Adult BMI Change and Risk of Colon Cancer in Postmenopausal Women

Purpose. We recently reported an association of adult BMI change with colon cancer risk. Here, we sought to further explore this association with respect to postmenopausal HRT use in a larger study population. Methods. We included 1,457 postmenopausal women participating in an ongoing population-based case-control study of colon cancer. Results. We confirmed a previously reported association of adulthood weight gain and increased risk of colon cancer: compared to those with <5 kg/m2 change of BMI, women who reported moderate (5–10 kg/m2) and large (>10 kg/m2) BMI changes since their 20s had OR estimates of 1.54 (95% CI = 1.09–2.19) and 1.45 (95% CI = 0.90–2.33), respectively (P for trend = 0.05). Stratified analyses showed that this association was limited to HRT nonusers: ORs were 1.77 (95% CI = 1.02–3.05) and 2.21 (95% CI = 1.09–4.45), respectively (P for trend = 0.03), for BMI changes occurring between the 20s decade and time of recruitment among non-users. Similar associations were observed for BMI changes since the 30s decade. There was no association among HRT users. Conclusion. Our results suggest early adulthood weight gain increases colon cancer risk in postmenopausal women who do not use HRT

Primary care for young adult cancer survivors: an international perspective.

Contains fulltext : 89604.pdf (publisher's version ) (Closed access)PURPOSE: Internationally, family physicians (FP) are not routinely involved in young adult cancer (YAC) care. In this short report, we would like to make a compelling argument for primary care involvement. METHODS: Comparative descriptions and literature review. RESULTS: Cancer among YAs is rare and usually not the first thing that comes into the FP's mind. Youth is sometimes mistakenly regarded as a protective factor. Across the countries, almost all YACs are treated in tertiary health care facilities with specialists providing the majority of care. Health care services are covered by the universal health insurance in Denmark, The Netherlands, and Canada but not in the US. Once the YAC has completed acute treatment and follow-up care, they often return to the care of the FPs who may potentially be expected to deal with and take action upon any possible medical, mental health, and psychosocial issues the YA cancer patient may present with. The role of the FP in follow-up care seems to be very limited. CONCLUSIONS: YACs in the western world seem to have comparable medical and psychosocial problems. However, the nature of health insurance is such that it impacts differently on the care of this group of cancer patients. Primary care features such as patient-centered, integrated, and comprehensive care over extended periods of time bring the FP into the unique position to provide follow-up for YAC. However, this will require integrating patient's perspectives on their care, professional continuing medical education (CME) initiatives, and an enhanced cooperative effort between those delivering and coordinating cancer care.1 oktober 201