Comparison of breast and bowel cancer screening uptake patterns in a common cohort of South Asian women in England

Background: Inequalities in uptake of cancer screening by ethnic minority populations are well documented in a number of international studies. However, most studies to date have explored screening uptake for a single cancer only. This paper compares breast and bowel cancer screening uptake for a cohort of South Asian women invited to undertake both, and similarly investigates these women's breast cancer screening behaviour over a period of fifteen years. Methods: Screening data for rounds 1, 2 and 5 (1989-2004) of the NHS breast cancer screening programme and for round 1 of the NHS bowel screening pilot (2000-2002) were obtained for women aged 50-69 resident in the English bowel screening pilot site, Coventry and Warwickshire, who had been invited to undertake breast and bowel cancer screening in the period 2000-2002. Breast and bowel cancer screening uptake levels were calculated and compared using the chi-squared test. Results: 72,566 women were invited to breast and bowel cancer screening after exclusions. Of these, 3,539 were South Asian and 69,027 non-Asian; 18,730 had been invited to mammography over the previous fifteen years (rounds 1 to 5). South Asian women were significantly less likely to undertake both breast and bowel cancer screening; 29.9% (n = 1,057) compared to 59.4% (n = 40,969) for non-Asians (p < 0.001). Women in both groups who consistently chose to undertake breast cancer screening in rounds 1, 2 and 5 were more likely to complete round 1 bowel cancer screening. However, the likelihood of completion of bowel cancer screening was still significantly lower for South Asians; 49.5% vs. 82.3% for non-Asians, p < 0.001. South Asian women who undertook breast cancer screening in only one round were no more likely to complete bowel cancer screening than those who decided against breast cancer screening in all three rounds. In contrast, similar women in the non-Asian population had an increased likelihood of completing the new bowel cancer screening test. The likelihood of continued uptake of mammography after undertaking screening in round 1 differed between South Asian religio-linguistic groups. Noticeably, women in the Muslim population were less likely to continue to participate in mammography than those in other South Asian groups. Conclusions: Culturally appropriate targeted interventions are required to reduce observed disparities in cancer screening uptakes

Dysregulation in Retinal Para-Inflammation and Age-Related Retinal Degeneration in CCL2 or CCR2 Deficient Mice

We have shown previously that a para-inflammatory response exists at the retinal/choroidal interface in the aging eye; and this response plays an important role in maintaining retinal homeostasis under chronic stress conditions. We hypothesized that dysregulation of the para-inflammatory response may result in an overt pro-inflammatory response inducing retinal degeneration. In this study, we examined this hypothesis in mice deficient in chemokine CCL2 or its cognate receptor CCR2. CCL2- or CCR2-deficient mice developed retinal degenerative changes with age, characterized as retinal pigment epithelial (RPE) cell and photoreceptor cell death. Retinal cell death was associated with significantly more subretinal microglial accumulation and increased complement activation. In addition, monocytes from CCL2- or CCR2-deficient mice had reduced capacity for phagocytosis and chemotaxis, expressed less IL-10 but more iNOS, IL-12 and TNF-α when compared to monocytes from WT mice. Complement activation at the site of RPE cell death resulted in C3b/C3d but not C5b-9 deposition, indicating only partial activation of the complement pathway. Our results suggest that altered monocyte functions may convert the protective para-inflammatory response into an overtly harmful inflammation at the retina/choroidal interface in CCL2- or CCR2-deficient mice, leading to RPE and photoreceptor degeneration. These data support a concept whereby a protective para-inflammatory response relies upon a normally functioning innate immune system. If the innate immune system is deficient chronic stress may tip the balance towards an overt inflammatory response causing cell/tissue damage

NATURALLY BICARBONATED WATER SUPPLEMENTATION DOES NOT IMPROVE ANAEROBIC CYCLING PERFORMANCE IN ACTIVE MEN AND WOMEN

Anthony M. Hagele1, Johnathan L. Boring1, Jessica M. Moon1, Kylie E. Walden1, Kayla M. Ratliff1, Logan Orr1, Connor J. Gaige1, Richard A. Stecker1, Kyle L. Sunderland1, Petey W. Mumford1, Chad M. Kerksick1, FACSM 1Lindenwood University, St. Charles, MO Completion of high-intensity exercise can result in robust perturbations of physiologic homeostasis, challenging the body’s natural buffering systems to mitigate the accumulation of metabolic byproducts. Supplementation with bicarbonate has previously been used to offset metabolic acidosis leading to improvements in anaerobic exercise performance. PURPOSE: The purpose of this study was to investigate the ergogenic properties of a naturally bicarbonated water on anaerobic cycling performance in recreationally active men and women. METHODS: Forty-two healthy, recreationally active men and women (28.1 ± 8.0 yrs, 169.8 ± 11.7 cm, 68.9 ± 10.8 kg, 20.1 ± 7.9 %fat, 42.8 ± 7.6 mL/kg/min) completed two separate testing sessions consisting of 15 cycling sprints (10-s sprint, 20-s active rest) against 7.5% of their body mass. In a randomized, double-blind, placebo controlled fashion, study participants consumed a 10 mL/kg dose of either low mineralized spring water (SW) or mineral water naturally high in bicarbonate (BW) content (35 mg/kg) over a 7 day period. After completion of 15 cycling sprints, averages of peak and mean power for bouts 1-5, 6-10, and 11-15 along with total work for the entire cycling protocol were calculated, then analyzed using mixed factorial ANOVA. RESULTS: pH was found to be significantly higher in BW immediately after (7.17 ± 0.09 mmol vs 7.20 ± 0.11 mmol) and 10-min post exercise (7.21 ± 0.11 mmol vs 7.24 ± 0.09 mmol). A similar pattern of change was observed 5-min post exercises whereby pH levels were lower in the SW group than those observed in the BW group, however this difference was non-significant (p=0.09). A statistical trend (p=0.06) was observed for lactate levels whereby lactate in BW tended to be lower than SW 5-min post exercise. Supplementation resulted in no change over time (p\u3e0.05) for total work, average peak power, or average power. No group x time interactions were observed (p\u3e0.05) for total work, average peak power, or average power. CONCLUSION: One week of consuming water with a naturally high bicarbonate content showed no effect on anaerobic cycling performance. However, BW did significantly decrease post-exercise blood lactate production and increase blood pH. ACKNOWLEDGEMENTS: This study was funded by Borjomi, IDS