ACCOMPLISHMENTS
Aim 1: Decrease the incidence and slow the progression of cancer
Epidemiologic Studies
a) Genetic and Molecular Epidemiology
Dr. Jianfeng Xu and colleagues (Drs. Bao-Li Chang and Siqun Zheng) have identified two prostate susceptibility genes (MSR1 and RNASEL), described in Nature Genetics (Carpten et al., 2002; Xu, et al., 2002) and several prostate cancer risk modifier genes (TLR genes), providing strong support for a novel inflammation hypothesis of prostate cancer. This group of molecular and genetic epidemiologists was formed in 2000 and under Dr. Xu’s leadership has evolved from a two member team that was focused solely on genetic linkage analysis of prostate cancer to an internationally recognized comprehensive research team performing foundational molecular epidemiologic work in prostate cancer including germline and somatic genetic changes, as well as epigenetic changes. They have contributed significantly to the field of prostate cancer genetics by identifying multiple chromosomal regions that likely harbor major prostate cancer susceptibility genes. The findings have been published in the Proceedings of the National Academy of Sciences (Gillanders et al, 2004) and American Journal of Human Genetics (Xu and ICPCG, 2005). These linkage regions will receive intensive attention in the NCI CGEM study that will identify prostate cancer genes using a genome-wide association approach. Since 2000, this group of cancer control investigators has published over 55 peer-reviewed cancer related papers, including two papers in Nature Genetics, four papers in JNCI, one paper in PNAS, ten papers in Cancer Research, and five papers in American Journal of Human Genetics.
Another achievement is the identification of a critical mutation in a prostate specific gene NKX3.1. The mutation completely co-segregates with prostate cancer in a prostate cancer family. They also found functional impact of the mutation. (Zheng et al., Cancer Research, 2005). Together with investigators at the Karolinska Institute in Sweden and Johns Hopkins Medical Center they have obtained multiple pieces of genetic evidence to support a role of inflammation in prostate cancer development. Their findings of a genetic association between prostate cancer risk and several key genes regulating the inflammatory process are the basis for a new inflammation hypothesis of prostate cancer. Their results were recently published in two JNCI papers (Lindmark et al., 2004; Sun et al., 2005), Cancer Research (Zheng, 2004), and several other high impact journals (Sun et al.,Cancer Epidemiol Biomarkers Prev 2004; Lindmark et al., Br J Cancer, 2005; Lindstrom et al., Hum Genet, 2005; Xu et al., Cancer Epidemiol Biomarkers Prev, 2005; Sun et al., Prostate, 2005).
An emerging area in the field of genetics and cancer disparities is work conducted by Drs. Xu and Chang to study racial differences due to genetics in prostate cancer. Racial Differences in Prostate Cancer: Influences of Health Care Interaction and Host and Tumor Biology (DOD; Co-PI Jianfeng Xu) evaluates whether the different risks and severity of prostate cancer among whites and blacks is due to differences in mutations and frequencies of MSR1. Dr. Chang has just received funding for another study to examine the genetic epidemiology of prostate cancer in African-American and Caucasian men (DOD; “Contribution of AMACR and Phytanic Acid to Prostate Cancer Risk among African-American Men in North Carolina”, PI: Bao-Li Chang, Co-Is: Mara Vitolins, Jianfeng Xu). This study will recruit prostate cancer case-control study subjects in North Carolina to identify prostate cancer genetic and dietary susceptibility factors.
b) Nutrition and Environmental Risks
The vitamin D work of Dr. Gary G. Schwartz and colleagues provides an example of our translational work. Much of the interest in vitamin D stems from observations made by Dr. Schwartz and colleagues that prostate cancer mortality rates are highest where sunlight is most scarce. They suggested that this was due to the influence of vitamin D, which is derived from sunlight, in maintaining the normal phenotype of prostate cells. This hypothesis led to both chemoprevention trials and chemotherapeutic trials at WFUSM. This area began as a classic example of translational research from the “trench” to the bench in which Dr. Schwartz’s epidemiological work stimulated basic research on vitamin D and prostate biology by Dr. Cramer and other members of the CGS Program. Their collaboration led to additional translational bench-to-bedside research, such as the Zemplar trial in the Clinical Program; to collaboration with members of the DNAD Program on vitamin D and radiosensitization; and to collaboration within the CGS Program on the synergism between vitamin D and soy isoflavones.
Human prostate cells are known to possess specific receptors for the hormonal form of vitamin D, 1, 25(OH)2D. Dr. Schwartz and colleagues have shown have shown that when human prostate cancer cells are exposed to 1, 25(OH)2D, 1, 25(OH)2D promotes their differentiation and inhibits their proliferation, invasiveness, and metastases. These findings have led to human clinical trials of vitamin D and its 1, 25(OH)2D and 1, 25(OH)2D analogues as therapy for prostate cancer. They have recently demonstrated that prostate cells synthesize 1, 25(OH)2D from its prohormonal precursor, 25-Hydroxyvitamin D - an ability previously believed to be exclusive to kidney cells and keratinocytes.
Drs. Mark Cline (of the Cell Growth and Survival Program) and Mara Vitolins are collaborating to determine whether dietary soy in men with prostate cancer has an effect on the proliferation in neoplastic and adjacent prostate tissues. This work began within the Cancer Center and led to an R03 grant (“Effects of Dietary Soy on Biomarkers in Prostate”). Previous collaborations on soy protein research began with animal models, and the resulting data were used to support the conduct of a human clinical trial, the Soy Estrogen Alternative (SEA) study, which evaluated biomarkers in peri- and postmenopausal women. This collaboration has led to funding of a variety of animal and human trials of soy intervention including evaluating biomarkers of prostate cancer (“Effects of Dietary Soy on Biomarkers in Prostate Cancer”, “Use of a Soy-based Meal Replacement Weight Loss Intervention for Survivors of ER/PR Negative Breast Cancer”, and the “Soy Trial of the Prostate” (CALGB-NCI)).
Our work with Hispanic farmworkers provides an example of research that has progressed from discovery to translation to dissemination and builds on our work with the rural Hispanic community. Dr. Tom Arcury continues his focus on Hispanic farmworkers to examine pesticide exposure and green tobacco sickness. He found that farmworkers were exposed to carcinogenic pesticides and used cigarette smoking to reduce the incidence of green tobacco sickness (acute nicotine poisoning following dermal contact with mature tobacco plants). These findings were used to develop successful grant proposals testing intervention programs related to farm worker safety to reduce exposure to carcinogenic pesticides. “Preventing Agricultural Chemical Exposure (PACE)” was a community-based study to develop and test culturally appropriate interventions to reduce chemical exposure in seasonal and migrant farmworkers. Baseline data showed that only one third of farmworkers in North Carolina ever receive pesticide safety training, which is mandated for all workers at risk of exposure by the EPA’s Worker Protection Standard. Data from “Green Tobacco Sickness among Minority Farmworkers” also showed that green tobacco sickness is a major health problem for seasonal and migrant farmworkers. Results from these studies were used to develop another study of farmworker health disparities, “Occupational Skin Disease among Minority Farmworkers”. Dr. Arcury continues to study the epidemiology of this illness and is expected to receive funding to continue this work (“Community Participatory Approach to Measuring Farmworker Pesticide Exposure: PACE3”). The dissemination plan of this research addresses procedures for returning results to individual participants, and communicating results to farmworkers, service providers, and policy makers.
Behavioral and Pharmacologic Interventions
Drs. John Spangler, Kristie Long Foley, and Sonia Crandall created a tobacco cessation program for medical students using standardized patient instructors and a formal evaluation methodology. This program, designed to train physicians to successfully counsel patients in quitting, has won two national awards and was recently selected as an innovation in medical education by Academic Medicine. In 2003, Drs. Spangler, Foley, and Crandall received an NCI R25E training grant to develop a “Culturally Competent Web-Based Tobacco Curriculum” that builds upon these efforts. This program is culturally relevant, portable, and will be disseminated to medical schools nationwide.
Cancer and cognition is an emerging area in our Program in which ongoing studies conducted by Drs. Sally Shumaker (Cancer Control) and Stephen Rapp (Clinical Program) provide unique opportunities. One example is “Cognition in the Study of Tamoxifen and Raloxifene (Co-STAR)”, an ancillary study to the “Study of Tamoxifen and Raloxifene (STAR) for the Prevention of Breast Cancer”. STAR is a randomized trial designed to ascertain the relative prevention benefits and side effects of these two drugs in healthy women. Co-STAR is designed to determine the effects of tamoxifen and raloxifene on cognitive aging in non-demented STAR participants. The methods employed in Co-STAR parallel those used in the “Effects of Hormone Replacement Therapy on Cognitive Aging: Women’s Health Initiative Study on Cognitive Aging (WHISCA)”. WHISCA, an ancillary study to WHI, was designed to assess normal cognitive aging among a subset of postmenopausal women randomized to hormone therapy in the WHI hormone therapy trials.
Early Detection
Researchers at WFUSM have a long history of promoting early detection among underserved populations. The reputation of the CCCWFU has enabled the Cancer Control Program to create lasting partnerships with community-based agencies (e.g., American Cancer Society) and stakeholders that have created entrée into predominantly poor, minority communities. These partnerships, initially began as local county-based projects but evolved into a T32 partnership grant across two-states. These grants have crossed disease sites (cervical, breast, colon), ethnicity, and geography.
The “Robeson County Outreach, Screening and Education (ROSE)” project increased mammography utilization among high-risk African American, Native American and White women in eastern NC. Using interventions that targeted women through lay health advisors and local health care providers, investigators in the program demonstrated that screening rates could be improved among poor, high-risk women by increasing access and reducing barriers to early detection. Building upon the success of ROSE, funding was received for the “Carolina Colorectal Cancer Screening study (CARES)” to improve colorectal cancer screening among African-American, low-income women in North and South Carolina (PIs: Paskett/ Kristie Foley). This project was a quasi-experimental, community-based trial to increase endoscopy among low-income women living in subsidized housing. Using a T32 partnership grant sponsored by the American Cancer Society, we developed a sustainable program of colorectal screening education deliverable through local cancer control managers.
Dr. Kristie Foley recently completed a pilot study of Pap smear screening among Latina women (“CAPRELA: Cancer Prevention among Latinas”), which found poor regular utilization of free Pap smear screening (33%) among uninsured Latina women; this pilot study led to community-based intervention to improve Pap smear rates in this population. Drs. Foley and Brigitte Miller (Ob/Gyn-Clinical Program) have collaborated to test the effect of two different interventions to increase colposcopic evaluation among women referred to the CCCWFU colposcopy clinic. These interventions tripled the colposcopy show rate (from 21% to 65%) among Latina women.
Most of our prior early detection work has focused on women. Dr. Tom Arcury has recently expanded these efforts to men. Partnering with Clinical Program colleagues (Drs. Peter Clark and John Stewart IV) he has received R01 funding for “African American Men Prostate and Colorectal Cancer Beliefs”. This project will determine if differences between African American and white men in their knowledge, beliefs and behavior of about prostate and colorectal cancer and screening are related to differences in social class, health care access, or culture. Interventions to increase screening among African American men will ultimately be tested. Another promising new direction for early detection is “Overcoming Literacy Barriers in Colorectal Cancer”, an ACS Career Development grant awarded to Dr. David Miller (Internal Medicine). This project, which originated from a Pull grant received from CCCWFU, focuses on using an interactive web-based multimedia educational computer program to address barriers faced by people with low literacy skills.
Aim 2: Survivorship: Improve Quality of Life and Survival of Those Who Develop Cancer
Epidemiologic Studies of Cancer Survivors
Our epidemiologic studies of quality of life in cancer survivors are providing data that will lead to improved targeted interventions in survivorship. These studies focus on collecting detailed information on the impact of chemotherapy on menstrual cycle changes and fertility, age differences in response to breast cancer, QOL at different stages of the disease process for ovarian cancer patients, and QOL of long-term cancer survivors. The DOD funded Behavioral Center of Excellence in Breast Cancer (Functional Status and Quality of Life Across the Lifespan, PI: Michelle Naughton) explores quality of life issues for breast cancer survivors across the lifespan. The DOD Center contains three separate, but interrelated research projects.
The second project (Project #2, “Investigating Mechanisms to Explain Age Associated Differences in Quality of Life among Breast Cancer Patients”; PI: Dr. Nancy Avis) is designed to better understand why younger women have greater psychological morbidity following a breast cancer diagnosis than older women. Considerable research has shown that younger women have a more difficult time adjusting to a breast cancer diagnosis. Although several hypotheses have been generated – e.g., younger women have more aggressive treatment, they have more family and work responsibilities, it is an off-time event - no study has tested these various hypotheses. Understanding reasons for these age differences in adjustment will lead to improved interventions to help younger women adjust to a breast cancer diagnosis and treatment. This prospective observational cohort study looks at treatment characteristics, personal resources (e.g., social support, coping strategies, resiliency), and the impact of cancer on life roles and responsibilities on QOL.
Project #3, “Research on Optimal Recovery Practices in Breast Cancer (RESTORE)” (PI: Dr. Roger Anderson; Co-I: Dr. Shannon Mihalko) is testing two exercise interventions in 100 women, aged 40 years old and older, recently diagnosed with breast cancer to improve QOL and reduce lymphedema. Results of the main study are not yet available; however, analyses of the lymphedema portion have shown that combining fitness exercises, arm movement, a compression sleeve, and lymphedema education can effectively prevent lymphedema 6 to 9 months post-surgery among patients with node-positive disease. This important and understudied area has the opportunity to improve the QOL of many breast cancer survivors by improving postoperative patient care.
Dr. Nancy Avis’ “A Treatment Stage Specific Approach to Improving Quality of Life for Women with Ovarian Cancer”, seeks to determine QOL issues at four different stages: at diagnosis, in treatment, post treatment, and at recurrence, To date, most QOL interventions focus on the time period immediately after a cancer diagnosis. However, the hypothesis of this study is that the issues patients deal with and that impact their QOL change according to stage of treatment. If this hypothesis holds true, it will have important implications for the timing of the delivery of interventions to improve QOL.
The “Breast Cancer in Younger Women: Improving Quality of Life”, PI: Dr. Nancy Avis, project was conducted in two phases. The first phase was a cross-sectional observational study of women who had been diagnosed with breast cancer within the past three years. Results showed that the major problems reported by women were symptoms related to menopause, concerns about appearance, and sexual functioning. The second phase of this project was an intervention study in which newly diagnosed women were randomly assigned to receive a videotape developed specifically for this study or a standard booklet, and followed up to a year post surgery. Results indicated that QOL was primarily related to psychosocial factors such as coping and social support, not medical factors. (Avis, Crawford, Manuel, Psycho-Oncology, 2004; Avis, Crawford, Manuel, J Clin Oncol, 2005; Burwell, Case, Kaelin, Avis, J Clin Oncol, 2006)
Improving Quality of Life through Symptom Management and Behavioral Interventions
Patterns of Care
Our Program is developing the area of research that focuses on patterns of care to examine non-medical factors that influence the care cancer patients receive and whether patients are receiving recommended treatments. We have chosen to focus on methodological issues of automated data to define patterns of care, cancer care received by low income populations, and treatment effectiveness. One such methodological issue is the absence of good radiation and chemotherapy treatment data in the State Tumor Registry. Drs. Anderson, Foley and colleagues from the CCCWFU Clinical Program have developed methodological techniques to merge Medicaid and tumor registry data to provide a much more complete record of initial cancer treatments. This serves as the basis of a study that will evaluate patterns of outcomes in our region.
In their ACS-funded study “Classification of Care for Breast Cancer under Medicaid”, Drs. Roger Anderson and Kristie Foley documented multiple possible treatment disparities. Black women were more likely to have breast conserving surgery than white women, but less likely to receive radiation therapy. Women with more co-morbidities were more likely to receive mastectomy and chemotherapy. These findings have led to a competitive renewal, “Outcomes of Omission of Radiation with Lumpectomy among Low-Income Women”. Drs. Anderson, Foley, and Gretchen Kimmick (from Duke University Medical School) seek to ascertain the extent to which omission of radiation is causally linked to poorer survival. They also propose to add hormonal therapy to the dataset using existing Medicaid prescription claims which will provide additional data on access to care and is an important predictor for recurrence and survival analyses.
The “Breast and Prostate Cancer Data Quality and Patterns of Care” (CDC) study, Dr. Roger Anderson, will test the efficiency and effectiveness of a targeted audit protocol for registry data to improve the overall quality of registry data; assess the quality, completeness of staging and first course of treatment collected by the NC Central Cancer Registry using electronic edits and case record re-abstraction; and describe the receipt of standard of care for breast and prostate cancer.
Dr. Ann Geiger‘s “Breast Cancer Treatment Effectiveness in Older Women” is a medical-record-based, retrospective cohort study evaluating the effectiveness of primary and adjuvant therapies in preventing recurrence and death in women diagnosed with breast cancer at age 65 years and older, a group understudied in the clinical trials setting and in which therapy options are complicated by the presence of co-morbidities. This study is based in the NCI-funded HMO Cancer Research Network, in which automated data on large and diverse populations provide a unique opportunity for treatment effectiveness studies.
In “Is Stroke a Late Effect of Chemotherapy?”, Dr. Ann Geiger anticipates using automated data to estimate the association of stroke with chemotherapy among a group of over 110,000 ethnically diverse patients diagnosed with various types of cancer.
Selected Publications:
Anderson GL, Limacher M, Bonds D, Shumaker S, Prineas R, Naughton M, Burke G, Crouse R, Vitolins M, Washburn S. 2004. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial, JAMA, 291(14),1701-1712
Arcury TA, Bell RA, Vitolins MZ,Quandt SA. 2005. Rural older adults' beliefs and behavior related to complementary and alternative medicine use, Complement Health Pract Rev,10 (1),33-44
Arcury TA, Quandt SA. 2003. Pesticides at work and at home: exposure of migrant farmworkers, Lancet,362(9400),2021
Arcury TA, Quandt SA, Bell RA. 2001. Staying healthy: the salience and meaning of health 2maintenance behaviors among rural older adults in North Carolina, Soc Sci Med,53(11),1541-1556
Arcury TA, Quandt SA, Preisser JS, Bernert JT, Norton D, Wang J. 2003. High levels of transdermal nicotine exposure produce green tobacco sickness in Latino farmworkers, Nicotine Tob Res,5(3),315-321
Arcury TA, Quandt SA, Preisser JS, Norton D. 2001. The incidence of green tobacco sickness among Latino farmworkers, J Occup Environ Med, 43 (7),601-609
Arcury TA, Quandt SA, Russell GB. 2002. Pesticide safety among farmworkers: perceived risk and perceived control as factors reflecting environmental justice. Environ Health Perspect 110(Suppl 2):233-240
Avis NE, Assmann SF, Kravitz HM, Ganz PA, Ory M. 2004. Quality of life in diverse groups of midlife women: assessing the influence of menopause, health status and psychosocial and demographic factors, Qual Life Res,13 (5),933-946
Avis NE, Crawford S, Manuel J. 2004. Psychosocial problems among younger women with breast cancer, Psychooncology,13 (5),295-308
Avis NE, Crawford S, Manuel J. 2005. Quality of life among younger women with breast cancer, J Clin Oncol,23 (15),3322-3330
Avis NE, Ory M, Matthews KA, Schocken M, Bromberger J, Colvin A. 2003. Health-related quality of life in a multiethnic sample of middle-aged women: Study of Women's Health Across the Nation (SWAN), Med Care,41 (11),1262-1276
Avis NE, Smith KW, Link CL, Goldman MB. 2004. Increasing mammography screening among women over age 50 with a videotape intervention, Prev Med,39(3),498-506
Avis NE, Smith KW, Link CL, Hortobagyi GN, Rivera E. Factors associated with participating in breast cancer treatment clinical trials. Journal of Clinical Oncology 2006, 24
Avis NE, Smith KW, McGraw S, Smith RG, Petronis VM, Carver CS. 2005. Assessing quality of life in adult cancer survivors (QLACS), Qual Life Res,14 (4),1007-1023
Avis NE, Zhao X, Johannes CB, Ory M, Brockwell S, Greendale GA. 2005. Correlates of sexual function among multi-ethnic middle-aged women: results from the Study of Women's Health Across the Nation (SWAN), Menopause,12 (4),385-398
Baffoe-Bonnie AB, Smith JB, Stephan DA, Schleutker J, Carpten JD, Kainu T, Gillanders EM, Matikainen M, Xu JF, et al. 2005. A major locus for hereditary prostate cancer in Finland: localization by linkage disequilibrium of a haplotype in the HPCX region. Human Genetics 117(4):307-316
Bell RA, Shelton BJ, Paskett ED . 2001. Colorectal cancer screening in North Carolina: associations with diabetes mellitus and demographic and health characteristics. Prev Med 32(2):163-167
Brown WM, Lange EM, Chen H, Zheng SL, Chang B, Wiley KE, Isaacs SD, Xu J, Isaacs WB, Cooney KA. 2004. Hereditary prostate cancer in African American families: linkage analysis using markers that map to five candidate susceptibility loci. Br J Cancer 90(2):510-514
Burke GL, Legault C, Anthony M, Bland DR, Morgan TM, Naughton MJ, Leggett K, Washburn SA, Vitolins MZ. Soy protein and isoflavone effects on vasomotor symptoms in peri- and postmenopausal women: the Soy Estrogen Alternative Study. Menopause. 2003 Mar-Apr;10(2):147-53
Burwell SR, Case LD, Kaelin C, Avis NE. Sexual problems in younger women following breast cancer surgery. Journal of Clinical Oncology, in press.
Chang B-L, Gillanders EM, Isaacs SD, Wiley KE, Adams T, Turner AR, Zheng SL, Meyers DA, Carpten JD, Xu J. 2005. Evidence for a general cancer susceptibility locus at 3p24 in families with hereditary prostate cancer. Cancer Lett 219(2):177-182
Chang B-L, Isaacs SD, Wiley KE, Gillanders EM, Zheng SL, Meyers DA, Walsh PC, Trent JM, Xu J, Isaacs WB. 2005. Genome-wide screen for prostate cancer susceptibility genes in men with clinically significant disease. Prostate 64(4):356-361
Chang B-L, Zheng SL, Hawkins GA, Isaacs SD, Wiley KE, Turner A, Carpten JD, Bleecker ER, Meyers DA, Xu J. 2002. Joint effect of HSD3B1 and HSD3B2 genes is associated with hereditary and sporadic prostate cancer susceptibility, Cancer Res,62 (6),1784-1789
Chang B-L, Zheng SL, Hawkins GA, Isaacs SD, Wiley KE, Turner A,Carpten JD, Bleecker ER, Meyers DA, Xu J. 2002. Polymorphic GGC repeats in the androgen receptor gene are associated with hereditary and sporadic prostate cancer risk, Hum Genet,110(2),122-129
Chang B, Zheng SL, Isaacs SD, Turner A, Hawkins GA, Wiley KE, Bleecker ER, Walsh PC, Meyers DA, Xu J. 2003. Polymorphisms in the CYP1A1 gene are associated with prostate cancer risk. Int J Cancer 106(3):375-378
Chang BL, Zheng SL, Isaacs SD, Turner AR, Hawkins GA, Wiley KE, Bleecker ER, Walsh PC, Meyers DA, Xu J. 2003. Polymorphisms in the CYP1B1 gene are associated with increased risk of prostate cancer. Br J Cancer 89(8):1524-1529
Chang B, Zheng SL, Isaacs SD, Wiley KE, Carpten JD, Hawkins GA, Bleecker ER, Walsh PC, Meyers DA, Xu J. 2001. Linkage and association of CYP17 gene in hereditary and sporadic prostate cancer. Int J Cancer 95(6):354-359
Chang B, Zheng SL, Isaacs SD, Wiley KE, Turner A, Li G, Walsh PC, Meyers DA, Isaacs WB, Xu J. 2004. A polymorphism in the CDKN1B gene is associated with increased risk of hereditary prostate cancer. Cancer Res 64(6):1997-1999
Chen TC, Holick MF, Lokeshwar BL, Burnstein KL, Schwartz GG. 2003. Evaluation of vitamin D analogs as therapeutic agents for prostate cancer, Recent Results Cancer Res,164, 273-288
Cramer SD(CGS), Chang B-L, Rao A, Hawkins GA, Zheng SL, Wade WN, Bleecker ER, Meyers DA, Ohar J, Xu J. 2003. Association between genetic polymorphisms in the prostate-specific antigen gene promoter and serum prostate-specific antigen levels. J Natl Cancer Inst 95(14):1044-1053
Foley KL, Crandall SJ, George G, Roman M, Spangler JG. 2003. Reliability of a smoking cessation risk factor interview scale (SCRFIS) for use with standardized patient instructors, J Cancer Educ,18 (3),134-141
Foley KL, Farmer DF, Petronis VM, Smith RG, McGraw S, Smith K, Carver CS, Avis NE. 2005. A qualitative exploration of the cancer experience among long-term survivors: Comparison by cancer type, gender and age, Psychooncology. 2006 Mar;15(3):248-58
Foley KL, George G, Crandall SJ, Walker KH, Marion GS, Spangler JG. Training and evaluating tobacco-specific standardized patient instructors. Fam Med. 2006 Jan;38(1):28-37
Friedrichsen DM, Stanford JL, Isaacs SD, Janer M, Chang B, Deutsch K, Gillanders E, Kolb S, Zheng SL, Xu J. 2004. Identification of a prostate cancer susceptibility locus on chromosome 7q11-21 in Jewish families. Proc Natl Acad Sci U S A 101(7):1939-1944
Geiger AM, West CN, Nekhlyudov, L, Herrinton LJ, Liu IA, Altschuler A. Rolnick SJ, Harris EL, Greene SM, Elmore JG, Emmons KM, Fletcher SW. Contentment with quality of life among breast cancer survivors with and without contralateral prophylactic mastectomy. J Clin Oncol, 2006 Mar 20;24(9):1350-6
Gillanders EM, Xu J, Chang B, Lange EM, Wiklund F, Bailey-Wilson JE, Baffoe-Bonnie A, Zheng SL, Brown WM, Meyers DA. 2004. Combined genome-wide scan for prostate cancer susceptibility genes. J Natl Cancer Inst 96(16):1240-1247
Gold EB, Colvin A, Avis NE et al. Longitudinal analysis of vasomotor symptoms and race/ethnicity across the menopausal transition: Study of Women’s Health across the Nation (SWAN). American Journal of Public Health, in press
Hawkins GA, Mychaleckyj JC, Zheng SL, Faith DA, Kelly B, Isaacs SD, Chang B-L, Xu J, Meyers DA, et al. 2002. Germline sequence variants of the LZTS1 gene are associated with prostate cancer risk. Cancer Genet Cytogenet 137(1):1-7.
Hays J, Ockene JK, Brunner RL, Kotchen JM, Manson JE, Patterson RE, Aragaki AK, Shumaker SA, Brzyski RG, LaCroix AZ. 2003. Effects of estrogen plus progestin on health-related quality of life, N Engl J Med,348(19),1839-1854
Ho GY, Knapp M, Freije D, Nelson WG, Smith JR, Carpten JD, Bailey-Wilson JE, Xu J, Petersen G, Isaacs WB. 2002. Transmission/disequilibrium tests of androgen receptor and glutathione S-transferase pi variants in prostate cancer families. Int J Cancer 98(6):938-942
John EM, Dreon DM, Koo J,Schwartz GG. 2004. Residential sunlight exposure is associated with a decreased risk of prostate cancer, J Steroid Biochem Mol Biol, 89-90,549-552
John EM, Schwartz GG, Koo J, Van Den Berg D, Ingles SA. 2005. Sun exposure, vitamin D receptor gene polymorphisms, and risk of advanced prostate cancer, Cancer Res,65 (12),5470-5479
Killien M, Bigby JA, Champion V,Fernandez-Repollet E, Jackson RD, Kagawa-Singer M, Kidd K, Naughton MJ, Prout M. 2000. Involving minority and underrepresented women in clinical trials: The National Centers of Excellence in Women's Health, Journal of Womens Health & Gender-Based Med,9(10),1061-1070
Koval AE, Riganti AA, Foley KL. CAPRELA (Cancer Prevention for Latinas): findings of a pilot study in Winston-Salem, Forsyth County.N C Med J. 2006 Jan-Feb;67(1):9-15
Lindmark F, Zheng SL, Wiklund F, Bensen J, Balter KA, Chang B,Hedelin M, Clark J, Meyers DA, Xu J. 2004. H6D polymorphism in macrophage-inhibitory cytokine-1 gene associated with prostate cancer, J Natl Cancer Inst,96(16),1248-1254
Lippman SM, Goodman PJ, Klein EA, Parnes HL, Thompson IM Jr, Kristal AR, Santella RM, Schwartz GG, Moinpour CM, Coltman CA. 2005. Designing the Selenium and Vitamin E Cancer Prevention Trial (SELECT). J Natl Cancer Inst 97(2):94-102
Miller DC, Zheng SL, Dunn RL, Sarma AV, Montie JE, Lange EM, Meyers DA, Xu J, Cooney KA. 2003. Germ-line mutations of the macrophage scavenger receptor 1 gene: association with prostate cancer risk in African-American men. Cancer Res 63(13):3486-3489
Molnar I, Kute T, Willingham MC, Schwartz GG. 2004. 19-nor-1 alpha,25-dihydroxyvitamin D2 (paricalcitol) exerts anticancer activity against HL-60 cells in vitro at clinically achievable concentrations, J Steroid Biochem Mol Biol,89-90,539-543
Narla G, DiFeo A, Reeves HL, Schaid DJ, Hirshfeld J, Hod E, Xu J, Zheng SL, Chang B-L, Martignetti JA. 2005. A germline DNA polymorphism enhances alternative splicing of the KLF6 tumor suppressor gene and is associated with increased prostate cancer risk. Cancer Res 65(4):1213-1222
Naughton MJ, Jones AS, Shumaker SA. 2005. When practices, promises, profits, and policies outpace hard evidence: the post-menopausal hormone debate, J Soc Issues,61(1),159-179
Naughton MJ, Petrek JA, Ip E, Paskett ED, Naftalis E. 2005. Health-related quality of life of pre-menopausal breast cancer survivors, Journal of Clinical Oncology,23(16),37S-37S
Naughton MJ, Shumaker SA. 2003. The case for domains of function in quality of life assessment, Qual Life Res,12(Suppl 1),73-80
Peppercorn J, Herndon J, Kornblith AB, Peters W, Ahles T, Vredenburgh J, Schwartz G, Shpall E, Hurd DD, Holland J, Winer E. 2005. Quality of life among patients with Stage II and III breast carcinoma randomized to receive high-dose chemotherapy with autologous bone marrow support or intermediate-dose chemotherapy: Results form Cancer and Leukemia Group B 9066. Cancer 104(8):1580-1589
Petrek JA, Naughton MJ, Case LD, Paskett ED, Naftalis EZ, Singletary SE, Sukumvanich P. 2005. Incidence, time course, and determinants of menstrual bleeding after breast cancer treatment: a prospective study. Journal of Clinical Oncology 2006 Mar 1;24(7):1045-51. Epub 2006 Feb 13
Rapp SR , Rosdhal R, D'Agostino RB, Lovato J, Naughton M, Robbins ME, Shaw EG. 2004. Improving cognitive functioning in brain irradiated patients: A phase II trial of an acetylcholinesterase inhibitor (donepezil). Neuro-Oncology 6(4):357-357
Rapp SR, Espeland MA, Shumaker SA, Henderson VW, Brunner RL, Manson JE, Gass MLS, Stefanick ML, Coker LH, Dailey M. 2003. Effect of estrogen plus progestin on global cognitive function in postmenopausal women: the Women's Health Initiative Memory Study: a randomized controlled trial. JAMA 289(20):2663-2672
Schwartz GG. 2005. Vitamin D and the epidemiology of prostate cancer, Seminars In Dialysis,18(4),276-289
Shaw EG, Rosdhal R, D'Agostino RB, Lovato J, Naughton M, Rapp S. 2004. A phase II study of donepezil in irradiated brain tumor patients: Effect on health-related quality of life and mood. Neuro-Oncology 6(4):358-358
Shumaker SA, Legault C, Kuller L, Rapp SR, Thal L, Lane DS, Fillit H, Stefanick ML, Hendrix SL, Coker LH. 2004. Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: Women's Health Initiative Memory Study, JAMA,291(24),2947-2958
Shumaker SA, Legault C, Rapp SR, Thal L, Wallace RB, Ockene JK, Hendrix SL, Jones BN III, Assaf AR, Jackson RD. 2003. Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women: the Women's Health Initiative Memory Study: a randomized controlled trial, JAMA,289(20),2651-2662
Spangler JG, Case LD, Bell RA, Quandt SA. 2003. Tobacco use in a tri-ethnic population of older women in southeastern North Carolina. Ethn Dis 13(2):226-232
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