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J J Spinelli

Publications and source records attributed to J J Spinelli.

86 records · Page 5Linked to original sources
PubMed1985

Risk factors for ocular melanoma: Western Canada Melanoma Study.

Between April 1, 1979, and March 31, 1981, 90 individuals in the four western provinces of Canada were diagnosed as having ocular melanomas. Of 87 age-eligible cases (age 20-79 yr), 65 (75%) were interviewed along with age- and sex-matched controls chosen at random from the provincial populations. Individuals with blue eyes had a significantly greater crude risk of ocular melanoma than those with brown eyes [odds ratio (OR)=3.0, P=.04]. Subjects with red or blonde hair were at higher risk of having ocular melanoma than those with black or dark-brown hair (OR=7.7, P=.03). Indoor workers appeared to be at elevated risk for ocular melanoma even after controlling for eye and hair color (OR=3.5, P=.006).

Adult↗
PubMed1985

Reproductive variables as possible confounders in occupational studies of breast and ovarian cancer in females.

In a study of occupational mortality among all females dying at age 20 years or over in British Columbia during the period 1950 through 1978, significantly elevated proportional mortality ratios (PMRs) were seen for breast and/or ovarian cancer among teachers, nurses, office clerks, and sales clerks. Approximately 91% of the female deaths were recorded as occurring among "homemakers." When the PMRs were recalculated for "working women" only (ie., excluding homemakers), most of the excesses in risks for breast and ovarian cancer observed among the four occupational groups disappeared. The authors suggest that the differences in PMR values between all women and working women are due to protective higher parity and lower maternal age at first birth among homemakers as opposed to working women in general. In occupational studies of hormone-related tumors among women, every effort should be made to control for parity level and maternal age at first birth.

Adult↗
PubMed1984

Pigmentation and skin reaction to sun as risk factors for cutaneous melanoma: Western Canada Melanoma Study.

Between 1 April 1979 and 31 March 1981, 904 residents of the four western provinces of Canada (population 6.5 million), were diagnosed as suffering from primary cutaneous malignant melanoma. Of 801 patients aged 20-79 years, 665 (83%) were interviewed along with control subjects chosen at random from the general population and matched for age, sex, and province. After exclusion of 70 subjects with lentigo maligna or acral lentiginous melanoma, comparisons of the 595 case-control pairs showed that light hair, skin, and eye colour, a history of heavy freckling in adolescence, and a tendency to burn readily and tan poorly in the sun were significant risk factors for melanoma. The strongest primary associations were with blond hair (relative risk 7.1 compared with black hair), light colour of unexposed skin (relative risk 2.4), and severe freckling (relative risk 2.1). These associations were independent of ethnic origin and of recorded amount of exposure to the sun and were somewhat stronger for superficial spreading than for nodular melanoma. This study is the largest and most detailed of an incident series of melanomas to be published to date. The results were consistent with other studies reporting associations between melanoma and poor tanning ability, a tendency to burn easily, and a history of sunburn and showed that light hair colour was the strongest risk factor for the disease.

Adult↗
PubMed1984

Multiple myeloma, leukemia, and cancer of the ovary in cosmetologists and hairdressers.

In order to evaluate occupational mortality, age standardized proportional mortality ratios (PMR) were calculated for 160 female cosmetologists and hairdressers and 1,001 male barbers and hairdressers utilizing cause of death and occupation statements from British Columbia death registrations collected from 1950 to 1978. Female cosmetologists had elevated risks of death from multiple myeloma (PMR = 619, p = .03) and ovarian cancer (PMR = 204, p = .09). Male barbers and hairdressers had no corresponding elevated risk of myeloma but had a significantly high risk of death from leukemia (PMR = 188, p = .05). Further detailed studies of these occupations would be worthwhile to confirm and extend these findings.

Adult↗
PubMed1984

Second primary cancers of the breast: incidence and risk factors.

Between 1946 and 1976 over 9,000 women with breast cancer were seen within one year of diagnosis at the A. Maxwell Evans Clinic (AMEC) in Vancouver, British Columbia. By 1978, 275 had a subsequent diagnosis of a second primary in the contralateral breast: 100 were diagnosed within 1 year, and 175 after 1 year of the first primary. Two separate comparison groups of AMEC patients with unilateral breast cancer were selected to identify risk factors for bilateral breast cancer and to determine the incidence. The average annual incidence rates for a second primary in the contralateral breast were 5.0, 4.1 and 3.0 per 1,000 women for women less than 45 years, 45-54 years, and over 55 years of age at diagnosis of first primary breast cancer, respectively. These rates remained stable for at least 15 years after the diagnosis of the first primary. Two risk factors were found for bilateral cancer within 1 year of the first primary, histologic diagnosis of lobular carcinoma and absence of pathologic involvement of axillary nodes; one risk factor was found for bilateral breast cancer after 1 year of the first primary, family history of breast cancer.

Adult↗
PubMed1984

Occupational mortality patterns among British Columbia farm workers.

To examine mortality risks for farm laborers proportional mortality ratios (PMRs) were calculated for 2,328 British Columbia farm workers who died at age 20 years or over during the period 1950 through 1978. Significantly fewer deaths than expected from degenerative heart disease (PMR = 91, p less than .01) and from all cancers combined (PMR = 78, p less than .001) were observed. Deaths from bronchitis and emphysema (PMR = 70, p less than .05) were also fewer than anticipated. Elevated risks of death were found for accidents (PMR = 129, p less than .001), for homicide (PMR = 242, p less than .01), and for pneumonia (PMR = 146, p less than .001).

Accidents, Occupational↗
PubMed1983

Adjuvant BCG immunotherapy for stage I and II malignant melanoma.

Initial adjuvant immunotherapy trials have demonstrated a greater disease-free interval in patients treated with bacille Calmette-Guérin (BCG) compared with historical controls. In this study 149 patients at high risk of recurrence after surgical treatment of local or regional malignant melanoma were given BCG for 2 years and were followed up for a median of 28 months from the start of immunotherapy. The 36 patients in the comparison group had a higher rate of recurrence than the patients treated with BCG, and the rate in the treatment group was close to that reported from a similar study at the University of California at Los Angeles. The relatively long disease-free interval for the high-risk comparison patients in this study suggests that the control groups at other centres may have included patients with unrecognized additional risk. The rates of survival in the Canadian treatment group were also comparable to those reported by other centres. However, reports of a favourable BCG-mediated pattern of recurrence could not be confirmed. Therefore, the routine use of adjuvant BCG immunotherapy is not recommended.

Adult↗
PubMed1983

Prediction of malignant melanoma recurrence by serum N-acetylneuraminic acid.

Since serum N-acetylneuraminic acid (NANA) can serve as a relatively sensitive monitor of tumor burden, we wished to examine the relationship of NANA to other suggested prognostic factors for malignant melanoma. Eligible patients included 151 patients with stage-I disease and 10 with stage-II regional lymphatic extension. A proportional hazards model was used to examine nine factors, of which five were not significant predictors of recurrence: age, sex, primary site, tumor diameter, and stage. Significant predictors included: measured depth p = 7 X 10(-7); anatomic depth (Clark level), p = 7 X 10(-6); NANA, p = 0.003; and growth pattern (superficial spreading vs nodular), p = 0.01. However, on multivariate analysis only two predictors were independent; measured depth and NANA. The latter could not be explained by non-specific factors. The data were examined to define optimal test values for assignment of risk. According to this model, patients with lesions greater than 1.75 mm and NANA less than 2 mumol/ml have a more than 12-fold greater risk of recurrence by 2 years than those with lesions less than or equal to 1.75 mm and NANA less than or equal to 2 mumol/ml.

Adolescent↗
PubMed1983

Allergies and agricultural exposure as risk factors for multiple myeloma.

In a case-control study of 84 multiple myeloma patients and 168 age- and sex-matched controls with tumours at other sites, reported prior allergies were associated with an elevated risk of myeloma (RR = 3.1, P less than 0.001). In addition, more myeloma patients than controls reported prior myxoedema (RR = 5.0, P = 0.04). History of agricultural work was associated with an elevated risk of myeloma (RR = 2.2, P = 0.01), although no detailed information was available on the type of farming in which the subjects were engaged. More detailed studies are required to confirm and further delineate these findings.

Adult↗
PubMed1983

Effect of lymphoblastoid interferon on lymphocyte subsets in cancer patients.

The effect of interferon dose on lymphocyte subsets is unclear for humans, especially with prolonged intermittent administration. Enumeration of T4 and T8 cells and natural killer (NK) cell activity against K562 cells were examined as part of our ongoing randomized clinical study comparing low- and high-dose treatment strategies. Fifty-four patients have been entered into study, of which 46 are now evaluable. High-dose patients showed no significant changes during actual interferon infusion. However, over the entire period on study, there was a significant increase in NK cell activity (p = 0.001), a concurrent decrease in T8 (p = 0.004), and an increase in T4/T8 (p = 0.02). By contrast, for low-dose patients there was a trend of increasing NK activity during interferon administration, but no change during the total time on study, with a concurrent trend of decreasing T4/T8 and a significant increase in T8 (p = 0.01). Although there is as yet no significant response difference between high- and low-dose treatments, a favourable response was associated with an overall increase in NK activity (p = 0.005), a decrease in T8 (p = 0.02), and an increase in T4/T8 (p = 0.03). In a preliminary study of immune complexes in selected patients, an inverse relationship between NK cell activity and immune complex concentration was suggested. This was supported by in vitro addition of autologous immune complex-containing sera during NK cell assay.

Breast Neoplasms↗
PubMed1981

Estrogen receptor quantitation and staging as complementary prognostic indicators in breast cancer: a study of 583 patients.

Estrogen receptor (ER) quantity was measured at the time of primary diagnosis on 583 patients with breast cancer seen at the major treatment centre in British Columbia between 1975 and 1979. Survival rates (overall, recurrence-free and post-recurrence) were assessed relative to ER concentration, staging, menopausal status, age, differentiation, and therapy. A linear trend in increased survival was demonstrable through variations in ER concentration from less than 1 to greater than 260 fmoles/mg cytosol protein. This trend was highly significant and remained after adjustment for stage, menopausal status, and age, and was seen for all groups of patients except those with metastatic disease. The association of high ER concentration with increased recurrence-free survival was not due to differing responses to adjuvant therapy, but the trend in post-recurrence survival was only significant in patients who had received hormonal therapy. Survival was as strongly associated with receptor concentration as with staging, and these two factors were almost completely independent. A proportional hazards model was fitted to produce predictions of survival, and showed that TNM stage III patients with high ER concentrations have a better survival than stage I or II patients with lower ER concentrations. This suggests that quantitative assessment of ER status is essential to definition of risk in breast cancer patients and that stratification in clinical trials and consideration for adjuvant therapy ought to be guided, in part, by a standardized ER-quantitative determination performed on the primary tumor.

Adult↗
PubMedDate not supplied

Occupational associations among British Columbia male cancer patients.

In a study of 6,389 male cancer patients diagnosed and treated at the Cancer Control Agency of British Columbia from 1950-1975, several associations were detected between occupation and specific cancers. Elevated risks for lung cancer were seen in miners, metal processors and machinists, while a reduced risk was seen in farmers. Lip cancer excesses were detected in individuals involved in several outdoor occupations, and melanoma excesses were seen for three groups of predominantly indoor workers. These results confirm previous findings in the literature, whereas the following associations have not been previously reported. Fishermen were found to have an excess of Hodgkin's Disease (RR = 3.0, 95% C.I. = 1.4,6.5), engineers are at an elevated risk of cancer of the pancreas (RR = 4.2, C.I. = 1.8,9.9), and forestry workers have an elevated risk of bladder cancer (RR = 1.7, C.I. = 1.1,2.6). Further studies will be needed to replicate the new associations detected here.

British Columbia↗
PubMedDate not supplied

Mesothelioma surveillance to locate sources of exposure to asbestos.

To determine whether there were previously unrecognized sources of asbestos exposure in British Columbia, incident mesothelioma cases (n = 51) and population-based controls (n = 154) were interviewed about their occupational histories and asbestos exposures. The following occupations were at elevated risk: sheet metal workers (OR = 9.6, 95% CI: 1.5-106), plumbers and pipefitters (OR = 8.3, 95% CI: 1.5-86), shipbuilding workers (OR = 5.0, 95% CI: 1.2-23), painters (OR = 4.5, 95% CI: 1.0-24), welders (OR = 3.9, 95% CI: 0.8-22), gardeners (OR = 3.9, 95% CI: 0.8-22), bricklayers (OR = 3.5, 95% CI: 0.9-14), miners (OR = 3.4, 95% CI: 0.9-13), machinists (OR = 3.2, 95% CI: 1.0-11), construction foremen (OR = 3.1, 95% CI: 0.9-11), and electricians (OR = 3.0, 95% CI: 0.8-12). In a reanalysis excluding subjects who worked in occupations or processes considered strongly a priori at risk, three groups remained of interest: non-asbestos miners (OR = 9.6, 95% CI: 1.8-53), bricklayers (OR = 5.4, 95% CI: 1.0-28), and construction labourers (OR = 2.8, 95% CI: 0.7-10.6).

Adult↗