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1.
The association between occupational and the risk of breast cancer was analyzed using data from a case-control study of 257 women with breast cancer and 565 control women. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for occupations having light and medium activity compared with sedentary ones. After adjusted for potential confounders, women in sedentary occupations had a 29% higher risk, compared to those with the physically medium demanding jobs. For women at age > or =55 years higher occupational physical levels were associated with 53-60% reduction in the risk. There was a significant decreasing trend in the ORs from sedentary to medium work (P=0.001); while no association emerged in younger women. These findings demonstrate that the protective effect of higher levels activity in occupations on breast cancer appears to be confined to older women.  相似文献   

2.
Epidemiologic studies have been inconsistent in suggesting an association between abortion and breast cancer risk. Whether the protection provided by a full-term pregnancy also results from a short-term pregnancy or whether a prematurely terminated pregnancy could increase the risk of breast cancer is unclear. Data from a large, international collaborative study were used to evaluate the association between abortions, whether spontaneous or induced, and breast cancer risk. The data from seven countries included 3,958 breast cancer cases and 11,538 hospital controls with information on abortion history obtained through interviews. Compared with nulliparous women with no abortion (baseline), the odds ratios (OR) and 95 percent confidence intervals (CI) were: for nulliparous women with a history of prior abortion, 0,86 (CI=0.68–1.08); for parous women with no history of abortion, 0.63 (CI=0.57–0.69); for parous women with abortion before first birth, 0.82 (CI=0.69–0.97); and, for parous women with abortion only after first birth, 0.70 (CI=0.63–0.79). When restricting analysis to parous women, those with a history of abortion exhibited an elevated OR suggesting a 29 percent risk increase if the incomplete pregnancy occurred before first birth (CI=1.16–1.36) and an 11 percent risk increase for abortion only after first birth (CI=1.02–1.20) compared with women without such history. The associations observed were stronger among the youngest women. These results do not support a large overall association between abortion and breast cancer risk.Ms Michels and Drs Hsieh, Trichopoulos, and Willett are with the Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. Dr Willett is also affiliated with the Department of Nutrition, Harvard School of Public Health, and Channing Laboratory, Department of Medicine, brigham and Women's Hospital and Harvard Medical School, Boston, MA. Address correspondence to Ms Michels, Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.  相似文献   

3.
Cancer survivors are at increased risk of developing different co-morbid conditions. With an increasing number of long-term cancer survivors in the Nordic countries, the need for recommendations for long-term follow-up has become necessary. However, at present there are no general guidelines for follow-up in the Nordic countries. Three steps of follow-up should be distinguished and the objectives associated with each: 1) Follow-up research done as clinical studies in cancer survivors and as registry-based epidemiological investigations. Whenever possible these approaches should be combined with translational research relating clinical observations with findings from biological material for increased understanding of pathophysiology and aetiology. Such investigation has to provide evidence-based knowledge of late effects associated with the malignancy itself and its treatment. The Nordic countries have excellent possibilities for conducting such follow-up research; 2) Creation of guidelines, in an attempt to put results from research into clinical practice, should take the local situation and resources into consideration. Provision of an individualized Survivorship Care Plan is a first step; 3) Implementation of guidelines into daily health care. Guidelines have little influence on long-term cancer care if they do not reach the practitioners and convince them to comply. There is a need for well-planned follow-up to manage and reduce possible treatment-related morbidity and mortality in cancer survivors. The Nordic countries provide excellent possibilities for relevant research, but lack, so far evidence-based guidelines. In agreement with the initiatives of ASCO the development of Survivor Care Plans is the first step to improve on this situation.  相似文献   

4.

Book Review

Occupational cancer in developing countriesEdited by N. Pearce, E. Matos, H. Vainio, P. Bofetta, and M. Kogevinas International Agency for Research on Cancer, Lyon, France, 1994; IARC Scientific Publications No. 129 191 pp. ISBN 92 832 2129X; ISSN 0300-5085  相似文献   

5.
Several large epidemiological studies in the Nordic countries have failed to confirm an association between age at first birth and breast cancer independent of parity. To assess whether lack of power or heterogeneity between the countries could explain this, a meta-analysis was performed of 8 population-based studies (3 cohort and 5 case-control) of breast cancer and reproductive variables in the Nordic countries, including a total of 5,568 cases. It confirmed that low parity and late age at first birth are significant and independent determinants of breast-cancer risk. Nulliparity was associated with a 30% increase in risk compared with parous women, and for every 2 births, the risk was reduced by about 16%. There was a significant trend of increasing risk with increasing age at first birth, women giving first birth after the age of 35 years having a 40% increased risk compared to those with a first birth before the age of 20 years. Tests for heterogeneity between studies were not significant for any of the examined variables. In the absence of bias, this suggests that several individual Nordic studies may have had too little power to detect the weak effect of age at first birth observed in the meta-analysis.  相似文献   

6.
A joint Nordic study was conducted to elucidate the survival pattern in male breast cancer by means of regression analysis of annual relative survival rates. A total of 1429 (98.4%) of all patients diagnosed during a 25-year to 30-year period and reported to the Nordic cancer registries were available for follow-up through 1982. The relative survival rate was lower in older patients; the relative excess risk of dying (from breast cancer) during the first 5 years of observation, calculated by multiple regression modelling, increased in a regular fashion more than three-fold from patients younger than 40 years at diagnosis to those aged 80 years or older. Significantly lower rates were found among males in Denmark and Finland, the relative excess risks of dying (compared with Sweden) being 1.39 (1.06-1.80) and 1.73 (1.22-2.45), respectively, during the first 5 years. The authors concluded first that important differences exist between male and female patients with breast cancer in the relation between survival and age at diagnosis, and secondly that a later stage at presentation or national differences in the natural history are the most likely explanations for the worse prognosis in Denmark and Finland.  相似文献   

7.
Little is known about the etiology of hepatoblastoma. Because of the young age at diagnosis, several studies have looked at various birth characteristics. The purpose of our study was to investigate the incidence of hepatoblastoma in the Nordic countries and the association between selected birth characteristics and hepatoblastoma. Data from national cancer registries and birth registries in Denmark, Sweden, Norway and Finland 1985-2006 was used. Overall, 155 children with hepatoblastoma aged 0-14 years were included and individually matched to five controls drawn randomly from national population registries. The incidence rate of hepatoblastoma was 1.7 per million person-years with a predominance of boys (1.5:1). Incidence rate was highest before the age of 1 year (8.3 per million person-years). A higher risk of hepatoblastoma was found in children with birth weight <1,500 g [odds ratio (OR) = 9.5; 95% confidence interval (CI): 2.3-38.2], born preterm in week 22-32 (OR = 4.5; CI: 1.8-11.5) and Apgar scores <7 after 1 min (OR = 3.1; CI: 1.3-7.1) and 5 min (OR = 7.5; CI: 1.8-32.4). A doubling in risk was found in children who were large for gestational age (OR = 2.3; CI: 1.0-5.3). No associations were found with birth order, maternal age or maternal smoking. Our study indicates that intrauterine and/or neonatal factors are associated with increased risk of hepatoblastoma. These may include low birth weight and asphyxia leading to neonatal intensive care. Alternatively, the factors may be a consequence of hepatoblastoma developing in utero.  相似文献   

8.
Polymorphic variation in CYP19 and the risk of breast cancer   总被引:12,自引:0,他引:12  
The production of estrogen from androgen via the estrogen biosynthesis pathway is catalyzed by aromatase P450 (cyp19). We have assessed the frequency of allelic variants of the CYP19 intron 4 [TTTA]n repeat in 327 breast cancer cases and 253 controls from southern England. Previous studies have suggested that the [TTTA](10) repeat and [TTTA](12) repeat variants represent low penetrance breast cancer susceptibility alleles. Compared with controls our breast cancer cases had a statistically significant positive association with the [TTTA](10) allele (1.5 versus 0.2%, P = 0.028) and the [TTTA](8) allele (13.5 versus 8.7%, P = 0.012). The frequency of the [TTTA](12) allele was not significantly elevated in our study group compared with controls (2.3 versus 2.2%, P = 1.00). The CYP19 intron 4 [TTTA]n repeat is unlikely to have a functional effect on aromatase activity and it is more likely that the [TTTA](8) and [TTTA](10) variants are in linkage disequilibrium with other functional CYP19 variants.  相似文献   

9.
The relationship between occupational and leisure-time activity and the risk of breast cancer was analysed using data from a case–control study conducted in the Swiss Canton of Vaud between 1993 and 1998 on 246 incidents, histologically confirmed breast cancer cases and 374 controls below the age of 75 years, admitted to the same network of hospitals for acute, non neoplastic non hormone-related conditions. For occupational physical activity, the multivariate odds ratios (OR) for the highest versus the lowest level of physical activity were 0.6 (95% confidence interval, CI=0.35–1.04) when aged 15 to 19 years, 0.5 (95% CI=0.26–0.98) when aged 30 to 39 years, and 0.68 (95% CI=0.36–1.28) when aged 50 to 59. For leisure time physical activity, the ORs were 0.4 (95% CI=0.26–0.69), 0.5 (95% CI=0.30–0.81), and 0.4 (95% CI=0.22–0.80) for the highest versus the lowest level, respectively, in the three age groups, and an inverse trend in risk was significant in all groups. This study, based on one of the few European datasets on the issue, further suggests that physical activity is a favourable indicator of breast cancer risk.  相似文献   

10.
The aetiology of primary Fallopian tube carcinoma (PFTC) is poorly understood. Occupational exposures may contribute to PFTC risk. We studied incidence of PFTC in occupational categories in the Nordic female population aged 30-64 years during the 1960, 1970, 1980/1981 and/or 1990 censuses in Denmark, Finland, Iceland, Norway and Sweden. Standardized incidence ratios (SIRs) for the years following inclusion in the study up to 2005 were calculated for 53 occupations; the expected numbers of cases were based on PFTC incidence in the national populations. Altogether 2,206 PFTC cases were detected during follow up via data linkages with the Nordic cancer registries. Significantly increased risks of PFTC were observed for smelting workers (SIR 3.99, 95% confidence interval 1.46-8.68, Obs = 6), artistic workers (2.64, 1.44-4.43, Obs = 14), hairdressers (2.18, 1.41-3.22, Obs = 25), packers (1.62, 1.11-2.29, Obs = 32), nurses (1.49, 1.14-1.92, Obs = 60), shop workers (1.25, 1.07-1.46, Obs = 159) and clerical workers (1.20, 1.07-1.35, Obs = 271) and these sustained over times and different Nordic countries. There was a nonsignificant increased risk for PFTC among welders, printers, painters and chemical process workers. The risk was significantly and consistently low for women working in farming (0.68, 0.47-0.95, Obs = 34) and among economically inactive women (0.88, 0.82-0.94, Obs = 833). The possible role of occupational exposures to the PFTC risks found in this study must be further evaluated in studies with a possibility to adjust for possible confounding factors, such as reproductive and life-style factors, which was not possible in our study.  相似文献   

11.
Background: A lowering of colorectal cancer risk for the birth cohorts born around World War II (WWII) has previously been observed in Norway, a country which suffered some 20% caloric restriction during the war. The purpose of the study was to conduct a similar kind of analysis in the other Nordic countries and Estonia, which were also subjected to various degrees of energy restriction during WWII.Methods: All new cases of colorectal cancer in the Nordic countries and Estonia diagnosed between 40 and 84 years of age and born between 1874 and 1953, were collected from the national cancer registries. The incidence data were fitted to an age-period-cohort model.Results: A transient drop in the estimated colorectal cancer incidence rate was observed for the birth cohorts born around WWII in Estonia, together with a tendency of decreased risk in Sweden and Denmark.Conclusion: The previously observed lowering of colorectal cancer risk for persons born during WWII in Norway also prevails in Estonia. Energy restriction is a possible explanation for these findings, since the countries suffered from varying nutritional conditions during the war. Exogenous factors acting during periods early in life may have an impact on later colorectal cancer risk.  相似文献   

12.
The objective of the study was to assess the relationship between exposure to selected solvents and the risk of bladder cancer. This study is based on the Nordic Occupational Cancer (NOCCA) database and comprises 113,343 cases of bladder cancer diagnosed in Finland, Iceland, Norway and Sweden between 1961 and 2005 and 566,715 population controls matched according to country, sex and birth year. Census‐based occupational titles of the cases and controls were linked with the job exposure matrix created by the NOCCA project to estimate quantitative cumulative occupational exposures. A conditional logistic regression model was used to estimate hazard ratios (HRs) and their 95% confidence intervals (95% CI). Increased risks were observed for trichloroethylene (HR 1.23, 95% CI 1.12–1.40), toluene (HR 1.20, 95% CI 1.00–1.38), benzene (HR 1.16, 95% CI 1.04–1.31), aromatic hydrocarbon solvents (HR 1.10, 95% CI 0.94–1.30) and aliphatic and alicyclic hydrocarbon solvents (HR 1.08, 95% CI 1.00–1.23) at high exposure level versus no exposure. The highest excess for perchloroethylene was observed at medium exposure level (HR 1.12, 95% CI 1.02–1.23). The study provides evidence of an association of occupational exposure to trichloroethylene, perchloroethylene, aromatic hydrocarbon solvents, benzene and toluene and the risk of bladder cancer.  相似文献   

13.
BackgroundEarly-onset prostate cancer is often more aggressive and may have a different aetiology than later-onset prostate cancer, but has been relatively little studied to date. We evaluated occupation in relation to early- and later-onset prostate cancer in a large pooled study.MethodsWe used occupational information from census data in five Nordic countries from 1960 to 1990. We identified prostate cancer cases diagnosed from 1961 to 2005 by linkage of census information to national cancer registries and calculated standardised incidence ratios (SIRs) separately for men aged 30–49 and those aged 50 or older. We also conducted separate analyses by period of follow-up, 1961–1985 and 1986–2005, corresponding to pre- and post-prostate-specific antigen (PSA) screening.ResultsFor early-onset prostate cancer (n = 1521), we observed the highest SIRs for public safety workers (e.g. firefighters) (SIR = 1.71, 95% confidence interval [CI]: 1.23–2.31) and military personnel (SIR = 1.97, 95% CI: 1.31–2.85). These SIRs were significantly higher than the SIRs for later-onset disease (for public safety workers, SIR = 1.10, 95% CI: 1.07–1.14 and for military personnel, SIR = 1.09, 95% CI: 1.05–1.13; pheterogeneity = 0.005 and 0.002, respectively). Administrators and technical workers also demonstrated significantly increased risks for early-onset prostate cancer, but the SIRs did not differ from those of later-onset disease (pheterogeneity >0.05). While our early-onset finding for public safety workers was restricted to the post-PSA period, that for military personnel was restricted to the pre-PSA period.ConclusionOur results suggest that occupational exposures, particularly for military personnel, may be associated with early-onset prostate cancer. Further evaluation is needed to explain these findings.  相似文献   

14.
F L Williams  O L Lloyd 《Cancer》1989,64(8):1764-1768
Mainly on the basis of associations noted between international rates of male lung cancer and female breast cancer, passive smoking has been suggested recently as a major risk factor for female breast cancer. In this report, the authors describe the associations between data for female breast cancer and male lung cancer within five countries. For one country (Scotland) the authors examined the mortality rates of these cancers over time, and their relationship to trends for tobacco consumption. The correlations between female breast cancer and male lung cancer were significantly positive in Italy, USSR, and West Germany, weakly positive in Canada, absent in Scotland, and significantly negative in England and Wales. In Scotland, the mortality rates of these cancers over time were significantly correlated. There was a clear relationship between male lung cancer and tobacco consumption, but only a weak relationship between female breast cancer and tobacco consumption.  相似文献   

15.
16.
An increased risk of second primary cancers may depend on many reasons, including therapy for the first cancer and heritable causation. Population level data are not available exploring the risks of subsequent cancers after breast cancer considering a familial history of breast cancers. We used the nation-wide Swedish Family-Cancer Database to investigate such risks, based on 43,398 first invasive female breast cancers. Standardized incidence ratios (SIRs) were calculated for the second cancer after breast cancer using rates for first cancer as a reference. Many cancers at discordant sites were increased after breast cancer. SIRs for subsequent neoplasms in women who had a family history of breast cancer were increased for ovarian (2.0) and endometrial (1.8) cancers and for acute lymphoid leukemia (12.7) and myelofibrosis (9.4). The data suggest that the familial aggregation of breast and endometrial cancers may be explained by yet unidentified heritable causes. The remarkably high risks for second acute lymphoid leukemia and myelofibrosis, both characterized by chromosomal aberrations, in women with a family history of breast cancer may signal heritable defects in the ability to process DNA damage caused by ionizing radiation and chemotherapy.  相似文献   

17.
Genetic variation in SIPA1, signal‐induced proliferation‐associated gene 1, has been proposed to be associated with aggressive breast tumor characteristics related to metastasis and worse prognosis in humans and rodents. To test this hypothesis, we genotyped 3 single nucleotide polymorphisms (SNP) located at ?3092 (AT, rs3741378), and exon 14 + 14 (C>T, rs746429), and examined them in relation to breast cancer risk and overall survival, stratified by tumor characteristics in 2 independent case–control studies conducted in Poland (1,995 cases, 2,296 controls) and in Britain (2,142 cases, 2,257 controls). Vital status (n = 396 deaths) was available for 911 Polish and 1,919 British breast cancer cases with an average follow‐up time of 5.5 years. Overall, we found no significant associations between genetic variants of SIPA1 SNPs and breast cancer risk (per allele odds ratios, 95% confidence intervals (CI): rs931127–0.99, 0.93–1.06; rs3741378–1.03, 0.94–1.13; and, rs74642–0.98, 0.92–1.04). In both studies, SIPA1 polymorphisms were not related to overall mortality (per allele hazard ratios, 95% CI: 1.02, 0.88–1.17; 0.90, 0.72–1.11; 1.04, 0.90–1.21, respectively). Our results do not support a relationship between SIPA1 polymorphisms and breast cancer risk or subsequent survival. Published 2008 Wiley‐Liss, Inc.  相似文献   

18.
Pancreatic cancer (PC) is the sixth most frequent cause of death from cancer in Europe in men as well as women. Apart from smoking, little is known about the aetiology of PC. This study examines trends in incidence and mortality of PC in Denmark, Finland, Iceland, Norway, and Sweden from 1971 to 2000, using the database NORDCAN, with data on incident cases of PC derived from the national cancer registries and data on deaths from PC from the national registries on causes of death. The analysis included 91 842 incident cases and 96 430 deaths from PC in a total population of about 23 million. The mean age at diagnosis was 69 years for males in the Nordic countries for the period 1996-2000 and 72 years for females. Using the age-specific rates from year 2000 to calculate the cumulative risk, 8.4 of 1 000 Nordic men and 6.7 of 1 000 Nordic women will develop PC before the age of 75 years. Over the past 30 years incidence and mortality rates have been decreasing in males and remained stable without any particular trend in females whether examined by calendar time or birth cohort. However, there are considerable difficulties in obtaining true estimates of the incidence and mortality from PC, since less than 60% of incident cases are verified histologically and autopsy rates have decreased over time.  相似文献   

19.
Trends in incidence and mortality rates of prostate cancer were analyzed using data from the national cancer registries of Denmark, Finland, Iceland, Norway, and Sweden. Joinpoint regression models were used to quantify temporal trends for the period from 1980 to 2004. Incidence rates were increasing and similar in the Nordic countries during the 1980s. Around 1990, a more rapid incidence increase began in all Nordic countries except Denmark, where an increase was seen 5 years later. In 2001, incidence rates in Denmark were half of those seen in the other Nordic countries, but mortality rates varied only marginally among countries. Mean annual declines in prostate cancer mortality of 1.9% (95% CI = 0.4% to 3.3%) and 1.8% (95% CI = 0.5% to 3.0%) were observed from 1996 to 2004 in Finland and Norway, respectively. During the same period, mortality rates leveled off in Iceland and Sweden but continued to increase in Denmark. The rapid increase in incidence during the early 1990s coincided with the introduction of the prostate-specific antigen (PSA) test and conveys little information about the occurrence of potentially lethal disease. Mortality rates, however, have recently stabilized or declined in countries where PSA testing and curative treatment have been commonly practiced since the late 1980s. Although other explanatory factors may be in operation, these trends are consistent with a moderate effect of increased curative treatment of early diagnosed prostate cancer and improved treatment of more advanced disease.  相似文献   

20.

Introduction  

Cancer can cause adverse effects on survivors’ work ability. We compared the self-assessed work ability of breast, testicular, and prostate cancer survivors to that of people without cancer. We also investigated the association of disease-related and socio-demographic factors and job-related resources (organizational climate, social support, and avoidance behavior) with work ability and looked at whether these associations were different for the survivors and reference subjects.  相似文献   

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