Familial Risks and Proportions Describing Population Landscape of Familial Cancer

Background: Familial cancer can be defined through the occurrence of the same cancer in two or more family members. We describe a nationwide landscape of familial cancer, including its frequency and the risk that it conveys, by using the largest family database in the world with complete family structures and medically confirmed cancers. Patients/methods: We employed standardized incidence ratios (SIRs) to estimate familial risks for concordant cancer among first-degree relatives using the Swedish Cancer Registry from years 1958 through 2016. Results: Cancer risks in a 20–84 year old population conferred by affected parents or siblings were about two-fold compared to the risk for individuals with unaffected relatives. For small intestinal, testicular, thyroid and bone cancers and Hodgkin disease, risks were higher, five-to-eight-fold. Novel familial associations included adult bone, lip, pharyngeal, and connective tissue cancers. Familial cancers were found in 13.2% of families with cancer; for prostate cancer, the proportion was 26.4%. High-risk families accounted for 6.6% of all cancer families. Discussion/Conclusion: High-risk family history should be exceedingly considered for management, including targeted genetic testing. For the major proportion of familial clustering, where genetic testing may not be feasible, medical and behavioral intervention should be indicated for the patient and their family members, including screening recommendations and avoidance of carcinogenic exposure.

Mechanisms of Stratification in In-Person Instruction in the Wake of COVID-19

In this mixed-methods study, we ask why participation in in-person instruction during the COVID-19 pandemic varied by race/ethnicity and SES. We consider three possible mechanisms—stratified access to in-person instruction, stratified risks related to in-person instruction, and stratified parental availability to support remote learning. We use data from a national online survey fielded through Ipsos in December 2020 with a probability sample of 2,016 US parents with at least one child under 18. We analyze both closed-ended and open-ended questions regarding parents’ decisions about school-age children’s participation in in-person instruction during the 2020-2021 school year. After accounting for differences in access, risk, and parental availability, we found no significant racial/ethnic or SES differences in parents’ likelihood of choosing in-person instruction. Instead, access, risk, and parental availability were strongly predictive of these decisions. Our qualitative analyses further clarified how access, risk, and parental availability influenced families’ decisions regarding in-person school. Families with limited availability tended to choose in-person instruction because of the challenges of combining remote learning with full-time employment. Meanwhile, families who had high-risk family members and lived in communities with high rates of viral transmission tended to choose remote or homeschooling, particularly if they also had a family member who could provide support at home. We discuss the implications of these findings for efforts to understand and address the inequalities in students’ and families’ outcomes in the wake of COVID-19, concluding that families’ decisions were driven largely by pandemic and pre-pandemic inequalities in families’ lives.

An investigation of depression, anxiety, and stress and its relating factors during COVID-19 pandemic in Iran

Background The COVID-19 (SARS-CoV-2) is an emerging epidemic caused by the new Coronavirus. It has affected more than 200 countries, infected 5,939,234 people, and killed 367,255 in the world until 1 June 2020. While the disease epidemic could affect population mental health, this study aimed to investigate stress, anxiety, and depression during the Corona pandemic in Iran. Methods An online survey was designed using the depression, anxiety, and stress scale (DASS-21) questionnaire. The questionnaire was available for all Iranian population from 18 to 28 April 2020. Finally, 1498 participants filled the questionnaire using snowball sampling. Data were analyzed using multivariate regression models. Results Findings showed that most participants had experienced a normal level of stress (36.6%), anxiety (57.9%) and depression (47.9%). About 2.5% of respondents report an extremely severe level of stress. This amount of anxiety and depression was 6.3 and 7.9%, respectively. Regression model showed being female (CI: − 1.299; − 0.248), living with a high risk family member (CI: 0.325; 1.400), health status (CI: − 0.857; − 0.595), economic status (CI: − 0.396; − 0.141), social capital (CI: − 0.475; − 0.244), risk of disease (CI: 0.081; 0.729), and following COVID-19 news (CI: 0.111; 0.551) have a relation with stress level. Education level (CI: − 0.252; − 0.017), living with a high risk family member (CI: 0.0301; 1.160), health status (CI: − 0.682; − 0.471), social capital (CI: − 0.236; − 0.048), risk of disease (CI: 0.154; 0.674), and following COVID-19 news (CI: 0.046; 0.401) have a relation with anxiety score. Depression score was in relation with education level (CI: − 0.263; − 0.022), having a high-risk family member (CI: 0.292; 1.155), health status (CI: − 0.687; − 0.476), social capital (CI: − 0.235; − 0.048), risk of disease (CI: 0.144; 0.667), and following Covid-19 news (CI: 0.053; 0.408). Conclusions Most of the factors related to depression, anxiety, and stress are related to COVID-19, such as having a vulnerable person in the family, risk of disease, and following COVID-19 news. The findings suggest the factors that should be taken into consideration for improving population mental health during pandemics.

Cascade screening for glaucoma in high-risk family members of African-Caribbean glaucoma patients in an urban population in London

Background/aimsCascade screening has been used successfully in relatives of patients with inherited cancers and other genetic diseases to identify presymptomatic disease. This study was designed to examine if this approach would be successful in a high-risk group: first-degree relatives (FDR) of African-Caribbean glaucoma patients resident in London.MethodsAfrican-Caribbean patients (probands) with glaucoma from an inner London hospital setting in a deprived area were asked to disseminate personalised information to their FDR over the age of 30 and to arrange a free hospital-based screening. Data collected, including optical coherence tomography imaging, were reviewed by a glaucoma specialist and if glaucoma was diagnosed or suspected, local specialist referral via family doctor was made.Results203 probands were recruited from glaucoma clinics. 248 suitable FDR were identified as potentially eligible to attend screening. 57 (23%) FDR made contact with the research team of whom 18 (7%) attended a subsequent screening visit. No patients were diagnosed with glaucoma; one participant was diagnosed as glaucoma suspect. Reasons for poor uptake included reluctance by probands to involve their family members, and retirees spending significant time abroad.ConclusionCascade screening of FDR of African-Caribbean glaucoma patients in inner city London was unsuccessful. Research confidentiality guidance prohibiting research teams directly contacting family members was a barrier. Greater community engagement, community-based screening and permission to contact FDR directly might have improved uptake.

Identifying Risk Profiles for Antisocial Behavior in a Spanish Sample of Young Offenders

One of the main purposes of juvenile risk assessment is to distinguish different risk profiles, which may lead to referring youths into specific intervention programs tailored to their specific needs. This study is devoted to identifying main typologies of risk in a sample of 286 Spanish young offenders aged 14 to 22 ( M = 17.36; SD = 1.61) years. Participants were classified into different profiles, representing different levels of risk in terms of individual and psychosocial dynamic variables. A three-class (low-, middle-, and high-risk profiles) and a four-class (low-, middle-, high-risk family problems/callous–unemotional (CU) traits, and high-risk impulsive/undercontrolled) solutions were identified. These profiles showed their distinctiveness and meaningfulness in a set of comparisons on antisocial behavior and prior offenses measures. These findings highlight the presence of diverse patterns of risk and suggest that a limited number of specialized interventions may respond to the main needs of most institutionalized youths.

Genetic Epidemiology of Cancer

Chapter 5 reviews epidemiologic studies conducted to identify germline (inherited) susceptibility loci. These studies can involve associations observed within high-risk family pedigrees or in large studies of unrelated individuals. The chapter reviews the methods used to estimate the aggregate contribution of inherited genetic susceptibility and to identify specific genetic loci associated with risk. Although there is considerable variability across cancers, most cancers exhibit familial clustering, driven in part by a small number of known rare variants with large relative risks and a larger number of common variants with modest relative risks. The chapter discusses the implications of these findings for clinical care, public health, and tumor biology. It closes with a discussion of open questions, most notably the puzzle of “missing heritability”: the fact that—despite tremendous advances—multiple lines of evidence suggest that most specific risk variants, both rare and common, have yet to be discovered.