RESUMEN
The multiple information sources available may pose a challenge to physicians in providing accurate human papillomavirus (HPV) vaccine information to patients. The purpose of this study was to describe physicians' HPV vaccine information-seeking behaviors and assess if these behaviors differ by physician specialty and sociodemographic characteristics. In 2009, 1008 Family Physicians (FPs), Pediatricians (Peds), and Obstetricians/Gynecologists (OBGYNs) completed a survey to assess their HPV vaccine information-seeking behaviors and vaccination practices. The largest proportion obtained HPV vaccine information from professional organizations (50.0%), followed by the Advisory Council on Immunization Practices (ACIP) (36.0%), and medical conferences (33.1%). Peds and FPs were more likely to obtain vaccine information from the ACIP (p-values<0.05). OBGYNs, non-White/Caucasian physicians, and those aged 40-49 were more likely to obtain vaccine information from internet websites (p-values<0.05). There is a need for targeted HPV vaccine communication approaches based on sociodemographic and physician specialty characteristics.
Asunto(s)
Conducta en la Búsqueda de Información , Vacunas contra Papillomavirus/farmacología , Médicos , Adulto , Demografía , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Pautas de la Práctica en Medicina , Encuestas y CuestionariosRESUMEN
The association of dietary macronutrient composition with risk of breast cancer is not well understood. We investigated the macronutrient composition of diet in the 4-Corners Breast Cancer Study. Logistic regression models were used for case-control comparisons adjusted for age, center, education, smoking, total activity, calories, dietary fiber, dietary calcium, height, parity, recent hormone exposure, reference year body mass index (BMI), and the interaction of BMI and recent hormone exposure. Breast cancer risk declined with increasing dietary fat and increased with carbohydrates similarly across ethnicity and menopausal status. Associations of carbohydrate (direct) and fat (inverse), particularly saturated and monounsaturated fat, with breast cancer were present among normal and overweight postmenopausal women and absent among obese postmenopausal women. No substantive differences were noted in the association of macronutrients with risk of breast cancer between non-Hispanic white and Hispanic women. Associations of the macronutrients carbohydrate and fat with breast cancer risk were attenuated among postmenopausal obese women.
Asunto(s)
Neoplasias de la Mama/epidemiología , Dieta , Hispánicos o Latinos/estadística & datos numéricos , Población Blanca/estadística & datos numéricos , Adulto , Anciano , Arizona/epidemiología , Índice de Masa Corporal , Neoplasias de la Mama/etnología , Neoplasias de la Mama/prevención & control , Estudios de Casos y Controles , Colorado/epidemiología , Grasas de la Dieta , Ingestión de Energía , Análisis Factorial , Femenino , Humanos , Entrevistas como Asunto , Modelos Logísticos , Menopausia , Persona de Mediana Edad , New Mexico/epidemiología , Obesidad/etnología , Oportunidad Relativa , Factores de Riesgo , Encuestas y Cuestionarios , Utah/epidemiologíaRESUMEN
OBJECTIVE: To examine trends in the incidence of primary, malignant penile cancer in the United States. METHODS AND MATERIALS: A total of 1,817 men with primary, malignant penile cancer diagnosed between 1973 and 2002 from the Surveillance, Epidemiology and End Results Program Public-use data were used for analysis. Incidence rates were calculated by clinical and demographic variables of interest and decade of diagnosis (1973-1982, 1983-1992, and 1993-2002) using Surveillance, Epidemiology and End Results-Stat 6.1, and trends were examined using the annual percent change statistic. Additional incidence calculations were performed to examine further racial/ethnic differences. RESULTS: The overall incidence of primary, malignant penile cancer from 1973 to 2002 was 0.69 per 100,000. Incidence decreased significantly over time: 0.84 per 100,000 in 1973-1982 to 0.69 per 100,000 in 1982-1992 to 0.58 per 100,000 in 1993-2002. Incidence increased with increasing age at diagnosis. The majority of cases had squamous cell carcinomas, graded as I or II, and originated at the glans penis. Incidence of unknown grade primary, malignant penile cancer decreased significantly over the last 30 years, as did incidence of primary site penis, not otherwise specified primary, malignant penile cancer. The incidence of regional stage disease also increased over time. From 1993 to 2002, White Hispanics had the highest incidence rates (1.01 per 100,000) followed by Alaska Native/American Indians (0.77 per 100,000) and Blacks (0.62 per 100,000). CONCLUSIONS: The overall incidence of primary, malignant penile cancer in the United States has decreased, and these rates varied by race/ethnicity. Incidence rates increased with increasing age at diagnosis, and the incidence of regional stage disease increased over time, while incidence of unknown grade primary, malignant penile cancer decreased over the last 30 years.
Asunto(s)
Carcinoma de Células Escamosas/epidemiología , Neoplasias del Pene/epidemiología , Programa de VERF/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/etnología , Niño , Preescolar , Etnicidad/estadística & datos numéricos , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias/tendencias , Neoplasias del Pene/etnología , Grupos Raciales/estadística & datos numéricos , Programa de VERF/tendencias , Tasa de Supervivencia/tendencias , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: It is unknown whether dietary patterns or macronutrient composition contribute to the observed differences in rates of overweight and obesity among Hispanic and non-Hispanic white women in the United States. We assessed the association of dietary patterns and macronutrient composition with overweight and obesity in Hispanic and non-Hispanic white women. DESIGN: Cross-sectional analysis of dietary data from a case-control study of breast cancer. PARTICIPANTS: Population-based control participants (871 Hispanic and 1,599 non-Hispanic white women) from the southwestern United States who completed the diet and other components of the interview and whose anthropometric measurements were available. MAIN OUTCOME MEASURES: Body mass index (BMI; calculated as kg/m(2)), weight status (overweight, BMI 25 to 29.9; obese, BMI>30). STATISTICAL ANALYSES PERFORMED: Dietary patterns were defined using factor analysis. Associations of dietary patterns and macronutrient composition with overweight and obesity as compared with normal weight were assessed with logistic regression. RESULTS: Hispanic women reported consuming more energy, a greater proportion of energy from fat and vegetable protein, less alcohol, and less energy from animal protein compared with non-Hispanic white women. Western and dieter patterns were associated with higher prevalence of overweight and obesity; the Prudent dietary pattern was associated with a 29% lower prevalence of overweight and a halving of the prevalence of obesity similarly in Hispanic and non-Hispanic white women. Higher proportions of energy from protein (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.28 to 2.56) and animal protein (OR 2.10 95% CI 1.47 to 2.98) were associated with a greater risk of overweight; greater proportions of energy from fat (OR 2.28, 95% CI 1.27 to 4.08), protein (3.55 95% CI 2.38 to 5.29), or animal protein (3.44 95% CI 2.31 to 5.14) were associated with higher risk of obesity among non-Hispanic white women only. CONCLUSIONS: A Western dietary pattern was associated with greater risk and a Prudent diet with reduced risk of overweight and obesity. To reduce risk of overweight and obesity, Hispanic women should maintain healthful aspects of a native Hispanic diet, and non-Hispanic white women should replace animal protein with vegetable protein.
Asunto(s)
Dieta , Hispánicos o Latinos/estadística & datos numéricos , Obesidad/epidemiología , Sobrepeso , Población Blanca/estadística & datos numéricos , Aculturación , Adulto , Anciano , Consumo de Bebidas Alcohólicas , Índice de Masa Corporal , Estudios de Casos y Controles , Estudios Transversales , Carbohidratos de la Dieta/administración & dosificación , Grasas de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Ingestión de Energía , Análisis Factorial , Femenino , Humanos , Modelos Logísticos , Persona de Mediana Edad , Obesidad/etnología , Factores de Riesgo , Sudoeste de Estados Unidos/epidemiología , Encuestas y CuestionariosRESUMEN
PURPOSE: Cultural differences in diet and lifestyle patterns probably contribute to cancer rates among ethnic groups in the United States. In this paper, we describe physical activity patterns of Hispanic and non-Hispanic white women living in the southwestern United States and the effects of these patterns on obesity. METHODS: We use data from population-based controls (N = 2039) participating in the 4-Corner's Breast Cancer Study to evaluate associations between physical activity and language acculturation and the associated effects on obesity. RESULTS: The majority of both Hispanic and non-Hispanic white women did not perform 30 min of activity > or = 5 d x wk(-1), although a greater percentage of Hispanic women meet the goal if they reported higher levels of language acculturation. However, the type and intensity of activities performed by Hispanic and non-Hispanic women differed; Hispanic women reported more housework, dependent care giving, dancing, and work activity. Differences in activity patterns existed by level of language acculturation among Hispanic women. Hispanic women who had higher levels of language acculturation reported continued activity throughout their lives. Prevalence of obesity was greater among Hispanic than non-Hispanic white women for all levels of language acculturation. Women with intermediate levels of language acculturation had the greatest relative risk of obesity compared with non-Hispanic white women (odds ratio (OR) = 2.79, 95% confidence interval (CI) = 1.85-4.02); Hispanic women with higher levels of language acculturation also were at increased relative risk of obesity (OR = 1.78, 95% CI = 1.28-2.47). CONCLUSIONS: Interventions to increase physical activity among Hispanic women are needed to address the problems of physical inactivity and obesity in that population. Facilitating culturally relevant activities might be reasonable approaches to increasing physical activity.
Asunto(s)
Ejercicio Físico , Hispánicos o Latinos , Obesidad , Población Blanca , Aculturación , Adulto , Anciano , Tamaño Corporal , Femenino , Humanos , Persona de Mediana Edad , Sudoeste de Estados Unidos , Encuestas y CuestionariosRESUMEN
Circulating concentrations of IGF-I and IGFBP-3 are associated with risk of pre-menopausal breast cancer. Racial differences in levels of these factors have been reported, and determinants of IGF-I and IGFBP-3 levels within racial and ethnic groups are unclear. In this study we examine genetic, anthropometric, diet, and lifestyle factors that may predict serum levels of IGF-I and IGFBP-3 among Hispanic and non-Hispanic white women. A sample of healthy controls participating in the SHINE (Southwest Hormone, Insulin, Nutrition, and Exercise Study) case-control breast cancer in Arizona, Colorado, New Mexico, and Utah were included in these analyses. Subjects included 210 Hispanic and 284 non-Hispanic white women. Hispanic women had significantly lower levels of IGFBP-3 (mean=3764.3 mcg/ml) after adjusting for age, body size, physical activity, menopausal status, and dietary factors than non-Hispanic white women (mean = 4058.0 mcg/ml; p<0.01). The CC genotype of the -202 A>C polymorphism of the IGFBP3 gene was associated with lower IGFBP-3 levels in both ethnic groups. The frequency of the IGFBP3 C allele differed between Hispanic (0.65) and non-Hispanic white women (0.53), but serum levels of IGFBP-3 were lower for Hispanic women than non-Hispanic after accounting for IGFBP3 genotype. Body size indicators, vigorous physical activity, and dietary factors appeared to influence serum levels of IGF-1 and the ratio of IGF-1 to IGFBP-3 in pre-menopausal women more than in post-menopausal women. On the other hand, using aspirin/NSAIDs appeared to increase IGFBP-3 levels significantly among pre-menopausal Hispanic women. Results from this study suggest that differences in IGFBP-3 levels exist in Hispanic and non-Hispanic white women. These differences could be due to the combined effects of genetic and behavioral factors which could account for ethnic differences in the risk of breast cancer and other chronic diseases.