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1.
Allergy and risk of cancer. A prospective study using NHANESI followup data   总被引:1,自引:0,他引:1  
W P McWhorter 《Cancer》1988,62(2):451-455
The First National Health and Nutrition Examination Survey (NHANESI), conducted in 1971-1975, included a cohort of 6913 adults for whom history of smoking, allergies, and other factors was obtained. These persons were traced (with 93% success) approximately 10 years later by the NHANESI Epidemiologic Followup Survey, and incidence of malignancy in the interim period was determined. Primary allergy variables were physician-diagnosed asthma, hay fever, hives, food allergy, or other allergies. Excluded were persons with a prior history of cancer and cases of nonmelanoma skin cancer. After adjustment by logistic regression for age, sex, race, and smoking history, allergic history was found to increase the risk of subsequent malignancy (risk odds ratio = 1.40, 95% confidence interval = 1.10-1.77). The specific allergy type with the strongest cancer risk was hives. The cancer group with the strongest allergy association was lymphatic-hematopoietic (leukemia, lymphoma, myeloma). The risk odds ratio of developing leukemia, lymphoma, or myeloma for persons with hives history was 7.89 (95% CI = 3.13-19.89). These findings suggest that a history of allergy does not protect against subsequent cancer, and may be a risk factor. The possibility is raised that a history of hives may be a particular risk factor for lymphatic-hematopoietic malignancies.  相似文献   

2.
The nasal passages form one of the chief sources of contact of man with his environment. Hence, it is natural that the mucosa of the area should be the victim of assault with multitudes of potential allergens in Man’s environment, and as a result allergic reactions ensue. The immunological concept cannot easily account for some of the significant facts surrounding this disease. Based on model experiments and other considerations, an alternative theory has been postulated for atopic allergy by Szentivanyi (1968) and co-workers. According to this view, the fundamental abnormality in such cases is a selective beta-adrenergic blockade. The present study was undertaken to investigate whether the blockade of beta-adrenergic functions demonstrated in bronchial asthma (Cookson and Reed, 1963; Maselli et al., 1970; Fireman et al., 1970) holds true in other allergic conditions like nasal allergy and vasomotor rhinitis which has a striking clinical similarity to the former.  相似文献   

3.
Several studies have shown a decrease in glioma risk associated with a personal history of allergic conditions and the medications used to treat the symptoms. However, few studies have been able to examine risk within histological subgroups of glioma. Case-control data from M. D. Anderson Cancer Center and University of California, San Francisco were pooled to conduct the analysis stratified by histological subtype. A risk prediction model considering inflammation-related variables and antihistamine use was built using logistic regression. Of the subtypes examined, long-term antihistamine use was associated with increased risk of anaplastic gliomas, especially when length of use was considered in conjunction with history of asthma or allergy. Anaplastic cases with no history of asthma or allergy were 2.94 times more likely than controls to report antihistamine use for 10 years or more; whereas anaplastic cases with a history of asthma or allergy were 2.34 times more likely than controls to report antihistamine use for 10 years or more. Furthermore, anti-inflammatory medication use was associated with a protective effect against glioblastoma (OR = 0.80; 95% CI: 0.65, 0.99), especially among individuals with no history of asthma or allergies. No statistically significant effects of anti-inflammatory drugs or antihistamines were evident for the other histological subtypes. Thus, modulation of the immune system by the use of common drugs, such as antihistamines or nonsteroidal anti-inflammatory drugs, may contribute to the development of certain types of brain tumors.  相似文献   

4.
Epidemiologic evidence suggests that chronic inflammatory conditions of the lung may increase lung cancer risk. These chronic conditions, such as chronic obstructive pulmonary disease and asthma, commonly coexist with chronic rhinosinusitis. We prospectively examined if chronic rhinitis or sinusitis was associated with lung cancer risk in the Singapore Chinese Health Study, a population-based cohort of 63,257 Singapore Chinese, who were aged 45-74 years when recruited between 1993 and 1998. Each subject completed a comprehensive interview on medical conditions, dietary and lifestyle factors at recruitment, and cancer occurrence and survival status were determined via linkage to population-based registries. As of 31 December, 2005, 954 cohort participants had developed lung cancer. Compared with subjects without such history, subjects who reported a history of physician-diagnosed rhinitis or sinusitis at baseline, whether allergic or nonallergic, had a statistically significant 59% increase in risk of lung cancer (hazard ratio [HR] = 1.59; confidence interval [CI] = 1.06-2.37). This association was significant and stronger in women (HR = 2.32; 95% CI = 1.23-4.39) compared to men, and for the adenocarcinoma cell type (HR = 1.91; 95% CI = 1.07-3.42) compared to other histologies. Overall, a history of asthma, hay fever, allergic dermatitis, food allergy or any other allergic conditions asked in a single question was not related to lung cancer risk (HR = 1.11; 95% CI = 0.90-1.36). Chronic rhinosinusitis may be a marker of pan-airway inflammation and its association with lung cancer risk provides evidence linking inflammation to lung carcinogenesis, especially among women.  相似文献   

5.
Previous epidemiologic studies have reported that a history of allergy is associated with reduced risk of colorectal cancer and other malignancies. We studied the association between allergy history and incident colorectal cancer (n=410) prospectively in 21,292 Iowa women followed for 8 years. Allergy was defined from four self-reported questions about physician-diagnosed asthma (a), hay fever (b), eczema or allergy of the skin (c), and other allergic conditions (d). A history of any allergy was inversely associated with incident colorectal cancer: after multivariate adjustment, the hazard ratio (HR) was 0.74 [95% confidence interval (95% CI), 0.59-0.94]. Compared with women with no allergy, women reporting only one of the four types of allergy and women reporting two or more types had HRs of 0.75 (95% CI, 0.56-1.01) and 0.58 (95% CI, 0.37-0.90), respectively (P trend=0.02). The inverse association persisted in analyses restricted to any type of nonasthmatic allergy (HR, 0.73; 95% CI, 0.56-0.95). HRs were similar for rectal and colon cancers as well as for colon subsites: proximal and distal (HRs for any allergy ranged from 0.63 to 0.78 across these end points). Allergy history, which may reflect enhanced immunosurveillance, is associated with a reduced risk of colorectal cancer.  相似文献   

6.
Pesticide exposure has been associated with non-Hodgkin lymphoma (NHL) risk in a number of studies, and two recent studies suggest that the increased risk may be confined to those with a history of asthma. We examined the interaction between occupational pesticide exposure and atopy on risk of NHL in an Australian population-based case-control study. Incident cases (n = 694) were diagnosed in New South Wales or the Australian Capital Territory between 2000 and 2001 and controls (n = 694) were randomly selected from electoral rolls and frequency-matched to cases by age, sex and state of residence. Occupational pesticide exposure was determined by an expert occupational hygienist's assessment of job-specific questionnaires administered by telephone. History of atopy (asthma, hay fever, eczema and food allergy) was self-reported. Logistic regression models included the three matching variables, ethnicity and sun exposure. The OR for NHL with substantial pesticide exposure and any history of asthma was 3.07 (95% CI 0.55-17.10) and with substantial pesticide exposure and no asthma history it was 4.23 (95% CI 1.76-10.16). The p-value for interaction was 0.29. A similar pattern of risk was observed for each of the pesticide subtypes; for asthma at various times of life; for hay fever, eczema, food allergy and any atopy, in men only and for follicular lymphomas only. Although this study had limited power, the findings do not suggest modification of the association between pesticide exposure and NHL risk by asthma or atopic disease more generally.  相似文献   

7.
A personal history of asthma or allergy has been associated with a reduced risk for adult malignant gliomas. Recent reports on the use of nonsteroidal anti-inflammatory drugs (NSAID) and the presence of risk alleles in asthma susceptibility genes showed similar inverse associations. To further explore the relationship between immune mediators and gliomas, we examined the use of NSAID and antihistamines, history of asthma or allergy, and infection in 325 glioma cases and 600 frequency-matched controls from the metropolitan area of Houston, TX (2001-2006). The regular use of NSAID was associated with a 33% reduction in the risk for glioma, suggestive of possible antitumor activity. Surprisingly, regular long-term antihistamine use among those reporting a history of asthma or allergies was significantly associated with a 3.5-fold increase in the risk for glioma. Similar to previous reports, cases in our study were less likely to have reported asthma, allergy, or a history of a number of viral infections (chickenpox or shingles, oral herpes, and mononucleosis) than controls. We therefore speculate that the observed positive association with antihistamine use may reflect an alteration of protective immune factors in susceptible individuals. Our results lend additional support for an important but unknown link between malignant brain tumors and immune mediators.  相似文献   

8.
The relationship between selected aspects of medical history and the risk of colorectal cancer was analysed using data from a case-control study of 673 cases of colon cancer, 405 of rectal cancer and 1501 controls in hospital for acute, non-neoplastic, non-digestive tract conditions, unrelated to known or suspected risk factor for large bowel cancer. Significantly elevated risks (RR) were observed for history of cholelithiasis (RR = 1.5 [95% confidence interval (CI) 1.1–2.1] for colon; 1.6 [1.2–6.4] for rectum) and diabetes (1.6 [1.1–2.3] for colon; 1.3 [0.8-2.0] for rectum), and a significant protection emerged for history of drug allergy (0.6 [0.4-0.9] for colon; 0.6 [0.5–1.0] for rectum). No significant association was found with thyroid disease, gastroduodenal ulcer, liver cirrhosis, hepatitis, pancreatitis, gastrectomy, appendicectomy, treatment with cimetidine/ranitidine, treatment with chenodesoxycholic acid or with blood transfusions. The associations with cholelithiasis, diabetes and drug allergy were not materially modified by allowance for major identified potential confounding factors, and were not restricted to the diseases diagnosed within 5 or 10 years before large bowel cancer diagnosis. Thus, the analysis of this large dataset offered further quantitative evidence suggesting a possible, however moderate, association between gallbladder disease and colorectal cancer risk, which may be related to enhanced or continuous secretion of secondary bile acids. The associations with diabetes and drug allergy were unexpected, and probably indirect, lacking previous epidemiological support or any obvious biological interpretation. Thus, they should be simply regarded as working hypotheses worthy of further consideration.  相似文献   

9.
Anthracyclines have substantially improved the prognosis of patients with aggressive lymphoma. Increased risk of cardiotoxicity is a significant concern associated with the use of anthracyclines, particularly in patients with pre-existing heart disease, elderly or very young patients, and those with established risk factors. A prolonged infusional schedule may alleviate the toxicity, but is difficult to implement in clinical practice. The administration of dexrazoxane, a cardioprotective agent, may ameliorate cardiotoxicity associated with anthracyclines. However, it has come under scrutiny because of increased risk of hematological second malignancies particularly in children. Liposomal doxorubicin is a viable alternative with less cardiotoxicity and similar efficacy than conventional doxorubicin. Patients should be screened for heart disease and known risk factors before initiating therapy. Risk factors should be adequately controlled and alternatives should be explored in patients at risk for cardiac toxicity. Survivorship care is an integral part of treatment, and patients should be monitored for late effects of treatment.  相似文献   

10.
Nasal allergy is characterized by an IgE mediated inflammatory response of nasal mucosa to allergens and it has a close association with Asthma. Nasal allergy has been demonstrated to be a strong risk factor for the onset of asthma in adults. Spirometric parameters like Forced expiratory volume at timed interval of 1 s (FEV1) and forced expiratory flow (FEF25–75 %) are impaired in patients with nasal allergy or allergic rhinitis. The FEF25–75 % has been evidenced to be a reliable marker of early bronchial impairment in nasal allergy. Nasal allergy may be considered as the first step of the progression of respiratory allergy towards asthma. It has been demonstrated that FEF25–75 % is useful in predicting the presence of airway hyper responsiveness.It may be a more sensitive indicator of chronic airway obstruction than FEV1 and is considered as a risk factor for the persistence of respiratory symptoms in asthmatic patients. The impact of allergic rhinitis or nasal allergy on asthma (ARIA) guidelines, clearly underlined the role of allergic rhinitis as risk factor for asthma development. The possible presence of spirometric abnormalities in patient with allergic rhinitis has been well documented. So keeping this in mind, present study is undertaken to evaluate the impairment of spirometric parameters, like FEV1, FEF25–75 %, and forced vital capacity, in patients with nasal allergy and to predict the presence of airway hyper responsiveness.  相似文献   

11.
Intracerebral microinfusion (ICM) is an innovative technique of delivering therapeutic agents throughout large portions of the brain that circumvents the blood-brain barrier, minimizes systemic toxicity, and provides a homogeneous distribution of the infused agent. Temozolomide is a novel methylating agent with proven efficacy against malignant gliomas (MGs) after systemic administration but with dose-limiting myelotoxicity. Because MGs rarely metastasize, systemic drug delivery is unnecessary. Therefore, we evaluated the efficacy and toxicity of ICM with temozolomide in an athymic rat model of human MGs. Treatment of rats by ICM with temozolomide 3 days after intracerebral challenge with D54 human MG xenograft increased median survival by 128% compared with rats treated by ICM with saline, by 113% compared with rats treated with i.p. saline, and by 100% compared with rats treated with i.p. temozolomide (P < 0.001). Delay of treatment until 9 days after tumor challenge still resulted in a 23% increase in median survival in rats treated by ICM of temozolomide compared with rats treated with i.p. temozolomide. In addition, overall, 21.7% of rats treated by ICM with temozolomide survived for > 100 days without clinical or histological evidence of tumor. The dose of temozolomide delivered by ICM in this study was limited only by drug solubility, and no neurological or systemic toxicity could be attributed to ICM with temozolomide. Therefore, ICM of temozolomide may offer significant advantages in the treatment of MGs.  相似文献   

12.
Previous reports suggest that allergic disorders may protect against various types of cancer, but the association between history of allergy and pancreatic cancer risk has not been well studied. We did a systematic review and meta-analysis of published studies to evaluate the association of any type, and specific types, of allergy and the risk of pancreatic cancer. We did a comprehensive literature search using MEDLINE, PUBMED, and the ISI Web of Science databases to identify potential relevant case-control and cohort studies. Pooled relative risks (RR) and 95% confidence intervals (95% CI) were calculated using the fixed- and random-effects model. Fourteen population-based studies (4 cohort and 10 case-control studies) with a total of 3,040 pancreatic cancer cases fulfilled our inclusion criteria. A history of allergy was associated with a reduced risk of pancreatic cancer (RR, 0.82; 95% CI, 0.68-0.99). The risk reduction was stronger for allergies related to atopy (RR, 0.71; 95% CI, 0.64-0.80), but not for asthma (RR, 1.01; 95% CI, 0.77-1.31). There was no association between allergies related to food or drugs and pancreatic cancer (RR, 1.08; 95% CI, 0.74-1.58). Overall, there was no evidence of publication bias. Allergies, in particular those related to atopy, seem to be associated with a decreased risk of pancreatic cancer. The hyperactive immune system of allergic individuals may, therefore, in some way lead to increased surveillance and protect against pancreatic cancer development.  相似文献   

13.
Anaphylactoid systemic reactions to bleomycin are potentially lethal. Test dosing is recommended to prevent or quickly detect immediate hypersensitivity reactions in patients receiving bleomycin for the first time. Specific test dosage recommendations vary but general considerations include the patient's age, body size, and previous allergy history, and the care setting. Facilities administering bleomycin should implement guidelines that address bleomycin test dosing since the prevention and recognition of anaphylactoid reactions is a primary responsibility of the nurse administering chemotherapy.  相似文献   

14.
  目的  通过分析结直肠癌患者使用含奥沙利铂方案化疗前常规行地塞米松5 mg预处理后过敏反应发生的临床特征,为降低奥沙利铂过敏风险提供参考依据。  方法  回顾性分析2014年1月至2017年10月苏州大学附属常州肿瘤医院收治的242例含奥沙利铂方案化疗的结直肠癌患者临床资料,统计过敏反应发生率,对多项因素与过敏反应关系进行单因素分析,采用Logistic多因素回归模型分析影响过敏反应发生的独立因素,并探讨奥沙利铂过敏患者再次使用奥沙利铂治疗的结局。  结果  242例结直肠癌患者使用含奥沙利铂方案化疗前行地塞米松5 mg静推,发生过敏反应12例(4.9%),均为Ⅰ型过敏反应,中位发生时间6(5.5~ 10.5)个周期,中位累积剂量895(716.5~1 075.0)mg。多因素分析提示存在无奥沙利铂间隔期为过敏反应的独立预测因素(P= 0.04)。其中3例奥沙利铂过敏患者接受药物预处理后再次使用奥沙利铂,1例(33.3%)成功完成治疗。  结论  奥沙利铂使用前常规行小剂量地塞米松预处理,过敏反应发生率低于文献报道,安全性高,无奥沙利铂间隔期患者再次使用该药过敏反应发生率明显提高,奥沙利铂过敏患者再次使用需谨慎。   相似文献   

15.
To date, the prevalence and nature of the late toxicity of cisplatin-based combination chemotherapy for advanced testicular cancer has been poorly documented. Thirty men with a median age of 35 years (range, 23 to 63), who had undergone such treatment were assessed with detailed investigation to determine the type and frequency of chronic toxicity. The median follow-up from the time of commencement of chemotherapy was 75 months (range, 48 to 126). The most common late toxic effects were high tone hearing loss in 23 men (77%) and electrophysiological evidence of peripheral nerve damage in 15 (50%). Both the hearing and nerve abnormalities were predominantly asymptomatic. In addition, elevation of serum cholesterol, noted in 20 patients (67%), was significant (P = .014) when compared with a control population. Hyperuricemia was present in nine patients (30%). Only one patient, with other risk factors (smoking, family history), had evidence of ischaemic heart disease while 20% (all with a smoking history) had a diminished single breath diffusing capacity for carbon monoxide (DLCO). Cisplatin-based chemotherapy is relatively free of major long-term side effects and should not be withheld for fear of late toxicity.  相似文献   

16.
An increase of the prevalence of childhood allergic diseases and the incidence of childhood Hodgkin's (HL) and non-Hodgkin's lymphoma (NHL) were reported in the late 20th century. Among adults, several studies point to an inverse association with lymphoma; it remains to be confirmed whether allergy is also related to childhood lymphomas and whether the association, if any, is of an aetiologic nature. Between 1996 and 2008, 277 children (aged 0-14 years) with HL (N = 111) or NHL (N = 166) were enrolled in Nationwide Registry for Childhood Hematological Malignancies (NARECHEM), a Greek hospital-based-registry of childhood hematological malignancies. Hospital controls were individually matched to cases on age and sex. Multivariate conditional logistic regression was used to estimate odds ratios (ORs) with 95%confidence intervals (CIs) for associations of allergic diseases and other covariates with childhood HL or NHL risk. Subsequently, we combined our results with those of a French case-control study in a meta-analysis amounting to a total of 330 NHL cases/1478 controls and 239 HL cases/959 controls. After controlling for sociodemographic, perinatal and environmental factors, childhood NHL was less prevalent among children with allergy-associated symptoms overall (OR:0.50, 95%CI:0.27-0.92) or a history of asthma (OR:0.43, 95%CI:0.21-0.88). By contrast, allergy did not seem to be associated with childhood HL risk, although statistical power was limited. Fewer seaside holidays and higher birth weight were also associated with increased childhood NHL risk. The combined OR of the two studies for the association of asthma with NHL risk was: 0.52, 95%CI:0.32-0.84, whereas for HL: 0.86, 95%CI:0.51-1.45. Allergy seems to be strongly and inversely associated with childhood NHL. It remains to be elucidated in future investigations comprising larger populations, focusing on specific disease subtypes and employing more pertinent study-designs, whether this association is genuinely protective.  相似文献   

17.
Numerous epidemiological studies have evaluated some aspect of the association between a history of allergy and cancer occurrence. In this article, an overview of the epidemiological evidence is presented with a discussion of a number of methodological issues important in this area of study. Literature searches were conducted using the MEDLINE database from 1966 through to August 2005 to identify articles that explored a personal history of allergic disorders as a risk factor for cancer. Although it is difficult to draw conclusions between allergy and cancer at many sites because of insufficient evidence or a lack of consistency both within and among studies completed to date, strong inverse associations have been reported for pancreatic cancer and glioma, whereas lung cancer was positively associated with asthma. Additional studies are needed to confirm these finding and to address the limitations of previous studies, including the validity and reliability of exposure measures and control for confounding. Further, large prospective studies using cancer incidence would be particularly useful, including studies using biological markers of allergic status to reduce potential misclassification and to confirm the results of previous studies based on self-report. There is also a need for further basic research to clarify a potential mechanism, should an association exist.  相似文献   

18.

Purpose

To investigate the association between allergies, asthma, and breast cancer risk in a large, population-based case–control study.

Methods

Breast cancer cases (n = 3,101) were identified using the Ontario Cancer Registry and population controls (n = 3,471) through random digit dialing. Self-reported histories of allergies, hay fever, and asthma were collected by questionnaire. Logistic regression was used to assess associations between breast cancer risk and history of allergy/hay fever and asthma, with 16 possible confounders examined. Analyses were stratified by menopausal status.

Results

A history of allergies or hay fever was associated with a small reduction in breast cancer risk [age-adjusted odds ratio (AOR) = 0.86, 95 % confidence interval (CI) 0.77–0.96] and did not differ by menopausal status. Asthma was not associated with breast cancer risk overall; however, among premenopausal women, asthma was associated with a reduced risk of breast cancer (AOR = 0.72, 95 % CI 0.54–0.97).

Conclusions

A history of allergies may be associated with a modest reduction in breast cancer risk. Asthma does not appear to be associated with breast cancer risk overall; however, asthma may be associated with reduced breast cancer risk among premenopausal women.  相似文献   

19.
We investigated the relationship between childhood leukaemia and preceding history of allergy. A nationwide case-control study of childhood cancers was conducted in the United Kingdom with population-based sampling of cases (n = 839) and controls (n = 1,337), matched on age, sex and region of residence. Information about clinically diagnosed allergies was obtained from primary care records. More than a third of subjects had at least one allergy diagnosed prior to leukaemia diagnosis (cases) or pseudo-diagnosis (controls). For both total acute lymphoblastic leukaemia (ALL) and common-ALL/precursor B-cell ALL (c-ALL), a history of eczema was associated with a 30% significant reduction in risk: the odds ratios (OR) and 95% confidence intervals (CI) were 0.70 (0.51-0.97) and 0.68 (0.48-0.98), respectively. Similar associations were observed for hayfever (OR = 0.47; 95% CI: 0.26-0.85 and OR = 0.62; 95% CI: 0.33-1.16 for ALL and c-ALL, respectively). No such patterns were seen either for asthma and ALL, or for any allergy and acute myeloid leukaemia. A comparative analysis of primary care records with parents recall of allergy revealed only moderate agreement with contemporaneous clinical diagnoses for both cases and controls--confirming the unreliability of parental report at interview. Our finding of a reciprocal relationship between allergy and ALL in children is compatible with the hypothesis that a dysregulated immune response is a critical determinant of childhood ALL.  相似文献   

20.

Purpose

A history of allergy has been inversely associated with several types of cancer although the evidence is not entirely consistent. We examined the association between allergy history and risk of glioma, meningioma, acoustic neuroma, and parotid gland tumors using data on a large number of cases and controls from five INTERPHONE study countries (Australia, Canada, France, Israel, New Zealand), to better understand potential sources of bias in brain tumor case–control studies and to examine associations between allergy and tumor sites where few studies exist.

Methods

A total of 793 glioma, 832 meningioma, 394 acoustic neuroma, and 84 parotid gland tumor cases were analyzed with 2,520 controls recruited during 2000–2004. Conditional logistic regression models were used to obtain odds ratios (ORs) and 95 % confidence intervals (CIs) for associations between self-reported allergy and tumor risk.

Results

A significant inverse association was observed between a history of any allergy and glioma (OR = 0.73, 95 % CI 0.60–0.88), meningioma (OR = 0.77, 95 % CI 0.63–0.93), and acoustic neuroma (OR = 0.64, 95 % CI 0.49–0.83). Inverse associations were also observed with specific allergic conditions. However, inverse associations with asthma and hay fever strengthened with increasing age of allergy onset and weakened with longer time since onset. No overall association was observed for parotid gland tumors (OR = 1.21, 95 % CI 0.73–2.02).

Conclusions

While allergy history might influence glioma, meningioma, and acoustic neuroma risk, the observed associations could be due to information or selection bias or reverse causality.  相似文献   

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