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Biomedical subjects

R C Brownson

Publications and source records attributed to R C Brownson.

At least 109 records · Page 6Linked to original sources
PubMed1992

Gender and histologic type variations in smoking-related risk of lung cancer.

We conducted a registry-based case-control study to examine the relation between smoking and lung cancer by gender and histologic type. Our analyses were based on 14,596 cases and 36,438 age-matched controls. Relative risk associated with ever-smoking, and level of smoking was consistently higher in females than males for all lung cancers combined (ever-smoking odds ratios: 12.7 for females and 9.1 for males) and for each histologic type except adenocarcinoma. Female-male differences in relative risk were larger in younger age groups. The largest estimates of the attributable fraction due to smoking were observed for small cell carcinoma (97% in females and 91% in males); conversely, the smallest value was noted for adenocarcinoma (86% in females). Although our study was unable to measure absolute risk, our findings, other recent studies, and contemporary female smoking patterns raise concerns that female smokers may assume a proportionally greater burden of lung cancer morbidity and mortality in the future.

Adenocarcinoma↗
PubMed1992

Demographic and socioeconomic differences in beliefs about the health effects of smoking.

To assess sociodemographic differences in beliefs about the health effects of cigarette smoking and passive smoke exposure, we recently surveyed 2092 adults in St. Louis and Kansas City, Mo. The percentages of respondents who knew that smoking causes lung cancer, emphysema, and heart disease were 76.7, 74.1, and 67.2, respectively. After multivariate adjustment, knowledge about smoking's health effects was generally lower among women, older respondents, those of lower education level, and current smokers. Blacks were generally less likely to appreciate the health effects of active smoking, but were more likely to acknowledge the health effects of passive smoking.

Adolescent↗
PubMed1992

Passive smoking and lung cancer in nonsmoking women.

OBJECTIVES: The causes of lung cancer among nonsmokers are not clearly understood. To further evaluate the relation between passive smoke exposure and lung cancer in nonsmoking women, we conducted a population-based, case-control study. METHODS: Case patients (n = 618), identified through the Missouri Cancer Registry for the period 1986 through 1991, included 432 lifetime nonsmokers and 186 ex-smokers who had stopped at least 15 years before diagnosis or who had smoked for less than 1 pack-year. Control subjects (n = 1402) were selected from driver's license and Medicare files. RESULTS: No increased risk of lung cancer was associated with childhood passive smoke exposure. Adulthood analyses showed an increased lung cancer risk for lifetime nonsmokers with exposure of more than 40 pack-years from all household members (odds ratio [OR] = 1.3; 95% confidence interval [CI] = 1.0, 1.8) or from spouses only (OR = 1.3; 95% CI = 1.0, 1.7). When the time-weighted product of pack-years and average hours exposed per day was considered, a 30% excess risk was shown at the highest quartile of exposure among lifetime nonsmokers. CONCLUSIONS: Ours and other recent studies suggest a small but consistent increased risk of lung cancer from passive smoking. Comprehensive actions to limit smoking in public places and worksites are well-advised.

Adult↗
PubMed1991

Cigarette smoking and risk of adult leukemia.

A case-control study investigated the relation between cigarette smoking and histologic subtypes of adult leukemia in Missouri in 1984-1990. Among males, elevated risks associated with ever smoking were observed for acute nonlymphocytic leukemia (odds ratio (OR) = 1.5; 95% confidence interval (CI) 1.1-2.0) and acute myelocytic leukemia (OR = 1.5; 95% CI 1.1-2.1). Females also showed an increased risk of acute nonlymphocytic leukemia associated with ever smoking (OR = 1.4; 95% CI 1.0-1.9), with an increasing trend in risk by level of smoking (p less than 0.01). Attributable risk estimates of the proportion of acute nonlymphocytic leukemia caused by smoking were 33 percent in males and 29 percent in females. Elevations in risk were not apparent for chronic forms of leukemia. The findings support the hypothesis that some types of leukemia may be etiologically related to cigarette smoking.

Adult↗
PubMed1991

Underestimates of student substance use by school personnel: a cause for concern?

The present study was designed to compare school personnel's (i.e., principals, counselors, teachers) estimates of student substance use with student self-reported data. Comparisons were made in 78 schools between 5431 student self-reports of tobacco, alcohol, and drug use and 170 school personnel's estimates of student substance use. The results indicated that a significant number of school personnel were unable to estimate student substance use. Personnel who did provide estimates typically underestimated the degree of substance use, in comparison to student self-reported substance use. School personnel did not significantly overestimate use in comparison to student self-reported substance use for any substance in any grade or geographic area. It is suggested that school personnel may resist the adoption of prevention programs because of a perceived lack of need due to underestimation of the substance use problem.

Adolescent↗
PubMed1991

Physical activity on the job and cancer in Missouri.

We conducted a series of case-control studies to investigate the risks of 16 cancer types in relation to occupational physical activity. These studies were based on Missouri Cancer Registry data for 17,147 White male cancer patients registered between 1984 and 1989. Colon cancer risk was increased for both the moderate (odds ratio (OR) = 1.1; 95% confidence interval (CI) = 1.0, 1.3) and low (OR = 1.2; 95% CI = 1.0, 1.5) activity levels. Similar elevations were observed for prostate cancer at the moderate (OR = 1.1; 95% CI = 1.0, 1.3) and low (OR = 1.5; 95% CI = 1.2, 1.8) levels of activity, and for cancer of the testis at the low activity level (OR = 2.2; 95% CI = 1.3, 3.7). An opposite trend (p less than 0.01) was noted for lung cancer, which showed decreased risk at the moderate (OR = 0.9; 95% CI = 0.8, 1.0) and low (OR = 0.8; 95% CI = 0.6, 0.9) activity levels. These associations suggest that further study of the relationship between physical activity and site-specific cancer risk is warranted.

Case-Control Studies↗
PubMed1991

Association of brain cancer with dental X-rays and occupation in Missouri.

This investigation of a brain cancer cluster in Missouri used two approaches to investigate associations with potential risk factors. In a case-control study in a rural town, we interviewed surrogates of cases and controls about potential risk factors. We found a statistically significant positive association of brain cancer with reported exposure to dental X-rays. Occupation was not associated with the cluster in the rural town. In a standardized proportional mortality study for the state of Missouri, we calculated the observed and expected proportion of brain cancers by occupation and industry in Missouri decedents. We found that motor vehicle manufacturers, beauty shop workers, managers and administrators, elementary school teachers, and hairdressers and cosmetologists had significantly elevated proportions of brain cancer. Brain tumors are inconsistently associated with occupation in the literature. Further study of brain cancer etiology with respect to dental X-ray exposures seems warranted.

Adult↗
PubMed1990

Patterns of cigarette and smokeless tobacco use among children and adolescents.

Although cigarette and smokeless tobacco use are recognized as major problems among school-age youth, few nationwide or statewide data exist on the prevalence and patterns of use. To determine the patterns of tobacco use among children and adolescents in Missouri, self-report information was obtained from a representative sample of 5,431 students in grades 5, 8, and 12. Both cigarette smoking and smokeless tobacco use were more common among males than females for each grade level except the 12th, where 30% of females and 28% of males had smoked during the previous week. Smoking prevalence was considerably lower among blacks than whites. Smokeless tobacco use was rare among both blacks and females. Smokeless tobacco use was more common than cigarette smoking in rural areas, where 17% of 8th-grade males and 31% of 12th-grade males had used smokeless tobacco during the previous week. The mean age at first use of cigarettes was slightly lower in the rural than the urban area, whereas the mean age of initial smokeless tobacco use was more than a year earlier in the rural area. Data regarding the perceived difficulty of quitting smoking and quit rates suggested that adolescent females have more difficulty quitting smoking than males. Male smokeless tobacco users appeared to be more addicted than male cigarette smokers. Smokeless tobacco brand preference indicated that users may switch to progressively stronger types of smokeless tobacco as they get older and a nicotine tolerance is developed. The current study emphasizes the urgent need for carefully targeted tobacco prevention and cessation efforts among school-age youth.

Adolescent↗
PubMed1990

A public health response to cancer clusters in Missouri.

A protocol was developed in 1984 by the Missouri Department of Health to provide a systematic method for responding to citizen reports of cancer clusters. This protocol integrates public health and environmental expertise and includes two stages: the preliminary review and the investigation. The preliminary review is focused on problem definition and hypothesis generation. Cancer mortality and incidence data are reviewed. Information is gathered and verified through the efforts of citizens, local health officials, environmental staff, and the cancer program staff. Epidemiologic factors evaluated include type of cancer, temporal and spatial relations, population at risk, community profile, and possible environmental and occupational factors. The investigation is an expanded analytic study. Resources are focused on cancer inquiries that appear most likely to involve manageable common exposures. Program experience and protocol development highlights, including surveillance system improvement and educational programming, are described.

Causality↗
PubMed1990

An analysis of occupational risks for brain cancer.

We evaluated the risks of brain cancer in relation to employment history in a case-control study of 312 cases and 1,248 cancer controls. Subjects were identified through the Missouri Cancer Registry for the period 1984 through 1988. Job classification was based on data routinely abstracted from hospital records. Elevated risks were identified for certain white collar occupations: for men employed in engineering, the odds ratio (OR) = 2.1; 95% confidence interval (CI) = 0.4, 10.3; for social science professionals, the OR = 6.1; 95% CI = 1.5, 26.1. Among occupations with potential exposure to occupational carcinogens, increased risks were observed for men employed in agricultural crop production (OR = 1.5; 95% CI = 1.0, 2.4), printing and publishing (OR = 2.8; 95% CI = 1.0, 8.3), and brickmasons and tilesetters (OR = 2.5; 95% CI = 0.5, 11.5). Most of elevated brain cancer risks were due to astrocytic cancers, but the excess among agricultural workers occurred in other cell types. No increase in risk was noted for current cigarette smokers (OR = 0.9; 95% CI = 0.7, 1.5) or ex-smokers (OR = 1.0; 95% CI = 0.7, 1.5). This exploratory study indicates a need for further studies of occupational risks of brain cancer.

Astrocytoma↗
PubMed1990

Efforts in primary-care practice to control tobacco use.

In this article, the authors findings lead them to conclude that because of the devastating effects of smoking on health, the public could experience widespread health benefits if primary care physicians became more active in encouraging patients to stop smoking.

Allied Health Personnel↗
PubMed1990

Cancer control and public health in Missouri: a time for action.

National reports on cancer mortality now show that most cancer deaths are preventable. The recent national focus on prevention of such chronic diseases may indicate that public health departments need to consider a shift in emphasis from infectious to chronic disease control.

Humans↗