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R M Bostick

Publications and source records attributed to R M Bostick.

42 records · Page 3Linked to original sources
PubMed1993

Knowledge, attitudes, and personal practices regarding prevention and early detection of cancer.

METHODS: To determine population knowledge, attitudes, and personal practices regarding prevention and early detection of cancer, random population samples of 25- to 74-year-old men and women in six various-sized communities in three upper-midwestern states (N = 4,915) were administered surveys and interviews during 1987-1989. RESULTS: Four-fifths of respondents believed cancer to be preventable. Knowledge of warning signs/symptoms of cancer and of leading causes of cancer, however, was low. Over 95% of women had had a Papanicolaou smear and a clinical breast exam or had performed a breast self-exam; 65.7% of those ages 50-65 years had had a mammogram. Among men and women ages 50-65 years, 77% had had a digital rectal exam; 52.5%, a fecal occult blood test; and 48.3%, a sigmoidoscopy. CONCLUSIONS: Conditions are favorable for an increase in mammography, including favorable attitudes toward cancer prevention, strong consensus among policy-making organizations regarding guidelines for obtaining mammograms, and high levels of adherence to these recommendations by women who have had at least their first mammogram. Challenges now include acceptance of these guidelines by physicians, mammogram affordability/availability, and demonstration of efficacious, cost-effective, and reliable colorectal/prostate cancer screening tests.

Adult↗
PubMed1993

Difficulty becoming pregnant and family history as interactive risk factors for postmenopausal breast cancer: the Iowa Women's Health Study.

We recently provided data from a prospective cohort study of postmenopausal women which suggested that a first livebirth at age 30 or older (cf before age 20) was associated with a twofold increased risk of breast cancer in women without a family history, but a 5.8-fold higher risk in women with a positive family history. To address the question of whether these observations reflect difficulty becoming pregnant or maintaining a pregnancy, we performed additional analyses in which the outcome of each pregnancy was considered. During five years of follow-up, 620 incident cases of breast cancer were identified in the 37,105 women at risk. There was little evidence for an increased risk associated with a history of spontaneous abortion (relative risk [RR] = 1.1; 95 percent confidence interval [CI] = 0.9-1.4), nor was the risk higher among women who reported two or more spontaneous abortions in consecutive pregnancies (RR = 1.0, CI = 0.7-1.4). Although women who reported that they had tried unsuccessfully to become pregnant had only slightly and nonsignificantly elevated risks of breast cancer (RR = 1.1, CI = 0.9-1.3), a more pronounced and statistically significant association was noted in women with a positive family history (RR = 2.1, CI = 1.4-3.2). There was a strong inverse association between failure to become pregnant and parity (P < 0.0001); nearly 50 percent of the nulliparous married women reported having tried and failed to become pregnant, whereas the frequency was only 6.8 percent among married women with five or more livebirths.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗
PubMed1992

Antibiotic use in urban whites and blacks: the Minnesota Heart Survey.

OBJECTIVE: To assess racial differences in the use of antibiotics, including penicillins, erythromycins, tetracyclines, sulfas, and cephalosporins. DESIGN: Population-based surveys, conducted from 1985 to 1987. SETTING: The seven-county metropolitan area of Minneapolis-St. Paul, MN. PARTICIPANTS: 3127 whites (response rate 68 percent) and 1047 blacks (response rate 65 percent), aged 35-74 years. RESULTS: White women (26 percent of 1625) were more likely to report having taken an antibiotic in the past year than were white men (18 percent of 1502), black women (18 percent of 590), or black men (15 percent of 457). Reported antibiotic usage decreased with increasing age. Black men were more likely than white men to report the use of tetracyclines or sulfas; otherwise, white men reported higher usage prevalences. White women reported higher usage prevalences of all drug classes than black women. CONCLUSIONS: Significant independent predictors of antibiotic use were younger age, white race, and female gender. Potential explanations for these differences include differences in patient access, physician-prescribing behaviors, or both.

Adult↗
PubMed1991

Changes in physician practice for the prevention of cardiovascular disease.

To determine recent changes in physicians' practices for cardiovascular disease risk reduction, a randomly selected sample of practicing primary care physicians in the upper Midwest was interviewed by telephone in 1987 and again in 1989 (response rates, greater than 90%; N = 241). The reported mean cutoff levels for labeling a total serum cholesterol level as abnormal dropped from 5.84 to 5.43 mmol/L (226 to 210 mg/dL) and for initiating medication, from 7.34 to 6.54 mmol/L (284 to 253 mg/dL). The proportion of physicians using diuretics as preferred step 1 antihypertensive agents dropped from 60% to 32%. Preferences became evenly divided among diuretics, angiotensin-converting enzyme inhibitors, and beta-blockers. Advice about physical exercise changed little, but consensus among practicing physicians was high. Substantial improvements were found in smoking cessation activities. Practicing physicians are proving to be responsive to new scientific evidence and education in the prevention of cardiovascular disease.

Antihypertensive Agents↗
PubMedDate not supplied

Dietary fat and risk of breast cancer according to hormone receptor status.

The association of dietary fat with breast cancer in prospective cohort studies has generally been weak and not statistically significant. However, these studies have not considered whether the risk related to fat intake may differ according to estrogen or progesterone receptor status. Dietary habits and other breast cancer risk factors were assessed by mailed questionnaire in January 1986 in 34,388 postmenopausal Iowa women. Through 1991, 724 incident breast cancer cases were ascertained in this cohort using the Iowa cancer registry. Joint estrogen and progesterone receptor status was determined for 479 (66%) breast cancers. For tumors that were positive for both estrogen and progesterone receptors (ER+/PR+) (n = 329), age- and energy-adjusted relative risks for breast cancer adjusted from lowest to highest third of fat intake were 1.0, 1.05, and 1.22 (P trend = 0.14). Corresponding risks for ER+/PR- tumors (n = 75) were 1.0, 0.85, and 1.05 (P trend = 0.86) and for ER-/PR- tumors (n = 61) were 1.0, 1.06, and 0.73 (P trend = 0.68). Only 14 cases were classified as having ER-/PR+ tumors. Adjustment for other breast cancer risk factors did not appreciably alter these findings. There was a suggestion that dietary fat may be associated with ER+/PR+ breast cancers and not other breast cancers. These results are also consistent with an interpretation of no association between dietary fat with breast cancer, regardless of hormone receptor status. It has been suggested that etiological studies of breast cancer should investigate associations according to receptor status. This study provides evidence of a subset of breast cancers that may be related to dietary factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗