Trends in childhood leukemia incidence over two decades from 1992 to 2013

Incidence rates of childhood leukemia in the United States have steadily increased over the last several decades, but only recently have disparities in the increase in incidence been recognized. In the current analysis, Surveillance, Epidemiology and End Results (SEER) data were used to evaluate recent trends in the incidence of childhood leukemia diagnosed at age 0–19 years from 1992 to 2013, overall and by age, race/ethnicity, gender and histologic subtype. Hispanic White children were more likely than non‐Hispanic White, non‐Hispanic Black or non‐Hispanic Asian children to be diagnosed with acute lymphocytic leukemia (ALL) from 2009 to 2013. From 1992 to 2013, a significant increase in ALL incidence was observed for Hispanic White children [annual percent change (APC)_Hispanic = 1.08, 95% CI: 0.59, 1.58]; no significant increase was observed for non‐Hispanic White, Black or Asian children. ALL incidence increased by about 3% per year from 1992 to 2013 for Hispanic White children diagnosed from 15 to 19 years (APC = 2.67; 95% CI: 0.88, 4.49) and by 2% for those 10–14 years (APC = 2.09; 95% CI: 0.57, 3.63), while no significant increases in incidence were observed in non‐Hispanic White, Black, or Asian children of the same age. Acute myeloid leukemia (AML) incidence increased among non‐Hispanic White children under 1 year at diagnosis, and among Hispanic White children diagnosed at age 1–4. The increase in incidence rates of childhood ALL appears to be driven by rising rates in older Hispanic children (10–14, and 15–19 years). Future studies are needed to evaluate reasons for the increase in ALL among older Hispanic children.     

吸烟环境与肺癌关系研究

目的 找出在非吸烟人群中肺癌与吸烟环境暴露(ETS)之间的关系。方法 用流行病学方法在甘肃进行人群病例—对照研究。研究对象包括有233名肺癌患者(200名女性和33名男性)和521名对照(407名女性和114名男性)。结果 暴露在ETS中的人员,比值比(OR)为1.19(95％置信限0.7～2.0),且随暴露量增加有显著增高趋势(P<0.05)。对无暴露、暴露量<10包-年、暴露量为10～19包-年和暴露量≥20包-年的人员,OR值分别为1.00,1.04,1.13和1.51。未成年期(≤18岁)的ETS暴露具有附加危险度。在对成年期受到的ETS暴露进行调整后,未成年期受ETS暴露,OR值为1.52(95％置信限1.1～2.2),且随未成年期暴露量包-年数的增加有显著增加趋势(P<0.01)。对未成年期无暴露、暴露量<10包-年、10～19包-年和≥20年-年的未成年暴露人员,OR值分别为1.00,1.43,1.81和2.95。在对未成年期ETS暴露调整后,发现成年期ETS暴露不会产生附加危险度。成年期受ETS暴露人员,OR值为0.90(95％置信限0～1.4)。结论 未成年期(18岁以下)非吸烟人员受ETS暴露,肺癌相对危险度明显增大。吸烟成年人对与其生活在一起的未成年人的影响要比预期的大。     

Lung cancer and indoor exposure to coal and biomass in rural China

Incomplete combustion of coal in homes has been linked with lung cancer in China. We report on a lung cancer case-control study in a rural area of China, where many residents live in underground dwellings and burn coal and unprocessed biomass (crop residues, wood, sticks, and twigs) for heating and cooking. We interviewed 846 patients with lung cancer (626 men, 220 women; aged 30 to 75 years) diagnosed between 1994 and 1998, and 1740 population-based controls. The odds ratio for lung cancer associated with coal use compared with that for biomass in the house of longest residence was 1.29 (95% confidence interval, 1.03 to 1.61), adjusted for smoking and socioeconomic status. The risk for lung cancer increased relative to the percentage of time that coal was used over the past 30 years (P = 0.02). Our findings suggest that coal may contribute to the risk of lung cancer in this rural area of China.     

Second malignant neoplasms among long-term survivors of Hodgkin's disease: a population-based evaluation over 25 years.

PURPOSE: To quantify the relative and absolute excess risks (AER) of site-specific second cancers, in particular solid tumors, among long-term survivors of Hodgkin's disease (HD) and to assess risks according to age at HD diagnosis, attained age, and time since initial treatment. PATIENTS AND METHODS: Data from 32,591 HD patients (1,111 25-year survivors) reported to 16 population-based cancer registries in North America and Europe (1935 to 1994) were analyzed. RESULTS: Two thousand one hundred fifty-three second cancers (observed-to-expected ratio [O/E] = 2.3; 95% confidence interval [CI] = 2.2 to 2.4), including 1,726 solid tumors (O/E = 2.0; 95% CI, 1.9 to 2.0) were reported. Cancers of the lung (observed [Obs] = 377; O/E = 2.9), digestive tract (Obs = 376; O/E = 1.7), and female breast (Obs = 234; O/E = 2.0) accounted for the largest number of subsequent malignancies. Twenty-five years after HD diagnosis, the actuarial risk of developing a solid tumor was 21.9%. The relative risk of solid neoplasms decreased with increasing age at HD diagnosis, however, patients aged 51 to 60 years at HD diagnosis sustained the highest cancer burden (AER = 79.2/10,000 patients/year). After a progressive rise in relative risk and AER of all solid tumors over time, there was an apparent downturn in risk at 25 years. Temporal trends and treatment group distribution for cancers of the esophagus, stomach, rectum, female breast, bladder, thyroid, and bone/connective tissue were suggestive of a radiogenic effect. CONCLUSION: Significantly increased risks of second cancers were observed in all HD age groups. Although significantly elevated risks of stomach, female breast, and uterine cervix cancers persisted for 25 years, an apparent decrease in relative risk and AER of solid tumors at other sites is suggested.     

Lung cancer and environmental tobacco smoke in a non-industrial area of China

We report results from a population-based case-control study of lung cancer and environmental tobacco smoke (ETS) among never-smokers conducted in 2 rural prefectures of China, including 200 female and 33 male lung cancer cases, and 407 female and 114 male controls, matched on age, sex and prefecture of current residence. The odds ratio (OR) for ever-exposed to ETS was 1.19 (95% CI 0.7-2.0), with a significant trend (p<0.05) with increasing exposure. ORs were 1.00, 1.04, 1.13 and 1.51 for non-exposed, <10, 10-19 and >/=20 pack-years of ETS exposure, respectively. Excess risks were limited to ETS exposures in childhood (相似文献