Research Interests:
Background: Weight gain and obesity are associated with increased risk of postmenopausal breast cancer. Further, women who develop breast cancer and are obese have a poorer prognosis compared to women of normal weight. Regular mammography... more
Background: Weight gain and obesity are associated with increased risk of postmenopausal breast cancer. Further, women who develop breast cancer and are obese have a poorer prognosis compared to women of normal weight. Regular mammography every 1–2 years has been recommended by many organizations as the gold standard for early breast cancer detection, but adherence to these recommendations may differ both by weight and race/ethnicity. In the Hawaii and Los Angeles Multiethnic Cohort (MEC) Study, only 53% of non-Hispanic White, 49% of Japanese American, 45% of Native Hawaiian, 42% of Hispanic and 44% of African American women reported having had a mammography regularly every 1–2 years over a 6-year period of follow-up. Purpose: The purpose of this study was to describe the association between body mass index (BMI) and frequency of regular mammography over an approximate 6-year period within this study after controlling for the influence of demographic and behavioral factors, and medical history. This association was examined overall and by race/ethnicity in a multiethnic cohort of women aged 45–74 years including African American, Japanese American, Hispanic, Native Hawaiian, and non-Hispanic White women. Data Analysis: The data analysis included 81,722 women from the Hawaii and Los Angeles MEC. Unconditional logistic regression was used to assess the association between BMI and regular annual or biennial (every 1–2 years) mammography overall and by race/ethnicity. Findings: The findings of the study revealed approximately 71% of MEC African American women were overweight or obese (body mass index [BMI] ≥ 25 kg/m2), followed by Native Hawaiian (65%); Hispanic (64%), non-Hispanic White (42%) and Japanese American (27%) women. Women who were overweight (OR=0.96; 95% CI 0.92–1.01) or obese (OR=0.88; 95% CI 0.84–0.93) were less likely to have regular annual mammography compared to women of normal weight. With the exception of Japanese Americans, the odds of having regular annual mammography was lower for women with BMI ≥ 25 kg/m2 compared to normal BMI for each racial/ethnic group; this association was statistically significant for non-Hispanic White, Native Hawaiian and African American women (p Conclusions: BMI is negatively associated with regular annual and biennial mammography in multiethnic women warranting the need for culturally sensitive educational strategies that promote healthy behaviors toward regular mammography and maintenance of normal BMI.
Research Interests:
B42 The National Health Interview Survey (NHIS) of the National Center of Health Statistics indicates that mammogram use within the past 2 years as reported by women 40 years and older increased from 29% in 1987 to 67% in 1998 and 70% in... more
B42 The National Health Interview Survey (NHIS) of the National Center of Health Statistics indicates that mammogram use within the past 2 years as reported by women 40 years and older increased from 29% in 1987 to 67% in 1998 and 70% in 2003; use was similar for Non-Hispanic White (71%) and African-American women (71%) followed by Hispanic (65%) and Asian women (58%). In the current analysis, we examined whether mammography use as reported by women enrolled in the Hawaii and Los Angeles (LA) CA Multiethnic Cohort (MEC) met National Cancer Institute recommendations for women ages 40 and over to receive a mammogram every 1-2 years, defined as 9regular9 mammogram in this analysis. Also, we assessed whether disparities in regular mammogram use exist by race/ethnicity and whether this use is influenced by age, education, socioeconomic status (SES) and family history of breast cancer. The analysis included 89,104 women ages 45-75 at MEC enrollment with complete mammography history. Results: 91% of MEC women reported ever having a mammogram at baseline, however only 48% of those had a regular mammogram from 1994 through 1998. Regular mammogram use differed by race/ethnicity with the most frequent use of regular mammograms reported by Non-Hispanic White women (52.7%; 95% CI 52.1-53.4), followed by Japanese (48.8%; 95% CI 48.2-49.4), Hawaiian (44.1%; 95% CI 42.3-45.9), African-American (43.6%; 95% CI 42.8-44.3) and Hispanic women (41.2%; 95% CI 40.5-42.0). When we examined the odds of having a regular mammogram by race/ethnicity, race remained an important indicator of use even after controlling for age, education, SES (for LA residents only) and family history of breast cancer. The odds of regular mammograms were significantly lower for African-American (ORadj=0.70, CI 0.67-0.73); Hispanic (ORadj=0.74, 0.71-0.78), Native Hawaiian (ORadj=0.75, CI 0.71-0.79), and Japanese (ORadj=0.90, CI 0.86-0.93) women when compared to Non-Hispanic White women. Regular mammograms peaked for women 50-59 years of age and declined thereafter. Women in the 70-74 (OR= 0.81; 95% CI 0.78-0.85) and 75 and over (OR=0.78; 95% CI 0.72-0.86) age groups were less likely to get regular mammograms compared to women 45-49. A significant trend (P
Research Interests:
Research Interests:
Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL BACKGROUND: Triple-negative breast cancers (TNBC) are tumors with low or no expression of estrogen receptor, progesterone receptor, or human epidermal growth factor... more
Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL BACKGROUND: Triple-negative breast cancers (TNBC) are tumors with low or no expression of estrogen receptor, progesterone receptor, or human epidermal growth factor receptor-2. These tumors have a poor prognosis, remain a clinical challenge, and are more common among women with BRCA1 mutations. We tested whether there are distinguishing features of TNBC after BRCA1 mutation status has been taken into account. METHODS: We sequenced BRCA1/2 genes in a population-based sample of 1,469 incident breast cancer patients aged 20-49 years from Los Angeles County. Information on tumor receptor status was available for 1,167 women. Clinical, pathologic and hormone-related lifestyle characteristics were compared across patient subgroups defined by BRCA1-mutation status and triple-negative receptor status. RESULTS: Forty-eight percent of BRCA1 mutation carriers had TNBC in contrast with only 12% of non-carriers. Within BRCA1 mutation carriers, as well as within non-carriers, triple-negative receptor status was associated with younger age at diagnosis and higher tumor grade. Among women without a BRCA1 mutation we observed that women with TNBC had higher premenopausal body mass index and earlier age at first full-term pregnancy than those with non-TNBC. Age at menarche and other reproductive factors were not associated with triple-negative status regardless of BRCA1 mutation status. Within BRCA1 mutation carriers, Ashkenazi Jewish women were about 5 times more likely to have TNBC than non-Ashkenazi Jewish women. CONCLUSIONS: Our results suggest that among BRCA1 mutation carriers, as among non-carriers, there are unique characteristics associated with the triple-negative subtype. The finding in Ashkenazi Jewish BRCA1 mutation carriers should be confirmed. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5609. doi:10.1158/1538-7445.AM2011-5609
Research Interests:
Research Interests:
Research Interests:
ABSTRACTHispanic/Latinos have been underrepresented in genome-wide association studies (GWAS) for anthropometric traits despite notable anthropometric variability with ancestry proportions, and a high burden of growth stunting and... more
ABSTRACTHispanic/Latinos have been underrepresented in genome-wide association studies (GWAS) for anthropometric traits despite notable anthropometric variability with ancestry proportions, and a high burden of growth stunting and overweight/obesity in Hispanic/Latino populations. This address this knowledge gap, we analyzed densely-imputed genetic data in a sample of Hispanic/Latino adults, to identify and fine-map common genetic variants associated with body mass index (BMI), height, and BMI-adjusted waist-to-hip ratio (WHRadjBMI). We conducted a GWAS of 18 studies/consortia as part of the Hispanic/Latino Anthropometry (HISLA) Consortium (Stage 1, n=59,769) and validated our findings in 9 additional studies (HISLA Stage 2, n=9,336). We conducted a trans-ethnic GWAS with summary statistics from HISLA Stage 1 and existing consortia of European and African ancestries. In our HISLA Stage 1+2 analyses, we discovered one novel BMI locus, as well two novel BMI signals and another novel h...
Research Interests:
Research Interests:
Research Interests:
BACKGROUND Outdoor artificial light at night (ALAN) has been implicated in a growing number of adverse health outcomes. ALAN is believed to disrupt circadian rhythms and has been associated with increased inflammation, one of the... more
BACKGROUND Outdoor artificial light at night (ALAN) has been implicated in a growing number of adverse health outcomes. ALAN is believed to disrupt circadian rhythms and has been associated with increased inflammation, one of the hallmarks of cancer. We examined the association between outdoor ALAN and a cancer strongly associated with autoimmune and inflammatory conditions, non-Hodgkin lymphoma (NHL), in the prospective California Teachers Study cohort. METHODS Outdoor ALAN was assigned to participant addresses at study baseline (1995-96) through use of the New World Atlas of Artificial Night Sky Brightness. Among 105,937 women followed from 1995 to 2015, linkage to the California Cancer Registry identified 873 incident cases of NHL. Age-stratified Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % confidence intervals (95 %CI) for overall NHL and the most common NHL subtypes; diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Multivariate analyses adjusted for previously reported subtype specific covariates (e.g. body mass index (BMI) for DLBCL). RESULTS Compared to the lowest quintile, participants residing in the highest quintile of outdoor ALAN at baseline were more likely to develop NHL (HR = 1.32, 95 %CI = 1.07-1.63), and, in particular, DLBCL (HR = 1.87, 95 %CI = 1.16-3.02). The elevated risk for DLBCL remained statistically significant after adjusting for age, race/ethnicity, BMI, and socioeconomic status (DLBCL:HR = 1.87, 95 %CI = 1.16-3.02, NHL:HR = 1.32, 95 %CI = 1.07-1.63). There was no association between ALAN and FL or CLL/SLL. CONCLUSION DLBCL risk was elevated among women residing in neighborhoods with greater outdoor ALAN. Future research in circadian disruption and DLBCL may clarify potential biological processes implicated in this association.
Research Interests:
Recent studies using next-generation sequencing of selected individuals, such as those with familial leukemia or congenital syndromes, have identified rare and highly penetrant germline mutations that predispose to childhood acute... more
Recent studies using next-generation sequencing of selected individuals, such as those with familial leukemia or congenital syndromes, have identified rare and highly penetrant germline mutations that predispose to childhood acute lymphoblastic leukemia (ALL). High hyperdiploidy (HD), the most common cytogenetic subtype of childhood ALL, is enriched in children with RASopathies who develop ALL and, similarly, a high proportion of ALL patients with germline ETV6 or IKZF1 mutations presented with the HD subtype. Here, we aimed to identify novel predisposition genes in a selected group of HD-ALL patients. Targeted sequencing of 538 cancer-relevant genes was carried out using the UCSF500 Cancer Gene Panel in diagnostic bone marrow (i.e. tumor) DNA from 57 HD-ALL patients from the California Childhood Leukemia Study (CCLS). HD-ALL patients were selected based on absence of somatic KRAS or NRAS hotspot mutations detectable by Sanger sequencing, and absence of somatic copy number deletions...
Research Interests:
High hyperdiploidy (HD) is the most common cytogenetic subtype of childhood acute lymphoblastic leukemia (ALL), and a higher incidence of HD has been reported in ALL patients with congenital cancer syndromes. We assessed the frequency of... more
High hyperdiploidy (HD) is the most common cytogenetic subtype of childhood acute lymphoblastic leukemia (ALL), and a higher incidence of HD has been reported in ALL patients with congenital cancer syndromes. We assessed the frequency of predisposing germline mutations in 57 HD‐ALL patients from the California Childhood Leukemia Study via targeted sequencing of cancer‐relevant genes. Three out of 57 patients (5.3%) harbored confirmed germline mutations that were likely causal, in NBN, ETV6, and FLT3, with an additional six patients (10.5%) harboring putative predisposing mutations that were rare in unselected individuals (<0.01% allele frequency in the Exome Aggregation Consortium, ExAC) and predicted functional (scaled CADD score ≥ 20) in known or potential ALL predisposition genes (SH2B3, CREBBP, PMS2, MLL, ABL1, and MYH9). Three additional patients carried rare and predicted damaging germline mutations in GAB2, a known activator of the ERK/MAPK and PI3K/AKT pathways and binding partner of PTPN11‐encoded SHP2. The frequency of rare and predicted functional germline GAB2 mutations was significantly higher in our patients (2.6%) than in ExAC (0.28%, P = 4.4 × 10−3), an observation that was replicated in ALL patients from the TARGET project (P = .034). We cloned patient GAB2 mutations and expressed mutant proteins in HEK293 cells and found that frameshift mutation P621fs led to reduced SHP2 binding and ERK1/2 phosphorylation but significantly increased AKT phosphorylation, suggesting possible RAS‐independent leukemogenic effects. Our results support a significant contribution of rare, high penetrance germline mutations to HD‐ALL etiology, and pinpoint GAB2 as a putative novel ALL predisposition gene.
Research Interests:
To identify genetic variants associated with diabetic retinopathy (DR), we performed a large multiethnic genome-wide association study. Discovery included eight European cohorts (n = 3,246) and seven African American cohorts (n = 2,611).... more
To identify genetic variants associated with diabetic retinopathy (DR), we performed a large multiethnic genome-wide association study. Discovery included eight European cohorts (n = 3,246) and seven African American cohorts (n = 2,611). We meta-analyzed across cohorts using inverse-variance weighting, with and without liability threshold modeling of glycemic control and duration of diabetes. Variants with a P value <1 × 10−5 were investigated in replication cohorts that included 18,545 European, 16,453 Asian, and 2,710 Hispanic subjects. After correction for multiple testing, the C allele of rs142293996 in an intron of nuclear VCP-like (NVL) was associated with DR in European discovery cohorts (P = 2.1 × 10−9), but did not reach genome-wide significance after meta-analysis with replication cohorts. We applied the Disease Association Protein-Protein Link Evaluator (DAPPLE) to our discovery results to test for evidence of risk being spread across underlying molecular pathways. One...
Research Interests:
Allergic disease is suspected to play a role in the development of childhood acute lymphoblastic leukemia (ALL). Studies conducted over the last several decades have yielded mixed results. We examined the association between allergy, a... more
Allergic disease is suspected to play a role in the development of childhood acute lymphoblastic leukemia (ALL). Studies conducted over the last several decades have yielded mixed results. We examined the association between allergy, a common immune-mediated disorder, and ALL in the California Childhood Leukemia Study (CCLS), a case-control study of 977 children diagnosed with ALL and 1,037 matched controls (1995-2015). History of allergies in the first year of life was obtained from interviews, mainly reported by mothers. Logistic regression analyses were conducted to estimate ORs and 95% confidence intervals (CIs), controlling for birth order, daycare attendance, and mode of delivery. In addition, we conducted meta-analyses with data from the CCLS and 12 published studies and employed a new method to estimate between-study heterogeneity (R_b). Overall, no associations were observed between childhood ALL risk and specific allergy phenotypes or any allergy, as a group. However, havi...
Research Interests:
Genome-wide association studies of childhood acute lymphoblastic leukemia (ALL) have identified regions of association at PIP4K2A and upstream of BMI1 at chromosome 10p12.31-12.2. The contribution of both loci to ALL risk and underlying... more
Genome-wide association studies of childhood acute lymphoblastic leukemia (ALL) have identified regions of association at PIP4K2A and upstream of BMI1 at chromosome 10p12.31-12.2. The contribution of both loci to ALL risk and underlying functional variants remain to be elucidated. We carried out single nucleotide polymorphism (SNP) imputation across chromosome 10p12.31-12.2 in Latino and non-Latino white ALL cases and controls from two independent California childhood leukemia studies, and additional Genetic Epidemiology Research on Aging study controls. Ethnicity-stratified association analyses were performed using logistic regression, with meta-analysis including 3133 cases (1949 Latino, 1184 non-Latino white) and 12,135 controls (8584 Latino, 3551 non-Latino white). SNP associations were identified at both BMI1 and PIP4K2A. After adjusting for the lead PIP4K2A SNP, genome-wide significant associations remained at BMI1, and vice-versa (P <10 ), supporting independent effects. L...
Research Interests:
To characterize and provide population-based prevalence estimates of myopic degeneration (MD) among Chinese Americans, the fastest-growing minority population in the United States in the last decade. Population-based, cross-sectional... more
To characterize and provide population-based prevalence estimates of myopic degeneration (MD) among Chinese Americans, the fastest-growing minority population in the United States in the last decade. Population-based, cross-sectional study. A total of 1523 Chinese-American adults with myopia, aged 50 years and older, residing in the city of Monterey Park, California, underwent an interview and comprehensive eye examination, including subjective and objective refraction and stereoscopic fundus photography. For each participant, the eye with the worse myopic refractive error was included in this analysis. MD was assessed in a masked manner by an expert grader. The prevalence of any MD was 44.9% among myopic subjects, based on the presence of any degenerative lesion secondary to myopia. The prevalence was 32.2% when MD was defined by a modified version of the Meta-Analysis for Pathologic Myopia. The prevalence of specific lesions included tessellation (31.7%), tilted disc (28.1%), peri...
Research Interests:
To describe the study design, operational and recruitment strategies, procedures, and baseline characteristics of the African American Eye Disease Study (AFEDS), a population-based assement of the prevalence of visual impairment, ocular... more
To describe the study design, operational and recruitment strategies, procedures, and baseline characteristics of the African American Eye Disease Study (AFEDS), a population-based assement of the prevalence of visual impairment, ocular disease, visual function, and health-related quality of life in African Americans. This population-based, cross-sectional study included over 6000 African Americans 40 years and older residing in and around Inglewood, California. A detailed interview and eye examination was performed on each eligible participant. The interview included an assessment of demographic, behavioral, and ocular risk factors and health-related and vision-related quality of life. The eye examination included measurements of visual acuity, intraocular pressure, visual fields; fundus and optic disc photography; a detailed anterior and posterior segment examination; and measurements of blood pressure, glycosylated hemoglobin levels, and blood glucose levels. The AFEDS cohort inc...
Research Interests:
Childhood acute lymphoblastic leukemia (ALL) (age 0-14 years) is 20% more common in Latino Americans than non-Latino whites. We conduct a genome-wide association study in a large sample of 3263 Californian children with ALL (including... more
Childhood acute lymphoblastic leukemia (ALL) (age 0-14 years) is 20% more common in Latino Americans than non-Latino whites. We conduct a genome-wide association study in a large sample of 3263 Californian children with ALL (including 1949 of Latino heritage) and 3506 controls matched on month and year of birth, sex, and ethnicity, and an additional 12,471 controls from the Kaiser Resource for Genetic Epidemiology Research on Aging Cohort. Replication of the strongest genetic associations is performed in two independent datasets from the Children's Oncology Group and the California Childhood Leukemia Study. Here we identify new risk loci on 17q12 near IKZF3/ZPBP2/GSDMB/ORMDL3, a locus encompassing a transcription factor important for lymphocyte development (IKZF3), and at an 8q24 region known for structural contacts with the MYC oncogene. These new risk loci may impact gene expression via local (four 17q12 genes) or long-range (8q24) interactions, affecting function of well-char...
Research Interests:
Research Interests:
To identify factors associated with prevalent diabetic retinopathy (DR) among Chinese American adults with type 2 diabetes mellitus (T2DM), and to compare these factors to ones previously described for a population-based sample of Latinos... more
To identify factors associated with prevalent diabetic retinopathy (DR) among Chinese American adults with type 2 diabetes mellitus (T2DM), and to compare these factors to ones previously described for a population-based sample of Latinos with a higher DR prevalence. Population-based cross-sectional study. 4582 Chinese Americans aged 50 or older residing in Monterey Park, California. Participants completed an in-home questionnaire on socio-demographic status and medical history, and a comprehensive clinical eye examination, using the same protocol implemented in the Los Angeles Latino Eye Study. Fundus photographs from 7 Early Treatment Diabetic Retinopathy fields were graded in a masked manner using a modified Airlie House grading system to assess presence and severity of DR. Logistic regression analyses based on a conceptual model of DR risk identified factors associated with prevalent DR. Odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with DR and vision-threatening DR (VTDR). In total, 238 participants were diagnosed with any DR; 27 of these were classified as having VTDR. Both, any DR and VTDR showed statistically significant positive associations with T2DM duration (OR= 1.24, OR= 2.07, OR= 3.99), glycosylated hemoglobin (HbA1c) (OR= 1.33, OR= 1.86, OR= 3.22), systolic blood pressure (SBP) (OR= 1.19), and insulin treatment (OR= 2.44). For VTDR, we also found novel associations with antihypertensive drugs (OR: 0.18; 95% CI: 0.06-0.61) and statins (OR: 4.96; 95% CI: 1.60-16.41). Chinese Americans and Latinos had a nearly identical DR probability based on HbA1c and SBP. However, Latinos had a higher DR probability at every year of duration of T2DM (≥ 5 years). While we observed an overall lower DR prevalence in Chinese Americans than in Latinos (35.8% of individuals with TD2M in Chinese Americans versus 42.0% in Latinos), our data indicate that the impact of increasing HbA1c and SBP on DR probability is incrementally the same in both populations. However, increasing T2DM duration is associated with higher DR probability in Latinos than Chinese Americans, even after controlling for other known predictors. Novel factors associated with VTDR include antihypertensive drugs and statins. However, to determine if these drugs impact VTDR susceptibility, we need longitudinal data and more cases.
Research Interests:
Central nervous system (CNS) tumors are relatively rare with high associated morbidity and mortality. In the US, approximately 16 500 cases are diagnosed each year with an associated 13 000 deaths from the disease. The causes of most... more
Central nervous system (CNS) tumors are relatively rare with high associated morbidity and mortality. In the US, approximately 16 500 cases are diagnosed each year with an associated 13 000 deaths from the disease. The causes of most nervous system tumors are unknown. Ionizing radiation is the only well-established environmental risk factor, but only a few percent of incident CNS tumors are likely to relate to such exposure. Certain inherited syndromes predispose individuals to CNS tumors, however, only a few percent of cases have one of these rare conditions. Other factors under investigation include nonionizing radiation, pesticides, occupational exposures, infection, prior head trauma, and diet. Evidence for these suspected factors has been less consistent in epidemiological studies. Recent progress in the understanding of the molecular characteristics of CNS tumors and genetical and epigenetical factors that influence susceptibility may help to improve understanding of disease etiology.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Visual impairment (VI) and blindness continue to be major public health problems worldwide. Despite previously published studies on VI in Chinese and other racial/ethnic populations, there are no data specific to Chinese American adults.... more
Visual impairment (VI) and blindness continue to be major public health problems worldwide. Despite previously published studies on VI in Chinese and other racial/ethnic populations, there are no data specific to Chinese American adults. To determine the age- and sex-specific prevalence and causes of VI and blindness in adult Chinese Americans and to compare the prevalence to other racial/ethnic groups. In this population-based, cross-sectional study of 10 US Census tracts in the city of Monterey Park, California, 4582 Chinese American adults 50 years and older underwent complete ophthalmologic examinations, including measurement of presenting and best-corrected visual acuity (BCVA) for distance using the Early Treatment Diabetic Retinopathy Study protocol from February 1, 2010, through October 31, 2013. Age-specific prevalence and causes of VI and blindness for presenting and BCVA. Of the 5782 eligible adults, 4582 (79.2%) completed an in-clinic eye examination. Of the 4582 partici...
To identify the prevalence and determinants of self-reported eye care use among Chinese Americans. Population-based, cross-sectional study. A total of 4582 Chinese Americans 50 years and older residing in Monterey Park, California.... more
To identify the prevalence and determinants of self-reported eye care use among Chinese Americans. Population-based, cross-sectional study. A total of 4582 Chinese Americans 50 years and older residing in Monterey Park, California. Multivariable logistic regression analyses based on Andersen's Behavioral Model of Health Services Use were conducted to identify predisposing, enabling, and need variables associated with self-reported eye care use. Prevalence of self-reported use assessed as eye care visit in the past 12 months, dilated eye examination in the past 12 months, and ever having had a dilated examination, and odds ratios for factors associated with these measures. Overall, 36% of participants reported an eye care visit and 21% reported a dilated examination in the past 12 months. Forty-eight percent reported ever having had a dilated eye examination. Older age, female sex, preference for English, more education, health and vision insurance, a usual place for health care,...
Research Interests:
We determined the age- and sex-specific prevalence of posterior subcapsular (PSC), nuclear, cortical, and mixed lens opacities in a population-based sample of Chinese-American adults. A population-based sample of Chinese-Americans 50... more
We determined the age- and sex-specific prevalence of posterior subcapsular (PSC), nuclear, cortical, and mixed lens opacities in a population-based sample of Chinese-American adults. A population-based sample of Chinese-Americans 50 years and older, from 10 census tracts in Monterey Park, CA, USA, underwent a detailed interview and a comprehensive clinical examination that included assessment of different types of lens opacities by the slit-lamp-based Lens Opacities Classification System II (LOCS II). All lens changes (including pseudophakia/aphakia), PSC, nuclear, and/or cortical opacities, were evaluated and graded. Of the 5782 eligible subjects, 4582 (79.2%) Chinese Americans aged 50 years and older completed a comprehensive eye examination. Of the participants with LOCS II grading (n = 4234/4582, 92%), 3.0% had PSC opacities, 38.1% had nuclear opacities, and 23.4% had cortical opacities. The prevalence of all lens changes was 48.0% for all age groups and was higher by 10-year i...
Research Interests:
Incidence rates of childhood leukemia in the United States have steadily increased over the last several decades, but only recently have disparities in the increase in incidence been recognized. In the current analysis, Surveillance,... more
Incidence rates of childhood leukemia in the United States have steadily increased over the last several decades, but only recently have disparities in the increase in incidence been recognized. In the current analysis, Surveillance, Epidemiology and End Results (SEER) data were used to evaluate recent trends in the incidence of childhood leukemia diagnosed at age 0-19 years from 1992 to 2013, overall and by age, race/ethnicity, gender and histologic subtype. Hispanic White children were more likely than non-Hispanic White, non-Hispanic Black or non-Hispanic Asian children to be diagnosed with acute lymphocytic leukemia (ALL) from 2009 to 2013. From 1992 to 2013, a significant increase in ALL incidence was observed for Hispanic White children [annual percent change (APC)Hispanic = 1.08, 95% CI: 0.59, 1.58]; no significant increase was observed for non-Hispanic White, Black or Asian children. ALL incidence increased by about 3% per year from 1992 to 2013 for Hispanic White children ...
Research Interests:
This study found evidence of a threshold effect in which the presence of bilateral soft drusen and depigmentation of retinal pigment epithelium was associated with substantially low health-related quality of life (HRQoL) in adult Latinos... more
This study found evidence of a threshold effect in which the presence of bilateral soft drusen and depigmentation of retinal pigment epithelium was associated with substantially low health-related quality of life (HRQoL) in adult Latinos from the United States. To assess the association of general and vision-specific HRQoL with age-related macular degeneration (AMD), overall and by bilaterality and severity, in adult Latinos. This cross-sectional, population-based study included 4876 participants from the general urban community in 6 US Census tracts in La Puente, California. The data for these analyses were collected as part of a population-based study of ocular diseases in adult Latinos in the Los Angeles Latino Eye Study from February 1, 2000, through May 31, 2003. The analysis was performed from November 2010 to February 2011. Additional analyses were performed in June 2014. Mean-adjusted HRQoL scores and effect sizes. Of the 4876 participants included in the analysis, 4402 (90....
Research Interests:
The number of individuals with visual impairment (VI) and blindness is increasing in the United States and around the globe as a result of shifting demographics and aging populations. Tracking the number and characteristics of individuals... more
The number of individuals with visual impairment (VI) and blindness is increasing in the United States and around the globe as a result of shifting demographics and aging populations. Tracking the number and characteristics of individuals with VI and blindness is especially important given the negative effect of these conditions on physical and mental health. To determine the demographic and geographic variations in VI and blindness in adults in the US population in 2015 and to estimate the projected prevalence through 2050. In this population-based, cross-sectional study, data were pooled from adults 40 years and older from 6 major population-based studies on VI and blindness in the United States. Prevalence of VI and blindness were reported by age, sex, race/ethnicity, and per capita prevalence by state using the US Census projections (January 1, 2015, through December 31, 2050). Prevalence of VI and blindness. In 2015, a total of 1.02 million people were blind, and approximately 3.22 million people in the United States had VI (best-corrected visual acuity in the better-seeing eye), whereas up to 8.2 million people had VI due to uncorrected refractive error. By 2050, the numbers of these conditions are projected to double to approximately 2.01 million people with blindness, 6.95 million people with VI, and 16.4 million with VI due to uncorrected refractive error. The highest numbers of these conditions in 2015 were among non-Hispanic white individuals (2.28 million), women (1.84 million), and older adults (1.61 million), and these groups will remain the most affected through 2050. However, African American individuals experience the highest prevalence of visual impairment and blindness. By 2050, the highest prevalence of VI among minorities will shift from African American individuals (15.2% in 2015 to 16.3% in 2050) to Hispanic individuals (9.9% in 2015 to 20.3% in 2050). From 2015 to 2050, the states projected to have the highest per capita prevalence of VI are Florida (2.56% in 2015 to 3.98% in 2050) and Hawaii (2.35% in 2015 and 3.93% in 2050), and the states projected to have the highest projected per capita prevalence of blindness are Mississippi (0.83% in 2015 to 1.25% in 2050) and Louisiana (0.79% in 2015 to 1.20% in 2050). These data suggest that vision screening for refractive error and early eye disease may reduce or prevent a high proportion of individuals from experiencing unnecessary vision loss and blindness, decrease associated costs to the US economy for medical services and lost productivity, and contribute to better quality of life. Targeted education and screening programs for non-Hispanic white women and minorities should become increasingly important because of the projected growth of these populations and their relative contribution to the overall numbers of these conditions.
Research Interests:
Chinese American individuals are a fast-growing segment of people in the United States, but the burden and effect of diabetic complications on this group of people is not fully understood. To determine the age- and sex-specific prevalence... more
Chinese American individuals are a fast-growing segment of people in the United States, but the burden and effect of diabetic complications on this group of people is not fully understood. To determine the age- and sex-specific prevalence of diabetic retinopathy (DR) overall and by severity, duration of diabetes, and treatment history in adult Chinese American individuals. The Chinese American Eye Study (CHES), a population-based, cross-sectional study, was conducted from February 2010 to October 2013 for 10 census tracts in Monterey Park, California. This analysis, conducted between February 16, 2010, and October 9, 2013, included 4582 Chinese residents 50 years and older. Prevalence of nonproliferative DR, proliferative DR, and macular edema, as well as stereoscopic fundus photography of 7 standard Early Treatment Diabetic Retinopathy Study fields. Of the 4582 survey participants, most were first-generation immigrants from China (68.7%) and female (63%). In total, 736 participants...
Population-based prevalence estimates of age-related macular degeneration (AMD) need to be determined to assess its burden among Chinese Americans, the fastest growing racial group in the United States. To determine the age- and sex-... more
Population-based prevalence estimates of age-related macular degeneration (AMD) need to be determined to assess its burden among Chinese Americans, the fastest growing racial group in the United States. To determine the age- and sex- specific prevalence of AMD among Chinese Americans. The Chinese American Eye Study (CHES) was conducted in a general urban community of 10 census tracts in Monterey Park, California. A total of 4582 Chinese American adults aged 50 years or older participated in this population-based, cross-sectional study from February 16, 2010, through October 9, 2013, and underwent an interview as well as comprehensive clinical and eye examinations, including detailed retinal photography of both eyes. Fundus photographs were graded for drusen and retinal pigment epithelium abnormalities and were evaluated for AMD. The prevalence of early and advanced AMD, drusen, geographic atrophy, and neovascular AMD were determined by using a modified Wisconsin Age-Related Maculopa...
To describe the risk factors associated with hyperopia and myopia among children 6 to 72 months of age. Population-based cross-sectional study. Population-based samples of 9970 children 6 to 72 months of age from Los Angeles County,... more
To describe the risk factors associated with hyperopia and myopia among children 6 to 72 months of age. Population-based cross-sectional study. Population-based samples of 9970 children 6 to 72 months of age from Los Angeles County, California, and Baltimore, Maryland. Participants were preschool African-American, Hispanic, and non-Hispanic white children (n = 9770) from Los Angeles, California, and Baltimore, Maryland. Parental questionnaires and a comprehensive eye examination were administered. Demographic, behavioral, and clinical risk factors associated with hyperopia (≥2.00 diopters [D]) and myopia (≤-1.00 D) were determined. Odds ratios (ORs) for risk factors associated with myopia and hyperopia. Compared with non-Hispanic whites, African-American (OR, 6.0) and Hispanic (OR, 3.2) children were more likely to be myopic. Children 6 to 35 months of age were more likely to be myopic compared with those 60 to 72 months of age (OR, ≥1.7). Compared with African-American children, non-Hispanic white (OR, 1.63) and Hispanic (OR, 1.49) children were more likely to be hyperopic. Children whose parents had health insurance (OR, 1.5) and those with a history of maternal smoking during pregnancy (OR, 1.4) were more likely to have hyperopia. Astigmatism of 1.5 D or more at any axis was associated with myopia (OR, 4.37) and hyperopia (OR, 1.43). Children in specific racial or ethnic groups and age groups are at higher risk of having myopia and hyperopia. Cessation of maternal smoking during pregnancy may reduce the risk of hyperopia in these children. Given that both myopia and hyperopia are risk factors for the development of amblyopia and strabismus, these risk factors should be considered when developing guidelines for screening and intervention in preschool children. The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Research Interests: Ophthalmology, Myopia, Los Angeles, Humans, Child, and 14 moreBaltimore, Infant, Risk factors, Ethnic Groups, African Americans, Clinical Sciences, Questionnaires, Optometry and Ophthalmology, Public health systems and services research, Odds ratio, European Continental Ancestry Group, Risk Factors, Cross Sectional Studies, and Child preschool
Studies of related individuals have consistently demonstrated notable familial aggregation of cancer. We aim to estimate the heritability and genetic correlation attributable to the additive effects of common single-nucleotide... more
Studies of related individuals have consistently demonstrated notable familial aggregation of cancer. We aim to estimate the heritability and genetic correlation attributable to the additive effects of common single-nucleotide polymorphisms (SNPs) for cancer at 13 anatomical sites. Between 2007 and 2014, the US National Cancer Institute has generated data from genome-wide association studies (GWAS) for 49 492 cancer case patients and 34 131 control patients. We apply novel mixed model methodology (GCTA) to this GWAS data to estimate the heritability of individual cancers, as well as the proportion of heritability attributable to cigarette smoking in smoking-related cancers, and the genetic correlation between pairs of cancers. GWAS heritability was statistically significant at nearly all sites, with the estimates of array-based heritability, hl (2), on the liability threshold (LT) scale ranging from 0.05 to 0.38. Estimating the combined heritability of multiple smoking characteristi...
Research Interests:
Childhood acute lymphoblastic leukemia (ALL) is a biologically heterogeneous disease, and mutations in the KRAS and NRAS oncogenes are present at diagnosis in about one-fifth of cases. Ras mutations were previously associated with... more
Childhood acute lymphoblastic leukemia (ALL) is a biologically heterogeneous disease, and mutations in the KRAS and NRAS oncogenes are present at diagnosis in about one-fifth of cases. Ras mutations were previously associated with environmental exposures in leukemias as well as in many other cancer types. This study examined whether Ras mutation could define a unique etiologic group of childhood ALL associated with tobacco smoke, a well-established mutagen and carcinogen. We included 670 children with ALL enrolled in a case-control study in California (1995-2013), including 50.6% Latinos. Parental and child exposure to tobacco smoke was obtained from interviews. Sanger sequencing was used to detect the common KRAS and NRAS hotspot mutations in diagnostic bone marrow DNA. ALL cases were also characterized for common chromosome abnormalities. In case-case analyses, logistic regression analyses were used to estimate odds ratios to describe the association between tobacco smoke exposure...
Gliomas account for approximately 80 % of all primary malignant brain tumors and, despite improvements in clinical care over the last 20 years, remain among the most lethal tumors, underscoring the need for gaining new insights that could... more
Gliomas account for approximately 80 % of all primary malignant brain tumors and, despite improvements in clinical care over the last 20 years, remain among the most lethal tumors, underscoring the need for gaining new insights that could translate into clinical advances. Recent genome-wide association studies (GWAS) have identified seven new susceptibility regions. We conducted a new independent GWAS of glioma using 1,856 cases and 4,955 controls (from 14 cohort studies, 3 case-control studies, and 1 population-based case-only study) and found evidence of strong replication for three of the seven previously reported associations at 20q13.33 (RTEL), 5p15.33 (TERT), and 9p21.3 (CDKN2BAS), and consistent association signals for the remaining four at 7p11.2 (EGFR both loci), 8q24.21 (CCDC26) and 11q23.3 (PHLDB1). The direction and magnitude of the signal were consistent for samples from cohort and case-control studies, but the strength of the association was more pronounced for loci rs...
Research Interests:
Tobacco smoke exposure has been associated with risk of childhood acute lymphoblastic leukemia (ALL). Understanding the relationship between tobacco exposures and specific mutations may yield etiologic insights. We carried out a case-only... more
Tobacco smoke exposure has been associated with risk of childhood acute lymphoblastic leukemia (ALL). Understanding the relationship between tobacco exposures and specific mutations may yield etiologic insights. We carried out a case-only analysis to explore whether prenatal and early-life tobacco smoke exposure influences the formation of leukemogenic genomic deletions. Somatic copy-number of 8 genes frequently deleted in ALL (CDKN2A, ETV6, IKZF1, PAX5, RB1, BTG1, PAR1 region, and EBF1) was assessed in 559 pre-treatment tumor samples from the California Childhood Leukemia Study. Parent and child passive tobacco exposure was assessed using interview-assisted questionnaires as well as DNA methylation in aryl-hydrocarbon receptor repressor (AHRR), a sentinel epigenetic biomarker of exposure to maternal smoking during pregnancy. Multivariable Poisson regressions were used to test association between the smoking exposures and total number of deletions. Deletion burden varied by subtype,...