Longitudinal Gompertzian analysis of stomach cancer mortality in the U.S., 1962-1987: a thermodynamic analogy of its declining mortality

Age-adjusted mortality rates for stomach cancer (SC) in the United States from 1962 to 1987 were subjected to longitudinal Gompertzian analysis. Age-adjusted SC mortality rate distributions between age 50 and 85 years were highly Gompertzian for each and every year for both men and women. The environmental 'temperature' or intensity factor declined (improved) 1.55-fold for men and 2.04-fold for women in 1987 as compared to 1962. If the environmental 'pressure' or frequency factor had remained constant, the age at the theoretical common intersect point would have been 56.0 years for men and 80.0 years for women and overall SC mortality would have increased. However, between 1962 and 1987, non-age-standardized annual crude SC mortality rates decreased 46.8% for men and 44.0% for women. The thermodynamic analogy for this apparent discrepancy is that the environmental 'pressure' factor has not remained constant, but rather declined 51.7% for men and 60.9% for women between 1962 and 1987. This suggests that the overall frequency of environmental challenges that contribute to SC mortality has become significantly reduced.     

Longitudinal Gompertzian analysis of ischemic heart disease mortality in the U.S., 1962-1986: a method of demonstrating the deterministic dynamics describing its decline

Age-adjusted mortality rates for ischemic heart disease (IHD) in the United States from 1962 to 1986 were subjected to longitudinal Gompertzian analysis. Age-adjusted IHD mortality rate distributions between age 40 and 85 years were determined by a variable environmental factor and an extrapolated common intersect point. The environmental factor declined (improved) 3.73-fold for men and 2.07-fold for women in 1986 as compared to 1962. However, the environmental factor in 1986 remained 15.34 fold more conductive to IHD mortality among men than women. The age at the extrapolated common intersect point was 126.7 years for men and 267.4 years for women. Longitudinal Gompertzian analysis of IHD mortality data suggests that IHD will remain a significant cause of mortality for men despite advances in risk factor reduction and medical therapy.     

Longitudinal Gompertzian analysis of pancreatic cancer mortality in the U.S., 1962-1987: distinguishing between competitive and environmental influences upon evolving mortality patterns.

Pancreatic cancer (PanC) is an extraordinarily lethal neoplasm that is currently the fifth leading cause of cancer death in the United States. Annual age-specific mortality rates for PanC in the U.S. from 1962 to 1987 were subjected to longitudinal Gompertzian analysis. Age-specific PanC mortality rate distributions between age 30 and 60 years were determined by a common fixed intersect point and a variable competitive factor. The intersect point for PanC occurred at age 59.5 years and mortality rate 37.4 per 100,000 for men, and at age 53.2 years and mortality rate 7.9 per 100,000 for women. These intersect points are determined by genetic and environmental influences upon mortality. The observation that these points have remained fixed suggests that there has been no significant alteration in environmental etiopathogenic influences upon PanC mortality. Longitudinal Gompertzian analysis suggests that the emergence of PanC in the U.S. as a significant cause of cancer mortality has been the consequence of competitive influences upon PanC mortality dynamics.     

Longitudinal Gompertzian analysis of cervical cancer mortality in the US, 1962-1987: a method of quantitatively demonstrating changing environmental influences upon deterministic mortality dynamics.

Age-specific mortality rates for cervical cancer (CC) in the United States from 1962 through 1987 were subjected to longitudinal Gompertzian analysis. Age-specific CC mortality rate distributions for women display two distinct Gompertzian slopes, one between age 20 and 35 years and the other between age 40 and 85 years. These two distinct Gompertzian regions suggest that CC may be clinically and biologically classified into pre- and postmenopausal varieties, similar to breast cancer. Between 1962 and 1987, the annual crude CC mortality rate declined 60.0%. The basis for the decline of CC mortality is shown to be that aggregate environmental (etiopathogenic) influences upon premenopausal CC age-specific mortality rate distributions decreased 57.8%, and upon postmenopausal CC, decreased 28.0%.     

Longitudinal Gompertzian analysis of lung cancer mortality in the U.S., 1968-1986. Rising lung cancer mortality is the natural consequence of competitive deterministic mortality dynamics

Age-adjusted mortality rates for lung cancer (LC) in the United States from 1968 to 1986 were subjected to longitudinal Gompertzian analysis. Age-adjusted LC mortality rate distributions between age 20 and 50 years were determined by a variable environmental factor and a common intersect point. The environmental factor declined (improved) 1.89-fold for men and 3.11-fold for women in 1986 as compared to 1968. The age at the common intersect point was 47.2 years for men and 39.1 years for women. Between 1968 and 1986, the non-age-standardized annual crude LC mortality rate increased 44.8% for men and 217.6% for women. Longitudinal Gompertzian analysis of LC mortality data suggests that the rising LC mortality rates in the United States are the natural consequence of competitive deterministic mortality dynamics and not a reflection of an environment that is directly more conductive to LC mortality. That is, more people are dying of LC because they are not dying from other diseases such as ischemic heart disease and stroke. Longitudinal Gompertzian analysis demonstrates that single disease mortality should not be studied in isolation, but rather examined in relation to other causes of death. When viewed from this perspective, the basis for the more dramatic rise in LC mortality in women becomes immediately evident.     

Longitudinal Gompertzian analysis of primary malignant brain tumor mortality in the U.S., 1962–1987: Rising mortality in the elderly is the natural consequence of competitive deterministic dynamics

Age-adjusted mortality rates for primary malignant brain tumors (PMBT) in the United States from 1962 to 1987 were subjected to longitudinal Gompertzian analysis. Age-adjusted PMBT mortality rate distributions between age 25 and 65 years were determined by a variable environmental factor and a common intersect point. The environmental factor declined (improved) 1.58-fold for men and 2.34-fold for women in 1987 as compared to 1962. The age at the common intersect point was 68.4 years for men and 64.1 years for women. Between 1962 and 1987, non-age-???     

Longitudinal Gompertzian analysis of stroke mortality in the U.S., 1951-1986: declining stroke mortality is the natural consequence of competitive deterministic mortality dynamics

Age-adjusted mortality rates for stroke in the United States from 1951 to 1986 were subjected to longitudinal Gompertzian analysis. Age-adjusted stroke mortality rate distributions were determined by a variable environmental factor and a constant Gompertz slope. Compared to 1951 values, the environmental factor in 1986 had declined (improved) 49.8% for men and 59.1% for women. This was associated with a 51.9% and 31.4% decrease in the annual crude mortality rate from stroke for men and women respectively. However, the Gompertz slope remained remarkably constant from 1951 to 1986; 0.050152 for men and 0.048341 for women. The constant Gompertz slope for age-adjusted mortality rate distributions for stroke is in sharp contrast to the increasing Gompertz slope which occurs with an improving environment in 'degenerative' diseases and aging in general. These findings suggest that the recent dramatic decline in overall stroke mortality is the natural consequence of competitive deterministic mortality dynamics. As the overall environment becomes more conducive to human survival, Gompertzian diseases with converging mortality rate distributions must increase as causes of human mortality at the expense of diseases with constant Gompertz slopes.     

Longitudinal Gompertzian analysis of adult mortality in the U.S., 1900-1986

Analysis of mortality data for the United States from 1900 through 1986 demonstrates near perfect Gompertzian mortality rate distributions for adult American men and women. In the U.S. between 1900 and 1986, annual age-adjusted mortality rate distributions were determined by a fixed common intersect point (for men, the mortality rate at age 87.41 years was 18,810/100,000; for women, the extrapolated mortality rate at age 108.69 years was 75,365/100,000) and a variable environmental factor. Despite living in the same environment, the environmental factor contributing to adult mortality is at present significantly less for women than men. However, analysis predicts that in an environment less conducive to human survival than has existed in the United States during this century, the environmental factor contributing to adult mortality was less for men than women. The study further implies that as the environment becomes more favorable for human survival, men will experience an effective lowering of their theoretical maximal life span toward a limit of 87.4 years. The calculated maximal life span for men has already decreased 7 years during this century. This negative effect of a more favorable environment also occurs in women, although the theoretical maximal life span in women is lowered only toward a limit of 108.7 years.     

Longitudinal Gompertzian analysis of prostate cancer mortality in the U.S., 1962–1987: A method of demonstrating relative environmental, genetic and competitive influences upon mortality

Age-specific mortality rates for prostate cancer (PC) in the United States from 1962 to 1987 were subjected to longitudinal Gompertzian analysis. Age-specific PC mortality rate distributions between age 55 and 85 years were determined by a variable competitive factor and a common intersect point. The intersect point for PC occurred at age 61.5 years and mortality rate 27.9 per 100 000 and reflects genetic and environmental influences upon mortality. Between 1962 and 1987, non-age-standardized annual crude PC mortality rates increased 41.6%. Longitudinal Gompertzian analysis suggests that rising PC mortality rates in the United States are the natural consequence of competitive deterministic mortality dynamics. Moreover, longitudinal Gompertzian analysis is a method that demonstrates the relative contribution of environmental, genetic and competitive influences upon disease specific mortality.     

Mortality among the elderly in the U.S., 1956-1987: demonstration of the upper boundary to Gompertzian mortality.

Mortality in the United States among individuals aged 85 years and older between the years 1956 and 1987 was analyzed using a cumulative summation technique. This analysis demonstrates that general mortality conforms to Gompertzian dynamics through age 96 years for both men and women. Of the 33 320 985 deaths in men in the U.S. between 1956 and 1987, only 123,643 (0.37%) occurred in men aged 97 years and older. Of the corresponding 26,946,599 deaths in women, only 327,291 (1.21%) occurred in women aged 97 years and older. These results suggest that the competitive and deterministic features of the Gompertzian model of human aging and mortality remain valid through age 96 years and cover the vast majority of human mortality.     

Longitudinal Gompertzian analysis of emphysema mortality in the US, 1962-1987: the differing basis for evolving mortality patterns in men and women.

Age-specific mortality rates for emphysema in the United States from 1962 through 1987 were subjected to longitudinal Gompertzian analysis, a method that can be used to identify and distinguish aggregate genetic, environmental, and competitive influences upon mortality. Annual crude emphysema mortality rates (per 100,000) among men increased from 11.77 in 1962 to 20.94 in 1968, and then fell to 7.74 in 1987. The basis for this rise and fall is shown to be the corresponding changes in environmental influences upon emphysema mortality in men. Between 1962 and 1987, the annual crude emphysema mortality rates among women increased from 1.71 to 4.25. The basis for the increase of emphysema mortality in women, on the other hand, is shown to be an enhancement of the competitiveness of emphysema as a cause of mortality in women, and not the result of worsening environmental influences. The capability to distinguish between environmental and competitive influences upon evolving human mortality patterns could have a significant impact upon public health policy.     

Longitudinal Gompertzian analysis of amyotrophic lateral sclerosis mortality in the U.S., 1977-1986: evidence for an inherently susceptible population subset

Age-adjusted mortality rates for amyotrophic lateral sclerosis (ALS) for men and women in the United States from 1977 to 1986 were determined and subjected to longitudinal Gompertzian analysis. The exponential decline in the rate of increase of age-adjusted ALS mortality rates after age 55 years is most consistent with the existence of an inherently susceptible population subset that is decreasing faster than the general population. In the U.S. between 1977 and 1986, annual age-adjusted ALS mortality rate distributions were determined by a common fixed intersect point (for men, the death rate at age 46.38 years was 0.91/100,000; for women, the death rate at age 45.85 years was 0.46/100,000); and an environmental factor that varied erratically during the decade by a factor of 7.21 for men and 11.64 for women. On the average, the U.S. environment during this period was 4.33 times more conducive to mortality from ALS in men than in women. Overall ALS mortality between 1977 and 1986 increased 46% and 49% for men and women, respectively. The common fixed intersect point in mortality rate distributions suggests that these increases were real and not merely the result of improved diagnosis and/or better reporting. The overall increase in ALS mortality most likely results from an effective increase in the susceptible population subset due to increasing life expectancy, rather than to environmental factors. That is, as life expectancy increases, more of the susceptible population subset live long enough to express the disease.     

Longitudinal Gompertzian analysis of mortality from pancreatic cancer in Japan, 1955–1993

Age-specific mortality rates from pancreatic cancer (PanC) in Japan from 1955 through 1993 were subjected to longitudinal Gompertzian analysis. Age-specific PanC mortality rate distributions between age 30 and 79 years were highly Gompertzian for each and every year for both men and women. Between 1955 and 1993, age-adjusted PanC mortality rates increased 5.1 times for men and 4.3 times for women. The environmental factor for PanC mortality increased 68% for men and 89% for women over this period. Gompertzian analysis suggests that rising mortality from PanC in Japan may be related to rapidly changing lifestyles among Japanese. Pure alcohol consumption was the identified environmental factor most strongly correlated with PanC mortality.     

Longitudinal Gompertzian analysis of ALS mortality in England and Wales, 1963-1989: estimates of susceptibility in the general population.

Mortality statistics in amyotrophic lateral sclerosis (ALS), which is more commonly and generally termed motoneurone disease (MND) in the United Kingdom, have been shown to reflect the incidence of previously diagnosed cases of the disease in a more complete way than in other conditions [1,2]. An analysis of changing patterns of mortality may therefore be a particularly appropriate way of tracing the underlying trends in the disease and is in principle a useful way of investigating the relationship between environmental and genetically controlled factors in the genesis of the condition. The majority of analyses so far have concentrated on the crude rise in reported mortality rates evident in recent decades in a number of countries [2-5], on the uneven geographical distribution [6,7] and on the complex range of plausible causes for these reported rises. Debates have centred on whether the increases represent 'real' or 'artifactual' changes, with no apparent resolution of the issue [8,3]. Recently Riggs [9] proposed a novel way of analysing this issue by using a Gompertzian model and provided evidence of the existence of an inherently susceptible subset of the US population. Riggs indicated that while the rise in ALS mortality is real, it is for the most part the result of an increase in the size of this inherently susceptible sub-population due to greater longevity. In order to examine the wider applicability of a Gompertzian model to ALS the technique has been replicated with the mortality rates for England and Wales for the 27-year period from 1963 to 1989. The technique has been developed and extended to produce an estimate of the size of the inherently susceptible sub-population (both male and female) over the entire period.     

Fine particulate air pollution and mortality in 20 U.S. cities, 1987-1994

BACKGROUND: Air pollution in cities has been linked to increased rates of mortality and morbidity in developed and developing countries. Although these findings have helped lead to a tightening of air-quality standards, their validity with respect to public health has been questioned. METHODS: We assessed the effects of five major outdoor-air pollutants on daily mortality rates in 20 of the largest cities and metropolitan areas in the United States from 1987 to 1994. The pollutants were particulate matter that is less than 10 microm in aerodynamic diameter (PM10), ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide. We used a two-stage analytic approach that pooled data from multiple locations. RESULTS: After taking into account potential confounding by other pollutants, we found consistent evidence that the level of PM10 is associated with the rate of death from all causes and from cardiovascular and respiratory illnesses. The estimated increase in the relative rate of death from all causes was 0.51 percent (95 percent posterior interval, 0.07 to 0.93 percent) for each increase in the PM10 level of 10 microg per cubic meter. The estimated increase in the relative rate of death from cardiovascular and respiratory causes was 0.68 percent (95 percent posterior interval, 0.20 to 1.16 percent) for each increase in the PM10 level of 10 microg per cubic meter. There was weaker evidence that increases in ozone levels increased the relative rates of death during the summer, when ozone levels are highest, but not during the winter. Levels of the other pollutants were not significantly related to the mortality rate. CONCLUSIONS: There is consistent evidence that the levels of fine particulate matter in the air are associated with the risk of death from all causes and from cardiovascular and respiratory illnesses. These findings strengthen the rationale for controlling the levels of respirable particles in outdoor air.     

Racial-ethnic background and specialty choice: a study of U.S. medical school graduates in 1987

This study used two Association of American Medical Colleges' questionnaires to determine whether there was a relationship between the racial-ethnic backgrounds and the specialty choices of a 1987 cohort of 11,136 U.S. medical school seniors, both prior to entering medical school and as they prepared for residency training. Their specialty preferences as premedical students were shown by their responses to the Premedical Student Questionnaire, administered when they registered for the Medical College Admission Test; their specialty choices at the end of their medical school training were shown by their responses to the Medical Student Graduation Questionnaire, which they completed shortly before graduation. Racial-ethnic backgrounds, self-recorded, were classified into black, other underrepresented minorities, Asian, other non-underrepresented minorities, and white. Specialties were clustered into primary care, medical specialties, surgical specialties, and supporting services. Before entering medical school, the students had similar specialty preferences regardless of background. As seniors in medical school, there was even greater convergence of specialty choices among the students of all backgrounds. Racial-ethnic background in itself appears not to have been a major factor influencing the senior medical students' specialty choices.     

Genome analysis of H1N1 influenza virus strains isolated in the U.S.S.R. during an epidemic in 1961–1962

Summary Genome composition and polypeptides of H1N1 influenza virus strains isolated in the U.S.S.R. during an epidemic in 1961–1962 have been studied as well as H2N2 influenza virus strains that dominated at that time. The H1N1 isolates did not contain genes of the simultaneously circulating H2N2 viruses. H1N1 influenza viruses have proved to be genetically similar to A/FM/1/47 (H1N1) influenza virus strain differing in only two genes, rather than to H1N1 influenza viruses isolated in 1977 differing in six genes.With 1 Figure     

Body-mass index and mortality in a prospective cohort of U.S. adults.

BACKGROUND: Body-mass index (the weight in kilograms divided by the square of the height in meters) is known to be associated with overall mortality. We investigated the effects of age, race, sex, smoking status, and history of disease on the relation between body-mass index and mortality. METHODS: In a prospective study of more than 1 million adults in the United States (457,785 men and 588,369 women), 201,622 deaths occurred during 14 years of follow-up. We examined the relation between body-mass index and the risk of death from all causes in four subgroups categorized according to smoking status and history of disease. In healthy people who had never smoked, we further examined whether the relation varied according to race, cause of death, or age. The relative risk was used to assess the relation between mortality and body-mass index. RESULTS: The association between body-mass index and the risk of death was substantially modified by smoking status and the presence of disease. In healthy people who had never smoked, the nadir of the curve for body-mass index and mortality was found at a body-mass index of 23.5 to 24.9 in men and 22.0 to 23.4 in women. Among subjects with the highest body-mass indexes, white men and women had a relative risk of death of 2.58 and 2.00, respectively, as compared with those with a body-mass index of 23.5 to 24.9. Black men and women with the highest body-mass indexes had much lower risks of death (1.35 and 1.21), which did not differ significantly from 1.00. A high body-mass index was most predictive of death from cardiovascular disease, especially in men (relative risk, 2.90; 95 percent confidence interval, 2.37 to 3.56). Heavier men and women in all age groups had an increased risk of death. CONCLUSIONS: The risk of death from all causes, cardiovascular disease, cancer, or other diseases increases throughout the range of moderate and severe overweight for both men and women in all age groups. The risk associated with a high body-mass index is greater for whites than for blacks.