The Copenhagen case-control study of renal pelvis and ureter cancer: role of analgesics

Analgesic intake was investigated for 96 patients with cancer of the renal pelvis and ureter (including papillomas) and 294 hospital controls. In comparison with persons who never used analgesics, increased relative risks (RR) were seen for users of phenacetin-containing drugs after adjustment for smoking and high-risk occupational exposure (men: RR = 2.4; women: RR = 4.2). A significant relative risk for aspirin use among women was also observed. There was an indication of a dose-effect relationship for both types of analgesics. The influence of phenacetin and aspirin on the development of renal pelvis and ureter tumours could not be separated since in this study the two compounds occurred so frequently in the same formulation. Experimental studies and phenacetin metabolism makes it biologically most relevant to attribute the observed association in the present study to the phenacetin component of the drugs.     

Cigarette smoking and cancers of the renal pelvis and ureter.

A population-based case-control study of renal pelvis and ureter cancers (502 cases, 496 controls) conducted in three areas of the United States found cigarette smoking to be associated with a 3.1-fold increase in risk, with long-term (greater than 45 years) smokers having a 7.2-fold increased risk. Statistically significant dose-response associations were observed for both cancer sites and in both sexes regardless of the measure used: cigarettes per day, duration of use, or pack years. A significant decreasing trend in risk with increasing years quit smoking was also demonstrated for these cancers. Attributable risk estimates indicate that approximately 7 of 10 cancers of the renal pelvis and ureter among men and almost 4 of 10 among women are caused by smoking. The results of this study, the largest to date, confirm that cigarette smoking is the major cause of cancers of the renal pelvis and ureter, and that cessation of smoking could eliminate a large proportion of these tumors.     

肾盂及输尿管肿瘤的临床特点与治疗分析

为了探讨肾盂输尿管肿瘤的发病特点和治疗经验,对31例原发性肾盂输尿管肿瘤的临床资料进行回顾性分析.多数病例的临床表现为明显肉眼血尿或伴有泌尿刺激症状、腰痛和肾积水,主要检查以B超、CT、逆行肾盂输尿管造影和尿脱落细胞学检查,本组患者术前确诊28例.手术切除肿瘤是主要治疗方式.初步研究结果提示,对不明原因尿路全程肉眼血尿、腰痛等临床表现应及时查找原因,进行相关检查,仔细分析,尽早确诊并手术治疗.     

Analgesics, cigarette smoking, and other risk factors for cancer of the renal pelvis and ureter

Results from a population-based case-control study of cancer of the renal pelvis and ureter are reported. Telephone interviews were conducted with 187 residents of Los Angeles County diagnosed with cancer of the renal pelvis and ureter over a 4-year period ending December 31, 1982, and with individually sex-, age- and race-matched neighborhood controls. The major risk factor identified for cancer of the renal pelvis and ureter was cigarette smoking. Subjects who smoked more than 25 years had a relative risk of 4.5 of developing these tumors, compared to nonsmokers (P less than 0.0001). Heavy use of over-the-counter analgesics was also associated with a significant increase in risk; it appears that an elevated risk was conveyed by all the major active constituents of those compounds currently marketed in the United States, aspirin, caffeine, and acetaminophen. Persons who had used these drugs for 30 consecutive days at any time in their life preceding diagnosis had twice the risk of developing cancer of the renal pelvis or ureter compared to persons not reporting such use (P less than 0.01). Heavy coffee drinkers (greater than or equal to 7 cups/day) had a 1.8-fold increase in risk compared to nondrinkers. Although risk tended to increase with increasing consumption, this result was not statistically significant. The risk associated with heavy coffee consumption was reduced to 1.3 after adjusting for smoking. Nine cases compared to no controls reported a first degree relative with kidney cancer. A history of kidney stones was associated with an increased risk of cancer of the ureter (relative risk = 2.5) that was not, however, statistically significant.     

不能手术肾癌及肾盂输尿管癌放疗效果分析

目的 回顾性分析不能手术治疗的肾癌及肾盂输尿管癌放疗结果。方法 2006—2015年间 29例无法行肾癌及肾盂输尿管癌手术患者实行了放疗,其中男 18例、女 11例,年龄 41~95岁(中位数 76岁);肾癌 17例,肾盂输尿管癌 12例;临床血尿 14例,腰背痛 7例。采用剂量递增放疗模式,其中伽马刀治疗 17例、HT治疗 12例。伽马刀50%等剂量线为处方剂量线,3~5 Gy/次,PTV边缘 40~50 Gy,GTV边缘 60~70 Gy。HT 50、60、70 Gy分 15~20次。结果 原发灶CR率为17%(5/29)、PR率为69%(20/29),总有效率(CR+PR)为86%。血尿消失93%,腰背痛消失100%。3、5年样本量分别为15、11例,肾癌和肾盂输尿管癌3、5年生存率分别为81%、81%和69%、69%。治疗期间1、2级消化系统反应 25例,1、2级骨髓抑制 20例,给予药物对症治疗后好转。结论 肾癌和肾盂输尿管癌伽马刀和HT安全有效切可提高LC和OS率,为不能手术肾癌和肾盂输尿管癌患者提供了有效治疗手段。     

Involuntary smoking and lung cancer: a case-control study

In a case-control study in 4 hospitals from 1971 to 1981, 134 cases of lung cancer and 402 cases of colon-rectum cancer (the controls) were identified in nonsmoking women. All cases and controls were confirmed by histologic review of slides, and nonsmoking status and exposures were verified by interview. Odds ratios (OR) increased with increasing number of cigarettes smoked by the husband, particularly for cigarettes smoked at home. The OR for women whose husbands smoked 20 or more cigarettes at home was 2.11 (95% confidence limits: 1.13, 3.95). A logistic regression analysis showed a significant positive trend of increasing risk with increased exposure to the husband's smoking at home, controlled for age, hospital, socioeconomic class, and year of diagnosis. Comparison of women classified by number of hours exposed a day to smoke in the last 5 years and in the last 25 years showed no increase in risk of lung cancer.     

Bladder cancer and cigarette smoking in males: a case-control study

Cigarette consumption was compared between 355 males with cancer of the lower urinary tract and 276 male hospital controls. Both duration of smoking and average daily consumption of cigarettes showed a dose-response relationship with risks of developing bladder cancer. Quitting smoking seems to have a protective role, whereas higher relative risks are associated with an early age at start of smoking. The use of a filter seems to have a weak protective effect.     

Prognostic factors in urothelial renal pelvis and ureter tumours: a multicentre Rare Cancer Network study

To assess the prognostic factors in patients with transitional-cell carcinoma of the renal pelvis and/or ureter, a series of 138 patients with transitional-cell carcinoma of the renal pelvis and/or ureter was collected in a retrospective multicentre study. 12 patients with distant metastases were excluded from the statistical evaluation. All but 3 patients underwent radical surgery: nephroureterectomy (n=71), nephroureterectomy and lymphadenectomy (n=20), nephroureterectomy and partial bladder resection or transurethral resection (n=20), nephrectomy (n=10), and ureterectomy (n=5). Sixty-one per cent (n=77) of the tumours were located in the renal pelvis, and 21% (n=27) in the ureter (both in 22 [17%]). Following surgery, residual tumour was still present in 33 patients (16 microscopic and 17 macroscopic). Postoperative radiotherapy was given to 45 (36%) patients. The median follow-up period was 39 months. In a median period of 9 months, 66% of the patients relapsed (34 local, 7 locoregional, 16 regional, and 24 distant). The 5- and 10-year survival were 29% and 19%, respectively, in all patients. In univariate analyses, statistically significant factors influencing the outcome were Karnofsky index, pT-classification, pN-classification, tumour localisation, grade, and residual tumour after surgery. Multivariate analysis revealed that independent prognostic factors influencing outcome were pT-classification, the existence of residual tumour, and tumour localisation. In patients with urothelial renal pelvis and/or ureter tumours, a radical surgical attitude is mandatory; and the presence of tumour in the ureter is associated with a poorer prognosis.     

The Copenhagen case-control study of bladder cancer. II. Effect of coffee and other beverages

During the years 1979-1981 a population-based case-control study of bladder cancer including papilloma was performed in greater Copenhagen. A total of 371 patients (280 males; 91 females), and a comparable age- and sex-stratified group of 771 controls (577 males; 194 females) remained for logistic regression analysis. Controls were selected at random from the general population of the study area. All persons were questioned about their drinking habits with respect to coffee, tea and other beverages, as well as their exposure to a number of known or suspected risk factors for bladder cancer. After adjustment for tobacco smoking, the relative risk of bladder cancer in relation to coffee drinking was not statistically significant among either men or women. A significant association was found between bladder cancer and tea drinking among men, but with no regular trend for increasing consumption. An association was found between risk of bladder cancer and both total daily liquid intake and non-cola soft drinks. This population-based case-control study provides no evidence of an isolated influence of coffee drinking or caffeine intake on bladder cancer risk.     

控烟是预防肺癌的主要措施——记太原市肺癌病例对照流行病学调查

背景 与目的:山西省太原市空气污染常较为严重.了解各种类型肺癌的危险因素,以采取有效的预防措施.方法:2005年3月—2007年9月,山西省太原市396例肺癌新发病例和465名健康对照者纳入本研究.利用太原市肿瘤医院病理学检查确诊的肺癌病例,配以人群为基础、随机选择的对照,进行病例对照询问调查和环境监测.分析时注意排除...     

Occupational exposures and risk of gastric cancer in a population-based case-control study

Gastric cancer trends seem to follow improvements in the environment of blue-collar workers, but the etiological role of occupational exposures in gastric carcinogenesis is scantily investigated. The risk of gastric adenocarcinoma in 10 common occupational industries, and particularly the long-term effects of asbestos, organic solvents, impregnating agents, insecticides, and herbicides, were evaluated in a population-based case-control study, including data on most established risk factors. The study base included all individuals of ages 40-79, born in Sweden and living in either of two areas (total population, 1.3 million) with differing gastric cancer incidences, from February 1989 through January 1995. We interviewed 567 cases classified to site (cardia/noncardia) and histological type, and 1,165 population-based controls, frequency-matched for age and sex. Metal workers had a 46% excess gastric cancer risk [adjusted odds ratio (OR), 1.46; 95% confidence interval (CI), 1.10-1.94], increasing to 1.65 (95% CI, 1.17-2.32) for >10 years in the industry. The elevated risk after exposure to herbicides (OR, 1.56; 95% CI, 1.13-2.15) was attributable to phenoxyacetic acids (adjusted OR, 1.70; 95% CI, 1.16-2.48), similarly across tumor subtypes, and not modified by smoking, body mass index, or Helicobacter pylori. The absence of interaction was demonstrated by the pure multiplicative effect found among those exposed to both H. pylori and phenoxyacetic acids (OR, 3.42; 95% CI, 1.41-8.26). Organic solvents, insecticides, impregnating agents, and asbestos were not associated with gastric cancer risk. Employment in the metal industry and exposure to phenoxyacetic acids were both positively and independently associated with gastric cancer risk. The fractions of all gastric cancers attributable to these job-related exposures were small but not negligible (7 and 5%, respectively) in the Swedish population.     

Possible relation between hypertension and cancers of the renal pelvis and ureter

To evaluate the relationship of selected medical conditions and medications with cancers of the renal pelvis and ureter, we interviewed 308 subjects with renal pelvis cancer, 194 subjects with ureter cancer and 496 control subjects in 3 areas of the United States. After controlling for the effects of smoking, age, gender and geographic residence, a history of hypertension (reported to have been diagnosed more than 5 years before interview) was associated with a small but significantly increased risk (odds ratio [OR] = 1.3; 95% confidence interval [CI], 1.0–1.8), whereas no relationship was observed with a variety of other medical conditions or medications. Stratified analysis showed that the risk associated with hypertension was twice as high among users of diuretics or other antihypertensive drugs (OR = 2.4; 95% CI, 1.1–4.9) as it was among those who never used these medications (OR = 1.2; 95% CI, 0.8–1.7). Our findings suggest that the association previously reported between hypertension and renal cell cancer may extend to cancers of the renal pelvis and ureter. Int. J. Cancer, 70:265–268, 1997. © 1997 Wiley-Liss, Inc.

1 This article is a US Government work and, as such, is in the public domain in the United States of America.