Heather M Ochs-Balcom

University at Buffalo, The State University of New York | SUNY Buffalo · Department of Epidemiology and Environmental health

Background There is emerging evidence that cancer and its treatments may accelerate the normal aging process, increasing the magnitude and rate of decline in functional capacity. This accelerated aging process is hypothesized to hasten the occurrence of common adverse age-related outcomes in cancer survivors, including loss of muscle mass and decre...

Background: While there is growing evidence that physical activity increases ovarian cancer risk, studies to date have been focused primarily on women of European ancestry. Little is known about whether physical inactivity is also associated with ovarian cancer risk in women of African ancestry. Methods: In three studies in the Ovarian Cancer in Wo...

Background: Most studies examining post-menopausal menopausal hormone therapy (MHT) use and ovarian cancer risk have focused on White women and few have included Black women. Methods: We evaluated MHT use and ovarian cancer risk in Black (n = 800 cases, 1783 controls) and White women (n = 2710 cases, 8556 controls), using data from the Ovarian C...

Objective Telomere length (TL) is a posited pathway through which chronic stress results in biological dysregulation and subsequent adverse health outcomes. Food insecurity is associated with shorter TL. Social support, which is defined by the size and function of an individual’s social network, is associated with better health outcomes. The presen...

Purpose There is increasing evidence that sleep duration may affect breast cancer survival through effects on circadian function, influencing disease progression. However, further investigation of this association is needed. Methods In a population-based, prospective cohort study of women from the Western New York Exposures and Breast Cancer Study...

Objective: To evaluate associations between endometriosis and uterine leiomyomas with ovarian cancer risk by race and the effect of hysterectomy on these associations. Methods: We used data from four case-control studies and two case-control studies nested within prospective cohorts in the OCWAA (Ovarian Cancer in Women of African Ancestry) cons...

Current guidelines recommend that physicians use a shared decision-making (SDM) approach to engage with patients on the potential benefits and harms of prostate cancer screening based on their individual risk. In a sample of 4,118 men aged 55-69 from the 2018 New York State Behavioral Risk Factor Surveillance Survey (BRFSS), we compared the frequen...

Sleep Disordered Breathing (SDB) is a common disease associated with increased risk for cardiometabolic, cardiovascular, and cognitive diseases. How SDB affects the molecular environment is still poorly understood. We study the association of three SDB measures with gene expression measured using RNA-seq in multiple blood tissues from the Multi-Eth...

Unlabelled: We evaluated the influence of two endogenous hormones on bone health in older women. Higher FSH was associated with bone disease, especially in lower estradiol environments. FSH attenuated the relationship between estradiol and bone. This may provide a mechanism through which future clinical research intervenes on bone loss. Introduct...

PURPOSE: Women with endometriosis have a 2 to 3-fold greater risk of endometrioid and clear cell ovarian cancer than other women, based on estimates from studies predominantly of White women. Fibroids have not been consistently associated with ovarian cancer risk but are the most common indication for hysterectomies in the U.S. Hysterectomy has bee...

Background Epidemiological evidence suggests that inadequate sleep duration and insomnia may be associated with increased risk of metabolic syndrome (MetS). However, longitudinal data with repeated measures of sleep duration and insomnia and of MetS are limited. We examined the association of sleep duration and insomnia with MetS and its components...

Background: Obesity disproportionately affects African American (AA) women and has been shown to increase ovarian cancer risk, with some suggestions that the association may differ by race. Methods: We evaluated body mass index (BMI) and invasive epithelial ovarian cancer (EOC) risk in a pooled study of case-control and nested case-control studi...

Introduction: Obstructive sleep apnea (OSA) is a common disorder associated with increased risk for cardiovascular disease, diabetes, and premature mortality. There is strong clinical and epi-demiologic evidence supporting the importance of genetic factors influencing OSA, but limited data implicating specific genes. Methods: Leveraging high dep...

Background Sleep Disordered Breathing (SDB) is characterized by repeated breathing reductions or cessations during sleep, often accompanied by oxyhemoglobin desaturation. How SDB affects the molecular environment is still poorly understood. Methods We studied the association of three SDB measures: the Apnea Hypopnea Index (AHI), average and minimu...

Objectives More than 40% of U.S. adults are obese. Obesity, and in particular abdominal obesity, is associated with increased risk for developing a variety of chronic diseases. Obesity, aging, and menopause are each associated with differential shifts in the gut microbiome. We examined the association of visceral adiposity tissue (VAT) and the gut...

Background: Menstrual cycle characteristics-including age at menarche and cycle length- have been associated with ovarian cancer risk in White women. However, the associations between menstrual cycle characteristics and ovarian cancer risk among Black women have been sparsely studied. Methods: Using the Ovarian Cancer in Women of African Ancestr...

Background Evidence from animal studies suggests that the gradual rise in follicle stimulating hormone (FSH) during reproductive senescence may contribute to the change in adiposity distribution characteristic of menopause. The potential independent role the interrelationships of FSH and estradiol may play in postmenopausal adiposity changes are no...

Background Head and neck cancer (HNC) and its treatment are associated with muscle weakness and considerable long-term comorbidity. The goal of this study was to determine whether skeletal muscle density (SMD) as quantified from pretreatment computed tomography (CT) scans will correlate with measures of function and strength prior to treatment in p...

Aim: To determine the association of coenzyme Q10 (CoQ10) use with the resolution of statin-associated muscle symptoms (SAMS). Patients & methods: Retrospective analysis of a large, multi-center survey study of SAMS (total n = 511; n = 64 CoQ10 users). Univariate and multivariate logistic regression models assessed the association between CoQ10 use...

Obstructive sleep apnea (OSA) is a common disorder associated with increased risk of cardiovascular disease and mortality. Iron and heme metabolism, implicated in ventilatory control and OSA comorbidities, was associated with OSA phenotypes in recent admixture mapping and gene enrichment analyses. However, its causal contribution was unclear. In th...

Head and neck cancer (HNC) treatment-related morbidity can be detrimental to quality of life (QOL). Myosteatosis is associated with poor QOL in multiple cancers. If predictive of poor QOL trajectories, myosteatosis would be a tool for clinicians to determine which patients may require additional support during treatment. The purpose of this study w...

We examined the association between self-reported sleep quality, sleep duration, and dietary patterns among police officers in the Buffalo Cardio-Metabolic Occupational Stress (BCOPS) study. 422 police officers aged 21–74 (2004–2009). We used a cross-sectional study design and obtained sleep quality and duration from responses to the 19-item Pittsb...

Purpose of Study: We used multiple mediation analysis to examine why African-American women have poorer ovarian cancer survival compared to white women. Methods: We examined data from the OCWAA consortium which harmonized questionnaire-based data on 1,075 African-American women and 3,272 white women with ovarian cancer from seven U.S. studies. We f...

Introduction: Visceral adipose tissue (VAT) is a hypothesized driver of chronic disease. Dual-energy X-ray absorptiometry (DXA) potentially offers a lower cost and more available alternative compared to gold-standard magnetic resonance imaging (MRI) for quantification of abdominal fat sub-compartments, VAT and subcutaneous adipose tissue (SAT). We...

Introduction: Family history is a risk factor for colorectal cancer (CRC), however whether family history also contributes to non-syndromic early-onset CRC is unknown. Methods: We estimated risk to first-, second-, and third-degree relatives of early-onset CRC cases in the Utah Pedigree Database. Results: We observed elevated risks beyond RR =...

Background: Genital powder use is more common among African-American women; however, studies of genital powder use and ovarian cancer risk have been conducted predominantly in White populations, and histotype-specific analyses among African-American populations are limited. Methods: We used data from five studies in the Ovarian Cancer in Women o...

Family history (FH) of ovarian cancer and breast cancer are well‐established risk factors for ovarian cancer, but few studies have examined this association in African American (AA) and white women by histotype. We assessed first‐ and second‐degree FH of ovarian and breast cancer and risk of epithelial ovarian cancer in the Ovarian Cancer in Women...

Background The D3-creatine (D3Cr) dilution method provides a direct measure of skeletal muscle. The aim of this study was to compare the association of D3Cr muscle mass with lean body mass (LBM) measured by dual energy x-ray absorptiometry (DXA) and examine its relation with physical function in postmenopausal women. Methods 74 community dwelling...

PURPOSE: To date, the epidemiology of epithelial ovarian cancer (EOC) among African-American women has been severely understudied. It remains unclear to what extent variation in the prevalence of EOC risk factors may explain incidence disparities between African-American and white women. Genital powder use is more common among African-American wome...

Background The causes of racial disparities in epithelial ovarian cancer (EOC) incidence remain unclear. Differences in the prevalence of ovarian cancer risk factors may explain disparities in EOC incidence among African American (AA) and White women. Methods We used data from four case-control studies and three case-control studies nested within...

Purpose. Although the incidence of epithelial ovarian cancer is highest among non-Hispanic white women, African-American women have the worst survival of all racial/ethnic groups. We hypothesize that differences in the prevalence of known and suspected ovarian cancer risk factors may explain a portion of the differences in incidence of epithelial o...

Significance: Lifestyle influences eye health and other chronic diseases. All health care providers, not just primary care physicians, should have the necessary information and training to advise and refer patients on lifestyle to take advantage of opportunities to provide such advice. Purpose: The extent to which optometrists offer lifestyle ad...

Family history and body mass index (BMI) are well‐known risk factors for colorectal cancer (CRC), however, their joint effects are not well described. Using linked data for genealogy, self‐reported height and weight from driver's licenses, and the Utah Surveillance, Epidemiology, and End‐Results cancer registry, we found that an increasing number o...

Objective: Obesity disproportionately affects African American (AA) women, and there is some suggestion that its association with ovarian cancer risk may be stronger among AA compared to white women, but no study to date has been adequately powered to compare risk between the two populations. The Ovarian Cancer in Women of African Ancestry (OCWAA)...

Background: Family history of ovarian and breast cancers is a well-established risk factor for ovarian cancer and recent findings suggest that the risk of ovarian cancer may be higher for African American (AA) women compared to other racial/ethnic groups. Few studies have been able to examine this association in both AA and White participants takin...

The most common adverse drug reaction from statins are statin-associated muscle symptoms (SAMS), characterized by myopathy (weakness), myalgia (muscle pain), and commonly elevation in serum creatine kinase. All statins are substrates of the organic anion transporter 1B1 (OATP1B1; gene: SLCO1B1), albeit to different degrees. A genetic polymorphism i...

Short sleep duration, recognized as a public health epidemic, is associated with adverse health conditions, yet little is known about the association between sleep and bone health. We tested the associations of usual sleep behavior and bone mineral density (BMD) and osteoporosis. In a sample of 11,084 postmenopausal women from the Women's Health In...

Average arterial oxyhemoglobin saturation during sleep (AvSpO2S) is a clinically relevant measure of physiological stress associated with sleep-disordered breathing, and this measure predicts incident cardiovascular disease and mortality. Using high-depth whole-genome sequencing data from the National Heart, Lung, and Blood Institute (NHLBI) Trans-...

Cachexia is a multifactorial syndrome that is characterized by loss of skeletal muscle mass in cancer patients. The biological pathways involved remain poorly characterized. Here, we compare urinary metabolic profiles in newly diagnosed colorectal cancer patients (stage I–IV) from the ColoCare Study in Heidelberg, Germany. Patients were classified...

Purpose Although the incidence rate of epithelial ovarian cancer (EOC) is somewhat lower in African American (AA) than white women, survival is worse. The Ovarian Cancer in Women of African Ancestry (OCWAA) consortium will overcome small, study-specific sample sizes to better understand racial differences in EOC risk and outcomes. Methods We harmo...

Telomere length is a heritable marker of cellular age that is associated with morbidity and mortality. Poor sleep behaviors, which are also associated with adverse health events, may be related to leukocyte telomere length (LTL). We studied a sub-population of 3,145 postmenopausal women enrolled 1993-1998 to the Women's Health Initiative (1,796 Eur...

Introduction Statins reduce cardiovascular disease risk and are generally well‐tolerated, yet up to 0.5% of statin‐treated patients develop incapacitating muscle symptoms including rhabdomyolysis. Our objective was to identify clinical factors related to statin‐associated muscle symptoms (SAMS). Methods Clinical and laboratory characteristics were...

Sleep disturbances are common and may influence falls and fracture directly by influencing bone turnover and muscle strength or indirectly through high comorbidity or poor physical function. To investigate the association between self‐reported sleep and falls and fractures, we prospectively studied 157,306 women in the Women's Health Initiative (WH...

Several genome-wide association studies (GWAS) have identified genetic variants associated with birth weight. To date, however, most GWAS of birth weight have focused primarily on European ancestry samples even though prevalence of low birth weight is higher among African-Americans. We conducted admixture mapping using 2918 ancestral informative ma...

Objective: We conducted a gene-environment interaction study to evaluate whether the association of body mass index (BMI) associated meta genome-wide association study single-nucleotide polymorphisms (SNPs) (as a genetic risk score) and BMI is modified by physical activity and age. Methods: In 8,206 women of European ancestry from the Women's He...

Background Clustering of breast and colorectal cancer has been observed within some families and cannot be explained by chance or known high-risk mutations in major susceptibility genes. Potential shared genetic susceptibility between breast and colorectal cancer, not explained by high-penetrance genes, has been postulated. We hypothesized that yet...

Odds ratio (OR) estimates with 95% confidence interval (CI) for association of selected colorectal cancer GWAS SNPs with the breast-colorectal cancer phenotype. (DOCX)

Odds ratio (OR) estimates with 95% confidence interval (CI) for association of selected breast cancer GWAS SNPs with the breast-colorectal cancer phenotype. (DOCX)

Functional annotation of the ROBO1 variants. (DOCX)

Quantile-quantile plot of genotyped and imputed data. (DOCX)

Manhattan plot (Discovery data). (DOCX)

ROBO1 gene expression across multiple human tissues, including breast and colon. (DOCX)

SNPs with P<5x10-4 (n = 549) in the Discovery Phase, and their Discovery, Replication, Meta-analysis, and stratified (by CCFR/BCFR) P-values, by chromosome. (DOCX)

ROBO1 mutations across different cancer types, including breast and colorectal. (DOCX)

Context: Cancer patients' continued tobacco use results in poorer therapeutic outcomes including decreased quality of life and survival. Objective: To assess reach and impact of a free, opt-out, telephone-based tobacco cessation program for thoracic cancer center patients. Design: Observational study. Setting: Comprehensive Cancer Center in...

Study objectives: Night shift work is associated with increased breast cancer risk, possibly from altered sleep. Epidemiologic evidence is sparse regarding sleep disturbances and breast cancer tumor markers. We examined sleep disturbance in association with breast tumor aggressiveness and mortality following diagnosis. Methods: We analyzed assoc...

Purpose: Epidemiological studies suggest that short sleep duration and poor sleep quality may increase breast cancer risk. However, whether sleep is associated with breast tumor aggressiveness characteristics has largely been unexplored. Methods: The study included 4171 non-Hispanic whites (NHW) and 235 African Americans (AA) diagnosed with inci...

Background: Genome-wide association studies (GWAS) have identified associations of telomere maintenance genes with breast cancer risk. This, coupled with the recognized role of telomere dysfunction as a cancer hallmark, has motivated the need for further study of telomeres and breast cancer. Further, the meta-GWAS discovery of seven single nucleoti...

Introduction: We characterised tobacco use, cessation patterns, and patient satisfaction with a cessation support program at an NCI Designated Comprehensive Cancer Center following a mandatory tobacco assessment and automatic referral. Methods: A 3-month follow-up survey (via web, paper, or telephone) was administered between March 2013 and Novembe...

Context: Evidence supports a protective effect of menopausal hormone therapy (HT) on bone. However, whether genetic susceptibility modifies the association of HT and fracture risk is not sufficiently explored. Objective: The objective was to test an interaction between genetic susceptibility and HT on fracture risk. Design: We constructed two...

Background The nuclear hormone receptor superfamily acts as a genomic sensor of diverse signals. Their actions are often intertwined with other transcription factors. Nuclear hormone receptors are targets for many therapeutic drugs, and include the vitamin D receptor (VDR). VDR signaling is pleotropic, being implicated in calcaemic function, antiba...

Background: Fracture is a complex trait, affected by both genetic and environmental factors. A meta-analysis of genome-wide association studies (GWASs) identified multiple bone mineral density (BMD) and fracture-associated loci. Objective: We conducted a study to evaluate whether fracture genetic risk score (Fx-GRS) and bone mineral density gene...

Background. Disparities exist in the incidence of aggressive breast cancer characteristics by race. In order to characterize potential contributors to breast cancer disparities, we studied breastfeeding and parity characteristics in a sample of African American families with breast cancer. Based on evidence suggesting that lack of breastfeeding may...

Purpose: There is accumulating evidence that oxidative stress is an important contributor to carcinogenesis. We hypothesized that genetic variation in genes involved in maintaining antioxidant/oxidant balance would be associated with overall oxidative stress. Methods: We examined associations between single nucleotide polymorphisms (SNPs) in MnS...

Study Objective: Sleep problems may constitute a risk for health problems, including cardiovascular disease, depression, diabetes, poor work performance, and motor vehicle accidents. The primary purpose of this study was to assess the validity of the current Behavioral Risk Factor Surveillance System (BRFSS) sleep questions by establishing the sens...

Purpose: We tested the hypothesis that dietary intake of lutein is inversely associated with prevalence of diabetic retinopathy (DR) due to its antioxidant and anti-inflammatory properties and location within the retina. Methods: We used logistic regression to examine the association between prevalent DR and energy-adjusted lutein intake by quar...

Better sleep quality was associated with dietary patterns high in fruits, vegetables, and dairy products, specifically among women. Depression mediated the association between sleep quality and fruit and vegetable consumption among women and men.

Study objectives: Poor sleep quality and short sleep duration have been associated with elevated risk for several cancer types; however, the relationship between sleep and cancer outcomes has not been well characterized. We assessed the association between pre-diagnostic sleep attributes and subsequent cancer survival within the Women's Health Ini...

Study objective: Sleep problems may constitute a risk for health problems, including cardiovascular disease, depression, diabetes, poor work performance, and motor vehicle accidents. The primary purpose of this study was to assess the validity of the current Behavioral Risk Factor Surveillance System (BRFSS) sleep questions by establishing the sen...

Mutations in the p53 gene are among the most frequent genetic events in human cancer and may be triggered by environmental and occupational exposures. We examined the association of clinical and pathological characteristics of breast tumors and breast cancer risk factors according to the prevalence and type of p53 mutations. Using tumor blocks from...

This study characterizes tobacco cessation patterns and the association of cessation with survival among lung cancer patients at Roswell Park Cancer Institute: an NCI Designated Comprehensive Cancer Center. Lung cancer patients presenting at this institution were screened with a standardized tobacco assessment, and those who had used tobacco within...

The insulin-signaling pathway plays a pivotal role in cancer biology; however, evidence of genetic alterations in human studies is limited. This case-control study nested within the Framingham Heart Study (FHS) examined the association between inherited genetic variation in the insulin receptor (INSR) gene and obesity-related cancer risk. The study...

More than two-thirds of US women are overweight or obese, placing them at increased risk for postmenopausal breast cancer. To investigate in this secondary analysis the associations of overweight and obesity with risk of postmenopausal invasive breast cancer after extended follow-up in the Women's Health Initiative (WHI) clinical trials. The WHI cl...

Background/objectives: The relationship between obesity and circulating levels of antioxidants is poorly understood. Most studies that have examined the association of adiposity with blood or tissue concentrations of antioxidant micronutrients have been cross-sectional, and few have compared the associations for indices of overall obesity and cent...

A workshop entitled "Building a funded research program in cancer health disparities" was held at the 38th Annual American Society of Preventive Oncology (ASPO) Meeting. Organized by the Junior Members Interest Group, the session addressed topics relevant to career development for cancer disparities investigators. Such considerations include the de...

Statin-induced myopathy (SIM) is the most common reason for discontinuation of statin therapy. A polymorphism affecting the gene encoding glycine amidinotransferase (GATM rs9806699 G > A) was previously associated with reduced risk for SIM. Our objective was to replicate the GATM association in a large, multicenter SIM case-control study. Mild and...

Background: Declines in endogenous estrogen levels after menopause can lead to systemic bone loss, including loss of oral bone and alveolar crest height (ACH). However, few studies have assessed both serum 17β-estradiol (E2) and exogenous hormone therapy (HT) use in relation to oral bone loss. Methods: This study examines the associations among...

Background: Genome-wide association studies have identified polymorphisms associated with breast cancer subtypes and across multiple population subgroups; however, few studies to date have applied linkage analysis to other population groups. Methods: We performed the first genome-wide breast cancer linkage analysis in 106 African American families...

Lignans, a class of phytoestrogen commonly found in the Western diet, have been linked to decreased breast cancer risks in epidemiologic studies. Similar to estrogen receptors, the androgen receptor (AR), a prognostic factor in breast tumors, may be affected by lignans. However, few studies have investigated this link in the context of breast cance...

Background. Few studies have investigated the contribution of inherited genetic variation to breast cancer disparities and fewer have examined whether risk alleles shared in families may contribute to higher risk of aggressive tumors. One barrier is the challenge of effectively recruiting African American families for research. Methods. Using a com...

s: Sixth AACR Conference: The Science of Cancer Health Disparities; December 6–9, 2013; Atlanta, GA Background. Obesity is now a well-established risk factor for colon neoplasia, yet the biological mechanisms underlying this link are not fully understood. Increasing data support that adipokines play an important role in colon carcinogenesis, and i...

Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA Inflammation and angiogenesis are important pathways of colorectal carcinogenesis. We investigated interactions between genes related to both pathways and the use of NSAIDs on CRC risk. Furthermore, we assessed whether specific variants interact with the inflammation biomarkers...

Purpose. The association between obesity and colon neoplasia is well established but the underlying biological mechanisms are not fully understood. Rates of both obesity and colon cancer differ by race. Adipokines have been postulated as contributors to the observed association; however, few studies have examined the mediating effect of adipokines...

One barrier to searching for novel mutations in African American families with breast cancer is the challenge of effectively recruiting families-affected and non-affected relatives-into genetic research studies. Using a community-based participatory research (CBPR) orientation, we incorporated several evidence-based approaches through an iterative...

Background: Genome-wide association studies have identified several single nucleotide polymorphisms (SNPs) that are associated with risk of colorectal cancer. Prior research has evaluated the presence of gene-environment interaction involving the first 10 identified susceptibility loci, but little work has been conducted on interaction involving S...

Insulin resistance is believed to play an important role in the link between energy imbalance and colon carcinogenesis. Emerging evidence suggests that there are substantial racial differences in genetic and anthropometric influences on insulin-like growth factors (IGFs); however, few studies have examined racial differences in the associations of...

Purpose: Most tobacco cessation studies in cancer patients rely upon retrospective reviews in a small subsample of cancer patients presenting for treatment. The purpose of this study is to describe the tobacco use and cessation patterns for all patients (100% sampling) presenting to a thoracic oncology clinic at a NCI Designated Comprehensive Cance...

Objective Chronic lung disease is exacerbated by comorbid psychiatric issues and treatment of depression may improve disease symptoms. We sought to add to the literature as to whether depression is associated with pulmonary function in healthy adults.Methods In 2551 healthy adults from New York State, we studied the association of depression via th...

Genotyping and imputation platforms used by all participating studies. (DOC)

Imputation quality at 8 associated loci. (DOC)

Local ancestry analysis for two top variants (rs2075064 at LHX2 and rs6931262 at RREB1) with single GC-corrected p-value<5×10−8. (DOC)

Figure S1a – Quantile-quantile and Manhattan plots for genome-wide association for waist circumference and waist circumference adjusted for BMI in sex-specific samples and all samples. Figure S1b – Quantile-quantile and Manhattan plots for genome-wide association for waist-hip ratio and waist-hip ratio adjusted for BMI in sex-specific samples and a...

Study sample characteristics by gender. (DOC)

Gender-specific association analysis at 8 associated loci. (DOC)

Study specific methods. (DOC)

Central obesity, measured by waist circumference (WC) or waist-hip ratio (WHR), is a marker of body fat distribution. Although obesity disproportionately affects minority populations, few studies have conducted genome-wide association study (GWAS) of fat distribution among those of predominantly African ancestry (AA). We performed GWAS of WC and WH...