The role of family history of Cancer in Oral Cavity Cancer

Objectives Oral and oropharyngeal squamous cell carcinoma (SCC) is the 10th most common cancer in the United States (8th in males, 13th in females), with an estimated 54,010 new cases expected in 2021, and is primarily associated with smoked tobacco, heavy alcohol consumption, areca nut use and persistent high-risk human papillomavirus (HPV). Family history of cancer (FHC) and family history of head and neck cancer (FHHNC) have been reported to play an important role in the development of OSCC. We aimed to investigate the role of FHC, FHHNC and personal history of cancer in first/second degree-relatives as co-risk factors for oral cancer. Methods This was a retrospective study of patients diagnosed with OSCC at the Division of Oral Medicine and Dentistry at Brigham and Women’s Hospital and at the Division of Head and Neck Oncology at Dana Farber Cancer Institute. Conditional logistic regressions were performed to examine whether OSCC was associated with FHC and FHHNC of FDRs and SDRs, personal history of cancer and secondary risk factors. Results Overall, we did not find an association between FHC, FHHNC and OSCC risk, whereas patients with a cancer history in one of their siblings were 1.6-times more likely to present with an OSCC. When secondary risk factors were considered, patients with a history of oral leukoplakia and dysplasia had a 16-times higher risk of having an OSCC. Conclusions Our study confirmed that a previous history of oral leukoplakia or dysplasia was an independent risk factor for OSCC. A positive family history of cancer in one or more siblings may be an additional risk factor for OSCC.

Supplemental folic acid and/or multivitamins in pregnancy is associated with a decreased risk of childhood and adolescent nasopharyngeal carcinoma

The aim of this study was to evaluate the association between prenatal and neonatal period exposures and the risk of childhood and adolescent nasopharyngeal carcinoma (NPC). From January 2009 to January 2016, a total of 46 patients with childhood and adolescent NPC (i.e., less than 18 years of age) who were treated at Sun Yat-sen University Cancer Center were screened as cases, and a total of 45 cancer-free patients who were treated at Sun Yat-sen University Zhongshan Ophthalmic Center were selected as controls. The association between maternal exposures during pregnancy and obstetric variables and the risk of childhood and adolescent NPC was evaluated using logistic regression analysis. Univariate analysis revealed that compared to children and adolescents without a family history of cancer, those with a family history of cancer had a significantly higher risk of childhood and adolescent NPC [odds ratios (OR) = 3.15, 95% confidence interval (CI) = 1.02–9.75, P = 0.046], and the maternal use of folic acid and/or multivitamins during pregnancy was associated with a reduced risk of childhood and adolescent NPC in the offspring (OR = 0.07, 95% CI = 0.02–0.25, P < 0.001). After multivariate analysis, only the maternal use of folic acid and/or multivitamins during pregnancy remained statistically significant. These findings suggest that maternal consumption of folic acid and/or multivitamins during pregnancy is associated with a decreased risk of childhood and adolescent NPC in the offspring.

Exposure to pesticides and development of hematological cancers: a case-control study

The aim of this study was to analyze the association between chronic exposure to pesticides and the development of hematological cancers in a region with intense agricultural activity. This is a hospital-based case-control study. Socioeconomic, demographic, occupational and health-related aspects of patients were investigated. The univariate odds ratio (OR) of cases was verified using logistic regression analysis. In the multivariate analysis, the relevant variables in the model were maintained (p = 0.05). There was a predominance of males in the case (54.0%) and control (53.0%) groups. The mean age was 58.8 ± 14.5 years in the case group and 55.6 ± 12.9 years in the control group. It was found that 38.7% of the cases were farmers, and that contact for more than five years with pesticides increases the chances of developing hematological cancers by 2.19 times (OR = 2.19; 95% CI 1, 19 - 4.06). It was also found that the higher the family income, the lower the chances of these neoplasms to appear (OR = 0.26; 95% CI 0.11 - 0.65). In addition, patients who did not have a family history of cancer were 96% less likely (OR = 0.04; 95% CI 0.02 - 0.08) to develop the disease. Chronic exposure to pesticides, family history of cancer and socioeconomic status are associated with greater chances of developing hematological neoplasms. Rural workers exposed to these substances for periods of more than five years are more vulnerable.

The Role of Community Health Advisors’ Cancer History in Implementation and Efficacy of a Cancer Control Intervention

Purpose: Community health advisors (CHAs) play a key role in promoting health in medically underserved communities, including in addressing cancer disparities. There is a need to expand the research on what criteria makes for an effective CHA. We examined the relationship between CHAs’ personal and family history of cancer, and implementation and efficacy outcomes in a cancer control intervention trial.Methods: Twenty-eight trained CHAs implemented a series of three cancer educational group workshops for N=375 workshop participants across 14 churches. Implementation was operationalized as participant attendance at the educational workshops and efficacy as workshop participants’ cancer knowledge scores at 12-month follow-up, controlling for baseline scores. Results: CHA’s personal history of cancer was not significantly associated with implementation, nor knowledge outcomes. However, CHAs with family history of cancer had significantly greater participant attendance at the workshops than CHAs without family history of cancer (p=.03). In addition, there was a significant, positive association between male CHAs’ family history of cancer and male workshop participants’ prostate cancer knowledge scores at 12 months (estimated beta coefficient=0.49, p<.01) after adjusting for workshop participant baseline knowledge scores, the CHAs’ competence score, and the CHAs’ education levels. Conclusions: Findings suggest CHAs with family history of cancer may be particularly suitable for cancer peer education, though further research is needed to confirm this and identify other factors conducive to CHAs’ success.

Burden of Renal Cysts Imaging: A Survey of Patients among the Greater Plains Collaborative

<b><i>Purpose:</i></b> Renal cysts are a frequent incidental finding on cross-sectional radiographic imaging. While most cysts are indolent, individuals with such cysts are frequently monitored for interval growth and potential malignant transformation, which is ultimately rare. In this study, we aimed to assess patients’ values and preferences (believes and attitudes) about renal cysts. <b><i>Methods:</i></b> We deployed a cross-sectional survey to a random sample of patients with a diagnosis of renal cysts who were identified by billing code and self-identification. We collected data about demographics, insurance status, family history and overall health, and characteristics of patients with renal cysts. We performed a binary regression analysis (adjusted for age, gender, family history of cancer and kidney disease, and treatment plan for renal cysts) to determine anxiety predictors in patients with renal cysts. <b><i>Results:</i></b> We included 301 respondents in whom billing code and self-identification corresponded; of these, 138 had renal cysts and 163 did not. In an adjusted regression analysis, there was a suggestion that a clear management plan (OR = 0.49, 95% CI [0.22–1.11]) (<i>p</i> value 0.08) may be associated with less anxiety and a family history of renal disease may be associated with more anxiety (OR = 1.94 [0.76–4.94]) (<i>p</i> value 0.17). Family history of cancer also did not significantly predict anxiety (OR = 0.54 [0.24–1.19]) (<i>p</i> value 0.13). All these results were not statistically significant and had wide confidence intervals of the effect estimates make the results imprecise. <b><i>Conclusion:</i></b> Findings of this pilot study suggest a clear management plan for the renal cyst(s) management may be associated with a lower level of anxiety, thereby by emphasizing the importance of good communication, patient engagement and evidence-based guidance. More definitive, adequately powered studies are needed to evaluate this finding further. In addition, further studies exploring differences in imaging practices, patient symptomatology and patient engagement by different provider types would be insightful. Ultimately, tools to improve shared decision-making are needed to provide more patient-centered care.

Cancer Spectrum, Family History of Cancer and Overall Survival in Men with Germline BRCA1 or BRCA2 Mutations

BACKGROUND: Men with germline BRCA1/2 mutations are not well studied compared to their female counterparts. This study evaluates the cancer characteristics, family history of cancer, and outcomes of male BRCA1/2 mutation carriers. METHODS: All men with germline BRCA1/2 mutations who attended genetic assessment between October 1995 and October 2019 at the Medical University of Vienna were identified. Clinicohistopathological features, family history of cancer, and outcomes were assessed by mutation status. RESULTS: Of the 323 men included, 45 (13.9%) had a primary cancer diagnosis, many of whom were BRCA2 carriers (75.5%). Breast cancer (BC) was the most common cancer (57.8%) followed by prostate cancer (15.6%). Invasive ductal carcinoma and hormone receptor positive tumors were the most common. Among 26 BC-affected patients, 42% did not have any relatives with cancer. Parent of origin was only known in half of the 26 men, with 42% of them inherited through the maternal lineage versus 8% through the paternal. BRCA2 carriers and those with a family history of BC had worse overall survival (20 y vs. 23 y BRCA1 carriers; P = 0.007; 19 y vs. 21 y for those without family history of BC; P = 0.036). CONCLUSION: Male BRCA2 carriers were most likely to develop cancer and had worse prognosis. In our dataset, BC was the most common cancer, likely due to referral bias. Not all mutation carriers present with BC or have a family history of cancer to warrant genetic testing.

The impact of risk perception on emotional distress in individuals with a family history of cancer

Purpose: Understanding the factors impacting individuals’ emotional distress in the context of a family history of cancer is key in designing and implementing psychosocial interventions. Our study investigated the extent to which having a family history of cancer is associated with emotional distress and whether the perceived risk to develop colorectal cancer (CRC) plays any role in this equation. Methods: This cross-sectional study included 253 individuals from the general population who volunteered to take part in this study. We assessed their family history of cancer and perceived risk for developing CRC, and assessed the emotional distress. Findings: Individuals with a family history of cancer have higher levels of emotional distress compared to individuals without a family history, t(251)=-10.16, p<.001. Our data show that risk perception to develop CRC moderates the relationship between the family history of cancer and emotional distress (β=0.38, CI=(1.68, 5.92), r2=0.24, p<.001, d=0.25). Conclusion: This study was aimed at corroborating the role family history of cancer and risk perception have in explaining the emotional distress associated with cancer. Our results contribute to a clearer understanding of the impact family history of cancer has on emotional distress and show that risk perception is key in this relationship.