Women's perception of the benefits of mammography screening: population-based survey in four countries

Background Screening programmes are often actively promoted to achieve high coverage, which may result in unrealistic expectations. We examined women's understanding of the likely benefits of mammography screening. Methods Telephone survey of random samples of the female population aged ≥15 years in the US, UK, Italy, and Switzerland using three closed questions on the expected benefits of mammography screening. Results A total of 5964 women were contacted and 4140 women (69%) participated. Misconceptions were widespread: a majority of women believed that screening prevents or reduces the risk of contracting breast cancer (68%), that screening at least halves breast cancer mortality (62%), and that 10 years of regular screening will prevent 10 or more breast cancer deaths per 1000 women (75%). In multivariate analysis higher number of correct answers was positively associated with higher educational status (odds ratio [OR] = 1.44, 95% CI: 1.25, 1.66) and negatively with having had a mammography in the last 2 years (OR = 0.86, 95% CI: 0.73, 1.01). Compared with US women (reference group) and Swiss women (OR = 0.98, 95% CI: 0.82, 1.18) respondents in Italy (OR = 0.61, 95% CI: 0.50, 0.74) and the UK (OR = 0.73, 95% CI: 0.60, 0.88) gave fewer correct answers. Conclusion In the US and three European countries a high proportion of women overestimated the benefits that can be expected from screening mammography. This finding raises doubts on informed consent procedures within breast cancer screening programme

Evidence against the proposition that “UK cancer survival statistics are misleading”: simulation study with National Cancer Registry data

Objectives To simulate each of two hypothesised errors in the National Cancer Registry (recording of the date of recurrence of cancer, instead of the date of diagnosis, for registrations initiated from a death certificate; long term survivors who are never notified to the registry), to estimate their possible effect on relative survival, and to establish whether lower survival in the UK might be due to one or both of these errors

Varicose veins of the lower limbs and venous capacitance in postmenopausal women: Relationship with obesity

AbstractObjective: The purpose of this study was to examine the association between body mass index (BMI), venous capacitance, and clinical evidence of varicose veins after adjustment for sex hormones in postmenopausal women. Methods: This study group of the DIANA (DIet and ANdrogens) project (a randomized controlled trial on the effect of some dietary changes on sex hormone pattern in women with elevated androgenic hormone levels in Italy) was comprised of 104 healthy volunteer postmenopausal women, aged 48 to 65 years. The main outcome measures were physical examination to determine the presence and severity of varicose veins and plethysmographic measurement of lower limb venous capacitance and outflow. Results: Women in the upper quartile of BMI (>30 kg/m2) showed a positive association with clinical evidence of varicose veins (odds ration, 5.8; 95% CI, 1.2 to 28.2) after adjustment for age, estradiol, testosterone, and sex hormone binding globulin. No association was found between BMI and plethysmographic measurements of venous parameters. Conclusion: Obesity is associated with clinical evidence of varicose veins independently from the influence of sex hormones in postmenopausal women and is not associated with venous capacitance. Increased body weight increases the risk of varicose veins. (J Vasc Surg 2002;36:965-8.

Plasma Retinol and Prognosis of Postmenopausal Breast Cancer Patients

Abstract Background: The role of retinol (vitamin A) in breast cancer prognosis has never been investigated in postmenopausal women. We prospectively assessed the long-term prognostic role of retinol plasma levels in a cohort of postmenopausal breast cancer patients. Patients and Methods: We investigated 208 women self-reported as postmenopausal operated on for T1-2N0M0 breast cancer who participated in a chemoprevention trial as controls and never received chemotherapy or hormone therapy. Plasma samples were collected 3 months (median) after surgery and assayed within 3 weeks for retinol. Minimum and median potential follow-up were 12 and 15 years, respectively. The main analyses were on all women and on a subgroup ages ≥55 years, assumed too old to be in perimenopause. The main end point was breast cancer death. Breast cancer survival was estimated by the Kaplan-Meier method. The hazard ratios of breast cancer death by retinol level were estimated by Cox models stratified for age, where relevant, and recruitment period, and adjusted for tumor size and histology. Results: At 12 years, patients with low retinol (<2.08 μmol/L, median of distribution) had lower breast cancer survival than those with high retinol (log-rank P = 0.052); the difference was significant for women ≥55 years (log-rank P = 0.006). The adjusted hazard ratios for low versus high retinol were 2.11 (95% confidence interval, 1.08-4.14) for all women and 3.58 (95% confidence interval, 1.50-8.57) for those ≥55 years. Conclusions: Low plasma retinol strongly predicts poorer prognosis in postmenopausal breast cancer patients. Retinol levels should be determined as part of the prognostic workup. (Cancer Epidemiol Biomarkers Prev 2009;18(1):42–8

Women's perception of the benefits of mammography screening: population-based survey in four countries

Background: Screening programmes are often actively promoted to achieve high coverage, which may result in unrealistic expectations. We examined women's understanding of the likely benefits of mammography screening. Methods: Telephone survey of random samples of the female population aged 15 years in the US, UK, Italy, and Switzerland using three closed questions on the expected benefits of mammography screening. Results: A total of 5964 women were contacted and 4140 women (69%) participated. Misconceptions were widespread: a majority of women believed that screening prevents or reduces the risk of contracting breast cancer (68%), that screening at least halves breast cancer mortality (62%), and that 10 years of regular screening will prevent 10 or more breast cancer deaths per 1000 women (75%). In multivariate analysis higher number of correct answers was positively associated with higher educational status (odds ratio [OR] = 1.44, 95% CI: 1.25, 1.66) and negatively with having had a mammography in the last 2 years (OR = 0.86, 95% CI: 0.73, 1.01). Compared with US women (reference group) and Swiss women (OR = 0.98, 95% CI: 0.82, 1.18) respondents in Italy (OR = 0.61, 95% CI: 0.50, 0.74) and the UK (OR = 0.73, 95% CI: 0.60, 0.88) gave fewer correct answers. Conclusion: In the US and three European countries a high proportion of women overestimated the benefits that can be expected from screening mammography. This finding raises doubts on informed consent procedures within breast cancer screening programmes. [Authors]]]> Breast Neoplasms ; Health Knowledge, Attitudes, Practice ; Mammography ; Mass Screening eng https://serval.unil.ch/resource/serval:BIB_7F081FA0D56E.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_7F081FA0D56E9 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_7F081FA0D56E9 info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_7F0821E3DC67 2022-05-07T01:21:22Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_7F0821E3DC67 Mucoepidermoid Carcinoma as a Masquerade Syndrome of Scleral Melting and Granulomatous Kerato-Uveitis. info:doi:10.1055/s-0031-1273241 info:eu-repo/semantics/altIdentifier/doi/10.1055/s-0031-1273241 info:eu-repo/semantics/altIdentifier/pmid/21484645 Moulin, A.P. Hamedani, M. Majo, F. Schaefer, F. Guex-Crosier, Y. info:eu-repo/semantics/article article 2011 Klinische Monatsblatter Fur Augenheilkunde, vol. 228, no. 4, pp. 347-349 info:eu-repo/semantics/altIdentifier/eissn/1439-3999 urn:issn:0023-2165 eng oai:serval.unil.ch:BIB_7F0838694976 2022-05-07T01:21:22Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_7F0838694976 Effects of Different Training Intensity Distributions Between Elite Cross-Country Skiers and Nordic-Combined Athletes During Live High-Train Low. info:doi:10.3389/fphys.2018.00932 info:eu-repo/semantics/altIdentifier/doi/10.3389/fphys.2018.00932 info:eu-repo/semantics/altIdentifier/pmid/30072913 Schmitt, L. Willis, S.J. Coulmy, N. Millet, G.P. info:eu-repo/semantics/article article 2018 Frontiers in physiology, vol. 9, pp. 932 info:eu-repo/semantics/altIdentifier/pissn/1664-042X urn:issn:1664-042X <![CDATA[&lt;b&gt;Purpose:&lt;/b&gt; To analyze the effects of different training strategies (i.e., mainly intensity distribution) during living high - training low (LHTL) between elite cross-country skiers and Nordic-combined athletes. &lt;b&gt;Methods:&lt;/b&gt; 12 cross-country skiers (XC) (7 men, 5 women), and 8 male Nordic combined (NC) of the French national teams were monitored during 15 days of LHTL. The distribution of training at low-intensity (LIT), below the first ventilatory threshold (VT1), was 80% and 55% in XC and NC respectively. Daily, they filled a questionnaire of fatigue, and performed a heart rate variability (HRV) test. Prior (Pre) and immediately after (Post), athletes performed a treadmill incremental running test for determination of &lt;mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"&gt; &lt;mml:mover&gt; &lt;mml:mtext&gt;V&lt;/mml:mtext&gt; &lt;mml:mo&gt;˙&lt;/mml:mo&gt; &lt;/mml:mover&gt; &lt;/mml:math&gt; O &lt;sub&gt;2max&lt;/sub&gt; and &lt;mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"&gt; &lt;mml:mover&gt; &lt;mml:mtext&gt;V&lt;/mml:mtext&gt; &lt;mml:mo&gt;˙&lt;/mml:mo&gt; &lt;/mml:mover&gt; &lt;/mml:math&gt; O &lt;sub&gt;2&lt;/sub&gt; at the second ventilatory threshold ( &lt;mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"&gt; &lt;mml:mover&gt; &lt;mml:mtext&gt;V&lt;/mml:mtext&gt; &lt;mml:mo&gt;˙&lt;/mml:mo&gt; &lt;/mml:mover&gt; &lt;/mml:math&gt; O &lt;sub&gt;2V T2&lt;/sub&gt; ), a field roller-skiing test with blood lactate ([La-]) assessment. &lt;b&gt;Results:&lt;/b&gt; The training volume was in XC and NC, respectively: at LIT: 45.9 ± 6.4 vs. 23.9 ± 2.8 h ( &lt;i&gt;p&lt;/i&gt; &lt; 0.001), at moderate intensity: 1.9 ± 0.5 vs. 3.0 ± 0.4 h, ( &lt;i&gt;p&lt;/i&gt; &lt; 0.001), at high intensity: 1.2 ± 0.9 vs. 1.4 ± 02 h ( &lt;i&gt;p&lt;/i&gt; = 0.05), in strength (and jump in NC): 7.1 ± 1.5 vs. 18.4 ± 2.7 h, ( &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Field roller-skiing performance was improved (-2.9 ± 1.6%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) in XC but decreased (4.1 ± 2.6%, &lt;i&gt;p&lt;/i&gt; &lt; 0.01) in NC. [La-] was unchanged (-4.1 ± 14.2%, &lt;i&gt;p&lt;/i&gt; = 0.3) in XC but decreased (-27.0 ± 11.1%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) in NC. Changes in field roller-skiing performance and in [La-] were correlated ( &lt;i&gt;r&lt;/i&gt; = -0.77, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). &lt;mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"&gt; &lt;mml:mover&gt; &lt;mml:mtext&gt;V&lt;/mml:mtext&gt; &lt;mml:mo&gt;˙&lt;/mml:mo&gt; &lt;/mml:mover&gt; &lt;/mml:math&gt; O &lt;sub&gt;2max&lt;/sub&gt; increased in both XC and NC (3.7 ± 4.2%, &lt;i&gt;p&lt;/i&gt; = 0.01 vs. 3.7 ± 2.2%, &lt;i&gt;p&lt;/i&gt; = 0.002) but &lt;mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"&gt; &lt;mml:mover&gt; &lt;mml:mtext&gt;V&lt;/mml:mtext&gt; &lt;mml:mo&gt;˙&lt;/mml:mo&gt; &lt;/mml:mover&gt; &lt;/mml:math&gt; O &lt;sub&gt;2V T2&lt;/sub&gt; increased only in XC (7.3 ± 5.8%, &lt;i&gt;p&lt;/i&gt; = 0.002). HRV analysis showed differences between XC and NC mainly in high spectral frequency in the supine position (HF &lt;sub&gt;SU&lt;/sub&gt; ). All NC skiers showed some signs of overreaching at Post. &lt;b&gt;Conclusion:&lt;/b&gt; During LHTL, despite a higher training volume, XC improved specific performance and aerobic capacities, while NC did not. All NC skiers showed fatigue states. These findings suggest that a large amount of LIT with a moderate volume of strength and speed training is required during LHTL in endurance athletes

Publication of the International Union Against Cancer

Because of large intra-individual variation in hormone levels, few studies have investigated the relation of serum sex hormones to breast cancer (BC) in premenopausal women. We prospectively studied this relation, adjusting for timing of blood sampling within menstrual cycle. Premenopausal women (5,963), recruited to the Hormones and Diet in the Etiology of Breast Tumors (ORDET) cohort study, provided a blood sample in the 20 -24th day of their menstrual cycle. The hypothesis that breast cancer (BC) is related to ovarian function dates back over a century. 1 Epidemiological, in vitro and in vivo studies conducted in the second half of the last century made it clear that steroid sex hormones regulate cell proliferation and play a major role in promoting BC. 2,3 Several mechanistic hypotheses for the development of BC have been proposed, 2,4 but until recently, hormone measurements by epidemiological studies have failed to corroborate any of them. Over the last decade, however, several prospective cohort studies in postmenopausal women have shown that BC development is preceded by alterations in levels of circulating sex hormones. 5 High serum levels of free and total estradiol, total testosterone and other estrogens and androgens, as well as low serum levels of sex hormone-binding globulin (SHBG), have been found to be implicated in the risk of BC. 5 Our own study also indicated that high serum levels of free testosterone are associated with the risk of BC. 6 These prospective investigations were carried out with the help of thousands of healthy women who provided blood samples for storage and future nested-in-the-cohort case-control analyses. Compared to case control studies in clinical settings, the strengths of prospective studies are that control subjects belong to the same cohort that generates the incident disease cases and that blood is collected before the diagnosis of cancer thereby excluding abnormal values that may be due to overt illness. Hormone measurements in premenopausal women are difficult to interpret because serum levels change with the menstrual cycle and because cycle length varies inter-and intra-individually. Only a few prospective investigations have addressed the role of sex hormone levels in BC before the menopause; 7-10 all considered small numbers of case women and did not produce clear results. The endocrine basis of BC in premenopause is therefore the subject of several disparate hypotheses. These include the hypothesis of Grattarola, advanced in the 1960s, 11-12 that hyperandrogenism with luteal inadequacy plays a role in the induction of BC, and of Henderson et al. The present prospective study was designed to investigate whether luteal inadequacy and hyperandrogenism increase the risk of BC in premenopausal women. We collected blood samples from premenopausal women participating in the study on Hormones and Diet in the Etiology of Breast Tumors (ORDET). 6,14 Samples were taken between the 20th and 24th day of the cycle (theoretically during the mid luteal phase). The first day of menstrual bleeding subsequent to sampling was also recorded to provide an additional data point for correctly locating the sampling day within the cycle. In these women, we analyzed the relationship between BC and serum levels of the androgens dehydroepiandrosterone sulfate (DHEAS), total testosterone, free testosterone, androstenedione and androstanediol-glucoronide (Adiol-G), and also progesterone, 17-OH-progesterone, SHBG, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Estradiol was not considered in the present analysis because of its extraordinary intra-individual variation in premenopausal women

Sleep behavior and daily activity levels in people with metabolic syndrome: effect of 1 year of metformin treatment

Impaired sleep and low daily activity levels increase the risk of developing metabolic syndrome (MS). Metformin (MET), an insulin sensitizer drug, is effective in regressing MS and has been recently studied as an adjuvant agent for managing sleep disorders. The present study aimed to assess whether 1,700 mg/day of MET treatment modifies sleep and daily activity levels in people with MS evaluated by Rest-Activity circadian Rhythm (RAR), which is the expression of 24 h of spontaneous activity parameters. A total of 133 subjects with MS, randomized into the MET (n = 65) or placebo (PLA, n = 68) group, underwent a clinical/anthropometric examination and carried out a continuous 7-day actigraphic monitoring to investigate sleep and RAR parameters at baseline and after 1 year of intervention. After 1 year of intervention, 105 subjects were analyzed. The MET group showed greater anthropometric and metabolic improvements compared with placebo, with a significant reduction in weight (p = 0.01), body mass index (p = 0.01), waist circumference (p = 0.03), and glucose (p &lt; 0.001). With regard to sleep parameters, the MET group showed a significant increase in actual sleep time (p = 0.01) and sleep efficiency (p = 0.04) compared with placebo. There were no significant changes reported in the RAR parameters. Our study suggests that MET might be used as an adjuvant treatment for sleep disorders in people with MS