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L M Robison

Publications and source records attributed to L M Robison.

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

Food-consumption trends between adolescent and adult years and subsequent risk of prostate cancer.

A population-based, case-control study of prostate cancer in Utah was used to assess reported food-consumption patterns for the adolescent and adult years. Men reported eating eggs, whole milk, butter, white bread, cereals, and candy less frequently and red meat, fish, low-fat milk, cheese, yogurt, ice cream, margarine, fruits and vegetables, and whole-wheat bread more frequently as adults, indicating that diets changed in the hypothesized direction to correspond to national changes in food-consumption practices. Men who consumed a diet high in saturated fatty acids as adults were at a slightly increased risk of developing aggressive prostate cancer after adjusting for adolescent diet (odds ratio 1.8 comparing high with low intakes), whereas men who consumed a diet high in saturated fatty acids as adolescents were not at increased risk of developing these tumors after controlling for a diet high in saturated fatty acids as adults (odds ratio 1.1).

Adolescent↗
PubMed1990

Dietary vitamins A, C, and E and selenium as risk factors for cervical cancer.

The relation between cervical cancer and dietary intake of vitamins A, C, and E, beta-carotene, and selenium was examined in a population-based case-control study in Utah. Cervical cancer cases (n = 266) and population-based controls (n = 408) were interviewed between 1984 and 1987. Protective effects were observed for vitamins A, C, and E and beta-carotene but were attenuated by age, level of education, and lifetime cigarette use. Associated risk (comparing highest with lowest quartiles of intake) went from 0.53 (crude) to 0.71 (adjusted) for vitamin A; from 0.55 (crude) to 0.82 (adjusted) for beta-carotene; from 0.45 (crude) to 0.55 (adjusted) for vitamin C; from 0.58 (crude) to 0.60 (adjusted) for vitamin E; and from 0.95 (crude) to 0.70 (adjusted) for selenium. Adjustment for number of sex partners and church attendance, factors significantly related to cervical cancer risk, only slightly attenuated these adjusted risk estimates.

Adult↗
PubMed1990

Tobacco, alcohol, coffee, and caffeine as risk factors for colon cancer in a low-risk population.

We used data from a population-based case-control study to examine how use of tobacco products and consumption of alcohol, coffee, and caffeine relate to colon cancer in Utah. We hypothesized that low use of these substances is one factor contributing to the low colon cancer incidence in Utah and could help explain the low risk associated for colon cancer with being a member of the Church of Jesus Christ of Latter-day Saints. In females, we observed little or no increase in risk of colon cancer from smoking cigarettes or from consumption of alcohol, caffeine, or coffee. Males who used pipes, however, experienced an increased risk for colon cancer (OR = 4.1, 95% CI = 1.3-12.3). Risk for colon cancer associated with alcohol use was greatly attenuated after adjusting for caffeine and pipe use in males; males who consumed higher levels of caffeine during the two to three years prior to the interview were at higher risk than males who consumed low levels of caffeine (OR = 2.0, 95% CI = 1.0-4.2); similar associations were observed for coffee consumption. Nonuse of these substances could explain the low colon cancer incidence rates observed in members of the Church of Jesus Christ of Latter-day Saints and Utah males.

Adult↗
PubMed1989

Adolescent diet and breast cancer in Utah.

A population-based case-control study was conducted to assess the association between breast cancer risk, body mass index (BMI) and adolescent dietary fat and fiber consumption. Data were collected in Utah from white female cases (N = 172) and controls (N = 190) between the ages of 20 and 54 years. Odds ratios (OR) and 95% test-based confidence intervals (CI) were determined by multiple-logistic regression analysis controlling for age, education, age at menarche, and age at first pregnancy. Menopausal status was identified as an effect modifier, therefore, separate analyses were performed for pre and postmenopausal groups. An elevated risk (OR = 2.9 for highest quartile versus lowest, CI = 1.1-8.1) was associated with a larger BMI at age 12 in premenopausal women; a larger adult BMI lowered the odds ratio (OR = 0.4, CI = 0.2-1.0 for highest quartile versus lowest) in premenopausal women; BMI did not alter risk in postmenopausal women. Although not statistically significant, high fat intake consistently lowered the odds ratios below 1.0 in premenopausal women in the upper three quartiles compared to the lowest fat intake referent quartile (OR = 0.7, CI = 0.2-2.1 for highest versus lowest quartile) but was inconsistent in postmenopausal women (OR = 0.7, CI = 0.2-2.7 for highest versus lowest quartile). When fat intake was assessed by its component parts, fat from milk, cheese and yogurt reduced the odds ratios in both premenopausal (OR = 0.4, CI = 0.1-1.1 for highest versus lowest quartile) and postmenopausal women (OR = 0.2, CI = 0.0-0.8). In postmenopausal women, high fiber intake produced elevated odds ratios in all three upper quartiles (OR = 6.6, CI = 1.5-29.6 for highest versus lowest quartile), while fiber from grains resulted in a decreased risk in both premenopausal (OR = 0.2, 95% CI = 0.2-0.7 for highest versus lowest quartile) and postmenopausal women (OR = 0.7, 95% CI = 0.3-2.0). The possibility of biased estimates from low response rates (cases = 60%, controls = 61%), potential recall bias, and some lack of precision in the dietary instrument should be considered. It appears from these analyses that the relation of breast cancer to dietary intake, especially during adolescent years, is not clear, and that risk associated with fat or fiber intake may be affected by the nutrient source.

Adolescent↗
PubMed1989

Cigarette smoking and exposure to passive smoke are risk factors for cervical cancer.

Personal cigarette smoking and exposure to passive smoke as risk factors for cervical cancer were examined in a population-based, case-control study conducted in Utah. Personal cigarette smoking was found to increase the risk of cervical cancer, after adjusting for age, educational level, church attendance, and sexual activity. The adjusted risk estimate associated with being a current smoker was 3.42 (95% confidence interval [Cl], 2.10 to 5.57); for having smoked for 5 or more pack-years, it was 2.81 (95% Cl, 1.73 to 4.55); and for having smoked at least 100 lifetime cigarettes, it was 2.21 (95% Cl, 1.44 to 3.39). The adjusted risk estimate (also adjusted for actual cigarettes smoked) associated with passive smoke exposure for 3 or more hours per day was 2.96 (95% Cl, 1.25 to 7.03). Risk from passive smoking was greater in women who were not smokers (odds ratio, 3.43; 95% Cl, 1.23 to 9.54) than in women who smoked (odds ratio, 2.59; 95% Cl, 0.23 to 29.24).

Adult↗
PubMed1989

Uncertainty in the diagnosis of histologically confirmed pancreatic cancer cases.

In doing a case-control study of cancer of the exocrine pancreas, a set of criteria was developed to classify cancer of the exocrine pancreas by pathological and diagnostic data as to the probability that the tumor arose in the pancreas. We applied these criteria to the records of 125 consecutive patients between the ages of 40-79 years who were identified as having adenocarcinomas of the exocrine pancreas from a population-based cancer registry. We found that histological confirmation by a cancer registry does not guarantee the site of origin is the pancreas. Of the histologically confirmed cases meeting our study criteria, 28.7% may not have arisen in the pancreas. Forty-seven per cent of non-histologically confirmed cases, which most studies exclude, were almost certainly of pancreatic origin based on computerized tomogram (CT) scan and/or surgical palpation and subsequent clinical course. These figures may underestimate the full extent of diagnostic misclassification, especially in older age groups. We conclude that epidemiological studies of cancer of the exocrine pancreas need more uniform criteria for defining cases, and these criteria should take into account uncertainty as to site of origin. Sufficient detail of our scheme is presented so it can be applied in other studies.

Adult↗
PubMed1989

Sexual activity, contraception, genital infections, and cervical cancer: support for a sexually transmitted disease hypothesis.

A case-control study was conducted in Utah between 1984 and 1987 to examine risk factors for cervical cancer. Interviews were completed with 266 histologically confirmed carcinoma in situ and invasive squamous cell cervical cancer cases who were categorically matched by age to 408 controls. Among the factors identified as altering risk for cervical cancer, after adjustment for age, education, church attendance, and cigarette smoking, were: having numerous sex partners (odds ratio (OR) = 8.99 for 10 or more partners); the current mate having several sex partners (adjusted OR for 10 or more partners = 8.62); using foam or jelly as a contraceptive method (OR, adjusted for number of sex partners, = 0.44); reported Trichomonas infection (OR, adjusted for number of sex partners, = 2.10); and herpes simplex virus type 2 infection as determined by 2:1 neutralization index values above 100 (OR = 2.70). A protective effect was noted from the use of diaphragms (OR = 0.67) or condoms (OR = 0.53) in women who reported more than one sex partner. These data support the hypothesis that cervical cancer is a sexually transmitted disease.

Adult↗
PubMed1989

Nutrient intake and ovarian cancer.

A case-control study was conducted in Utah between 1984 and 1987 to evaluate the effects of nutrient intake on risk of developing ovarian cancer. Detailed dietary intake information was available from 85 first primary ovarian cancer cases and 492 population-based controls. Calories, fat, protein, fiber, and vitamins A and C did not appreciably alter the risk of developing ovarian cancer. However, high intake of beta-carotene appears to confer protection against ovarian cancer (odds ratio = 0.5, 95% confidence interval 0.3-1.0) after adjusting for age, number of pregnancies, and the body mass index of weight/height.

Adult↗
PubMed1989

Dietary intake and colon cancer: sex- and anatomic site-specific associations.

A case-control study was conducted in Utah between July 1979 and June 1983 in which 231 cases of colon cancer identified through the Utah Cancer Registry and 391 controls identified through random digit dialing were interviewed. Odds ratios (OR) were calculated comparing the highest exposure categories with the lowest exposure categories. The highest quintile of body mass index (weight (kg)/height (m)2 for males; weight (kg)/height (m)1.5 for females) was associated with increased risk in both males (OR = 2.1) and females (OR = 2.3). In females, total dietary fat (OR = 1.9) and energy intake (OR = 1.5) were associated with an increased colon cancer risk after adjusting for age, body mass index, and crude fiber. Fiber was protective in females (OR = 0.5) after adjusting for age, body mass index, and energy intake, as was beta-carotene (OR = 0.5) after also adjusting for crude fiber. Adjusted risk estimates in males were 2.0 for total dietary fat, 3.8 for polyunsaturated fat, 2.1 for monounsaturated fat, 2.1 for energy intake, 2.5 for protein, 0.3 for fiber, 0.4 for beta-carotene, and 0.3 for cruciferous vegetables. Risk estimates differed by site of cancer within the colon. In males, protein (OR = 3.8) was a risk factor for cancer of the descending colon, while fats (OR = 2.7-8.8) increased the risk of cancer of the ascending colon. The hypotheses that dietary fat increases colon cancer risk while dietary fiber decreases colon cancer risk and that fat and protein may be independently associated with colon cancer risk are supported.

Aged↗
PubMed1988

Fluid intake and bladder cancer in Utah.

A population-based, incident case-control study was conducted in Utah to assess the relationship between fluid intake and bladder cancer. Cancer cases (n = 419) were identified through the Utah Cancer Registry, and controls (n = 889) were obtained through random digit dialing and the Health Care Financing Administration. After adjustment for cigarette smoking, age, sex, history of diabetes, and history of bladder infections using multiple logistic regression analysis, total fluid intake was not found to be related to bladder cancer development. Specific fluids related to bladder cancer risk were milk intake (OR = 0.64) and caffeinated coffee intake (OR = 1.60). A linear trend for a dose-response protective effect was observed for milk, while coffee increased risk only when 40 or more cups were consumed per week. Alcohol increased risk only when consumed at high levels (over 3.64 ounces or 103 g per week) by people who never smoked cigarettes (OR = 2.37). Likewise, tea consumption in non-cigarette smokers increased bladder cancer risk (OR = 2.25). Results from this study suggest that types of fluids consumed may play a role in the development of bladder cancer. Furthermore, it is hypothesized that the dietary components of these beverages may be related to the development of bladder cancer.

Adult↗
PubMed1988

Smoking and bladder cancer. The modifying effect of cigarettes on other factors.

A population-based, incidence case-control study was used to assess the effect of cigarette smoking on other risk factors for the development of bladder cancer. White men (n = 332) between the ages of 21 and 84 with bladder cancer were compared with 686 population-based controls. Cigarette smokers were classified by current smoking status as well as by amount, duration, inhalation patterns, age at first having smoked, and years since having stopped smoking. These variables were associated with a change in the risk for bladder cancer. The population-attributable risk associated with cigarette smoking was 48.5%. Risks from the use of other tobacco products such as cigars, pipes, snuff, and chewing tobacco, and from caffeinated coffee, tea, and alcoholic beverages were evaluated in light of cigarette smoking status. Cigarette smoking was shown to be both a confounder and an effect modifier. Risk estimates for bladder cancer associated with caffeinated coffee and alcoholic beverages were decreased after controlling for the effects of cigarette smoking. However, an increased risk of developing bladder cancer from cigar smoking (Odds ratio [OR] = 2.46) and tea drinking (OR = 3.14) was only seen in men who never smoked cigarettes. An increased but not significant risk was also seen for pipe, snuff, and chewing tobacco use in noncigarette smokers. The population-attributable risk from cigars and tea in the population of white men who had never smoked was 6.3% and 18.9%, respectively. Our results suggest that cigarette smoking may obscure other risk factors unless those who never smoked are separately studied.

Adult↗
PubMed1984

Differences in risk estimations from a hospital and a population-based case-control study.

A hospital-based and population-based case-control study of cervical cancer (in situ and invasive) was conducted in urban Utah to determine if methods of respondent selection affect estimates of risk for variables thought to be associated with the disease. Population cases (N = 409) and cases from two large hospitals (N = 124) were identified through the Utah Cancer Registry. Population-based controls (N = 379) were identified through random-digit dialing; hospital-based controls (N = 150) with gynaecological disorders other than cancers and elective abortions were chosen from the same hospitals as the cases for the hospital study. Both control groups were frequency matched to cases by age. Approximately 79% of the identified cases and 85% of the selected controls completed interviews conducted in their homes. Most risk estimates were lower in the hospital-based study because of the more case-like attributes of this group. Stratified analysis for social class led to adjusted risk estimates which were lower than the unadjusted risk estimates for the population-based study, but not for the hospital-based study. The close social class matching in the hospital-based study seems to have led to concurrent overmatching on other risk factors since many of these are closely related to social class. Findings are discussed in terms of implications for case-control study design.

Adult↗
PubMedDate not supplied

Antidepressant pharmacotherapy: economic outcomes in a health maintenance organization.

Recent pharmacotherapeutic advances in the treatment of depression have included the development of selective serotonin re-uptake inhibitors (SSRIs). The present study was designed to contrast direct health service expenditures for the treatment of depression among patients enrolled in a health maintenance organization (HMO) and prescribed either the SSRI fluoxetine or one of three tricyclic antidepressants (TCAs) (amitriptyline, nortriptyline, or desipramine). Information regarding health service utilization was derived from the computer archive of a network-model HMO system serving 400,000 beneficiaries. A total of 701 HMO beneficiaries were found to satisfy the study selection criteria. Multivariate regression analysis was used to discern the incremental influence of selected demographic, clinical, financial, and provider characteristics on 1 year post-period expenditures (PPE) for health care. Analysis-of-variance procedures with Duncan's multiple-range test, or chi-square analyses, revealed no significant difference across antidepressant pharmacotherapy for age, sex, 6-month prior-period expenditures for physician visits, psychiatric visits, laboratory tests, hospitalizations, or psychiatric hospital services related to the treatment of depression, or number of prescribed therapeutic agents for disease state processes other than depression. Receipt of fluoxetine was associated with a significantly (P < or = 0.05) higher rate of initial prescribing by psychiatrists, an increase in the number of prescriptions for antidepressant pharmacotherapy obtained (30-day supplies), and a reduction in the number of monthly intervals during which time antidepressant pharmacotherapy was not procured. Receipt of fluoxetine as antidepressant pharmacotherapy was associated with a significantly (P < or = 0.05) higher mean medication possession ratio (MPR) relative to amitriptyline, nortriptyline, or desipramine. Multivariate findings for patient-level data reflecting a definitive diagnosis of depression (n = 555) indicate that receipt of a TCA resulted in a significant (P < or = 0.05) increase in the use of physician visits ($36.07), psychiatric visits ($41.38), laboratory tests ($1.71), hospitalizations ($208.77), and psychiatric hospital services ($187.27), and a significant (P < or = 0.05) reduction in expenditures for antidepressant pharmacotherapy (-$162.21), for a total increase in health service utilization of $312.99 (P < or = 0.05) 1 year post-initiation of antidepressant pharmacotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Financial incentive and the use of mammography among Hispanic migrants to the United States.

Researchers in migrant health clinics in Washington state found cost to be the single most commonly reported reason given by foreign-born Hispanic women for never having had a mammogram. The true significance of this finding beyond self-report was unknown. A randomized intervention trial designed to test the effect of fully subsidized mammograms on utilization was conducted within this population. Women in the intervention group received standard clinic instruction plus a voucher for a free mammogram. Controls received standard clinic instruction alone. Eighty-seven percent of women receiving vouchers obtained a mammogram within 30 days, compared with 17.5% of controls. Logistic regression analysis revealed that women receiving vouchers were 47 times more likely to obtain a mammogram than controls. This confirms women's self-report that cost is a major barrier to accessing screening mammograms in this low-income migrant population, and that women are more likely to utilize this service when financial barriers are removed.

Adult↗
PubMedDate not supplied

Ethnicity and the prescribing of antidepressant pharmacotherapy: 1992-1995.

Little is known about the prescribing pattern for antidepressant pharmacotherapy by ethnicity. The present study was designed to determine the rates of office-based visits documenting the utilization of antidepressant pharmacotherapy, a diagnosis of a depressive disorder, or both, among whites, blacks, and Hispanics age 20-79 years. Data from the National Ambulatory Medical Care Survey for 1992-93 and 1994-95 were utilized for this analysis. Comparing these time periods, we observed several trends: (1) The annualized mean rate per 100 US population of office-based visits documenting the use of antidepressant pharmacotherapy for any reason increased from 13.4 to 15.9 among whites (p < or = 0.0001) and from 6.5 to 7.7 among blacks (p < or = 0.0001), but remained unchanged at 7.3 for Hispanics (p > 0.05). (2) Documentation of a diagnosis of a depressive disorder increased for whites (10.9 to 12.0; p < or = 0.0001), for blacks (4.2 to 5.6; p < or = 0.0001), and for Hispanics (4.8 to 5.6; p < or = 0.0001). (3) The recording of a diagnosis of a depressive disorder in concert with the initial prescription or continuation of antidepressant pharmacotherapy also increased for whites (6.5 to 7.7; p < or = 0.0001), for blacks (2.6 to 3.4; p < or = 0.0001), and for Hispanics (3.0 to 3.2; p < or = 0.0001). We conclude that the rate of office-based visits documenting the utilization of antidepressant pharmacotherapy, a diagnosis of a depressive disorder, or both, was comparable among blacks and Hispanics by 1994-95, but was less than half the rate for whites in either time period examined. Further prospective research is required to discern the reasons for observed differences by ethnicity.

Adult↗