Use of cancer controls in case-control cancer studies.
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Epidemiologic Methods↗
Biomedical subjects
M S Linet
Publications and source records attributed to M S Linet.
Serum protein electrophoresis patterns in chronic lymphocytic leukemia. Clinical and epidemiologic correlations.
Serum protein electrophoresis (SPEP) data obtained at diagnosis were available for 98 of 342 patients with chronic lymphocytic leukemia (CLL) identified in a population-based case-control epidemiologic study. Patients tested with SPEP at diagnosis were significantly younger, more likely to have lymphadenopathy, and more likely to have had their conditions diagnosed at a university hospital than those not tested. Four categories of electrophoretic patterns were identified: normal (N = 56), hypogammaglobulinemia (N = 28), hypergammaglobulinemia (N = 11), and monoclonal gammopathy (N = 3). A higher proportion of those with hypergammaglobulinemia were black, and patients with hypergammaglobulinemia and monoclonal gammopathy were more likely to die within the first year following diagnosis than patients in the other SPEP groups. No association was found, however, between SPEP pattern and a clinical staging classification for CLL. These findings suggest that SPEP may be a useful adjunct in categorizing possible subtypes of CLL and developing future clinical staging classifications.
Agammaglobulinemia↗
Comparison of methods for determining occupational exposure in a case-control interview study of chronic lymphocytic leukemia.
A comparison was made between two indirect methods for linking reported lifetime occupations and industries of employment with specific exposures and with directly reported exposure information, using data from a population-based case-control interview study of chronic lymphocytic leukemia (CLL). Exposures previously suspected of being associated with CLL were examined using a job-exposure matrix developed by Hoar et al and a linkage between observed occupational exposures and specific occupations, by industry, based on data collected in the National Occupational Hazard Survey (NOHS). In general, concordance on exposure for the two occupation-exposure linkage methods was fairly poor, although it was better for some of the exposures studied (butadiene and asbestos, for which most kappas were between 0.40 and 0.60) than for others (carbon tetrachloride and benzene with kappas ranging from 0.01 to 0.12). Higher proportions of cases and controls directly reported exposure to benzene and asbestos than was determined using the two more indirect methods, neither of which showed consistently greater agreement with direct reporting.
Epidemiologic Methods↗
Chronic lymphocytic leukemia and acquired disorders affecting the immune system: a case-control study.
The relationship of a number of subacute or chronic infectious diseases, connective tissue or autoimmune disorders, allergic conditions, and surgical excision of lymphoid tissue with chronic lymphocytic leukemia (CLL) was examined in a case-control study involving 342 cases and 342 matched controls. In both analyses of all matched pairs and those pairs in which both subjects were respondents, no statistically significant association was found between a history of subacute viral infections or subacute and chronic bacterial infections and CLL. Connective tissue or autoimmune disorders also were found not to be associated with CLL. Examination of the association between several allergic conditions and CLL suggested a protective effect as did a "dose-response" analysis, although none of the individual disorders showed a statistically significant relationship; however, a test for linear trend was significant (P = .04). Similarly, examination of the relationship between surgical excision of lymphoid tissue in several anatomic locations and CLL showed a protective effect, statistically significant for tonsillectomy-adenoidectomy (odds ratio = 0.69; 95% confidence interval = 0.48, 0.98). A statistically significant negative dose-response relationship, substantiating the protectiveness of the effect, was found.
Aged↗
Incidence of aplastic anemia in a three county area in South Carolina.
An apparent cluster of four aplastic anemia (AA) cases in teenagers residing in a small South Carolina town was further investigated. Incidence of AA in all age groups in a surrounding three county area (TCA) over a 12-year time interval was determined and compared with AA incidence rates in Baltimore, representing the only known population based United States incidence data. The same general age-specific incidence pattern (based on 27 cases in the TCA and 118 in Baltimore) was found in the two areas, both overall and for the four race-sex groups. Although based on small numbers, nonwhite average annual age-adjusted rates for males and females were higher in the TCA (6.8 and 13.7 per million) than in Baltimore (4.7 and 7.3). For whites, TCA rates were 11.7 and 5.4 (for males and females) and Baltimore rates were 7.1 and 5.4. The differences for non-whites in the two areas may indicate a greater prevalence of risk factors for AA in the TCA than in Baltimore, but the small numbers of cases and the lack of comparable data from other areas of the country, together with the possibility of misdiagnosis of the disease, make definitive conclusions impossible.
Age Factors↗
An apparent cluster of aplastic anemia in a small population of teenagers.
Four teenagers with severe aplastic anemia, initially diagnosed and evaluated over a seven-year period at The Johns Hopkins Bone Marrow Transplant Unit, Baltimore, were residents of the same small town in South Carolina. Estimated annual incidence for that age group in the town, based on the four cases, was 100 times the expected rate. All four of the teenagers had attended one of two junior high schools. An exploratory survey of all high-school students, comparing risk factors of those who had attended the "affected" junior high school with those who had attended the "unaffected" junior high school, showed no associations with exposure to glue, paint or varnishes, pesticides, history of hepatitis or infectious mononucleosis, or use of chloramphenicol or other suspected drugs. Weak associations were found between the affected junior high school and employment in the textile industry and in agriculture (specifically peach orchards).
Adolescent↗
Migraine headache: epidemiologic perspectives.
Clinical and epidemiologic studies suggest that a number of factors are associated with the risk of migraine and precipitation of an attack. However, the degree to which causal associations can be inferred from reported studies is very limited and is a result of the methodological problems discussed throughout this review. The study of migraine in many ways parallels the pattern seen in early investigations of other conditions, such as rheumatoid arthritis and systemic lupus erythematosus, because a number of methodological problems had to be resolved in the study of these conditions before significant progress could be made. To achieve significant advances in the improvement of our understanding of the causes of migraine, a number of related issues must be addressed and resolved in future studies. Most noteworthy among these are Recognition of the probable heterogeneity of migraine, not merely in the manifestation of symptoms but, more importantly, in the existence of distinct etiologic subtypes. A number of findings suggest that some migraine subtypes are sensitive to certain precipitants, some appear to be a part of a more generalized constitutional disorder, and some are accompanied by a higher prevalence of migraine among family members. Efforts should be made in understanding the relationship between specific biochemical markers and traits (such as monoamine oxidase deficiency and tyramine sensitivity); precipitants related to the migraine attack; and epidemiologic characteristics such as age at onset and sex. Creation of a more precise, reliable, and practically useful definition of migraine. Without such a definition, it is difficult, if not impossible, to compare results between studies, to understand the relationship between risk factors and migraine subtypes, to understand properly associations identified in selected clinic populations, and, in general, to understand the epidemiology of migraine. More accurate characterization of the case group under study. More documentation of the age at onset, symptoms, frequency of attacks, and other characteristics related to migraine would be very useful to compare properly results between studies. Additional descriptive epidemiologic studies of migraine which would include reliable estimates of age-specific incidence, prevalence, remission rates, and natural history of the various migraine subtypes.(ABSTRACT TRUNCATED AT 400 WORDS)
Adolescent↗
Compliance with cancer therapy by patients and physicians.
Although compliance with treatment regimens has been shown to be a significant problem in many areas of medicine, there are little data quantitatively describing the extent of the compliance problem for cancer patients. Traditionally, compliance has been understood as the degree to which a patient's behavior coincides with the prescribed medical regimen. However, patient behavior may be only one of several factors that determine compliance; other important components may include physician behavior, the patient-physician relationship, and the patient's support system, including family. In this report, we review the literature on cancer compliance in terms of the patient, the physician, and patient-physician relationships. Subgroups of patients are identified as appropriate for compliance research, and methodologic considerations and research strategies are explored.
Adolescent↗
The prevalence and incidence of juvenile rheumatoid arthritis in an urban Black population.
We determined the prevalence and incidence of juvenile rheumatoid arthritis (JRA) in an urban Black population in Baltimore, identifying three cases through review of computerized outpatient encounters and a fourth case by reviewing discharge records at area hospitals. The prevalence of JRA among Blacks, as of December 31, 1980, was estimated as 0.26 per 1,000 (95 per cent confidence interval: 0.07, 0.66), the average annual incidence 6.6 per 100,000 per year (0.8, 23.8) for the years 1979 and 1980. These data suggest that Black race is not associated with significantly increased risk of development of JRA.
Adolescent↗
Benzene, leukemia, and the Supreme Court.
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Benzene↗
Is cigarette smoking a risk factor for non-Hodgkin's lymphoma or multiple myeloma? Results from the Lutheran Brotherhood Cohort Study.
Among 17,633 U.S. white male insurance policy holders whose use of tobacco was characterized in a 1966 self-administered questionnaire, there were 49 deaths from non-Hodgkin's lymphoma (NHL) and 21 from multiple myeloma (MM) during a 20-year follow-up. Men who had ever smoked cigarettes had an elevated mortality from NHL (RR = 2.1; CI = 0.9-4.9), with risk almost four-fold greater among the heaviest smokers (RR = 3.8; CI = 1.4-10.1) compared with those who used no tobacco. In contrast, risk of MM was only slightly elevated among those who had ever smoked cigarettes (RR = 1.3; CI = 0.4-3.9) and without evidence of a dose-response trend. Since this is the first cohort study suggesting a link between cigarette smoking and NHL and findings from case-control studies have been inconsistent, additional clarification should be sought from larger incidence-based cohort investigations.
Adult↗
Multiple myeloma and occupation in Sweden.
The occurrence of multiple myeloma by occupational and industrial category was systematically assessed using the Swedish Cancer-Environment Registry, which links cancer incidence (1961-1979) with occupational data from the 1960 census. Incidence of multiple myeloma was significantly increased for a number of occupational groups such as farmers, smelter and metallurgy workers, and miners-quarrymen-rock blasters. Although caution must be applied in drawing causal inferences, this national linked-registry analysis may provide clues to the environmental determinants of multiple myeloma.
Humans↗
Chronic lymphocytic leukemia and multiple myeloma in husband and wife.
Chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) are rare, B-lymphocyte malignancies of unknown etiology. CLL appears to have a strong familial component; MM has also been reported in families but to a lesser extent. Clinical reports have suggested associations between each of these disorders and prior history of chronic antigenic stimulation from chronic infections, inflammatory or autoimmune diseases; chronic use of certain drugs; and various occupational exposures thought to be related to certain chemicals. Hypotheses as to possible etiologic agents or exposures are usually suggested by clinical clues from in-depth medical histories. We report four suspect exposures shared by a husband and wife who developed the rare, B-cell tumors, CLL and multiple myeloma.
Aged↗
Migraine headaches and panic attacks.
Migraine headache and panic attacks are two common conditions which first occur at an early age and appear to have a number of underlying physiologic abnormalities in common. In a population-based telephone interview survey examining headache occurrence in approximately 10,000 subjects, 12-29 years old, we assessed the prevalence of panic disorder (and a less severe entity designated as panic syndrome) using an abbreviated version of the National Institute of Mental Health Diagnostic Interview Survey. Subjects with panic disorder or panic syndrome reported more frequent occurrence of headaches during the preceding week, as well as headaches of longer duration and substantially more headaches with migraine symptoms than individuals without a history of panic attack. Males with panic disorder were 7 times more likely than those without this condition to report the occurrence of a migraine headache in the previous week. In addition, 5.5% of males and 9.5% of females with panic disorder or panic syndrome reported 25% of the total migraine headaches described by all study subjects in the one-week recall period.
Adolescent↗
Headache characteristics associated with physician consultation: a population-based survey.
In a population-based telephone interview survey of 9,380 Washington County, Maryland, residents 12-29 years of age who reported a headache in the prior year, only 26.7% of women and 13.6% of men had ever sought a physician's advice for a headache problem. Women (13.9%) were more than twice as likely as men (5.6%) to have consulted a doctor for this condition within the previous 12 months. The likelihood of seeking medical care for headache increased with age among women but not men. Married women were more likely to have consulted with a physician for a headache problem than single or divorced women. Men and women consulting a doctor for this disorder within the previous 12 months described recent headaches (within the prior week) that were more severe, of longer duration (women only), and more likely to have migraine characteristics than recent headaches of persons not seeking medical attention. Compared with persons never consulting a physician for a headache problem, men and women who sought medical care had elevated attack rates of certain, probable, and possible migraine and mixed migraine-tension type headaches within the preceding week. Differences in attack rates for migraine and mixed migraine-tension headaches between those who recently and those who more than 12 months ago sought a physician's advice were more striking for men than for women.
Adolescent↗