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  1. Article: The importance of addressing early life environmental exposures in cancer epidemiology.

    Niehoff, Nicole M / Goldberg, Mandy / White, Alexandra J

    Current epidemiology reports

    2022  Volume 9, Page(s) 49–65

    Abstract: Purpose of review: Environmental exposures during early stages of life may be particularly relevant for cancer etiology because of the rapid hormonal and tissue changes that occur during puberty and, in women, through first birth. We review evidence ... ...

    Abstract Purpose of review: Environmental exposures during early stages of life may be particularly relevant for cancer etiology because of the rapid hormonal and tissue changes that occur during puberty and, in women, through first birth. We review evidence from the past five years on environmental exposures during childhood/adolescence through first birth and the risk of breast and other cancers during adulthood.
    Recent findings: The studies of breast cancer (n=14) reported associations for childhood/adolescent environmental tobacco smoke (ETS), smoking initiation, pesticides, hair dye use, and living on a road with high traffic. Smoking before first childbirth was also associated with increased breast cancer risk. We identified 12 studies on other cancers, with only 1-2 studies per cancer type, with most focused on ETS or active smoking.
    Summary: Despite studies suggesting an important role of exposure to environmental factors during early life and cancer risk in adulthood, few studies have been conducted. Future studies could utilize stored biologic samples from relevant periods or complete residential histories for geographically-based exposures.
    Language English
    Publishing date 2022-04-05
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2196-2995
    ISSN 2196-2995
    DOI 10.1007/s40471-022-00289-6
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  2. Article ; Online: Region of origin and cervical cancer stage in multiethnic Hispanic/Latinx patients living in the United States.

    Dinicu, Andreea Ioana / Dioun, Shayan / Goldberg, Mandy / Crookes, Danielle M / Wang, Yongzhe / Tergas, Ana I

    Cancer medicine

    2023  Volume 12, Issue 23, Page(s) 21452–21464

    Abstract: Background: Hispanic/Latinx people have the second highest cervical cancer incidence rates in the U.S. However, there is a lack of disaggregated data on clinical outcomes for this diverse and populous group, which is critical to direct resources and ... ...

    Abstract Background: Hispanic/Latinx people have the second highest cervical cancer incidence rates in the U.S. However, there is a lack of disaggregated data on clinical outcomes for this diverse and populous group, which is critical to direct resources and funding where they are most needed. This study assessed differences in stage at diagnosis of cervical cancer among Hispanic/Latinx subpopulations and associated factors.
    Methods: We analyzed patients with primary cervical cancer from 2004 to 2019 in the National Cancer Database. Hispanic/Latinx patients were further categorized into Mexican, Puerto Rican (PR), Cuban, Dominican, and Central/South American, as per standard NCDB categories, and evaluated based on stage at diagnosis and sociodemographic characteristics. Multinomial logistic regression quantified the odds of advanced stage at presentation. Regression models were adjusted for age, education, neighborhood income, insurance status, and additional factors.
    Results: Hispanic/Latinx cervical cancer patients were more likely to be uninsured (18.9% vs. 6.0%, p < 0.001) and more likely to live in low-income neighborhoods (28.6% vs. 16.9%, p < 0.001) when compared to non-Hispanic White populations. Uninsured Hispanic/Latinx patients had 37.0% higher odds of presenting with regional versus localized disease (OR 1.37; 95% CI, 1.19-1.58) and 47.0% higher odds of presenting with distant versus. Localized disease than insured patients (OR 1.47; 95% CI, 1.33-1.62). When adjusting for age, education, neighborhood income, and insurance status, PR patients were 48% more likely than Mexican patients to present with stage IV versus stage I disease (OR 1.48; 95% CI, 1.34-1.64).
    Conclusion: Disaggregating health data revealed differences in stage at cervical cancer presentation among Hispanic/Latinx subpopulations, with insurance status as a major predictor. Further work targeting structural factors, such as insurance status, within specific Hispanic/Latinx subpopulations is needed.
    MeSH term(s) Female ; Humans ; Educational Status ; Hispanic or Latino ; United States/epidemiology ; Uterine Cervical Neoplasms/epidemiology
    Language English
    Publishing date 2023-11-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2659751-2
    ISSN 2045-7634 ; 2045-7634
    ISSN (online) 2045-7634
    ISSN 2045-7634
    DOI 10.1002/cam4.6697
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  3. Article ; Online: Personal Care Product Use during Puberty and Incident Breast Cancer among Black, Hispanic/Latina, and White Women in a Prospective US-Wide Cohort.

    Goldberg, Mandy / Chang, Che-Jung / Ogunsina, Kemi / O'Brien, Katie M / Taylor, Kyla W / White, Alexandra J / Sandler, Dale P

    Environmental health perspectives

    2024  Volume 132, Issue 2, Page(s) 27001

    Abstract: Background: Some personal care products (PCPs) contain endocrine-disrupting chemicals that may affect breast cancer (BC) risk. Patterns of use vary by race and ethnicity. Use often starts in adolescence, when rapidly developing breast tissue may be more ...

    Abstract Background: Some personal care products (PCPs) contain endocrine-disrupting chemicals that may affect breast cancer (BC) risk. Patterns of use vary by race and ethnicity. Use often starts in adolescence, when rapidly developing breast tissue may be more susceptible to environmental carcinogens. Few studies have examined associations of BC with PCP use during this susceptible window.
    Objectives: We characterized race and ethnicity-specific patterns of PCP use at 10-13 years of age and estimated associations of use with incident BC.
    Methods: At enrollment (2003-2009), Sister Study participants (
    Results: During a mean follow-up time of 10.8 y, 280 Black, 128 Latina, and 3,137 White women were diagnosed with BC. Classes of adolescent PCP use were not clearly associated with BC diagnosis among Black, Latina, or White women. HRs were elevated but imprecise for frequent nail product and perfume use in Black women (
    Discussion: This work provides some support for the hypothesis that PCP use during puberty is associated with BC risk. More research is needed to confirm these novel findings. https://doi.org/10.1289/EHP13882.
    MeSH term(s) Adolescent ; Female ; Humans ; Breast Neoplasms/chemically induced ; Breast Neoplasms/epidemiology ; Cosmetics ; Hispanic or Latino ; Perfume ; Prospective Studies ; Puberty ; White ; Black or African American
    Chemical Substances Cosmetics ; Perfume
    Language English
    Publishing date 2024-02-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 195189-0
    ISSN 1552-9924 ; 0091-6765 ; 1078-0475
    ISSN (online) 1552-9924
    ISSN 0091-6765 ; 1078-0475
    DOI 10.1289/EHP13882
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  4. Article ; Online: RE: "GROWTH TRAJECTORIES, BREAST SIZE, AND BREAST-TISSUE COMPOSITION IN A BRITISH PREBIRTH COHORT OF YOUNG WOMEN".

    Goldberg, Mandy / Terry, Mary Beth

    American journal of epidemiology

    2018  Volume 187, Issue 9, Page(s) 2069

    MeSH term(s) Cohort Studies ; Ethnic Groups ; European Continental Ancestry Group ; Female ; Humans ; Pregnancy
    Language English
    Publishing date 2018-05-23
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2937-3
    ISSN 1476-6256 ; 0002-9262
    ISSN (online) 1476-6256
    ISSN 0002-9262
    DOI 10.1093/aje/kwy107
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  5. Article ; Online: Use of personal care product mixtures and incident hormone-sensitive cancers in the Sister Study: A U.S.-wide prospective cohort.

    Chang, Che-Jung / O'Brien, Katie M / Keil, Alexander P / Goldberg, Mandy / Taylor, Kyla W / Sandler, Dale P / White, Alexandra J

    Environment international

    2023  Volume 183, Page(s) 108298

    Abstract: Background: Personal care products (PCPs), a source of endocrine-disrupting chemical exposure, may be associated with the risk of hormone-sensitive cancers. Few studies have investigated associations for PCP use with the incidence of hormone-sensitive ... ...

    Abstract Background: Personal care products (PCPs), a source of endocrine-disrupting chemical exposure, may be associated with the risk of hormone-sensitive cancers. Few studies have investigated associations for PCP use with the incidence of hormone-sensitive cancers or considered the joint effect of multiple correlated PCPs. We examined associations between frequently used, or "everyday", PCPs and incident cancers of the breast, ovary, and uterus with a fucus on the joint effect of multiple product exposure.
    Methods: Sister Study participants (n=49 899) self-reported frequency of use in the year before enrollment (2003-2009) for 41 PCPs. Using five-level frequency categories based on questionnaire options, hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for the associations between multiple PCP use and incident breast, ovarian, and uterine cancer using quantile-based g-computation with Cox proportional hazards regression as the underlying model. Multiple PCP use was examined using groupings (beauty, hygiene, and skincare products) determined by both a priori knowledge and Spearman correlation coefficients for co-occurring product use. Associations between individual PCPs and the three cancers were also examined using Cox proportional hazards models coupling with Benjamini-Hochberg procedure for multiple comparisons.
    Results: Over an average of 11.6 years, 4 226 breast, 277 ovarian, and 403 uterine cancer cases were identified. Positive associations were observed between the hygiene mixture and ovarian cancer (HR=1.35, 95%CI=1.00, 1.83) and the beauty mixture with postmenopausal breast cancer (HR=1.08, 95%CI=1.01, 1.16). Additionally, we observed an inverse association between the skincare mixture and breast cancer (HR=0.91, 95%CI=0.83, 0.99). No significant associations were observed for individual products after corrected for multiple comparison.
    Conclusions: Findings from this multi-product, joint-effect approach contribute to the growing body of evidence for associations between PCPs and breast cancer and provides novel information on ovarian and uterine cancer.
    MeSH term(s) Female ; Humans ; Prospective Studies ; Risk Factors ; Breast Neoplasms/epidemiology ; Cosmetics ; Uterine Neoplasms/complications ; Hormones
    Chemical Substances Cosmetics ; Hormones
    Language English
    Publishing date 2023-11-02
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 554791-x
    ISSN 1873-6750 ; 0160-4120
    ISSN (online) 1873-6750
    ISSN 0160-4120
    DOI 10.1016/j.envint.2023.108298
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  6. Article ; Online: Early-life exposures and age at thelarche in the Sister Study cohort.

    Goldberg, Mandy / D'Aloisio, Aimee A / O'Brien, Katie M / Zhao, Shanshan / Sandler, Dale P

    Breast cancer research : BCR

    2021  Volume 23, Issue 1, Page(s) 111

    Abstract: Background: Early age at breast development (thelarche) has been associated with increased breast cancer risk. Average age at thelarche has declined over time, but there are few established risk factors for early thelarche. We examined associations ... ...

    Abstract Background: Early age at breast development (thelarche) has been associated with increased breast cancer risk. Average age at thelarche has declined over time, but there are few established risk factors for early thelarche. We examined associations between pre- and postnatal exposures and age at thelarche in a US cohort of women born between 1928 and 1974.
    Methods: Breast cancer-free women ages 35-74 years who had a sister diagnosed with breast cancer were enrolled in the Sister Study from 2003 to 2009 (N = 50,884). At enrollment, participants reported information on early-life exposures and age at thelarche, which we categorized as early (≤ 10 years), average (11-13 years), and late (≥ 14 years). For each exposure, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) for early and late thelarche using polytomous logistic regression, adjusted for birth cohort, race/ethnicity and family income level in childhood.
    Results: Early thelarche was associated with multiple prenatal exposures: gestational hypertensive disorder (OR = 1.25, 95% CI 1.09-1.43), diethylstilbestrol use (OR = 1.23, 95% CI 1.04-1.45), smoking during pregnancy (OR = 1.20, 95% CI 1.13-1.27), young maternal age (OR 1.30, 95% CI 1.16-1.47 for < 20 vs. 25-29 years), and being firstborn (OR = 1.25, 95% CI 1.17-1.33). Birthweight < 2500 g and soy formula use in infancy were positively associated with both early and late thelarche.
    Conclusions: Associations between pre- and postnatal exposures and age at thelarche suggest that the early-life environment influences breast development and therefore may also affect breast cancer risk by altering the timing of pubertal breast development.
    MeSH term(s) Adult ; Aged ; Breast ; Breast Neoplasms/epidemiology ; Breast Neoplasms/etiology ; Cohort Studies ; Female ; Humans ; Menarche ; Middle Aged ; Pregnancy ; Siblings
    Language English
    Publishing date 2021-12-11
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 2015059-3
    ISSN 1465-542X ; 1465-5411
    ISSN (online) 1465-542X
    ISSN 1465-5411
    DOI 10.1186/s13058-021-01490-z
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  7. Article ; Online: Gestational Hypertensive Disorders and Maternal Breast Cancer Risk in a Nationwide Cohort of 40,720 Parous Women.

    Goldberg, Mandy / Díaz-Santana, Mary V / O'Brien, Katie M / Zhao, Shanshan / Weinberg, Clarice R / Sandler, Dale P

    Epidemiology (Cambridge, Mass.)

    2022  Volume 33, Issue 6, Page(s) 868–879

    Abstract: Background: Preeclampsia and gestational hypertension are hypothesized to be associated with reduced maternal breast cancer risk, but the epidemiologic evidence is inconclusive. Our objective was to examine associations between gestational hypertensive ... ...

    Abstract Background: Preeclampsia and gestational hypertension are hypothesized to be associated with reduced maternal breast cancer risk, but the epidemiologic evidence is inconclusive. Our objective was to examine associations between gestational hypertensive disorders and breast cancer in a nationwide cohort of women with a family history of breast cancer.
    Methods: Women ages 35-74 years who had a sister previously diagnosed with breast cancer, but had never had breast cancer themselves, were enrolled in the Sister Study from 2003 to 2009 (N = 50,884). At enrollment, participants reported diagnoses of eclampsia, preeclampsia, or gestational hypertension in each pregnancy. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between history of a gestational hypertensive disorder and incident invasive breast cancer or ductal carcinoma in situ among 40,720 parous women. We used age as the time scale and adjusted for birth cohort, race-ethnicity, and reproductive, socioeconomic, and behavioral factors. We examined effect measure modification by risk factors for gestational hypertensive disease and breast cancer and assessed possible etiologic heterogeneity across tumor characteristics.
    Results: The prevalence of gestational hypertensive disease was 12%. During follow-up (mean = 10.9 years), 3,198 eligible women self-reported a breast cancer diagnosis. History of a gestational hypertensive disorder was not associated with breast cancer risk (HR = 1.0; 95% CI = 0.90, 1.1). We did not observe clear evidence of effect measure modification or etiologic heterogeneity.
    Conclusions: History of a gestational hypertensive disorder was not associated with breast cancer risk in a cohort of women with a first-degree family history of breast cancer.
    MeSH term(s) Adult ; Aged ; Breast Neoplasms/epidemiology ; Breast Neoplasms/etiology ; Cohort Studies ; Female ; Humans ; Hypertension, Pregnancy-Induced/epidemiology ; Middle Aged ; Pre-Eclampsia/epidemiology ; Pregnancy ; Risk Factors
    Language English
    Publishing date 2022-05-30
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 1053263-8
    ISSN 1531-5487 ; 1044-3983
    ISSN (online) 1531-5487
    ISSN 1044-3983
    DOI 10.1097/EDE.0000000000001511
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    Zs.A 3121: Show issues Location:
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  8. Article ; Online: Childhood physical activity and pubertal timing: findings from the LEGACY girls study.

    Kehm, Rebecca D / Knight, Julia A / Houghton, Lauren C / McDonald, Jasmine A / Schwartz, Lisa A / Goldberg, Mandy / Chung, Wendy K / Frost, Caren J / Wei, Ying / Bradbury, Angela R / Keegan, Theresa H M / Daly, Mary B / Buys, Saundra S / Andrulis, Irene L / John, Esther M / Terry, Mary Beth

    International journal of epidemiology

    2024  Volume 53, Issue 1

    Abstract: Background: There is limited research on whether physical activity (PA) in early childhood is associated with the timing of pubertal events in girls.: Methods: We used data collected over 2011-16 from the LEGACY Girls Study (n = 984; primarily aged 6- ...

    Abstract Background: There is limited research on whether physical activity (PA) in early childhood is associated with the timing of pubertal events in girls.
    Methods: We used data collected over 2011-16 from the LEGACY Girls Study (n = 984; primarily aged 6-13 years at study enrolment), a multicentre North American cohort enriched for girls with a breast cancer family history (BCFH), to evaluate if PA is associated with age at thelarche, pubarche and menarche. Maternal-reported questionnaire data measured puberty outcomes, PA in early childhood (ages 3-5 years) and total metabolic equivalents of organized PA in middle childhood (ages 7-9 years). We used interval-censored Weibull parametric survival regression models with age as the time scale and adjusted for sociodemographic factors, and we tested for effect modification by BCFH. We used inverse odds weighting to test for mediation by body mass index-for-age z-score (BMIZ) measured at study enrolment.
    Results: Being highly active vs inactive in early childhood was associated with later thelarche in girls with a BCFH [adjusted hazard ratio (aHR) = 0.39, 95% CI = 0.26-0.59), but not in girls without a BCFH. In all girls, irrespective of BCFH, being in the highest vs lowest quartile of organized PA in middle childhood was associated with later menarche (aHR = 0.70, 95% CI = 0.50-0.97). These associations remained after accounting for potential mediation by BMIZ.
    Conclusion: This study provides new data that PA in early childhood may be associated with later thelarche in girls with a BCFH, also further supporting an overall association between PA in middle childhood and later menarche.
    MeSH term(s) Female ; Child ; Child, Preschool ; Humans ; Puberty ; Menarche ; Body Mass Index ; Racial Groups ; Family
    Language English
    Publishing date 2024-01-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 187909-1
    ISSN 1464-3685 ; 0300-5771
    ISSN (online) 1464-3685
    ISSN 0300-5771
    DOI 10.1093/ije/dyad193
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  9. Article ; Online: Pubertal timing and breast cancer risk in the Sister Study cohort.

    Goldberg, Mandy / D'Aloisio, Aimee A / O'Brien, Katie M / Zhao, Shanshan / Sandler, Dale P

    Breast cancer research : BCR

    2020  Volume 22, Issue 1, Page(s) 112

    Abstract: Background: Earlier age at menarche is an established risk factor for breast cancer. While age at menarche has been fairly stable over the past half-century, age at breast development (thelarche) has continued to decrease. Recently, earlier age at ... ...

    Abstract Background: Earlier age at menarche is an established risk factor for breast cancer. While age at menarche has been fairly stable over the past half-century, age at breast development (thelarche) has continued to decrease. Recently, earlier age at thelarche and a longer time between thelarche and menarche (pubertal tempo) were shown to be associated with increased breast cancer risk. Our objective was to examine how breast cancer risk was associated with pubertal timing and tempo in a prospective US cohort.
    Methods: Women ages 35-74 years without a history of breast cancer, but who had a sister previously diagnosed with breast cancer, were enrolled in the Sister Study from 2003 to 2009 (N = 50,884). At enrollment, participants reported their ages at thelarche and menarche. Pubertal tempo was age at menarche minus age at thelarche. We estimated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for each pubertal milestone and risk of breast cancer (invasive or ductal carcinoma in situ) using Cox proportional hazards regression. We examined whether associations between age at thelarche and breast cancer risk were modified by birth cohort, race/ethnicity, weight at age 10, and extent of breast cancer family history, as characterized by a Bayesian score based on first-degree family structure.
    Results: During follow-up (mean = 9.3 years), 3295 eligible women were diagnosed with breast cancer. Early ages at thelarche (HR = 1.23, 95% CI 1.03-1.46 for < 10 vs. 12-13 years) and menarche (HR = 1.10, 95% CI 1.01-1.20 for < 12 vs. 12-13 years) were positively associated with breast cancer risk. Pubertal tempo was not associated with breast cancer risk (HR = 0.99, 95% CI 0.97-1.02 per 1-year longer tempo). When considering early thelarche (< 10 years) and early menarche (< 12 years) jointly, women with both had a 30% greater risk of breast cancer compared with women with neither risk factor (95% CI 1.07-1.57). The association between age at thelarche and breast cancer risk did not significantly vary by birth cohort, race/ethnicity, childhood weight, or Bayesian family history score.
    Conclusions: Earlier ages at thelarche and menarche may enhance susceptibility to breast carcinogenesis. Age at thelarche is an important risk factor to consider given secular trends towards earlier development.
    MeSH term(s) Adolescent ; Adult ; Aged ; Bayes Theorem ; Body Mass Index ; Body Weight ; Breast/growth & development ; Breast Neoplasms/epidemiology ; Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Child ; Cohort Studies ; Female ; Humans ; Incidence ; Menarche ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Puberty ; Risk Factors ; Siblings ; Time Factors ; United States/epidemiology
    Language English
    Publishing date 2020-10-27
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 2015059-3
    ISSN 1465-542X ; 1465-5411
    ISSN (online) 1465-542X
    ISSN 1465-5411
    DOI 10.1186/s13058-020-01326-2
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  10. Article ; Online: Early Life Anti-Müllerian Hormone Trajectories in Infant Girls.

    Chin, Helen B / Krall, Jenna R / Goldberg, Mandy / Stanczyk, Frank Z / Darge, Kassa / Stallings, Virginia A / Rogan, Walter J / Umbach, David M / Baird, Donna D

    Epidemiology (Cambridge, Mass.)

    2023  Volume 34, Issue 4, Page(s) 568–575

    Abstract: Background: Minipuberty is a period of increased reproductive axis activity in infancy, but the importance of this period is not well understood, especially in girls. Previous studies reported a peak in hormone concentrations at 3 to 4 months old. Our ... ...

    Abstract Background: Minipuberty is a period of increased reproductive axis activity in infancy, but the importance of this period is not well understood, especially in girls. Previous studies reported a peak in hormone concentrations at 3 to 4 months old. Our objective is to describe anti-Müllerian hormone (AMH) trajectories in the context of other minipuberty factors among healthy infant girls using longitudinal measures of AMH.
    Methods: The Infant Feeding and Early Development study is a longitudinal cohort study of healthy infants, recruited from hospitals in the Philadelphia area during 2010 to 2013. We measured AMH in 153 girls who contributed 1366 serum samples across 11 study visits over 36 weeks. We also measured follicle stimulating hormone (FSH), estradiol, and ovarian characteristics. We used latent class mixed effects models to cluster trajectories of AMH concentration with age. Using linear mixed models, we estimated FSH and ovarian characteristic trajectories separately by AMH cluster.
    Results: We classified infants into four clusters that represent patterns of AMH that were high and decreasing (decreasing), had a peak around 12 weeks or 20 weeks (early peak and middle peak), or were consistently low (low). Infants in these clusters differed in their FSH trajectories, timing of estradiol production, and ovarian characteristics.
    Conclusions: The AMH clusters identified suggest variation in the timing and the magnitude of the minipuberty response in infant girls. The decreasing and low clusters have not been described previously and should be further evaluated to determine whether they represent an opportunity for the early identification of later reproductive conditions.
    MeSH term(s) Female ; Infant ; Humans ; Longitudinal Studies ; Anti-Mullerian Hormone ; Follicle Stimulating Hormone ; Ovary ; Estradiol
    Chemical Substances Anti-Mullerian Hormone (80497-65-0) ; Follicle Stimulating Hormone (9002-68-0) ; Estradiol (4TI98Z838E)
    Language English
    Publishing date 2023-03-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1053263-8
    ISSN 1531-5487 ; 1044-3983
    ISSN (online) 1531-5487
    ISSN 1044-3983
    DOI 10.1097/EDE.0000000000001610
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