Kathy J Helzlsouer's research while affiliated with Johns Hopkins Bloomberg School of Public Health and other places
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Publications (389)
Objective
Evaluate the association between cancer incidence and immunosuppressive treatment in patients with ocular inflammatory disease (OID).
Methods and analysis
We performed a retrospective cohort study of patients from 10 US OID subspecialty practices. Patients with non-infectious OID were included; HIV-infected patients were excluded. Time-d...
Objective:
To determine the incidence of all-cause and cancer mortality in association with immunosuppression.
Design:
Retrospective cohort study at ocular inflammatory disease (OID) subspecialty centers. We harvested exposure and covariate data retrospectively from clinic inception (earliest in 1979) through 2010 inclusive. Then we ascertained...
Purpose:
Genetic testing is a tool used in a variety of settings for medical and nonhealth related purposes. The goal of this analysis was to better understand the awareness and use of genetic testing in the United States.
Methods:
Data from the 2020 Health Information National Trends Survey 5 cycle 4 were used to assess the awareness and use of...
Strategic planning is conducted by many organizations to systematically evaluate and assess their current state, establish or update their mission and/or goals, and identify strategies and activities to achieve the goals. The National Cancer Institute (NCI) Cohort Consortium is a collaborative network of 62 prospective cohort studies and their affi...
Background:
Whether circulating polyunsaturated fatty acids (PUFA) levels are associated with pancreatic cancer risk is uncertain. Mendelian randomization (MR) represents a study design using genetic instruments to better characterize the relationship between exposure and outcome.
Methods:
We utilized data from genome-wide association studies wi...
Background:
While the primary role of central cancer registries in the United States is to provide vital information needed for cancer surveillance and control, these registries can also be leveraged for population-based epidemiologic studies of cancer survivors. This study was undertaken as a pilot project to assess the feasibility of using the N...
Background:
Although 20 pancreatic cancer susceptibility loci have been identified through genome-wide association studies (GWAS) in individuals of European ancestry, much of its heritability remains unexplained and the genes responsible largely unknown.
Methods:
To discover novel pancreatic cancer risk loci and possible causal genes, we perform...
Background:
TAILORx demonstrated that women with node-negative, hormone receptor-positive, HER2-negative breast cancers and Oncotype DX recurrence scores (RS) of 0-25 had similar 9-year outcomes with endocrine vs chemo-endocrine therapy; evidence for women aged 50 years and younger and RS 16-25 was less clear. We estimated how expected changes in...
The National Cancer Institute (NCI) sponsored a 2-day workshop, “Next Steps in Studying the Human Microbiome and Health in Prospective Studies,” in Bethesda, Maryland, May 16–17, 2017. The workshop brought together researchers in the field to discuss the challenges of conducting microbiome studies, including study design, collection and processing...
Previous prospective studies assessing the relationship between circulating concentrations of vitamin D and prostate cancer risk have shown inconclusive results, particularly for risk of aggressive disease. In this study, we examine the association between prediagnostic concentrations of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,...
In 2020, 146,063 deaths due to pancreatic cancer are estimated to occur in Europe and the United States combined. To identify common susceptibility alleles, we performed the largest pancreatic cancer GWAS to date, including 9040 patients and 12,496 controls of European ancestry from the Pancreatic Cancer Cohort Consortium (PanScan) and the Pancreat...
In 2020, 146,063 deaths due to pancreatic cancer are estimated to occur in Europe and theUnited States combined. To identify common susceptibility alleles, we performed the largest pancreatic cancer GWAS to date, including 9040 patients and 12,496 controls of European ancestry from the Pancreatic Cancer Cohort Consortium (PanScan) and the Pancreati...
Background:
In many countries, there are growing numbers of persons living with a prior diagnosis of cancer, due to the aging population and more successful strategies for treatment. There is also growing evidence of the importance of healthful diet and weight management for survivorship, yet many long-term cancer survivors are not successfully fo...
Animal and experimental data suggest that anti-Müllerian hormone (AMH) serves as a marker of ovarian reserve and inhibits the growth of ovarian tumors. However, few epidemiologic studies have examined the association between AMH and ovarian cancer risk. We conducted a nested case-control study of 302 ovarian cancer cases and 336 matched controls fr...
PurposeThe objective of this study was to examine the associations between aromatase inhibitors (AIs) and side effects less frequently reported in the literature, including difficulty concentrating, forgetfulness, hair loss, and numbness in the extremities. Methods
Data were analyzed from a cohort of 146 breast cancer patients initiating AI therapy...
Background:
The Mullerian ducts are the embryological precursors of the female reproductive tract, including the uterus; anti-Mullerian hormone (AMH) has a key role in the regulation of foetal sexual differentiation. Anti-Mullerian hormone inhibits endometrial tumour growth in experimental models by stimulating apoptosis and cell cycle arrest. To...
Kelly K Filipski, John D Murphy, Kathy J Helzlsouer Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA Abstract: Pharmacogenomics has identified important drug–gene interactions that affect the safety and efficacy of medications. Direct-to-consumer genetic te...
e21619
Background: Hair loss and thinning have been reported by breast cancer patients treated with aromatase inhibitors (AIs); these side effects are documented to be reasons that patients discontinue their AI therapy and have been shown to be associated with a decrease in quality of life. Despite this knowledge, there is a paucity of detailed dat...
Genome wide association studies (GWAS) have mapped multiple independent cancer susceptibility loci to chr5p15.33. Here, we show that fine-mapping of pancreatic and testicular cancer GWAS within one of these loci (Region 2 in CLPTM1L) focuses the signal to nine highly correlated SNPs. Of these, rs36115365-C associated with increased pancreatic and t...
PurposeBiologic evidence suggests that the Insulin-like growth factor (IGF)-family may be involved in the etiology of epithelial invasive ovarian cancer (EOC). However, prospective studies investigating the role of IGF-I in ovarian carcinogenesis have yielded conflicting results. Methods
We pooled and harmonized data from 6 case–control studies nes...
Background:
Relationships between fruit, vegetable, and mature bean consumption and prostate cancer risk are unclear.
Methods:
We examined associations between fruit and vegetable groups, specific fruits and vegetables, and mature bean consumption and prostate cancer risk overall, by stage and grade, and for prostate cancer mortality in a pooled...
Invasive epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy. The etiology of EOC remains elusive; however, experimental and epidemiologic data suggest a role for hormone-related exposures in ovarian carcinogenesis and risk factor differences by histologic phenotypes and developmental pathways. Research on pre-diagnosis androg...
Objective:
To identify reproductive, lifestyle, hormonal, and other correlates of circulating antimüllerian hormone (AMH) concentrations in mostly late premenopausal women.
Design:
Cross-sectional study.
Setting:
Not applicable.
Patient(s):
A total of 671 premenopausal women not known to have cancer.
Intervention(s):
None.
Main outcome me...
![Figure 1. Odds ratios (95% confidence intervals [CIs]) of prostate...](publication/304994299/figure/fig3/AS:381384779681794@1467940625958/Odds-ratios-95-confidence-intervals-CIs-of-prostate-cancer-associated-with-fifths-of_Q320.jpg)
![Figure 2. Study-specific odds ratios (95% confidence intervals [CIs])...](publication/304994299/figure/fig1/AS:381384779681792@1467940625805/Study-specific-odds-ratios-95-confidence-intervals-CIs-of-prostate-cancer-per-80th_Q320.jpg)
![Figure 3. Odds ratios (95% confidence intervals [CIs]) of prostate...](publication/304994299/figure/fig2/AS:381384779681793@1467940625878/Odds-ratios-95-confidence-intervals-CIs-of-prostate-cancer-associated-with-an-80th_Q320.jpg)
Background
Some observational studies suggest that a higher selenium status is associated with a lower risk of prostate cancer but have been generally too small to provide precise estimates of associations, particularly by disease stage and grade.
Methods
Collaborating investigators from 15 prospective studies provided individual-participant recor...
The purpose of this study was to compare the cardiovascular health of Black and White breast cancer patients undergoing adjuvant treatment. Baseline data from a cohort study of Black (n = 45) and White (n = 101) breast cancer patients initiating aromatase inhibitor treatment were analyzed. Participants had a cardiovascular health assessment, includ...
Genome-wide association studies (GWAS) have identified common pancreatic cancer susceptibility variants at 13 chromosomal loci in individuals of European descent. To identify new susceptibility variants, we performed imputation based on 1000 Genomes (1000G) Project data and association analysis using 5,107 case and 8,845 control subjects from 27 co...
Cognitive impairment following treatment is a common complaint among breast cancer patients. Commonly affected cognitive domains include executive level functioning, working and verbal memory, concentration and information processing. A feasibility study was conducted to evaluate the ability to recruit for a choral-based music therapy intervention...
The role of insulin-like growth factors (IGFs) in prostate cancer development is not fully understood. To investigate the association between circulating concentrations of IGFs (IGF-I, IGF-II, IGFBP-1, IGFBP-2, IGFBP-3) and prostate cancer risk, we pooled individual participant data from 17 prospective and two cross-sectional studies, including up...
Background:
The present study examined racial differences in the cardiovascular health effects of aromatase inhibitors.
Patients and methods:
Data were analyzed from 77 white and 35 black patients with early-stage breast cancer initiating aromatase inhibitor therapy and subsequently followed for 1 year. At baseline and a 1-year follow-up clinic...
Background: Studies of related individuals have consistently demonstrated notable familial aggregation of cancer. We aim to estimate
the heritability and genetic correlation attributable to the additive effects of common single-nucleotide polymorphisms (SNPs)
for cancer at 13 anatomical sites.
Background:
Individual studies have suggested that circulating carotenoids, retinol, or tocopherols may be associated with prostate cancer risk, but the studies have not been large enough to provide precise estimates of associations, particularly by stage and grade of disease.
Objective:
The objective of this study was to conduct a pooled analys...
Background:
Body mass index (BMI), a measure of obesity typically assessed in middle age or later, is known to be positively associated with pancreatic cancer. However, little evidence exists regarding the influence of central adiposity, a high BMI during early adulthood, and weight gain after early adulthood on pancreatic cancer risk.
Design:
W...
The association between prediagnostic interleukin-6 (IL-6) concentrations and risk of colorectal cancer was evaluated in a nested case-control study and a meta-analysis of prospective studies.
Colorectal cancer cases (n = 173) and matched controls (n = 345) were identified between 1989 and 2000 among participants in the CLUE II cohort of Washington...
To examine whether the addition of narrow band imaging (NBI) to traditional white light during laparoscopic surgery impacts pain and quality of life (QOL) at 3- and 6-months post-surgery among women with suspected endometriosis and/or infertility.
Randomized controlled trial.
Level I: Evidence obtained from a properly designed, randomized, controll...
Evidence on the association between vitamin D status and pancreatic cancer risk is inconsistent. This inconsistency may be partially attributable to variation in vitamin D regulating genes. We selected 11 vitamin D-related genes (GC, DHCR7, CYP2R1, VDR, CYP27B1, CYP24A1, CYP27A1, RXRA, CRP2, CASR and CUBN) totaling 213 single nucleotide polymorphis...
Breast cancer survivors commonly experience fatigue, but family-focused interventions as a means to reduce fatigue are understudied. This qualitative study explored the experience of adding a family component to a multi-modal group intervention for fatigue. Data were collected from group observations, in-depth interviews, and debriefing sessions wi...
The primary objective of the study was to evaluate the ability of narrow band imaging (NBI) in conjunction with standard white light imaging to improve the detection and diagnosis of endometriosis during laparoscopic evaluation compared to white light imaging alone. Sensitivity of NBI in detecting endometriosis was assessed and compared to white li...
Purpose. The goal of this study was to examine differences in physical functioning limitations among African-American and white breast cancer survivors. Methods. Data were analyzed from 724 African-American and 116 white breast cancer survivors who responded to a hospital registry-based survey. Physical functioning limitations were assessed using a...
Objective. To examine clinical care providers' perspectives on cancer survivors' body size and weight management. Study Design. In-depth, semi-structured, qualitative interviews. Methods. Interviews were conducted with 33 providers (eg. oncologists, surgeons, primary care providers, nurses, dietitians) across academic and community clinical setting...
Evidence on the association between vitamin D status and pancreatic cancer risk is inconsistent. This inconsistency may be partially attributable to variation in vitamin D regulating genes. We selected 11 vitamin D-related genes (GC, DHCR7, CYP2R1, VDR, CYP27B1, CYP24A1, CYP27A1, RXRA, CRP2, CASR and CUBN) totaling 213 single nucleotide polymorphis...
Purpose: Breast cancer patients may have poor outcomes due to the toxic effects of breast cancer treatments in the presence of co-morbid conditions. Thus, it is hypothesized that racial disparities in breast cancer outcomes are, in part, related to a higher prevalence of certain co-morbid conditions prior to treatment among black compared to white...
Epidemiological studies have examined breast cancer risk in relation to sex hormone concentrations measured by different methods: "extraction" immunoassays (with prior purification by organic solvent extraction, with or without column chromatography), "direct" immunoassays (no prior extraction or column chromatography), and more recently with mass...
BACKGROUND
Chronic inflammation and obesity may contribute to the genesis or progression of benign prostatic hyperplasia (BPH) and BPH-associated lower urinary tract symptoms (LUTS). The influence of variants in genes related to these states on BPH has not been studied extensively. Thus, we evaluated the association of 17 single nucleotide polymorp...
Purpose:
Although cancer is often thought of as a teachable moment, many cancer survivors do not adhere to behavioral recommendations that might improve their health. This study explored health care providers' perspectives on the importance and feasibility of addressing behavior change, specifically healthy diet, with cancer survivors.
Methods:...
Objective
This study aims to examine the associations between musculoskeletal pain and health-related quality of life (HR-QOL) among breast cancer patients on aromatase inhibitors (AIs) and women without a history of breast cancer.
Methods
A cross-sectional study was conducted among 68 breast cancer patients on AIs for an average of 3.5 years an...
John Cunningham virus (JCV) is a common polyomavirus classified as a possible carcinogen by the International Agency for Research on Cancer. JCV may play a role in colorectal carcinogenesis, although we previously reported no association between JCV capsid antibodies and colorectal cancer (CRC). No studies have examined the role of seroreactivity t...
We performed a multistage genome-wide association study including 7,683 individuals with pancreatic cancer and 14,397 controls of European descent. Four new loci reached genome-wide significance: rs6971499 at 7q32.3 (LINC-PINT, per-allele odds ratio (OR) = 0.79, 95% confidence interval (CI) 0.74-0.84, P = 3.0 × 10(-12)), rs7190458 at 16q23.1 (BCAR1...
Context:
Cholinesterase (ChE) specific activity is the ratio of ChE activity to ChE mass and, as a biomarker of exposure to cholinesterase inhibitors, has a potential advantage over simple ChE activity.
Objective:
To examine the association of several potential correlates (serum arylesterase/paraoxonase activity, serum albumin, sex, age, month o...
The goal of this study was to examine differences in physical functioning limitations among African-American and white breast cancer survivors.
Data were analyzed from 115 African-American and 712 white breast cancer survivors who responded to a hospital registry-based survey. Physical functioning limitations were assessed using a series of eight q...
The objective of this study was to examine the associations between aromatase inhibitor therapy and hair loss or hair thinning among female breast cancer survivors. Data were analyzed from 851 female breast cancer survivors who responded to a hospital registry-based survey. Data on hair loss, hair thinning, demographic characteristics, and health h...
As of June 2012, there were approximately 13.7 million U.S. cancer survivors, of which 64% have survived five or more years post-diagnosis. Cancer survivors are at increased risk of cancer recurrence, a second incidence of cancer, development of other chronic diseases. Survivors also report poorer health than adults who have not had cancer. Interve...
We developed an absolute risk model to identify individuals in the general population at elevated risk of pancreatic cancer.
Using data on 3,349 cases and 3,654 controls from the PanScan Consortium, we developed a relative risk model for men and women of European ancestry based on non-genetic and genetic risk factors for pancreatic cancer. We estim...
Improvements in the prognosis of cancer patients attributable to advances in early detection and treatment have resulted in a large number of cancer survivors who are living longer lives. There are approximately 11.7 million cancer survivors in the United States, of whom 64% survive five or more years post-diagnosis. Cancer survivors are at increas...
Proceedings: AACR 104th Annual Meeting 2013; Apr 6-10, 2013; Washington, DC
Background: Fragmented care, limited psychosocial support, and poor symptom management plague some women with breast cancer, especially those with low income, leading to poor health outcomes among disadvantaged groups. To address these disparities a “virtual” navigator sys...
Purpose:
Musculoskeletal pain is a common side effect of aromatase inhibitors (AIs), the adjuvant hormonal treatment of choice for postmenopausal estrogen-receptor-positive breast cancer. Although the pain is usually attributed to the estrogen depletion associated with AIs, not all women on AIs experience these symptoms. Thus, the goal of this stu...
Background
Estrogen receptor-negative (ER(-)) breast cancer has few known or modifiable risk factors. Because ER(-) tumors account for only 15% to 20% of breast cancers, large pooled analyses are necessary to evaluate precisely the suspected inverse association between fruit and vegetable intake and risk of ER(-) breast cancer.Methods
Among 993 466...
Cancer is a broad term for many disparate diseases with different etiologies, commonly classified by affected organ site. This review summarizes the published evidence from prospective cohort studies examining the associations between vitamin D, measured as serum 25-hydroxyvitamin D (25OHD) concentrations, and the risk of rarer cancer sites includi...
Background
Carotenoids, micronutrients in fruits and vegetables, may reduce breast cancer risk. Most, but not all, past studies of circulating carotenoids and breast cancer have found an inverse association with at least one carotenoid, although the specific carotenoid has varied across studies.Methods
We conducted a pooled analysis of eight cohort...
Background and objective:
Survival of patients with pancreatic adenocarcinoma is limited and few prognostic factors are known. We conducted a two-stage genome-wide association study (GWAS) to identify germline variants associated with survival in patients with pancreatic adenocarcinoma.
Methods:
We analysed overall survival in relation to single...
Leisure time physical activity and hazard ratio of mortality according to age at baseline.
(DOCX)
Forest plot of association between leisure time physical activity and mortality: 15.0–22.4 MET-h/wk versus 0.0 MET-h/wk. HRs are indicated by the box, and the size of the box is inversely proportional to the variance of the log HR estimate in each cohort. The lines show the 95% CIs. Models are adjusted for gender, alcohol consumption (0, 0.1–14.9,...
Multivariate hazard ratios of mortality in relation to joint categories of physical activity level and body mass index among healthy never smokers. HRs are shown for participants aged 40 y or older with no history of smoking, heart disease, or cancer and with a BMI of at least 18.5 kg/m2 (n = 236,828; deaths = 16,074). The bars indicate the HRs for...
Hazard ratios of mortality in relation to joint categories of physical activity level and body mass index. HRs are shown for participants aged 40 y or older who had a BMI of at least 18.5 kg/m2 (n = 632,091; deaths = 80,767). The bars indicate the HRs for each joint category, and the vertical lines are the 95% CIs. The reference category is normal...
Years of life expectancy lost after age 40 in relation to joint categories of physical activity level and body mass index among healthy never smokers. Years of life expectancy gained/lost according to level of physical activity and BMI are shown for participants aged 40 y or older with no history of smoking, heart disease, or cancer and with a BMI...
Leisure time physical activity and hazard ratios of mortality. In this figure, the line is a natural cubic spline [28] showing the shape of the dose–response curve for the association between physical activity and risk of mortality. HRs are indicated by the solid line, and 95% CIs by the dashed lines. The reference point is 0.0 MET-h/wk, with knots...
Forest plot of association between leisure time physical activity and mortality: 0.1–3.74 MET-h/wk versus 0.0 MET-h/wk. HRs are indicated by the box, and the size of the box is inversely proportional to the variance of the log HR estimate in each cohort. The lines show the 95% CIs. Models are adjusted for gender, alcohol consumption (0, 0.1–14.9, 1...
Forest plot of association between leisure time physical activity and mortality: 3.75–7.4 MET-h/wk versus 0.0 MET-h/wk. HRs are indicated by the box, and the size of the box is inversely proportional to the variance of the log HR estimate in each cohort. The lines show the 95% CIs. Models are adjusted for gender, alcohol consumption (0, 0.1–14.9, 1...
Forest plot of association between leisure time physical activity and mortality: 7.5–14.9 MET-h/wk versus 0.0 MET-h/wk. HRs are indicated by the box, and the size of the box is inversely proportional to the variance of the log HR estimate in each cohort. The lines show the 95% CIs. Models are adjusted for gender, alcohol consumption (0, 0.1–14.9, 1...