| |||
Cancer Sites (cancer + site)
Selected AbstractsCoffee consumption and risk of colorectal cancer in a population-based prospective cohort of Japanese men and womenINTERNATIONAL JOURNAL OF CANCER, Issue 6 2007Kyung-Jae Lee Abstract We prospectively examined the association between coffee consumption and the risk of developing colorectal cancer in a large population-based cohort study (the JPHC Study) of Japanese men and women. Data were analyzed from a population-based cohort of 96,162 subjects (46,023 men and 50,139 women). A total of 1,163 incident colorectal cancers were identified during the follow-up period, including 763 cases of colon cancer and 400 of rectal cancer. We observed a significant inverse association between coffee consumption and the risk of developing invasive colon cancer among women. Compared with those who almost never consumed coffee, women who regularly consumed 3 or more cups of coffee per day had a RR of 0.44 (95% CI = 0.19,1.04; p for trend = 0.04) after adjustment for potential confounding factors. However, no significant association was found for rectal cancer in women. In men, no significant decrease was observed in any colorectal cancer site. Further, additional analyses on the association of green tea consumption with colorectal cancer risk found no significant association in men or women. These findings suggest that coffee consumption may lower the risk of colon cancer among Japanese women. © 2007 Wiley-Liss, Inc. [source] Cancer mortality among French nuclear contract workersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2009Sylvie Guérin PhD Abstract Background Nuclear workers from French contracting companies have received higher doses than workers from Electricité de France (EDF) or Commissariat à l'Energie Atomique (CEA). Methods A cohort study of 9,815 workers in 11 contracting companies, monitored for exposure to ionizing radiation between 1967 and 2000 were followed up for a median duration of 12.5 years. Standardized mortality ratios (SMRs) were computed. Results Between 1968 and 2002, 250 deaths occurred. Our study demonstrated a clear healthy worker effect (HWE) with mortality attaining half that expected from national mortality statistics (SMR,=,0.54, 95% CI,=,[0.47,0.61]). The HWE was lower for all cancers (SMR,=,0.65) than for non-cancer deaths (SMR,=,0.46). The analysis by cancer site showed no excess compared with the general population. Significant trends were observed according to the level of exposure to ionizing radiation for deaths from cancer, deaths from digestive cancer and deaths from respiratory cancer. Conclusions The mortality of nuclear workers from contracting companies is very low compared to French national mortality. Am. J. Ind. Med. 52:916,925, 2009. © 2009 Wiley-Liss, Inc. [source] Epidemiological changes in colorectal cancer in Shiraz, Iran: 1980,2000ANZ JOURNAL OF SURGERY, Issue 7 2004Seyed Vahid Hosseini Background: The present study was performed to determine trends in colorectal cancer rates over the past two decades (1970,80 vs 1990,2000) with in a main referral centre in Shiraz, Iran. Methods: The Cancer Registry data on all colorectal cancer cases from 1970 to 2000 in Shiraz, Iran, were analysed. Demographic characteristics, clinical features, cancer site and type and stage of cancer were compared in the populations of two different decades. Results: The age-adjusted incidence of colorectal cancer per 100 000 population per year increased in men from a mean annual incidence of 1.61 in the decade 1970,80 to 4.2 in 1990,2000 (P < 0.05), and in women from 2.35 to 2.72 (P < 0.05). In 1970,80, patients over 60 years had 62.5% of all the colorectal cancers, which decreased to 30% in 1990,2000 (P < 0.05). The distribution of right and left sided cancers were almost equal and showed no significant difference between the two decades (P > 0.05). Conclusion: A marked increase in the incidence of colorectal cancer has been shown in Shiraz. Also, the marked increase in the incidence of colorectal cancer in the 40,60-year-old age group shown in the present study necessitates a more detailed work-up in younger age group patients. [source] The role of colour Doppler ultrasonography in detecting prostate cancerBJU INTERNATIONAL, Issue 3 2000K. Shigeno Objective To determine the usefulness of colour Doppler ultrasonography (CDUS) in detecting prostate cancer, by comparing CDUS with grey-scale transrectal ultrasonography (TRUS) and magnetic resonance imaging (MRI). Patients and methods In all, 278 patients who underwent prostate biopsies because of an abnormal digital rectal examination, elevated prostate specific antigen levels, and/or abnormal TRUS between May 1998 and November 1999 were evaluated. The diagnostic accuracies of TRUS, CDUS, MRI and combinations of these imaging techniques in detecting prostate cancer were compared, based on the biopsy results. Results Carcinoma was detected in 233 of 1696 specimens, and 87 patients were diagnosed with prostate cancer. For each detected cancer site, the sensitivity of CDUS was lower than those of other imaging techniques, but CDUS had high a specificity and positive predictive value. The combination of grey-scale TRUS and CDUS or MRI improved the sensitivity and negative predictive value. The specificity and positive predictive value of the combination of grey-scale TRUS and MRI were less than those for grey-scale TRUS alone, while those for the combination of grey-scale TRUS and CDUS were higher than those for grey-scale TRUS alone. Five tumours were isoechoic but seen as hypervascular lesions with CDUS. Conclusion CDUS provides information useful for detecting prostate cancer when used in combination with grey-scale TRUS, and should be included in the routine examination for prostate cancer. [source] Interleukin-6 predicts recurrence and survival among head and neck cancer patients,CANCER, Issue 4 2008Sonia A. Duffy PhD Abstract BACKGROUND. Increased pretreatment serum interleukin (IL)-6 levels among patients with head and neck squamous cell carcinoma (HNSCC) have been shown to correlate with poor prognosis, but sample sizes in prior studies have been small and thus unable to control for other known prognostic variables. METHODS. A longitudinal, prospective cohort study determined the correlation between pretreatment serum IL-6 levels, and tumor recurrence and all-cause survival in a large population (N = 444) of previously untreated HNSCC patients. Control variables included age, sex, smoking, cancer site and stage, and comorbidities. Kaplan-Meier plots and univariate and multivariate Cox proportional hazards models were used to study the association between IL-6 levels, control variables, and time to recurrence and survival. RESULTS. The median serum IL-6 level was 13 pg/mL (range, 0-453). The 2-year recurrence rate was 35.2% (standard error, 2.67%). The 2-year death rate was 26.5% (standard error, 2.26%). Multivariate analyses showed that serum IL-6 levels independently predicted recurrence at significant levels [hazard ratio (HR) = 1.32; 95% confidence interval (CI), 1.11 to 1.58; P = .002] as did cancer site (oral/sinus). Serum IL-6 level was also a significant independent predictor of poor survival (HR = 1.22; 95% CI, 1.02 to 1.46; P = .03), as were older age, smoking, cancer site (oral/sinus), higher cancer stage, and comorbidities. CONCLUSIONS. Pretreatment serum IL-6 could be a valuable biomarker for predicting recurrence and overall survival among HNSCC patients. Using IL-6 as a biomarker for recurrence and survival may allow for earlier identification and treatment of disease relapse. Cancer 2008. © 2008 American Cancer Society. [source] The use of symptoms to predict colorectal cancer site.COLORECTAL DISEASE, Issue 8 2010Can we reduce the pressure on our endoscopy services? No abstract is available for this article. [source] Epidemiologic evaluation of pharmaceuticals with limited evidence of carcinogenicityINTERNATIONAL JOURNAL OF CANCER, Issue 9 2009Gary D. Friedman Abstract Thorough review by the International Agency for Research on Cancer (IARC) has resulted in classifying many substances, including pharmaceuticals, as probably or possibly carcinogenic to humans, based on experiments on animals or limited data on humans. We evaluated 9 such pharmaceuticals for evidence of carcinogenicity in patients receiving them in a large medical care program with automated pharmacy records and a cancer registry. Nested case,control analyses were performed in a cohort of 6.5 million subscribers with up to 12 years of follow-up, focusing on cancer sites suggested by previous evidence and other sites with odds ratio of at least 1.50, p < 0.01 and some evidence of dose,response. Unmeasured confounding was estimated in sensitivity analyses. We found some supportive evidence for carcinogenicity of griseofulvin, metronidazole and phenytoin and for the known carcinogen, cyclophosphamide, which was added for validation of our data and analyses. Findings for chloramphenicol, iron-dextran complex, phenoxybenzamine and phenobarbital were essentially non-contributory. Confounding by cigarette smoking and prior thyroid disease could account, respectively, for associations of oxazepam with lung cancer and propylthiouracil with thyroid cancer. Although not definitive, these findings should be considered in the evaluations of these pharmaceuticals. © 2009 UICC [source] Dietary patterns and risk of cancer: A factor analysis in UruguayINTERNATIONAL JOURNAL OF CANCER, Issue 6 2009Eduardo De Stefani Abstract A multisite case,control study on factor analysis and several cancer sites (mouth and pharynx, esophagus, stomach, colon, rectum, larynx, lung, breast, prostate, bladder, kidney) was conducted in Uruguay. The study included 3,528 cases and 2,532 controls. Factor analysis (principal components) was modeled among controls. This patterning method retained 4 factors per sex, labeled as prudent, drinker, traditional and Western. Odds ratios for these cancer sites, stratified by sex, were estimated using polytomous regression. Whereas the prudent pattern was mainly negatively associated with cancers of the upper aerodigestive tract, the Western pattern showed a strong increase in breast, lung and colon cancers. The study allowed for the reproducibility of the prudent, drinker and Western patterns, whereas the traditional pattern appears to be country specific. © 2008 Wiley-Liss, Inc. [source] Carbaryl exposure and incident cancer in the Agricultural Health StudyINTERNATIONAL JOURNAL OF CANCER, Issue 8 2007Rajeev Mahajan Abstract Carbaryl is a carbamate insecticide with a broad spectrum of uses in agricultural, commercial and household settings. It has previously been linked with non-Hodgkin lymphoma (NHL) but studies of cancer risk in humans are limited. We examined occupational carbaryl use and risk of all cancers in the Agricultural Health Study, a prospective study of a cohort of pesticide applicators in North Carolina and Iowa. This analysis included 21,416 subjects (1,291 cases) enrolled from 1993,1997 and followed for cancer incidence through 2003. Pesticide exposure and other data were collected using self-administered questionnaires. Poisson regression was used to calculate rate ratios (RRs) and 95% confidence intervals (CIs) while controlling for potential confounders. Carbaryl was not associated with cancer risk overall. Relative to subjects who never used carbaryl, melanoma risk was elevated with >175 lifetime exposure-days (RR = 4.11; 95%CI, 1.33,12.75; p -trend = 0.07), >10 years of use (RR = 3.19; 95%CI, 1.28,7.92; p -trend = 0.04), or ,10 days of use per year (RR = 5.50; 95%CI, 2.19,13.84; p -trend < 0.001). Risk remained after adjusting for sunlight exposure. Although not significant, there appeared to be a trend of decreasing prostate cancer risk with increasing level of exposure. A small increase in NHL risk was observed using some, but not all, exposure measures. No associations were observed with other examined cancer sites. Because the observed results were not hypothesized a priori and because of limited study of their biological plausibility, they should be interpreted with caution. © 2007 Wiley-Liss, Inc. [source] Cancer survival in Germany and the United States at the beginning of the 21st century: An up-to-date comparison by period analysisINTERNATIONAL JOURNAL OF CANCER, Issue 2 2007Adam Gondos Abstract Transatlantic cancer survival comparisons are scarce and involve mostly aggregate European data from the late 1980s. We compare the levels of cancer patient survival achieved in Germany and the United States (US) by the beginning of the 21st century, using data from the Cancer Registry of Saarland/Germany and the SEER Program of the US. Age-adjusted 5- and 10-year relative survival for 23 common forms of cancer derived by period analysis for the 2000,2002 period were calculated, with additional detailed age- and stage-specific analyses for cancers with the highest incidence. Among the 23 cancer sites, 5 (10) year relative survival was significantly higher for 1 (2) and 8 (5) cancers in Germany and the US, respectively. In Germany, survival was significantly higher for patients with stomach cancer, whereas survival was higher in the US for patients with breast, cervical, prostate, colorectal and oral cavity cancer. Among the most common cancers, age-specific survival differences were particularly pronounced for older patients with breast, colorectal and prostate cancer. Survival advantages of breast cancer patients in the US were mainly due to more favorable stage distributions. This comprehensive survival comparison between Germany and the US suggests that although survival was similar for the majority of the compared cancer sites, long-term prognosis of patients continues to be better in the US for many of the most common forms of cancer. Among these, differences between patients with breast and prostate cancer are probably due to more intensive screening activities. © 2007 Wiley-Liss, Inc. [source] A history of cancer in the husband does not increase the risk of breast cancerINTERNATIONAL JOURNAL OF CANCER, Issue 12 2006Eva Negri Abstract Spouses share the home environment, and dietary and other lifestyle habits. Furthermore, a cancer diagnosis in the husband is a stressful event for the wife also. Thus, a history of cancer in the husband may be an indicator of breast cancer risk. We investigated the issue in a large Italian multicentric case-control study on 2,588 women with incident breast cancer and 2,569 female hospital controls, admitted for acute, non neoplastic diseases. The adjusted odds ratio (OR) was 1.0 (95% confidence interval, CI, 0.7,1.4) for a history of any type of cancer in the husband, 1.0 (95% 0.4,2.7) for stomach, 0.7 (95% 0.2,2.3) for intestinal (chiefly colorectal), 0.9 (95% CI 0.5,1.7) for lung, and 1.3 (95% CI 0.4,4.3) for prostate cancer. The OR was close to unity also when data were analyzed in separate strata of patient's or husband's age, patient's education, or vital status of the husband. This study suggests that women whose husband had a diagnosis of cancer are not at increased risk of breast cancer, although results for individual cancer sites should be interpreted with caution, due to small numbers. © 2006 Wiley-Liss, Inc. [source] Birth characteristics and adult cancer incidence: Swedish cohort of over 11,000 men and womenINTERNATIONAL JOURNAL OF CANCER, Issue 4 2005Valerie A. McCormack Abstract Associations between larger size at birth and increased rates of adult cancer have been proposed but few empirical studies have examined this hypothesis. We investigated overall and site-specific cancer incidence in relation to birth characteristics in a Swedish population-based cohort of 11,166 singletons born in 1915,1929 for whom we have detailed obstetric data and who were alive in 1960. A total of 2,685 first primary cancers were registered during follow-up from 1960 to 2001. A standard deviation (SD) increase in birth weight for gestational age (GA) was associated with (sex-adjusted) increases of 13% (95% CI = 0.03,0.23) in the rates of digestive cancers and of 17% (95% CI = 0.01,0.35) in the rates of lymphatic cancers. Women who had higher birth weights also had increased rates of breast cancer under age 50 years (by 39% per SD increase; 95% CI = 0.09,0.79), but reduced rates (by 24%; 95% CI = 0.07,0.38) of endometrial (corpus uteri) cancer at all ages. There was no evidence of associations with other cancer sites. For overall cancer incidence, men had an 8% increased risk at all ages per SD increase in birth weight for GA while women only had an increased risk under age 50 years (mainly driven by the association with breast cancer). These findings provide evidence of a modest association of birth size and adult cancer risk, resulting from positive associations with a few cancer sites and a possible inverse association with endometrial cancer. © 2005 Wiley-Liss, Inc. [source] Environmental and heritable causes of cancer among 9.6 million individuals in the Swedish family-cancer databaseINTERNATIONAL JOURNAL OF CANCER, Issue 2 2002Kamila Czene Abstract The genetic and environmental components in 15 common cancers were estimated using the nationwide Swedish Family-Cancer Database. Tetrachoric correlations were used to describe similarity in cancer liability among family members. Structural equation modeling was used to derive estimates of the importance of genetic and environmental effects. Statistically significant estimates of proportion of cancer susceptibility, accounted for by genetic effects, were obtained for all studied cancers except for leukemia. The estimate was highest in thyroid cancer (53%), followed by tumors at endocrine glands (28%), testis (25%), breast (25%), cervix (22%), melanoma (21%), colon (13%), nervous system (12%), rectum (12%), non-Hodgkin lymphoma (10%), lung (8%), kidney (8%), urinary bladder (7%), stomach (1%) and leukemia (1%). The estimates of shared environmental effects ranged from 0% (cervix) to 15% (stomach). The childhood shared environmental effects were most important in testicular cancer (17%), stomach cancer (13%) and cervix in situ (13%). Our results indicate that environment has a principal causative role in cancer at all studied sites except for thyroid. The relatively large effect of heritability in cancer at some sites, on the other hand, indicates that even though susceptibility genes have been described at many cancer sites, they are likely to explain only part of the genetic effects. © 2002 Wiley-Liss, Inc. [source] Internet-Based Interactive Support for Cancer Patients: Are Integrated Systems Better?JOURNAL OF COMMUNICATION, Issue 2 2008David H. Gustafson To compare the benefits of the Internet generally versus a focused system of services, 257 breast cancer patients were randomly assigned to a control group, access to the Internet with links to high-quality breast cancer sites, or access to an eHealth system (Comprehensive Health Enhancement Support System, CHESS) that integrated information, support, and decision and analysis tools. The intervention lasted 5 months, and self-report data on quality of life, health-care competence, and social support were collected at pretest and at 2-, 4-, and 9-month posttests. CHESS subjects logged on more overall than Internet subjects and accessed more health resources, but the latter used non health-related sites more. Subjects with access to the Internet alone experienced no better outcomes than controls at any of the 3 time points, compared to pretest levels. Subjects with CHESS experienced greater social support during the intervention period and had higher scores on all 3 outcomes at 9 months, 4 months after the intervention ended. CHESS subjects also scored higher than those with Internet access during the intervention period but not significantly after the intervention ended. Thus, CHESS (with one simple interface and integrated information, communication, and skills services) helped newly diagnosed breast cancer patients even after computers were removed. In contrast, patients received little benefit from Internet access, despite having links to a variety of high-quality sites. Résumé Le soutien interactif sur Internet des patients atteints du cancer : les systèmes intégrés sont-ils meilleurs? Afin de comparer les bénéfices de l'Internet en général par rapport à un système concentré de services, 257 patientes atteintes du cancer du sein furent assignées au hasard à l'un de trois groupes : un groupe témoin, un groupe ayant accès à Internet avec des liens vers des sites de haute qualité concernant le cancer du sein, ou un groupe ayant accès à un système eHealth (CHESS) qui intègre information, soutien et outils de décision et d'analyse. L'intervention a duré cinq mois et une collecte de données auto-évaluées (à propos de la qualité de vie, de la compétence en ce qui a trait aux soins de santé et du soutien social) fut faite avant le test et deux, quatre et neuf mois après le début du test. Les participantes ayant accès au CHESS se sont globalement connectées plus souvent que les participantes ayant accès à Internet et elles ont accédéà plus de ressources liées à la santé, mais les participantes ayant accès à Internet ont visité plus de sites non liés à la santé. Les participantes ayant seulement accès à Internet n'ont pas présenté de meilleurs résultats que le groupe témoin à aucun des trois moments de cueillette, en comparaison avec les niveaux pré-test. Les participantes ayant accès au CHESS ont reçu un meilleur soutien social pendant la période d'intervention et eurent des résultats plus élevés quant aux trois thèmes à l'évaluation de neuf mois, soit quatre mois après la fin de l'intervention. Les participantes CHESS ont également enregistré des résultats plus élevés que ceux avec Internet pendant la période d'intervention, mais pas de manière significative une fois que l'intervention s'est terminée. Ainsi, CHESS (avec une interface unique et simple et de l'information intégrée, des services de communication et de compétences) a aidé les patientes nouvellement diagnostiquées avec le cancer du sein, même lorsque les ordinateurs furent retirés. De façon constrastée, les patientes n'ont pas beaucoup bénéficié de l'accès à Internet, bien qu'elles aient été orientées vers une variété de sites de haute qualité. Abstract Internetbasierte interaktive Unterstützung für Krebspatienten: Sind integrierte Systeme besser? Um die Vorteile des Internets im allgemeinen mit den Vorteilen eines fokussierten Systems von Angeboten zu vergleichen wurden 257 Brustkrebspatienten zufällig auf eine von drei Gruppen verteilt: eine Kontrollgruppe, eine Versuchsgruppe mit Zugang zum Internet mit Links zu hochqualitativen Seiten zum Thema Krebs und eine zweite Versuchgruppe mit Zugang zu einem eHealth System (CHESS), welches Informationen, Betreuung und Entscheidungs- und Analysewerkzeuge integriert. Die Intervention dauerte 5 Monate. Selbstauskunftsdaten zur Lebensqualität, Gesundheitsfürsorgekompetenz und sozialer Unterstützung wurden vorher, und als 2-, 4- und 9-Monate Nachhermessung erhoben. CHESS-Nutzer griffen generell häufiger auf das Angebot zu als Internetnutzer und nutzten mehr Gesundheitsressourcen; allerdings griffen Internetnutzer häufiger auf Seiten ohne Gesundheitsbezug zu. Teilnehmer mit Internetzugang zeigten bezogen auf die Vorhermessung keine besseren Ergebnisse im Vergleich zur Kontrollgruppe. CHESS-Nutzer erlebten eine größere soziale Unterstützung während der Intervention und hatten höhere Werte für alle drei Ergebnismessungen zum Zeitpunkt 9 Monate, also 4 Monate nach Ende der Intervention. CHESS-Teilnehmer punkteten während aber nicht nach Ende der Intervention höher als jene mit Internet-Zugang. CHESS (mit einem einfachen Interface und integrierter Information, Kommunikation und Services) half neu diagnostizierten Brustkrebspatienten sogar nachdem die Computer entfernt wurden. Im Gegensatz dazu bekamen Patienten wenig Unterstützung vom Internet-Zugang, obwohl sie Links zu eine Vielzahl hochqualitativer Seiten hatten. Resumen Apoyo Interactivo a través del Internet para Pacientes con Cáncer: ¿Son Mejores los Sistemas Integrados? Para comparar los beneficios del Internet generalmente versus un sistema de servicios focalizados, 257 pacientes con cáncer de mama fueron asignados aleatoriamente a un grupo de control, acceso al Internet con conexiones a sitios de cáncer de mama de alta calidad, ó acceso a un sistema de Salud (CHESS) que integraba información, apoyo, y herramientas de decisión y análisis. La intervención que duró cinco meses, reportó datos individuales sobre la calidad de vida, la competencia de la asistencia médica y el apoyo social coleccionados a través de una prueba inicial y pruebas a los 2, 4, y 9 meses después. Los participantes de CHESS entablaron sesiones con más frecuencia que los sujetos de Internet y accedieron a más recursos sobre la salud, pero éstos últimos usaron más sitios no relacionados con la salud. Los sujetos que solamente accedieron al Internet no experimentaron mejores resultados que los grupos de control durante los tres puntos, comparados con los niveles de pruebas iniciales. Los sujetos con CHESS experimentaron un apoyo social mayor durante el período de intervención y tuvieron puntajes más altos en los 3 resultados a los 9 meses, 4 meses después que la intervención finalizara. Los sujetos de CHESS obtuvieron mayores puntajes que los participantes con acceso al Internet durante el período de la intervención, pero no significativamente después de que la intervención finalizara. Así, CHESS (con una interfase simple e información integrada, comunicación y servicios de habilidades) ayudaron a los pacientes recientemente diagnosticados con cáncer de mama aún después de que las computadoras fueron removidas. En contraste, los pacientes recibieron poco beneficio del acceso al Internet, a pesar de tener acceso a conexiones con una variedad de sitios de alta calidad. ZhaiYao Yo yak [source] Lung cancer and regular use of aspirin and nonaspirin nonsteroidal anti-inflammatory drugs,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008Judith P. Kelly RN Abstract Purpose Lung cancer is the leading cause of cancer death in the US. There is evidence of a reduced risk of some cancer sites associated with use of aspirin (ASA) and nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDs). Our objective was to examine the association of regular use of ASA and NANSAIDs with lung cancer. Methods A hospital-based case,control study of 1884 incident cases of lung cancer and 6251 controls with noncancer diagnoses. Use of ASA and NANSAIDs was considered ,regular' if it occurred on ,4,days/week and lasted for ,3,months. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals. Results The OR for regular use of ASA was 1.1 (0.9,1.4), and the corresponding estimate for regular NANSAID use was 1.0 (0.7,1.3). There was no evidence of decreased risk within strata of age, sex, years of education, or interview year. Examining the association within strata of duration of use, recency of use, cigarette smoking status, pack-years of cigarette smoking, or histologic type of cancer produced no ORs significantly different from 1.0. Conclusions The hypothesis that regular use of ASA or NANSAIDs reduces the risk of lung cancer is not supported by the present data. Copyright © 2007 John Wiley & Sons, Ltd. [source] Mortality of older construction and craft workers employed at department of energy (DOE) nuclear sitesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2009John M. Dement PhD Abstract Background The U.S. Department of Energy (DOE) established medical screening programs at the Hanford Nuclear Reservation, Oak Ridge Reservation, the Savannah River Site, and the Amchitka site starting in 1996. Workers participating in these programs have been followed to determine their vital status and mortality experience through December 31, 2004. Methods A cohort of 8,976 former construction workers from Hanford, Savannah River, Oak Ridge, and Amchitka was followed using the National Death Index through December 31, 2004, to ascertain vital status and causes of death. Cause-specific standardized mortality ratios (SMRs) were calculated based on US death rates. Results Six hundred and seventy-four deaths occurred in this cohort and overall mortality was slightly less than expected (SMR,=,0.93, 95% CI,=,0.86,1.01), indicating a "healthy worker effect." However, significantly excess mortality was observed for all cancers (SMR,=,1.28, 95% CI,=,1.13,1.45), lung cancer (SMR,=,1.54, 95% CI,=,1.24,1.87), mesothelioma (SMR,=,5.93, 95% CI,=,2.56,11.68), and asbestosis (SMR,=,33.89, 95% CI,=,18.03,57.95). Non-Hodgkin's lymphoma was in excess at Oak Ridge and multiple myeloma was in excess at Hanford. Chronic obstructive pulmonary disease (COPD) was significantly elevated among workers at the Savannah River Site (SMR,=,1.92, 95% CI,=,1.02,3.29). Conclusions DOE construction workers at these four sites were found to have significantly excess risk for combined cancer sites included in the Department of Labor' Energy Employees Occupational Illness Compensation Program (EEOCIPA). Asbestos-related cancers were significantly elevated. Am. J. Ind. Med. 52:671,682, 2009. © 2009 Wiley-Liss, Inc. [source] Leukemia and exposure to ionizing radiation among German uranium minersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2006Matthias Möhner PhD Abstract Background It is well known that uranium miners are at an increased risk of lung cancer. Whether they also have an increased risk for other cancer sites remains under discussion. The aim of this study was to examine the leukemia risk among miners. Methods An individually matched case-control study of former uranium miners in East Germany was conducted with 377 cases and 980 controls. Results Using conditional logistic regression models, a dose,response relationship between leukemia risk and radon progeny could not be confirmed. Yet, a significantly elevated risk is seen in the category ,400 mSv when combining ,-radiation and long-lived radionuclides. Conclusions The results suggest that an elevated risk for leukemia is restricted to employees with a very long occupational career in underground uranium mining or uranium processing. Moreover, the study does not support the hypothesis of an association between exposure to short-lived radon progeny and leukemia risk. Am. J. Ind. Med. 49:238,248, 2006. © 2006 Wiley-Liss, Inc. [source] Cancer incidence rates among Lawrence Livermore National Laboratory (LLNL) employees: 1974,1997,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2004M. Donald Whorton MD Abstract Background In the mid-1970's an excess of malignant melanoma of the skin was noted among employees at the Lawrence Livermore National Laboratory (LLNL). A 1984 cancer incidence study showed a non-significant excess of total cancers among female employees with significant excesses for melanoma, rectum and anus, and salivary gland cancers. For male employees, there was a non-significant deficit of total cancer with significant excesses in melanoma and non-brain nervous system cancers. This paper reports the results of a surveillance effort to update our understanding of the patterns of cancer incidence in this population. Methods We used California Cancer Registry (CCR) data to ascertain employees who had worked for six or more consecutive months at LLNL during the 24-year period of 1974 through 1997 who were diagnosed weith cancer during that time frame. We used the Standardized Incidence Ratio (SIR) in our analyses. Results There were 17,785 employees who provided 186,558 person-years of observation: 145,203 were from males and 41,355 were from females. The CCR, through its linkage techniques, identified 541 individuals with invasive cancer and 96 with in situ cancer. A total of 404 males had invasive cancer and 33 had in situ cancer whereas there were 137 females with invasive cancer and 63 with in situ cancer. The SIR for invasive cancer in males was 69 (95% CI 62,76). The overall cancer SIR for males was unaffected by calendar time. There were only two invasive cancer sites with significant excess: melanoma and cancer of the testes. For eight categories or cancer sites, we found a statistical deficit in cancer incidence. The most striking deficit occurred in cancer of the lungs and bronchus with a SIR of 36 (95% CI 26,50). The SIR for invasive cancer in females was 80 (95% CI 67,94). The overall cancer SIR for females decreased over calendar time. There was a statistically significant deficit for cancers of the female genital organs. There were 84 cases of invasive and in situ melanoma in both genders. Time-trend analyses for melanoma showed a significant excess during the years 1974,1985 but a reduction to community rates from 1986 through 1997. There were 21 individuals with testicular cancer with a SIR of 207 (95% CI 129,317). There were no differences in age at diagnosis or cell type with the comparison population. We analyzed the data using the same radiosensitive cancer categories used in the 1984 study. There were no increases in SIRs in any of these categories. Conclusions We found that the LLNL employees had less cancer than expected with males having relatively fewer cancers than females. The lung cancer rate for males was remarkably low. Since 1986 the melanoma rates resemble the community rates. Testicular cancer rates are modestly elevated and appear to have been so for the past 20 years. Lifestyle patterns, including smoking, and cancer screening activities are probably important contributors to the observed low cancer rates. Am. J. Ind. Med. 45:24,33, 2004. © 2003 Wiley-Liss, Inc. [source] Effect of cancer diagnosis on patient employment status: a nationwide longitudinal study in Korea,PSYCHO-ONCOLOGY, Issue 7 2009Jae-Hyun Park Abstract Background: Cancer diagnosis may adversely affect employment status. Our aim was to investigate whether cancer diagnosis effects employment status by comparing employment status changes in cancer patients withto that of cancer-free workers over a 5,6-year period. Methods: All 25,55-year-old, non-self-employed, Korean workers who were diagnosed with cancer for the first time in 2001 were identified as first baseline study subjects (n=4991). Of these, those who lost their jobs within 1 year of cancer diagnosis were selected as second baseline subjects (n=1334). Sex- and age-matched cancer-free individuals from the general population were used as a reference group. We compared the time until job loss from the first baseline and the time until re-employment from the second baseline between these two groups during the 5,6-year follow-up period while adjusting for sex, age group, job-type, and equivalent household income using the National Health Insurance administrative database. Results: Cancer patients were more likely to lose their jobs after cancer diagnosis and were less likely to be re-employed than cancer-free individuals in almost all sex and age groups. Most major cancer sites were also associated with decreased employment status, with the exception of thyroid cancer. Conclusion: Cancer diagnosis adversely affects employment status in Korea, and the effects are widespread in almost all sex and age groups. Significant efforts are needed to improve the employment status of cancer patients in Korea, as well as in developing or newly developed countries that have similar social security systems. Copyright © 2008 John Wiley & Sons, Ltd. [source] An Age-Stratified Poisson Model for Comparing Trends in Cancer Rates Across Overlapping RegionsBIOMETRICAL JOURNAL, Issue 4 2008Yi Li Abstract The annual percent change (APC) has been used as a measure to describe the trend in the age-adjusted cancer incidence or mortality rate over relatively short time intervals. The yearly data on these age-adjusted rates are available from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. The traditional methods to estimate the APC is to fit a linear regression of logarithm of age-adjusted rates on time using the least squares method or the weighted least squares method, and use the estimate of the slope parameter to define the APC as the percent change in the rates between two consecutive years. For comparing the APC for two regions, one uses a t-test which assumes that the two datasets on the logarithm of the age-adjusted rates are independent and normally distributed with a common variance. Two modifications of this test, when there is an overlap between the two regions or between the time intervals for the two datasets have been recently developed. The first modification relaxes the assumption of the independence of the two datasets but still assumes the common variance. The second modification relaxes the assumption of the common variance also, but assumes that the variances of the age-adjusted rates are obtained using Poisson distributions for the mortality or incidence counts. In this paper, a unified approach to the problem of estimating the APC is undertaken by modeling the counts to follow an age-stratified Poisson regression model, and by deriving a corrected Z -test for testing the equality of two APCs. A simulation study is carried out to assess the performance of the test and an application of the test to compare the trends, for a selected number of cancer sites, for two overlapping regions and with varied degree of overlapping time intervals is presented. (© 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Effect of familial history and smoking on common cancer risks in JapanCANCER, Issue 10 2007Takeshi Suzuki MD Abstract BACKGROUND Inherited genetic predispositions are important risk factors for the development of cancer in general. To determine genetic susceptibility for 14 common cancers, a case,control study of the impact of a family history of cancer in first-degree relatives was conducted. The authors further evaluated the effect modification by habitual smoking with adjustment for other confounding environmental factors. METHODS In total, 18,836 cancer cases and 28,125 age,matched and sex,matched controls, confirmed as being free of cancer, were recruited. Odds ratios (ORs) and 95% confidence intervals were determined by multiple logistic regression analysis, including stratification by family history for 14 cancer sites and interactions with a smoking history. RESULTS The associations between family history and risk of cancer were generally stronger at the same sites than across cancer sites. Risks to first-degree relatives at the same sites were found to be significantly elevated with 8 of 14 cancer sites; especially high ORs were found for prostate and thyroid cancers. Some across-site associations were observed; in particular, a reciprocal association between breast and prostate cancer was found. The interaction between family history and smoking history for breast cancer was found to be statistically significant. There was no statistical evidence for the interactions in other sites, but among subjects with a family history, the ORs were found to be higher in smokers compared with nonsmokers. CONCLUSIONS The results of the current study support the hypothesis of a genetic susceptibility to cancers in family members. For breast cancer, the interaction between family history and smoking history was observed to be significant. Cancer 2007. © 2007 American Cancer Society. [source] Long-term trends in cancer mortality in the United States, 1930,1998,CANCER, Issue S12 2003M.S., Phyllis A. Wingo Ph.D. Abstract BACKGROUND Progress against cancer can be examined by analyzing long-term trends in cancer incidence and mortality. The recent directive from the U.S. Department of Health and Human Services to adopt the 2000 U.S. standard population for the age adjustment of death rates prompted the American Cancer Society to update historical cancer mortality statistics using the new standard. METHODS Mortality data were abstracted by race, gender, year, and age at death for 1930 through 1959 from annual volumes of Vital Statistics of the United States. For 1960 through 1998, these data were obtained from data tapes provided by the National Center for Health Statistics. Two U.S. standard million populations (1970 and 2000) were used to calculate age-adjusted rates. Average annual percent change was estimated for each decade by site, gender, and age, and the statistical significance of the change was assessed at p < 0.05. RESULTS After long-term increases or mostly level trends that date from the 1930s for some sites, death rates for cancers of the lung (in males), prostate, female breast, colon-rectum, pancreas, leukemia, and ovary were decreasing in the 1990s. Liver cancer death rates were increasing in the 1990s. Throughout the study period, death rates for female lung cancer increased, while death rates for stomach and uterine cancers declined. CONCLUSIONS The trends of decreasing cancer death rates for the leading cancer sites in the 1990s are encouraging. However, surveillance researchers must continue to monitor these declines to assess whether the progress seen in this decade persists. Efforts also must be made to study the sites with increasing trends and identify potential underlying causes. Cancer 2003;97(12 Suppl):3133,3275. Published 2003 by the American Cancer Society. DOI 10.1002/cncr.11380 [source] |