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Occurrence of Endocrine and Thyroid Cancers Among Alaska Native People, 1969-2013.

https://arctichealth.org/en/permalink/ahliterature289759
Source
Thyroid. 2018 Apr; 28(4):481-487
Publication Type
Journal Article
Date
Apr-2018
Author
Sarah H Nash
Anne P Lanier
Molly B Southworth
Author Affiliation
1 Alaska Native Tumor Registry, Alaska Native Epidemiology Center , Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, Alaska.
Source
Thyroid. 2018 Apr; 28(4):481-487
Date
Apr-2018
Language
English
Publication Type
Journal Article
Abstract
Nationwide, the incidence of thyroid cancer is lower among American Indian/Alaska Native (AI/AN) people than among U.S. whites (USW). However, little is known about the incidence of thyroid or other endocrine cancers specifically among Alaska Native (AN) people.
Data were examined from the National Cancer Institute's Surveillance, Epidemiology, and End Results Alaska Native Tumor Registry on endocrine cancers diagnosed among AN people from 1969-2013, with a specific focus on thyroid cancers. Frequencies of endocrine cancers by site and also of thyroid cancers by histology, size, and stage at diagnosis were evaluated. Distributions were compared to USW (Surveillance, Epidemiology, and End Results 9 Registries) using the chi-square test. Five-year average annual age-adjusted incidence rates of thyroid cancers were calculated, stratified by histology, age, and five-year period of diagnosis, and compared to those observed among USW. Five-year cause-specific survival was evaluated using cause of death data from the National Death Index Plus from the National Center for Health Statistics.
During the 45-year period (1969-2013), 224 endocrine cancers were diagnosed among AN people, of which 210 (94%) were thyroid cancers. Compared to USW, AN people were diagnosed at a slightly younger age, had a higher proportion of thyroid cancers diagnosed with a size of 20-40?mm, and a larger proportion of patients with regional metastases. More than 85% of AN thyroid cancers were of papillary histology. The incidence of thyroid cancers was similar between AN people and USW, and appeared to increase among AN people over the period of surveillance. Finally, five-year cause-specific survival rate was 100% for papillary carcinoma patients and 86.3% [confidence interval 54.7-96.5] for follicular thyroid cancer patients.
This study is the first report of endocrine cancers and the first detailed examination of thyroid cancer among AN people. The incidence of thyroid cancer was similar among AN people and USW. However, compared to USW, AN people appear to be at risk for diagnosis at a younger age, larger size, and higher stage. Further research is needed to explore the causes of these differences.
Notes
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PubMed ID
29439613 View in PubMed
Less detail

Occurrence of Endocrine and Thyroid Cancers Among Alaska Native People, 1969-2013.

https://arctichealth.org/en/permalink/ahliterature297521
Source
Thyroid. 2018 04; 28(4):481-487
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Date
04-2018
Author
Sarah H Nash
Anne P Lanier
Molly B Southworth
Author Affiliation
1 Alaska Native Tumor Registry, Alaska Native Epidemiology Center , Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, Alaska.
Source
Thyroid. 2018 04; 28(4):481-487
Date
04-2018
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Keywords
Adrenal Gland Neoplasms - ethnology
Adult
Aged
Alaska Natives
Female
Humans
Incidence
Male
Middle Aged
Parathyroid Neoplasms - ethnology
Pituitary Neoplasms - ethnology
Registries
Thyroid Neoplasms - ethnology
United States
Abstract
Nationwide, the incidence of thyroid cancer is lower among American Indian/Alaska Native (AI/AN) people than among U.S. whites (USW). However, little is known about the incidence of thyroid or other endocrine cancers specifically among Alaska Native (AN) people.
Data were examined from the National Cancer Institute's Surveillance, Epidemiology, and End Results Alaska Native Tumor Registry on endocrine cancers diagnosed among AN people from 1969-2013, with a specific focus on thyroid cancers. Frequencies of endocrine cancers by site and also of thyroid cancers by histology, size, and stage at diagnosis were evaluated. Distributions were compared to USW (Surveillance, Epidemiology, and End Results 9 Registries) using the chi-square test. Five-year average annual age-adjusted incidence rates of thyroid cancers were calculated, stratified by histology, age, and five-year period of diagnosis, and compared to those observed among USW. Five-year cause-specific survival was evaluated using cause of death data from the National Death Index Plus from the National Center for Health Statistics.
During the 45-year period (1969-2013), 224 endocrine cancers were diagnosed among AN people, of which 210 (94%) were thyroid cancers. Compared to USW, AN people were diagnosed at a slightly younger age, had a higher proportion of thyroid cancers diagnosed with a size of 20-40?mm, and a larger proportion of patients with regional metastases. More than 85% of AN thyroid cancers were of papillary histology. The incidence of thyroid cancers was similar between AN people and USW, and appeared to increase among AN people over the period of surveillance. Finally, five-year cause-specific survival rate was 100% for papillary carcinoma patients and 86.3% [confidence interval 54.7-96.5] for follicular thyroid cancer patients.
This study is the first report of endocrine cancers and the first detailed examination of thyroid cancer among AN people. The incidence of thyroid cancer was similar among AN people and USW. However, compared to USW, AN people appear to be at risk for diagnosis at a younger age, larger size, and higher stage. Further research is needed to explore the causes of these differences.
PubMed ID
29439613 View in PubMed
Less detail

Timeliness of Breast Cancer Treatment Within The Alaska Tribal Health System.

https://arctichealth.org/en/permalink/ahliterature286495
Source
J Rural Health. 2017 Oct 14;
Publication Type
Article
Date
Oct-14-2017
Author
Stacy F Kelley
Gretchen M Day
Christine A DeCourtney
Sarah H Nash
Source
J Rural Health. 2017 Oct 14;
Date
Oct-14-2017
Language
English
Publication Type
Article
Abstract
This study examined the time from breast cancer diagnosis to initiation of treatment among Alaska Native (AN) women. We evaluated the impact of age, cancer stage, and rural/urban residence at diagnosis.
We evaluated characteristics of women recorded in the Alaska Native Tumor Registry who received a first diagnosis of breast cancer between 2009 and 2013. Median time from diagnosis to treatment was assessed. Associations of demographic and clinical characteristics with timely initiation of treatment were evaluated using logistic regression and Cox proportional hazards models.
Two hundred seventy-eight (278) AN women were diagnosed with invasive breast cancer in years 2009-2013. Mean age at diagnosis was 56.8 years (SD = 13.0). The median time from diagnosis to initiation of treatment was 23 days (P
PubMed ID
29030951 View in PubMed
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Agreement between self-reported and central cancer registry-recorded prevalence of cancer in the Alaska EARTH study.

https://arctichealth.org/en/permalink/ahliterature297981
Source
Int J Circumpolar Health. 2019 Dec; 78(1):1571383
Publication Type
Journal Article
Date
Dec-2019
Author
Sarah H Nash
Gretchen Day
Vanessa Y Hiratsuka
Garrett L Zimpelman
Kathryn R Koller
Author Affiliation
a Alaska Native Tumor Registry, Alaska Native Epidemiology Center, Community Health Services , Alaska Native Tribal Health Consortium , Anchorage , AK , USA.
Source
Int J Circumpolar Health. 2019 Dec; 78(1):1571383
Date
Dec-2019
Language
English
Publication Type
Journal Article
Abstract
Reliance on self-reported health status information as a measure of population health can be challenging due to errors associated with participant recall. We sought to determine agreement between self-reported and registry-recorded site-specific cancer diagnoses in a cohort of Alaska Native people. We linked cancer history information from the Alaska Education and Research Towards Health (EARTH) cohort and the Alaska Native Tumor Registry (ANTR), and calculated validity measures (sensitivity, specificity, positive predictive value, negative predictive value, kappa). Multiple logistic regression models were used to assess independent associations of demographic variables with incorrect reporting. We found that among Alaska EARTH participants, 140 self-reported a history of cancer, and 99 matched the ANTR. Sensitivity ranged from 79% (colorectal cancer) to 100% (prostate cancer); specificity was over 98% for all-sites examined. Kappa was higher among prostate and female breast cancers (?=0.86) than colorectal cancers (?=0.63). Women (odds ratio [OR] (95% confidence interval [CI]): 2.8 (1.49-5.31)) and participants who were older than 50 years (OR (95% CI): 2.8 (1.53-4.12)) were more likely to report incorrectly. These data showed good agreement between self-reported and registry-recorded cancer history. This may be attributed to the high quality of care within the Alaska Tribal Health System, which strongly values patient-provider relationships and the provision of culturally appropriate care.
PubMed ID
30724720 View in PubMed
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Cancer survival among Alaska Native people.

https://arctichealth.org/en/permalink/ahliterature290828
Source
Cancer. 2018 Jun 15; 124(12):2570-2577
Publication Type
Journal Article
Date
Jun-15-2018
Author
Sarah H Nash
Angela L W Meisner
Garrett L Zimpelman
Marc Barry
Charles L Wiggins
Author Affiliation
Alaska Native Tumor Registry, Alaska Native Epidemiology Center, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, Alaska.
Source
Cancer. 2018 Jun 15; 124(12):2570-2577
Date
Jun-15-2018
Language
English
Publication Type
Journal Article
Abstract
Recent cancer survival trends among American Indian and Alaska Native (AN) people are not well understood; survival has not been reported among AN people since 2001.
This study examined cause-specific survival among AN cancer patients for lung, colorectal, female breast, prostate, and kidney cancers. It evaluated whether survival differed between cancers diagnosed in 1992-2002 (the earlier period) and cancers diagnosed in 2003-2013 (the later period) and by the age at diagnosis (
PubMed ID
29579335 View in PubMed
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Stable isotope models of sugar intake using hair, red blood cells, and plasma, but not fasting plasma glucose, predict sugar intake in a Yup'ik study population.

https://arctichealth.org/en/permalink/ahliterature106303
Source
J Nutr. 2014 Jan;144(1):75-80
Publication Type
Article
Date
Jan-2014
Author
Sarah H Nash
Alan R Kristal
Scarlett E Hopkins
Bert B Boyer
Diane M O'Brien
Author Affiliation
Center for Alaska Native Health Research, Institute of Arctic Biology, and.
Source
J Nutr. 2014 Jan;144(1):75-80
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska
Beverages
Biological Markers - blood
Blood Glucose - chemistry
Body mass index
Carbohydrates - blood
Carbon Isotopes - blood
Diet
Erythrocytes - chemistry
Fasting - blood
Female
Hair - chemistry
Humans
Linear Models
Male
Middle Aged
Models, Theoretical
Nitrogen Isotopes - blood
Nutrition Assessment
Obesity - blood - etiology
Questionnaires
Young Adult
Abstract
Objectively measured biomarkers will help to resolve the controversial role of sugar intake in the etiology of obesity and related chronic diseases. We recently validated a dual-isotope model based on RBC carbon (d(13)C) and nitrogen (d(15)N) isotope ratios that explained a large percentage of the variation in self-reported sugar intake in a Yup'ik study population. Stable isotope ratios can easily be measured from many tissues, including RBCs, plasma, and hair; however, it is not known how isotopic models of sugar intake compare among these tissues. Here, we compared self-reported sugar intake with models based on RBCs, plasma, and hair d(13)C and d(15)N in Yup'ik people. We also evaluated associations of sugar intake with fasting plasma glucose d(13)C. Finally, we evaluated relations between d(13)C and d(15)N values in hair, plasma, RBCs, and fasting plasma glucose to allow comparison of isotope ratios across tissue types. Models using RBCs, plasma, or hair isotope ratios explained similar amounts of variance in total sugar, added sugar, and sugar-sweetened beverage intake (~53%, 48%, and 34%, respectively); however, the association with d(13)C was strongest for models based on RBCs and hair. There were no associations with fasting plasma glucose d(13)C (R(2) = 0.03). The d(13)C and d(15)N values of RBCs, plasma, and hair showed strong, positive correlations; the slopes of these relations did not differ from 1. This study demonstrates that RBC, plasma, and hair isotope ratios predict sugar intake and provides data that will allow comparison of studies using different sample types.
PubMed ID
24198311 View in PubMed
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The carbon isotope ratio of alanine in red blood cells is a new candidate biomarker of sugar-sweetened beverage intake.

https://arctichealth.org/en/permalink/ahliterature114464
Source
J Nutr. 2013 Jun;143(6):878-84
Publication Type
Article
Date
Jun-2013
Author
Kyungcheol Choy
Sarah H Nash
Alan R Kristal
Scarlett Hopkins
Bert B Boyer
Diane M O'Brien
Author Affiliation
Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, USA.
Source
J Nutr. 2013 Jun;143(6):878-84
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alanine - blood
Alaska
Beverages - adverse effects
Biological Markers - blood
Body mass index
Carbon Isotopes - blood
Diet
Dietary Sucrose - administration & dosage - adverse effects
Erythrocytes - chemistry
Female
Hair - chemistry
Humans
Male
Middle Aged
Obesity - etiology
Sweetening Agents - adverse effects
Abstract
An objective dietary biomarker would help clarify the contribution of sugar-sweetened beverage (SSB) intake to obesity and chronic disease risk. Previous studies have proposed the carbon isotope ratio (d(13)C) as a biomarker of SSB intake but found associations that were of modest size and confounded by other components of the diet. We investigated whether the d(13)C values of nonessential amino acids (d(13)CNEAA) in RBCs could provide valid biomarkers that are more specific to SSBs. We assessed the associations of RBC d(13)CNEAA with SSB intake in a study population of 68 Yup'ik people, using gas chromatography/combustion/isotope ratio mass spectrometry to measure d(13)CNEAA and four 24-h dietary recalls to assess intake. Among RBC nonessential amino acids, alanine d(13)C (d(13)Calanine) was strongly correlated with intake of SSBs, added sugar, and total sugar (r = 0.70, 0.59, and 0.57, respectively; P
Notes
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Comment In: J Nutr. 2013 Jun;143(6):763-523616500
PubMed ID
23616504 View in PubMed
Less detail

Carbon and nitrogen stable isotope ratios predict intake of sweeteners in a Yup'ik study population.

https://arctichealth.org/en/permalink/ahliterature117895
Source
J Nutr. 2013 Feb;143(2):161-5
Publication Type
Article
Date
Feb-2013
Author
Sarah H Nash
Alan R Kristal
Andrea Bersamin
Scarlett E Hopkins
Bert B Boyer
Diane M O'Brien
Author Affiliation
Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska-Fairbanks, AK, USA. shnash@alaska.edu
Source
J Nutr. 2013 Feb;143(2):161-5
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska
Beverages - analysis
Biological Markers - blood
Carbon Isotopes
Diet - ethnology
Erythrocytes - metabolism
Female
Humans
Indians, North American
Male
Middle Aged
Models, Biological
Nitrogen Isotopes
Nutrition Assessment
Sweetening Agents - administration & dosage - analysis
Young Adult
Abstract
The carbon isotope ratio (d¹³C) is elevated in corn- and cane sugar-based foods and has recently shown associations with sweetener intake in multiple U.S. populations. However, a high carbon isotope ratio is not specific to corn- and sugar cane-based sweeteners, as other foods, including meats and fish, also have elevated d¹³C. This study examines whether the inclusion of a second marker, the nitrogen isotope ratio (d¹5N), can control for confounding dietary effects on d¹³C and improve the validity of isotopic markers of sweetener intake. The study participants are from the Yup'ik population of southwest Alaska and consume large and variable amounts of fish and marine mammals known to have elevated carbon and nitrogen isotope ratios. Sixty-eight participants completed 4 weekly 24-h recalls followed by a blood draw. RBC d¹³C and d¹5N were used to predict sweetener intake, including total sugars, added sugars, and sugar-sweetened beverages. A model including both d¹³C and d¹5N explained more than 3 times as much of the variation in sweetener intake than did a model using only d¹³C. Because carbon and nitrogen isotope ratios are simultaneously determined in a single, high-throughput analysis, this dual isotope marker provides a simple method to improve the validity of stable isotope markers of sweetener intake with no additional cost. We anticipate that this multi-isotope approach will have utility in any population where a stable isotope biomarker is elevated in several food groups and there are appropriate "covariate" isotopes to control for intake of foods not of research interest.
Notes
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PubMed ID
23256142 View in PubMed
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Relation between stable isotope ratios in human red blood cells and hair: implications for using the nitrogen isotope ratio of hair as a biomarker of eicosapentaenoic acid and docosahexaenoic acid.

https://arctichealth.org/en/permalink/ahliterature147682
Source
Am J Clin Nutr. 2009 Dec;90(6):1642-7
Publication Type
Article
Date
Dec-2009
Author
Sarah H Nash
Alan R Kristal
Bert B Boyer
Irena B King
Jordan S Metzgar
Diane M O'Brien
Author Affiliation
Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK 99775-7000, USA.
Source
Am J Clin Nutr. 2009 Dec;90(6):1642-7
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Biological Markers
Docosahexaenoic Acids - administration & dosage
Eicosapentaenoic Acid - administration & dosage
Erythrocytes - metabolism
Female
Hair - metabolism
Humans
Male
Middle Aged
Nitrogen Isotopes - metabolism
Abstract
The nitrogen isotope ratio (expressed as delta(15)N) of red blood cells (RBCs) is highly correlated with the RBC long-chain omega-3 (n-3) fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in Yup'ik Eskimos. Because delta(15)N can also be measured in hair samples, it could provide a noninvasive, retrospective biomarker for EPA and DHA intakes.
We investigated the agreement between delta(15)N in hair and RBCs and then evaluated the relations between hair delta(15)N and RBC EPA and DHA. We also assessed the agreement in carbon isotope ratios (delta(13)C) between hair and RBCs, because delta(13)C has been proposed as a dietary biomarker in other populations.
We assessed relations between hair and RBC delta(15)N and delta(13)C in a community-based sample of 144 Yup'ik Eskimos and examined the correlations between delta(15)N and RBC EPA and DHA in a subset of these participants (n = 44).
We showed a 1:1 relation with good agreement between hair and RBC delta(15)N (r = 0.91) and delta(13)C (r = 0.87). Hair isotope ratios were greater than RBC ratios by 1.5 per thousand for delta(15)N and by 2.3 per thousand for delta(13)C. There were strong correlations between hair delta(15)N and RBC EPA and DHA (r = 0.83 and 0.84, respectively).
These results support the use of hair delta(15)N values as a biomarker of EPA and DHA intakes. Because hair collection is noninvasive and the samples require no special processing, studies of EPA and DHA intakes in large populations could use biomarkers rather than self-reports to assess these fatty acids.
Notes
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PubMed ID
19864410 View in PubMed
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A stable isotope biomarker of marine food intake captures associations between n-3 fatty acid intake and chronic disease risk in a Yup'ik study population, and detects new associations with blood pressure and adiponectin.

https://arctichealth.org/en/permalink/ahliterature104817
Source
J Nutr. 2014 May;144(5):706-13
Publication Type
Article
Date
May-2014
Author
Diane M O'Brien
Alan R Kristal
Sarah H Nash
Scarlett E Hopkins
Bret R Luick
Kimber L Stanhope
Peter J Havel
Bert B Boyer
Author Affiliation
Center for Alaska Native Health Research, Institute of Arctic Biology, and.
Source
J Nutr. 2014 May;144(5):706-13
Date
May-2014
Language
English
Publication Type
Article
Keywords
Adiponectin - blood
Adolescent
Adult
Alaska - epidemiology
Biological Markers - metabolism
Blood pressure
Chronic Disease
Cross-Sectional Studies
Eating
Fatty Acids, Omega-3 - administration & dosage
Female
Humans
Hypertension - ethnology - metabolism
Incidence
Inuits - statistics & numerical data
Male
Metabolic Diseases - ethnology - metabolism
Middle Aged
Nitrogen Isotopes - diagnostic use
Obesity - ethnology - metabolism
Risk factors
Seafood
Young Adult
Abstract
The nitrogen isotope ratio (d(15)N) of RBCs has been proposed as a biomarker of marine food intake in Yup'ik people based on strong associations with RBC eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). However, EPA and DHA derive from marine fats, whereas elevated d(15)N derives from marine protein, and these dietary components may have different biologic effects. Whether d(15)N is similarly associated with chronic disease risk factors compared with RBC EPA and DHA is not known. We used covariate-adjusted linear models to describe biomarker associations with chronic disease risk factors in Yup'ik people, first in a smaller (n = 363) cross-sectional study population using RBC EPA, DHA, and d(15)N, and then in a larger (n = 772) cross-sectional study population using d(15)N only. In the smaller sample, associations of RBC EPA, DHA, and d(15)N with obesity and chronic disease risk factors were similar in direction and significance: d(15)N was positively associated with total, HDL, and LDL cholesterol, apolipoprotein A-I, and insulin-like growth factor binding protein-3 (IGFBP-3), and inversely associated with triglycerides. Based on comparisons between covariate-adjusted ?-coefficients, EPA was more strongly associated with circulating lipids and lipoproteins, whereas d(15)N was more strongly associated with adipokines, the inflammatory marker interleukin-6, and IGFBP-3. In the larger sample there were new findings for this population: d(15)N was inversely associated with blood pressure and there was a significant association (with inverse linear and positive quadratic terms) with adiponectin. In conclusion, d(15)N is a valid measure for evaluating associations between EPA and DHA intake and chronic disease risk in Yup'ik people and may be used in larger studies. By measuring d(15)N, we report beneficial associations of marine food intake with blood pressure and adiponectin, which may contribute to a lower incidence of some chronic diseases in Yup'ik people.
PubMed ID
24598880 View in PubMed
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