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Biomedical subjects

Paul R Billings

Publications and source records attributed to Paul R Billings.

12 recordsLinked to original sources
PubMed2006

Colorectal cancer screening using stool DNA analysis in clinical practice: early clinical experience with respect to patient acceptance and colonoscopic follow-up of abnormal tests.

BACKGROUND: Stool-based DNA screening for colorectal cancer (CRC) was recently made available for use in daily clinical practice (PreGen-Plus). The main objectives of this study were to examine patients' screening experiences with stool DNA testing in routine clinical practice and the results of diagnostic colonoscopy in patients with an antecedent abnormal stool DNA test. PATIENTS AND METHODS: Patients undergoing stool-based DNA testing were asked to complete and return via mail an anonymous 10-item questionnaire inquiring about their test-related experiences. Colonoscopy findings for all abnormal stool-based DNA tests were ascertained via a telephone survey of the ordering primary care clinicians' offices. RESULTS: Patient survey responses were collected between August 2003 and July 2005 and reflect an 18% (1211 of 6730) response rate. The majority reported that the specimen collection process was very easy/easy to perform (87%), that they were very likely/likely to use the test again (91%), and that they had never been screened for CRC previously by any method (52%). Tests were ordered predominantly by the patient's primary care clinician (90%), including obstetrician/gynecologist providers. Colonoscopy findings from 69 of 159 patients with an antecedent abnormal stool DNA test screened with PreGen-Plus between August 2003 and July 2004 were available for review. An abnormal stool DNA test correlated with a colonoscopically demonstrable abnormality in 49% of cases (34 of 69). Abnormal findings, including CRC in 3 patients (4%; 1 with Dukes A and 2 with Dukes B disease), single or multiple adenomatous polyps in 23 patients (33%), hyperplastic polyps in 3 patients (4%), and colitis in 5 patients (7%). Colonoscopy was reported as negative in 51% of patients (35 of 69), including 2 cases (3%) with an altered BAT-26 microsatellite caused by a normal polymorphism. CONCLUSION: Stool DNA testing provides an acceptable noninvasive alternative for CRC screening that can identify early-stage CRCs and adenomatous polyps in routine clinical practice. Ongoing and broader surveys are indicated to support these early findings.

Aged↗
PubMed2005

Genetic nondiscrimination.

The identification and investigation of sentinel cases has illuminated genetic discrimination in the US. Its occurrence impedes applications of biotechnology and is a primary focus of public policy activity at the federal level. Continued research and informed responses may make genetic nondiscrimination more likely.

Genetic Privacy↗
PubMed2002

Concentrations of estrogens and IGFs in umbilical cord blood plasma: a comparison among Caucasian, Hispanic, and Asian-American females.

It has been hypothesized that exposure to elevated levels of estrogens and IGFs before birth may increase breast cancer risk in female offspring. We examined whether the concentrations of estrone, E2, IGF-I, IGF-II, and IGF-binding protein-1 (IGFBP-1), -2, and -3 in umbilical cord blood plasma differed in female neonates of three racial/ethnic groups with contrasting breast cancer risk. The study included 57 Caucasian, 22 Hispanic, and 22 Asian-American subjects. Relative contribution of race/ethnicity to the analyte level variability was the largest for IGFBP-1 (P = 0.06). The only statistically significant (P < 0.05) mean difference was the lower IGFBP-3 levels in Asian than in Caucasian subjects. Adjusted mean levels of estrone and E2 for Asian subjects were 128% and 109% of the Caucasian means, respectively, whereas the Hispanic group showed lower means (85% and 84% of the Caucasian means). IGF-I, IGFBP-1, and IGFBP-3 showed lower adjusted means for both Hispanics and Asians compared with Caucasians. However, these differences were not statistically significant. In summary, we have shown that concentrations of estrogens, IGF-I, IGF-II, and IGFBPs are not different in cord blood samples from Caucasian, Hispanic, and Asian-American subjects. These data do not support a link between antenatal exposure to elevated levels of estrogens and IGFs and breast cancer.

Adult↗