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Biomedical subjects

C L Carter

Publications and source records attributed to C L Carter.

At least 37 records · Page 2Linked to original sources
PubMed1990

Body fat distribution and breast cancer in the Framingham Study.

We examined the relation between central body fat distribution and breast cancer in a prospective cohort of women who participated in the Framingham Study. At the baseline examination in 1948, a total of 2,201 women aged 30-62 years were analyzed. An index of central to peripheral body fat (the central adiposity ratio) was calculated from the sum of the trunkal skinfolds (chest, subscapular, and abdominal) divided by the sum of the extremity skinfolds (triceps and thigh). These skinfolds were measured at the fourth examination in 1954. The cohort was followed for up to 28 years and yielded 106 cases of breast cancer. When divided into quartiles based on the central adiposity ratio, only women in the fourth quartile (those with the highest central to peripheral body fat distribution) demonstrated an increased risk for breast cancer. The age- and adiposity-adjusted relative risk estimate for having an increased central adiposity ratio (fourth quartile) compared to lower central adiposity ratios was 1.8 (95% confidence interval, 1.2-2.6). Adjustment for potential confounders of height, parity, and education did not appreciably alter this estimate (1.7, 1.1-2.5). There was no association between degree of adiposity, as measured by the sum of the five skinfolds or by body mass index (weight in kg divided by height in m2), and subsequent breast cancer. The results of this study suggest that increased central to peripheral body fat distribution predicts breast cancer risk independently of the degree of adiposity and may be a more specific marker of a premalignant hormonal pattern than degree of adiposity.

Adult↗
PubMed1990

Evidence of a rare gene for low systolic blood pressure in the Framingham Heart Study.

A major risk factor for coronary heart disease in both men and women is elevated systolic blood pressure (SBP). We performed segregation analysis on age, sex-adjusted, and transformed systolic blood pressure data on 1,141 families from the Framingham cohort-offspring study using the segregation analysis program POINTER. The results of hypothesis testing revealed: (1) these data are consistent with familial transmission; (2) there is evidence for the transmission of a rare, major gene for low SBP with a gene frequency of q = 0.02; and (3) most of the transmissible component to SBP can be attributed to the polygenic background with H = 0.31.

Adult↗
PubMed1989

Is alcohol consumption related to breast cancer? Results from the Framingham Heart Study.

We studied the relation between alcohol consumption and breast cancer among women in the Framingham Heart Study cohort. A total of 2,636 women aged 31-64 years provided information on alcohol consumption at the second biennial examination. They were followed for up to 32 years; during this period, breast cancer was diagnosed in 143 of these women. Alcohol intake was also assessed at 10 and 20 years of follow-up and every 2 years thereafter. In analyses using only baseline alcohol intake, the multiple risk factor-adjusted relative risk (RR) estimate of breast cancer for any drinking, compared with nondrinking, was 0.8 [95% confidence interval (CI), 0.5-1.1]. For three levels of alcohol intake (0.1-1.4 g/day, 1.5-4.9 g/day, and greater than or equal to 5.0 g/day), the baseline analyses yielded RRs (vs. nondrinking) of 1.0 (CI, 0.6-1.5), 0.7 (CI, 0.4-1.1), and 0.6 (CI, 0.4-1.0), respectively. In analyses incorporating repeated measures of alcohol, the comparable RRs were 0.9 (CI, 0.6-1.2) for any drinking (vs. nondrinking) and 0.7 (CI, 0.4-1.4), 1.1 (CI, 0.7-1.8), and 0.8 (CI, 0.5-1.2), respectively, for the three levels of intake (vs. nondrinking). Alcohol consumption was not associated with an increased risk of breast cancer in this cohort.

Adult↗
PubMed1989

Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases.

Two of the most important prognostic indicators for breast cancer are tumor size and extent of axillary lymph node involvement. Data on 24,740 cases recorded in the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute were used to evaluate the breast cancer survival experience in a representative sample of women from the United States. Actuarial (life table) methods were used to investigate the 5-year relative survival rates in cases with known operative/pathologic axillary lymph node status and primary tumor diameter. Survival rates varied from 45.5% for tumor diameters equal to or greater than 5 cm with positive axillary nodes to 96.3% for tumors less than 2 cm and with no involved nodes. The relation between tumor size and lymph node status was investigated in detail. Tumor diameter and lymph node status were found to act as independent but additive prognostic indicators. As tumor size increased, survival decreased regardless of lymph node status; and as lymph node involvement increased, survival status also decreased regardless of tumor size. A linear relation was found between tumor diameter and the percent of cases with positive lymph node involvement. The results of our analyses suggest that disease progression to distant sites does not occur exclusively via the axillary lymph nodes, but rather that lymph node status serves as an indicator of the tumor's ability to spread.

Breast Neoplasms↗
PubMed1989

Bowel function and breast cancer in US women.

We studied bowel function in relation to 123 breast cancer cases among 7,702 women from the US NHANES I Epidemiologic Follow-up Study. Results suggest a slight increased risk of breast cancer for both decreased frequency of bowel movements (relative risk = 1.5, 95% confidence interval = 0.8, 2.7) and firm stool consistency (RR = 1.8, 95% CI = 1.0, 3.2.) These observations are consistent with an hypothesized association between constipation and increased risk of breast cancer.

Breast Neoplasms↗
PubMed1988

Site-specific analysis of total serum cholesterol and incident cancer in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study.

We studied the relation of total serum cholesterol to all cancer and site-specific cancer incidence in a cohort based on a probability sample of the United States population. A total of 5125 men (yielding 459 cancers) and 7363 women (398 cancers) were initially examined in 1971-75 and followed a median of 10 yr. An examination of age-adjusted incidence rates by cholesterol level showed an inverse association between cholesterol and all cancer; lung, colorectal, pancreatic, and bladder cancers; and leukemia. In women a weak inverse relation (reflecting an elevated rate among those only in the lowest cholesterol quintile) was apparent for all cancer; more prominent inverse associations were seen for cancers of the lung, pancreas, bladder, cervix, and for leukemia. A more detailed analysis of cholesterol and colorectal cancer revealed little association in both men and women. For an aggregate group of smoking-related cancers, the inverse relation was especially prominent: the multivariate relative risk estimates for subjects in the lowest cholesterol quintile, compared to those in the highest quintile, were 2.1 (1.1-3.8) and 3.3 (1.4-7.8) for men and women, respectively. The inverse association was present for smoking-related cancers diagnosed 6 or more yr after cholesterol determination in both men and women, suggesting that this association cannot be simply dismissed as a preclinical cancer effect. Further investigation of the cholesterol-cancer question, particularly the relation between cholesterol and smoking-related cancers, may provide useful etiological leads.

Adult↗
PubMed1988

A prospective study of the development of breast cancer in 16,692 women with benign breast disease.

The authors studied the relation between benign breast disease and subsequent breast cancer in 16,692 women with biopsy-diagnosed benign breast disease who had participated in the Breast Cancer Detection Demonstration Project throughout the United States. Women were classified into one of five benign breast disease categories: atypical hyperplasia, proliferative disease without atypia, nonproliferative disease, fibroadenoma, and other benign breast disease. A total of 485 incident cases of breast cancer were identified in the women from August 1973 to February 1986 after a median follow-up period of 8.3 years from the diagnosis of benign breast disease. Age-adjusted incidence rates were calculated for benign breast disease types stratified by family history and calcification status. Relative risk (RR) estimates of breast cancer for women in the five benign breast disease categories, compared with the screened women who did not develop recognizable breast disease (normal subjects), were computed using the proportional hazards model. Results indicated that risk was associated with the degree of epithelial atypia. Over all age groups, women with nonproliferative disease, proliferative disease without atypia, and atypical hyperplasia displayed progressively increasing risks of 1.5, 1.9, and 3.0, respectively, compared with normal subjects, with 95% confidence intervals (CI) exceeding unity. Particularly high risk was seen among women under age 46 years with atypical hyperplasia (RR = 5.7, 95% CI 3.0-10.6). Women with fibroadenoma as the only indication of their benign breast disease had a relative risk of 1.7, with a lower 95% confidence limit of 1.0. No increased risk was seen for women with other benign breast disease. Positive family history (RR = 1.8) and calcification (RR = 1.2) significantly increased a woman's risk proportionately over the risk associated with each benign breast disease subtype. The authors conclude that the risk of developing breast cancer varies by category of benign breast disease and is directly related to the degree of epithelial atypia.

Adenofibroma↗
PubMed1988

Prospects for cancer prevention through genetics: family studies and population screening.

The ultimate goal of all genetic analyses, whether at the statistical or molecular level, is to identify individual genes and their function. The application of genetic epidemiological tools to common diseases, together with the recent implementation of recombinant DNA methodology, makes it feasible to identify, characterize, and even isolate genes involved in the major diseases of mankind. This paper outlines how the classical epidemiologic approach interfaces with the new DNA technologies. We review the progress of restriction fragment length polymorphism analyses in family studies and address their current and potential use in studies of unrelated individuals. In addition, we briefly discuss the role that oncogenes and inherited genetic alterations seem to play in the development of human cancers. The use of these techniques provides a framework for a better understanding of cancer etiology and may eventually help to define strategies for cancer prevention.

Genetic Linkage↗
PubMed1987

Serum cholesterol and cancer in the NHANES I epidemiologic followup study. National Health and Nutrition Examination Survey.

The relation between total serum cholesterol and cancer incidence and mortality was studied in a cohort based on a probability sample of the United States population. 5125 men (yielding 459 incident cancers and 258 cancer deaths) and 7363 women (398 cases, 186 deaths) were initially examined in 1971-75 and followed up for a median of 10 years. Men in the lowest cholesterol quintile had nearly double the risk of those in the highest quintile for both incidence and mortality. Among women a similar relation was seen for cancer mortality, but cancer incidence in the lowest quintile was only 1.2 times that of women in the highest quintile. The inverse cholesterol-cancer relation in men was present for cholesterol determinations made 6 or more years before diagnosis of cancer. It may be premature to dismiss the inverse relation between serum cholesterol and cancer simply as a preclinical marker of disease.

Adult↗
PubMed1987

Alcohol consumption and breast cancer in the epidemiologic follow-up study of the first National Health and Nutrition Examination Survey.

We investigated the relation between alcohol consumption and breast cancer in the Epidemiologic Follow-up Study of the first National Health and Nutrition Examination Survey, a cohort study based on sample of the U.S. population. A total of 7188 women 25 to 74 years of age who were examined during the period 1971 through 1975 were included in the analysis. Information about alcohol consumption was obtained during the base-line interview. The median follow-up period for this cohort was 10 years. One hundred twenty-one cases of breast cancer that developed after the baseline examination were identified through hospital records or death certificates. The relative-risk estimate for any amount of drinking relative to no drinking was 1.5 (95 percent confidence interval, 1.1 to 2.2). The estimates for three levels of consumption, from the lowest to the highest, were 1.4 (confidence interval, 0.9 to 2.3), 1.5 (0.9 to 2.6), and 1.6 (1.0 to 2.7), in comparison to no drinking at all. These relative-risk estimates were not materially affected by adjustment for known risk factors for breast cancer or for several dietary factors. The results of this study, consistent with those of two other cohort studies and a number of case-control studies, suggest that moderate alcohol consumption is associated with an elevation in the risk of breast cancer of 50 to 100 percent.

Adult↗
PubMed1980

Exercise response during wall-pulley versus bicycle ergometer work.

The purpose of this study was to test the significance of differences between cardiopulmonary responses to wall-pulley arm exercise and to bicycle ergometer leg exercise. The heart rate responses were greater for arm exercise than for leg exercise at comparable external work rates or energy cost levels. The systolic blood pressure responses and myocardial oxygen cost were greater for arm exercise at given external work loads, but not a comparable energy cost levels. The clinical and theoretical significance of these results is discussed.

Adult↗
PubMed1980

Segregation analysis of schizophrenia under a mixed genetic model.

Family data were collected on a multi-ethnic cohort of hospitalized schizophrenics in Hawaii in 1942. Results showed that prevalence rates for Orientals were significantly higher (p less than 0.001) than rates for Caucasians, Polynesians and others. Complex segregation analysis using a generalized mixed genetic model was performed on 507 sibships collected under both complete and incomplete selection. Likelihood ratio tests between the generalized model and two subhypotheses of a major gene effect and a polygenic effect revealed that neither subhypotheses could be rejected at the 5% level of significance. While neither hypothesis could be adequately supported by the likelihood ratio test, certain aspects of the findings suggest a preference for the multifactorial model in explaining the inheritance of schizophrenia in these data.

Asian People↗
PubMed1977

Infarct size and exercise capacity after myocardial infarction.

Estimation of infarct size from serum creatine phosphokinase elevations of 22 acute myocardial infarction (AMI) patients was compared to their functional exercise capacity determined on a bicyle ergometer. Eleven of these patients entered a controlled exercise program for 3-4 mo and were subsequently retested. Aerobic power of the exercise group increased significantly (mean +- SE 1.42 +- 0.5 met) and was also significantly greater than an unpaired control group tested the same number of months after infarct. Patients grouped 2.5-4.5 mo post-AMI demonstrated a correlation between aerobic power and estimated infarct size (r = -0.68, n = 15). This correlation was higher (r = -0.84, n = 11) after 3-4 mo of a controlled exercise program.

Creatine Kinase↗