Whole-body PET/CT scanning is accompanied by substantial radiation dose and cancer risk.

Posted on March 17, 2016 by Maurice Preter MD

 

Whole-body PET/CT scanning is accompanied by substantial radiation dose and cancer risk.

http://tinyurl.com/h6vzzns

Huang B1, Law MW, Khong PL.

1Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Rd, Room 406, Block K, Hong Kong.

Abstract

PURPOSE:

To estimate the radiation dose from whole-body fluorine 18 ((18)F)-fluorodeoxyglucose (FDG) positron emission tomographic (PET)/computed tomographic (CT) studies and to evaluate the induced cancer risk to U.S. and Hong Kong populations.

MATERIALS AND METHODS:

Fluorine 18-FDG PET/CT studies obtained by using a 64-detector CT unit and one of three CT protocols were evaluated. CT protocol A consisted of 120 kV; rotation time, 0.5 second; pitch, 0.984; 100-300 mA; and noise level, 20. CT protocol B was the same as A, except for a fixed tube current of 250 mA. CT protocol C consisted of 140 kV; rotation time, 0.5 second; pitch, 0.984; 150-350 mA; and noise level, 3.5. CT doses were measured in a humanoid phantom equipped with thermoluminescent dosimeters. Doses from (18)F-FDG PET scanning were estimated by multiplying the (18)F-FDG radioactivity (370 MBq) with dose coefficients. Effective doses were calculated according to International Commission on Radiological Protection publication 103. Lifetime attributable risk (LAR) of cancer incidence was estimated according to the National Academies’ Biological Effects of Ionizing Radiation VII Report.

RESULTS:

Effective doses with protocols A, B, and C, respectively, were 13.45, 24.79, and 31.91 mSv for female patients and 13.65, 24.80, and 32.18 mSv for male patients. The LAR of cancer incidence associated with the dose was higher in the Hong Kong population than in the U.S. population. For 20-year-old U.S. women, LARs of cancer incidence were between 0.231% and 0.514%, and for 20-year-old U.S. men, LARs of cancer incidence were between 0.163% and 0.323%; LARs were 5.5%-20.9% higher for the Hong Kong population. The induced cancer risks decreased when age at exposure increased.

CONCLUSION:

Whole-body PET/CT scanning is accompanied by substantial radiation dose and cancer risk. Thus, examinations should be clinically justified, and measures should be taken to reduce the dose.

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Genetic Radiation Risks-A Neglected Topic in the Low Dose

Posted on March 17, 2016 by Maurice Preter MD

 

Genetic Radiation Risks-A Neglected Topic in the Low Dose

http://tinyurl.com/zosu2v8

Busby C1, Schmitz-Feuerhake I2, Pflugbeil S3.

1Environmental Research SIA, Riga, Latvia.

2University of Bremen, Bremen, Germany.

3German Society for Radiation Protection, Berlin, Germany.

Abstract

The committee of the United Nations for the Evaluation of Radiation Effects UNSCEAR as well as the International Commission on Radiological Protection ICRP up to now have derived a very low risk for hereditary diseases in humans from experiments in mice. They claim that there are no human data to refer to, and missing effects in the acute exposed Japanese A-bomb survivors are erroneously generalized to situations of chronic exposure. We made a compilation of findings about early deaths, congenital malformations, Downs syndrome, cancer and other effects, which were observed in humans after the exposure of parents. A few pointers are available from occupationally exposed groups, and much information can be drawn from studies in populations exposed by Chernobyl fallout and from the descendants of liquidators. Nearly all types of hereditary defects were found, which are to be expected ac-cording to our general knowledge of mechanism. We show that the official risk estimates are much too low.

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Glycemic Index (GI), Glycemic Load (GL) and Lung Cancer Risk

Posted on March 17, 2016 by Maurice Preter MD

M1340336_who-is-at-risk_377x171

Glycemic Index (GI), Glycemic Load (GL) and Lung Cancer Risk

http://tinyurl.com/jq5hmqq

Stephanie C. Melkonian1,
Carrie R. Daniel1,
Yuanqing Ye1,
Jeanne A. Pierzynski1,
Jack A. Roth2, and
Xifeng Wu1,*,

1Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.

2Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

↵*Corresponding Author:

Xifeng Wu, Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Unit 1340, 1155 Pressler Boulevard, Houston, TX 77030. Phone: 713-745-2485; Fax: 713-792-4657; E-mail: xwu@mdanderson.org

Abstract

Background: Postprandial glucose (PPG) and insulin responses play a role in carcinogenesis. We evaluated the association between dietary glycemic index (GI) and glycemic load (GL), markers of carbohydrate intake and PPG, and lung cancer risk in non-Hispanic whites.

Methods: GL and GI were assessed among 1,905 newly diagnosed lung cancer cases recruited from the University of Texas MD Anderson Cancer Center (Houston, TX) and 2,413 healthy controls recruited at Kelsey-Seybold Clinics (Houston, TX). We assessed associations between quintiles of GI/GL and lung cancer risk and effect modification by various risk factors. ORs and 95% confidence intervals (CI) were estimated using multivariable logistic regression.

Results: We observed a significant association between GI [5th vs. 1st quintile (Q) OR = 1.49; 95% CI, 1.21–1.83; Ptrend <0.001] and lung cancer risk and GIac (5th vs. 1st Q OR = 1.48; 95% CI, 1.20–1.81; Ptrend = 0.001) and lung cancer risk. We observed a more pronounced association between GI and lung cancer risk among never smokers (5th vs. 1st Q OR = 2.25; 95% CI, 1.42–3.57), squamous cell carcinomas (SCC; 5th vs. 1st Q OR = 1.92; 95% CI, 1.30–2.83), and those with less than 12 years of education (5th vs. 1st Q OR = 1.75; 95% CI, 1.19–2.58, Pinteraction = 0.02).

Conclusion: This study suggests that dietary GI and other lung cancer risk factors may jointly and independently influence lung cancer etiology.

Impact: Understanding the role of GI in lung cancer could inform prevention strategies and elucidate biologic pathways related to lung cancer risk. Cancer Epidemiol Biomarkers Prev; 25(3); 532–9. ©2016 AACR.

Footnotes

Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

Received July 13, 2015.
Revision received December 14, 2015.
Accepted January 1, 2016.
©2016 American Association for Cancer Research.

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Significant Associations with the Inflammation Biomarkers for age, BMI, Dietary Saturated fat, and EPA+DHA Omega-3 fatty acids

Posted on March 17, 2016 by Maurice Preter MD

 

Significant Associations with the Inflammation Biomarkers for age, BMI, Dietary Saturated fat, and EPA+DHA Omega-3 fatty acids

http://tinyurl.com/hyjq6hn

Sandi L. Navarro1,*,
Elizabeth D. Kantor1,2,
Xiaoling Song1,
Ginger L. Milne3,
Johanna W. Lampe1,
Mario Kratz1, and
Emily White1

1Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington.
2Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, New York.
3Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee.

↵*Corresponding Author:

Sandi L. Navarro, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N, M4-B402, Seattle, WA 98109. Phone: 206-667-6583; Fax: 206-667-7850; E-mail:snavarro@fredhutch.org

Abstract

Background: While much is known about correlates of C-reactive protein (CRP), little is known about correlates of other inflammation biomarkers. As these measures are increasingly being used in epidemiologic studies, it is important to determine what factors affect inflammation biomarker concentrations.

Methods: Using age, sex, and body mass index (BMI) adjusted linear regression, we examined 38 exposures (demographic and anthropometric measures, chronic disease history, NSAIDs, dietary factors, and supplement use) of 8 inflammation biomarkers [CRP, IL1β, IL6, IL8, TNFα, and soluble TNF receptors (sTNFR) in plasma; and prostaglandin E2 metabolite (PGE-M) in urine] in 217 adults, ages 50 to 76 years.

Results: Increasing age was associated with higher concentrations of all biomarkers except IL1β. BMI was positively associated with CRP and sTNFR I and II. Saturated fat intake was associated with increased CRP, sTNFRII, TNFα, and IL1β, whereas eicosapentaenoic acid + docosahexaenoic acid (EPA+DHA) intake (diet or total) was associated with decreased CRP, TNFα, and IL1β. Results for sex were varied: CRP and IL6 were lower among men, whereas PGE-M and sTNFRI were higher. Higher CRP was also associated with smoking, hormone replacement therapy use, and γ-tocopherol intake; lower CRP with physical activity, and intakes of dietary vitamin C and total fiber.

Conclusions: Although the associations varied by biomarker, the factors having the greatest number of significant associations (P ≤ 0.05) with the inflammation biomarkers were age, BMI, dietary saturated fat, and EPA+DHA omega-3 fatty acids.

Impact: Our results suggest that potential confounders in epidemiologic studies assessing associations with inflammation biomarkers vary across specific biomarkers. Cancer Epidemiol Biomarkers Prev; 25(3); 521–31. ©2016 AACR.

Received September 9, 2015.

Revision received December 23, 2015.

Accepted December 28, 2015.

©2016 American Association for Cancer Research.

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Metformin use after Cervical Cancer Diagnosis among Older Women with Diabetes may be Associated with a Significant Decrease in Mortality

Posted on March 16, 2016 by Maurice Preter MD

 

Metformin use after Cervical Cancer Diagnosis among Older Women with Diabetes may be Associated with a Significant Decrease in Mortality

http://tinyurl.com/jjrnofe

Kathy Han1,2,*,
Melania Pintilie3,
Lorraine L. Lipscombe4,55,
Iliana C. Lega4,
Michael F. Milosevic1,2, and
Anthony W. Fyles1,2

1Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
2Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
3Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
4Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada.
5Institute of Clinical Evaluative Studies, Toronto, Ontario, Canada.

↵*Corresponding Author:

Kathy Han, Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada. Phone: 141-6946-2919; Fax: 141-6946-6561; E-mail: Kathy.Han@rmp.uhn.on.ca
Note: M.F. Milosevic and A.W. Fyles contributed equally to this article.

Abstract

Background: To examine the association between metformin use and mortality in patients with diabetes and cervical cancer.

Methods: Using Ontario health databases, a retrospective, population-based cohort study was conducted in women with diabetes ≥ age 66 years diagnosed with cervical cancer between 1997 and 2010. The association between metformin exposure and cervical cancer–specific mortality was examined using Fine–Gray regression models, with noncancer death as a competing risk and cumulative metformin use as a time-varying exposure. The association with overall mortality was examined using Cox regression models.

Results: Among the 181 women with diabetes and cervical cancer, there were 129 deaths, including 61 cervical cancer–specific deaths. The median follow-up was 5.8 years (interquartile range 4.2–9.6 years) for surviving patients. Cumulative dose of metformin after cervical cancer diagnosis was independently associated with a decreased risk of cervical cancer–specific mortality and overall mortality in a dose-dependent fashion [HR 0.79; 95% confidence interval (CI), 0.63–0.98; and HR 0.95; 95% CI, 0.90–0.996 per each additional 365 g of metformin use, respectively]. There was no significant association between cumulative use of other antidiabetic drugs and cervical cancer–specific mortality.

Conclusion: This study suggests an association between cumulative metformin use after cervical cancer diagnosis and lower cervical cancer–specific and overall mortality among older women with diabetes.

Impact: Cumulative dose of metformin use after cervical cancer diagnosis among older women with diabetes may be associated with a significant decrease in mortality. This finding has important implications if validated prospectively, as metformin is inexpensive and can be easily combined with standard treatment for cervical cancer. Cancer Epidemiol Biomarkers Prev; 25(3); 507–12. ©2015 AACR.

Received September 29, 2015.

Revision received December 18, 2015.

Accepted December 18, 2015.

©2015 American Association for Cancer Research.

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