Hannah Lui Park - Academia.edu (original) (raw)

Papers by Hannah Lui Park

Research paper thumbnail of Construct validation of the dietary inflammatory index among postmenopausal women

Annals of Epidemiology, Jun 1, 2015

PurposeMany dietary factors have either pro- or anti-inflammatory properties. We previously devel... more PurposeMany dietary factors have either pro- or anti-inflammatory properties. We previously developed a dietary inflammatory index (DII) to assess the inflammatory potential of diet. In this study we conducted a construct validation of the DII based on data from a food frequency questionnaire and three inflammatory biomarkers in a subsample of 2,567 postmenopausal women in the Women’s Health Initiative Observational Study.MethodsWe used multiple linear and logistic regression models, controlling for potential confounders, to test whether baseline DII predicted concentrations of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha receptor 2 (TNFα-R2), or an overall biomarker score combining all three inflammatory biomarkers.ResultsThe DII was associated with the four biomarkers with beta estimates (95%CI) comparing the highest with lowest DII quintiles as follows: IL-6: 1.26 (1.15, 1.38), Ptrend<0.0001; TNFα-R2: 81.43 (19.15, 143.71), Ptrend=0.004; dichotomized hs-CRP (odds ratio for higher versus lower hs-CRP): 1.30 (0.97, 1.67), Ptrend=0.34); and the combined inflammatory biomarker score: 0.26 (0.12, 0.40), Ptrend=0.0001.ConclusionThe DII was significantly associated with inflammatory biomarkers. Construct validity of the DII indicates its utility for assessing the inflammatory potential of diet and for expanding its use to include associations with common chronic diseases in future studies.

Research paper thumbnail of Abstract 5892: Factors associated with longitudinal changes in mammographic density in a multiethnic breast screening cohort of postmenopausal women

Cancer Research

Mammographic density is an important risk factor for breast cancer and is known to differ in wome... more Mammographic density is an important risk factor for breast cancer and is known to differ in women by characteristics such as age and race/ethnicity. Women who experience longitudinal decreases in breast density have a reduced risk of breast cancer; however, besides age, which correlates with decreases in breast density, it is unclear what other factors contribute to changes in breast density over time. Understanding factors associated with density changes may enable a better understanding of breast cancer risk and potential strategies for prevention. This study investigated factors associated with changes in mammographic density in a cohort of 3,392 postmenopausal women (mean age=61.3±8.8 years) with no history of breast cancer who had at least two mammograms spaced at least three months apart at a University of California, Irvine Health breast imaging facility between 2011-2017. Self-reported information on demographics, breast and reproductive history, and lifestyle factors, incl...

Research paper thumbnail of 1476-P: Comparison of Cardiovascular Risk Factors between Type 1 and Type 2 Diabetes

Diabetes, 2019

The incidences of both T1D and T2D are increasing in the U.S., and CVD is the leading cause of de... more The incidences of both T1D and T2D are increasing in the U.S., and CVD is the leading cause of death among both cohorts. Despite differences in the underlying pathophysiology of T1D and T2D, CVD prevention approaches for T1D have been widely extrapolated from T2D studies. A few prior studies have compared CVD incidence and mortality rates between patients with T1D and T2D; however, a comparison of CVD risk factors between T1D and T2D within the same study cohort, as a measure of differences in progression to CVD events, has not been done. We thus compared CVD risk factors between patients with T1D and T2D, among U.S. adults (≥age 20) with self-reported diabetes from NHANES 1999-2016. First, we classified diabetes cases (n=5347) into T1D (n=230) and T2D (n=4677) using a treatment-based approach we developed, regardless of age at diagnosis (n=440 excluded as unassigned). Next, we compared the demographics, classical CVD risk factors and diabetes-related risk factors by diabetes type u...

Research paper thumbnail of Abstract 2599: Association of periodontal disease and breast health in women undergoing screening mammography

Cancer Research, 2016

It is well established that chronic and persistent inflammation contributes to cancer development... more It is well established that chronic and persistent inflammation contributes to cancer development. Chronic inflammation is often associated with periodontal disease, or gum disease. Periodontal disease, which can be prevented or ameliorated by following proper oral hygiene, is known to be associated with various systemic disorders including coronary heart disease and some cancers, including head and neck cancer and pancreatic cancer. However, little is known about its potential association with breast cancer, with only one report in which periodontal disease was a positive predictor for breast cancer in a Swedish cohort. To examine if a potential link exists between periodontal disease and breast cancer in a separate cohort, mammography patients from the UC Irvine Athena Breast Health Network cohort were recruited to participate in a survey that included questions about their periodontal health. Diagnosis of invasive breast cancer, DCIS, and benign breast diseases was determined thr...

Research paper thumbnail of Abstract 872: Long-term and recent recreational physical activity reduces risk of triple negative and other subtypes of invasive breast cancer in the California Teachers Study

Cancer Research, 2015

Background. Evidence has accumulated showing that physical activity reduces breast cancer risk. W... more Background. Evidence has accumulated showing that physical activity reduces breast cancer risk. Whether risk reduction pertains to all breast cancer or specific receptor-defined subtypes is unclear. Moreover, few studies have examined whether changes in the amount of physical activity during adulthood influence breast cancer risk. Methods. Among 108,907 women, ages 22 to 79 years with no history of breast cancer when they joined the California Teachers Study in 1995-1996 (baseline), 5,578 women were diagnosed with invasive breast cancer during follow-up through December, 2011. Subtypes were defined by the expression status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Cox proportional hazards models were fit to data to estimate adjusted hazard rate ratios (HRs) and 95% confidence intervals (CIs) associated with long-term and recent (within 3 years of baseline) recreational physical activity. Among 54,690 women who provide...

Research paper thumbnail of Abstract B88: Breast cancer risk factors and Gail risk score distribution in a heavily Hispanic population

Cancer Epidemiology, Biomarkers & Prevention, 2012

Background: The Athena Breast Health Network is a collaborative University of California (UC) ini... more Background: The Athena Breast Health Network is a collaborative University of California (UC) initiative, focused on providing evidence-based innovations in the screening, diagnosis and treatment of cancer, as well as changing the way patients and providers interact to prevent and manage the disease. An initial goal of the Athena project is to integrate standardized risk assessment into breast cancer screening. Women at highest cancer risk are identified and offered personalized counseling and referrals for prevention services. Previous studies have shown a difference in breast cancer risk factor distribution between Hispanics and non-Hispanic whites. This current study will describe these factors in the UC Irvine Athena cohort, a heavily Hispanic population. Methods: Between March, 2011 and July, 2012, 1,407 patients completed an electronic questionnaire at the time of their screening mammography and consented to enroll in the UC Irvine Athena Breast Health Network as a research pa...

Research paper thumbnail of Abstract PD03-09: Statins and breast cancer risk: A follow-up analysis of the Women's Health Initiative Cohort

Cancer Research, 2012

Introduction: Statins (HMG CoA reductase inhibitors) are a class of cholesterol lowering drugs th... more Introduction: Statins (HMG CoA reductase inhibitors) are a class of cholesterol lowering drugs that affect many intracellular pathways and have implications for chemopreventive activity against cancer. Epidemiological data on statins and breast cancer risk are conflicting. We analyzed updated data from the Women's Health Initiative (WHI) to assess the relationship between statins and breast cancer risk. Methods: This analysis included 154,587 post-menopausal women ages 50–79 years at baseline, in which 7,430 incident cases of invasive breast cancer were identified over an average of 10.8 (SD 3.3) years of follow-up. All cases of breast cancer were confirmed by review of medical records and pathology reports. Participants were asked to bring all current medications to their baseline visits and information on statin use was recorded. Statins were classified as lipophilic (lovastatin, simvastatin, fluvastatin) or hydrophilic (pravastatin and atorvastatin). Self and interviewer-admi...

Research paper thumbnail of Additional file 1 of Mammography screening and mortality by risk status in the California teachers study

Additional file 1: S1 Table. Baseline characteristics of 93,438 participants from California Teac... more Additional file 1: S1 Table. Baseline characteristics of 93,438 participants from California Teacher Study by age group.

Research paper thumbnail of Association of Glyphosate Exposure with Blood DNA Methylation in a Cross-Sectional Study of Postmenopausal Women

Environmental Health Perspectives, 2022

Background: Glyphosate is the most commonly used herbicide in the world and is purported to have ... more Background: Glyphosate is the most commonly used herbicide in the world and is purported to have a variety of health effects, including endocrine disruption and an elevated risk of several types of cancer. Blood DNA methylation has been shown to be associated with many other environmental exposures, but to our knowledge, no studies to date have examined the association between blood DNA methylation and glyphosate exposure. Objective: We conducted an epigenome-wide association study to identify DNA methylation loci associated with urinary glyphosate and its metabolite aminomethylphosphonic acid (AMPA) levels. Secondary goals were to determine the association of epigenetic age acceleration with glyphosate and AMPA and develop blood DNA methylation indices to predict urinary glyphosate and AMPA levels. Methods: For 392 postmenopausal women, white blood cell DNA methylation was measured using the Illumina Infinium MethylationEPIC BeadChip array. Glyphosate and AMPA were measured in two urine samples per participant using liquid chromatography–tandem mass spectrometry. Methylation differences at the probe and regional level associated with glyphosate and AMPA levels were assessed using a resampling-based approach. Probes and regions that had an false discovery rate q<0.1 in ≥90% of 1,000 subsamples of the study population were considered differentially methylated. Differentially methylated sites from the probe-specific analysis were combined into a methylation index. Epigenetic age acceleration from three epigenetic clocks and an epigenetic measure of pace of aging were examined for associations with glyphosate and AMPA. Results: We identified 24 CpG sites whose methylation level was associated with urinary glyphosate concentration and two associated with AMPA. Four regions, within the promoters of the MSH4, KCNA6, ABAT, and NDUFAF2/ERCC8 genes, were associated with glyphosate levels, along with an association between ESR1 promoter hypomethylation and AMPA. The methylation index accurately predicted glyphosate levels in an internal validation cohort. AMPA, but not glyphosate, was associated with greater epigenetic age acceleration. Discussion: Glyphosate and AMPA exposure were associated with DNA methylation differences that could promote the development of cancer and other diseases. Further studies are warranted to replicate our results, determine the functional impact of glyphosate- and AMPA-associated differential DNA methylation, and further explore whether DNA methylation could serve as a biomarker of glyphosate exposure. https://doi.org/10.1289/EHP10174

Research paper thumbnail of Abstract P5-19-01: The impact of streamlined processes and patient-directed messaging to improve enrollment in a remote, pragmatic clinical trial

Cancer Research, 2022

Background Recent advances in technology have made it possible to conduct remote clinical trials ... more Background Recent advances in technology have made it possible to conduct remote clinical trials that allow individuals to participate from home with comfort, privacy, and ease. Despite these advances, challenges persist in running remote trials, such as survey question redundancies, lack of patient-initiated data-sharing tools, and unclear patient communication around critical enrollment steps. The Women Informed to Screen Depending on Measures of risk (WISDOM) Study is a pragmatic, preference-tolerant randomized control breast cancer screening trial comparing personalized risk-based screening to traditional, annual screening. The study population includes women ages 40-74 without a history of breast cancer or DCIS. Since 2016, study enrollment has been available to all women in the U.S. who meet study eligibility criteria. Since October 2020, WISDOM has implemented multiple strategies to improve participant experience: participant-initiated data-sharing tools and clear participant...

Research paper thumbnail of Factors Associated with Women’s Unwillingness to Decrease Alcohol Intake to Decrease Breast Cancer Risk

Objective: Alcohol intake is a known risk factor for breast cancer. National organizations recomm... more Objective: Alcohol intake is a known risk factor for breast cancer. National organizations recommend that women consume no more than one serving of alcohol per day, if at all; however, many women exceed this recommendation, and some are unwilling to decrease consumption. Our study sought to identify factors associated with women’s unwillingness to decrease their alcohol intake to decrease their breast cancer risk. Methods: 942 women in a screening mammography cohort were asked questions about their demographics, personal and family health history, lifestyle factors, and willingness/unwillingness to decrease alcohol intake to decrease their breast cancer risk. Univariate and multivariate analyzes of their responses were performed. Results: 13.2% of women in our cohort indicated they were unwilling to decrease their alcohol intake to reduce their breast cancer risk. After adjusting for potential confounders, women who were 60 years and older were more than twice as unwilling to decrea...

Research paper thumbnail of NMDA receptor type 2A at 16p13 is epigenetically inactivated in human colorectal carcinoma

… of the American …, 2006

Proc Amer Assoc Cancer Res, Volume 47, 2006 56 N-methyl-D-aspartate receptors (NMDARs) are glutam... more Proc Amer Assoc Cancer Res, Volume 47, 2006 56 N-methyl-D-aspartate receptors (NMDARs) are glutamate receptors and the predominant excitatory neurotransmitter receptors in the mammalian brain. However, little is known about the role of NMDARs in human cancers. We have previously demonstrated that NMDA receptor 2B is epigenetically inactivated and exhibits tumor suppressor activity in human esophageal cancer. In this current study, we further investigated the role of NMDA receptor 2A in human primary colorectal cancers. We found that NMDA receptor 2A was epigenetically silenced in human colorectal carcinoma. Demethylating agent, 5-aza-2′-deoxycytidine could highly reactivate NMDA receptor 2A expression, despite that the normal expression of NMDA receptor 2A is undetectable in all seven colorectal carcinoma (CRC) cell lines we tested. Direct sequencing of bisulfate treated DNA from 7 CRC cell lines confirmed the promoter hypermethylation of NMDA receptor 2A in CRC cell lines. Furthermore, we analyzed NMDA receptor 2A methylation status on 100 paired normal colon and primary CRC using methylation specific quantittive PCR, and detected promoter hypermethylation in 82% of CRC and 20% of paired normal tissue, suggesting that hypermethylation of NMDA receptor 2A promoter in CRC is tumor specific. We also demonstrated that overexpression of NMDA receptor 2A in CRC cells almost abolished the ability of the cells to form colonies in culture, suggesting its tumor suppressive activity. Taken together, we conclude that NMDA receptor 2A hypermethylation is a common event and could be a potential tumor suppressor gene in CRC.

Research paper thumbnail of Mammography screening and mortality by risk status in the California teachers study

Research paper thumbnail of Abstract 3661: Association of mammographic density with blood DNA methylation

Molecular and Cellular Biology / Genetics

Research paper thumbnail of Organophosphate Pesticide Exposure and Breast Cancer Risk: A Rapid Review of Human, Animal, and Cell-Based Studies

International Journal of Environmental Research and Public Health

Background: Organophosphate pesticides (OPs) are one of the most commonly used classes of insecti... more Background: Organophosphate pesticides (OPs) are one of the most commonly used classes of insecticides in the U.S., and metabolites of OPs have been detected in the urine of >75% of the U.S. population. While studies have shown that OP exposure is associated with risk of neurological diseases and some cancers, the relationship between OP exposure and breast cancer risk is not well understood. Methods: The aim of this rapid review was to systematically evaluate published literature on the relationship between OP exposure and breast cancer risk, including both epidemiologic and laboratory studies. Twenty-seven full-text articles were reviewed by searching on Pubmed, EMBASE, and Cochrane databases. Results: Some human studies showed that malathion, terbufos, and chlorpyrifos were positively associated with human breast cancer risk, and some laboratory studies demonstrated that malathion and chlorpyrifos have estrogenic potential and other cancer-promoting properties. However, the hu...

Research paper thumbnail of Breast Cancer Risk Prediction in Korean Women: Review and Perspectives on Personalized Breast Cancer Screening

Research paper thumbnail of Epigenetic Biomarkers for Environmental Exposures and Personalized Breast Cancer Prevention

International Journal of Environmental Research and Public Health

Environmental and lifestyle factors are believed to account for >80% of breast cancers; howeve... more Environmental and lifestyle factors are believed to account for >80% of breast cancers; however, it is not well understood how and when these factors affect risk and which exposed individuals will actually develop the disease. While alcohol consumption, obesity, and hormone therapy are some known risk factors for breast cancer, other exposures associated with breast cancer risk have not yet been identified or well characterized. In this paper, it is proposed that the identification of blood epigenetic markers for personal, in utero, and ancestral environmental exposures can help researchers better understand known and potential relationships between exposures and breast cancer risk and may enable personalized prevention strategies.

Research paper thumbnail of Rationale, Study Design, and Cohort Characteristics for the Markers for Environmental Exposures (MEE) Study

International Journal of Environmental Research and Public Health

Environmental factors have been linked to many diseases and health conditions, but reliable asses... more Environmental factors have been linked to many diseases and health conditions, but reliable assessment of environmental exposures is challenging. Developing biomarkers of environmental exposures, rather than relying on self-report, will improve our ability to assess the association of such exposures with disease. Epigenetic markers, most notably DNA methylation, have been identified for some environmental exposures, but identification of markers for additional exposures is still needed. The rationale behind the Markers for Environmental Exposures (MEE) Study was to (1) identify biomarkers, especially epigenetic markers, of environmental exposures, such as pesticides, air/food/water contaminants, and industrial chemicals that are commonly encountered in the general population; and (2) support the study of potential relationships between environmental exposures and health and health-related factors. The MEE Study is a cross-sectional study with potential for record linkage and follow-...

Research paper thumbnail of Effective risk communication to promote behavioral change in patients at elevated risk for breast cancer based on the Health Belief Model

The breast journal, Jan 6, 2018

Research paper thumbnail of Beyond Serendipity to an Algorithmic Approach

Plastic and reconstructive surgery. Global open, 2018

Research paper thumbnail of Construct validation of the dietary inflammatory index among postmenopausal women

Annals of Epidemiology, Jun 1, 2015

PurposeMany dietary factors have either pro- or anti-inflammatory properties. We previously devel... more PurposeMany dietary factors have either pro- or anti-inflammatory properties. We previously developed a dietary inflammatory index (DII) to assess the inflammatory potential of diet. In this study we conducted a construct validation of the DII based on data from a food frequency questionnaire and three inflammatory biomarkers in a subsample of 2,567 postmenopausal women in the Women’s Health Initiative Observational Study.MethodsWe used multiple linear and logistic regression models, controlling for potential confounders, to test whether baseline DII predicted concentrations of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha receptor 2 (TNFα-R2), or an overall biomarker score combining all three inflammatory biomarkers.ResultsThe DII was associated with the four biomarkers with beta estimates (95%CI) comparing the highest with lowest DII quintiles as follows: IL-6: 1.26 (1.15, 1.38), Ptrend<0.0001; TNFα-R2: 81.43 (19.15, 143.71), Ptrend=0.004; dichotomized hs-CRP (odds ratio for higher versus lower hs-CRP): 1.30 (0.97, 1.67), Ptrend=0.34); and the combined inflammatory biomarker score: 0.26 (0.12, 0.40), Ptrend=0.0001.ConclusionThe DII was significantly associated with inflammatory biomarkers. Construct validity of the DII indicates its utility for assessing the inflammatory potential of diet and for expanding its use to include associations with common chronic diseases in future studies.

Research paper thumbnail of Abstract 5892: Factors associated with longitudinal changes in mammographic density in a multiethnic breast screening cohort of postmenopausal women

Cancer Research

Mammographic density is an important risk factor for breast cancer and is known to differ in wome... more Mammographic density is an important risk factor for breast cancer and is known to differ in women by characteristics such as age and race/ethnicity. Women who experience longitudinal decreases in breast density have a reduced risk of breast cancer; however, besides age, which correlates with decreases in breast density, it is unclear what other factors contribute to changes in breast density over time. Understanding factors associated with density changes may enable a better understanding of breast cancer risk and potential strategies for prevention. This study investigated factors associated with changes in mammographic density in a cohort of 3,392 postmenopausal women (mean age=61.3±8.8 years) with no history of breast cancer who had at least two mammograms spaced at least three months apart at a University of California, Irvine Health breast imaging facility between 2011-2017. Self-reported information on demographics, breast and reproductive history, and lifestyle factors, incl...

Research paper thumbnail of 1476-P: Comparison of Cardiovascular Risk Factors between Type 1 and Type 2 Diabetes

Diabetes, 2019

The incidences of both T1D and T2D are increasing in the U.S., and CVD is the leading cause of de... more The incidences of both T1D and T2D are increasing in the U.S., and CVD is the leading cause of death among both cohorts. Despite differences in the underlying pathophysiology of T1D and T2D, CVD prevention approaches for T1D have been widely extrapolated from T2D studies. A few prior studies have compared CVD incidence and mortality rates between patients with T1D and T2D; however, a comparison of CVD risk factors between T1D and T2D within the same study cohort, as a measure of differences in progression to CVD events, has not been done. We thus compared CVD risk factors between patients with T1D and T2D, among U.S. adults (≥age 20) with self-reported diabetes from NHANES 1999-2016. First, we classified diabetes cases (n=5347) into T1D (n=230) and T2D (n=4677) using a treatment-based approach we developed, regardless of age at diagnosis (n=440 excluded as unassigned). Next, we compared the demographics, classical CVD risk factors and diabetes-related risk factors by diabetes type u...

Research paper thumbnail of Abstract 2599: Association of periodontal disease and breast health in women undergoing screening mammography

Cancer Research, 2016

It is well established that chronic and persistent inflammation contributes to cancer development... more It is well established that chronic and persistent inflammation contributes to cancer development. Chronic inflammation is often associated with periodontal disease, or gum disease. Periodontal disease, which can be prevented or ameliorated by following proper oral hygiene, is known to be associated with various systemic disorders including coronary heart disease and some cancers, including head and neck cancer and pancreatic cancer. However, little is known about its potential association with breast cancer, with only one report in which periodontal disease was a positive predictor for breast cancer in a Swedish cohort. To examine if a potential link exists between periodontal disease and breast cancer in a separate cohort, mammography patients from the UC Irvine Athena Breast Health Network cohort were recruited to participate in a survey that included questions about their periodontal health. Diagnosis of invasive breast cancer, DCIS, and benign breast diseases was determined thr...

Research paper thumbnail of Abstract 872: Long-term and recent recreational physical activity reduces risk of triple negative and other subtypes of invasive breast cancer in the California Teachers Study

Cancer Research, 2015

Background. Evidence has accumulated showing that physical activity reduces breast cancer risk. W... more Background. Evidence has accumulated showing that physical activity reduces breast cancer risk. Whether risk reduction pertains to all breast cancer or specific receptor-defined subtypes is unclear. Moreover, few studies have examined whether changes in the amount of physical activity during adulthood influence breast cancer risk. Methods. Among 108,907 women, ages 22 to 79 years with no history of breast cancer when they joined the California Teachers Study in 1995-1996 (baseline), 5,578 women were diagnosed with invasive breast cancer during follow-up through December, 2011. Subtypes were defined by the expression status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Cox proportional hazards models were fit to data to estimate adjusted hazard rate ratios (HRs) and 95% confidence intervals (CIs) associated with long-term and recent (within 3 years of baseline) recreational physical activity. Among 54,690 women who provide...

Research paper thumbnail of Abstract B88: Breast cancer risk factors and Gail risk score distribution in a heavily Hispanic population

Cancer Epidemiology, Biomarkers & Prevention, 2012

Background: The Athena Breast Health Network is a collaborative University of California (UC) ini... more Background: The Athena Breast Health Network is a collaborative University of California (UC) initiative, focused on providing evidence-based innovations in the screening, diagnosis and treatment of cancer, as well as changing the way patients and providers interact to prevent and manage the disease. An initial goal of the Athena project is to integrate standardized risk assessment into breast cancer screening. Women at highest cancer risk are identified and offered personalized counseling and referrals for prevention services. Previous studies have shown a difference in breast cancer risk factor distribution between Hispanics and non-Hispanic whites. This current study will describe these factors in the UC Irvine Athena cohort, a heavily Hispanic population. Methods: Between March, 2011 and July, 2012, 1,407 patients completed an electronic questionnaire at the time of their screening mammography and consented to enroll in the UC Irvine Athena Breast Health Network as a research pa...

Research paper thumbnail of Abstract PD03-09: Statins and breast cancer risk: A follow-up analysis of the Women's Health Initiative Cohort

Cancer Research, 2012

Introduction: Statins (HMG CoA reductase inhibitors) are a class of cholesterol lowering drugs th... more Introduction: Statins (HMG CoA reductase inhibitors) are a class of cholesterol lowering drugs that affect many intracellular pathways and have implications for chemopreventive activity against cancer. Epidemiological data on statins and breast cancer risk are conflicting. We analyzed updated data from the Women's Health Initiative (WHI) to assess the relationship between statins and breast cancer risk. Methods: This analysis included 154,587 post-menopausal women ages 50–79 years at baseline, in which 7,430 incident cases of invasive breast cancer were identified over an average of 10.8 (SD 3.3) years of follow-up. All cases of breast cancer were confirmed by review of medical records and pathology reports. Participants were asked to bring all current medications to their baseline visits and information on statin use was recorded. Statins were classified as lipophilic (lovastatin, simvastatin, fluvastatin) or hydrophilic (pravastatin and atorvastatin). Self and interviewer-admi...

Research paper thumbnail of Additional file 1 of Mammography screening and mortality by risk status in the California teachers study

Additional file 1: S1 Table. Baseline characteristics of 93,438 participants from California Teac... more Additional file 1: S1 Table. Baseline characteristics of 93,438 participants from California Teacher Study by age group.

Research paper thumbnail of Association of Glyphosate Exposure with Blood DNA Methylation in a Cross-Sectional Study of Postmenopausal Women

Environmental Health Perspectives, 2022

Background: Glyphosate is the most commonly used herbicide in the world and is purported to have ... more Background: Glyphosate is the most commonly used herbicide in the world and is purported to have a variety of health effects, including endocrine disruption and an elevated risk of several types of cancer. Blood DNA methylation has been shown to be associated with many other environmental exposures, but to our knowledge, no studies to date have examined the association between blood DNA methylation and glyphosate exposure. Objective: We conducted an epigenome-wide association study to identify DNA methylation loci associated with urinary glyphosate and its metabolite aminomethylphosphonic acid (AMPA) levels. Secondary goals were to determine the association of epigenetic age acceleration with glyphosate and AMPA and develop blood DNA methylation indices to predict urinary glyphosate and AMPA levels. Methods: For 392 postmenopausal women, white blood cell DNA methylation was measured using the Illumina Infinium MethylationEPIC BeadChip array. Glyphosate and AMPA were measured in two urine samples per participant using liquid chromatography–tandem mass spectrometry. Methylation differences at the probe and regional level associated with glyphosate and AMPA levels were assessed using a resampling-based approach. Probes and regions that had an false discovery rate q<0.1 in ≥90% of 1,000 subsamples of the study population were considered differentially methylated. Differentially methylated sites from the probe-specific analysis were combined into a methylation index. Epigenetic age acceleration from three epigenetic clocks and an epigenetic measure of pace of aging were examined for associations with glyphosate and AMPA. Results: We identified 24 CpG sites whose methylation level was associated with urinary glyphosate concentration and two associated with AMPA. Four regions, within the promoters of the MSH4, KCNA6, ABAT, and NDUFAF2/ERCC8 genes, were associated with glyphosate levels, along with an association between ESR1 promoter hypomethylation and AMPA. The methylation index accurately predicted glyphosate levels in an internal validation cohort. AMPA, but not glyphosate, was associated with greater epigenetic age acceleration. Discussion: Glyphosate and AMPA exposure were associated with DNA methylation differences that could promote the development of cancer and other diseases. Further studies are warranted to replicate our results, determine the functional impact of glyphosate- and AMPA-associated differential DNA methylation, and further explore whether DNA methylation could serve as a biomarker of glyphosate exposure. https://doi.org/10.1289/EHP10174

Research paper thumbnail of Abstract P5-19-01: The impact of streamlined processes and patient-directed messaging to improve enrollment in a remote, pragmatic clinical trial

Cancer Research, 2022

Background Recent advances in technology have made it possible to conduct remote clinical trials ... more Background Recent advances in technology have made it possible to conduct remote clinical trials that allow individuals to participate from home with comfort, privacy, and ease. Despite these advances, challenges persist in running remote trials, such as survey question redundancies, lack of patient-initiated data-sharing tools, and unclear patient communication around critical enrollment steps. The Women Informed to Screen Depending on Measures of risk (WISDOM) Study is a pragmatic, preference-tolerant randomized control breast cancer screening trial comparing personalized risk-based screening to traditional, annual screening. The study population includes women ages 40-74 without a history of breast cancer or DCIS. Since 2016, study enrollment has been available to all women in the U.S. who meet study eligibility criteria. Since October 2020, WISDOM has implemented multiple strategies to improve participant experience: participant-initiated data-sharing tools and clear participant...

Research paper thumbnail of Factors Associated with Women’s Unwillingness to Decrease Alcohol Intake to Decrease Breast Cancer Risk

Objective: Alcohol intake is a known risk factor for breast cancer. National organizations recomm... more Objective: Alcohol intake is a known risk factor for breast cancer. National organizations recommend that women consume no more than one serving of alcohol per day, if at all; however, many women exceed this recommendation, and some are unwilling to decrease consumption. Our study sought to identify factors associated with women’s unwillingness to decrease their alcohol intake to decrease their breast cancer risk. Methods: 942 women in a screening mammography cohort were asked questions about their demographics, personal and family health history, lifestyle factors, and willingness/unwillingness to decrease alcohol intake to decrease their breast cancer risk. Univariate and multivariate analyzes of their responses were performed. Results: 13.2% of women in our cohort indicated they were unwilling to decrease their alcohol intake to reduce their breast cancer risk. After adjusting for potential confounders, women who were 60 years and older were more than twice as unwilling to decrea...

Research paper thumbnail of NMDA receptor type 2A at 16p13 is epigenetically inactivated in human colorectal carcinoma

… of the American …, 2006

Proc Amer Assoc Cancer Res, Volume 47, 2006 56 N-methyl-D-aspartate receptors (NMDARs) are glutam... more Proc Amer Assoc Cancer Res, Volume 47, 2006 56 N-methyl-D-aspartate receptors (NMDARs) are glutamate receptors and the predominant excitatory neurotransmitter receptors in the mammalian brain. However, little is known about the role of NMDARs in human cancers. We have previously demonstrated that NMDA receptor 2B is epigenetically inactivated and exhibits tumor suppressor activity in human esophageal cancer. In this current study, we further investigated the role of NMDA receptor 2A in human primary colorectal cancers. We found that NMDA receptor 2A was epigenetically silenced in human colorectal carcinoma. Demethylating agent, 5-aza-2′-deoxycytidine could highly reactivate NMDA receptor 2A expression, despite that the normal expression of NMDA receptor 2A is undetectable in all seven colorectal carcinoma (CRC) cell lines we tested. Direct sequencing of bisulfate treated DNA from 7 CRC cell lines confirmed the promoter hypermethylation of NMDA receptor 2A in CRC cell lines. Furthermore, we analyzed NMDA receptor 2A methylation status on 100 paired normal colon and primary CRC using methylation specific quantittive PCR, and detected promoter hypermethylation in 82% of CRC and 20% of paired normal tissue, suggesting that hypermethylation of NMDA receptor 2A promoter in CRC is tumor specific. We also demonstrated that overexpression of NMDA receptor 2A in CRC cells almost abolished the ability of the cells to form colonies in culture, suggesting its tumor suppressive activity. Taken together, we conclude that NMDA receptor 2A hypermethylation is a common event and could be a potential tumor suppressor gene in CRC.

Research paper thumbnail of Mammography screening and mortality by risk status in the California teachers study

Research paper thumbnail of Abstract 3661: Association of mammographic density with blood DNA methylation

Molecular and Cellular Biology / Genetics

Research paper thumbnail of Organophosphate Pesticide Exposure and Breast Cancer Risk: A Rapid Review of Human, Animal, and Cell-Based Studies

International Journal of Environmental Research and Public Health

Background: Organophosphate pesticides (OPs) are one of the most commonly used classes of insecti... more Background: Organophosphate pesticides (OPs) are one of the most commonly used classes of insecticides in the U.S., and metabolites of OPs have been detected in the urine of >75% of the U.S. population. While studies have shown that OP exposure is associated with risk of neurological diseases and some cancers, the relationship between OP exposure and breast cancer risk is not well understood. Methods: The aim of this rapid review was to systematically evaluate published literature on the relationship between OP exposure and breast cancer risk, including both epidemiologic and laboratory studies. Twenty-seven full-text articles were reviewed by searching on Pubmed, EMBASE, and Cochrane databases. Results: Some human studies showed that malathion, terbufos, and chlorpyrifos were positively associated with human breast cancer risk, and some laboratory studies demonstrated that malathion and chlorpyrifos have estrogenic potential and other cancer-promoting properties. However, the hu...

Research paper thumbnail of Breast Cancer Risk Prediction in Korean Women: Review and Perspectives on Personalized Breast Cancer Screening

Research paper thumbnail of Epigenetic Biomarkers for Environmental Exposures and Personalized Breast Cancer Prevention

International Journal of Environmental Research and Public Health

Environmental and lifestyle factors are believed to account for >80% of breast cancers; howeve... more Environmental and lifestyle factors are believed to account for >80% of breast cancers; however, it is not well understood how and when these factors affect risk and which exposed individuals will actually develop the disease. While alcohol consumption, obesity, and hormone therapy are some known risk factors for breast cancer, other exposures associated with breast cancer risk have not yet been identified or well characterized. In this paper, it is proposed that the identification of blood epigenetic markers for personal, in utero, and ancestral environmental exposures can help researchers better understand known and potential relationships between exposures and breast cancer risk and may enable personalized prevention strategies.

Research paper thumbnail of Rationale, Study Design, and Cohort Characteristics for the Markers for Environmental Exposures (MEE) Study

International Journal of Environmental Research and Public Health

Environmental factors have been linked to many diseases and health conditions, but reliable asses... more Environmental factors have been linked to many diseases and health conditions, but reliable assessment of environmental exposures is challenging. Developing biomarkers of environmental exposures, rather than relying on self-report, will improve our ability to assess the association of such exposures with disease. Epigenetic markers, most notably DNA methylation, have been identified for some environmental exposures, but identification of markers for additional exposures is still needed. The rationale behind the Markers for Environmental Exposures (MEE) Study was to (1) identify biomarkers, especially epigenetic markers, of environmental exposures, such as pesticides, air/food/water contaminants, and industrial chemicals that are commonly encountered in the general population; and (2) support the study of potential relationships between environmental exposures and health and health-related factors. The MEE Study is a cross-sectional study with potential for record linkage and follow-...

Research paper thumbnail of Effective risk communication to promote behavioral change in patients at elevated risk for breast cancer based on the Health Belief Model

The breast journal, Jan 6, 2018

Research paper thumbnail of Beyond Serendipity to an Algorithmic Approach

Plastic and reconstructive surgery. Global open, 2018