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Biomedical subjects

L Garfinkel

Publications and source records attributed to L Garfinkel.

152 records · Page 9Linked to original sources
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Twenty-year follow-up of the breast cancers diagnosed during the Breast Cancer Detection Demonstration Project.

This study reports on the 20-year follow-up of the women diagnosed with breast cancer in the Breast Cancer Detection Demonstration Project (BCDDP) between 1973 and 1980. This project provided 5 years of screening with physical examination and two-view mammography for 280,000 volunteer women across the United States. Based on a 96% follow-up from 1993 to 1995 of the 4,051 women with breast cancer available for analysis, 2,658 (66%) were alive and 1,393 (34%) were dead. A high proportion of the cancers were detected by mammography alone, and 28.6% of all the cancers were smaller than 1.0 cm. Survival rates were calculated by life table method with deaths from breast cancer as the outcome. The adjusted survival rate for the entire group was 80.5%, and the observed survival rate was 61.7%. Adjusted and observed survival rates were 97.2% and 78.5%, respectively, for women with non-invasive cancers and 78.2% and 59.3%, respectively, for those with invasive cancers. Lymph node status and the size of the cancer at diagnosis were prognostic indicators of survival in the BCDDP Women with invasive cancers and negative lymph nodes had an 85.5% breast cancer survival rate and a 65.6% observed survival rate. Adjusted survival rates for women with invasive breast cancers were 90.2% for cancers smaller than 1 cm, 80.5%, for cancers 1.0 to 1.9 cm, 70.5% for cancers 2.0 to 4.9 cm, and 60.6% for cancers larger than 5 cm. Women 40 to 49 years of age demonstrated a greater survival with noninvasive or invasive cancers smaller than 5.0 cm compared with women 50 to 59 and 60 to 69 years of age at diagnosis. These results from the BCDDP are discussed in the context of the recent decline in breast cancer incidence and mortality in the United States.

Adult↗
PubMedDate not supplied

U.S. cancer incidence, mortality and survival: 1973-1996.

Earlier predictions of morbidity and mortality improvements for the four leading sites of cancer are beginning to occur. After decades of increases, incidence and mortality rates for all cancers combined have declined since 1992. Between 1990 and 1996 the age-adjusted death rates for all cancers had dropped 3.7 percent to 166.9 per 100,000 and incidence rates had decreased 2.8 percent to 388.6. The overall decreases were greater among men than women; male mortality rates dropped 6.2 percent and incidence dropped 5.2 percent for men versus 1.8 and 1.9 percent, respectively, for women. Lung cancer incidence among men continued its more than 10-year decline in age-adjusted rates and mortality rates dropped for a fifth consecutive year to 68.2 per 100,000 population. Among women, lung cancer incidence rates began to plateau in the mid-1990s similar to the pattern experienced by men a decade earlier. The rates of prostate cancer have begun to decrease but remain 65 to 75 percent higher among black men than white. Mortality rates dropped 9.5 percent among white men but only 2.0 percent among blacks since 1990. By 1996 even breast cancer death rates were declining ahead of the predicted decrease by the end of the century. Mortality rates for all women combined was 24.3 per 100,000 population, 24.0 for white women and 30.8 for blacks, 11.3, 12.1 and 2.5 percent, respectively lower than in 1990. The previously noted decreases in colorectal cancer mortality and incidence continue with age-adjusted rates dropping to 16.8 and 42.7 per 100,000 population, respectively, in 1996.

Age Distribution↗
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The epidemiology of cancer in black Americans.

Cancer incidence rates among blacks average 10-20 percent higher than among non-minorities, with a much greater excess for several cancers, namely, esophagus, multiple myeloma, cervix, stomach, pancreas, larynx and prostate. Cancer mortality rates for blacks are 20-40 percent higher than for non-minority men, with the greatest excess evident for esophageal cancer, followed by cervix, multiple myeloma and prostate. Blacks have a five-year relative survival rate 30 percent lower than that for whites primarily because blacks seek treatment at a more advanced stage of disease than whites. Preventive health messages and programs need to be expanded to serve disadvantaged communities.

Adolescent↗
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Preventing cancer.

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Diet↗
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Cancer incidence, mortality and survival: trends in four leading sites.

Cancer mortality rates in the United States have stabilized in the past few years after rising for more than 50 years. Incidence and mortality rates for all cancers tend to be higher among men than women, among blacks than whites and among those over age 65. In 1994 cancer of the lung, prostate, breast, and colon/rectum (colorectal) will account for an estimated 57 percent of all new cancer cases and 55 percent of cancer deaths. Analysis of incidence, mortality and survival rates of these four major cancers indicate some encouraging trends. That is, even though age-adjusted incidence rates continue to increase, it appears that educational and screening efforts are having a positive influence on mortality rates. Lung cancer incidence has declined in recent years following a decrease in smoking among men that began some 20 years ago; evidence also indicates a start of a declining trend in their mortality from this disease, as well. Lung cancer incidence and mortality rates among women, however, continue to rise. In 1986 lung cancer became the leading cause of cancer deaths among women. Increased use and improved techniques of cancer detection for prostate, breast and colorectal cancers are resulting in larger numbers of these cancers being detected at early stages when they are more readily treatable. It is hoped that such activities will ultimately reduce mortality for these three major cancer sites.

Black or African American↗
PubMedDate not supplied

Probability of developing or dying of cancer United States, 1991.

Since the mid-1960s, the proportion of deaths from the leading cause of U.S. mortality, heart disease, has decreased fairly steadily. The proportion of cancer deaths has risen over the same period, however, from 16.3 percent in 1965 to 23.7 in 1991. Public awareness of this increase has resulted in questions being raised about the probability of developing or dying of cancer. Analyses of published data in the 1973-1991 Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute estimated a person's lifetime risk of developing or dying of cancer. The lifetime risk of developing cancer is 44.8 percent for men and 39.3 percent for women. For both sexes, the risk of dying of lung cancer is higher than for any other cancer.

Adolescent↗