Browsing by Author "Duggan, M.A."
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Item Data Set for the Reporting of Carcinomas of the Cervix: Recommendations from the International Collaboration on Cancer Reporting (ICCR)(International Journal of Gynecological Pathology, 2017-07) McCluggage, W.G.; Judge, M.J.; Alvarado-Cabrero, I.; Duggan, M.A.; Horn, L.-C.; Hui, P.; Ordi, J.; Otis, C.N.; Park, K.J.; Plante, M.; Stewart, C.J.R.; Wiredu, E.K.; Rous, B.; Hirschowitz, L.A comprehensive pathologic report is essential for optimal patient management, cancer staging and prognostication. In many countries, proforma reports are used but the content of these is variable. The International Collaboration on Cancer Reporting is an alliance formed by the Royal Colleges of Pathologists of Australasia and the United Kingdom, the College of American Pathologists, the Canadian Partnership Against Cancer and the European Society of Pathology, for the purpose of developing standardized, evidence-based reporting data sets for each cancer site. This will reduce the global burden of cancer data set development and reduplication of effort by different international institutions that commission, publish and maintain standardized cancer-reporting data sets. The resultant standardization of cancer-reporting benefits not only those countries directly involved in the collaboration but also others not in a position to develop their own data sets. We describe the development of an evidence-based cancer data set by the International Collaboration on Cancer Reporting expert panel for the reporting of primary cervical carcinomas and present the "required" and "recommended" elements to be included in the pathology report as well as an explanatory commentary. This data set encompasses the International Federation of Obstetricians and Gynaecologists and Union for International Cancer Control staging systems for cervical neoplasms and the updated World Health Organization classification of gynecologic tumors. The data set also addresses controversial issues such as tumor grading and measurement, including measurement of multifocal carcinomas. The widespread implementation of this data set will facilitate consistent and accurate data collection, comparison of epidemiological and pathologic parameters between different populations, facilitate research, and hopefully result in improved patient management.Item Reproductive factors and risk of breast cancer by tumor subtypes among Ghanaian women: A population-based case–control study(International Journal of Cancer, 2020-02-18) Clegg-Lamptey, J-N.; Figueroa, J.D.; Lynn, B.C.D.; Edusei, L.; Titiloye, N.; Adjei, E.; Yarney, J.; Wiafe-Addai, B.; Awuah, B.; Duggan, M.A.; Wiafe, S.; Nyarko, K.; Aitpillah, F.; Ansong, D.; Hewitt, S.M.; Ahearn, T.; Garcia-Closas, M.; Brinton, L.A.; Ghana Breast Health Study TeamHigher proportions of early-onset and estrogen receptor (ER) negative cancers are observed in women of African ancestry than in women of European ancestry. Differences in risk factor distributions and associations by age at diagnosis and ER status may explain this disparity. We analyzed data from 1,126 cases (aged 18–74 years) with invasive breast cancer and 2,106 controls recruited from a population-based case–control study in Ghana. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for menstrual and reproductive factors using polytomous logistic regression models adjusted for potential confounders. Among controls, medians for age at menarche, parity, age at first birth, and breastfeeding/pregnancy were 15 years, 4 births, 20 years and 18 months, respectively. For women ≥50 years, parity and extended breastfeeding were associated with decreased risks: >5 births vs. nulliparous, OR 0.40 (95% CI 0.20–0.83) and 0.71 (95% CI 0.51–0.98) for ≥19 vs. <13 breastfeeding months/pregnancy, which did not differ by ER. In contrast, for earlier onset cases (<50 years) parity was associated with increased risk for ER-negative tumors (p-heterogeneity by ER = 0.02), which was offset by extended breastfeeding. Similar associations were observed by intrinsic-like subtypes. Less consistent relationships were observed with ages at menarche and first birth. Reproductive risk factor distributions are different from European populations but exhibited etiologic heterogeneity by age at diagnosis and ER status similar to other populations. Differences in reproductive patterns and subtype heterogeneity are consistent with racial disparities in subtype distributions.