A prospective study of dietary patterns and cancer mortality among Blacks and Whites in the REGARDS cohort

Akinyemiju, Tomi; Moore, Justin Xavier; Pisu, Maria; Lakoski, Susan G.; Shikany, James M.; Goodman, Michael; Judd, Suzanne E.

doi:10.1002/ijc.30287

Cited by 18 publications

(22 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Often, data are available on the timing of death from cancer, but not on the timing of diagnosis of cancer; researchers then follow all cohort members (rather than a survivor cohort) from study entry to cancer death. [24][25][26] Such studies can highlight strategies to improve the health and longevity of the population, likely through primary prevention of cancer because interventions that reduce cancer incidence will reduce cancer mortality even if they have no effect on postdiagnosis survival. However, research on a prediagnosis exposure's association with cancer mortality cannot distinguish the extent to which associations are driven by exposure's association with cancer incidence versus with survival after cancer onset.…”

Section: Resultsmentioning

confidence: 99%

Methodological considerations for disentangling a risk factor's influence on disease incidence versus postdiagnosis survival: The example of obesity and breast and colorectal cancer mortality in the Women's Health Initiative

Feliciano

Prentice

Aragaki

et al. 2017

Intl Journal of Cancer

View full text Add to dashboard Cite

Often, studies modeling an exposure’s influence on time to disease-specific death from study enrollment are incorrectly interpreted as if based on time to death from disease diagnosis. We studied 151,996 post-menopausal women without breast or colorectal cancer in the Women’s Health Initiative with weight and height measured at enrollment (1993–1998). Using Cox regression models, we contrast hazard ratios (HR) from two time-scales and corresponding study subpopulations: time to cancer death after enrollment among all women and time to cancer death after diagnosis among only cancer survivors. Median follow-up from enrollment to diagnosis/censoring was 13-years for both breast (7633 cases) and colorectal cancer (2290 cases). Follow-up from diagnosis to death/censoring was 7-years for breast and 5-years for colorectal cancer. In analyses of time from enrollment to death, body mass index (BMI)≥35-kg/m2 versus 18.5-<25-kg/m2 was associated with higher rates of cancer mortality: HR=1.99; 95%CI: 1.54, 2.56 for breast cancer (p-trend <0.001) and HR=1.40; 95%CI: 1.04, 1.88 for colorectal cancer (p-trend=0.05). However, in analyses of time from diagnosis to cancer death, trends indicated no significant association (for BMI≥35-kg/m2, HR=1.25; 95%CI: 0.94, 1.67 for breast [p-trend=0.33] and HR=1.18; 95%CI: 0.84, 1.86 for colorectal cancer [p-trend=0.39]). We conclude that a risk factor that increases disease incidence will increase disease-specific mortality. Yet, its influence on post-diagnosis survival can vary, and requires consideration of additional design and analysis issues such as selection bias. Quantitative tools allow joint modeling to compare an exposure’s influence on time from enrollment to disease incidence and time from diagnosis to death.

show abstract

Section: Resultsmentioning

confidence: 99%

Methodological considerations for disentangling a risk factor's influence on disease incidence versus postdiagnosis survival: The example of obesity and breast and colorectal cancer mortality in the Women's Health Initiative

Feliciano

Prentice

Aragaki

et al. 2017

Intl Journal of Cancer

View full text Add to dashboard Cite

show abstract

“…The age-adjusted estimate of the proportion with an education level Յhigh school was 20% for white participants (95% CI, 18% to 22%) and 38% for black participants (95% CI, 35% to 42%), which differed by 18% (95% CI, 15% to 22%). The odds of developing hypertension during follow-up was 1. stroke, 13 coronary heart disease, 16 end-stage renal disease and chronic kidney disease, 17 sepsis, 18 cancer mortality, 19 and cognitive decline. 20 The Southern diet also has been shown to be a large mediating factor for the difference in stroke risk between black and white individuals.…”

Section: Discussionmentioning

confidence: 99%

Association of Clinical and Social Factors With Excess Hypertension Risk in Black Compared With White US Adults

Howard

Cushman

Moy

et al. 2018

JAMA

Self Cite

131

View full text Add to dashboard Cite

The high prevalence of hypertension among the US black population is a major contributor to disparities in life expectancy; however, the causes for higher incidence of hypertension among black adults are unknown. OBJECTIVE To evaluate potential factors associated with higher risk of incident hypertension among black adults. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study of black and white adults selected from a longitudinal cohort study of 30 239 participants as not having hypertension at baseline (2003-2007) and participating in a follow-up visit 9.4 years (median) later. EXPOSURES There were 12 clinical and social factors, including score for the Southern diet (range, −4.5 to 8.2; higher values reflect higher level of adherence to the dietary pattern), including higher fried and related food intake. MAIN OUTCOMES AND MEASURES Incident hypertension (systolic blood pressure Ն140 mm Hg, diastolic blood pressure Ն90 mm Hg, or use of antihypertensive medications) at the follow-up visit. RESULTS Of 6897 participants (mean [SD] age, 62 [8] years; 26% were black adults; and 55% were women), 46% of black participants and 33% of white participants developed hypertension. Black men had an adjusted mean Southern diet score of 0.81 (95% CI, 0.72 to 0.90); white men, −0.26 (95% CI, −0.31 to −0.21); black women, 0.27 (95% CI, 0.20 to 0.33); and white women, −0.57 (95% CI, −0.61 to −0.54). The Southern diet score was significantly associated with incident hypertension for men (odds ratio [OR], 1.16 per 1 SD [95% CI, 1.06 to 1.27]; incidence of 32.4% at the 25th percentile and 36.1% at the 75th percentile; difference, 3.7% [95% CI, 1.4% to 6.2%]) and women (OR, 1.17 per 1 SD [95% CI, 1.08 to 1.28]; incidence of 31.0% at the 25th percentile and 34.8% at the 75th percentile; difference, 3.8% [95% CI, 1.5% to 5.8%]). The Southern dietary pattern was the largest mediating factor for differences in the incidence of hypertension, accounting for 51.6% (95% CI, 18.8% to 84.4%) of the excess risk among black men and 29.2% (95% CI, 13.4% to 44.9%) of the excess risk among black women. Among black men, a higher dietary ratio of sodium to potassium and an education level of high school graduate or less each mediated 12.3% of the excess risk of incident hypertension. Among black women, higher body mass index mediated 18.3% of the excess risk; a larger waist, 15.2%; less adherence to the Dietary Approaches to Stop Hypertension diet, 11.2%; income level of $35 000 or less, 9.3%; higher dietary ratio of sodium to potassium, 6.8%; and an education level of high school graduate or less, 4.1%. CONCLUSIONS AND RELEVANCE In a mediation analysis comparing incident hypertension among black adults vs white adults in the United States, key factors statistically mediating the racial difference for both men and women included Southern diet score, dietary ratio of sodium to potassium, and education level. Among women, waist circumference and body mass index also were key factors.

show abstract

“…changes in diet or reproductive behaviour) or environmental exposures that are more prevalent in the USA might lead to an increased risk of mortality for certain cancers. [82][83][84][85][86][87][88][89][90][91][92][93][94][95] Because the country of origin is missing for a large proportion of cancer patients in the Surveillance, Epidemiology and End Results (SEER) Program data, descriptive analyses on incidence and mortality by country of origin based on this resource must be interpreted with caution. 96 Substantial evidence has shown that unequal cancer burden among populations of different races/ethnicities can be partially explained by their population-specific genetic background or genetic ancestry.…”

Section: Healthcarementioning

confidence: 99%

“…changes in diet or reproductive behaviour) or environmental exposures that are more prevalent in the USA might lead to an increased risk of mortality for certain cancers. 82 – 95 Because the country of origin is missing for a large proportion of cancer patients in the Surveillance, Epidemiology and End Results (SEER) Program data, descriptive analyses on incidence and mortality by country of origin based on this resource must be interpreted with caution. 96 …”

Section: Factors That Contribute To Health Disparities For Multiple Tmentioning

confidence: 99%

Cancer health disparities in racial/ethnic minorities in the United States

et al. 2020

View full text Add to dashboard Cite

There are well-established disparities in cancer incidence and outcomes by race/ethnicity that result from the interplay between structural, socioeconomic, socio-environmental, behavioural and biological factors. However, large research studies designed to investigate factors contributing to cancer aetiology and progression have mainly focused on populations of European origin. The limitations in clinicopathological and genetic data, as well as the reduced availability of biospecimens from diverse populations, contribute to the knowledge gap and have the potential to widen cancer health disparities. In this review, we summarise reported disparities and associated factors in the United States of America (USA) for the most common cancers (breast, prostate, lung and colon), and for a subset of other cancers that highlight the complexity of disparities (gastric, liver, pancreas and leukaemia). We focus on populations commonly identified and referred to as racial/ethnic minorities in the USA—African Americans/Blacks, American Indians and Alaska Natives, Asians, Native Hawaiians/other Pacific Islanders and Hispanics/Latinos. We conclude that even though substantial progress has been made in understanding the factors underlying cancer health disparities, marked inequities persist. Additional efforts are needed to include participants from diverse populations in the research of cancer aetiology, biology and treatment. Furthermore, to eliminate cancer health disparities, it will be necessary to facilitate access to, and utilisation of, health services to all individuals, and to address structural inequities, including racism, that disproportionally affect racial/ethnic minorities in the USA.

show abstract

A prospective study of dietary patterns and cancer mortality among Blacks and Whites in the REGARDS cohort

Cited by 18 publications

References 36 publications

Methodological considerations for disentangling a risk factor's influence on disease incidence versus postdiagnosis survival: The example of obesity and breast and colorectal cancer mortality in the Women's Health Initiative

Methodological considerations for disentangling a risk factor's influence on disease incidence versus postdiagnosis survival: The example of obesity and breast and colorectal cancer mortality in the Women's Health Initiative

Association of Clinical and Social Factors With Excess Hypertension Risk in Black Compared With White US Adults

Cancer health disparities in racial/ethnic minorities in the United States

Contact Info

Product

Resources

About