Annual Meeting Proceedings Part 1 - American Society of Clinical ...

1571 General Poster Session (Board #5E), Sat, 1:15 PM-5:15 PM
The effect of family history on adherence to breast cancer screening
guidelines. Presenting Author: Lauren Marie Hibler, Yale University, New
Haven, CT
Background: A family history of breast cancer increases the risk of
developing this disease. We sought to determine the effect of a family
history of a first degree relative with breast cancer (FDFHx) on adherence to
mammography (MMG) and clinical breast examination (CBE) guidelines.
Methods: The National Health Interview Survey (NHIS), conducted annually
by the Centers for Disease Control, is designed to be representative of the
US population. The 2010 NHIS data was used to evaluate the effect of
FDFHx on the likelihood that women aged � 30 had MMG and/or CBE
within the past year. Results: Of the 12,320 women aged � 30, 1276
(10.7%) had a FDFHx; 1263 (99.0%) of female breast cancer and 13
(1.0%) of male breast cancer. Overall, 4573 (38.4%) of women reported
having had MMG within the past year; 5377 (46.3%) had CBE within the
past year. FDFHx was associated with use of MMG and CBE within the past
year (58.0% vs. 36.0%, p�0.001, and 57.5% vs. 45.0%, p�0.001,
respectively). Women with a FDFHx of male breast cancer were no more
likely to have MMG (72.5% vs. 57.9%, p�0.313) nor CBE (66.8% vs.
57.4%, p�0.518) within the past year than those with a FDFHx of female
breast cancer. On multivariate analysis controlling for age, race, personal
history of breast cancer (PHx), income, insurance, education and region,
FDFHx was associated with a higher likelihood of having MMG (OR�1.75;
95% CI: 1.48-2.06, p�0.001) and CBE (OR�1.48; 95% CI: 1.26-1.74,
p�0.001) within the past year. Region was not associated with adherence
to either MMG or CBE screening guidelines. Conclusions: FDFHx, along with
age, race, PHx, income, insurance, and education, is an independent
predictor of adherence to screening MMG and CBE guidelines. Still, only
58% of women with a FDFHx had MMG and CBE in the past year. Further
efforts are warranted to improve screening in this population at increased
risk.
Multivariate analysis.
Factor
MMG
p value
CBE
p value
FHx �0.001 �0.001
Age �0.001 �0.001
Race 0.018 �0.001
PHx �0.001 �0.001
Income �0.001 �0.001
Insurance �0.001 �0.001
Education 0.005 �0.001
Region 0.700 0.196
1573 General Poster Session (Board #5G), Sat, 1:15 PM-5:15 PM
Esophageal cancer incidence gender disparity. Presenting Author: Luckson Noe
Mathieu, Sidney Kimmel Comphrehensive Cancer Center at Johns Hopkins
Hospital, Baltimore, MD
Background: Over the past 30 years, esophageal cancer incidence has been
increasing more rapidly than any other solid neoplasm in the Western world.
Globally, there is a large male predominance in both esophageal squamous and
adenocarcinoma. The reasons for this gender difference and the possible role of
estrogen are unclear. The objective of this study is to determine if estrogen
exposure is consistent with the male predominance observed in esophageal
cancer incidence. Methods: A database assessment of esophageal cancer
incidence rates (age-adjusted) from 1975 to 2008 was conducted in the
National SEER 9 Database and the Maryland Cancer Registry. Rates by gender
and age were calculated. Gender-specific incidence rate ratios were compared
across age groups. Annual percentage change (APC) was compared for each
gender-age group. Results: In both national and state, male and female, adeno
and squamous cell histologies, incidence rates increase with patient age. SEER
data trends revealed the 50-64 aged female cohort as the only gender-age cohort
APC decreasing between 1975-2008. Furthermore, a significant increase in
incidence for females is observed in the 65� age groups; whereas among males,
the rates are rising in all age groups. Conclusions: Using age as a proxy for
estrogen exposure, our findings suggest a hormonal component in the declining
male: female esophageal cancer incidence rate ratios with increasing age and
confirm gender differences in incidence long observed in esophageal cancer.
Histological features may be predictive of a lower rate ratio. (Bodelon et al.
2011) Estrogen exposure may play a protective role in esophageal cancer which
dissipates with time after age 60-69. Our data suggest possible future roles of
estrogen as a chemopreventive agent in esophageal cancer (Barone et al. 2011).
Esophageal cancer annual percentage change, 1975-2008, SEER 9.
Age 50-64 Age 65-74 Age 75�
Males �1.2 �1.4 �1.9
Females -1.5 �0.3 �0.7
The M: F incidence ratio decreases with age in the nation (SEER) and in Maryland.
Male to female incidence ratio, SEER, 1975-2008 and MD Registry 1992-
2008.
Age 40-49 Age 50-59 Age 60-69 Age 70-79 Age 80-89
SEER 9.0 7.6 7.9 5.7 4.3
MD 6.0 6.0 5.4 4.2 3.3
Cancer Prevention/Epidemiology
103s
1572 General Poster Session (Board #5F), Sat, 1:15 PM-5:15 PM
ABO blood group and the risk of breast cancer: Multicenter, case-control,
observational study. Presenting Author: Yuksel Urun, Department of
Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
Background: The role of genetic factors in the development of cancer is
widely accepted. ABO blood type is an inherited characteristic and previous
studies have observed an association between ABO blood group and risk of
certain malignancies, including pancreatic and gastric cancer. The data on
the role of ABO blood group and Rh factor in breast cancer is inconclusive.
Methods: All patients who had breast cancer (BC) and treated between
2000-2010 at the Departments of Medical Oncology of both Ankara and
Hacettepe Universities (Ankara, Turkey) with defined ABO blood type and
Rh factor were included in our retrospective reviews of tumor registry
records. A group of volunteer healthy women donors of Turkish Red
Crescent between 2004-2011 were identified as a control group, without
any matching factors. The relationship of ABO blood types and Rh factor
with various prognostic factors such as age at diagnosis, menopausal
status, family history of breast cancer, and ER/PR/HER2 status were
evaluated from 1740 BC patients. We compared the distributions of ABO
blood types, Rh factors among 1740 patients and 204,553 healthy
controls. Among BC patients, differences between each of aforementioned
ABO blood groups and Rh factors with respect to various prognostic factors
were explored, respectively. Results: Overall distributions of ABO blood
groups as well as Rh factor were comparable between patients (44% A, 8%
AB, 16% B, 32% O, 88% Rh�) and controls (41% A, 8% AB, 16% B, 35%
O, 87% Rh�). However, there were statistically significant differences
between patients and controls with respect to A vs. nonA (p�0.019) and
marginal significance (p�0.051) for O vs. nonO. Among patients, there
were statistically significant differences between A and nonA with respect
to HER2 (p�0.0421), M stage (p�0.0447), T stage (p�0.0020). Only T
stage (p�0.0337) were significantly different between O vs nonO. Grade
(p�0.0227) and M stage (p�0.0107) were significantly different between
Rh factors. Conclusions: In our study sample, ABO blood type was
statistically significantly associated with breast cancer. Additional studies
are necessary to determine the mechanisms by which ABO blood type may
influence the risk of breast cancer.
1574 General Poster Session (Board #5H), Sat, 1:15 PM-5:15 PM
Study KBP-2010-CPHG: Characteristics and management of 7,051 new
cases of lung cancer managed in French general hospitals in 2010.
Presenting Author: Chrystele Locher, Saint-Faron Hospital, Meaux, France
Background: An initial epidemiologic study was performed in 2000 by the
French College of General Hospital Respiratory Physicians (Study KBP-
2000-CPHG). Over the last 10 years, lung cancer management changed:
new drugs such as targeted therapies appeared; new diagnostic techniques
such as exploration for genetic mutations in the tumour have been
developed; a new TNM classification has been drawn up. The aims of this
study were to describe patient characteristics, first-line management, 1, 4
and 5-year survival rates and to compare the results with those of Study
KBP-2000-CPHG. Methods: A prospective multi-centre study included all
patients �18 years presenting with a new case of primary lung cancer,
histologically or cytologically diagnosed between 1 January and 31 December
2010 and managed by one of the participating centers. A standardised
form was completed for each patient. A steering committee checked the
exhaustivity of data’s collection. Results: 7,610 patients from 119 general
hospitals were included between 1 January and 31 December 2010. The
main patient characteristics were: mean age 65.5 years (�/-11.3); 24.3%
female; 10.9% non-smokers, 39.9% ex-smokers, 49.2% current smokers;
68.9% performance status 0 and 1; 9.1% of patients had lost �10 kg
within the previous 3 months. The main tumour characteristics were:
13.7% small-cell lung cancer; 46.2% adenocarcinoma, 26.8% squamouscell
carcinoma; EGFR mutation, explored in 30.5% of cases, were found in
10.5% of cases; 16.4% stage IA to IIB, 13.4% stage IIIA, 10.2% stage
IIIB and 60.0% stage IV. First-line treatments were: curative surgery,
16.6%; chemotherapy, 63.4%; radiotherapy alone, 17.8%; combined
radio-chemotherapy, 8.8%; and supportive care, 11.1%. Targeted therapy
was used in 6.6% of patients treated by chemotherapy. Conclusions: In 10
years, characteristics of lung cancer patients changed with an significantly
increase of women, non-smokers, adenocarcinoma histology and stage IV at
diagnosis.
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