Journal of the National Cancer Institute
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J. Natl. Cancer Inst. · Dec 2007
Multicenter StudyProjecting individualized absolute invasive breast cancer risk in African American women.
The Breast Cancer Risk Assessment Tool of the National Cancer Institute (NCI) is widely used for counseling and determining eligibility for breast cancer prevention trials, although its validity for projecting risk in African American women is uncertain. We developed a model for projecting absolute risk of invasive breast cancer in African American women and compared its projections with those from the Breast Cancer Risk Assessment Tool. ⋯ The CARE model usually gave higher risk estimates for African American women than the Breast Cancer Risk Assessment Tool and is recommended for counseling African American women regarding their risk of breast cancer.
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J. Natl. Cancer Inst. · Dec 2007
Association of diet-induced hyperinsulinemia with accelerated growth of prostate cancer (LNCaP) xenografts.
Prior research suggested that energy balance and fat intake influence prostate cancer progression, but the influence of dietary carbohydrate on prostate cancer progression has not been well characterized. We hypothesized that hyperinsulinemia resulting from high intake of refined carbohydrates would lead to more rapid growth of tumors in the murine LNCaP xenograft model of prostate cancer. ⋯ A diet high in refined carbohydrates is associated with increased tumor growth and with activation of signaling pathways distal to the insulin receptor in a murine model of prostate cancer.
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J. Natl. Cancer Inst. · Nov 2007
Multicenter StudyPredicting risk of breast cancer in postmenopausal women by hormone receptor status.
Strategies for estrogen receptor (ER)-positive breast cancer risk reduction in postmenopausal women require screening of large populations to identify those with potential benefit. We evaluated and attempted to improve the performance of the Breast Cancer Risk Assessment Tool (i.e., the Gail model) for estimating invasive breast cancer risk by receptor status in postmenopausal women. ⋯ In postmenopausal women, the Gail model identified populations at increased risk for ER-positive but not ER-negative breast cancers. A model with fewer variables appears to provide a simpler approach for screening for breast cancer risk.
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J. Natl. Cancer Inst. · Nov 2007
CommentStatistical methods for analyzing sequentially randomized trials.
In this issue of the Journal, Thall et al. present the results of a clinical trial that makes use of sequential randomization, a novel trial design that allows the investigator to study adaptive treatment strategies. Our aim is to complement this groundbreaking work by reviewing the current state of the art of statistical methods available for such analyses. Using the data collected by Thall et al. as an example, we focus on two different approaches for estimating the success rates of different adaptive treatment strategies of interest. By emphasizing the intuitive appeal and straightforward implementation of these methods and illustrating the striking findings to which these methods can lead, we hope to convince the reader that this novel trial design provides a rich source of information that is made readily accessible through current analytical approaches.