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Biomedical subjects

J F Fraumeni

Publications and source records attributed to J F Fraumeni.

At least 163 records · Page 9Linked to original sources
PubMed1995

Smoking and cancer mortality among U.S. veterans: a 26-year follow-up.

On the 30th anniversary of the U.S. Surgeon General's report Smoking and Health, we present updated results from one of the original cohort studies that comprised the groundbreaking document. A 26-year follow-up of 248,046 U.S. veterans evaluating the risks of cigarette smoking revealed strong dose-response effects between smoking and total cancer and a large number of cancer sites. Over 50% of cancer deaths among current smokers and 23% of cancer deaths among former smokers were attributable to cigarette smoking. These findings further demonstrate the large and unique role cigarette smoking plays in cancer etiology and the importance of smoking cessation to reduce this enormous public health burden.

Adult↗
PubMed1995

Cancer risk after hip replacement with metal implants: a population-based cohort study in Sweden.

BACKGROUND: Joint replacement with metal implants has been the standard procedure for surgical treatment of irreversible degeneration of hip and knee joints for more than two decades. However, reports of local malignancy after joint replacement and experimental studies that suggest a carcinogenic action of metal ions and polymethylmethacrylate (an acrylic compound used to stabilize the implant in the host) have raised concern about the possible long-term risks associated with metal implants. PURPOSE: Our aim was to study cancer risk in a Swedish cohort of patients who had hip replacement surgery during the period 1965 through 1983. METHODS: We studied the risk of cancer in a cohort of 39 154 patients (14 869 men and 24 285 women), identified in the nationwide Swedish Inpatient Register with at least one hip replacement during the period 1965 through 1983. The patients were followed through 1989 by means of record linkage to the Swedish Cancer Register. The cohort contributed a total of 327 922 person-years at risk. Standardized incidence ratios (SIRs) were computed using age-, sex-, and period-specific incidence rates derived from the entire Swedish population. RESULTS: The overall relative risk of cancer was increased by only 3%. Bone cancer--the focus of previous concerns--occurred in six cases versus 4.3 expected, and connective tissue cancer occurred in 28 cases versus 25.9 expected. Increased risks were observed for kidney cancer (SIR = 1.31; 95% confidence interval [CI] = 1.13-1.51), prostate cancer (SIR = 1.13; 95% CI = 1.04-1.22), and melanoma (SIR = 1.23; 95% CI = 1.00-1.50). The relative risk of gastric cancer steadily declined with increasing follow-up time, in both men and women (SIR = 0.58; 95% CI = 0.39-0.84 more than 10 years after hip replacement). CONCLUSION: In this study, the largest study to date to evaluate hip replacement and subsequent cancer risk, the overall cancer risk appears to be negligible from a public health perspective, and our results have not produced any strong evidence against the continued use of these devices. Nevertheless, the small but statistically significant increases in kidney and prostate cancers and the decrease in gastric cancer deserve further study.

Aged↗
PubMed1995

High bladder cancer mortality in rural New England (United States): an etiologic study.

An interview study of next-of-kin of 325 persons who died of bladder cancer and 673 individuals who died of other causes in Vermont and New Hampshire (United States) was conducted to assess reasons for the persistent pattern of elevated bladder cancer mortality for both genders in rural New England. There are some evidence of elevated risks for both leather and textile workers that rose to over twofold for workers who also lived near these industries and for persons with French-Canadian ancestry. Occupational exposures in the textile and leather industry may explain at least a portion of the excess bladder cancer risk in rural New England.

Case-Control Studies↗
PubMed1995

Cigarette smoking and alcohol consumption and the risk of pancreatic cancer: a case-control study in Shanghai, China.

Cancer of the pancreas has been rising in incidence in Shanghai, China since the early 1970s. In 1987-89, this malignancy ranked eighth in cancer incidence among men and ninth among women in Shanghai. To examine risk factors for this tumor in urban Shanghai, a population-based case-control study was conducted. Cases (n = 451) were permanent residents of Shanghai, 30 to 74 years of age, newly diagnosed with pancreatic cancer between 1 October 1990 and 30 June 1993. Deceased cases (19 percent) were excluded from the study. Controls (n = 1,552) were selected among Shanghai residents, frequency-matched to cases by gender and age. Cases and controls were interviewed about their demographic background and potential risk factors, including tobacco, alcohol and beverage consumption, diet, and medical history. Adjusted odds ratios (OR) and 95 percent confidence intervals (CI) were estimated using logistic regression models. Current cigarette smoking was associated with excess risk of pancreatic cancer in both men (OR = 1.6, CI = 1.1-2.2) and women (OR = 1.4, CI = 0.9-2.4). ORs increased significantly with number of cigarettes smoked per day, and with duration and pack-years of smoking. Risk increased three- to sixfold among those in the highest categories of cigarette consumption, while risk decreased with increasing years since smoking cessation. Former smokers who stopped smoking for 10 or more years had risks comparable to nonsmokers.

Adult↗
PubMed1995

Cancer risk following polymyositis and dermatomyositis: a nationwide cohort study in Denmark.

Polymyositis and dermatomyositis (PM/DM) have been associated with cancer, although the long-term risks are poorly understood. To evaluate the risk of cancer by time periods subsequent to PM/DM diagnosis, a cohort of 539 patients hospitalized with PM/DM in Denmark between 1977 and 1989 was identified from the Danish Central Hospital Discharge Register. Cancer incidence among cohort members was ascertained by linkage to the Danish Cancer Registry using a unique personal-identification number. The overall cancer risk was elevated significantly among patients with DM (standardized incidence ratio [SIR] = 3.8, 95 percent confidence interval [CI] = 2.6-5.4) and to a lesser extent PM (SIR = 1.7, CI = 1.1-2.4). Significant excesses were observed for cancers of lung, ovary, and lymphatic and hematopoietic system. However, the excess cancer incidence declined steadily with increasing years since initial diagnosis of PM/DM. The cancer risk was increased about sixfold (SIR = 5.9, CI = 3.8-8.7) during the first year, but was lower during the second year (SIR = 2.5, CI = 1.1-4.8), with no significant excesses in subsequent years of follow-up. These findings confirm that PM/DM may occur as a paraneoplastic syndrome that calls for steps aimed at early cancer detection and treatment. Among long-term survivors of PM/DM, however, there is little evidence to warrant extensive preventive and screening measures beyond those recommended for the general population.

Adult↗
PubMed1995

Smoking and biliary tract cancers in a cohort of US veterans.

Except for gallstones, the risk factors for cancers of the biliary tract (CBTs) are poorly understood. Recent case-control studies have suggested cigarette smoking as a potential risk factor. In a cohort study of nearly 250,000 US veterans whose mortality was followed for up to 26 years, we evaluated the risk of CBT associated with tobacco use. Relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated. A total of 303 CBT deaths were observed during the follow-up period. Compared with those who had never used any tobacco, current cigarette smokers at entry to the cohort had a 50% excess risk of CBT (RR = 1.5, CI = 1.1-2.0). A nearly 2-fold risk was observed among those who smoked more than 20 cigarettes per day and among those who started smoking under age 20. Non-significant increases in risk occurred among smokers of other forms of tobacco. This cohort study is consistent with reports that smoking is a risk factor for CBT, but further studies are needed to clarify whether the effect is specific for certain subsites and whether it reflects an association with pre-existent gallstones.

Adult↗
PubMed1995

Occupational risks for cutaneous melanoma among men in Sweden.

A population-based linked-registry was used to evaluate incidence of malignant melanoma of the skin among Swedish men by industry and occupation. There were 3850 cutaneous melanoma cases identified in the 19-year follow-up of men employed in 1960. New associations were observed for men employed in the breweries and malt-processing industry and in shoe fabrication from leather and skins. Several findings supported associations previously reported in other countries, including an excess risk among workers in basic chemical production and the printing industry and among professional, technical, and white-collar workers. Risk overall was not increased among farmers, despite a significant excess of melanoma of the face, neck, and scalp. Although this linked registry analysis lacked information about specific agents, duration of employment, and occupational and recreational sun exposures, it did provide leads for new associations and confirmed previous ones. Nevertheless, because of these limitations, etiologic clues must be interpreted cautiously.

Adolescent↗
PubMed1995

Racial, ethnic, and gender variations in cancer risk: considerations for future epidemiologic research.

There is no question that the risk of many cancers varies substantially by race, ethnic group, and gender. Although important clues to cancer etiology may come from investigating the differences in risk across subgroups of the population, epidemiologic research has often focused on white men. More descriptive and analytic studies are needed to identify and explain variations in risk among population subgroups. Especially important are studies to clarify the role of differential exposures, susceptibility, and diagnostic factors in cancer incidence, although differences in treatment may contribute to variations in cancer mortality. Improvements in classification of ethnicity, assessment of carcinogenic exposures in various subpopulations, and measures of host susceptibility states should augment future epidemiologic research designed to better understand mechanisms underlying the racial, ethnic, and gender differences in cancer risk.

Carcinogens, Environmental↗
PubMed1995

Risk of renal cell cancer in relation to diuretics, antihypertensive drugs, and hypertension.

Although recent data have suggested an association between renal cell cancer and the use of diuretics, it remains unclear whether these medications or hypertension is the important risk factor. In a population-based case-control study including 440 renal cell cancer cases, spouses of an additional 151 cases, and 691 controls, we assessed renal cell cancer risk associated with hypertension and use of diuretics and other antihypertensive medications. Risks increased with the use of diuretics or other drugs that lower blood pressure, especially among persons who reported no history of hypertension. After adjustment for hypertension, the use of diuretics alone was associated with a 40% excess risk (OR = 1.4; 95% CI = 0.8-2.2), while use of other antihypertensive drugs was linked to a 2-fold risk (OR = 2.0; 95% CI = 1.2-3.3). The excess risk was not restricted to any specific products, and no trend was observed with estimated lifetime consumption of any product. Furthermore, risk was not potentiated by the presence of both hypertension and the use of antihypertensive drugs. Among persons who did not use antihypertensive drugs, a history of hypertension was associated with a significant 40-50% excess risk of renal cell cancer. Excluding subjects with hypertension diagnosed within 5 years of cancer diagnosis or interview had only a small effect on risk. These findings suggest small effects on renal cell cancer risk associated with hypertensive disease and with the use of diuretics and other antihypertensive drugs, but it is difficult to disentangle the separate effects due to potential misclassification of highly correlated events.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Dietary factors and the risk of pancreatic cancer: a case-control study in Shanghai China.

In Shanghai, China, age-adjusted incidence rates for pancreatic cancer have increased steadily, beginning in the early 1970s. To examine the effects of diet on this cancer, a population-based case-control study was conduct. Cases (n = 451) were permanent residents of Shanghai, 30-74 years of age, newly diagnosed with pancreatic cancer between October 1, 1990 and June 30, 1993. Decreased cases (19%) were excluded from the study. Controls (n = 1552) were selected among Shanghai residents, frequency matched to cases by gender and age. Information on usual adult dietary intake was obtained by trained interviewers in person, using a food frequency questionnaire. Dietary associations were measured by odds ratios and 95% confidence intervals. Risks of pancreatic cancer were inversely associated with consumption of vegetables (P for trend among men = 0.03; among women = 0.15) and fruits (P among men = 0.02; among women = 0.08). Reductions in risk were related also to intake of dietary fiber and micronutrients abundant in plant sources, such as vitamins C and E and carotene. There was also an inverse association with egg consumption (P for trend among men = 0.08; among women = 0.001). No consistent positive associations were observed with intake of other food groups, including preserved animal foods, fresh red meat, organ meat, poultry, and staple foods. On the other hand, risks increased with frequency of consumption of preserved vegetables and foods that were deep fried, grilled, cured, or smoked, providing clues to the possible role of nitrosamines, polycyclic aromatic hydrocarbons, and heterocyclic aromatic amines. The inverse associations observed with intake of dietary fat and protein in our study were unexpected, although these findings were based on consumptions well below the average intake in Western countries, where most previous studies on pancreatic cancer were conducted. Our results suggest that dietary variations have contributed little to the rising trends of pancreatic cancer in Shanghai. However, given the improving food availability and changing dietary patterns in China, further study of dietary and nutritional risk factors for pancreatic cancer appears warranted.

Adult↗
PubMed1994

Carcinogenic risk of dark vs. light liquor.

A previous report suggested that the cancer risk associated with hard liquor is greater among users of dark liquors, which may contain more potentially carcinogenic compounds than light liquors. To test this hypothesis, we examined alcohol consumption data obtained by interview with 921 cases and 900 controls who participated in 1984-1985 in a population-based case-control study of oral and pharyngeal cancer conducted in 4 areas of the United States. Among heavy liquor drinkers (30+ drinks/week), odds ratios were 13.2 (95% CI = 5.2-33.5) for those who usually drank light liquors vs. 4.6 (95% CI = 2.7-7.9) for those who usually drank dark liquors, with higher risks for light vs. dark liquors at each anatomical subsite. This analysis provides no support for the notion that dark liquors are more carcinogenic than light liquors or that non-ethanolic ingredients of alcoholic beverages are major contributors to the excess risk of oral and pharyngeal cancer.

Adolescent↗
PubMed1994

Protein intake and risk of renal cell cancer.

BACKGROUND: Renal cell cancer, although still relatively uncommon, has been increasing in incidence in the United States and other countries around the world. PURPOSE: Since previous studies have suggested an association with high intake of meat, we sought to further examine the role of diet in renal cell cancer risk. METHODS: Patients with histologically confirmed renal cell cancer that had been diagnosed between July 1, 1988, and December 31, 1990, were identified through the Minnesota Cancer Surveillance System, a statewide cancer registry. The patients eligible for inclusion in this study were white residents of Minnesota between 20 and 79 years of age. Control subjects were selected from the general population of Minnesota residents; subjects under age 65 were selected by use of a random-digit-dialing method and those 65 years or older were sampled from the Health Care Financing Administration files. Population-based control subjects were frequency-matched to cases by sex and 5-year age groups. A total of 690 patients and 707 control subjects were interviewed. Patients and control subjects were similar in distribution by sex, age, and educational level. Usual adult dietary intakes were assessed by questionnaire, and odds ratios were calculated by logistic regression analyses. RESULTS: Significantly increased risks of renal cell cancer were observed with increasing consumption of several food groups, including red meat (P for trend = .05), high-protein foods (P = .01), and staple (grains, breads, and potatoes) foods (P = .009). When examined by macronutrient status, risks increased monotonically with the amount of protein intake, from 1.2 (95% confidence interval [CI] = 0.7-1.9) to 1.4 (95% CI = 0.8-2.5) and 1.9 (95% CI = 1.0-3.6) (P for trend = .03) in the second, third, and fourth quartiles of intake, respectively, after adjustment for age, sex, caloric intake, body mass index, and cigarette smoking. No significant or consistent associations were detected with the intake of other dietary nutrients or beverages. CONCLUSION: Although an independent effect of dietary protein has not been previously associated with renal cell cancer, high protein consumption has been related to development of other chronic renal conditions that may predispose an individual to this cancer. IMPLICATION: These findings should prompt further study of dietary protein and its potential contribution to the origins of renal cell cancer.

Adult↗
PubMed1994

Risk factors for esophageal cancer in Shanghai, China. I. Role of cigarette smoking and alcohol drinking.

A population-based case-control study of esophageal cancer was conducted in urban Shanghai involving interviews with 902 cases and 1,552 controls. Risk of esophageal cancer was increased among tobacco smokers and alcohol drinkers. Odds ratios (OR) for smoking were 2.1 and 1.6 for men and women, respectively, and increased with number of cigarettes smoked per day, duration of smoking, number of pack-years and decreasing age at start of smoking. For men who were current alcohol drinkers OR was 1.4, with the excess risk primarily among heavy drinkers. Few women drank alcoholic beverages. The combined effect of heavy smoking and drinking among men was pronounced: OR was 12.0 for those who smoked more than 1 pack per day and drank more than 750 g of ethanol per week. The relation with smoking appeared stronger for cancers of the middle and lower thirds of the esophagus than for the upper third, while patterns of risk for squamous cell carcinoma and adenocarcinoma were similar. Heavy drinking affected all 3 subsites, with increased risks mainly limited to squamous cell carcinoma. Cigarette smoking and alcohol drinking combined accounted for almost 50% of all esophageal cancers among men in Shanghai; among women, 14% of cases were attributed to smoking. Our study confirms that smoking and drinking are important risk factors for esophageal cancer in China, thereby paralleling findings from developed countries.

Adenocarcinoma↗
PubMed1994

Risk factors for esophageal cancer in Shanghai, China. II. Role of diet and nutrients.

A population-based case-control study of esophageal cancer (902 cases, 1,552 controls) in Shanghai, China, investigated the etiologic role of diet. After adjustment for cigarette smoking, alcohol consumption and other risk factors, increasing consumption of fruits, dark orange vegetables and beef or mutton was associated with statistically significant decreasing trends in risk for esophageal cancer. In general, risks were about 40% lower among those in the upper vs. lower quartiles of intake of these foods. Fivefold increases in risk were observed among those who consumed burning hot soup or porridge, with smaller excesses for preserved vegetables, salty and deep fried foods. Nutrient analysis revealed that increased dietary intake of protein, carotene, vitamins C and E and riboflavin was associated with reduced esophageal cancer risk. Our findings support the notion that the reported temporal increases in the per capita consumption of fruits, vegetables and animal products contribute to the substantial reduction in the incidence of esophageal cancer in Shanghai, particularly since cigarette and alcohol use has not decreased.

Adult↗