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Biomedical subjects

F F Holmes

Publications and source records attributed to F F Holmes.

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

Childhood cancer survivors: attained adult heights. Compared with sibling controls.

As part of a large collaborative study, the authors administered a pretested questionnaire to 62 childhood and adolescent cancer survivors and 62 same-sex sibling controls. The authors requested information regarding attained adult height on the questionnaire. Mean adult height of survivors (172.2 cm) was less than that of controls (174.1 cm), at a borderline significant difference of p = 0.0757. Multivariate analysis examined four potential, independent variables as possible predictors of this difference. The presence of brain tumor (vs. nonbrain tumor) (p less than .0001) and diagnosis at an early age (less than or equal to 8 years vs. 9-15 years) (p = .05) were factors significantly related to the differential; sex of patient and type of therapy were not. Our findings thus identify malignancy site and age at diagnosis as important predictors of adult height in childhood and adolescent cancer survivors.

Adolescent↗
PubMed1990

Survival in acute non-lymphocytic leukaemia following breast cancer.

Acute non-lymphocytic leukaemia (ANLL) occurs with increased frequency in women with previously diagnosed breast cancer. Adjuvant radiotherapy and chemotherapy are related to this increase. We studied the interrelationships among age at breast cancer diagnosis, interval to ANLL diagnosis, and survival in 54 women of whom 11 were from Kansas and 43 were from two other published series. Median age at breast cancer diagnosis was 50.5 years, median interval to ANLL diagnosis was 4.8 years, and median survival after ANLL diagnosis was 2.2 months. Increasing age was associated with a decrease of the interval to ANLL diagnosis just short of statistical significance (P = 0.0591). There was no association of survival with either age or the interval to ANLL diagnosis. With an increase in the use of adjuvant therapy in breast cancer there is a need to identify women at greatest risk of subsequently developing ANLL, at present not possible.

Adult↗
PubMed1989

Marriage and divorce after childhood and adolescent cancer.

As part of a study of long-term survivors of childhood and adolescent cancer, we interviewed 2170 survivors and 3138 sibling control subjects about their marital histories. In a proportional hazards analysis, both male and female survivors were less likely to be ever married than control subjects (rate ratio [RR] for males, 0.87; 99% confidence interval, 0.76 to 0.99; RR for females, 0.86; 99% confidence interval, 0.76 to 0.97). Survivors of brain and central nervous system tumors accounted for most of the marriage deficit, which was greater in men than in women (RRs, 0.48 and 0.73, respectively). Survivors married at the same average age as control subjects, except for survivors of central nervous system tumors, who married slightly later. The average length of first marriages was shorter in survivors than in control subjects. Men who had survived central nervous system tumors diagnosed before 10 years of age and male survivors of retinoblastoma had higher divorce rates than male control subjects (RRs, 2.9 and 1.9, respectively). In this cohort (which received less intense therapy than given in current practice), altered marriage practices are substantial only among survivors of central nervous system tumors.

Adolescent↗
PubMed1989

A case-control study of soft-tissue sarcoma.

The roles of nonagricultural occupations, tobacco use, beverage consumption, medical history, and other factors in the development of soft-tissue sarcoma were examined in a population-based case-control study in Kansas. Based on 133 cases diagnosed between 1976-1982 and 948 controls, there were significant excesses associated with use of the drug chloramphenicol (odds ratio (OR) = 5.4, 95% confidence interval (Cl) 1.2-23.9) and chewing tobacco or snuff (OR = 1.8, 95% Cl 1.1-2.9). The risk associated with smokeless tobacco varied with the location of the tumors; greater risks were observed for tumors of the upper gastrointestinal tract (OR = 3.3), the lung, pleura, and thorax (OR = 3.1), and the head, neck, and face region (OR = 2.4) than other regions of the body (OR = 1.4). A nonsignificant excess was seen with the use of cholesterol-lowering drugs, such as clofibrate (OR = 1.7). Four cases reported histories of prior radiation treatment to the same area of their bodies as their tumors. Soft-tissue sarcoma was also associated with employment in woodworking occupations (OR = 1.7, 95% Cl 0.9-3.2) and risk increased with increasing duration of employment. Persons with first-degree blood relatives with a history of Hodgkin's disease, lymphoma, or cancers of the pancreas, prostate, brain, or skin were at increased risk. Many of the associations observed in this study, notably the risk of soft-tissue sarcoma with smokeless tobacco and medications such as chloramphenicol, deserve further evaluation.

Adult↗
PubMed1989

Accuracy of diagnosis of pancreatic cancer decreases with increasing age.

Pancreatic cancer is common in the elderly and often is diagnosed clinically without pathologic confirmation. We compared age distribution and survival of 240 elderly patients with clinically diagnosed pancreatic cancer and 712 elderly patients with pathologically confirmed adeno- and ductal pancreatic carcinoma. All patients were registered by the Kansas state cancer registry from 1975-1984. The percentage of clinical diagnoses increased significantly from 12% in those aged in their 60s to 59% for those in their 90s (P less than .005). Observed 5-year survival for all of the clinically diagnosed patients was 8.4% compared with 0.6% for those pathologically confirmed. When locally confined disease only was considered, 5-year survival was 27% for patients clinically diagnosed and 4% for those pathologically confirmed. Given the fact that long survival from pancreatic carcinoma is a rare event, these findings suggest that in many elderly patients clinical diagnoses of pancreatic cancer are wrong. The findings have implications for the statistics on increasing incidence of pancreatic cancer (particularly in the elderly) and in discussion of prognosis with elderly patients diagnosed with pancreatic cancer without pathologic confirmation.

Adenocarcinoma↗
PubMed1988

Reproductive problems and birth defects in survivors of Wilms' tumor and their relatives.

In a retrospective cohort study of 47 Wilms' tumor survivors and their 77 sibling controls, female survivors had a fourfold excess risk (risk ratio, 4.1; 95% confidence interval, 1.7-10.1) for any adverse livebirth outcome, including birth defects, compared with their sibling controls. Wives of male survivors had no apparent excess risk for problem pregnancies. The families had a number of severe reproductive problems and major birth defects, such as primary amenorrhea in two survivors, bicornuate uterus in two survivors and one control, and mental retardation in one male survivor and a male control. The son of a female survivor died after bilateral Wilms' tumors. Birth defects in the offspring of female survivors are compatible either with intrauterine constraint, possibly due to radiation-induced fibrosis or with the complex of malformations associated with Wilms' tumor. Female survivors of Wilms' tumor appear to be at increased risk for a variety of reproductive problems, from sterility to fetal loss, early delivery, and birth defects in offspring. Furthermore, relatives of survivors of Wilms' tumor may be at risk of having associated birth defects, with clinically significant consequences.

Adolescent↗
PubMed1988

A case-referent study of soft-tissue sarcoma and Hodgkin's disease. Farming and insecticide use.

A population-based case-referent study in Kansas examined the relationship between exposure to insecticides and the development of soft-tissue sarcoma (STS) and Hodgkin's disease (HD). Data from telephone interviews for 133 STS cases, 121 HD cases, and 948 referents indicated that STS was associated with use of insecticides on animals, but not on crops. HD was not significantly associated with either use. STS risk was higher among the farmers who themselves mixed or applied insecticides to animals than among farmers who did not. Farmers who failed to use any protective equipment to reduce insecticide exposure were at a significantly elevated risk of STS. Risk rose with early calendar year of first use. The excess risk appeared to be primarily among fibrous and myomatous sarcomas with little association seen for lipomatous or other STS neoplasms. Myomatous sarcomas increased significantly with duration and time since first use of insecticides on animals. If the reported association between STS and insecticides is causal, the data suggest that exposure to the agent(s) responsible may have been reduced in the mid-1950s or the agent(s) have an average latency period for STS of at least 20 years.

Aged↗
PubMed1987

Female patients with meningioma of the sphenoid ridge and additional primary neoplasms of the breast and genital tract.

Of 283 meningioma patients seen at the University of Kansas from 1948 to 1984, eight women acquired two primary extraneural cancers in addition to their meningiomas. Of these eight patients, six (75%) had sphenoid ridge meningiomas compared with 15% of meningioma patients overall (P less than 0.001). Seven (87.5%) had at least one breast or genital cancer (P less than 0.001). Of the six with sphenoid ridge meningiomas, five (83.3%) had both of their additional tumors in these two organ systems, and the sixth had one such tumor. It is proposed that this grouping of sphenoid ridge meningioma, breast cancer, and genital cancer represents a unique constellation of neoplasms in women.

Adult↗
PubMed1987

Cancer in offspring of long-term survivors of childhood and adolescent cancer.

A multicentre retrospective cohort study of long-term survivors of childhood and adolescent cancer identified 7 cases of cancer among 2308 offspring (0.30%) of 2283 case-survivors and 11 cases among 4719 offspring (0.23%) of 3604 controls. Overall, the observed numbers of cases were not significantly different from those expected in the general population. Among offspring of case-survivors observed for the first 5 years of life, the group with the most person-years of follow-up, 5 cancers were reported (3 confirmed), compared with 1.7 expected, a significant excess due mostly to boys whose mothers survived cancer. Some offspring with cancer had known single-gene traits; others resembled previously recognised patterns of family cancer. The remainder may represent chance occurrences or new cancer family syndromes, such as an association with malignant melanoma. The study had an overall 79% power to detect a 3-fold excess of cancer among offspring of case-survivors, but no excess was observed. The number person-years of follow-up in the second decade of life, when most cases of cancer developed, was small.

Adolescent↗
PubMed1987

Lung carcinoma in the elderly population. Influence of histology on the inverse relationship of stage to age.

Unlike most cancers, lung carcinoma is more likely to be localized at the time of diagnosis in older age groups when compared to those who are middle-aged. In an attempt to explain this inverse age-stage relationship we studied 9062 histologically confirmed cases of lung carcinoma occurring from 1975 to 1984 obtained from the regional cancer registry for Kansas and western Missouri. They were analyzed according to histologic type, age, sex, and stage at diagnosis. The data suggest that the proportion of squamous cell carcinoma rises and that of adenocarcinoma and small cell undifferentiated carcinoma falls with increasing age. The proportion of staged lung carcinoma with local disease at the time of diagnosis increases with age. In males this trend occurred in all cell types except large cell undifferentiated carcinoma but was most significant for squamous cell carcinoma. Squamous cell carcinoma was the only group to show a significant trend among females. The rise in squamous cell and fall in small cell carcinoma may partially explain the increased prevalence of local stage disease with advancing age.

Adenocarcinoma↗
PubMed1986

Agricultural herbicide use and risk of lymphoma and soft-tissue sarcoma.

A population-based case-control study of soft-tissue sarcoma (STS), Hodgkin's disease (HD), and non-Hodgkin's lymphoma (NHL) in Kansas found farm herbicide use to be associated with NHL (odds ratio [OR], 1.6; 95% confidence interval [CI], 0.9, 2.6). Relative risk of NHL increased significantly with number of days of herbicide exposure per year and latency. Men exposed to herbicides more than 20 days per year had a sixfold increased risk of NHL (OR, 6.0; 95% CI, 1.9, 19.5) relative to nonfarmers. Frequent users who mixed or applied the herbicides themselves had an OR of 8.0 (95% CI, 2.3, 27.9) for NHL. Excesses were associated with use of phenoxyacetic acid herbicides, specifically 2,4-dichlorophenoxyacetic acid. Neither STS nor HD was associated with pesticide exposure. This study confirms the reports from Sweden and several US states that NHL is associated with farm herbicide use, especially phenoxyacetic acids. It does not confirm the case-control studies or the cohort studies of pesticide manufacturers and Vietnam veterans linking herbicides to STS or HD.

Adult↗
PubMed1986

The availability of insurance to long-time survivors of childhood cancer.

The authors identified 100 adults who survived cancer who were diagnosed and treated in childhood between 1945 and 1975. Using standardized interviews, each survivor and matched same-sex sibling was asked about life and health including questions about insurance. Compared with their same-sex siblings, childhood cancer survivors had significantly more difficulty in securing life insurance (P less than 0.001), in having life insurance in force (P less than 0.004), and in obtaining health insurance because of health reasons (P less than 0.001). Survivors were significantly less likely than siblings to be covered by health insurance (P less than 0.04). Cure of childhood cancer has become more common, allowing thousands of survivors to enter adult life. This study suggests that childhood cancer survivors have an unmet need in respect to life and health insurance.

Adolescent↗
PubMed1985

Female gender is a major determinant of changing subsite distribution of colorectal cancer with age.

Distribution by subsite and sector of 948 colorectal cancers diagnosed in Kansas in 1982 was analyzed in respect to sex and age in a population-based study. Regression analysis of percentage versus age showed decreasing left, increasing right, and unchanged transverse colon occurrence of cancer for both sexes. However, this was statistically significant only for women; left, -0.7066% per year (P = 0.0088) and right +0.6023% per year (P = 0.0012). Regression for seven subsites showed significant changes only for women; with rectosigmoid and sigmoid decreasing and cecum and ascending colon increasing. Similar results were obtained in analysis of the 5822 cases available in the Kansas cancer registry for the years 1978 to 1982. These findings have important implications for screening and diagnosis of colorectal cancer in the elderly, particularly women, and also provide a useful clue in the investigation of colorectal carcinogenesis.

Adult↗