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Biomedical subjects

C Mettlin

Publications and source records attributed to C Mettlin.

At least 55 records · Page 3Linked to original sources
PubMed1992

Soft tissue sarcomas in whites and blacks living in the United States of America.

Five hundred four hospitals volunteered reports on 2,355 patients in a long-term study and 645 institutes reported on 3,457 in a short-term study. Out of 5,623 cases of soft tissue sarcoma (STS) reported in white and blacks living in the United States of America, 574 cases (10.2%) were reported in blacks. No striking differences were found between blacks and whites concerning anatomic sites, histologic types, histologic grades, or clinical stages of STS. A higher percentage of patients with recurrences were reported in whites with liposarcoma (37.7% compared to 28.9% in blacks), and leiomyosarcoma (45% in whites compared to 39.1% in blacks). On the other hand recurrences were more frequent in fibrosarcoma and rhabdomyosarcoma in black patients. No significant differences in survival was found between white and black patients with STS.

Adult↗
PubMed1992

Survival in Hodgkin's disease by stage and age.

Patterns of care for Hodgkin's disease in the United States were surveyed through voluntary audits of hospitals with cancer programs nonapproved and approved by the Cancer Commission of the American College of Surgeons. Four hundred and seventy-three hospitals reported 6,345 patients diagnosed immediately preceding December 31, 1975. The survival rates varied with age, being better at younger ages and worse in the elderly. By pathologic stage, the younger patients faired better than the elderly in each stage grouping. Histologic type was not a factor in this poor prognosis. Hodgkin's disease in elderly patients has a different biologic behavior than in younger patients.

Adolescent↗
PubMed1992

Cholesterol and cancer in a population of male civil service workers.

Cancer incidence and mortality were ascertained in a cohort of 1910 male participants of the Albany Cardiovascular Health Center (CVHC). The New York State Cancer Registry, vital records files, CVHC follow-up records, New York State Retirement System files, and New York State Department of Motor Vehicles driver's license files were used. Serum cholesterol measurements as well as values for other exposure variables were obtained from records of medical examinations which began in 1953-1954. The study cohort was divided into two groups, based on initial serum cholesterol measurement (less than or equal to 190 mg/100 ml and less than or equal to 190 mg/100 ml). For total cancers, both incidence and mortality were similar in these groups. For digestive cancer, both incidence and mortality were slightly lower in the less than or equal to 190 mg/100 ml group. The deficit was not statistically significant. For respiratory cancer, relative risk and rate ratio estimates were in the range of 1.4-1.7 for incidence and mortality. The excess risk in the less than or equal to 190 mg/100 ml group was of borderline statistical significance. The association was concentrated in the lowest cholesterol quintile rather than suggesting a strong dose-response relationship. The estimates were not found to be confounded by cigarette smoking, body mass index, education or age. A reduction in the crude rate ratio estimate from 1.5 to 1.2 was observed when early cases were excluded, suggesting that part of the observed excess may be due to preclinical cancer.

Adult↗
PubMed1991

Cancer control and the older person. Prevention and detection in older persons.

Older persons are appropriate targets for a range of prevention and early detection interventions, however, greater emphasis should be given to structuring the delivery of prevention and detection services to the special needs of this population. This may require research and program development to reach older persons in the most effective and cost-effective manner. The American Cancer Society and other program efforts must accommodate the heterogeneity and special needs of segments of the older population. Racial and cultural minorities, impoverished persons, the cognitively impaired, and the physically impaired are four groups requiring special attention. Early detection guidelines specific to older persons should be developed.

Aged↗
PubMed1991

The American Cancer Society National Prostate Cancer Detection Project. Findings on the detection of early prostate cancer in 2425 men.

The American Cancer Society National Prostate Cancer Detection Project (ACS-NPCDP) is a multidisciplinary, multicenter effort to assess the feasibility of early prostate cancer detection by digital rectal examination (DRE), transrectal ultrasound (TRUS), and prostate specific antigen (PSA) assay. By June 1990, 2425 men not previously suspected of having prostate cancer had been examined in ten participating clinical centers according to the project protocol. Three hundred ninety-six men (16.3%) were recommended for biopsy on the basis of TRUS or DRE. An analysis of the results of 330 completed biopsies showed 52 cancers detected by DRE and/or TRUS. Forty-four (84.6%) of the men with cancer had positive TRUS examination results compared with 33 (63.5%) with positive DRE. Five additional cancers were discovered as a result of elevated PSA levels. The overall detection rate was 2.4% and this rate varied by age. The detection rate in men 55 to 60 years of age was 1.3% and this rose to 3.3% in men older than 65 years of age. The estimated sensitivity was significantly greater for TRUS compared with DRE (77.2% versus 57.9%; P less than 0.05). The estimated specificity of DRE was greater than that of TRUS (96.3% versus 89.4%; P less than 0.01). The positive predictive value (PPV) for the tests varied as a function of patient and disease characteristics. The overall PPV was 28.0% for DRE and 15.2% for TRUS. The occurrence of elevated PSA levels significantly increased the PPV of both TRUS and DRE. The majority of cancers detected were at early stages. These preliminary data suggest the feasibility of using these techniques to promote cancer control, but additional data and follow-up are needed to assess the significance of the results.

Age Factors↗
PubMed1990

The association of age and familial risk in a case-control study of breast cancer.

To investigate the association of breast cancer risk, age, and family history of breast cancer, 779 breast cancer patients and 1,558 comparably aged control patients without cancer or a history of cancer were studied. All patients were admitted to Roswell Park Memorial Institute, Buffalo, New York between 1982 and 1987. After adjustment for the effects of other major breast cancer risk factors, no overall increase in risk for a history of breast cancer in a first-degree relative was observed among younger women. However, when the age at reported occurrence of breast cancer was considered, increased relative risk (RR) was observed when the affected first-degree relative was diagnosed at a young age (RR = 1.3). In contrast, among older patients, greater risk (RR = 1.9) was associated with diagnosis in a first-degree relative at an older age. Among patients aged 55 years or older, risk for reporting one first-degree relative with breast cancer was significant (RR = 1.8) and was greater when more than one first-degree relative was reported to have breast cancer (RR = 3.3). Bilaterality in an affected first-degree relative was associated with increased risk only among older patients (RR = 2.3). Other studies have observed various age-related effects, but the present research differs in that the authors studied both the age of the patient at risk and the age of the affected relatives across the full range of ages at which breast cancer occurs. These findings may have implications for the identification of populations for earlier initiation of routine screening and for laboratory investigation of the genetic etiology of breast cancer.

Adult↗
PubMed1990

Vasectomy and prostate cancer risk.

To assess the hypothesis that a history of vasectomy is a risk factor in the etiology of prostate cancer, the authors conducted a case-control study at Roswell Park Memorial Institute, Buffalo, NY, between 1982 and 1988. From epidemiologic data routinely collected from entering patients, information on vasectomy history and other data were obtained for 614 patients with prostate cancer and 2,588 comparable control subjects with cancer at another site. Age-specific and age-adjusted relative risks were calculated. Increased risk (relative risk = 1.7, 95% confidence interval 1.1-2.6) was found for reporting vasectomy at any age. Age-adjusted relative risk of 2.2 (95% confidence interval 1.0-4.6) was observed for men who reported vasectomy 13-18 years before diagnosis. A significant trend in the association of years since vasectomy and risk also was observed. Cases and controls were found to be nearly identical with respect to education, income, race, marital history, and number of children. A difference in smoking histories of cases and controls was found not to confound the observed associations. These data may suggest the importance of further epidemiologic and biologic research on vasectomy as a risk factor for prostate cancer.

Aged↗
PubMed1990

Results of a national survey of characteristics of hospital tumor conferences.

A descriptive survey of hospital tumor conferences, which are also referred to as tumor boards, was conducted by the National Cancer Institute in collaboration with the American College of Surgeons and Roswell Park Memorial Institute. The survey was done to assess the involvement of the tumor conference in the care of the patient with cancer and to lay the groundwork for additional studies of the conference. The data from the descriptive survey are based on questionnaires sent to 1,700 hospitals in the United States. The questionnaires requested information about frequency, attendance, composition, role of the chairman, agenda and other variables that relate to the format and purpose of the conference. From the results, we conclude that tumor conferences are an accepted and established institution for the multidisciplinary care of patients with cancer. They are a major source of consultation and education for physicians and for other professionals involved in oncology. Tumor conferences are conducted in a wide spectrum of hospitals and related institutions that vary in size and function.

Clinical Protocols↗
PubMed1989

Beta-carotene and animal fats and their relationship to prostate cancer risk. A case-control study.

A case-control study of 371 prostate cancer patients and comparable control subjects admitted to Roswell Park Memorial Institute (RPMI), Buffalo, New York, was conducted. Data were obtained from routine epidemiologic questionnaires administered to all patients on admission. An index of beta-carotene intake was computed based on the vitamin A activity of 27 fruits and vegetables included in a food frequency checklist. A similar measure of fat intake from meats was computed based on nine meats included in the checklist. Intake frequencies of common and alcoholic beverages also were studied. A significant age-adjusted and residence-adjusted protective effect for high levels of beta-carotene intake was observed (relative risk [RR], 0.60; 95% confidence interval [CI], 0.37 to 0.99). This effect was evident particularly among men 68 years of age and younger (RR, 0.30; 95% CI, 0.13 to 0.66), but not among subjects older than 68 years of age. A trend toward increased risk for fat intake was not significant. However, the reported usual consumption of high-fat milk was associated with increased risk (RR, 1.92; 95% CI, 1.05 to 3.50). A greater reported frequency of whole milk intake was similarly associated with increased risk. Men who reported drinking three or more glasses of whole milk daily had an RR of 2.49 (95% CI, 1.27 to 4.87), compared with men who reported never drinking whole milk. When these findings are evaluated in the context of other recent studies, the weight of the evidence appears to favor the hypothesis that animal fat intake is related to increased risk of prostate cancer.

Aged↗
PubMed1989

Milk drinking, other beverage habits, and lung cancer risk.

The reported beverage habits of 569 lung cancer patients and 569 control patients admitted to Roswell Park Memorial Institute (RPMI) were studied, 355 male cases and 214 female cases being matched to controls within strata of age and residence. Smoking history and an index of vitamin A from vegetables had significant, dose-response associations with risk. Animal fat intake as measured by an index of animal fats from meats showed elevated risks which were not significant. Three vegetables rich in vitamin A and 3 meats contributing to the animal fat index were, individually, associated with lung cancer risk. Frequency of consumption of milk, coffee, tea, soft drinks and alcoholic beverages was studied in multiple logistic regression analyses which controlled for smoking history, intake of vitamin A from vegetables and education level. Subjects reporting consumption of whole milk 3 or more times daily had a 2-fold increase in lung cancer risk compared to those who reported never drinking whole milk (RR = 2.14). The same frequency of intake of reduced-fat milk was associated with a significant protective effect (RR = .54). Significant risk variations were observed for other beverages but, with the exception of frequencies of reported diet cola and decaffeinated coffee intake, dose-response patterns were not evident.

Age Factors↗
PubMed1989

Prostate cancer in blacks: an update from the American College of Surgeons' patterns of care studies.

Data from the American College of Surgeons' prostate cancer surveys covering nearly a decade of experience demonstrate that the problem of prostate cancer is unique among black men in the United States. These data show that the distribution of stage at diagnosis changed across the 10-year interval. The data indicate that there have been improvements in the 5-year survival rates of both black and white patients, but the prostate cancer-specific survival of black patients remains significantly poorer than that of whites.

Black or African American↗
PubMed1989

Epidemiologic evidence of perinatal influence in the etiology of adult cancers.

Using data from 5489 cancer patients and 2647 patients without cancer we investigated whether parental age at the birth of the patient or the patient's rank within his sibship was related to the risk of cancer during adulthood. An increase of 10 years in maternal age was associated with an increase of 24% for the incidence of breast cancer (odds ratio = 1.24%; 95% CI = 1.09-1.41); the corresponding increase for paternal age was 19% (odds ratio = 1.19; 95% CI = 1.07-1.33). There was some evidence that the age of each parent may make an independent contribution to the risk of breast cancer. For certain types of genito-urinary cancers, the risk was higher when the parents were relatively young at the birth of the patient. These cancers included tumors arising in the prostate (odds ratios = 0.71 and 0.55 for maternal and paternal ages, respectively), testis (odds ratios = 0.57 and 0.52), penis (odds ratios = 0.37 and 0.45), kidney (odds ratios = 0.66 and 0.60), and bladder (odds ratio = 0.79 and 0.85). The associations for cancer of the prostate and bladder were stronger among patients who were diagnosed at a relatively young age. No statistically significant effects were found for birth order relative to adult cancers. The authors conclude that environmental factors that affect the parents or that operate in the perinatal period may have stronger influences on the incidence of adult cancers than have been previously recognized.

Adult↗
PubMed1989

National survey of patterns of care for brain-tumor patients.

An excellent response by participating institutions was realized in this survey of patterns of care for patients with primary brain tumors. Since the histopathology of the tumor is such a strong predictor of outcome and influences care so greatly, most analyses were performed not only on the overall series of patients but also by World Health Organization histological classification. Several factors that influence outcome were identified: tumor type, patient age, patient Karnofsky rating, tumor location, and therapy. Very few cases were coded as regards the American Joint Committee on Cancer clinical stage, and few potentially eligible cases were placed in investigative protocols. It behooves those centers providing investigative protocol opportunities to develop liaisons with practicing physicians nearby as well as at some distance and to provide an organizational framework that will make participation in these protocols practical for a larger segment of our brain-tumor patient population. Between 1980 and 1985, the increased use of magnetic resonance imaging in neuroradiology is apparent as well as the increased use of stereotactic biopsy and interstitial radiotherapy. Complications of therapy seem acceptably low. Five-year survival for benign brain tumor is high, while that for the most common primary tumor, glioblastoma multiforme, is only 5.5%. Some of the findings in this survey confirm those from the literature while others, particularly the pattern of care, represent new data.

Brain Neoplasms↗
PubMed1988

Descriptive and analytic epidemiology. Bridges to cancer control.

Epidemiology serves as a bridge between basic science and cancer control. The two major orientations of epidemiology are descriptive and analytic. The former is useful in assessing the scope and dimensions of the cancer problem and the latter is used to assess environmental and lifestyle sources of cancer risk. A recent development in descriptive epidemiology is the use of functional measures of disease such as lost life expectancy. In analytical epidemiology, there is new or renewed interest in several lifestyle factors including diet and exercise as well as environmental factors such as involuntary tobacco exposure and radon in dwellings. Review of the evidence should consider the strengths and weaknesses of different research procedures. Each method is inconclusive by itself but, the different research designs of epidemiology collectively may represent a hierarchy of proof. Although the roles of many factors remain to be defined, the aggregate epidemiologic data continue to demonstrate the special importance of personal behavior and lifestyle in affecting cancer risk.

Diet↗