Search PubMed⌕ Search

Biomedical subjects

M Melbye

Publications and source records attributed to M Melbye.

At least 127 records · Page 7Linked to original sources
PubMed1995

[Mandatory anonymous HIV-surveillance in Denmark. Experience with the new notification system].

A newly implemented mandatory, anonymous HIV surveillance system in Denmark is described. The system is based on a serially numbered form that is circulated among the laboratories, the physicians, and the national surveillance unit. All laboratories doing confirmatory tests for HIV antibodies must send a report form along with any positive test result. Before forwarding the form to the physician, the laboratory is to fill in the top part of the form with its own name, the name and address of the requesting physician and the date of testing. The back copy must be send to the surveillance unit. The Danish physicians are by law mandated to fill in the form with data on the patient and then send the original to the surveillance unit. The two copies are for the patient's file and for the physicians' own centralized filing system. After a revision of the system in 1992, a response rate of 95% was obtained during the first year. An increasing number and proportion of first-time identified HIV-infections in Denmark are acquired heterosexually, many of these infections are identified among foreigners. The newly developed mandatory HIV surveillance system is based on anonymous reporting but it allows routine evaluation of the completeness of reporting as well as nonresponding physicians to be reminded of their duty to report. Also, the system allows nested studies to be carried out among selected HIV-infected subpopulations of special research interest without compromising the anonymity of the patient.

Confidentiality↗
PubMed1995

[Kaposi sarcoma. An epidemiological perspective].

Prior to the 1980s, Kaposi's sarcoma was a rare tumour diagnosed three to four times more frequently among men than women. It was primarily seen among elderly men of Mediterranean or Jewish descent, in well-defined areas of Central Africa, or more scattered as individual cases with underlying immunosuppression. Geographical restrictions and suggested associations with certain HLA-types gave rise to early speculations of a genetic component involved in its etiology. With the AIDS epidemic, the epidemiology of Kaposi's sarcoma changed drastically. Although diagnosed among AIDS patients that are transfusion recipients, intravenous drug users and haemophiliacs, Kaposi's sarcoma is primarily found in homosexual men with AIDS among whom the risk has increased to 100,000 compared to the general population. Specific behaviours linked to homosexual men have been sought to explain this relationship, but accumulating evidence favours the involvement of an infectious agent in the etiology of Kaposi's sarcoma. The most promising candidate today is a possible new herpesvirus, similar to but distinct from Herpes-virus saimiri and Epstein-Barr virus.

AIDS-Related Opportunistic Infections↗
PubMed1995

Risk of lung cancer in pre- and post-menopausal women with ano-genital malignancies.

Women diagnosed during the period 1943-1990 and reported to the Danish Cancer Registry with invasive squamous-cell carcinomas of the uterine cervix, vulva, vagina or anus, together with those having pre-cancerous lesions (CIN III or carcinoma in situ) of the uterine cervix diagnosed in the period 1958-1990, were followed for the occurrence of subsequent lung cancer over 762,000 person-years. Overall, these patients developed 2 to 2 1/2 times more lung cancers than women in the general Danish population. Women in whom cervical cancer was diagnosed recently, and before the age of 45 years, had a 4.6 times elevated risk of developing lung cancer, while young women with vulvar or vaginal cancer were at a 4.0-fold elevated risk. Similarly, women in whom anal cancer was diagnosed before the age of 60 years were at a 3.5-fold increased risk of developing lung cancer. The present study supports the hypothesis that smoking is involved in the aetiology of ano-genital malignancies. The particularly high risk of developing subsequent lung cancers seen in women who were pre-menopausal (< 45 years) at the time of the ano-genital cancer diagnosis suggests that the effect of smoking in ano-genital carcinogenesis might be partly mediated through alterations in oestrogen metabolism. Alternatively, patients who developed their initial ano-genital cancer at a young age might harbour some genetic susceptibility which could explain their excess lung-cancer risk.

Adult↗
PubMed1995

Carcinoid tumors in Denmark 1978-1989 and the risk of subsequent cancers. A population-based study.

BACKGROUND: Previous studies have suggested an excess cancer risk in patients with carcinoid tumors. This association was reexamined using truly population-based data. METHODS: By means of data from the Danish Cancer Registry all carcinoid tumors diagnosed in Denmark between 1978 and 1989 were identified. All patients with primary carcinoid tumors were studied for the occurrence of subsequent cancers. The numbers of subsequent cancers observed in the follow-up period were compared with the expected numbers calculated from population rates. RESULTS: A total of 1029 patients with carcinoid tumors were identified (464 men and 565 women). The annual age-adjusted incidence rates (world standardized) for carcinoid tumors during 1978-1989 were stable at about 1.1 per 100,000 person-years for both men and women. The patients were followed for the occurrence of subsequent cancers over a period comprising 2512 person-years. Thirty subsequent cancers were identified in 29 patients. The overall relative risk of subsequent cancers was 1.1 (95% CI, 0.8-1.6). Subsequent cancers of the thyroid were in excess (RR, 21.4; 95% CI, 2.4-77.1; n = 2), as were tumors of the brain and nervous system (RR, 5.4; 95% CI, 1.1-15.9; n = 3) and non-Hodgkin's lymphomas (RR, 5.8; 95% CI, 1.2-16.9; n = 3). CONCLUSIONS: Overall, this population-based study does not support previous studies of an excess cancer risk in patients with carcinoid tumors. Increased risks of cancers of the thyroid, tumors of the brain and nervous system, and non-Hodgkin's lymphomas were observed, but these findings were based on few cases.

Aged↗
PubMed1995

Evidence of an association between non-Hodgkin's lymphoma and skin cancer.

OBJECTIVE: To investigate a possible link between exposure to ultraviolet light and the almost epidemic increase in non-Hodgkin's lymphoma worldwide. Because ultraviolet light is known to cause skin cancers, the association between non-Hodgkin's lymphoma and skin cancer was studied. DESIGN: Secondary occurrence of either malignant melanoma or squamous cell skin cancer in cohorts of patients with a first diagnosis of either non-Hodgkin's lymphoma or chronic lymphocytic leukaemia, and vice versa, were studied. Expected numbers of subsequent cancers were calculated by sex, age, and period specific national incidence rates multiplied by the person years under observation in the cohorts. SETTING: Denmark (1943-89) and Sweden (1958-89). SUBJECTS: Four population based cohorts identified in the nationwide cancer registries (34,641 people with non-Hodgkin's lymphoma, 17,400 with chronic lymphocytic leukaemia, 34,989 with malignant melanoma, 25,980 with squamous cell skin cancer). A total of 562,085 person years were accrued for the analysis. MAIN OUTCOME MEASURES: The ratios of observed to expected cancers (the standardised incidence ratio) served as a measure of the relative risk. RESULTS: The relative risk for developing squamous cell skin cancer was 5.5 (95% confidence interval 4.6 to 6.6) among patients with non-Hodgkin's lymphoma and 8.6 (7.2 to 10.3) among patients with chronic lymphocytic leukaemia. The relative risks remained high over more than 15 years of follow up. Relative risks for malignant melanoma were 2.4 (1.8 to 3.2) for patients with non-Hodgkin's lymphoma and 3.1 (2.1 to 4.4) for patients with chronic lymphocytic leukaemia. After squamous cell skin cancer had been diagnosed there was a twofold excess risk for non-Hodgkin's lymphoma and chronic lymphocytic leukaemia. By contrast, in each of the cohorts the general cancer risks excluding skin and lymphoproliferative malignancies were close to the expected. CONCLUSIONS: The occurrence of non-Hodgkin's lymphoma and skin cancer are strongly associated; this supports the hypothesis that the secular increase in exposure to ultraviolet light may have contributed to the increasing incidence of non-Hodgkin's lymphoma in recent decades.

Age of Onset↗
PubMed1995

New primary cancers after squamous cell skin cancer.

In a search for clues to the origin of squamous cell skin cancer (SCC), the authors investigated the pattern of new cancers in a cohort of 5,100 SCC patients whose tumors were diagnosed during the years 1978-1989 and recorded in the Danish Cancer Registry. Subsequent cancer experiences in SCC patients were compared with the cancer incidence in the Danish population using ratios of observed cancers to expected cancers as a measure of the relative risk. Overall, patients with SCC were at increased risk of new malignancies (relative risk (RR) = 1.6, 95% confidence interval (CI) 1.5-1.7). Significantly elevated risks were found for cancers of the respiratory organs (RR = 1.7, 95% CI 1.4-2.0); cancers of the lip, buccal cavity, and pharynx (RR = 3.1, 95% CI 2.1-4.5); non-Hodgkin's lymphoma (RR = 2.3, 95% CI 1.4-3.5); leukemia (RR = 2.5, 95% CI 1.7-3.5); malignant melanoma (RR = 2.6, 95% CI 1.5-4.3); and cancer of the small intestine in men (RR = 4.1, 95% CI 1.1-10.6). The risk of new cancers (other than nonmelanoma skin cancers) was higher in patients diagnosed with SCC before the age of 60 years (RR = 1.9, 95% CI 1.5-2.5) than in those diagnosed with SCC at or after that age (RR = 1.3, 95% CI 1.2-1.4). The data confirmed previous strong associations between SCC and malignant melanoma and cancers of the major salivary glands. A previously undocumented significant excess of smoking-related cancers was observed after an SCC diagnosis, suggesting that smoking may be involved in the development of SCC. Since a variety of other squamous cell cancers have already been linked to smoking, the authors speculate that some general effect of smoking might act on all human squamous epithelia. The observed significant associations with lymphoma and leukemia and the high risk of subsequent malignancies in young SCC patients merit further attention.

Aged↗
PubMed1995

Changing patterns of Kaposi's sarcoma in Danish acquired immunodeficiency syndrome patients with complete follow-up. The Danish Study Group for HIV Infection (DASHI).

The objective was to study changes in the occurrence of human immunodeficiency virus type 1-related Kaposi's sarcoma and the association with degree of immunodeficiency over time. Danish patients with acquired immunodeficiency syndrome (AIDS) diagnosed between 1979 and 1990 (n = 687) were followed clinically and with consecutive CD4 cell count measurement from time of AIDS-defining illness to date of death or censoring date, whichever came first. The proportion of homo-/bisexual men (n = 520) with Kaposi's sarcoma (n = 100) at AIDS diagnosis declined from 31% before 1985 to 13% in 1990, whereas the proportion of patients who died with Kaposi's sarcoma remained constant over time. Furthermore, the CD4 cell count at time of AIDS for patients diagnosed with Kaposi's sarcoma has declined in recent years. A CD4 cell count < 200 x 106/liter at the time of AIDS diagnosis predicted an increased risk of developing Kaposi's sarcoma after the AIDS diagnosis. Age, antiretroviral therapy, and primary Pneumocystis carinii pneumonia prophylaxis failed to influence the development of Kaposi's sarcoma. Thus, the occurrence of Kaposi's sarcoma remained constant over time but developed later in the course of AIDS and was associated with more severe immunosuppression in recent years.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Benign anal lesions and the risk of anal cancer.

BACKGROUND: Benign anal lesions are often considered to cause a predisposition to anal cancer. To reexamine this association, we linked national data on hospital discharge and cancer in Denmark. METHODS: After making certain exclusions, we used the Danish Central Hospital Discharge Register to identify 68,549 patients hospitalized with benign anal lesions between 1977 and 1989. Through computerized linkage to the Danish Cancer Registry, all incident cases of epidermoid anal cancer and colorectal cancer among these patients were identified. Follow-up for the occurrence of cancer started the month after the date of the first hospital discharge and continued until the patient died (10.6 percent of the sample), emigrated (0.7 percent), or was lost to follow-up (0.04 percent) or until December 31, 1989 (88.6 percent), whichever came first. RESULTS: The median follow-up period was 6.2 years. There were 23 epidermoid anal cancers and 416 colorectal cancers. The overall relative risk of anal cancer (observed vs. expected cases) was 4.4 (95 percent confidence interval, 2.8 to 6.6). The relative risk was 12.0 (95 percent confidence interval, 5.2 to 23.6) within the first year after hospitalization for benign lesions, 4.6 (95 percent confidence interval, 2.3 to 8.3) from one to four years after hospitalization, and 1.8 (95 percent confidence interval, 0.5 to 4.7) five or more years after hospitalization. The risk of colorectal cancer was significantly increased only during the first year after hospitalization (relative risk, 2.6; 95 percent confidence interval, 2.1 to 3.1). CONCLUSIONS: There is a strong temporal association between the diagnosis of benign anal lesions and the diagnosis of anal cancer. Although we could not exclude the possibility of a moderate increase in the long-term risk of anal cancer, our data do not support the view that benign anal lesions cause anal cancer.

Anus Diseases↗
PubMed1994

Malignancies that occur before and after anal cancer: clues to their etiology.

With the use of two different approaches to study multiple primaries in anal cancer patients, the authors sought clues to the etiology of anal cancer. Based on data from the Danish Cancer Registry for 1943-1989, previous cancers in 831 anal cancer patients were compared with cancers in 12,376 matched population controls, and subsequent cancers in 955 anal cancer patients were compared with expected numbers based on population rates. Overall, previous cancers were in excess among anal cancer patients (odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.3-2.1). Elevated risks were observed especially for the vulva/vagina (OR = 15.4, 95% CI 4.9-48.0), cervix (OR = 4.3, 95% CI 2.7-6.9), and lymphoma/leukemia (OR = 3.9, 95% CI 1.5-10.4). Subsequent cancers were also in excess (relative risk (RR) = 1.4, 95% CI 1.1-1.7), particularly for the lung (RR = 2.3, 95% CI 1.3-3.7), bladder (RR = 2.3, 95% CI 1.0-4.6), breast (RR = 2.0, 95% CI 1.2-3.3), vulva/vagina (RR = 12.3, 95% CI 4.0-28.7), and small intestine (two cases) (RR = 10.8, 95% CI 1.2-39.0). Colorectal cancers were reduced (RR = 0.3, 95% CI 0.1-0.9). The data support a multifactorial etiology for anal cancer, in which an infectious agent and smoking may be involved. The association with lymphatic/hematopoietic cancers may indicate a possible role for immunodeficiency in anal cancer development. Multiple cancers occurred predominantly in patients diagnosed with anal cancer at a young age (< 60 years), which raises the possibility of a genetic predisposition for some cases. The authors recommend that, in future hypothesis generating and hypothesis testing multiple cancer studies of rare malignancies, the combined study of cancer events both prior to and following an index cancer should be considered.

Age Factors↗
PubMed1994

Changing patterns of anal cancer incidence in the United States, 1940-1989.

Anal cancer has been hypothesized to be associated with a sexually transmitted agent and, more recently, with the epidemic of human immunodeficiency virus (HIV). The authors used a descriptive incidence study to evaluate these hypotheses based on US data from the Surveillance, Epidemiology, and End Results (SEER) program for 1973-1989 and from the Connecticut Tumor Registry for 1940-1988. Since 1960, anal cancer incidence in Connecticut increased 1.9-fold among men and 2.3-fold among women. Based on information from SEER, the incidence was lowest among white men (1973-1989 average: 0.41/100,000) and highest among black women (1973-1989 average: 0.74/100,000). Residents of the metropolitan areas had a twofold risk of anal cancer compared with populations in less densely populated areas. The most dramatic change in incidence was observed for white men in the San Francisco Bay area, among whom the incidence increased from 0.5/100,000 in 1973-1975 to 1.2/100,000 in 1988-1989 (p trend < 0.001). The relative risks (95% confidence intervals) of anal cancer among never married men compared with ever married men in the urban areas rose from 5.8 (0.9-8.7) in 1973-1978 to 6.7 (4.7-9.5) in 1979-1984 and 10.3 (7.5-14.1) in 1985-1989 (p trend = 0.02). No significant difference was observed among women. In conclusion, anal cancer incidence in the United States has increased significantly during the past 30 years and is now higher in women than men, in blacks than whites, and in residents of metropolitan rather than rural areas. Some of this changing pattern clearly relates to the period prior to the acquired immunodeficiency syndrome (AIDS) epidemic and argues that behavioral changes are important in anal cancer development. However, the recent remarkable change in rates among never married men and men living in the San Francisco Bay area suggests that homosexual men are at special and increasing risk. The authors speculate whether part of this recent increase could be attributed to the AIDS epidemic.

Adult↗
PubMed1994

High incidence of anal cancer among AIDS patients. The AIDS/Cancer Working Group.

Until now, the only cancers that have been strongly associated with AIDS are Kaposi's sarcoma and non-Hodgkin lymphoma. We used a linkage between AIDS (50,050 reports) and cancer (859,398 reports) registries in seven health departments in the USA to investigate the association between HIV infection and epidermoid anal cancer. We compared the numbers of observed cases and expected cases, calculated from general population rates with adjustment for age, sex, and race. The relative risk of anal cancer at and after AIDS diagnosis was 84.1 (95% CI 46.4-152) among homosexual patients (11 cases) and 37.7 (9.4-151) among non-homosexual patients (2 cases). The relative risk of anal cancer up to 5 years before the AIDS diagnosis (23 cases) was also increased; it was 13.9 (6.6-29.2) in the period 2-5 years before AIDS and 27.4 (15.9-47.2) during the 2 years before AIDS diagnosis (p for trend = 0.004). Among homosexual men, the relative risk of anal cancer was inversely related to age at AIDS onset (p for trend < 0.001). Excess risks were found in all geographical areas. This study establishes a strikingly increased risk of anal cancer among people with AIDS. These data are consistent with a previously hypothesized association between HIV-induced immunodeficiency and anal cancer development, but because homosexual men were at increased risk of anal cancer even before the AIDS epidemic, we cannot say how much of the increased risk is attributable to HIV infection. Nevertheless, clinicians should be aware that AIDS patients have an increased risk of anal cancer.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Risk of other cancers following Kaposi's sarcoma: relation to acquired immunodeficiency syndrome.

To evaluate the risk of another cancer among persons who initially developed Kaposi's sarcoma, the authors used data from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute for the years 1973-1990. In persons under 70 years of age, 4,946 cases of Kaposi's sarcoma were observed during the period 1980-1990 (6,217 person-years of follow-up). On the basis of rates seen during the period prior to the epidemic of acquired immunodeficiency syndrome (AIDS), 169 cases were expected. Therefore, cases of Kaposi's sarcoma in this group were assumed to be AIDS-related, while cases occurring in older persons or during the 1970s were assumed to be non-AIDS-related. Rates were compared with the numbers of cases expected overall and by site on the basis of age-, sex-, and calendar year-specific rates from the SEER data. Among the 4,946 persons with AIDS-related Kaposi's sarcoma, the risk of developing non-Hodgkin's lymphoma through 1990 was increased 198-fold (95% confidence interval 169-232). However, the risk of all other cancers was only marginally increased (1.5-fold; 95% confidence interval 0.95-2.3), a risk that was probably biased upward because of ascertainment and misclassification. Among 491 persons with non-AIDS-related Kaposi's sarcoma, the relative risk of all cancers, including non-Hodgkin's lymphoma, was 0.9 (upper 95% confidence limit 1.2), and the risk of non-Hodgkin's lymphoma alone was 0.6 (upper 95% confidence limit 3.3). As of 1990, the risk of having another cancer following Kaposi's sarcoma was increased only in persons infected with human immunodeficiency virus, who were at high risk of non-Hodgkin's lymphoma but probably not of other cancers as a whole.

Acquired Immunodeficiency Syndrome↗
PubMed1994

A profile of HIV-risk behaviours among travellers--a population based study of Danes visiting Greenland.

The population of Greenland has behavioural characteristics that indicate a high risk of HIV spread once HIV is introduced into the population. Much depends, however, on the degree of exposure from visitors, particularly in an initial phase. We used a national questionnaire survey of 4,680 randomly selected Danes between 18-59 years to study HIV risk behaviours among Danes with (+travellers) and without (-travellers) travel experience to Greenland. Median number of lifetime sexual partners was more than twice as high among male +travellers (median = 12 partners) compared to -travellers (median = 5; p < 0.0001) and also slightly higher among women (p = 0.03). Furthermore, a significantly higher percentage of male +travellers than -travellers reported prostitute contact (OR = 2.3 (95% CI: 1.4-3.9)), with a peak of 32.0% among men aged 40-49 years. A history of a sexually transmitted disease was three times (95% CI: 2.0-4.5) as common among +travellers as in -travellers. +Travellers were also significantly more likely to have visited other places outside Europe and Greenland, including HIV endemic areas (OR = 2.9 (2.0-4.1)). Overall, sexual contact with someone considered at high risk of HIV infection (a homo/bisexual man, intravenous drug user, prostitute, or previous or present resident of Sub-Saharan Africa) was reported by 33.5% of male +travellers compared to 15.6% of -travellers and among women by 9.7% and 5.0%, respectively. In conclusion, travellers tend to have more sexual partners and more sexual interaction with high HIV-risk group members than non-travellers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Mandatory anonymous HIV surveillance in Denmark: the first results of a new system.

OBJECTIVES: This paper describes the principles and first results of the newly implemented anonymous mandatory human immunodeficiency virus (HIV) reporting system in Denmark. METHODS: The system is based on a serially numbered form that is circulated among the laboratories, the physicians, and the national surveillance unit. All laboratories doing confirmatory tests for HIV antibodies must send a report form along with any positive test results. Before forwarding the form, the laboratory is to fill in the top part with the name and address of the requesting physician and send the back copy to the surveillance unit. The physicians are mandated by law to fill in the form with data on the patient and to keep two copies for their own files before sending the original to the surveillance unit. RESULTS: After a revision of the system, a response rate of 95% was obtained. CONCLUSIONS: We have established an anonymous mandatory HIV surveillance system in Denmark that enables routine evaluation of the completeness of reporting and nonresponding physicians to be reminded of their duty to report. Also, the physicians can act as mediators between patients and researchers; therefore, nested studies can be done without breaking the anonymity of the patient.

AIDS Serodiagnosis↗
PubMed1993

Trends in incidence of anal cancer in Denmark.

OBJECTIVE: To study long term trends in incidence of anal cancer in a well monitored, unselected population. DESIGN: Descriptive epidemiological study based on data from the Danish Cancer Registry. SETTING: Denmark, 1943-87. MAIN OUTCOME MEASURES: Time related changes in anal cancer incidence according to sex, age, birth cohort, urban or rural residence, and marital status. RESULTS: The incidence of anal cancer remained fairly constant in the period 1943-57 and was similar for men and women, but it increased 1.5-fold among men and nearly tripled among women thereafter. Among men the incidence increased from 0.25 per 100,000 population (world standardised) in 1958-62 to 0.38 in 1983-7 (p = 0.01) and among women from 0.28 to 0.74 (p < 0.01). The greatest increase was among residents of the capital (Copenhagen). During 1943-87 age specific trends increased in young and middle aged men and in all age groups among women. Men with anal cancer were significantly more likely throughout the study period to be unmarried than were patients with cancer of the colon (adjusted odds ratio 2.7; 95% confidence interval 2.0 to 3.6) and stomach (2.1; 1.5 to 2.8), but no association with marital status was found among women. CONCLUSIONS: The distribution and incidence of anal cancer have changed appreciably since around 1960, especially among women, which indicates important aetiological changes. Changes in sexual behaviour may have facilitated the spread of a transmittable agent of aetiological importance. It has recently been suggested that cigarette smoking promotes anal cancer, and this finds indirect support in the synchronism between changes in anal cancer incidence and heavy smoking behaviour. Factors associated with homosexuality are likely to explain some of the cases among men.

Adult↗
PubMed1993

Changes in knowledge of HIV/AIDS, sexual behaviour and practice among STD patients in Greenland 1990-1992. Monitoring the Stop-AIDS campaign in Greenland.

Due to a high incidence of STDs Greenland is considered to be a high risk area for an AIDS epidemic, and a close monitoring system has been set up to monitor the spread of HIV and changes in knowledge and sexual norms. This is the second report from surveys of knowledge, sexual behaviour and practice and STD patients i Greenland. Data were collected by means of self administered questionnaires in 1990 to 1992 in Nuuk, Sisimiut and Angmagssalik. The results from Nuuk in 1992 are compared with results from a similar survey from 1990.

Adolescent↗
PubMed1993

[The Anders Jahre Prize for young researchers 1992. HIV/AIDS--an epidemiological challenge].

Mads Melbye was awarded the Anders Jahre prize for young scientists in 1992 for his research into epidemiological infections. His pioneering work, which has elucidated the manner in which HIV and AIDS are transmitted sexually and via contaminated blood, has been of fundamental importance in understanding AIDS as an infectious disease. The article describes how this knowledge was obtained, and how it has added to our understanding of the pathogenesis of other diseases--here exemplified by a type of cancer.

Acquired Immunodeficiency Syndrome↗