Publications by authors named "Ruth Pfeiffer"

Introduction/aim: Patients with myotonic dystrophy type1 (DM1) have reduced lifespan. This study aimed to quantify mortality risks, and evaluate causes and time trends in DM1.

Methods: We identified 1021 DM1 patients and 15,104 matched DM1-free controls from the United Kingdom (UK) Clinical Practice Research Datalink.

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Purpose: Inflammatory breast cancer (IBC) is a rare and aggressive type of breast cancer, as many physicians may not be aware of it in terms of symptoms and diagnosis. Mammography is the first choice in breast screenings and diagnosis. Because of a lack of expertise and imaging datasets, IBC portrayal and machine learning-based diagnosis systems have not yet been studied thoroughly.

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Importance: Merkel cell carcinoma (MCC) is a rare but aggressive skin cancer. Quantifying the contribution of major potentially modifiable risk factors to the burden of MCC may inform prevention efforts.

Objective: To estimate the population attributable fraction of MCC cases in the US that were attributable to major immunosuppressing conditions (eg, HIV, solid organ transplant, chronic lymphocytic leukemia [CLL]), ambient UV radiation [UVR] exposure, and Merkel cell polyomavirus [MCPyV]).

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Background: Cancer risk among people with HIV (PWH) has declined over time as a result of antiretroviral therapy, but it is unclear whether all racial/ethnic groups and transmission risk groups have experienced equal declines.

Methods: We used data on PWH aged ≥20 years old from the HIV/AIDS Cancer Match Study during 2001-2019. We used Poisson regression to assess time trends in incidence rates for each cancer site by racial/ethnicity and risk group, adjusting for age, registry, and sex.

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Background: While female survivors of Hodgkin lymphoma (HL) have an increased risk of breast cancer (BC), no BC risk prediction model is available. We developed such models incorporating mean radiation dose to the breast or breast quadrant-specific radiation doses.

Methods: Relative risks and age-specific incidence for BC and competing events (mortality or other subsequent cancer) were estimated from 1194 Dutch five-year HL survivors, treated at ages 11-40 during 1965-2000.

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Article Synopsis
  • * A study involving 82 patients with gallbladder dysplasia and 1843 with gallstones found that NSAID use was inversely associated with gallbladder dysplasia, suggesting lower risk for users (OR: 0.48).
  • * Eight immune-related proteins showed an inverse association with dysplasia, indicating that further research is needed to explore the role of inflammation and NSAIDs in gallbladder health, ideally in future studies involving asymptomatic individuals.
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Background: Understanding factors associated with opioid dispensing in cancer patients is important for developing tailored guidelines and ensuring equitable access to pain management. We examined patterns and predictors of opioid dispensing among older cancer patients from 2008 to 2015.

Methods: We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database linked to Medicare claims.

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Solid organ transplant recipients (SOTRs) have a heightened risk of adverse coronavirus disease 2019 (COVID-19) outcomes because of immunosuppression and medical comorbidity. We quantified the burden of COVID-19 mortality in United States (US) SOTRs. A sample of deaths documented in the US solid organ transplant registry from June 2020 through December 2022 was linked to the National Death Index to identify COVID-19 deaths and weighted to represent all SOTR deaths during the study period.

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  • * A total of 17 studies involving 287,576 survivors were included, showing a significant reduction in CBC risk associated with endocrine therapy (RR: 0.62) without variation in effectiveness based on study design.
  • * The therapy was particularly effective for estrogen receptor (ER)-positive CBC, reducing risk significantly (RR: 0.55), but showed no benefit for ER-negative CBC (RR: 1.26), indicating the need for tailored treatment approaches.
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  • A study was conducted in 16 towns in China to assess the impact of screening for nasopharyngeal carcinoma (NPC) on mortality rates, comparing a screening group to a control group without intervention.
  • Residents aged 30-69 participated in serum tests for Epstein-Barr virus (EBV) antibodies, and follow-ups were conducted up to December 2019.
  • Results showed a significant 30% reduction in NPC-specific mortality in the screening group, particularly in participants aged 50 and older, indicating that NPC screening can improve survival outcomes.
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Background: Shorter duration therapy for hepatitis C virus (HCV) infection might reduce treatment costs and increase the number of patients treated and cured. We determined factors associated with treatment response after an 8-week sofosbuvir-based therapy and developed a simple model to predict an individual's likelihood of treatment success.

Methods: Among 2907 patients who received ledipasvir/sofosbuvir for 8 weeks, we determined failure rates by demographic and clinical characteristics, and IFNL4-∆G/TT genotype.

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A previous cancer diagnosis can preclude patients from consideration for solid organ transplantation. Statistical models may improve candidate selection. We fitted statistical cure models and estimated 5-year cancer-specific survival (5yCSS) for colorectal cancer patients in the United States using registry data.

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Background: Ultraviolet radiation (UVR) exposure is the primary risk factor for melanoma, although the relationship is complex. Compared with radiation from UVB wavelengths, UVA makes up a majority of the surface solar UVR, penetrates the skin more deeply, is the principal range emitted by tanning beds, and is less filtered by sunscreens and window glass. Few studies have examined the relationship between ambient UVA and UVB and melanoma risk.

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  • Epstein-Barr virus (EBV) is linked to classical Hodgkin lymphoma (cHL), but the role of antibodies against EBV in cHL patients isn't fully understood, prompting a study to investigate this connection.
  • Researchers conducted a custom protein microarray study comparing antibody responses in EBV-positive cHL patients from East Asia with healthy controls, discovering a specific antibody profile unique to this population.
  • The study found that a majority of these antibodies were also associated with cHL in a separate European population, indicating that certain EBV antibodies may serve as reliable biomarkers for EBV-positive cHL across different demographics.
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  • Immunosuppressed individuals, such as those with HIV and solid organ transplant recipients, face a higher risk of developing certain cancers, prompting a study to identify specific cancer types associated with these conditions.* -
  • Researchers analyzed cancer registry data in the U.S., finding a total of 38,047 cancer cases among organ transplant recipients and 53,592 among individuals with HIV, with elevated standardized incidence ratios of 1.66 and 1.49 respectively.* -
  • Specific cancers, like conjunctival squamous cell carcinoma, showed significantly higher risks in both populations, while others, such as sebaceous adenocarcinoma, were particularly heightened in solid organ transplant recipients, emphasizing the need for awareness and monitoring in these
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Background: Evidence continues to accumulate regarding the potential long-term health consequences of COVID-19 in the population. To distinguish between COVID-19-related symptoms and health limitations from those caused by other conditions, it is essential to compare cases with community controls using prospective data ensuring case-control status. The RESPIRA study addresses this need by investigating the lasting impact of COVID-19 on Health-related Quality of Life (HRQoL) and symptomatology in a population-based cohort in Costa Rica, thereby providing a robust framework for controlling HRQoL and symptoms.

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  • Statins have been thought to lower the risk of gallstones due to their anti-inflammatory properties, but this study specifically looked at their effects on inflammation in Chilean women with gallstones.
  • Researchers analyzed 400 women (200 with statin use and 200 without) to see if statins influenced 92 different inflammatory biomarkers.
  • The results showed no significant links between statin use and inflammation markers, indicating that statins do not effectively reduce inflammation after gallstones have developed.
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  • The study aimed to assess how tubal ligation and hysterectomy might affect hormone levels in postmenopausal women, focusing on androgens and estrogens, using data from the Women's Health Initiative.
  • Researchers analyzed blood samples from 920 women, with findings showing no significant differences in hormone levels based on tubal ligation status, but significant changes for those who had a hysterectomy, which resulted in lower testosterone and higher estrogen metabolite levels.
  • The study concluded that while tubal ligation does not appear to affect postmenopausal hormone levels, hysterectomy correlates with notable hormonal changes that could influence risks for hormone-related diseases in the future.*
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  • Thyroid cancer is more prevalent in women, particularly those of reproductive age, and a study examined potential links between hormone levels and the risk of developing papillary thyroid cancer during pregnancy.
  • The research involved 605 women diagnosed with papillary thyroid cancer and 1,185 matched controls, analyzing various thyroid and hormone markers from early-pregnancy blood samples.
  • Findings revealed that higher levels of thyroid peroxidase (TPO-Ab) and thyroglobulin antibodies (Tg-Ab) significantly correlated with increased odds of papillary thyroid cancer, while no significant links were found with other hormone levels, suggesting that thyroid autoimmunity in early pregnancy may elevate cancer risk.
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Our work was motivated by the question whether, and to what extent, well-established risk factors mediate the racial disparity observed for colorectal cancer (CRC) incidence in the United States. Mediation analysis examines the relationships between an exposure, a mediator and an outcome. All available methods require access to a single complete data set with these three variables.

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Introduction: Benign breast disease (BBD) and high mammographic breast density (MBD) are prevalent and independent risk factors for invasive breast cancer. It has been suggested that temporal changes in MBD may impact future invasive breast cancer risk, but this has not been studied among women with BBD.

Methods: We undertook a nested case-control study within a cohort of 15,395 women with BBD in Kaiser Permanente Northwest (KPNW; 1970-2012, followed through mid-2015).

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Background: Opioid safety initiatives may secondarily impact opioid prescribing and pain outcomes for cancer care.

Methods: We reviewed electronic health record data at a tertiary Veterans Affairs system (VA Palo Alto) for all patients from 2015 to 2021. We collected outpatient Schedule II opioid prescriptions data and calculated morphine milligram equivalents (MMEs) using Centers for Disease Control and Prevention conversion formulas.

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We compared methods to project absolute risk, the probability of experiencing the outcome of interest in a given projection interval accommodating competing risks, for a person from the target population with missing predictors. Without missing data, a perfectly calibrated model gives unbiased absolute risk estimates in a new target population, even if the predictor distribution differs from the training data. However, if predictors are missing in target population members, a reference dataset with complete data is needed to impute them and to estimate absolute risk, conditional only on the observed predictors.

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Background: Previous work in European ancestry populations has shown that adding a polygenic risk score (PRS) to breast cancer risk prediction models based on epidemiologic factors results in better discriminatory performance as measured by the AUC (area under the curve). Following publication of the first PRS to perform well in women of African ancestry (AA-PRS), we conducted an external validation of the AA-PRS and then evaluated the addition of the AA-PRS to a risk calculator for incident breast cancer in Black women based on epidemiologic factors (BWHS model).

Methods: Data from the Black Women's Health Study, an ongoing prospective cohort study of 59,000 US Black women followed by biennial questionnaire since 1995, were used to calculate AUCs and 95% confidence intervals (CIs) for discriminatory accuracy of the BWHS model, the AA-PRS alone, and a new model that combined them.

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Lewy body dementia is the second most common neurodegenerative dementia after Alzheimer's disease. Disease-modifying therapies for this disabling neuropsychiatric condition are critically needed. To identify drugs associated with the risk of developing Lewy body dementia, we performed a population-based case-control study of 148 170 US Medicare participants diagnosed with Lewy body dementia between 1 January 2008 and 31 December 2014 and of 1 253 043 frequency-matched controls.

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