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oai:open-archive.highwire.org:amjepid:116/1/12015-05-11HighWireOUPamjepid:116:1
SERIAL BLOOD PRESSURE MEASUREMENTS AND CARDIOVASCULAR DISEASE IN A JAPANESE COHORT
PRENTICE, R. L.
SHIMIZU, Y.
LIN, C. H.
PETERSON, A. V.
KATO, H.
MASON, M. W.
SZATROWSKI, T. P.
ORIGINAL CONTRIBUTIONS
A cohort of 16,711 residents of Hiroshima and Nagasaki have participated In a program of biennial clinical examination and history taking that began in 1958. During 1958–1974, a total of 621 confirmed cases of cerebrovascular disease and 218 confirmed cases of coronary heart disease were incident This study makes a detailed examination of the relationship between a series of biennial examination blood pressure (BP) measurements and cardiovascular disease risk. Two aspects are emphasized: the quantitative relationship between risk and both systolic blood pressure (SBP) and diastolic blood pressure (DBP), and the predictive value of BP levels some years in the past, given more recent BP determinations. Cerebral hemorrhage incidence is shown to depend markedly on recent DBP level, while earlier DBP levels make an additional important contribution to risk prediction. Corresponding SBP levels have little additional predictive value. With cerebral infarction, SBP is the more important predictor, though elevated DBP conveys some additional risk at high SBP levels. Recent BP levels are more strongly predictive for cerebral infarction than are BP levels some years earlier. Elevated SBP is also an important predictor of coronary heart disease risk in this population, while elevated DBP does not appear to be predictive at specified SBP. SBP levels several years in the past are more closely associated with coronary heart disease risk than are recent SBP readings. The dependence of BP relative risk functions on sex and age is examined and some departures from the results Just listed are noted at younger ages. Implications for disease mechanism and hypertensive therapy are discussed.
Oxford University Press
1982-07-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/116/1/1
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oai:open-archive.highwire.org:amjepid:116/1/1022015-05-11HighWireOUPamjepid:116:1
IMPAIRED PULMONARY FUNCTION AS A RISK FACTOR FOR MORTALITY
BEATY, T. H.
COHEN, B. H.
NEWILL, C. A.
MENKERS, H. A.
DIAMOND, E. L.
CHEN, C. J.
ORIGINAL CONTRIBUTIONS
Prospective follow-up information obtained between 1976 and 1981 on mortality among 2539 individuals showed that pulmonary function impairment is a risk factor for short-term mortality, even when risk factors such as age, sex, and smoking are considered. Predicted risk curves for impaired individuals (those with forced expiratory volume in one second less than 68% of forced vital capacity) are consistently higher among all race-sex categories over all ages. Survival analysis using the proportional hazards model shows a steeper decline in estimated survival among individuals with poor pulmonary function compared to those with good pulmonary function, adjusted for age, race, and smoking effects. These observations are consistent with the concept that impairment of pulmonary function is a risk factor for morbidity and mortality from several nonresplratory as well as respiratory diseases and that it acts by contributing to various pathogenic mechanisms in different organ systems.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/102
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Copyright (C) 1982, Oxford University Press
oai:open-archive.highwire.org:amjepid:116/1/1142015-05-11HighWireOUPamjepid:116:1
RELIABILITY OF RECALL OF DRUG USAGE AND OTHER HEALTH-RELATED INFORMATION
HILL, A. PAGANINI
ROSS, R. K.
ORIGINAL CONTRIBUTIONS
Health-related information from multiple sources was collected on 334 women living in two predominantly white, affluent retirement communities near Los Angeles as part of a case-control study of a serious chronic disease (cancer of the breast) conducted in 1977–1978. There was no evidence on interview of cases preferentially recalling more drug use or past diseases than controls. Agreement between interview and medical record for all disease conditions studied as well as for height, weight, and most menstrual and reproductive variables was of the order of 90% or better. Age at last menstrual period as reported on interview did not correspond particularly well with that recorded on the medical record. Agreement between data sources for ever/never drug use varied considerably with the type of drug studied, from a low of 69% for use of barbiturates and related drugs to a high of 87% for use of antlhypertenslve medications. Estrogen usage information was collected in detail. Better correspondence was observed between medical record and interview than between either medical and pharmacy records or interview and pharmacy records.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/114
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Copyright (C) 1982, Oxford University Press
oai:open-archive.highwire.org:amjepid:116/1/1232015-05-11HighWireOUPamjepid:116:1
THE ASSOCIATION OF SOCIAL RELATIONSHIPS AND ACTIVITIES WITH MORTALITY: PROSPECTIVE EVIDENCE FROM THE TECUMSEH COMMUNITY HEALTH STUDY
HOUSE, JAMES S.
ROBBINS, CYNTHIA
METZNER, HELEN L.
ORIGINAL CONTRIBUTIONS
The prospective association of social relationships and activities reported during a round of interviews and medical examinations in 1967–1969 with mortality over the succeeding nine to 12 years was examined for a cohort of 2754 adult (aged 35–69 years as of 1967–1969) men and women in the Tecumseh Community Health Study. After adjustments for age and a variety of risk factors for mortality, men reporting a higher level of social relationships and activities in 1967–1969 were significantly less likely to die during the follow-up period. Trends for women were similar, but generally nonsignificant once age and other risk factors were controlled. These results were invariant across age, occupational, and health status groups. No association was observed between mortality and satisfaction with social relationships or activities. How and why social relationships and activities predict mortality are discussed and identified as important foci for future research.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/123
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oai:open-archive.highwire.org:amjepid:116/1/1412015-05-11HighWireOUPamjepid:116:1
AN EPIDEMIOLOGIC STUDY OF HIP FRACTURE IN POSTMENOPAUSAL WOMEN
KREIGER, NANCY
KELSEY, JENNIFER L.
HOLFORD, THEODORE R.
O'CONNOR, THERESA
ORIGINAL CONTRIBUTIONS
In this case-control study of the epidemiology of hip fracture in postmenopausal women aged 45–74 years, cases of hip fracture and two control groups were selected from admissions to four general hospitals in Connecticut between September 1977 and May 1979. Fewer cases of hip fracture than controls had been exposed to estrogen replacement therapy, and among those who had been exposed, exposure time was shorter than that for controls. The cases had breastfed their children for shorter durations, and they more often had had both ovaries removed. Also, the cases were found to weigh less than the controls. The negative associations of hip fracture with estrogen replacement therapy, intact ovaries, and weight are consistent with the hypothesis that estrogens protect against hip fracture.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/141
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oai:open-archive.highwire.org:amjepid:116/1/1492015-05-11HighWireOUPamjepid:116:1
MENTAL FUNCTION FOLLOWING SCALP IRRADIATION DURING CHILDHOOD
RON, E.
MODAN, B.
FLORO, S.
HARKEDAR, I.
GUREWITZ, R.
ORIGINAL CONTRIBUTIONS
Between 1950 and 1960 about 20,000 Israeli children were treated for tinea capltis by x-ray therapy as part of a large public health campaign to eradicate the disease. Dosimetric studies determined that these children were subjected to a mean brain dose of 130 rads. Almost 20 years later, possible radiation effects on the central nervous system were evaluated by comparing several measures of mental and brain function in approximately 11,000 of the irradiated children and in two nonirradiated, tinea-free comparison groups: (a) ethnic, sex- and age-matched individuals from the general population, and (b) siblings. While not all comparisons were statistically significant, there was a consistent trend for the irradiated subjects to exhibit signs of central nervous system impairment more often than either comparison group. The irradiated children had lower examination scores on scholastic aptitude, intelligence quotient (IQ) and psychologic tests, completed fewer school grades, and had an increased risk for mental hospital admissions for certain disease categories. A slightly higher frequency of mental retardation was also suggested. These long-lasting scholastic and mental health effects lead the authors to conclude that radiation to the immature brain may cause damage to the central nervous system.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/149
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oai:open-archive.highwire.org:amjepid:116/1/1612015-05-11HighWireOUPamjepid:116:1
SEROEPIDEMIOLOGY OF INFECTION WITH HEPATITIS A VIRUS AND HEPATITIS B VIRUS IN THE SEYCHELLES
NUTI, MARIO
FERRARI, MAXIME J. D.
FRANCO, ELISABETTA
TALLANI, GLORIA
DE BAC, CARLO
ORIGINAL CONTRIBUTIONS
A batch of 417 serum samples obtained from native-born subjects were tested for the presence of hepatitis B surface antigen (HBsAg) and corresponding antibody (anti-HBs), by enzyme-linked immunosorbent assay (ELISA); and antibodies to hepatitis B core antigen (antl-HBc), e-antlgen (anti-HBe), and hepatitis A virus (anti-HAV), by radioimmunoassay (RIA). HBsAg was found in only two of the 417 subjects studied. Anti-HBs was detected in 112 samples (26.8%), anti-HBc in 114 (27.3%) and anti-HBe in 31 samples (7.4%). Serologlc evidence of a previous or present infection by hepatitis B virus (HBV) was found in 34.5% of the samples studied. Males showed a greater prevalence of anti-HBs and anti-HBc, while anti-HBe was more common in females; however, these differences were not significant. With regard to age, a significantly higher prevalence of anti-HBs (<it>p</it> < 0.05), anti-HBc (<it>p</it> < 0.025) and anti-HBe (<it>p</it> < 0.025) was found in the older age groups. Anti-HAV antibodies were present in 90% of the subjects studied, with no variation between the sexes. The anti-HAV rate in the group under 20 years was similar to that found in the older age groups. The total infection rate of hepatitis B virus in the Seychelles is lower than in other tropical areas, HBs antigen/antibody ratio approaching that in temperate areas. Elucidation of the reasons for the low prevalonce of hepatitis B virus carriers among the Seychelles population requires further investigation.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/161
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oai:open-archive.highwire.org:amjepid:116/1/1682015-05-11HighWireOUPamjepid:116:1
VALIDITY OF BERNOULLI CENSUS, LOG-LINEAR, AND TRUNCATED BINOMIAL MODELS FOR CORRECTING FOR UNDERESTIMATES IN PREVALENCE STUDIES
HOOK, ERNEST B.
REGAL, RONALD R.
ORIGINAL CONTRIBUTIONS
Most prevalence studies using health records are likely to miss some affected cases and thus be biased to underestimates. An adjustment for underascertainment is often necessary, but to our knowledge no validity studies of proposed methods have been done. Using a data set on Down syndrome which gives distributions by five different sources, the number listed in, say source X, i.e., the known “prevalence” (KP) of those in X, was compared with estimates of this prevalence derived (using only information on the intersections of X with other sources) by using several different models: 1) truncated <it>β</it>-binomial or Skellam (TS); 2) truncated binomial (TB); 3) Bernoulli census-independent sources (IS); 4) Bernoulli census-merged sources (MS); and 5) log-linear (LL). Up to three of the following assumptions are required by at least one of the models: (I) for each specific source X, each case in the population has the same probability of being listed by that source; (II) there is no variation between sources in these probabilities, i.e., the ascertainment probability is the same for all sources; and (III) the sources are independent. The TB model makes all three assumptions, the TS model makes assumptions two and three, the IS model makes assumptions one and three, and the MS and LL models make only the first assumption. Estimates derived from the TS model must always be greater than or equal to those from the TB model, and these in turn must be greater than or equal to those from the IS model. No such systematic relationship holds for estimates from the MS or LL models with regard to the others. Results by sources were <it>mental hygiene</it> records: KP = 263, estimates (as % of KP) were TS = 85%, TB = 84%, IS = 79%, MS = 81%, LL = 87%<it>schools</it>;KP = 252,TS =% 108%,TB = 95%, IS = 90%, MS = 95%, LL = 104%; <it>hospital records:</it> KP = 215,TS = 108%,TB = 108%, IS = 102%, MS = 105%, LL = 97%;<it>obstetrical records:</it> KP = 183, TS = 110%, TB = 109%, IS = 106%, MS = 121%, LL = 103%. (<it>Department of Health Records:</it> KP = 36, no estimates made.) The estimates derived from the log-linear models had in general the best agreement wtth the values of the known prevalences. In addition, for each source 95% confidence intervals include the known prevalences. The truncated β-binomial (Skellam) model (TS) was the only other model for which all confidence Intervals Include the known prevalences, but these intervals are so wide and so asymmetric around the known prevalences as to render this approach much less attractive. Thus, In general, the log-linear model, of those considered, appears preferable for prevalence estimation. The analyses presented here Illustrate the need for and value of collection and reporting of data by all source Intersections In multiple source Investigations.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/168
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oai:open-archive.highwire.org:amjepid:116/1/1772015-05-11HighWireOUPamjepid:116:1
SOME CONFOUNDING FACTORS IN THE STUDY OF MORTALITY AND OCCUPATIONAL EXPOSURES
GILBERT, E. S.
ORIGINAL CONTRIBUTIONS
With the recent interest in the study of occupational exposures, the impact of certain selective biases in the groups studied is a matter of some concern. In this paper, data from the Hanford nuclear facility population (southeastern Washington State, 1947–1976), which Includes many radiation workers, are used to Illustrate a method for examining the effect on mortality of such potentially confounding variables as calendar year, length of time since entering the industry, employment status, length of employment, job category, and initial employment year. The analysis, which is based on the Mantel-Haenszel procedure as adapted for a prospective study, differs from most previous studies of occupational variables which have relied primarily on comparing standardized mortality ratios (utilizing an external control) for various subgroups of the population. Results of this analysis confirm other studies in that reduced death rates are observed for early years of follow-up and for those with higher socioeconomic status (as indicated by job category). In addition, workers employed less than two years and especially terminated workers are found to have elevated death rates as compared with the remainder of the study population. It is important that such correlations be taken into account in planning and interpreting analyses of the effects of occupational exposure.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/177
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oai:open-archive.highwire.org:amjepid:116/1/1892015-05-11HighWireOUPamjepid:116:1
RE: "SEASONAL RELATIONSHIP OF SUDDEN INFANT DEATH SYNDROME AND ENVIRONMENTAL POLLUTANTS"
Goldstein, Inge F.
LETTERS TO THE EDITOR
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/189
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oai:open-archive.highwire.org:amjepid:116/1/1912015-05-11HighWireOUPamjepid:116:1
THE AUTHORS REPLY
Hoppenbrouwers, Toke
Hodgman, Joan E.
LETTERS TO THE EDITOR
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/191
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oai:open-archive.highwire.org:amjepid:116/1/1922015-05-11HighWireOUPamjepid:116:1
RE: STUDY OF SEASONALITY
Walter, S. D.
LETTERS TO THE EDITOR
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/192
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oai:open-archive.highwire.org:amjepid:116/1/1942015-05-11HighWireOUPamjepid:116:1
THE AUTHORS REPLY
Nam, Jun-mo
Scotto, Joseph
LETTERS TO THE EDITOR
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/194
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oai:open-archive.highwire.org:amjepid:116/1/1962015-05-11HighWireOUPamjepid:116:1
DECISION THEORY AND SCREENING
Hansen, Holger
LETTERS TO THE EDITOR
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/196
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oai:open-archive.highwire.org:amjepid:116/1/198-a2015-05-11HighWireOUPamjepid:116:1
RE: "NORWALK GASTROINTESTINAL ILLNESS: AN OUTBREAK ASSOCIATED WITH SWIMMING IN A RECREATIONAL LAKE AND SECONDARY PERSON-TO-PERSON TRANSMISSION."
Baron, Roy C.
Murphy, Frank D.
Greenberg, Harry B.
Davis, Cornelia E.
Bregman, Dennis J.
Gary, G. William
Hughes, James M.
Schonberger, Lawrence B.
LETTERS TO THE EDITOR
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/198-a
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oai:open-archive.highwire.org:amjepid:116/1/1982015-05-11HighWireOUPamjepid:116:1
AUTHORS' CORRECTION TO "COST CONSIDERATIONS AND SAMPLE SIZE REQUIREMENTS IN COHORT AND CASE-CONTROL STUDIES"
Pike, M. C.
Casagrande, J. T.
LETTERS TO THE EDITOR
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/198
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oai:open-archive.highwire.org:amjepid:116/1/292015-05-11HighWireOUPamjepid:116:1
BLOOD PRESSURE DURING THE FIRST TWO YEARS OF LIFE
SCHACHTER, JOSEPH
KULLER, LEWIS H.
PERFETTI, CAROL
ORIGINAL CONTRIBUTIONS
Blood pressure (BP) was measured on the third postnatal day in 392 healthy, full-term, appropriate weight infants, and again in 318 infants at six months, in 277 infants at 15 months, and in 232 infants at 24 months of age. Differences in average BP between white infants and black infants were small; BP did not vary significantly as a function of socloeconomlc class or sex. BP, measured during sleep, had increased from birth to six months of age, but showed no change from six to 15 months, a period of rapid growth, during which average weight increased 37% and average height Increased 16%. BP continued to show no change from 15 to 24 months, when waking BP measurements at 24 months were adjusted for sleep-waking differences in BP. Cross-sectional analyses revealed only modest weight-BP relationships at 15 and 24 months. Five per cent of the infants exhibited systolic BPs which remained above the 80th percentile at six, 15, and 24 months of age. This was six times the number expected by chance if BP was assumed to be uncorre-lated from measurement to measurement. This group of infants showed physical maturation, measured by weight change, which was almost identical with that of the total cohort.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/29
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oai:open-archive.highwire.org:amjepid:116/1/422015-05-11HighWireOUPamjepid:116:1
AIR POLLUTION AS A RISK FACTOR IN LUNG CANCER
VENA, JOHN E.
ORIGINAL CONTRIBUTIONS
Retrospective data on residential and employment history and on smoking were obtained from 417 white male lung cancer patients and 752 controls with nonrespiratory, nonneoplastic diseases, from Erie County, New York, admitted to Roswell Park Memorial Institute from 1957–1965. Total suspended particulate data and a historical review of problem point sources of pollution were used to delineate air pollution zones. The findings did not support the hypothesis that air pollution alone significantly increased risk for lung cancer. However, there was increased risk from smoking and occupational exposures if there was also long-term exposure to air pollution. The risk for heavy smokers with heavy exposure to air pollution was over four times that of men with none of the high exposure traits. The findings suggest an apparent synergistic mechanism involving smoking and air pollution and smoking and occupational exposures. The findings are consistent with previous epidemiologic studies and with biologic and experimental evidence. The limitations of the methods used here necessitate further study and replication. However, the study indicates that air pollution should not be dismissed as a risk factor in lung cancer.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/42
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oai:open-archive.highwire.org:amjepid:116/1/572015-05-11HighWireOUPamjepid:116:1
TRENDS IN THE INCIDENCE OF CANCER OF THE CORPUS UTERI IN CONNECTICUT, 1964-1979, IN RELATION TO CONSUMPTION OF EXOGENOUS ESTROGENS
MARRETT, LORAINE D.
MEIGS, J. WISTER
FLANNERY, JOHN T.
ORIGINAL CONTRIBUTIONS
The incidence of cancer of the uterine corpus diagnosed in the localized stage and reported to the Connecticut Tumor Registry changed little between 1964 and 1969. During the next six years, however, it increased substantially, reaching a peak in 1975, followed by an irregular decline through 1979. Women aged 45-64 years showed both the largest increase and the sharpest decline. The incidence of tumors diagnosed with regional or distant spread has been rising slightly but consistently through the period 1970–1979; this upward trend is statistically significant (p < 0.01). Rates corrected for hysterectomized women not truly at risk are 40–50% higher than uncorrected rates but trends are the same. Explanations which are considered are changes in diagnostic practices and changes in risk factor prevalence. The use of noncontraceptlve oral estrogens, a well documented risk factor for endometrlal cancer, increased between 1964 and 1975 and then declined sharply through 1979 in the United States. The Importance of these compounds in explaining the observed incidence trends is considered in terms of the major time- and stage-specific features of the exogenous estrogen-endometrial cancer association reported in the case-control studies.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/57
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oai:open-archive.highwire.org:amjepid:116/1/682015-05-11HighWireOUPamjepid:116:1
DIET IN THE EPIDEMIOLOGY OF BREAST CANCER
GRAHAM, SAXON
MARSHALL, JAMES
METTLIN, CURTIS
RZEPKA, THOMAS
NEMOTO, TAKUMA
BYRES, TIM
MARSHALL, JAMES
ORIGINAL CONTRIBUTIONS
A variety of studies have shown that diets high in fat, particularly polyun-saturated, have enhanced the production of tumors in animals challenged with chemical carcinogens. Other studies have found an apparent contradiction of no difference in the incidence of breast cancer among women with varying levels of serum cholesterol as measured decades earlier. The present study concerns 2024 breast cancer cases and 1463 control patients without neoplasms or pathology of the reproductive and digestive organs, seen at Roswell Park Memorial Institute from 1958 to 1965. Based upon the assessments of their varying ingestion of fats from their own reports of diets, no difference in risk was found. Similarly, there was no difference in risk of breast cancer associated with ingesting diets containing various levels of either vitamin C or the cruciferous vegetables. Risk for breast cancer in women 55 years of age and older increased somewhat with decreases in ingestion of foods containing vitamin A.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/68
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oai:open-archive.highwire.org:amjepid:116/1/762015-05-11HighWireOUPamjepid:116:1
SCROTAL CARCINOMA IN CONNECTICUT METALWORKERS: SEQUEL TO A STUDY OF SINONASAL CANCER
ROUSH, GEORGE C.
KELLY, JO ANN
MEIGS, J. WISTER
FLANNERY, JOHN T.
ORIGINAL CONTRIBUTIONS
An excess risk for sinonasal cancer among Connecticut metalworkers with potential exposure to cutting oils led to the hypothesis of a relationship between the same occupational category and squamous cell carcinoma of the scrotum. Cases of this latter tumor (<it>n</it> = 45) diagnosed in 1935–1973 were identified by the Connecticut Tumor Registry. For decedents, male controls from Connecticut death certificates were matched to decedent cases on age, year of birth, and availability of occupational information; for living subjects, male controls from records of the Connecticut Department of Motor Vehicles were matched on the above variables and town of residence. Death certificates and city directories provided occupational information. For the narrowly defined indicator of cutting oil exposure (toolmaker, setter, set-up man, hardener, polisher, automatic screw machine operator), the odds ratio for squamous cell carcinoma of the scrotum was 4.9, 95% confidence limits (CL): 1.8, 15.9. The broad indicator of cutting oil exposure (the aforementioned categories plus machinist and machine operator (not otherwise specified)) had an odds ratio of 10.5, 95% CL: 4.0, 36.9 and explained 57% of the cancers. For this broad category, the risk persisted in the most recent time period of diagnosis, 1966–1973 (OR = 18.6). For this broad category, major biases could not be detected when the following additional covarlables were taken into account individually where possible: source of occupation, nativity, town of residence, stage at diagnosis, and cause of death. City directory and death certificate information implied that at least 80% of cases in the high risk category worked in the Connecticut region before age 40.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/76
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oai:open-archive.highwire.org:amjepid:116/1/862015-05-11HighWireOUPamjepid:116:1
A CASE-CONTROL STUDY OF CHOLECYSTECTOMY AND RIGHT-SIDE COLON CANCER: THE INFLUENCE OF ALTERNATIVE DATA SOURCES AND DIFFERENTIAL INTERVIEW PARTICIPATION PROPORTIONS ON ODDS RATIO ESTIMATES
VERNICK, LEONARD J.
KULLER, LEWIS H.
ORIGINAL CONTRIBUTIONS
One hundred fifty patients with right-side colon cancer (i.e., patients with adenocarinoma of the cecum or ascending colon) were compared to 150 matched left-side colon cancer controls (i.e., patients with adenocarclnoma of the descending or sigmold colon) and to 123 neighborhood controls, Pittsburgh, Pennsylvania, Standard Metropolitan Statistical Area, 1975–1978. The gastrointestinal surgical history was ascertained for all study subjects so that the presence or absence of a history of cholecystectomy could be noted. Cholecystectomy history was obtained through telephone interviews and whenever possible subsequently validated from operative and pathology reports at time of cholecystectomy. Cholecystectomy history for the colon cancer patients was also abstracted from hospital records at time of colon cancer diagnosis with an attempt to confirm the gallbladder's status through operative reports, cholecystograms, and physical examinations. Hospital records and interviews for the colon cancer patients appeared to provide accurate exposure history. Point estimates of the odds ratios and confidence intervals for intra- and inter-data source comparisons (i.e., hospital records, interviews, and hospital records and interviews combined) were comparable with similar measures of effect. Consistent odds ratio estimates appeared in both left-side colon cancer controls (1.9) and neighborhood controls (1.89). The authors suggest that changes in bile acid metabolism following cholecystectomy may be associated with an increased risk of right-side colon cancer.
Oxford University Press
1982-07-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/116/1/86
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Copyright (C) 1982, Oxford University Press