Correction: Decline in breast cancer incidence due to removal of promoter: combination estrogen plus progestin

Due to an oversight, the author of the above article [1] was incorrectly listed as having no competing interests. The competing interests section of this article should have read: Competing interests GC has served as an expert witness for plaintiff lawyers preparing hormone therapy litigation. GC has received research support from GlaxoSmithKline, from the American Cancer Society, and from the Breast Cancer Research Foundation. No group or organization funded this manuscript. Referenc

Menopausal hormone therapy after breast cancer

The use of postmenopausal hormone therapy after breast cancer remains controversial. Evidence shows variation by study design, and even among three randomized controlled trials there is substantial heterogeneity of results. Two Swedish trials of comparable size show relative risks of recurrence of 3.3 and 0.82 on comparing women receiving postmenopausal hormone therapy with control women. The extent of use of tamoxifen and concomitant use of progestins in combination with estrogen, although raised as one possible explanation for this heterogeneity, are not supported by evidence from trials of high-dose progestins used after breast cancer. Caution is needed when considering the use of postmenopausal hormone therapy after breast cancer

Ensuring long-term sustainability of existing cohorts remains the highest priority to inform cancer prevention and control

The case for continued follow-up of existing cohorts arises from the key attributes of cohorts that are already meeting the goals proposed by Potter for the creation of a new cohort. These attributes include the basic nature of ongoing cohorts in that they are, by design, hypothesis-driven and must adapt to emerging technologies over time. Importantly, cohort investigators must identify and address gaps in knowledge that will inform public health strategies and clinical practices. Above all, cohorts must capitalize on their unique features to address public health priorities and inform our prevention strategies. Continued follow-up adds substantial return on investment to guide cancer prevention

What can be learnt from models of incidence rates?

Models of breast cancer incidence have evolved from the observation by Armitage and Doll in the 1950s that the pattern of incidence by age differs for reproductive cancers from those of other major malignancies. Both two-stage and multistage models have been applied to breast cancer incidence. Consistent across modeling approaches, risk accumulation or the rate of increase in breast cancer incidence is most rapid from menarche to first birth. Models that account for the change in risk after menopause and the temporal sequence of reproductive events summarize risk efficiently and give added insights to potentially important mechanistic features. First pregnancy has an adverse impact on progesterone receptor negative tumors, while increasing parity reduces the risk of estrogen/progesterone receptor positive tumors but not estrogen/progesterone receptor negative tumors. Integrated prediction models that incorporate prediction of carrier status for highly penetrant genes and also account for lifestyle factors, mammographic density, and endogenous hormone levels remain to be efficiently implemented. Models that both inform and reflect the emerging understanding of the molecular and cell biology of carcinogenesis are still a long way off

Telemedicine infectious diseases consultations and clinical outcomes: A systematic review

Background: Telemedicine use is increasing in many specialties, but its impact on clinical outcomes in infectious diseases has not been systematically reviewed. We reviewed the current evidence for clinical effectiveness of telemedicine infectious diseases consultations, including outcomes of mortality, hospital readmission, antimicrobial use, cost, length of stay, adherence, and patient satisfaction. Methods: We queried Ovid MEDLINE 1946-, Embase.com 1947-, Scopus 1823-, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov 1997- through August 5, 2019, for studies looking at clinical outcomes of infectious diseases in the setting of telemedicine use. We did not restrict by language or year of publication. Clinical outcomes searched included 30-day all-cause mortality, 30-day readmissions, patient compliance/adherence, patient satisfaction, cost or cost-effectiveness, length of hospital stay, antimicrobial use, and antimicrobial stewardship. Bias was assessed using standard methodologies. PROSPERO CRD42018105225. Results: From a search pool of 1154 studies, only 18 involved telemedicine infectious diseases consultation and our selected clinical outcomes. The outcomes tracked were heterogeneous, precluding meta-analysis, and the majority of studies were of poor quality. Overall, clinical outcomes with telemedicine infectious diseases consultation seem comparable to in-person infectious diseases consultation. Conclusions: Although in widespread use, the clinical effectiveness of telemedicine infectious diseases consultations has yet to be sufficiently studied. Further studies, or publication of previously collected and available data, are warranted to verify the cost-effectiveness of this widespread practice. Systematic review registration: PROSPERO CRD42018105225