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Biomedical subjects

M Melbye

Publications and source records attributed to M Melbye.

At least 109 records · Page 6Linked to original sources
PubMed1997

Cancer and diabetes--a follow-up study of two population-based cohorts of diabetic patients.

OBJECTIVES: To study the occurrence of cancer amongst patients with diabetes mellitus (DM). DESIGN: Population based cohort study. SETTING: Denmark. SUBJECTS: Two cohorts of patients with DM were identified. One cohort comprised 1659 conscripts diagnosed with type I DM before the age of 20 years. Another cohort comprised 1499 men and women with insulin treated DM identified by means of medical prescriptions on 1 July 1973. Both cohorts were followed until the end of 1992. MAIN OUTCOME MEASURES: The relative risk of cancer in the two cohorts was estimated as the ratio of observed to expected number of cancers in the cohort (SIR). RESULTS: No unusual risk of cancer was observed amongst the conscripts (SIR 0.9, n = 13) or amongst patients with onset of DM before the age of 30 years in the prescription cohort (SIR 0.9, n = 32). Amongst those aged 30 years or more at DM onset in the prescription cohort, the overall risk of cancer did not depart from normal (SIR 1.0, n = 103), however, pancreatic cancer occurred in excess both immediately (< 1 year) (SIR 190, n = 1), and during 1-9 years after DM onset (SIR 9.0, n = 4). Similarly, the risk of non-Hodgkin's lymphoma was increased significantly (SIR 3.3, n = 6), all cases occurring more than 10 years after DM onset. CONCLUSIONS: Our data suggest that there is no unusual risk of cancer associated with type I DM. Type II DM may be the first symptom of pancreatic cancer and may be associated with an increased risk of non-Hodgkin's lymphoma.

Adult↗
PubMed1997

Cancer risk in a cohort of Danes working in Greenland.

Greenland is a high-incidence area for certain virus-associated cancers. The long term cancer risk in a cohort of 7,761 Danish employees who had been working for some time (median 19.7 months) in Greenland during the period 1955-1978 was studied. During a total of 162,300 person-years (average 20.9 years) of follow-up ending on December 31, 1992, the number of cancers observed was 732 vs. 669 expected (relative risk (RR) = 1.09, 95% confidence interval (CI) 1.02-1.18). Whereas the men did not experience any unusual cancer incidence at any cancer site, the women were at elevated risk of developing breast cancer (RR = 1.5, 95% CI 1.2-1.8 (n = 96)); malignant melanoma (RR = 1.8, 95% CI 1.0-2.9 (n = 16)); and lymphatic and hematopoietic malignancies (RR = 1.7, 95% CI 1.0-2.8 (n = 16)). Exposure during adulthood to a high-incidence area for cervical cancer, nasopharyngeal carcinoma and tumors of the major salivary glands did not confer any measurable increase in the risk for these virus-associated cancers. Postponement of childbearing might explain part of the elevated breast cancer risk. Intensive exposure to ultraviolet light, that is likely to explain the increased risk of malignant melanoma among the women, might also be involved in the excess incidence of lymphatic and hematopoietic malignancies observed in these women. However, why the men did not experience similar alterations in the risk of melanoma and cancers of the immune system is enigmatic.

Adolescent↗
PubMed1996

Anal and cervical abnormality in women--prediction by human papillomavirus tests.

A total of 151 women at risk of human immunodeficiency virus infection were investigated, to study the strength of the association between cervix and anus regarding the presence of HPV and cytological abnormality. An equal percentage of women had abnormal cervical (12.2%) and anal (12.1%) Papanicolaou smears. HPV measured by PCR was detected in 93.3% of cervical squamous intraepithelial lesions (SIL) compared to 49.1% of normal cervical cytologies, and in 100% of anal SIL and 67.4% of normal anal cytologies, respectively. After controlling for HPV-PCR status, immunodeficiency, as measured by a low CD4+ count and HIV positivity, increased the detection of cervical and to some extent anal squamous intraepithelial lesions (SIL). We evaluated how precisely an HPV test could predict cervical disease and found that the HPV-PCR test was slightly more sensitive than the HPV-hybrid capture (HC) test (PCR: 93.3% vs. HC: 88.9%), whereas the HC test was significantly more specific (83.6% vs. 50.9%), and with a much higher positive predictive value (43.2% vs. 20.6%). Similar results were obtained for anal SIL. HIV positivity increased sensitivity, lowered specificity and increased the positive predictive value of the tests. A diagnosis of cervical SIL was associated with a more than 3-fold increased risk of a simultaneous abnormal anal smear (p < 0.05). In conclusion, cervical and anal disease were significantly associated and almost exclusively seen in the presence of HPV. Immunodeficiency and HIV positivity increased the risk of disease in HPV-positive subjects. Hybrid capture, which requires a higher viral load than PCR to detect HPV, was clearly superior in predicting cervical and anal disease. Altogether, these findings suggest that a high level of HPV infection may be important for the development of SIL in the population studied.

Adult↗
PubMed1996

Risk for subsequent cancer after diagnosis of basal-cell carcinoma. A population-based, epidemiologic study.

BACKGROUND: Considerable debate is taking place over whether patients with basal-cell carcinoma and other skin neoplasms are at increased risk for internal cancer. OBJECTIVE: To investigate risk for subsequent cancer in patients with basal-cell carcinoma. DESIGN: Population-based cohort study. SETTING: Denmark, from 1978 ot 1991. PATIENTS: 37674 patients followed for a maximum of 14 years after a first diagnosis of basal-cell carcinoma. MEASUREMENTS: The occurrence of subsequent cancer was compared with the expected cancer pattern (which was determined on the basis of national incidence data). Standardized incidence ratios (SIRs), ratios of actual to expected number of cases of cancer, yielded estimates of the relative risk. RESULTS: During 190945 patient-years of follow-up, 3663 new cases of cancer occurred where only 3245 were expected. As anticipated, malignant melanoma occurred frequently (SIR, 2.64 [95% CI, 2.21 to 3.13]), but patients were also at increased risk for noncutaneous cancer (SIR, 1.19 [CI, 1.13 to 1.24] for men and 1.09 [CI, 1.03 to 1.16] for women). The excess risk for noncutaneous cancer pertained to cancer of the lip (SIR, 2.07), salivary glands (SIR, 2.45), larynx (SIR, 1.41), lung (SIR, 1.40), breast (SIR, 1.13), and kidney (SIR, 1.30) and non-Hodgkin lymphoma (SIR, 1.36). Patients receiving a diagnosis of basal-cell carcinoma before 60 years of age (SIR, 1.26) had a statistically higher risk for developing new cancer (P < 0.01) than did those receiving the diagnosis at 60 years of age or older (SIR, 1.11). This applied to breast cancer (SIR, 1.37 in patients < 60 years of age compared with 1.05 in those > or = 60 years of age), testicular cancer (SIR, 3.52 in patients < 60 years of age compared with 0 seen and 1.96 expected in those > or = 60 years of age), and non-Hodgkin lymphoma (SIR, 2.50 in patients < 60 years of age compared with 1.16 in those > or = 60 years of age), and non-hodgkin lymphoma (SIR, 2.50 in patients < 60 years of age compared with 1.16 in those > or = 60 years of age). CONCLUSION: In addition to having an increased risk for new skin cancer, patients with basal-cell carcinoma have an increased risk for noncutaneous cancer at various sites. Increased risks for testicular cancer, breast cancer, and non-Hodgkin lymphoma should be kept in mind, particularly for patients in whom basal-cell carcinoma is diagnosed when they are at a young age.

Adult↗
PubMed1996

Cancer risk in fathers and brothers of testicular cancer patients in Denmark. A population-based study.

There are several reports of familial testicular cancer in the literature but few systematic attempts have been made to estimate the risk of testicular cancer in first-degree relatives of patients with this neoplasm, and the risk remains to be fully assessed in population-based studies. By means of data from the Danish Cancer Registry, we identified all testicular cancer patients (index cases) born and diagnosed during 1950-1993 in Denmark. Their fathers were identified from national registries, as were the brothers of a subcohort of these patients. Familial cancer occurrence was determined through linkage with the cancer registry and compared with the cancer incidence in the general male population in Denmark. The ratio of observed to expected cancers generated the measure used for the relative risk. Fathers of 2,113 index cases with testicular cancer experienced an almost 2-fold risk of developing testicular cancer themselves (RR = 1.96; 95% CI: 1.01-3.43). Overall, the fathers had a decreased relative cancer risk (RR = 0.84; 95% CI: 0.74-0.95) with a significantly decreased risk of cancers of the lung and digestive organs. Brothers of a subcohort of 702 index cases showed a markedly increased risk of testicular cancer (RR = 12.3; 95% CI: 3.3-3 1.5). In conclusion, we documented a significantly increased familial risk of testicular cancer which was relatively more pronounced between brothers than between fathers and sons. These findings support the possible involvement of a genetic component in the aetiology of testicular cancer, but also leave room for a hypothesized influence of in-utero exposures, such as specific maternal hormone levels, that might be shared by brothers.

Adult↗
PubMed1996

[Carcinoid tumors in Denmark 1978-1989 and the risk of development of new cancers].

Previous studies have suggested an excess cancer risk in patients with carcinoid tumours. We re-examined this association by the use of truly population-based data from the Danish Cancer Register. One thousand and twenty-nine patients with carcinoid tumours diagnosed in Denmark 1978-89 were identified and followed for the occurrence of subsequent cancers. The ratio of observed to expected cancers calculated from population rates served as a measure of the relative cancer risk (RR). The annual age-adjusted incidence rate for carcinoid tumours was 1.1 per 100,000 person-years (world standardized). The overall relative risk of subsequent cancers was 1.1 (95% CI 0.8-1.6). Thyroid cancer, tumours of the brain and nervous system and non-Hodgkin's lymphomas were in excess. Overall, this study does not support previous findings of a general excess cancer risk in patients with carcinoid tumors. Significantly increased risks of cancer were observed at some sites, but these findings were based on small numbers, and consequently need further confirmation.

Adult↗
PubMed1996

Oestrogen-related cancer risk in mothers of testicular-cancer patients.

The belief that oestrogens are involved in the pathogenesis both of testicular cancer in young men and of cancers of the endometrium and female breast has become widespread. In a search for possible hormonal links between these cancers, we investigated the cancer pattern in a cohort of women who had given birth to sons who developed testicular cancer. Particular focus, was given to oestrogen-related cancers. The present retrospective population-based cohort study is based on data from the Danish Cancer Registry. Mothers of 2,204 testicular-cancer patients were followed for the occurrence of cancer over a total of 70,063 person years. The ratio of observed cancers in the cohort over the expected numbers based on cancer incidence in the underlying female population served as measure of the relative risk (RR). The RR of developing breast cancer among mothers of testicular-cancer patients was 0.8 (95% confidence interval 0.6-1.1), the relative risk of endometrial cancer 0.6 (0.3-1.0) and of ovarian cancer 1.0 (0.6-1.6). Mothers of testicular-cancer patients are not at increased risk of developing oestrogen-related cancers.

Adult↗
PubMed1996

Epidemiology of classic Kaposi's sarcoma in Denmark between 1970 and 1992.

BACKGROUND: Studies have suggested that the incidence of classic Kaposi's sarcoma (KS) varies considerably within Europe. The epidemiology of classic KS in Denmark was described for the period between 1970 and 1992 and association with marital status and country of origin were evaluated. METHODS: A descriptive epidemiology study was carried out using data from the Danish Cancer Registry and from all Danish pathology departments. The effects of marital status and of immigration were evaluated in a case-control study with sex- and age-matched controls for 50 cases of classic KS. RESULTS: A total of 59 patients with classic KS, 34 men, 25 women, were identified between 1970 and 1992, yielding world standardized incidence rates of 0.40 and 0.22 per 1,000,000 population among men and women, respectively. Among men, a larger proportion of the patients with classic KS were of non-Danish origin [odds ratio (OR) = 3.8, 95% confidence interval (CI) = 1.5-9.6]. No excess of foreign born persons was observed among women with KS. Never-married men were at a markedly increased risk for classic KS (OR = 2.8, 95% CI = 1.2-6.7). This risk was, however, restricted to men younger than 60 years (OR = 18.8, 95% CI 3.4-104.8), whereas no increased risk was observed in men age 60 years or older nor was there an increased risk in women. CONCLUSIONS: Classic KS is a rare disease in Denmark. However, men, immigrants and never-married men age 60 years or younger experienced an excess risk. Even though the latter finding might reflect an association with male homosexuality, the observation should be interpreted with caution due to the limited number of observations.

Case-Control Studies↗
PubMed1996

[New cancers after squamous cell skin cancer].

The subsequent cancer experience in 5,100 patients with squamous cell skin cancer (SCC) was compared with the cancer incidence in the Danish population. Ratios of observed to expected cancers served as the measure of the relative cancer risk (RR). Overall, SCC patients were at significantly increased cancer risk due to cancers of the respiratory organs (RR = 1.7); cancers of the lip, buccal cavity and pharynx (RR = 3.1); non-Hodgkin's lymphoma (RR = 2.3); leukaemia (RR = 2.5); malignant melanoma (RR = 2.6); and small intestine cancers in men (RR = 4.1). The risk of new cancers was higher in patients diagnosed with SCC before the age of 60 years than in those diagnosed with SCC after that age. A previously undocumented, significant excess of smoking-related cancers was observed after a diagnosis of SCC. Since a variety of other squamous cell cancers have been linked to smoking, the authors hypothesize that some general effect of smoking might act on all human squamous epithelia.

Adult↗
PubMed1996

Marital status in relation to Kaposi's sarcoma, non-Hodgkin's lymphoma, and anal cancer in the pre-AIDS era.

Persons with human immunodeficiency virus/AIDS are at high risk of Kaposi's sarcoma (KS), non-Hodgkin lymphoma (NHL), and possibly anal cancers. To examine whether this risk preceded the AIDS epidemic, we used pre-AIDS era data from the Surveillance, Epidemiology, and End Results program (excluding Connecticut) from 1973 to 1976, and the Connecticut Tumor Registry from 1940 to 1976. We compared risk of being single (a surrogate to identify men who might be homosexual) to those ever married, using a case control matching study with up to 10 controls per case. Overall, no excess risk was observed for KS (risk ratio for men 20-59 years old: 1.00; 95% confidence interval 0.218-3.61), but there was a suggestion of higher risk (4.00; 0.54-29.48) in 1973-1976, the period just before the AIDS epidemic. The NHL risk (0.85; 0.74-0.99) was slightly low, but for anal cancer the risk ratio of being single was significantly high both in men 20-59 years old (5.68) and older men (2.78) long before the AIDS epidemic. If the excess risk was solely due to being homosexual, the actual relative risk in the subset who were homosexual must have been much higher, given that only a fraction of the single men would have been homosexual. As comparison groups to verify the methodology, we used colon (no association with marital status) and prostatic cancer (decreased in single men), with findings as reported in other studies. Thus, single men may have been at an excess risk of KS (but a slightly low risk of NHL) just before the AIDS epidemic and have been at excess risk of anal cancer for many years before the AIDS epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Recent increase in the incidence of non-Hodgkin's lymphoma among young men and women in Denmark.

Time-related trends in the incidence of non-Hodgkin's lymphoma (NHL) in Denmark were analysed for the period 1943-89. A total of 13 822 patients (7565 men and 6257 women) were included in the study. In men, world-standardised incidence rates per 100 000 population increased from 2.5 in 1943-47 to 9.3 in 1988-89. In women, a similar increase was seen, i.e. from 1.9 in 1943-47 to 6.5 per 100 000 population in 1988-89. For all birth cohorts, the male-to-female incidence ratio was highest among young subjects and fell significantly after the age of 29 years. Trends in age-specific incidence were analysed separately for two periods, i.e. 1943-77 and 1978-89, reflecting an early, pre-AIDS period and a later period possibly influenced by AIDS. In both periods, the incidence of NHL increased in all age groups. However, in recent years a noticeable increase in incidence averaging 8% annually was observed in men and women aged 40-49 years. A number of factors including changes in the perception of NHL and in the diagnostic methods available are considered insufficient to explain the observed increase. The remarkable and parallel time trends observed in young men and women in recent years indicate that factors other than AIDS must be considered.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Nasopharyngeal carcinoma: an EBV-associated tumour not significantly influenced by HIV-induced immunosuppression. The AIDS/Cancer Working Group.

We used a link between cancer (859,398 reports) and AIDS (50,050 reports) registries in the United States to study whether nasopharyngeal carcinoma (NPC) was increased in the population with AIDS. There was no indication of a significantly increased risk up to or after the AIDS diagnosis, which argues against progressively failing immunity being important in the development of this malignancy.

Adult↗
PubMed1996

Epidemiology of Kaposi's sarcoma in the Nordic countries before the AIDS epidemic.

Based on data from the Nordic cancer registries, time-related trends in incidence of Kaposi's sarcoma (KS) were analysed in four ethnically similar populations before the AIDS epidemic. Data were available for different time periods in Denmark (1970-79), Sweden (1958-79), Finland (1953-79) and Norway (1953-79). KS was more common among men than among women aged 60 years or more, whereas no differences were observed for younger persons. The incidence of KS differed significantly between the four countries (P = 0.0001); Sweden having the highest and Denmark the lowest rates. Similarly, regional differences in incidence were observed within Sweden, rates being higher in the northern than in the southern areas (Ptrend = 0.002). Overall, in Nordic men the world standardised incidence rose from 0.5/1,000,000 person-years in the period 1953-57 to 1.8/1,000,000 person-years in 1978-79; in Nordic women, the corresponding rates were 0.2/1,000,000 person-years and 0.8/1,000,000 person-years respectively. The rate of increase was similar in Sweden, Finland and Norway (P = 0.14), whereas the short period of observation in Denmark precluded precise assessment of time-related incidence trends. These observations cannot be explained by registrational procedures or known risk factors for KS, and argue that environmental factors play an important role in the development of the disease.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Age of wife as a major determinant of male-to-female transmission of HIV-2 infection: a community study from rural West Africa.

OBJECTIVE: To examine whether proviral load is important for transmission between spouses, since we have previously found that the proviral load of HIV-2 predicts the severity of infection. DESIGN: Proviral load was examined in 121 HIV-2-infected adults in a rural area of Guinea-Bissau. For the 68 subjects who had a spouse of known HIV status the risk of the spouse being infected was examined. METHODS: Statistical methods for dependent data were used, because several couples were polygamous. RESULTS: Twenty-seven HIV-2-infected men had 52 current wives of whom 17 (33%) were HIV-2-seropositive. Forty-one HIV-2-infected women had 36 current husbands of known HIV serostatus; nine (25%) were HIV-2-positive. In univariate analyses, concordance of female partners of HIV-2-infected men increased with a previous history of prostitution, age of wife, lack of age difference between the spouses, number of previous husbands, number of wives of the man, and the proviral load. The only significant predictor of concordance in multivariate analyses when wives with a history of prostitution were excluded was an age of 45 years or older [odds ratio (OR), 8.68; 95% confidence interval (CI), 2.34-32.22]. This tendency was not explained by the length of current marriage. Although husbands with a high proviral load were more likely to have concordant spouses than those with a low proviral load (< 20 copies/10(5) CD4 cells), this association was not statistically significant (OR, 2.59; 95% CI, 0.90-7.46). Among spouses of HIV-2-infected women, none of the examined factors, including previous prostitution or proviral load in the woman, predicted whether the husband was HIV-2-infected. CONCLUSIONS: Women appear to be more susceptible to HIV-2 infection after 40-45 years of age. The apparent change in susceptibility may be a major reason for the distinctive age pattern of HIV-2 infection observed in West Africa.

Adolescent↗
PubMed1996

HPV-16-positive anal and penile carcinomas in a young man--anogenital 'field effect' in the immunosuppressed male?

This report presents the unusual occurrence of metachronous perianal and penile carcinomas in a young, immunosuppressed man. Both anogenital cancers were HPV-16-DNA-positive by the polymerase chain reaction. DNA in situ hybridization analysis of the penile carcinoma revealed HPV-16 in most neoplastic cells. HPV-16 appears to have played a central role in both anogenital cancers in this patient, suggesting that, like in immunologically susceptible women, a carcinogenic 'field effect' may exist in the anogenital area of the immunosuppressed male.

Adult↗