Biomedical subjects
P Watson
Publications and source records attributed to P Watson.
Communication. Towers of Babel?
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Protected environment units for the cancer patient.
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Case study: Mary is a healthy 33-year-old woman concerned about her risk of breast cancer.
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The tumor spectrum in HNPCC.
HNPCC is an inherited disorder characterized by an increased risk for cancers of the colorectum and endometrium. An increased risk of cancer of other organs, and heterogeneity among HNPCC families in extracolonic cancer risk, has been hypothesized. We evaluated these hypotheses in a study of 1317 high risk members of 23 HNPCC families. Expected numbers of cancer occurrences were calculated from general population incidence data, and compared to observed numbers. The distribution of cancers among families was compared to the distribution expected under the hypothesis of uniform risk. Significant excesses of cancers of the stomach, small bowel, hepatobiliary system, upper urologic tract, and ovary were found. Gastrointestinal tract cancers were uniformly distributed among families, but urologic tract and gynecologic tract cancers were significantly heterogeneously distributed. Our results indicate that HNPCC family members are at increased risk for cancer at specific extracolonic sites. We also found evidence of heterogeneity among HNPCC families in the risk for some extracolonic cancers.
The epidemiology of endometrial cancer in hereditary nonpolyposis colorectal cancer.
Family members from hereditary nonpolyposis colorectal cancer (HNPCC) families are at an increased risk of developing endometrial cancer. The present study was performed to investigate the epidemiology of endometrial cancer associated with HNPCC. Data on 125 cases of endometrial cancer from HNPCC families were collected from seven countries. The mean age at diagnosis was 48 years (range: 27-72 years). Fifty-seven percent of the cases were diagnosed under 50 years of age and 98 percent under 65 years. The mean ages at diagnosis of endometrial cancer were not significantly different between the countries. At the time of the investigation, 58 of the 125 cases had died (mean age at death: 59 years; range: 32-88 years). Fifteen of the 125 (12%) patients died from endometrial cancer. In 75 of the 113 (61%) endometrial cancer cases, a second primary cancer occurred. Most of these cancers (54 out of 75) were colorectal cancers. In 18 (15%) of the cases of endometrial cancers, more than two primary cancers occurred. In conclusion, endometrial cancer in HNPCC develops at a significant earlier age than in the general population. More than half of the cases had a second primary tumor. Endometrial cancer is an infrequent cause of death in the HNPCC families. A prospective study is warranted to assess the value of surveillance for endometrial cancer in these families.
HIV transmission ideas outdated.
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Adenoma follow-up in at-risk Lynch syndrome family members.
Persons at 50% risk of Lynch Syndrome were screened with colonoscopy at six or twelve month intervals. On initial exam, eight of fifty-five patients had adenomas. Follow-up was available in 27 patients (mean 35.5 months). Estimated time to finding new adenomas was 58 months for patients clear on first colonoscopy and 16 months for patients who had adenomas on first exam (p < 0.01). One adenocarcinoma has been found, arising in a tubulovillous adenoma. The short-term risk of colorectal cancer in Lynch syndrome relatives without adenomas is low, as is the risk in those who had all adenomas removed.
A prisoner of prejudice.
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