Empowering Pediatricians to Prevent Chronic Disease Across Generations

Terry, Mary Beth; Forman, Michéle R.

doi:10.1542/peds.2015-4268m

Cited by 9 publications

(8 citation statements)

References 7 publications

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“…Adolescence is a vulnerable window for breast health, a critical developmental time for adopting healthy behaviors, and a time of increasing direct communication with physicians, especially in the context of adolescent medicine. (5,11,24) Similar to our findings in younger girls,(4) there were no differences in alcohol use, diet or exercise in BCFH+ girls compared to BCFH-girls, despite girls from BCFH+ girls reporting greater breast cancer risk. The reported health behaviors were generally similar or better than that reported with national YRBS sample (25) While almost all girls reported similar endorsement of high maternal encouragement of health behaviors, only a small majority across groups endorsed positive beliefs about healthy lifestyle behaviors contributing to breast cancer risk reduction.…”

Section: Discussionsupporting

confidence: 84%

“…(9, 10) Thus, targeted health promotion around modifiable risk factors for breast cancer, in the context of prevention across the lifespan, is especially relevant for adolescent daughters in high risk families. (11) Adolescent health providers play a critical role in educating adolescents and families about health behaviors related to cancer prevention. (11) As such, it is important to understand preventative health and risk behaviors and their associates among adolescent girls, especially among those growing up in breast cancer families with elevated risk.…”

mentioning

confidence: 99%

“…(11) Adolescent health providers play a critical role in educating adolescents and families about health behaviors related to cancer prevention. (11) As such, it is important to understand preventative health and risk behaviors and their associates among adolescent girls, especially among those growing up in breast cancer families with elevated risk.…”

mentioning

confidence: 99%

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Preventative Health and Risk Behaviors Among Adolescent Girls With and Without Family Histories of Breast Cancer

Schwartz

Henry‐Moss

Egleston

et al. 2019

Journal of Adolescent Health

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To compare health behaviors (smoking, alcohol use, fruit and vegetable intake, exercise frequency) and breast self-exam (BSE) between girls with breast cancer family history (BCFH+) and without (BCFH-) and assess associates of behaviors across all girls.Methods: 208 BCFH+ girls (11-19 yo), with first-or-second degree relatives with breast cancer or a mother with a BRCA1/2 mutation, and 112 BCFH-peers reported their health behaviors, beliefs and psychosocial function.Results: Despite higher BCFH+ girls' greater perceived breast cancer risk, there were no differences between BCFH+ and BCFH-girls on diet, exercise, alcohol initiation, or BSE. BCFH+ girls were slightly more likely to report trying cigarettes (11% vs 5%, p=0.04). In multivariable models with all girls, categorical associations with behaviors included: developmental and demographic factors with smoking, alcohol, diet, and exercise; family breast cancer history and experience with smoking, alcohol, and diet; psychosocial factors with smoking; girls perceptions of cancer controllability and mother support for health behaviors with alcohol, diet, exercise, and BSE; and mother behaviors with diet.Conclusions: Adolescent girls from BCFH+ families reported similar health behaviors to BCFH-peers, signaling that they are not translating their higher perceived risk into cancer control behaviors. Both uncontrollable (i.e., breast cancer experiences) and modifiable factors relate to health behaviors and warrant further investigation. Results indicate that interventions with teens and parents that target modifiable variables such as controllability perceptions, maternal modeling, and communication may relate to better health behaviors and reduced future breast cancer risk.

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Section: Discussionsupporting

confidence: 84%

mentioning

confidence: 99%

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Preventative Health and Risk Behaviors Among Adolescent Girls With and Without Family Histories of Breast Cancer

Schwartz

Henry‐Moss

Egleston

et al. 2019

Journal of Adolescent Health

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“…Furthermore, just as family-based studies facilitated the discovery of breast cancer genes relevant to all women, studies during specific WOS will facilitate the assessment of the effects from environmental exposures that will be relevant outside of these WOS. As evidence from WOS accumulates, the paradigm for breast cancer needs to expand beyond the secondary prevention efforts of screening and mid-life risk assessment to primary prevention efforts with involvement of community partners, educators and school districts, families, and primary care providers including pediatricians for lifelong impact [207].…”

Section: Discussionmentioning

confidence: 99%

Environmental exposures during windows of susceptibility for breast cancer: a framework for prevention research

Michels²,

et al. 2019

Self Cite

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Background The long time from exposure to potentially harmful chemicals until breast cancer occurrence poses challenges for designing etiologic studies and for implementing successful prevention programs. Growing evidence from animal and human studies indicates that distinct time periods of heightened susceptibility to endocrine disruptors exist throughout the life course. The influence of environmental chemicals on breast cancer risk may be greater during several windows of susceptibility (WOS) in a woman’s life, including prenatal development, puberty, pregnancy, and the menopausal transition. These time windows are considered as specific periods of susceptibility for breast cancer because significant structural and functional changes occur in the mammary gland, as well as alterations in the mammary micro-environment and hormone signaling that may influence risk. Breast cancer research focused on these breast cancer WOS will accelerate understanding of disease etiology and prevention. Main text Despite the plausible heightened mechanistic influences of environmental chemicals on breast cancer risk during time periods of change in the mammary gland’s structure and function, most human studies of environmental chemicals are not focused on specific WOS. This article reviews studies conducted over the past few decades that have specifically addressed the effect of environmental chemicals and metals on breast cancer risk during at least one of these WOS. In addition to summarizing the broader evidence-base specific to WOS, we include discussion of the NIH-funded Breast Cancer and the Environment Research Program (BCERP) which included population-based and basic science research focused on specific WOS to evaluate associations between breast cancer risk and particular classes of endocrine-disrupting chemicals—including polycyclic aromatic hydrocarbons, perfluorinated compounds, polybrominated diphenyl ethers, and phenols—and metals. We outline ways in which ongoing transdisciplinary BCERP projects incorporate animal research and human epidemiologic studies in close partnership with community organizations and communication scientists to identify research priorities and effectively translate evidence-based findings to the public and policy makers. Conclusions An integrative model of breast cancer research is needed to determine the impact and mechanisms of action of endocrine disruptors at different WOS. By focusing on environmental chemical exposure during specific WOS, scientists and their community partners may identify when prevention efforts are likely to be most effective.

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“…Unfortunately, it lasted less than 1 year after the parent’s cancer diagnosis and did not last if the parent survived for more than 5 years. Strategies are needed to ensure that these healthy behaviors are maintained 38 .…”

Section: Discussionmentioning

confidence: 99%

Health behaviors and psychological burden of adolescents after parental cancer diagnosis

Kim

Choi

et al. 2022

Sci Rep

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This study aims to investigate health behaviors and psychological burdens in adolescent children of cancer parents. We compared health behaviors and mental health outcomes between 266 adolescent children with a parent diagnosed with cancer and 3163 control adolescents aged 12–19 years using data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2010 to 2018. Alcohol use of adolescents increased between 2 and 5 years after parental cancer diagnosis (adjusted odds ratio [aOR], 1.72; 95% confidence interval [CI], 1.01–2.94) but decreased after 5 years. Parental cancer was associated with increased vaccination uptake in adolescents within 1 year of diagnosis (aOR, 3.19; 95% CI, 1.55–6.54), but after 2 years, there was no difference from rates in their peers. Maternal cancer was associated with increased depression among adolescents (aOR, 1.73; 95% CI, 1.10 − 2.73). Although the risks of suicidal thoughts/plans/attempts increased within 1 year after parental cancer diagnosis (aOR, 2.96; 95% CI, 1.00 − 8.83), it reduced 2 years after diagnosis, leading to no significant difference from the frequency in peers. Within five years after the parent was diagnosed with cancer, support for their adolescent children's health behaviors and mental health is necessary in the community.

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Empowering Pediatricians to Prevent Chronic Disease Across Generations

Cited by 9 publications

References 7 publications

Preventative Health and Risk Behaviors Among Adolescent Girls With and Without Family Histories of Breast Cancer

Preventative Health and Risk Behaviors Among Adolescent Girls With and Without Family Histories of Breast Cancer

Environmental exposures during windows of susceptibility for breast cancer: a framework for prevention research

Health behaviors and psychological burden of adolescents after parental cancer diagnosis

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