Christina D Williams

Journal Article Cancer Epidemiol Biomarkers Prev · November 1, 2024 BACKGROUND: Risk for colorectal cancer may accumulate through multiple environmental factors. Understanding their effects, along with genetics, age, and family history, could allow improvements in clinical decisions for screening protocols. We aimed to ext ... Full text Link to item Cite

Lung Cancer Survival Trends in the Veterans Health Administration.

Conference Clin Lung Cancer · May 2024 INTRODUCTION: Lung cancer survival is improving in the United States. We investigated whether there was a similar trend within the Veterans Health Administration (VHA), the largest integrated healthcare system in the United States. MATERIALS AND METHODS: D ... Full text Link to item Cite

Longitudinal Patterns of Multimorbidity in Gulf War Era Veterans With and Without Gulf War Illness.

Journal Article J Aging Health · April 9, 2024 Objectives: To examine whether severe Gulf War illness (SGWI) case status was associated with longitudinal multimorbidity patterns. Methods: Participants were users of the Veteran Health Administration Health Care System drawn from the Gulf War Era Cohort ... Full text Link to item Cite

Military exposures and Gulf War illness in veterans with and without posttraumatic stress disorder.

Journal Article J Trauma Stress · February 2024 Gulf War illness (GWI) is a chronic multisymptom disorder of unknown etiology that is believed to be caused by neurotoxicant exposure experienced during deployment to the Gulf War. Posttraumatic stress disorder (PTSD) covaries with GWI and is believed to p ... Full text Link to item Cite

Colorectal Cancer Polygenic Risk Score Is Associated With Screening Colonoscopy Findings but Not Follow-Up Outcomes.

Journal Article Gastro Hep Adv · 2024 BACKGROUND AND AIMS: Colorectal cancer (CRC) polygenic risk scores (PRS) may help personalize CRC prevention strategies. We investigated whether an existing PRS was associated with advanced neoplasia (AN) in a population undergoing screening and follow-up ... Full text Link to item Cite

Characterizing Deficit Accumulation Among Gulf War Era Veterans.

Journal Article J Frailty Aging · 2024 BACKGROUND: Veterans of the first Gulf War (1990-1991) are reaching middle and older adulthood in differing degrees of health and biological age. Many Gulf War veterans report myriad negative symptoms classified as Gulf War illness (GWI), a chronic multi-s ... Full text Link to item Cite

Self-reported gastrointestinal disorders among veterans with gulf war illness with and without posttraumatic stress disorder.

Journal Article Neurogastroenterol Motil · May 2023 BACKGROUND: Gulf War Illness (GWI) is a chronic, multi-symptom disorder affecting 25%-32% of Gulf War veterans. Veterans with GWI disproportionately suffer from gastrointestinal (GI) disorders. Given the increasing evidence supporting a gut-brain axis, we ... Full text Link to item Cite

Health outcomes and healthcare resource utilization among Veterans with stage IV non-small cell lung cancer treated with second-line chemotherapy versus immunotherapy.

Journal Article PLoS One · 2023 BACKGROUND: Until recently, multi-agent chemotherapy (CT) was the standard of care for patients with advanced non-small cell lung cancer (NSCLC). Clinical trials have confirmed benefits in overall survival (OS) and progression-free survival with immunother ... Full text Link to item Cite

Medications Associated with Lower Mortality in a SARS-CoV-2 Positive Cohort of 26,508 Veterans.

Journal Article J Gen Intern Med · December 2022 BACKGROUND: Many severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positive patients take commonly prescribed medications with properties which may affect mortality. OBJECTIVE: Assess if common medications postulated to affect clinical outcomes ... Full text Link to item Cite

Longitudinal assessment of colonoscopy adverse events in the prospective Cooperative Studies Program no. 380 colorectal cancer screening and surveillance cohort.

Journal Article Gastrointest Endosc · September 2022 BACKGROUND AND AIMS: Data are limited regarding colonoscopy risk during long-term, programmatic colorectal cancer screening and follow-up. We aimed to describe adverse events during follow-up in a colonoscopy screening program after the baseline examinatio ... Full text Link to item Cite

Ten or More Cumulative Lifetime Adenomas Are Associated with Increased Risk for Advanced Neoplasia and Colorectal Cancer.

Journal Article Dig Dis Sci · June 2022 BACKGROUND: Colorectal cancer (CRC) screening guidelines recommend frequent colonoscopies and consideration of genetic testing in individuals with ≥10 cumulative adenomas. However, it is unclear how these guidelines apply to routine practice. AIMS: We esti ... Full text Link to item Cite

Health-Related Quality of Life by Gulf War Illness Case Status.

Journal Article Int J Environ Res Public Health · April 7, 2022 This study examines how health-related quality of life (HRQOL) and related indices vary by Gulf War illness (GWI) case status. The study population included veterans from the Gulf War Era Cohort and Biorepository (n = 1116). Outcomes were physical and ment ... Full text Link to item Cite

Screening Colonoscopy Findings Are Associated With Noncolorectal Cancer Mortality.

Journal Article Clin Transl Gastroenterol · April 1, 2022 INTRODUCTION: Controversy exists regarding the impact of various risk factors on noncolorectal cancer (CRC) mortality in healthy screening populations. We examined the impact of known CRC risk factors, including baseline colonoscopy findings, on non-CRC mo ... Full text Link to item Cite

The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2.

Journal Article Int J Environ Res Public Health · December 31, 2021 This data-based cohort consisted of 26,508 (7%) United States veterans out of the 399,290 who tested positive for SARS-CoV-2 from 1 March to 10 September 2020. We aimed to assess the interaction of post-index vitamin D (Vit D) and corticosteroid (CRT) use ... Full text Link to item Cite

Gene-Toxicant Interactions in Gulf War Illness: Differential Effects of the PON1 Genotype.

Journal Article Brain Sci · November 25, 2021 About 25-35% of United States veterans who fought in the 1990-1991 Gulf War report several moderate or severe chronic systemic symptoms, defined as Gulf War illness (GWI). Thirty years later, there is little consensus on the causes or biological underpinni ... Full text Link to item Cite

COVID-19-Associated Mortality in US Veterans with and without SARS-CoV-2 Infection.

Journal Article Int J Environ Res Public Health · August 11, 2021 BACKGROUND: We performed an observational Veterans Health Administration cohort analysis to assess how risk factors affect 30-day mortality in SARS-CoV-2-infected subjects relative to those uninfected. While the risk factors for coronavirus disease 2019 (C ... Full text Open Access Link to item Cite

Interventions designed to increase the uptake of lung cancer screening and implications for priority populations: a scoping review protocol.

Journal Article BMJ Open · July 28, 2021 BACKGROUND: When designing any health intervention, it is important to respond to the unequal determinants of health by prioritising the allocation of resources and tailoring interventions based on the disproportionate burden of illness. This approach, cal ... Full text Link to item Cite

Characterizing chronological accumulation of comorbidities in healthy veterans: a computational approach.

Journal Article Sci Rep · April 14, 2021 Understanding patient accumulation of comorbidities can facilitate healthcare strategy and personalized preventative care. We applied a directed network graph to electronic health record (EHR) data and characterized comorbidities in a cohort of healthy vet ... Full text Open Access Link to item Cite

Development of a Multi-Study Repository to Support Research on Veteran Health: The VA Cooperative Studies Program Epidemiology Center-Durham (CSPEC-Durham) Data and Specimen Repository.

Journal Article Front Public Health · 2021 Federal agencies, including the Department of Veterans Affairs (VA), have prioritized improved access to scientific data and results collected through federally funded research. Our VA Cooperative Studies Program Epidemiology Center in Durham, North Caroli ... Full text Link to item Cite

Use and Outcomes of SBRT for Early Stage NSCLC Without Pathologic Confirmation in the Veterans Health Care Administration.

Journal Article Adv Radiat Oncol · 2021 PURPOSE: Stereotactic body radiation therapy (SBRT) use has increased among patients without pathologic confirmation (PC) of lung cancer. Empirical SBRT without PC raises concerns about variation in workup and patient selection, but national trends have no ... Full text Link to item Cite

Genetic Colorectal Cancer and Adenoma Risk Variants Are Associated with Increasing Cumulative Adenoma Counts.

Conference Cancer Epidemiol Biomarkers Prev · November 2020 BACKGROUND: The genetic basis for most individuals with high cumulative lifetime colonic adenomas is unknown. We investigated associations between known colorectal cancer-risk single-nucleotide polymorphisms (SNP) and increasing cumulative adenoma counts. ... Full text Link to item Cite

Risk Factors for Early-Onset Colorectal Cancer.

Journal Article Gastroenterology · August 2020 BACKGROUND & AIMS: Colorectal cancer (CRC) incidence and mortality are increasing among persons younger than 50 years old in the United States, but risk factors associated with early-onset CRC (EOCRC) have not been widely studied. METHODS: We conducted a c ... Full text Link to item Cite

High-Risk Adenomas at Screening Colonoscopy Remain Predictive of Future High-Risk Adenomas Despite an Intervening Negative Colonoscopy.

Journal Article Am J Gastroenterol · August 2020 INTRODUCTION: Limited data inform the current postpolypectomy surveillance guidelines, which suggest a shortened interval to third colonoscopy after a negative second examination if high-risk adenomas (HRA) were present on the initial screening colonoscopy ... Full text Link to item Cite

Baseline Colonoscopy Findings Associated With 10-Year Outcomes in a Screening Cohort Undergoing Colonoscopy Surveillance.

Journal Article Gastroenterology · March 2020 BACKGROUND & AIMS: Few studies have evaluated long-term outcomes of ongoing colonoscopic screening and surveillance in a screening population. We aimed to determine the 10-year risk for advanced neoplasia (defined as adenomas ≥10mm, adenomas with villous h ... Full text Link to item Cite

Racial Differences in Treatment and Survival among Veterans and Non-Veterans with Stage I NSCLC: An Evaluation of Veterans Affairs and SEER-Medicare Populations.

Journal Article Cancer Epidemiol Biomarkers Prev · January 2020 BACKGROUND: Surgery is the preferred treatment for stage I non-small cell lung cancer (NSCLC), with radiation reserved for those not receiving surgery. Previous studies have shown lower rates of surgery among Blacks with stage I NSCLC than among Whites. ME ... Full text Link to item Cite

Survival Advantage With Adjuvant Chemotherapy for Locoregionally Advanced Rectal Cancer: A Veterans Health Administration Analysis.

Journal Article J Natl Compr Canc Netw · January 2020 BACKGROUND: Adjuvant chemotherapy (AC) after chemoradiation (CRT) and surgery for locoregionally advanced rectal cancer (LARC) is a standard of care in the United States. This study examined the role, optimal regimen, and duration of AC using data from the ... Full text Link to item Cite

Gender-based Differences among 1990-1991 Gulf War Era Veterans: Demographics, Lifestyle Behaviors, and Health Conditions.

Journal Article Womens Health Issues · June 25, 2019 OBJECTIVE: The 1990-1991 Gulf War employed more women servicemembers than any prior conflict. Gender-based differences among veterans of this era have yet to be explored. This study is among the first and most recent to stratify Gulf War veteran demographi ... Full text Link to item Cite

Racial/Ethnic Disparities in BRCA Counseling and Testing: a Narrative Review.

Journal Article Journal of racial and ethnic health disparities · June 2019 Background/objectiveDespite increases in BRCA mutation testing, racial/ethnic disparities in counseling and testing have persisted for decades. The purpose of the review was to summarize recent literature as it relates to detecting, understanding, ... Full text Cite

Long-term Clinical Outcomes of Nonoperative Management With Chemoradiotherapy for Locally Advanced Rectal Cancer in the Veterans Health Administration.

Journal Article Int J Radiat Oncol Biol Phys · March 1, 2019 PURPOSE: Standard therapy for locally advanced rectal cancer includes neoadjuvant chemoradiation and surgery. Complete response (CR) rates after chemoradiation can be as high as 29%, suggesting that nonoperative management (NOM) may be reasonable with appr ... Full text Link to item Cite

Cancer Among Women Treated in the Veterans Affairs Healthcare System.

Journal Article Journal of women's health (2002) · February 2019 BackgroundThe Veterans Affairs (VA) healthcare system is a high-volume provider of cancer care. Women are the fastest growing patient population using VA healthcare services. Quantifying the types of cancers diagnosed among women in the VA is a cr ... Full text Cite

Increasing PET Use in Small Cell Lung Cancer: Survival Improvement and Stage Migration in the VA Central Cancer Registry.

Journal Article J Natl Compr Canc Netw · February 2019 Background: Accurate staging for small cell lung cancer (SCLC) is critical for determining appropriate therapy. The clinical impact of increasing PET adoption and stage migration is well described in non-small cell lung cancer but not in SCLC. The objectiv ... Full text Link to item Cite

Cardiovascular disease-related chronic conditions among Veterans Affairs nonmetastatic colorectal cancer survivors: a matched case-control analysis.

Journal Article Cancer Manag Res · 2019 PURPOSE: The growing number of colorectal cancer (CRC) survivors often have multiple chronic conditions. Comparing nonmetastatic CRC survivors and matched noncancer controls, our objectives were to determine the odds of CRC survivors being diagnosed with c ... Full text Open Access Link to item Cite

Structured Approach for Evaluating Strategies for Cancer Ascertainment Using Large-Scale Electronic Health Record Data.

Journal Article JCO Clin Cancer Inform · December 2018 PURPOSE: Cancer ascertainment using large-scale electronic health records is a challenge. Our aim was to propose and apply a structured approach for evaluating multiple candidate approaches for cancer ascertainment using colorectal cancer (CRC) ascertainme ... Full text Link to item Cite

Aging

Chapter · October 31, 2018 Full text Cite

Improved Survival of Stage I Non-Small Cell Lung Cancer: A VA Central Cancer Registry Analysis.

Journal Article J Thorac Oncol · December 2017 INTRODUCTION: The combined impact of advances in diagnosis and treatment of stage I NSCLC has not been assessed comprehensively. To define the survival impact of modern staging and treatment techniques for clinical stage I NSCLC, the Veterans Administratio ... Full text Link to item Cite

Cancer Incidence Among Patients of the U.S. Veterans Affairs Health Care System: 2010 Update.

Journal Article Mil Med · July 2017 INTRODUCTION: Nearly 50,000 incident cancer cases are reported in Veterans Affairs (VA) Central Cancer Registry (VACCR) annually. This article provides an updated report of cancer incidence recorded in VACCR. MATERIALS AND METHODS: Data were obtained from ... Full text Link to item Cite

Metformin, Diabetes, and Survival among U.S. Veterans with Colorectal Cancer-Response.

Journal Article Cancer Epidemiol Biomarkers Prev · June 2017 Full text Link to item Cite

Next steps to improve disparities in lung cancer treatment clinical trial enrollment.

Journal Article Ann Transl Med · March 2017 Full text Link to item Cite

Use of NCCN Guidelines, Other Guidelines, and Biomarkers for Colorectal Cancer Screening.

Journal Article J Natl Compr Canc Netw · November 2016 Colorectal cancer (CRC) remains a common cancer and significant public health burden. CRC-related mortality is declining, partly due to the early detection of CRC through robust screening. NCCN has established the NCCN Guidelines for CRC Screening to help ... Full text Link to item Cite

Impact of Race on Treatment and Survival among U.S. Veterans with Early-Stage Lung Cancer.

Journal Article J Thorac Oncol · October 2016 INTRODUCTION: Numerous reports suggest lower rates of surgical procedures and poorer survival for black patients with early-stage (stage I or II) NSCLC than for white patients. This study examined treatment trends among blacks and whites with early-stage N ... Full text Link to item Cite

Metformin, Diabetes, and Survival among U.S. Veterans with Colorectal Cancer.

Journal Article Cancer Epidemiol Biomarkers Prev · October 2016 BACKGROUND: Metformin has been associated with improved colorectal cancer survival, but investigations are limited by small numbers of patients and confounding by diabetic severity. We examined the association between metformin use and overall survival (OS ... Full text Link to item Cite

Effect of age on the efficacy of adjuvant chemotherapy for resected non-small cell lung cancer.

Journal Article Cancer · August 1, 2015 BACKGROUND: Adjuvant chemotherapy after surgical resection improves outcomes for patients with early-stage non-small cell lung cancer (NSCLC). To the authors' knowledge, there are no published prospective trials to date of adjuvant chemotherapy after surgi ... Full text Link to item Cite

Carbohydrate intake, glycemic index and prostate cancer risk.

Journal Article Prostate · March 1, 2015 BACKGROUND: Reported associations between dietary carbohydrate and prostate cancer (PC) risk are poorly characterized by race. METHODS: We analyzed the association between carbohydrate intake, glycemic index (GI), and PC risk in a study of white (N = 262) ... Full text Link to item Cite

Cisplatin and etoposide versus carboplatin and paclitaxel with concurrent radiotherapy for stage III non-small-cell lung cancer: an analysis of Veterans Health Administration data.

Journal Article J Clin Oncol · February 20, 2015 PURPOSE: The optimal chemotherapy regimen to use with radiotherapy in stage III non-small-cell lung cancer is unknown. Here, we compare the outcome of patents treated within the Veterans Health Administration with either etoposide-cisplatin (EP) or carbopl ... Full text Link to item Cite

Lung and colorectal cancer treatment and outcomes in the Veterans Affairs health care system.

Journal Article Cancer Manag Res · 2015 Lung cancer (LC) and colorectal cancer (CRC) are the second- and third-most commonly diagnosed cancers in the Veterans Affairs (VA) health care system. While many studies have evaluated the treatment quality and outcomes of various aspects of VA LC and CRC ... Full text Link to item Cite

Racial disparities in cancer care in the Veterans Affairs health care system and the role of site of care.

Journal Article Am J Public Health · September 2014 OBJECTIVES: We assessed cancer care disparities within the Veterans Affairs (VA) health care system and whether between-hospital differences explained disparities. METHODS: We linked VA cancer registry data with VA and Medicare administrative data and exam ... Full text Link to item Cite

Use and impact of adjuvant chemotherapy in patients with resected non-small cell lung cancer.

Journal Article Cancer · July 1, 2014 BACKGROUND: Despite clinical trials demonstrating improved survival with adjuvant chemotherapy (AC) for patients with American Joint Committee on Cancer stages I to III non-small cell lung cancer (NSCLC), it is unclear whether this survival benefit extends ... Full text Link to item Cite

Cisplatin versus carboplatin-based regimens for the treatment of patients with metastatic lung cancer. An analysis of Veterans Health Administration data.

Journal Article J Thorac Oncol · May 2014 BACKGROUND: While platinum-based doublet chemotherapy is standard of care for patients presenting with metastatic non-small-cell lung cancer, the optimal platinum agent (cisplatin versus carboplatin) is unclear. We therefore compared survival and toxicity ... Full text Link to item Cite

Evolution of the Quality Oncology Practice Initiative supportive care quality measures portfolio and conformance at a Veterans Affairs medical center.

Journal Article Journal of oncology practice · May 2013 PurposeA growing set of quality measures is being implemented to evaluate all components of cancer care, from diagnosis through the end of life. We investigated the Quality Oncology Practice Initiative (QOPI) quality measures portfolio. Additional ... Full text Cite

Antioxidants and prevention of gastrointestinal cancers.

Journal Article Curr Opin Gastroenterol · March 2013 PURPOSE OF REVIEW: Gastrointestinal cancers account for 20% of all incident cancers in the United States. Much work has been done to understand the role dietary factors play in the prevention of gastrointestinal cancers, yet evidence regarding the potentia ... Full text Link to item Cite

Influence of comorbidity on racial differences in receipt of surgery among US veterans with early-stage non-small-cell lung cancer.

Journal Article J Clin Oncol · February 1, 2013 PURPOSE: It is unclear why racial differences exist in the frequency of surgery for lung cancer treatment. Comorbidity is an important consideration in selection of patients for lung cancer treatment, including surgery. To assess whether comorbidity contri ... Full text Link to item Cite

The association of race with timeliness of care and survival among Veterans Affairs health care system patients with late-stage non-small cell lung cancer.

Journal Article Cancer Manag Res · 2013 BACKGROUND: Non-small cell lung cancer is the leading cause of cancer-related mortality in the United States. Patients with late-stage disease (stage 3/4) have five-year survival rates of 2%-15%. Care quality may be measured as time to receiving recommende ... Full text Link to item Cite

Associations between Intake of Folate, Methionine, and Vitamins B-12, B-6 and Prostate Cancer Risk in American Veterans.

Journal Article J Cancer Epidemiol · 2012 Prostate cancer (PC) is the second leading cause of cancer death in men. Recent reports suggest that excess of nutrients involved in the one-carbon metabolism pathway increases PC risk; however, empirical data are lacking. Veteran American men (272 control ... Full text Open Access Link to item Cite

Dietary calcium and risk for prostate cancer: a case-control study among US veterans.

Journal Article Prev Chronic Dis · 2012 OBJECTIVE: The objective of this study was to examine the association between calcium intake and prostate cancer risk. We hypothesized that calcium intake would be positively associated with lower risk for prostate cancer. METHODS: We used data from a case ... Full text Link to item Cite

A high ratio of dietary n-6/n-3 polyunsaturated fatty acids is associated with increased risk of prostate cancer.

Journal Article Nutr Res · January 2011 Experimental studies suggest omega-3 (n-3) polyunsaturated fatty acids (PUFA) suppress and n-6 PUFA promote prostate tumor carcinogenesis. Epidemiologic evidence remains inconclusive. The objectives of this study were to examine the association between n-3 ... Full text Link to item Cite

Antioxidant and DNA methylation-related nutrients and risk of distal colorectal cancer.

Journal Article Cancer Causes Control · August 2010 OBJECTIVE: To investigate the relationship between antioxidant nutrients (vitamins C and E, beta-carotene, selenium) and DNA methylation-related nutrients (folate, vitamins B6 and B12) and distal colorectal cancer risk in whites and African Americans and t ... Full text Link to item Cite

Associations of red meat, fat, and protein intake with distal colorectal cancer risk.

Journal Article Nutr Cancer · 2010 Studies have suggested that red and processed meat consumption elevate the risk of colon cancer; however, the relationship between red meat, as well as fat and protein, and distal colorectal cancer (CRC) specifically is not clear. We determined the risk of ... Full text Link to item Cite

Adiponectin and prostate cancer mortality: to be or not to be skinny?

Journal Article Clin Chem · January 2010 Full text Link to item Cite

Dietary patterns, food groups, and rectal cancer risk in Whites and African-Americans.

Journal Article Cancer Epidemiol Biomarkers Prev · May 2009 BACKGROUND: Associations between individual foods and nutrients and colorectal cancer have been inconsistent, and few studies have examined associations between food, nutrients, dietary patterns, and rectal cancer. We examined the relationship between food ... Full text Link to item Cite

Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis: the GENEVA study. Rationale, study design and demographic characteristics.

Journal Article Neuroepidemiology · 2008 Recent reports of a potentially increased risk of amyotrophic lateral sclerosis (ALS) for veterans deployed to the 1990-1991 Persian Gulf War prompted the Department of Veterans Affairs to establish a National Registry of Veterans with ALS, charged with th ... Full text Link to item Cite