[Assessment of prostate cancer morbidity in the Samarsky Region, 1989-1998].
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Biomedical subjects
Publications and source records attributed to M B Prianichnikova.
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The article analyses relative risk of occupational diseases in men and women. Exposure to oil products increases oncologic risk 14.8 times; rare urination--14.3 times; drinking less than 11 per day--6.5 times; vibration--2.5 times. Significantly (5.6-fold) increased risk in women was demonstrated for exposure to oil products. In occupational group of cleaners working with chloride of lime high risk may be connected with exposure to trihalomethanes appearing in water during chloration.
A case-control study was performed to evaluate hormonal status in 154 female patients with bladder cancer and 213 healthy women. Cancer patients were characterized by shorter reproductive period and miscarriage, absence of gestation, endometrial and breast cancer and ovarian cysts in the past history. Evaluation of tryptophan metabolism in 131 male and 111 female patients with bladder cancer showed the occurrence of a carcinogenic metabolite--3-oxyanthranilic acid--in the urine to be higher in women. Blood hormone levels were measured in 55 female patients and 49 healthy women by radioimmunoassay. Decreased levels of progesterone and estradiol as well as of hormones potentiating their production (folitropin and lutropin) were the most frequent hormonal disorders encountered.
A cooperative study of urinary bladder cancer morbidity in Kuibyshev and Tambov Provinces was conducted. A higher morbidity level was established in the latter area. However, morbidity growth rate was higher both in the whole population and individual age and sex groups in Kuibyshev Province. The results suggest that epidemiologic studies of bladder neoplasia should be continued in said areas.
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On the basis of 3,000 questionnaires used in the population survey, the authors distinguished 430 persons who were at risk. This group comprised from 5.3 to 20.9 per cent with regard to certain professional characteristics. The rest 2570 persons served as controls. Urologic investigation (microscopic and cytologic study of the urinary sediment and detection of the urologic symptoms) performed in 307 (71.4 per cent) persons from the risk group and 1540 (59.9 per cent) controls were shown to require 46 (15 per cent) cystoscopies for those enrolled in the risk group and 18 for the controls (1.2 per cent). The study resulted in the diagnosis of papillary carcinoma, papilloma, the inflammation of the Lieutaud's triangle and the neck of the urinary bladder in 2, 2 and 33 examinees, respectively. The same inflammation was diagnosed in 11 persons enrolled in the control group. Histological study (biopsy) employed in 22 (7.2 per cent) risk-group persons and in 7 (0.5 per cent) controls revealed 11 oncological cases in the risk-group patients; 2 transitional carcinomas, 3 papillomas, 4 leukoplakias and 2 epithelial dysplasias. In general, cancer or precancer diseases of the urinary bladder were diagnosed in 22 (7.2 per cent) persons from the risk group and precancer conditions (inflammation with reactive epithelial proliferation) in 7 (0.5 per cent) controls. The results obtained permitted the used questionnaires to be assessed with the concentration index as 15.7, sensitivity index as 75.8 and specificity index as 84.3 per cent.
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In a controlled trial a gynecological history has been studied for 154 females with bladder tumors against 213 matched women without the tumor. The risk to develop the tumor was found to rise with the history of a short reproductive period, abortions, primary infertility, cancer of the corpus uteri and of the breast, ovarian cysts. Tryptophan metabolism assessed in 242 and 541 women and men with bladder cancer and free of it, respectively, was indicative of more frequent urinary registration of carcinogenic tryptophan metabolite 3-oxyantranilic acid: for females 40.5 per 100 in case of cancer, 10 per 100 in healthy ones; for males with cancer 33.9, without cancer 7.4 per 100 examinees. Radioimmunoassays of hormone concentrations in the serum with correlation to tryptophan metabolism for 55 cancer and 49 healthy females showed lowered levels of progesterone, folitropin and lutropine to occur more often in cancer women with urinary 3-oxyantranilic acid. The above endogenic factors analyzed retrospectively suggest involvement of hormonal status alterations in bladder cancer onset.
A retrospective analysis of 160 cases of bladder tumors in females revealed that in 9 of these cases cancer in the bladder arose 1 to 22 years after radiation for uterine and breast cancer. This secondary tumor manifested in 2 females as dysuria, in one of them transition cell cancer of the bladder followed Brunno's cystitis 2 years after the cystitis diagnosis. The other patients had macrohematuria. Being a frequent complication of radiotherapy of pelvic cancer, dysuria and macrohematuria should not be considered as a sign of radiation-induced cystitis. Such patients should be carefully followed up with annual microscopic and cytological examinations of residual urine and cystoscopic control.
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