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Biomedical subjects

E Pukkala

Publications and source records attributed to E Pukkala.

At least 199 records · Page 11Linked to original sources
PubMed1994

Increased incidence of lung and skin cancer in Finnish silicotic patients.

Cancer incidence during 1953 to 1991 in 811 Finnish silicotic patients diagnosed between 1936 and 1977 was evaluated. In comparison with the general population, excesses were observed for all cancers (standardized incidence ratio, 1.7 [95% confidence interval, 1.4 to 1.9]), all lung cancers (2.9 [2.4 to 3.5]), squamous cell lung cancers (3.3 [2.3 to 4.5]), and skin cancers: melanoma (3.0 [0.8 to 7.6]) and nonmelanoma (2.9 [1.2 to 6.1]). Confounding by tobacco smoking did not explain the lung cancer increment. The consistency of the association between silicosis and lung cancer across a large number of studies suggests that silicosis represents a direct or indirect lung cancer hazard. The skin cancer excess, a relatively novel finding, may be explained either by carcinogens in foundries, or silica-induced lowering of immunocompetence, which would lead to a more pronounced effect of solar ultraviolet radiation.

Adult↗
PubMed1994

Employment as hairdresser and risk of ovarian cancer and non-Hodgkin's lymphomas among women.

The incidence of ovarian cancer and non-Hodgkin's lymphomas (NHL) between 1971 and 1985 or 1987 has been studied on the basis of cancer registry data among women employed in hairdressing or related occupations at 1970 census in Denmark, Sweden, Norway, and Finland. Overall, the standardized incidence ratio (SIR) for ovarian cancer was 1.18 (95% confidence interval, 0.98 to 1.40). The increase was present among hairdressers from Denmark (SIR, 1.23) and Finland (SIR, 1.88); whereas hairdressers from Sweden and Norway had an incidence close to expectation (SIR 0.95 and 0.96, respectively). In three of the four countries, the SIR was higher in 1971 to 1975 than in later years. The SIR for NHL was 1.20 (0.84 to 1.66); an excess was seen in Denmark (SIR, 1.92) and a decrease was found in Sweden (SIR, 0.63). In previous studies, hairdressers have been reported to be at increased risk of ovarian cancer: this study adds some evidence in favor of the presence of an association. This study also offers some support to the hypothesis of an association between exposure to hair dyes and risk of NHL, that was reported among personal users from the United States. This study, however, strongly suggests that occupational cancer risk among female hairdressers depends on temporal and geographical factors.

Adult↗
PubMed1994

A novel approach to estimate the proportion of hereditary nonpolyposis colorectal cancer of total colorectal cancer burden.

The incidence of hereditary nonpolyposis colorectal cancer (HNPCC) is not precisely known. Common estimates are 4 to 6% of all colorectal cancers (CRCs), but lower figures have been published. In an attempt to obtain an independent new estimate of this proportion and to identify more HNPCC families, we designed a new method. Based on the fact that age at diagnosis is considerably lower in hereditary than in sporadic CRC, a cohort of 227 CRC patients aged 44 years or younger diagnosed during the years 1985-1989 and reported to the Finnish Cancer Registry was chosen as probands. Pedigrees of the probands were constructed by combining information from the Finnish Population Register Center and Finnish Cancer Registry using only automatically processed data. Sixteen pedigrees were extended further by the help of parish registers. Six of these turned out to be new possible HNPCC families but none met the stringent criteria of the cancer syndrome. Our results can be interpreted to suggest that the proportion of HNPCC of all CRCs is between 0.5 and 0.9%, depending on the diagnostic criteria used. Modifications of our method should be useful in other research projects dealing with diseases in which a subset is due to genetically or environmentally determined susceptibility.

Adolescent↗
PubMed1993

Risk of cancer in Finnish children living close to power lines.

OBJECTIVE: To investigate the risk of cancer in children living close to overhead power lines with magnetic fields of > or = 0.01 microteslas (microT). DESIGN: Cohort study. SETTING: The whole of Finland. SUBJECTS: 68,300 boys and 66,500 girls aged 0-19 years living during 1970-89 within 500 m of overhead power lines of 110-400 kV in magnetic fields calculated to be > or = 0.01 microT. Subjects were identified by record linkages of nationwide registers. MAIN OUTCOME MEASURES: Numbers of observed cases in follow up for cancer and standardised incidence ratios for all cancers and particularly for nervous system tumours, leukaemia, and lymphoma. RESULTS: In the whole cohort 140 cases of cancer were observed (145 expected; standardised incidence ratio 0.97, 95% confidence interval 0.81 to 1.1). No statistically significant increases in all cancers and in leukaemia and lymphoma were found in children at any exposure level. A statistically significant excess of nervous system tumours was found in boys (but not in girls) who were exposed to magnetic fields of > or = 0.20 microT or cumulative exposure of > or = 0.40 microT years. CONCLUSIONS: Residentia magnetic fields of transmission power lines do not constitute a major public health problem regarding childhood cancer. The small numbers do not allow further conclusions about the risk of cancer in stronger magnetic fields.

Adolescent↗
PubMed1993

Malignant lymphomas and leukemias, and exposures in the wood industry: an industry-based case-referent study.

Jobs and exposures in woodwork may entail an elevated risk of lymphomas and leukemias. Exposures occurring in woodwork were scrutinized in a small industry-based case-referent study of four cases of Hodgkin's disease, eight cases of non-Hodgkin's lymphoma, 12 cases of leukemia, and 152 matched referents, all from the Finnish wood industry. Past exposures to wood dust, chlorophenols, terpenes, and engine exhaust, individually reconstructed through plant- and period-specific job exposure matrices, were unrelated to lymphoma/leukemia risk. Exposures to various solvents were associated with an odds ratio (OR) of 5.6 (95% confidence interval 1.0-32.0). The OR for formaldehyde was 2.5 (nonsignificant). The results are interpreted as providing limited evidence of the role of exposure to some as yet unidentified organic solvents in increasing the risk of malignant lymphomas. Formaldehyde may be another woodwork-related risk factor for some lymphomas, but the power of the study was too low for empirical confirmation of this possibility. Leukemias did not seem to be associated with any of the exposures studied.

Air Pollutants, Occupational↗
PubMed1993

Cervical cancer incidence and mortality trends in Finland and Estonia: a screened vs. an unscreened population.

Long term trends in the incidence of and mortality from invasive cervical cancer have been studied in Finland (1953-1987) and Estonia (1968-1987). The analyses are based on the data from the Finnish and Estonian Cancer Registries. An organised nationwide screening programme for cervical cancer was started in Finland in the early 1960s. In Estonia, no cytological screening programme has been introduced, and cervical malignancies are diagnosed in routine gynaecological practice. During 1968-1987, both the incidence of and mortality from cervical cancer were considerably higher in Estonia than in Finland. A decrease has taken place in the cervical cancer incidence and mortality in both countries since the mid-1960s, but whereas in Finland the decrease has been marked, in Estonia it has been less pronounced and levelled off in the 1980s. In 1987, the age-standardised (world population) incidence rate per 100,000 women was 14.0 in Estonia and 3.8 in Finland, and the age-standardised mortality rate was 6.0 and 1.6 per 100,000, respectively. The difference in the incidence of the disease in the two neighbouring countries can be partially attributed to socioeconomic factors. The main reason for the different slopes of the trend curves for cervical cancer is probably the difference in public health policies: an effective mass screening programme is being conducted in Finland but not in Estonia.

Adult↗
PubMed1993

Does the month of diagnosis affect survival of cancer patients?

Some earlier studies based on relatively small data sets have suggested that the month of diagnosis affects survival of breast cancer patients. This phenomenon has been suggested to be attributable to daylight-related hormonal factors. Factors related to the holidays of both the medical personnel and the women themselves might also provide the explanation. In this study we assessed the effect of the month of diagnosis on the survival of 32,807 female breast cancer patients diagnosed in Finland in 1956-1985. Our results indicate that the month of diagnosis is a significant prognostic factor after adjusting for age at diagnosis, period of diagnosis, and stage at diagnosis. The adjusted relative excess risk of death was highest among those diagnosed in July and August, and lowest in March and November, the difference between the lowest and highest risk being 18%. Since colorectal cancer should not have any daylight-related hormone dependent risk determinants, a control cohort of 12,950 women with a diagnosis of colorectal cancer in the same calendar period was studied in a similar way. The survival pattern by month of diagnosis among the colorectal cancer patients was similar to that among breast cancer patients, indicating that general factors associated with the health behaviour of women and the health services (such as holidays) rather than biological factors may cause seasonal variations in survival of cancer patients.

Breast Neoplasms↗
PubMed1993

Cancer incidence among 78,000 asthmatic patients.

The risk of cancer was evaluated among 77,952 asthma patients with bronchial asthma. The series was obtained through linkage of two registers: the Finnish Social Insurance Institution's file of asthma patients and the Finnish Cancer Registry. There was a significant excess risk of lung cancer in both sexes, the standardized incidence ratio (SIR) being 1.32 among men and 1.66 among women. In women, the risk of cancer of the rectum was significantly increased (SIR 1.42), whereas the risks of cancer of the corpus uteri and multiple myeloma were lower than expected (SIR 0.76 and 0.53, respectively). In men, the incidence of cancer of the larynx was significantly reduced (SIR 0.63) and that of the bladder increased (SIR 1.25). When both sexes were combined, cancers of the colon (SIR 1.17) and rectum (SIR 1.28) also showed a significantly elevated risk. A reduction in risk was seen in stomach cancer (SIR 0.88) and lymphatic leukaemia (SIR 0.55). The increased lung cancer risk may be due to local inflammatory changes. It is possible that differences in the immune system, e.g. natural killer cell activity, explain some of the reduced cancer risks.

Adult↗
PubMed1993

Life-long physical activity and cancer risk among Finnish female teachers.

This cohort study on Finnish female teachers of physical education (PE) and languages (L) was performed as an attempt to evaluate the importance of physical activity as a risk determinant of cancer, PE representing a physically active and L a less active subcohort. All the PE and L teachers graduating from 1920 onwards were obtained from four registers compiled from 1958-73 supplemented by an extension cohort drawn from the union membership register 1984-91 (in total 1,499 PE and 8,619 L teachers). Results of a questionnaire to representative samples of L and PE teachers did not reveal any major intergroup differences in social status, general health status, nutrition, maturation history, reproductive history, consumption of alcohol, smoking, or diet. However, the PE teachers reported higher life-long physical activity values than the L teachers. During the follow-up period 1967-91, the number of cancer cases totalled 108 for the PE and 513 for the L teachers. Expected numbers of cancer cases were calculated on the basis of national incidence figures, and the standardized incidence ratios (SIRs) were defined as ratios of observed and expected numbers of cases. The SIR for total cancers was 1.1 for the PE and 1.2 for the L teachers. In both teacher groups the SIRs for cancers of the breast, endometrium, ovary and colon were similarly elevated and the SIR for cervical cancer was reduced. There was an increased SIR for lung cancer (1.4) and skin melanoma (2.0) in the PE but not in the L teachers (0.5 and 0.9, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1993

Survival rates in lung cancer patients with and without bronchial asthma.

Bronchial asthma itself or the treatment of asthma may modify the immunological response to cancer. The survival of lung cancer patients with a preceding diagnosis of bronchial asthma was compared with that of non-asthmatic lung cancer patients in Finland during 1970-1989. This was accomplished by linking two nation-wide data registers, the medication reimbursement register and the cancer registry. For 921 out of the 926 asthmatic patients with lung cancer diagnosed after the diagnosis of bronchial asthma, a non-asthmatic referent patient, matching with respect to sex, anatomical site, and histological type of tumour, as well as to age and year of lung cancer diagnosis, was successfully found in the files of the Cancer Registry. Another referent group was formed by using the stage of lung cancer at diagnosis as an extra matching criterion; this search was successful for 895 asthmatic lung cancer patients. The corrected 5-year survival rate of asthmatic lung cancer patients was 8.4% and that of the referent patients, not matched for stage, 9.6%. When stage was included as matching criterion the corresponding rates were 8.5% and 8.1% respectively. None of these differences were significant. The prognosis of asthmatic and non-asthmatic lung cancer patients thus seemed to be similar.

Asthma↗
PubMed1992

Cancer risk among workers at a copper/nickel smelter and nickel refinery in Finland.

A total of 1,388 workers employed for at least 3 months at a copper/nickel smelter and nickel refinery were followed up for cancer from 1953 to 1987 through the Finnish Cancer Registry. There were 1,339 male and 49 female workers, making a total of 27,130 and 706 person-years, respectively. All of the women worked in the refinery, which opened in 1960, the same year the smelting of nickel began. A total of 67 cancers were diagnosed among the men, the standardized incidence ratio for all cancers being 1.0. No cancer was found among the women (1.8 expected). The risk of cancer among men was analysed according to primary site, exposure to nickel, type of work, years since first exposure and age at diagnosis. In the subcohort of nickel refinery workers, one case of sinonasal cancer was observed, against 0.02 expected, but otherwise no significantly increased risks of cancer were found. In addition to the small size of the cohort, the non-positive finding concerning lung cancer might be related to the relatively low arsenic exposure and, perhaps, to the late commencement of nickel production.

Cohort Studies↗
PubMed1992

Changing cancer risk pattern among Finnish hairdressers.

A cohort of 3637 female and 168 male hair-dressers in Finland was followed up for cancer through the Finnish Cancer Registry in 1970-1987. Compared with the total population, the women had a significantly elevated risk (standardized incidence ratio 1.7) during the first third of the observation period, but not thereafter. For the total follow-up period, the relative risks were highest for nonmelanoma skin cancer (2.0), lung cancer (1.7), ovarian cancer (1.6), cervical cancer (1.5), and cancer of the pancreas (1.5); only the risk of ovarian cancer was statistically significant. A decrease in relative risk with time was observed for many primary sites, e.g., pancreas, cervix uteri, central nervous system, and thyroid. The opposite was true for lung and skin: An increased risk was found only in 1982-1987. The excess was most prominent in the oldest age groups with the longest time span since the first employment as a hairdresser. Among men, too, the general cancer risk was highest (1.6) during the first third of the observation period. An excess of cancers of the lung and the pancreas was observed. The small numbers, however, did not allow any further conclusions. The changes in the cancer risk pattern over time may be associated with changes in working conditions in hairdressing salons.

Adolescent↗
PubMed1992

Increased risk of cancer in patients with systemic lupus erythematosus.

To evaluate the risk of cancer in patients with systemic lupus erythematosus (SLE) a series of 205 consecutive patients (182 women and 23 men) were followed up for cancer through the files of the Finnish Cancer Registry. The follow up consisted of a total of 2340 person years. Fifteen cancers were diagnosed against 5.7 expected (relative risk (RR) 2.6, 95% confidence interval (CI) 1.5 to 4.4). Among the women there were four non-Hodgkin's lymphomas against 0.09 expected (RR 44, CI 11.9 to 111) and two soft tissue sarcomas against 0.04 expected (RR 49, CI 6.0 to 177). When evaluated by a case control study previous treatment with cytostatic drugs showed no influence on the occurrence of cancer in this series of patients with SLE.

Adult↗
PubMed1991

Leanness and lung-cancer risk.

Body mass index (weight/height2) was studied for its prediction of lung cancer in Finnish men examined by the Social Insurance Institution's Mobile Clinic and followed up by the Finnish Cancer Registry. Among 25,994 participants aged 20 to 75 years and free from cancer at the start of the study, 504 lung-cancer cases were diagnosed during a maximum follow-up of 19 years. There was a significant inverse gradient between body mass index and the incidence of lung cancer. This association was not due to confounding by age, smoking, social class, self-perceived general health, history of stress symptoms, chronic cough or chest X-ray findings, although these factors correlated with body mass index and were also significantly predictive of lung cancer. After adjustment for these factors, the relative risks of lung cancer were 1.0, 1.4, 1.5 and 1.8 (p for trend less than 0.001) from the highest to the lowest quartiles of body mass index. The association was noted among current smokers, but it was most obvious among men who had never smoked, the relative risk of lung cancer between the lowest and highest quartiles of body mass index being 7.6 (95% confidence interval = 2.0 to 29.4). The inverse gradient persisted throughout the entire follow-up period, and was most distinct after the first 10 years of follow-up, the relative risks for the quartiles of body mass index being 1.0, 1.9, 2.3 and 2.6 (p less than 0.001). The present study shows that the thinner the man, the more liable he is to develop lung cancer. Leanness or some factor or cluster of factors closely correlated to it, may play an aetiological role in lung cancer.

Adult↗
PubMed1991

Dietary antioxidants and the risk of lung cancer.

The relation between the intake of retinoids, carotenoids, vitamin E, vitamin C, and selenium and the subsequent risk of lung cancer was studied among 4,538 initially cancer-free Finnish men aged 20-69 years. During a follow-up of 20 years beginning in 1966-1972, 117 lung cancer cases were diagnosed. Inverse gradients were observed between the intake of carotenoids, vitamin E, and vitamin C and the incidence of lung cancer among nonsmokers, for whom the age-adjusted relative risks of lung cancer in the lowest tertile of intake compared with that in the highest tertile were 2.5 (p value for trend = 0.04), 3.1 (p = 0.12), and 3.1 (p less than 0.01) for the three intakes, respectively. Adjustment for various potential confounding factors did not materially alter the results, and the associations did not seem to be due to preclinical cancer. In the total cohort, there was an inverse association between intake of margarine and fruits and risk of lung cancer. The relative risk of lung cancer for the lowest compared with the highest tertile of margarine intake was 4.0 (p less than 0.001), and that for fruits was 1.8 (p = 0.01). These associations persisted after adjustment for the micronutrient intakes and were stronger among nonsmokers. The results suggest that carotenoids, vitamin E, and vitamin C may be protective against lung cancer among nonsmokers. Food sources rich in these micronutrients may also have other constituents with independent protective effects against lung cancer.

Adult↗