Day1: July 11, 2019
Senior Scientist, Henry Ford Health System, Michigan, USA
Azadeh Stark is a cancer and molecular epidemiologist and holds the position of senior scientist at the Department of Pathology at Henry Ford Health System, Professor-in-Practice at the School of Interdisciplinary Studies at the University of Texas at Dallas and Visiting Research Professor at the School of Nursing, Chiang Mai International University in Thailand. She has authored and co-authored more than 35 peer-reviewed manuscripts and three book chapters. Dr. Stark believes the best science and the most effective population health interventions result from constructive interdisciplinary collaboration. She has been an active participants in various community health improvement projects.
Breast cancer (BC) mortality is 45% higher in African-American (AAm) than WhiteAmerican (WAm) women, despite comparable incidence rates. The scientific premise of our work has been that this higher mortality is due to biological differences between AAms and WAms. Initially, we reported that HER2+ was associated with advanced stages and poorly differentiated BC only among WAs. In the follow-up cohort study of 1,263 women, members were categorized into four BC subtype groups, Luminal A, Luminal B, EGFR2+/ER- and triple negative (TNBC). Prevalence of TNBC was higher among premenopausal (32.7%) and post-menopausal (21.8%) AAms, than premenopausal (21.5%) and postmenopausal (12.4%) WAms. African heritage was an independent risk for TNBC (OR= 1.72, 95% CI 1.17- 2.54, P=.006). We compared risk of recurrence after diagnosis of DCIS between AAs and WAs. AAms had an 8-year cumulative risk of recurrence (HR= 3.96, 95% CI 1.42-11.04). Finally, we assembled a cohort of 2,588 AAms and 3,566 WAms diagnosed with their first benign breast conditions. Members of the cohort were followed-up until the diagnosis of BC, death or departure from the healthcare system. 103 (4.1%) of AAms and 143 (4.0%) of WAms were diagnosed with subsequent BC. The 10-year risk for developing TNBC was 0.56% (95%CI,0.32%-1.0%) for AAms and 0.25% (95%CI, 0.12%-0.53%) for WAms. Among the 66 AAms who developed invasive BC, 16 (24.2%) developed TNBC compared with 7 (7.4%) of the 94 WAms (P=.01). Our findings portend that African heritage is a risk factor for TNBC and a potential contributor to disparity in BC treatment outcomes.
Professor, Dept of Public Health Dentistry, ITS Dental College, India
Dr Ipseeta Menon, is presently working as Professor, Dept of Public Health Dentistry, in ITS Dental College, Ghaziabad. She has attended and presented papers in many National and International Conferences. She has authored books in her specialty. She has many National and International publications to her credit. She is in the editorial board for many National Journals, and reviewer for reputed International Journals. She has won many laurels in the field of Public Health Dentistry. She was awarded the Excellence in PUBLIC HEALTH DENTISTRY AWARD - Indian Health Professional Award in 2017.
Today’s generations should be made responsible in understanding the devastating nature of tobacco consumption amounting to severe health, social, environmental and economic disaster to one’s self and his country. Tobacco products cause incredible addictiveness to their consumers and hence require constant support from health care providers to help them quit the same. Tobacco Cessation is the only intervention method which has the potential to reduce tobacco-related morbidity and mortality in the short- and medium-term. Tobacco Cessation has the range of techniques including motivation, advice and guidance, counseling, telephone and internet support and appropriate pharmaceutical aids. Given the high prevalence of tobacco use, even small steps towards tobacco cessation have the potential to produce major health benefits. As tobacco consumption is a chronic addiction, repeated reinforcements, opportunity-based interventions are most effective in addressing physical dependence and modifying deeply ingrained patterns of beliefs and behavioral related issues. In 2003, the Centers for Disease Control and Prevention (CDC) found from self-reports that 41% of current smokers (20.2 million) had tried to quit smoking for 1 or more days within the previous 12 months. Unfortunately, most smokers are not successful in quitting, primarily because they are addicted to nicotine. Cognitive behavioral methods are the bench mark for counseling programs and can be offered by trained counselors, psychologists, or clinicians. Curiosity is associated with various forms of tobacco advertising. Curiosity can act as an early warning signal for potential future tobacco users and limit exposure to tobacco among potential users.