American Association for Cancer Research

March 2008 CEBP Highlights

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Selected Articles from the March 1, 2008 Issue

The articles referenced in this Highlights section will be available online in HTML and PDF formats to all interested users at no charge until the next issue of Cancer Epidemiology, Biomarkers & Prevention is published. Click on the article title to view the complete article.

View the Table of Contents for the March 2008 issue of Cancer Epidemiology, Biomarkers & Prevention


Different Paths Aim to Reduce Melanoma Mortality

Wartman and Weinstock   Page 469

Melanoma is a heterogeneous disease with both host and environment components of risk. Meta-analyses find that intermittent sun exposure, total sun exposure, and sunburns are related to melanoma risk. Solar exposure influences melanoma risk through interactions with host susceptibility factors that may result in identifiable phenotypes. Although there are numerous questions remaining, Tucker concludes that the body of evidence implicates UV exposure as a major contributor to melanoma etiology. Wartman and Weinstock acknowledge the undeniable public-health impact of melanoma; however, they point out that educational and media campaigns to encourage sun avoidance have failed to achieve the desired behavioral changes in young people in the US, have had limited impact on elderly patients who have already experienced decades of damaging sun exposure, and most importantly, have failed to decrease the incidence of melanoma. They believe the best method to reduce deaths from melanoma is to emphasize early detection and treatment of suspicious lesions through combined efforts of both patients and providers. 
 

Birth Defects and Cancer Risk

Bjørge et al.

Page 500

Cancer and birth defects may share factors that influence risk. A malformation may involve physiologic changes or changes in lifestyle that affect cancer risk. Bjørge and colleagues linked population-based birth and cancer registries to identify subsequent cancer occurrence in children with birth defects, and among their parents and siblings. The authors observed an increased overall cancer risk in individuals with birth defects. The highest risks were seen for individuals with malformations of the nervous system, Down syndrome, and among those with multiple defects. No overall increase in cancer was seen among their parents or siblings. 


Lipid Metabolism SNPs Contribute to Biliary Tract Cancers

Andreotti et al.

Page 525

Biliary tract cancers, encompassing the gallbladder, extrahepatic bile duct, and ampulla of Vater, are uncommon but frequently fatal malignancies. Gallstones, the primary risk factor for biliary cancers, are linked with hyperlipidemia. Andreotti and colleagues examined the associations of 12 single nucleotide polymorphisms (SNPs) in five genes involved in lipid metabolism with risk of biliary cancers and stones in a population-based case-control study in Shanghai, China. Their findings suggest that gene variants in lipid metabolism contribute to the risk of biliary tract stones and cancers, particularly of the bile duct. 


Evidence linking sex hormone concentrations with risk of recurrence in women diagnosed with breast cancer is limited; however, beneficial effects of antiestrogenic therapy on recurrence-free survival suggest that these hormones affect progression and risk of recurrence. Rock and colleagues examined whether baseline serum concentrations of estradiol, testosterone and sex-hormone binding globulin (SHBG) were associated with recurrence-free survival. Although genetic and metabolic factors probably modulate the relationship between circulating sex hormones and risk, results from this study provide evidence that higher serum estrogen concentration contributes to risk of recurrence in women diagnosed with early-stage breast cancer. 


MRI Needed for Women with BRCA Mutations

Bigenwald et al.

Page 706

Several observational studies have demonstrated that magnetic resonance imaging (MRI) is markedly more sensitive than mammography for screening women over age 25 at high risk of BRCA1/2 breast cancer; however, MRI is more costly and less specific than mammography. Bigenwald and colleagues investigated the extent to which the low sensitivity of mammography is due to greater breast density in this high-risk group. They found that, although mammography may be somewhat more sensitive for detecting invasive cancers with lower rather than higher breast density, even with low density, sensitivity was less than 50%. The authors conclude that it is necessary to add MRI to mammography for screening women with BRCA mutations, even if their breast density is low.


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