2011

The incidence of estrogen receptor negative (ER-) breast cancer, an aggressive form of breast cancer, is greater in African American women than in other American women. Research has been devoted to identifying genetic polymorphisms associated with this subtype of breast cancer that could explain the ethnic difference.  In a collaborative analysis that included data from several studies, a polymorphism at the TERT-CLPTM1L locus was associated with ER- breast cancer in both African ancestry and European ancestry women.  link to online article

Black women have a higher incidence of uterine fibroids (leiomyomata) than women in other racial/ethnic groups. In an assessment of dietary factors, the incidence of uterine fibroids in BWHS participants was lower in women who had the highest intake of fruits.  Fruits have many good health effects and BWHS data suggest that one of them may be a reduction in the risk of developing fibroids.  link to online article

The incidence of colon cancer has been lower in regular aspirin users than nonusers in some studies, raising the possibility that aspirin may also be associated with reduced risk of other cancers.  We found a lower incidence of breast cancer in BWHS participants who used aspirin regularly than in nonusers, but there was also a lower incidence among women who regularly used drugs containing acetaminophen; there is no accepted mechanism for the latter finding.  Results from other studies have been inconsistent and a beneficial effect of aspirin on breast cancer risk remains uncertain.  link to online article

Very large studies of white Americans have established that the risk of death increases with increasing levels of body mass index (a combined measure of weight and height that measures overall obesity). It was unclear if this pattern applied to African Americans because the studies carried out had been small and results were inconsistent. Results from the BWHS have now removed the uncertainty. The risk of death in the BWHS increased as body mass index increased, and women who were most obese had the highest risk. There was also evidence of higher risk for women with a large waist circumference (which is a marker of abdominal obesity).  The strongest association was with death from heart disease. Weight reduction would be expected to reduce the risk. link to online article

Not all breast cancers are the same. There are several subtypes, some of which are more aggressive and difficult to treat than others.  Estrogen receptor (ER) negative breast cancer is one such aggressive subtype and it occurs more commonly among African American women. We found that BWHS participants with more children had a higher risk of ER-negative breast cancer than participants with fewer children if they had not breastfed.  If women had breast fed, there was no increase in risk. These findings suggest that breast feeding may lead to a reduction in the risk of ER-negative breast cancer. link to online article

Many genetic variants may be associated with breast cancer occurrence, but the increases in risk for most variants are so small that very large studies are needed to identify them.  The BWHS collaborated with eight other epidemiologic studies of African American women for this purpose; DNA samples from 3,016 cases of breast cancer and 2,745 comparison women were genotyped. This study confirmed the importance of several genetic regions for breast cancer in African American women. Further work is needed to further refine exactly which genetic variants are involved and to understand their functions. link to online article

Systemic lupus erythematosus (lupus) is an auto-immune disease. We assessed genetic variants on an area of a chromosome, the major histocompatibility complex, which has been associated with other auto-immune diseases.  Based on 380 cases of lupus and twice as many comparison women unaffected by lupus, we found that three genetic variants that had been identified in studies of Chinese and European-ancestry women were associated with lupus in the BWHS. We also identified four new genetic variants.  Investigation of the functions of these genetic variants should shed light on how lupus develops. link to online article

Vitamins and herbal preparations are widely used. Among BWHS participants who are breast cancer survivors, more than half reported use of a multivitamin and close to 40% had taken at least one herbal supplement. The most commonly used herbals were garlic, gingko, and echinacea. link to online article

Colorectal adenomas are noncancerous growths in the colon and rectum that often precede the development of colorectal cancer. Preventing adenomas would result reduced risk of developing cancer. Based on 620 cases of colorectal adenomas among BWHS participants, we found that the risk of colorectal adenoma was lower among women who had a high score for a “prudent” dietary pattern, also known as the vegetable/fruit pattern, than among women with a low score. In addition, the risk was greater in women who had a high score on the “western” food pattern, also known as the meat/fried foods pattern, than among women with a low score. These results are yet another reason to try to increase fruits and vegetables and reduce  meats and fried foods in our diets. link to online article

Researchers have identified many genes that are associated with increased risk of developing specific diseases. Yet these genes explain only a small part of the variability in disease incidence and they are poor predictors of disease occurrence. This paper proposes a theory that may explain why these genes are poor predictors and describes how the theory can be tested. link to online article

Two patterns of dietary consumption have emerged from analyses of food consumption data provided by BWHS participants — a vegetable/fruit pattern, which is high in fruits, vegetables, legumes, fish, and whole grains, and a meat/fried foods pattern, which is high in red meat, processed meat, French fries, fried chicken, and added fat. BWHS participants who had a high score for the vegetable/fruit dietary pattern gained less weight during 14 years of follow-up than women who had a low score on that pattern, and women with a high score on the meat/fried foods pattern gained more weight than those with a lower score. Thus, BWHS data indicate that a vegetable/fruit pattern is effective for reducing weight gain. link to online article

Glaucoma is a leading cause of blindness worldwide and it occurs more commonly among African Americans. Periodic eye examinations are important because the condition can be treated effectively if caught early. Based on 366 confirmed cases of primary open angle glaucoma in the BWHS, we found that glaucoma occurred more commonly among women with type 2 diabetes and was also associated with alcohol consumption. Among women less than 50 years of age, risk was greater among obese women, drinkers, and smokers. If confirmed, these results indicate that women can reduce their risk of developing glaucoma by weight control and limiting alcohol consumption and smoking. link to online article

Abuse victimization during childhood and the teenage years reported by BWHS participants was not related to the incidence of breast cancer during follow-up from 1995 to 2009.  However, there was a small increase in the incidence of breast cancer among women who reported having been physically abused in adulthood. The BWHS is the very first study to report this association and it requires confirmation in other studies. link to online article

Studies of the genetic causes of a particular disease compare genetic variants in people with the disease (“cases”) to those in people without the disease (“controls”).  If, for example, variant A of a gene is present in 50% of cases and just 25% of controls, this suggests that the gene could be involved as a cause of the disease.  The results of these studies can be biased if the cases and controls have different ancestry unrelated to developing the disease. Based on BWHS data, we showed that genotyping 30 selected genetic variants in cases and controls will allow for avoiding this type of bias. link to online article

We obtained information on the “urban form” of neighborhoods in New York City, Chicago, and Los Angeles in which BWHS participants lived from 1995-2001.  The neighborhoods ranged from auto-oriental sprawling areas in which walking to get to a store or transportation is difficult, to urban areas with many interconnected streets and access to public transportation. We found that women who lived in more urban areas gained less weight than those who lived in more sprawling suburban and rural areas. link to online article

Sarcoidosis is a systemic granulomatous disorder whose causes are unknown. The illness occurs more frequently among African American women than other Americans. During follow-up through 2007, 435 BWHS participants reported having been newly diagnosed with sarcoidosis. The diagnosis was confirmed for 96% of the cases for which medical record data were obtained. The site most frequently affected was the lung, and the most commonly used medication was prednisone. Outside of the lung, the most commonly affected sites were the lymph nodes, skin, and eyes.  We will continue to identify new cases of sarcoidosis as follow-up continues and will assess risk factors for the illness. link to online article