Relationship of epithelial ovarian cancer to other malignancies within families

The relationship of family history of cancer of the breast, colon/rectum, cervix, endometrium, lung, and thyroid to the risk of epithelial ovarian cancer was investigated in a large population-based case-control study. The data consisted of family histories from 493 epithelial ovarian cancer cases and 2,465 controls aged 20-54 years. After controlling for potential confounders, risk for epithelial ovarian cancer was found to be significantly elevated among women reporting breast cancer and colo/rectal cancer in a first-degree relative. Adjusted odds ratios were 1.5 (95% CI = 1.1-2.1) and 1.9 (95% CI = 1.1-3.3), respectively. None of the remaining four types of cancer was found to be statistically associated with the risk of epithelial ovarian cancer. However, when histologic subtypes of epithelial ovarian cancer were considered, a family history of breast cancer was found to be associated with an elevated risk of endometrioid ovarian cancer (odds ratio = 2.3; 95% CI = 1.1-4.7), as was a family history of endometrial cancer (odds ratio = 2.7; 95% CI = 1.0-6.9). The results are considered in the context of other studies of familial patterns of cancer and are compared with published findings concerning the occurrence of multiple primary cancers in the same individual. The findings indicate that further study is warranted regarding possible genetic relationships between epithelial ovarian cancer and cancers arising in other organs.     

甲醛接触工人肿瘤死亡流行病学

采用回顾性队列死亡率研究方法,凡1977年12月31日前在5家脲醛和/或酚醛树脂生产工厂工作满一年以上的工人进入队列,失访率低于5%。观察至1987年12月31日止接触组(1316人男性813人,人年19400)。男性接触组全肿瘤,肺癌、肝癌、胃癌、膀胱癌队列。具统计学意义的超额死亡,男性接触者为全肿瘤,脑瘤、肺癌、胃癌和膀胱癌,女性为全肿瘤,肺癌和肝癌。超额死亡危险随接触工龄延长而增加,三例鼻癌均发生于接触组,工龄在10以上。纠正了吸烟因素后,接触组死亡率高于对照组。     

扬中市上消化道癌地区聚集性研究

目的：探讨恶性肿瘤高发区江苏省扬中市内部是否存在上消化道癌地区聚集性并分析可能的原因，方法：利用扬中市肿瘤发病登记报告系统提供的资料分析各镇胃癌，食管癌，肝癌发病情况，观察地区间差异，并与各镇土壤微量元素硒含量进行相关性分析。结果：Poisson分布配合适度X^2检验；X^2胃癌＝190．4986，X^2食管癌＝103．3659，X^2肝癌＝59．1429，P＜0．001），提示扬中市各镇胃癌，食管癌，肝癌等发病率实际分布与理论分布不一致，其中以三跃镇最高发，三茅镇最低发。胃癌，肝癌发病率与土壤微量元素Se浓度呈负相关，相关系数分别为－0．7312和－0．7091。结论：扬中市上消化道癌分布存在地区聚集性，地质环境的影响可能是其中一个重要因素。     

Formaldehyde and cancer: a critical review

Formaldehyde is a naturally occurring chemical found in every human cell. It has been in widespread use for over a century as a disinfectant and preservative agent, and more recently in a number of industrial products. Animal studies indicate that formaldehyde is a rat carcinogen at high levels (>_ 10 ppm) of exposure. Results for lower levels of exposure show less clear-cut carcinogenic effects, and some species, such as mice and hamsters, appear much less sensitive to any carcinogenic potential of formaldehyde. Epidemiologic studies of the effects of formaldehyde exposure among humans provide inconsistent results. In general, these nonexperimental studies suffer from a number of biases and flaws. The epidemiologic studies fall into three categories: formaldehyde industry workers, case-control studies, and studies of professionals who use formaldehyde. Studies of industry workers with known exposure to formaldehyde report little evidence of an excess cancer risk. Nasopharyngeal cancer, the one cancer considered most strongly linked to formaldehyde among humans, appears after close examination to be likely a result of multiple subgroup analyses and misclassification. The case-control studies usually lack any direct measure of formaldehyde exposure and rely instead on hypothetical exposure based on occupational exposure matrices. Most of these studies, after adjustment for confounding factors, fail to find a significant association with putative formaldehyde exposure. The studies that do report a significant association suffer from methodologic problems limiting their interpretation. The investigations of professionals who use formaldehyde in their work, such as embalmers, pathologists, and anatomists, have the advantage over case-control studies of a much higher likelihood of actual formaldehyde exposure. The findings among these individuals, however, are at odds with those of the other two groups, with excesses of deaths from cancer of the brain and leukemia. The inconsistency between professionals and formaldehyde industry workers in cancer risk patterns suggest that formaldehyde is not the etiologic agent. When the epidemiologic data on formaldehyde and human cancer are examined in light of the widely accepted causal criteria of strength of the association, consistency and specificity of results, dose-response effects, and biologic coherence and plausibility, the studies published so far fail to provide credible causal evidence.     

A mixed methods,community‐based investigation on women's cancer awareness in Haiti

Despite a high number of cases, the awareness of breast and cervical cancer in Haiti and other low and middle‐income countries (LMICs) remains relatively unknown. The objective of the research was to understand perceptions and attitudes towards breast and cervical cancer in Haiti through community‐engaged research. We report Haitians perceptions of breast and cervical cancer symptoms, diagnosis, complications, treatment, community support and access to medical services. Five non‐governmental Haitian organisations performed a large survey across the country of Haiti in 2015. The survey and focus groups addressed demographics, reported knowledge of women's cancer, infrastructural issues and barriers to care, communication and media channels. The mixed quantitative and qualitative surveys with open‐ and closed‐ended questions were administered to 414 participants aged 13–65 (75% of whom were women). A separate, smaller survey on community support and gender‐based violence was conducted in 50 breast cancer patients and survivors as well. The quantitative data indicate low levels of knowledge about cancer across all geographic regions of the country amongst men and women. After coding participants' qualitative responses as “accurate” or “not accurate”, we determined the percentage of accurate responses related to knowledge. Data are reported broken down by geographic region, education, economic status and sex. Approximately one in five respondents reported knowing how a woman contracts breast or cervical cancer. Only 30% reported to know complications of breast cancer and 22% the complications of cervical cancer. When asked if they knew where to get a test for breast cancer, 20% said yes and 33% said they knew where to get a test for cervical cancer. The wealthiest and best educated generally had the most knowledge, but the poorest consistently had the second best. Forty percent of cancer patients reported to be victims of on‐going gender‐based violence. Further investigation should be undertaken examining the role of gender‐based violence and to address the knowledge of the working poor.     

Cancer incidence among laboratory workers in biomedical research and routine laboratories in Israel: Part I-the cohort study

BACKGROUND: Laboratory work is associated with exposure to a mixture of carcinogens. METHODS: The cohort is comprised of 4,300 laboratory workers. Cancer incidence was followed from 1960 to 1997. RESULTS: A total of 230 cases were included in the cohort. The overall cancer standardized incidence ratio (SIR) was 1.04 (0.91-1.18). When a 20-year latency was introduced, SIR was increased significantly: 1.35 (1.13-1.61). Among routine workers and researchers, SIR was elevated significantly for the total population and for women, when a 20-year latency was introduced. SIR was also elevated significantly in research, routine, bacteriology and virology, and isotope laboratories. With respect to specific sites, significantly increased SIR was observed in breast, ovary, and thyroid cancer among women; and prostate cancer, leukemia, and melanoma among men. CONCLUSIONS: We suggest that work in research and biomedical laboratories might involve an increased risk of certain types of cancer. Am. J. Ind. Med. 44:600-610, 2003.     

Cancer incidence among laboratory workers in biomedical research and routine laboratories in Israel: Part II-nested case-control study

BACKGROUND: A case-control study nested within a cohort study of biomedical laboratory workers was conducted to examine whether the excess cancer morbidity that we found can be explained by exposure to a particular group of substances, taking into consideration potential confounders. METHODS: The study population included 163 cases and two matched control groups: laboratory workers (311) and general population (448) workers. RESULTS: Multiple conditional regression analysis showed that working in research laboratories involved an increased risk of cancer generally among women [risk ratio 2.2 (1.2-4.3)], and of breast cancer particularly [risk ratio 2.3 (1.1-4.7). Seventy-six percent (76%) of breast, 87% of thyroid, 60% of ovary and prostate, 94% of melanoma, and 50% of leukemia cases were ever exposed to at least one known human carcinogen. CONCLUSION: Our results exclude the possibility that the excess cancer morbidity was related to personal risk factors but they may be explained by exposure factors. Am. J. Ind. Med. 44:611-626, 2003.     

Asbestos as a systemic carcinogen: The evidence from eleven cohorts

Most known occupational carcinogens are site-specific, which implies that they are “complete” carcinogens with both “initiating” and “promoting” properties (Berenblum's terminology). Excess cancer at gastrointestinal sites among cohorts occupationally exposed to asbestos has been interpreted as reflecting additional site-specific effects, although excess at other sites has also been observed in some studies. The hypothesis that excess cancer at gastrointestinal sites cannot be distinguished from excess cancer at all nonpulmonary sites is tested by data from New York-New Jersey insulation workers working in 1943; similar workers employed after 1943; U.S.-Canadian insulation workers; London factory workers, male and female; Quebec miners and millers; retired U.S. factory workers; U.S. shipyard insulators; Italian shipyard workers in Genoa; Amosite factory workers; and U.S. factory workers. Excluding lung cancer and mesothelioma, observed-expected ratios for nonpulmonary cancer mortality range from 0.97 to 2.78, and do not differ significantly from gastrointestinal ratios. A dose-response gradient is observed for both ratios, when dose is estimated from lung cancer ratios, or in some studies, measured exposures. Site-specificity is unlikely for nonpulmonary cancer associated with asbestos exposure more than 20 years previously. Systemic carcinogenesis may be an example of promotion or impairment by asbestos of some cancer defense mechanism; immunological mechanisms have been suggested by Turner-Warwick and Parkes. Prospective studies are indicated.     

Persisting risk of nickel related lung cancer and nasal cancer among Clydach refiners

Objective

To evaluate the risk of lung cancer and nasal cancer among workers employed at the Clydach nickel refinery, South Wales since 1930 by combining data from the two most recently published papers on this cohort.

Methods

Observed and expected numbers of cancer deaths were extracted for workers who had a minimum of five years service and were employed for the first time between 1902 and 1992. Standardised mortality ratios (SMR) were calculated for subgroups according to year of employment, time since first employment, and process work.

Results

A persisting excess of respiratory cancer was found for workers employed in the period 1930–92, with a lung cancer SMR of 133 (95% CI 103 to 172) and a SMR for nasal cancer of 870 (95% CI 105 to 3141). The lung cancer excess was most clearly seen 20 years or more after first employment and seemed to be confined to process workers. There was no indication of a further reduction in risk since 1930.

Conclusion

The extreme nickel related cancer hazard at the refinery before 1920 was greatly reduced during subsequent years. Some of the carcinogenic exposures seem to have remained after 1930, producing an elevated risk of nasal cancer and a 30% excess of lung cancer in the workforce. There was evidence of a persisting risk among process workers first employed since 1953.     

人源性宫颈癌、子宫内膜癌、卵巢癌异种移植动物模型的建立

目的构建人来源的宫颈癌(cervical cancer,CC)、子宫内膜癌(endometrial cancer,EC)、卵巢癌(ovarian cancer,OC)人源性肿瘤异种移植动物模型,为研究和开发新药及个体化治疗提供实验模型。方法收集2018年2月至2019年4月新疆医科大学第一附属医院CC、EC、OC患者各5例的新鲜手术切除标本,移植至重度免疫缺陷(immunodeficiency,NOG)小鼠和非肥胖糖尿病/重症联合免疫缺陷(non-obese diabetes/severe combined immunodeficiency,NOD/SCLD)小鼠皮下,监测荷瘤小鼠体重和肿瘤体积,对长至500~1 000 mm^3大小的肿瘤进行传代移植,通过苏木精-伊红染色法(hematoxylin-eosin staining,HE)染色及免疫组化(immunohistochemistry,IHC)验证移植肿瘤组织与患者肿瘤组织的病理学一致性。结果本研究收集并移植15例CC、EC、OC肿瘤标本,成功构建CC、EC、OC PDX模型8例,建模成功率为53%。结论模型较好地保留了原发肿瘤的特征,为后续研究开发CC、EC、OC新的治疗方案、临床药物筛选以及个体化治疗提供了实验平台。     

Micronutrients and Breast Cancer Progression: A Systematic Review

Epidemiological studies on micronutrient consumption have reported protective associations in the incidence and/or progression of various cancer types. Supplementation with some of these micronutrients has been analyzed, showing chemoprotection, low toxicity, antiproliferation, and the ability to modify epigenetic signatures in various cancer models. This review investigates the reported effects of micronutrient intake or supplementation in breast cancer progression. A PubMed search was conducted with the keywords “micronutrients breast cancer progression”, and the results were analyzed. The selected micronutrients were vitamins (C, D, and E), folic acid, metals (Cu, Fe, Se, and Zn), fatty acids, polyphenols, and iodine. The majority of in vitro models showed antiproliferative, cell-cycle arrest, and antimetastatic effects for almost all the micronutrients analyzed, but these effects do not reflect animal or human studies. Only one clinical trial with vitamin D and one pilot study with molecular iodine showed favorable overall survival and disease-free interval.     

Cancer incidence rates among Lawrence Livermore National Laboratory (LLNL) employees: 1974-1997

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.     

Role of Vitamin C in Selected Malignant Neoplasms in Women

Since the first reports describing the anti-cancer properties of vitamin C published several decades ago, its actual effectiveness in fighting cancer has been under investigation and widely discussed. Some scientific reports indicate that vitamin C in high concentrations can contribute to effective and selective destruction of cancer cells. Furthermore, preclinical and clinical studies have shown that relatively high doses of vitamin C administered intravenously in ‘pharmacological concentrations’ may not only be well-tolerated, but significantly improve patients’ quality of life. This seems to be particularly important, especially for terminal cancer patients. However, the relatively high frequency of vitamin C use by cancer patients means that the potential clinical benefits may not be obvious. For this reason, in this review article, we focus on the articles published mainly in the last two decades, describing possible beneficial effects of vitamin C in preventing and treating selected malignant neoplasms in women, including breast, cervical, endometrial, and ovarian cancer. According to the reviewed studies, vitamin C use may contribute to an improvement of the overall quality of life of patients, among others, by reducing chemotherapy-related side effects. Nevertheless, new clinical trials are needed to collect stronger evidence of the role of this nutrient in supportive cancer treatment.     

Serious co-morbidity among unselected cancer patients newly diagnosed in the southeastern part of The Netherlands in 1993-1996

The purpose of this study was to determine the prevalence of serious concomitant conditions at diagnosis among unselected patients with cancer, increasingly older in industrialized countries. About 34,000 newly diagnosed cancer patients were recorded in the Eindhoven Cancer Registry between 1993 and 1996; subsequently data on serious co-morbidity, classified according to the Charlson scheme (J Chron Dis 1987; 40: 373–383), were collected from the clinical records by registry personnel. Co-morbid conditions were present in 12% of adult patients below 45 years of age, 28% of those 45–59 years, 53% of those 60–74 years, and 63% of patients over 75 years of age, the prevalence being highest for patients with lung (58%), kidney (54%), stomach (53%), bladder (53%), and prostate cancer (51%). Males exhibited a 10% higher prevalence than females with similar tumors. Among patients over 60 years the most frequent conditions were heart and vascular diseases (ranging across the various tumors from 10% to 30%), hypertension (11–25%), another cancer (10–20%), COPD (chronic obstructive pulmonary disease) (3–25%), and diabetes mellitus (5–25%). Inclusion of frequent co-morbid conditions in prognostic research as well as the development of specific guidelines for patient care seems warranted.     

胱抑素C与肺癌、结肠直肠癌、子宫卵巢癌的关系

目的研究血清胱抑素C与肺癌、结肠直肠癌、子宫卵巢癌的关系。方法随机收集2008年10月至2009年11月间中山大学附属第三医院住院的肺癌、结肠直肠癌及子宫卵巢癌各84、56和53例,并根据临床资料排除有肾功能损害的患者作为研究对象,同时收集2009年8月份于我院健康体检者97例作为对照组。用胶乳增强免疫透射比浊法测定患者及对照组血清CysC水平,各患者组与对照者之间的比对采用方差分析。结果肺癌、结肠直肠癌和子宫卵巢癌患者中血清CysC水平均明显低于健康体检者,有统计学意义（P〈0.01）。结论在肺癌、结肠直肠癌和子宫卵巢癌患者中血清CysC水平均与恶性肿瘤有一定关系,这为以后临床诊断和治疗恶性肿瘤提供新思路。     

Acceptability of narratives to promote colorectal cancer screening in an online community

Objective

To assess the acceptability of narratives to promote colorectal cancer (CRC) screening among members of an online weight loss community.

Method

Members of online weight loss community completed an Internet survey in 2010. Multiple logistic regression models examined demographic and attitudinal correlates of interest in sharing and receiving CRC screening narratives.

Results

Participants (n = 2386) were 92% female with mean (SD) age 58 (6) years; 68% were up-to-date with CRC screening. Among those who were up-to-date, 39% were interested in sharing their narratives with other members. African-Americans were more likely than other racial groups to be interested in sharing narratives (adjusted OR 2.02, 95% CI 1.14-3.57). Older, married members and those with greater CRC screening worries were less likely to be interested in sharing narratives. Among those not up-to-date, 63% were interested in receiving narratives from online community members, and those with higher perceived salience of CRC screening were more likely to be interested in receiving narratives (adjusted OR 1.86, 95% CI 1.31-2.65).

Conclusions

Members of this online weight loss community expressed interest in sharing and receiving narratives for CRC screening promotion. Attitudes and demographic characteristics may predict successful recruitment of those who would share and receive narratives.