Browsing by Author "Ferreccio, C"
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- ItemArsenic exposure from drinking water and birth weight(LIPPINCOTT WILLIAMS & WILKINS, 2003) Hopenhayn, C; Ferreccio, C; Browning, SR; Huang, B; Peralta, C; Gibb, H; Hertz Picciotto, IBackground: Arsenic exposures front drinking water increase the risk of various cancers and noncancer health endpoints. Limited evidence suggests that arsenic may have adverse human reproductive effects. We investigated the association between drinking water arsenic exposure and fetal growth, as manifest in birth weight.
- ItemArsenic-related cancer mortality in Northern Chile, 1989-98(LIPPINCOTT WILLIAMS & WILKINS, 2004) Bates, M; Marshall, G; Ferreccio, C; Smith, A
- ItemArsenic-related chromosomal alterations in bladder cancer(2002) Moore, LE; Smith, AH; Eng, C; Kalman, D; DeVries, S; Bhargava, V; Chew, K; Moore, D; Ferreccio, C; Rey, OA; Waldman, FMBackground: Previous studies have demonstrated that ingestion of arsenic in drinking water is a strong risk factor for several forms of cancer, including bladder cancer. It is not known whether arsenic-related cancers are genetically similar to cancers in unexposed individuals or what mechanisms of carcinogenesis may underlie their formation. This study was designed to compare chromosomal alterations in bladder cancers of arsenic-exposed individuals to provide insight into the mechanism of how arsenic may induce or promote cancer. Methods: A case-case study was conducted in Argentina and Chile examining chromosomal alterations in bladder tumor DNA in 123 patients who had been exposed to arsenic in their drinking water. Patients were placed into one of four arsenic exposure categories according to their average 5-year peak arsenic exposure. Patients were also classified as ever smokers or never smokers. Comparative genomic hybridization was used to identify chromosomal alterations throughout the genome. All statistical tests were two-sided. Results: The total number of chromosomal alterations was higher in individuals exposed to higher arsenic levels (5.7 +/- 5.1, 5.6 +/- 5.1, 7.3 +/- 7.4, and 9.1 +/- 6.5 [mean standard deviation] chromosomal alterations per tumor with increasing arsenic exposure; P-trend = .02, adjusted for stage and grade). The trend was stronger in high-grade (G2-G3) tumors (6.3 +/- 5.5, 8.3 +/- 4.7, 10.3 +/- 7.8, and 10.5 +/- 6.4 alterations per tumor; P-trend = .01) than it was in low-grade (G1) tumors (3.5 +/- 3.1, 1.1 +/- 1.1, 2.5 +/- 2.5, and 3.6 +/- 3.2 alterations per tumor; P-trend = .79). The mean number of chromosomal alterations also increased with tumor stage and grade (P-trend<.001) independently of arsenic exposure but was not associated with smoking history. Deletion of part or all of chromosome 17p (P-trend<.001) showed the strongest association with arsenic exposure. Conclusions: Bladder tumors in patients with higher levels of arsenic exposure showed higher levels of chromosomal instability. Most of the chromosomal alterations associated with arsenic exposure were also associated with tumor stage and grade, raising the possibility that bladder tumors from arsenic-exposed patients may behave more aggressively than tumors from unexposed patients.
- ItemChildhood exposure to arsenic in water in Chile and increased mortality from chronic pulmonary disease(LIPPINCOTT WILLIAMS & WILKINS, 2005) Smith, AH; Marshall, G; Yuan, Y; Ferreccio, C; Liaw, J; von Ehrenstein, O; Steinmaus, C
- ItemChronic arsenic exposure and risk of infant mortality in two areas of Chile(2000) Hopenhayn-Rich, C; Browning, SR; Hertz-Picciotto, I; Ferreccio, C; Peralta, C; Gibb, HChronic arsenic exposure has been associated with a range of neurologic, vascular, dermatologic, and carcinogenic effects. However, limited research has been directed at the association of arsenic exposure and human reproductive health outcomes. The principal aim of this study was to investigate the trends in infant mortality between two geographic locations in Chile: Antofagasta, which has a well-documented history of arsenic exposure from naturally contaminated water, and Valparaiso, a comparable low-exposure city. The arsenic concentration in Antofagasta's public drinking water supply rose substantially in 1958 with the introduction of a new water source, and remained elevated until 1970. We used a retrospective study design to examine time and location patterns in infant mortality between 1950 and 1996, using univariate statistics, graphical techniques, and Poisson regression analysis. Results of the study document the general declines in late fetal and infant mortality over the study period in both locations. The data also indicate an elevation of the late fetal, neonatal, and postneonatal mortality rates for Antofagasta, relative to Vaparaiso, for specific time periods, which generally coincide with tbe period of highest arsenic concentration in the drinking water of Antofagasta. Poisson regression analysis yielded an elevated and significant association between arsenic exposure and late fetal mortality [rate ratio (RR) = 1.7; 95% confidence interval (CI), 1.5-1.9], neonatal mortality (RR = 1.53; CI, 1.4-1.7), and postneonatal mortality (RR = 1.26; CI, 1.2-1.3) after adjustment for location and calendar time. The findings from this investigation may support a role for arsenic exposure in increasing the risk of late fetal and infant mortality.
- ItemFollow-up care of women with an abnormal cytology in a low-resource setting(ELSEVIER SCI LTD, 2003) Gage, JC; Ferreccio, C; Gonzales, M; Arroyo, R; Huivin, M; Robles, SCStudy purpose: We ascertained the follow-up care after an abnormal cytology (Papanicolaou) screening in the San Martin region of Peru and assessed the status of women who had not received adequate care. Basic procedures: We identified women with an abnormal cytology and assessed their medical records, laboratory registries, death certificates and interviewed them at home. Re-screening, diagnosis and treatment were offered. Main findings: Only 46 (25%) of the 183 women identified received appropriate follow-up care. At re-screening 31 (34%) had a normal result, 9 (10%) were diagnosed with CIN1 and 50 (56%) had CIN2 or worse. Principal conclusions: In this setting, follow-up care after an abnormal cytology was very poor and could explain the lack of impact of cervical cancer screening Women with an abnormal cytology constitute a high-risk group that should be a priority for health services. (C) 2003 International Society for Preventive Oncology. Published by Elsevier Ltd. All rights reserved.
- ItemP53 alterations in bladder tumors from arsenic and tobacco exposed patients(2003) Moore, LE; Smith, AH; Eng, C; DeVries, S; Kalman, D; Bhargava, V; Chew, K; Ferreccio, C; Rey, OA; Hopenhayn, C; Biggs, ML; Bates, MN; Waldman, FMPrevious studies demonstrated that tobacco and arsenic exposure are risk factors for bladder cancer. A case-case study was conducted to compare p53 mutations in 147 bladder tumors from South American patients by tobacco and arsenic exposure. Information on residential history and lifestyle factors was collected. The prevalence of p53 mutations and protein expression was examined in relation to tumor stage, grade, patient age, gender, tobacco and arsenic exposure. Smokers were grouped as ever/never smokers and by pack years of exposure (0, 1-20, >20). Patients were also grouped into four arsenic exposure categories based on the average of the five highest years arsenic concentration in their drinking water: group 1, non-detectable to <10 mug/l (n=50); group 2, 10-99 mug/l (n=31); group 3, 100-299 mug/l (n=35); group 4, >300 mug/l (n=30). The proportion of tumor samples with p53 mutations and P53 immunopositivity increased strongly with both stage and grade, but not with arsenic exposure or smoking. The prevalence of tumors containing mutational transitions increased markedly with tumor stage (from 14 to 52%, P-trend=0.005) and grade (from 11 to 48%, P-trend=0.004) and was higher in smokers than in non-smokers (34 versus 18%, respectively, P=0.10). An increasing trend was observed with pack years of smoking (P=0.09). The majority of mutations in tumors from both smokers and non-smokers were G-->A transitions, however, in smokers a preference for G-->A transitions at CpG sites was observed (P=0.07, two-tailed) and a positive trend was observed with pack years of exposure (P=0.04). A hotspot was found at codon 273 in 12% of the tumors from smokers but was not observed in never smokers (P=0.05) and a positive trend was observed with pack years of tobacco exposure (P=0.001). Neither stage nor grade demonstrated a preference for CpG site mutation, suggesting that these changes may be early exposure-related events in carcinogenesis and are not related to tumor progression. Arsenic exposure was not associated with an increased prevalence of p53 mutation or P53 immunopositivity and there was no evidence of interaction between arsenic and smoking with these outcome variables.
- ItemPopulation-based prevalence and age distribution of human papillomavirus among women in Santiago, Chile(AMER ASSOC CANCER RESEARCH, 2004) Ferreccio, C; Prado, RB; Luzoro, AV; Ampuero, SL; Snijders, PJF; Meijer, CJLM; Vaccarella, SV; Jara, AT; Puschel, KI; Robles, SC; Herrero, R; Franceschi, SF; Ojeda, JMMore than 18 types of human papillomavirus (HPV) are associated with cervical cancer, the relative importance of the HPV types may vary in different populations.
- ItemPrevalence of Epstein Barr virus infection in healthy individuals in Santiago, Chile(SOC MEDICA SANTIAGO, 1995) Ferres, M; Prado, P; Ovalle, J; Fuentes, R; Villarroel, L; Ferreccio, C; Vial, PTo study the rate of infection by Epstein Barr virus (EBV) in Santiago, Chile, the prevalence of antibody to the viral capsid antigen (VCA-lgG) was determined in a group of 663 healthy individuals grouped by age and socioeconomic level (SEL). In addition, several risk factors for infection were studied. VCA-lgG was determined by ELISA. The total prevalence was 76,7%. When grouped by age and SEL, 50% of the children from low and medium SEL had been already infected by the age two, compared to 5,9% in the high SEL (p<0.01). However, by age twenty, 90% of the total sample had already specific antibodies to EBV. Age and number of household members were positively associated with the infection. High socioeconomic level represented a delay factor in the acquisition of the virus, (p<0.01). These results show that EBV infection is frequent in Santiago, occurring early in childhood among medium and low SEL. Hence, the classical infectious mononucleosis should be recognized more frequently among adolescents and young adults belonging to high SEL, while the clinical spectrum of associated manifestations different from the typical mononucleosis syndrome should be investigated among these exposed in early age.
- ItemProfile of urinary arsenic metabolites during pregnancy(US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE, 2003) Hopenhayn, C; Huang, B; Christian, J; Peralta, C; Ferreccio, C; Atallah, R; Kalman, DChronic exposure to inorganic arsenic (In-As) from drinking water is associated with different health effects, including skin, lung, bladder, and kidney cancer as well as vascular and possibly reproductive effects. In-As is metabolized through the process of methylation, resulting in the production and excretion of methylated species, mainly monomethylarsenate (MMA) and dimethylarsenate (DMA). Because a large percentage of the dose is excreted in urine, the distribution of urinary In-As, MMA, and DMA is considered a useful indicator of methylation patterns in human populations. Several factors affect these patterns, including sex and exposure level. In this study, we investigated the profile of urinary in-As, MMA, and DMA of pregnant women. Periodic urine samples were collected from early to late pregnancy among 29 pregnant women living in Antofagasta, Chile, who drank tap water containing 40 mug/L In-As. The total urinary arsenic across four sampling periods increased with increasing weeks of gestation, from an initial mean value of 36.1 to a final value of 54.3 mug/L. This increase was mainly due to an increase in DMA, resulting in lower percentages of In-As and MMA and a higher percentage of DMA. Our findings indicate that among women exposed to moderate arsenic from drinking water during pregnancy, changes occur in the pattern of urinary arsenic excretion and metabolite distribution. The toxicologic significance of this is not dear, given recent evidence suggesting that intermediate methylated species may be highly toxic. Nevertheless, this study suggests that arsenic metabolism changes throughout the course of pregnancy, which in turn may have toxicologic effects on the developing fetus.
- ItemSexual behavior, condom use, and human papillomavirus: Pooled analysis of the IARC human papillomavirus prevalence surveys(AMER ASSOC CANCER RESEARCH, 2006) Vaccarella, S; Franceschi, S; Herrero, R; Munioz, N; Snijders, PJF; Clifford, GM; Smith, JS; Lazcano Ponce, E; Sukvirach, S; Shin, HR; de Sanjose, S; Molano, M; Matos, E; Ferreccio, C; Anh, PTH; Thomas, JO; Meijer, CJLM; IARC HPV Prevelence Surveys StudyHuman papillomavirus (HPV) is a sexually transmitted infection but it is unclear whether differences in transmission efficacy exist between individual HPV types. Information on sexual behavior was collected from 11 areas in four continents among population-based, age-stratified random samples of women of ages >= 5 years. HPV testing was done using PCR-based enzyme immunoassay. Unconditional logistic regression was used to estimate odds ratios (OR) of being HPV positive and corresponding 95% confidence intervals (95% CI). Variables were analyzed categorically. When more than two groups were compared, floating confidence intervals were estimated by treating ORs as floating absolute risks. A total of 11,337 women (mean age, 41.9 years) were available. We confirmed that lifetime number of sexual partners is associated with HPV positivity (OR for >= 2 versus 1, 1.86; 95% CI, 1.63-2.11) but the association was not a linear one for HPV18,31, and 33 (i.e., no clear increase for >= 3 versus 2 sexual partners). Women who had multiple-type infection and highrisk HPV type infection reported a statistically nonsignificant higher number of sexual partners than women who had single-type and low-risk type infections, respectively. Early age at sexual debut was not significantly related to HPV positivity. Husband's extramarital sexual relationships were associated with an OR of 1.45 (95% CI, 1.24-1.70) for HPV positivity in their wives after adjustment for age and lifetime number of women's sexual partners. We did not observe a significant association with condom use. Our study showed an effect of both women's and their husbands' sexual behavior on HPV positivity. Furthermore, it suggests some differences in the pattern of the association between sexual behavior and different HPV types.
- ItemWorldwide distribution of human papillomavirus types in cytologically normal women in the international Agency for Research on Cancer HPV prevalence surveys: a pooled analysis(ELSEVIER SCIENCE INC, 2005) Clifford, GM; Gallus, S; Herrero, R; Munoz, N; Snijders, PJF; Vaccarella, S; Anh, PTH; Ferreccio, C; Hieu, NT; Matos, E; Molano, M; Rajkumar, R; Ronco, G; de Sanjose, S; Shin, HR; Sukvirach, S; Thomas, JO; Tunsakul, S; Meijer, CJLM; Franceschi, S; IARC HPV Prevalence Surveys StudyBackground The proportion of women infected with human papillomavirus (HPV) varies greatly across populations, as might the distribution of HPV types. We aimed to compare HPV-type distribution in representative samples of women from different world regions.