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G Colditz

Publications and source records attributed to G Colditz.

25 records · Page 2Linked to original sources

Oral contraceptives and breast cancer. Review and meta-analysis.

To evaluate the relation between use of oral contraceptives and the incidence of breast cancer, the authors reviewed the epidemiologic literature and used quantitative methods to summarize the data. Study results for any use of oral contraceptives were pooled using a model that accounted for both interstudy and intrastudy variability. The authors also explored interstudy variability and modeled a duration-effect relation between oral contraceptive use and breast cancer. Case-control and follow-up studies were considered separately. Overall, the authors observed no increase in the risk of breast cancer for women who had ever used oral contraceptives, even after a long duration of use. These results were consistent across study design. However, data combined from case-control studies revealed a statistically significant positive trend (P = 0.001) in the risk of premenopausal breast cancer for women exposed to oral contraceptives for longer duration. This risk was predominant among women who used oral contraceptives for at least 4 years before their first term pregnancy (relative risk = 1.72; 95% confidence interval = 1.36 to 2.19). Additional study is required to determine whether this finding in a subgroup of exposed women is confirmed and whether the risk remains increased with advancing age.

Adult

Coffee, caffeine, and cardiovascular disease in men.

BACKGROUND: For many years, an association between coffee consumption and the risk of coronary heart disease has been suspected. Although based on small numbers of end points, a prospective study has suggested a particularly strong association between recent coffee drinking and the incidence of cardiovascular disease. METHODS: We examined prospectively the relation of coffee consumption with the risk of myocardial infarction, need for coronary-artery bypass grafting or angioplasty, and risk of stroke in a cohort of 45,589 U.S. men who were 40 to 75 years old in 1986 and who had no history of cardiovascular disease. RESULTS: During two years of follow-up observation, 221 participants had a nonfatal myocardial infarction or died of coronary heart disease, 136 underwent coronary-artery surgery or angioplasty, and 54 had a stroke. Total coffee consumption was not associated with an increased risk of coronary heart disease or stroke. The age-adjusted relative risk for all cardiovascular disease among participants who drank four or more cups of coffee per day was 1.04 (95 percent confidence intervals, 0.74 to 1.46). Increasing levels of consumption of caffeinated coffee were not associated with higher risks of cardiovascular disease. Higher consumption of decaffeinated coffee, however, was associated with a marginally significant increase in the risk of coronary heart disease (relative risk, 1.63; 95 percent confidence interval, 1.02 to 2.60). Finally, we observed no pattern of increased risk across the subgroups of participants with increasing intakes of caffeine from all sources. Adjustment for major cardiovascular-risk indicators, dietary intake of fats, and cholesterol intake did not materially alter these associations. CONCLUSIONS: These findings do not support the hypothesis that coffee or caffeine consumption increases the risk of coronary heart disease or stroke.

Adult

Continuing education in general practice. 2. Impact of education activities.

Should continuing education for doctors be compulsory? Our study of General Practitioners in Queensland evaluated the usefulness of and preference for various types of educational activities. Lectures and consultants' letters were considered the most useful while pharmaceutical company evenings and visiting lecturers were most regularly attended. These latter activities were a useful source of medical knowledge: patient management skills were gained at weekend conferences; and procedural skills were obtained through hospital training courses.

Australia

Continuing education in general practice. 1. Attitudes of general practitioners.

As part of a Queensland survey, we made an assessment of the attitudes of general practitioners to continuing education. We analysed responses for age, sex, type and geographical location of practice. Almost all the respondents (99%) agreed that commitment to CME is lifelong. Most of them did not feel that there is too much concern with keeping up-to-date. Recognition of their own educational needs is a problem for a sizeable minority. Most feel that GP skills can be taught through CME courses, which should focus on patient management. Informal communication with colleagues is a useful mode of learning. Although exactly half the doctors felt that CME should be mandatory, a greater proportion of younger doctors were in favour.

Adult