The longitudinal study and the social distribution of cancer.
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Humans↗
Biomedical subjects
L J Kinlen
Publications and source records attributed to L J Kinlen.
Leukaemia and smoking habits among United States veterans.
The relation between leukaemia and smoking habits was examined in data from the veterans' smoking study, a prospective study of mortality among 248,000 United States veterans, of whom 723 died of leukaemia during 1954-69. A significant increase in mortality from leukaemia among cigarette smokers (relative risk 1.53) was found, together with a dose-response relation with amount smoked (trend p less than 0.001). The relation was strongest (relative risk 1.72) for monocytic and chronic and unspecified myeloid leukaemias (ICD (7th revision) codes 204.1 and 204.2). For these leukaemias the increase was almost twofold (relative risk 1.93) among current smokers of over 20 cigarettes daily. Ex-cigarette smokers also showed an increase of leukaemia (relative risk 1.39; p less than 0.001). These findings are consistent with other studies and relevant to the interpretation of minor increases of leukaemia both in population and in individual based studies. If causal they also imply that smoking is responsible for many more deaths from leukaemia in adults than all other known causes combined.
Dose-Response Relationship, Drug↗
Tea consumption and cancer.
Following the report from Hawaii (Heilbrun et al., 1986) of relationships between tea consumption and respectively rectal cancer (positive) and prostate cancer (negative), these questions were examined using data from a prospective mortality study of London men initiated in 1967. The small numbers of men who did not usually drink any tea prevented a reliable study of this sub group. Nevertheless no evidence of a dose-response relationship was found for rectal, colon or prostate cancer. Significant relationships were found, however, between tea consumption and deaths from stomach, lung and kidney cancers. In the case of stomach and lung cancer, these were partly due to the effects of social class and smoking, and possible reasons are considered for the residual relations.
Adult↗
Decline in the lung cancer hazard: a prospective study of the mortality of iron ore miners in Cumbria.
The mortality of 1947 Cumbrian iron ore miners has been studied over the period 1939-82 in relation to that among other groups of men in England and Wales: (a) all men, (b) men of similar social class, and (c) men living in similar types of (mainly rural) area. Significant excesses were found for deaths from tuberculosis and respiratory diseases compared with each of the reference populations. Lung cancer showed an excess over that in comparable (mainly rural) areas of England and Wales, as reported in a previous study using a proportionate method of analysis and which covered the period 1948-67 but no appreciable excess after 1967. Reasons for this decline are discussed.
Adult↗
Cancer of the testis and month of birth.
It has recently been reported that a series of testis cancers shows a temporal cycle in birth dates with a peak in certain months. This observation has been tested by an examination of a larger series covering all testis cancers diagnosed in the years 1971-84 in England and Wales, in men born in 1940 or later. Limited evidence was found of a 4-monthly cycle, but this was due to a 2-monthly cycle shown by teratomas in men born in the years 1945-49. No evidence was found for such a cycle outside this period, nor for a peak in any particular month.
Adult↗
Breast cancer and month of birth.
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Breast Neoplasms↗
Cancer in patients receiving long-term dialysis treatment.
A large excess of non-Hodgkin's lymphoma has been documented in renal transplant patients and may be related to immunosuppressive therapy, persistent antigenic challenge from the graft, or both. To determine whether immuno-suppression resulting from chronic renal failure is associated with an elevated risk of certain tumors such as non-Hodgkin's lymphoma, the authors studied cancer incidence in a national cohort of 28,049 patients in the United States with chronic renal failure who received maintenance dialysis for at least six months (totaling 66,706 person-years of observation). Compared with national incidence rates, the relative risk (RR) of cancer was 0.9 (excluding nonmelanoma skin cancer, multiple myeloma, kidney cancer, and uterine cervix cancer). Moderate excesses of leukemia, non-Hodgkin's lymphoma, Hodgkin's disease, thyroid cancer, and biliary tract cancer were found, but were not statistically significant for both sexes combined. A significantly elevated risk of non-Hodgkin's lymphoma among patients with chronic glomerulonephritis (RR = 2.6) accounted for the excess observed in the total series, raising the possibility of factors specific to this disease.
Aged↗
The use of old records in current research on dietary causes of cancer.
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Diet↗
Fat and breast cancer.
Breast cancer mortality and incidence in different countries show a strongly positive correlation with the per caput consumption of fat. In addition, the disease has increased among the Japanese, both in Japan and in the United States, and in both groups fat consumption has been increasing. In contrast, both case-control and prospective studies have on the whole failed to confirm the relationship. Despite these negative findings, the hypothesis that fat causes breast cancer has continued to be popular. The evidence for fat as a cause of breast cancer seems to have been exaggerated, and insufficient attention given to alternative explanations for the geographical correlations and for the changes among the Japanese in the frequency of the disease. These include the effects on breast cancer risk of body weight, body size, age at menarche (all influenced by excess calories) and age at the birth of the first child, as well as effects of obesity on the fatality rate in breast cancer. Evidence is lacking that the source of calories is important.
Breast Neoplasms↗
Ethnic composition, age and sex, together with location and standard of housing as determinants of HLTV-I infection in an urban Trinidadian community.
The presence of antibody to human T-cell leukaemia virus (HLTV-I) has been assessed in 2,143 men and women who represent 83% of all adults aged 35 to 69 years resident in a defined urban community in Trinidad. Individuals of African descent had a higher sero-positivity rate (7.0%) than those originating from India (1.4%), Europe (0%) or of mixed descent (2.7%). Women were infected more frequently than men, and the prevalence of infection increased with age in both sexes. Sero-positivity rates were significantly increased in adults who lived in housing of poor quality (p less than 0.001) or close to water courses (p less than 0.025). These data and others raise the possibility that one route of HLTV-I transmission may be via insect vectors under particular domestic circumstances.
Adult↗
Fat and cancer aetiology.
Strongly positive correlations exist between the incidence of breast and large bowel cancers in different countries and the corresponding per caput intake of fat. However, attempts to confirm these relationships have, on the whole, proved disappointing, in studies of individuals whether using the case-control or the prospective approach. Moreover no positive relationship is evident in prospective studies between blood lipid levels and colon or breast cancers. Overall the human evidence for fat as a cause of these cancers is weak. Possible reasons are considered for the findings in different studies.
Breast Neoplasms↗
Prospective study of cancer in patients with hypogammaglobulinaemia.
Among 377 patients with primary hypogammaglobulinaemia, mainly common variable immunodeficiency (CVID), 316 patients survived the first 2 years after diagnosis and were the subject of a study of cancer incidence. Among the 220 patients with CVID, there was a 5-fold increase of cancer due mainly to large excesses of stomach cancer (47-fold) and lymphomas (30-fold). The excess of stomach cancer is probably related to the high frequency of achlorhydria in CVID. 3 of the 7 patients with stomach cancer and CVID survived for 5 years or longer.
Adolescent↗
Incidence of cancer in rheumatoid arthritis and other disorders after immunosuppressive treatment.
A prospective study in the United Kingdom of 1,634 patients without transplants treated with immunosuppressive drugs (68 percent with azathioprine, 28 percent with cyclophosphamide) found an excess of non-Hodgkin's lymphoma and squamous cell skin cancer, suggesting that the excesses (although larger) of the same malignancies found among transplant recipients are not due solely to the foreign antigens of the graft. A separate analysis of the 643 patients with rheumatoid arthritis found a 13-fold increase of non-Hodgkin's lymphoma (whether treated with azathioprine or cyclophosphamide). This increase is not significantly different from the excess in similarly treated patients with other disorders in the study. In patients with rheumatoid arthritis not receiving immunosuppressive drugs, this excess is greater than that in a Finnish population and lower than that in another United Kingdom population. The findings are consistent with other evidence that immunosuppression favors the development of non-Hodgkin's lymphoma, which includes the excess of malignancies found among transplant recipients, long-term renal dialysis patients, and patients with certain primary immunodeficiency disorders. The higher risk among transplant recipients may reflect the effects of the foreign antigens, the more intensive immunosuppressive therapy, or both of these factors. In addition, the predilection for the brain, which is a well-known feature of the lymphomas after transplantation, may also apply (to a lesser extent) to other patients after immunosuppressive treatment, judging from the increasing numbers of case reports in such patients of this exceedingly rare type of malignancy. In view of the evidence of an increase of non-Hodgkin's lymphoma in rheumatoid arthritis in the absence of immunosuppressive treatment, any additional increase is likely to be small in absolute terms. Nevertheless, it needs to be weighed against the clinical benefits.
Adolescent↗
Pancreas cancer and coffee and tea consumption: a case-control study.
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Adult↗
Mortality among British veterinary surgeons.
A total of 3440 veterinary surgeons resident in Britain were followed up from 1949-53 until 1975. A roughly twofold increase in mortality from suicide was observed and also a decreased mortality from respiratory diseases. There was no excess of deaths from leukaemia or other cancers as recently reported from the United States and as implied by the hypothesis that veterinary surgeons are unusually exposed to oncogenic viruses.
Adult↗
A study of cancer of the breast and other sites in women after total colectomy and ileostomy for non-malignant disorders.
To assess the role in breast-cancer aetiology of oestrogenic substances apparently produced by intestinal bacteria from faecal residues associated with a high-fat diet and other absorbable and possibly carcinogenic colonic substances, cancer incidence and mortality were studied in 2425 women in the UK who had previously had total colectomy and terminal ileostomy, mostly for ulcerative colitis for Crohn's disease. The incidence of breast cancer in this group of women was no lower than would be expected, although there was a slight deficiency of deaths from this cause. These findings suggest that, at least in adult life, the colon is not involved in the aetiology of breast cancer. There were pronounced excesses of rectal and bile-duct cancers in ulcerative colitis patients despite previous colectomy.
Adult↗
A proportionate study of cancer mortality among members of a vegetarian society.
A proportionate study was carried out of the causes of death of the 759 Vegetarian Society members whose deaths were recorded in Society records and whose death certificates could be traced. Compared to the general population, a lower proportion of deaths from respiratory diseases and from lung cancer was noted particularly in long-standing members, consistent with the evidence that vegetarians smoke less than the average. The proportion of deaths from colorectal cancer was slightly lower than in the general population but there was no reduction in the proportions of deaths from other diseases that have been linked with meat or fat consumption, such as cardiovascular diseases and breast cancer. The proportions of deaths from stomach cancer and from accidents and violence were greater than expected. The significance of the findings is discussed and also the possible limitations of the proportionate method of analysis in relation to studies of vegetarians.
Diet, Vegetarian↗