based upon the theory of repeated significance tests, one of several sequential methods currently available. Group sequential methods permit repeated significance testing of relative risks obtained from periodically accumulated data while maintaining the required overall level of significance. Tables are presented for cohort and case-control studies in which the average sample size required for a group sequential design is compared to that of the conventionl fixed sample size plan for the usual constant relative risk situation. The tables show that group sequential designs are in general more efficient than fixed sample size plans for cohort and case-control studies. Computer simulations showed that group sequential methods can be employed when stratified data analyses are to be used and when the sample sizes of the two study groups are unequal.
— id: 10293, year: 1981, vol: 113, page: 182, stat: Journal Article,

THE LATE EFFECTS OF LOW-LEVEL EXPOSURE TO LEAD IN CHILDHOOD
SHORE, R; PASTERNACK, B; FRIEDMAN, D; ALBERT, R
1981 ;114(3):427-428, American journal of epidemiology
— id: 40189, year: 1981, vol: 114, page: 427, stat: Journal Article,

Breast cancer risk from low-dose exposures to ionizing radiation: results of parallel analysis of three exposed populations of women
Land CE; Boice JD Jr; Shore RE; Norman JE; Tokunaga M
1980 Aug;65(2):353-376, Journal of the National Cancer Institute
Breast cancer incidence data were analyzed from three populations of women exposed to ionizing radiation: survivors of the Hiroshima and Nagasaki atomic bombs, patients in Massachusetts tuberculosis sanitoria who were exposed to multiple chest fluoroscopies, and patients treated by X-rays for acute postpartum mastitis in Rochester, New York. Parallel analyses by radiation dose, age at exposure, and time after exposure suggested that risk of radiation-induced cancer increased approximately linearly with increasing dose and was heavily dependent on age at exposure; however, the risk was otherwise remarkably similar among the three population, at least for age 10-40 years at exposure, and followed the same temporal pattern of occurrence as did breast cancer incidence in nonexposed women of similar ages
— id: 38465, year: 1980, vol: 65, page: 353, stat: Journal Article,

Group sequential methods for cohort and case-control studies
Pasternak BS; Shore RE
1980 ;33(6):365-373, Journal of chronic diseases
— id: 38466, year: 1980, vol: 33, page: 365, stat: Journal Article,

Synergism between radiation and other risk factors for breast cancer
Shore RE; Woodard ED; Hempelmann LH; Pasternack BS
1980 Nov;9(6):815-822, Preventive medicine
— id: 10294, year: 1980, vol: 9, page: 815, stat: Journal Article,

Radiation and host factors in human thyroid tumors following thymus irradiation
Shore RE; Woodard ED; Pasternack BS; Hempelmann LH
1980 Apr;38(4):451-465, Health physics
— id: 10296, year: 1980, vol: 38, page: 451, stat: Journal Article,

Mammography
Shore, R E; Pasternack, B S
1980 Jul 19;123(2):97-98, Canadian Medical Association journal
— id: 110399, year: 1980, vol: 123, page: 97, stat: Journal Article,

LONG-TERM EFFECTS OF X-RAY THERAPY FOR RINGWORM OF THE SCALP
Shore, R; Albert, R; Pasternack, B
1980 ;112(3):442-442, American journal of epidemiology
— id: 27969, year: 1980, vol: 112, page: 442, stat: Journal Article,

Identification of occupational settings with very high risks of lung cancer
Albert RE; Pasternack BS; Shore RE; Nelson N
1979 Dec;63(6):1289-1290, Journal of the National Cancer Institute
— id: 10297, year: 1979, vol: 63, page: 1289, stat: Journal Article,

Risk of breast cancer following low-dose radiation exposure
Boice JD Jr; Land CE; Shore RE; Norman JE; Tokunaga M
1979 Jun;131(3):589-597, Radiology
Risk of breast cancer following radiation exposure was studied, based on surveys of tuberculosis patients who had multiple fluoroscopic examinations of the chest, mastitis patients given radiotherapy, and atomic bomb survivors. Analysis suggests that the risk is greatest for persons exposed as adolescents, although exposure at all ages carries some risk. The dose-response relationship was consistent with linearity in all studies. Direct evidence of radiation risk at doses under 0.5 Gy (50 rad) is apparent among A-bomb survivors. Fractionation does not appear to diminish risk, nor does time since exposure (even after 45 years of observation). The interval between exposure and the clinical appearance of radiogenic breast cancer may be mediated by hormonal or other age-related factors but is unrelated to dose. Age-specific absolute risk estimates for all studies are remarkably similar. The best estimate of risk among American women exposed after age 20 is 6.6 excess cancers/10(4) WY-G-Y (10(6) WY-rad)
— id: 38467, year: 1979, vol: 131, page: 589, stat: Journal Article,

Lung cancer following exposure to chloromethyl ethers
Pasternack BS; Shore RE
Proceedings of the International Conference on Critical Current Issues in Environmental Health Hazards, Tel Aviv, March 1979 [S.l. : s.n.], 1979,
— id: 2839, year: 1979, vol: , page: 76, stat: Chapter,

A case-control study of hair dye use and breast cancer
Shore RE; Pasternack BS; Thiessen EU; Sadow M; Forbes R; Albert RE
1979 Feb;62(2):277-283, Journal of the National Cancer Institute
A case-control study of the relationship between hair dye use and breast cancer included 129 breast cancer patients and 193 control women drawn from the records of a multiphasic screening clinic. Information was obtained by telephone interview on a number of risk factors for breast cancer and on variables pertaining to hair dye use: chronologic time, duration, frequency, type, and color. From this, quantitative measures of cumulative hair dye use at various intervals prior to breast cancer (or an equivalent for controls) were obtained. A multivariate risk factor score was used to control for confounding variables. The adjusted relative risks for breast cancer versus hair dye use were greater than unity but were not generally significant. However, integral measures of hair dye use (No. of yr times frequency per yr) were significantly related to breast cancer when confounding variables were controlled. The association between hair dye use and breast cancer was greatest among women over 50 years of age and among those at lower natural risk for breast cancer. An analysis of temporal patterns showed that breast cancer was related mainly to hair dye use 10 or more years before cancer diagnosis. Because of the retrospective nature of the hair dye data and the small sample size, these results require further validation.
— id: 10300, year: 1979, vol: 62, page: 277, stat: Journal Article,

INTERACTIONS BETWEEN RADIATION AND RISK-FACTORS FOR BREAST- CANCER
Shore, R; Pasternack, B; Woodard, E; Hempelmann, L
1979 ;110(3):367-367, American journal of epidemiology
— id: 30082, year: 1979, vol: 110, page: 367, stat: Journal Article,

HAIR DYE USE AND BREST CANCER - REPLY
Shore, RE; Pasternack, BS
1979 ;62(6):1327-1328, Journal of the National Cancer Institute
— id: 30096, year: 1979, vol: 62, page: 1327, stat: Journal Article,

Follow-up study of patients treated by X-ray epilation for tinea capitis: psychiatric and psychometric evaluation
Omran AR; Shore RE; Markoff RA; Friedhoff A; Albert RE; Barr H; Dahlstrom WG; Pasternack BS
1978 Jun;68(6):561-567, American journal of public health. AJPH
To investigate the late effects of radiation to the head upon subclinical mental disorders, a psychiatric and psychometric evaluation was performed on 177 cases treated 10-29 years earlier for ringworm of the scalp by X-ray therapy (N :109) or, by chemotherapy (N :68). Analyses which controlled for educational level and family psychiatric disorders showed that, among whites, the irradiated group manifested more psychiatric symptoms and more deviant MMPI (Minnesota Multiphasic Personality Inventory) scores. They were also judged more maladjusted from their MMPI profiles, and more frequently had a history of treated psychiatric disorders; however, the psychiatrist's overall rating of current psychiatric status showed only a borderline differnece between the two groups. There were no significant differences between irradiated and chemotherapy treated blacks.
— id: 10302, year: 1978, vol: 68, page: 561, stat: Journal Article,

RADIATION-FACTORS AND HOST-FACTORS IN THYROID TUMORS FOLLOWING THYMUS IRRADIATION
Shore, R; Hempelmann, L; Pasternack, B; Woodard, E
1978 ;108(3):233-233, American journal of epidemiology
— id: 29769, year: 1978, vol: 108, page: 233, stat: Journal Article,

DOSE-RESPONSE RELATIONSHIP IN RADIOGENIC BREAST-CANCER - REPLY
Shore, RE
1978 ;60(4):728-728, Journal of the National Cancer Institute
— id: 29837, year: 1978, vol: 60, page: 728, stat: Journal Article,

Statistical methods for assessing risk following exposure to environmental carcinogens
Pasternack BS; Shore RE
Environmental health : quantitative methods Philadelphia : SIAM, 1977,
— id: 2793, year: 1977, vol: , page: 49, stat: Chapter,

Occupational exposure to chloromethyl ethers. A retrospective cohort mortality study (1948-1972)
Pasternack BS; Shore RE; Albert RE
1977 Nov;19(11):741-746, Journal of occupational medicine
This industry-wide epidemiologic study to evaluate the human carcinogenicity of the chloromethyl ethers (CME) included 1827 CME-exposed workers and 8870 controls. Duration and relative intensity of exposure were classified by job description in the personnel records. This information permitted assigning relative magnitude of exposure scores for each job category at several plants, with allowance for temporal changes in the plant processes. Social security records were used for the ascertainment of deaths among separated employees. Death certificates were obtained for virtually all known deaths, and hospital pathology reports were obtained where possible for the cancer-related deaths. No differences in noncancer death rates were found. An increased risk of respiratory cancer death in CME-exposed workers was found at only one firm where high exposures are known to have occurred. A clear dose-response relationship with risk ratios exceeding ten for the longest duration and greatest exposure subgroups was demonstrated for this firm.
— id: 10304, year: 1977, vol: 19, page: 741, stat: Journal Article,

Breast neoplasms in women treated with x-rays for acute postpartum mastitis
Shore RE; Hempelmann LH; Kowaluk E; Mansur PS; Pasternack BS; Albert RE; Haughie GE
1977 Sep;59(3):813-822, Journal of the National Cancer Institute
Breast cancer has been studied by mail survey up to 34 years in 571 of 606 women treated with x-rays for acute postpartum mastitis. The incidence of neoplasms was compared with that of three nonirradiated control groups--nonirradiated sisters of the treated women, women with acute postpartum mastitis not treated with X-rays, and their nonirradiated sisters. For the irradiated group, with mean dose of 247 rads to both breasts, the overall relative risk of breast cancer was 2.2 for years 10-34 post irradiation and 3.6 for years 20-34. The dose response for malignant and benign breast neoplasms was compatible with a linear fit. For comparable total doses, fractionation of exposure did not reduce carcinogenic action. Women over age 30 years at radiation treatment had as great an excess risk of breast cancer as did younger women. The overall excess risk of developing breast cancer was about 8-10 cases per million women per rad per year, an increase of about 0.5% per rad.
— id: 10305, year: 1977, vol: 59, page: 813, stat: Journal Article,

BREAST-CANCER FOLLOWING X-RAY THERAPY FOR ACUTE POSTPARTUM MASTITIS
SHORE, R; HEMPELMANN, L; PASTERNACK, B; KOWALUK, E
1977 ;106(3):230-230, American journal of epidemiology
— id: 39939, year: 1977, vol: 106, page: 230, stat: Journal Article,

Follow-up study of patients treated by x-ray epilation for tinea capitis. Estimation of the dose to the thyroid and pituitary glands and other structures of the head and neck
Harley NH; Albert RE; Shore RE; Pasternack BS
1976 Jul;21(4):631-642, Physics in medicine & biology
This study is a further investigation of radiation dose to various head structures in the children given X-ray therapy for tinea capitis (ringworm of the scalp). In this work, estimates of the dose to the thyroid and pituitary gland were obtained with lithium fluoride thermoluminescent dosemeters using a child's head phantom. Doses were also measured for the parotid gland and several skin sites where skin tumours developed in the irradiated cases. In a previous study, brain and scalp doses of 140 and 500-800 rad had been estimated for the treated group using this same head phantom. In this work dosemeters were also placed in the same brain locations so that comparisons could be obtained between the two studies. The thyroid dose was estimated to be 6 +/- 2 rad and the pituitary dose was 49 +/- 6 rad for the conventional tinea capitis treatment. The dose to the parotid gland was 39 rad and the dose to skin sites on the face and neck where tumours occurred ranged from 20 to 40 rad. The data for the thyroid adenoma response from this and other studies involving irradiation of children suggests a linear dose-response relationship within the first 30-40 years after exposure with a risk of about 0-04% per rad.
— id: 10308, year: 1976, vol: 21, page: 631, stat: Journal Article,

A statistical note on "differential misdiagnosis of blacks and whites by the MMPI"
Shore RE
1976 Feb;40(1):21-23, Journal of personality assessment
This report presents a critique of the conclusion by Strauss et al, that MMPI diagnostic decision-making rules derived from whites are inapplicable to blacks. It is shown that for the data from two of their three MMPI indices, a multiple discriminant function and the Goldberg Index, there was no clear evidence for greater misdiagnosis among blacks than whites when the hit rates among psychotics, behavior disorders or both are examined. For the third measure, semiactuarial profile analysis, the results show less diagnostic accuracy for blacks psychotics, but this one result does not warrant a broad generalization. A preferable method of analysis and a source of potential bias in one of the measures are pointed out
— id: 38468, year: 1976, vol: 40, page: 21, stat: Journal Article,

Follow-up study of patients treated by X-ray epilation for Tinea capitis; resurvey of post-treatment illness and mortality experience
Shore RE; Albert RE; Pasternack BS
1976 Jan-Feb;31(1):21-28, Archives of environmental health
This is the second follow-up study of 2,215 persons who during childhood between 1940 and 1959 had been given x-ray therapy for tinea capitis and of 1,395 persons well matched for age, sex, and race who were treated for the same disease during the same period without the use of x-ray therapy. The major finding of the study was an excess incidence in the irradiated cases of tumors of the head and neck including the skin, brain, thyroid, and parotid. However, between the groups there was no difference in death due to malignant neoplasms or any other cause. Among white patients, a 40% excess of treated psychiatric disorders was observed in the irradiated group, but there was no difference among blacks.
— id: 10311, year: 1976, vol: 31, page: 21, stat: Journal Article,

Relating influenza epidemics to childhood leukemia in tumor registries without a defined population base: a critique with suggestions for improved methods
Shore RE; Pasternack BS; Curnen MG
1976 Jun;103(6):527-535, American journal of epidemiology
— id: 10309, year: 1976, vol: 103, page: 527, stat: Journal Article,

Mortality patterns among workers exposed to chloromethyl ethers--a preliminary report
Albert RE; Pasternack BS; Shore RE; Lippmann M; Nelson N; Ferris B
1975 Jun;11:209-214, Environmental health perspectives
Chloromethyl methyl ether (CMME) has been used extensively as a crosslinking agent for ion-exchange resins. Commercial grades of CMME are contaminated to the extent of 2-8% with bischloromethyl ether, an alkylating agent which has been shown to be a very potent lung carcinogen in animals. Reports by other investigators in this and other countries have implicated CMME as a lung carcinogen in chemical workers. The purpose of the study reported here was to examine the lung cancer mortality experience with respect to intensity and duration of exposure in six of the seven chemical companies that account for virtually all of the CMME use in the United States. The study included about 1800 workers who were exposed in the period 1948 to 1972 and about 8000 workers not exposed to CMME from the same plants who served as controls. Exposed workers were characterized according to job description and duration of exposure. In several plants the intensity of exposure was numerically graded for each job category with adjustment for temporal changes in the plant processes. Social Security records were used to identify deaths among workers who had left the companies and death certificates have been obtained for virtually all known deaths. The age-adjusted death rate for respiratory cancer in the CMME exposed group as a whole was 2.5 times that in the control group, whereas death rates due to other causes were comparable. There was also a gradation of lung cancer risk according to intensity and duration of exposure and the time elapsed since the onset of exposure.
— id: 10316, year: 1975, vol: 11, page: 209, stat: Journal Article,

"BIOSTATISTICS - FOUNDATION FOR ANALYSIS IN HEALTH SCIENCES - DANIEL,WW"
Shore, RE
1975 ;70(350):490-491, Journal of the American Statistical Association
— id: 28524, year: 1975, vol: 70, page: 490, stat: Journal Article,

Follow-up of children overexposed to lead
Albert RE; Shore RE; Sayers AJ; Strehlow C; Kneip TJ; Pasternack BS; Friedhoff AJ; Covan F; Cimino JA
1974 May;7:33-39, Environmental health perspectives
— id: 10320, year: 1974, vol: 7, page: 33, stat: Journal Article,

Self-disclosure and interpersonal functioning
Halverson CF Jr; Shore RE
1969 Apr;33(2):213-217, Journal of consulting & clinical psychology
— id: 38469, year: 1969, vol: 33, page: 213, stat: Journal Article,

An electrophoretic analysis of proteins of cellular sap in normal and hybrid frog embryos
Shore RE
1965 Aug;14(1):1-14, Journal of embryology & experimental morphology
— id: 38470, year: 1965, vol: 14, page: 1, stat: Journal Article,

The role of childhood experiences in adult neurosis : a comparison of Freud, Adler, and Jung
Shore, Roy E
[S.l. : s.n.], 1962,
Honors paper in psychology -- Houghton College, 1962
— id: 1234, year: 1962, vol: , page: , stat: ,