Christina Williams

Positions:

Assistant Professor in Medicine

Medicine, Medical Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2009

University of North Carolina at Chapel Hill

Grants:

Publications:

Aging

MLA Citation
Zullig, L. L., et al. “Aging.” Handbook of Cancer Survivorship: Second Edition, 2018, pp. 91–109. Scopus, doi:10.1007/978-3-319-77432-9_6.
URI
https://scholars.duke.edu/individual/pub1421455
Source
scopus
Published Date
Start Page
91
End Page
109
DOI
10.1007/978-3-319-77432-9_6

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

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 cardiovascular disease (CVD)-related chronic conditions and their likelihood of control during the year after CRC diagnosis. Patients and methods: We retrospectively identified patients diagnosed with nonmetastatic CRC in the Veterans Affairs health care system from fiscal years 2009 to 2012 and matched each with up to 3 noncancer control patients. We used logistic regression to assess differences in the likelihood of being diagnosed with CVD-related chronic conditions and control between nonmetastatic CRC survivors and noncancer controls. Results: We identified 9,758 nonmetastatic CRC patients and matched them to 29,066 noncancer controls. At baseline, 69.4% of CRC survivors and their matched controls were diagnosed with hypertension, 52.4% with hyperlipidemia, and 36.7% with diabetes. Compared to matched noncancer controls, CRC survivors had 57% higher odds of being diagnosed with hypertension (OR=1.57, 95% CI=1.49-1.64) and 7% higher odds of controlled blood pressure (OR=1.07, 95% CI 1.02, 1.13) in the subsequent year. Compared to matched noncancer control patients, CRC survivors had half the odds of being diagnosed with hyperlipidemia (OR=0.50, 95% CI=0.48-0.52) and lower odds of low-density lipoprotein (LDL) control (OR 0.88, 95% CI 0.81-0.94). There were no significant differences between groups for diabetes diagnoses or control. Conclusion: Compared to noncancer controls, nonmetastatic CRC survivors have 1) greater likelihood of being diagnosed with hypertension and worse blood pressure control in the year following diagnosis; 2) lower likelihood of being diagnosed with hyperlipidemia or LDL control; and 3) comparable diabetes diagnoses and control. There may be a need for hypertension control interventions targeting cancer survivors.
Authors
Zullig, LL; Smith, VA; Lindquist, JH; Williams, CD; Weinberger, M; Provenzale, D; Jackson, GL; Kelley, MJ; Danus, S; Bosworth, HB
MLA Citation
Zullig, Leah L., et al. “Cardiovascular disease-related chronic conditions among Veterans Affairs nonmetastatic colorectal cancer survivors: a matched case-control analysis..” Cancer Manag Res, vol. 11, 2019, pp. 6793–802. Pubmed, doi:10.2147/CMAR.S191040.
URI
https://scholars.duke.edu/individual/pub1404026
PMID
31413631
Source
pubmed
Published In
Cancer Management and Research
Volume
11
Published Date
Start Page
6793
End Page
6802
DOI
10.2147/CMAR.S191040

Carbohydrate intake, glycemic index and prostate cancer risk.

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) and black (N = 168) veterans at the Durham VA Hospital. Cases were 156 men with biopsy-confirmed PC and controls (N = 274) had a PSA test but were not recommended for biopsy. Diet was assessed before biopsy with a self-administered food frequency questionnaire. Logistic regression models were used to estimate PC risk. RESULTS: In multivariable analyzes, higher carbohydrate intake, measured as percent of energy from carbohydrates, was associated with reduced PC risk (3rd vs. 1st tertile, OR = 0.41, 95% CI 0.21-0.81, P = 0.010), though this only reached significance in white men (p-trend = 0.029). GI was unrelated to PC risk among all men, but suggestively linked with reduced PC risk in white men (p-trend = 0.066) and increased PC risk in black men (p-trend = 0.172), however, the associations were not significant. Fiber intake was not associated with PC risk (all p-trends > 0.55). Higher carbohydrate intake was associated with reduced risk of high-grade (p-trend = 0.016), but not low-grade PC (p-trend = 0.593). CONCLUSION: Higher carbohydrate intake may be associated with reduced risk of overall and high-grade PC. Future larger studies are needed to confirm these findings.
Authors
Vidal, AC; Williams, CD; Allott, EH; Howard, LE; Grant, DJ; McPhail, M; Sourbeer, KN; Hwa, LP; Boffetta, P; Hoyo, C; Freedland, SJ
MLA Citation
Vidal, Adriana C., et al. “Carbohydrate intake, glycemic index and prostate cancer risk..” Prostate, vol. 75, no. 4, Mar. 2015, pp. 430–39. Pubmed, doi:10.1002/pros.22929.
URI
https://scholars.duke.edu/individual/pub1051057
PMID
25417840
Source
pubmed
Published In
Prostate
Volume
75
Published Date
Start Page
430
End Page
439
DOI
10.1002/pros.22929

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

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 groups and dietary patterns and risk for rectal cancer in non-Hispanic Whites and African-Americans. METHODS: Data were from the North Carolina Colon Cancer Study-Phase II and included 1,520 Whites (720 cases, 800 controls) and 384 African-Americans (225 cases, 159 controls). Diet was assessed using the Diet History Questionnaire. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals. RESULTS: Among Whites, non-whole grains and white potatoes were associated with elevated risk for rectal cancer whereas fruit, vegetables, dairy, fish, and poultry were associated with reduced risk. In African-Americans, high consumption of other fruit and added sugar suggested elevated risk. We identified three major dietary patterns in Whites and African-Americans. The high fat/meat/potatoes pattern was observed in both race groups but was only positively associated with risk in Whites (odds ratio, 1.84; 95% confidence interval, 1.03-3.15). The vegetable/fish/poultry and fruit/whole grain/dairy patterns in Whites had significant inverse associations with risk. In African-Americans, there was a positive dose-response for the fruit/vegetables pattern (P(trend) < 0.0001) and an inverse linear trend for the legumes/dairy pattern (P(trend) < 0.0001). CONCLUSION: Our findings indicate that associations of certain food groups and overall dietary patterns with rectal cancer risk differ between Whites and African-Americans, highlighting the importance of examining diet and cancer relationships in racially diverse populations.
Authors
Williams, CD; Satia, JA; Adair, LS; Stevens, J; Galanko, J; Keku, TO; Sandler, RS
MLA Citation
Williams, Christina Dawn, et al. “Dietary patterns, food groups, and rectal cancer risk in Whites and African-Americans..” Cancer Epidemiol Biomarkers Prev, vol. 18, no. 5, May 2009, pp. 1552–61. Pubmed, doi:10.1158/1055-9965.EPI-08-1146.
URI
https://scholars.duke.edu/individual/pub1114023
PMID
19423533
Source
pubmed
Published In
Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
Volume
18
Published Date
Start Page
1552
End Page
1561
DOI
10.1158/1055-9965.EPI-08-1146

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

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 demographics, lifestyle factors, and self-reported diagnoses by gender. METHODS: Data from the cross-sectional Gulf War Era Cohort and Biorepository pilot study (n = 1,318; collected between 2014 and 2016), including users and nonusers of the Veterans Health Administration, were used to calculate demographics and adjusted odds ratios. RESULTS: Women veterans were oversampled and comprised approximately 23% of the sample. Women reported similar rates of Veterans Health Administration use (44%) and deployment (67%) as men (46% and 72%, respectively). Women were less likely than men to report frequent alcohol use (adjusted odds ratio [aOR], 0.59; 95% confidence interval [CI], 0.43-0.81; p = .0009) or have a history of smoking (aOR, 0.65; 95% CI, 0.49-0.84; p = .0014). Among common health conditions, women were more likely than men to report a diagnosis of osteoporosis (aOR, 4.24; 95% CI, 2.39-7.51; p < .0001), bipolar disorder (aOR, 2.15; 95% CI, 1.15-4.04; p = .0167), depression (aOR, 2.39; 95% CI, 1.81-3.16; p < .0001), irritable bowel syndrome (aOR, 2.10; 95% CI, 1.43-3.09; p = .0002), migraines (aOR, 2.96; 95% CI, 2.18-4.01; p < .0001), asthma (aOR, 1.86; 95% CI, 1.29-2.67; p = .0008), and thyroid problems (aOR, 4.60; 95% CI, 3.14-6.73; p < .0001). Women were less likely than men to report hypertension (aOR, 0.55; 95% CI, 0.41-0.72; p < .0001), tinnitus (aOR, 0.46; 95% CI, 0.33-0.63; p < .0001), and diabetes (aOR, 0.44; 95% CI, 0.28-0.69; p = .0003). CONCLUSIONS: Health differences exist between female and male veterans from the 1990-1991 Gulf War. Gender-specific analyses are needed to better understand the unique health care needs of Gulf War Era veterans and direct future research.
Authors
Brown, MC; Sims, KJ; Gifford, EJ; Goldstein, KM; Johnson, MR; Williams, CD; Provenzale, D
MLA Citation
Brown, Mackenzie C., et al. “Gender-based Differences among 1990-1991 Gulf War Era Veterans: Demographics, Lifestyle Behaviors, and Health Conditions..” Womens Health Issues, vol. 29 Suppl 1, June 2019, pp. S47–55. Pubmed, doi:10.1016/j.whi.2019.04.004.
URI
https://scholars.duke.edu/individual/pub1377804
PMID
31253242
Source
pubmed
Published In
Womens Health Issues
Volume
29 Suppl 1
Published Date
Start Page
S47
End Page
S55
DOI
10.1016/j.whi.2019.04.004