Incidence of cancer among male waiters and cooks: two Norwegian cohorts

Previous occupational survey studies have identified waiter and cook as possible high risk occupations for cancer. However, few cohort studies have been performed among persons in the restaurant business, and we therefore have analyzed cancer incidence in two cohorts of Norwegian waiters and cooks. The cohorts consisted of skilled male workers, 1,463 waiters and 2,582 cooks, who received their craft certificate between 1958 and 1983. The cohorts were followed from 1959 through 1991. The standardized incidence ratio (SIR) for all causes of cancer was 1.4 (95 percent confidence interval [CI]=1.2–1.7] for waiters, and 1.1 (CI=0.9–1.4) for cooks. Cancers of the tongue, mouth, pharynx, larynx, esophagus, and liver were grouped together as alcohol-associated cancers. SIR for these cancers combined was 5.1 (CI=3.4–-7.4) for waiters and 4.2 (CI=2.2–7.2) for cooks. For lung cancer, SIR was 2.0 (CI=1.3–2.9) for waiters and 0.7 (CI=0.2–1.7) for cooks. For alcohol-associated cancers, the analysis carried out according to number of years since first employment showed a larger number of cases than expected for both occupations in all time-periods. The excess of lung cancer cases among waiters appeared after 30 years or more of employment. The study shows that waiters and cooks are at high risk of cancers associated with alcohol consumption, and that waiters, in addition, show high rates for lung cancer. The hypothesis of an occupational lung-cancer risk in cooks was not supported by this study.Dr Kjerheim and Mr Andersen are with The Cancer Registry of Norway. Address crrespondence to Dr Kjerheim, The Cancer Registry of Norway, Institute for Epidemiological Cancer Research, Montebello, 0310 Oslo, Norway. This project was supported by grants from the Confederation of Norwegian Business and Industry.     

Fatigue in Cancer

J. Armes, M. Krishnasami and I. Higginson (eds). Oxford UniversityPress, Oxford, UK, 2004, 334     

Cancer in Rwanda

Data are presented on the frequency of malignant tumours registered at the population-based cancer registry in the southern prefecture of Butare, Rwanda, from May 1991 until 2 months before the outbreak of civil war in April 1994. Beginning in 1992, subjects were also interviewed about socio-demographic and life-style factors that have been associated with cancer risk in the West. The distribution of cancer in Rwanda is similar to that in other countries in sub-Saharan Africa. The most frequent cancers are those with possible infectious aetiologies: liver cancer (12%), cervical cancer (12%) and stomach cancer (9%). In addition, cancers known to be associated with HIV infection are relatively frequent (Kaposi's sarcoma [6%] and non-Hodgkin's lymphoma [3%]). Chronic infection, including infection with HIV, high parity and multiple sexual partners are important determinants of cancer incidence in this population. Tobacco consumption is low in Rwanda and there are few tobacco-related tumours, such as lung and laryngeal cancer. Other tumours believed to be associated with aspects of Western life-style, such as colorectal and breast cancer, are also relatively infrequent. © 1996 Wiley-Liss, Inc.     

Cancer in Madagascar

Available data on cancer rates in Madagascar are given. Cervical cancer is the most common, accounting for 28% of diagnosed tumours and 47% of genital tumours in women. It occurs most often in women of about 40 years of age. Penile cancer represents 5.2% of male tumours but occurs at different rates in various ethnic groups. Kaposi's sarcoma is rare in Madagascar. Equally hepatocellular carcinoma occurs at a low incidence in this country and is found most frequently in males over the age of 40 years. Cancer control programmes and the problems they encounter are also discussed.     

Anemia in Cancer

In summary, anemia developing in a patient with cancer can be due to several different factors. A relative failure of erythropoiesis, in conjunction with a modestly shortened erythrocyte survival, is the most likely explanation for the anemia and can occur in patients with or without bone marrow invasion. Several theories have been proposed to explain the mechanism of limited red cell production in cancer. Internal iron starvation and cancer toxic factors have been widely implicated. Immunoglobulin inhibitors of erythropoiesis occur in the rare entity, pure red cell aplasia, which is sometimes associated with thymomas. Autoimmune hemolytic anemia and microangiopathic hemolytic anemia can also occur in patients with solid cancers, pointing out the need for a complete evaluation of anemia in any patient with recent-onset anemia. Successful treatment and prognostic implications of anemia in cancer is dependent on proper diagnosis.