Ohio Cancer Information Service: a decade of experience.
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Consumer Behavior↗
Biomedical subjects
R E Harris
Publications and source records attributed to R E Harris.
Cancer of the urinary bladder in blacks and whites. A case-control study.
Racial differences in the risk of cancer of the urinary bladder associated with cigarette smoking and alcohol consumption were examined in a study of 1663 cases (1534 whites and 129 blacks) and 4930 controls matched 3:1 by sex, race, and age to the cases. Significant increases in cancer risk associated with cigarette smoking were observed in whites and blacks; however, the dose-response patterns appeared to differ by race. In whites, statistically significant elevations of threefold and higher were observed in the odds ratios at all smoking levels above 20 pack-years, whereas in blacks, the corresponding point estimates did not increase significantly until greater than 60 pack-years of smoking. Although these risk patterns are compatible with the higher incidence of bladder cancer in white men, the sample of blacks was small, and tests of significance were only suggestive of higher risks for whites at specific amounts of smoking (P less than 0.15). Effects of alcohol consumption were inconsistent, and there was no detectable synergism between smoking and drinking. Additional study of race-specific risk factors and tobacco metabolism will be needed to determine the true nature of the apparent racial differences in the risk of urinary bladder cancer associated with cigarette smoking.
Adult↗
Case-control study on occupational exposure to diesel exhaust and lung cancer risk.
The association between lung cancer and occupations with probable exposure to diesel exhaust (DE) was studied among 2,584 cases and 5,099 hospital controls. The crude odds ratio (OR) for probable exposure was 1.31 (95% confidence interval [CI] 1.09-1.57), but adjustment for smoking and other confounders reduced the estimate to 0.95 (95% CI = 0.78-1.16). Similar results were observed for truck drivers, the only occupational category large enough for separate analysis. Data on self-reported exposure for 477 cases and 946 controls revealed a crude OR of 1.45 (95% CI = 0.93-2.27), which was reduced to 1.21 (95% CI = 0.78-2.02) after controlling for smoking and other confounders. The present results and a review of the literature do not definitively support an etiologic association between DE exposure and elevated lung cancer risk.
Adult↗
Undifferentiated acute leukemia and lineage infidelity (difficulties in classification and management).
The acute leukemias have been considered to represent a clonal expansion of a malignant transformed hematopoietic progenitor cell with adherence to either the myeloid or lymphoid lineage--"lineage fidelity." Lineage fidelity has been challenged by the demonstration of lineage switching or mixed-lineage leukemias. We describe a 7 year old male who presented with undifferentiated acute leukemia and nasopharyngeal and cervical masses. His blasts had the morphologic appearance of myeloblasts (FAB M1) and were positive solely for the myeloid antigen CD15. He entered a complete remission (CR) with acute nonlymphocytic leukemia therapy. At first relapse he had evidence of mixed-lineage leukemia with B-cell lymphoid and myeloid phenotypes. He again relapsed from a second CR with Burkitt-cell leukemia. Cytogenetic findings showed a consistent 14q+, 17p+ abnormality in the blasts and nasopharyngeal mass. The t(8;14) associated with Burkitt's lymphoma was found in the mass tissue only following passage in the nude mouse. Our patient demonstrates that limitations still exist in our ability to classify acute leukemia. That leukemic transformation occurred in a multipotential progenitor cell leading to undifferentiated leukemia at diagnosis and/or that chemotherapy can influence the genetic programs of leukemic cells leading to the evidence of mixed-lineage leukemia and lineage switching is supported.
Burkitt Lymphoma↗
Diesel exhaust exposure and bladder cancer risk.
A total of 136 cases of men with urinary bladder cancer and 272 matched hospital controls were examined for potential exposure to diesel exhaust. A lifetime occupational history was obtained for all subjects in the study and assessment of exposure to diesel exhaust was based on the job titles of the subject and self-reported exposure. The risk was assessed by odds ratios, with adjustment for confounding variables, in particular cigarette smoking. There was no evidence of elevated risk in occupations with possible or probable exposure (the ORs adjusted for smoking were 1.1. and 0.9 respectively). Truck driving alone was also not associated with elevated risk (adjusted OR = 0.5). There was a weak positive crude association with any exposure, including self-reports (OR = 1.4); however after adjustment for smoking, the estimate did not retain statistical significance (OR = 1.2, 95% CI = 0.8-2.0). This study provides little to support the hypothesis of an excess of bladder cancer risk from occupational exposure to diesel exhaust.
Aged↗
Oral contraceptives and breast cancer risk: a case-control study.
The association between breast cancer risk and oral contraceptive use was examined in 401 breast cancer patients and 519 hospital controls interviewed in New York City during 1979-1981. Control subjects were ascertained utilizing variable ratio matching to the cases (2:1 or 1:1) by sex, age, hospital, and time of diagnosis. No evidence of a positive association was found between cancer risk and the duration of use in either parous or nulliparous women. The odds ratios obtained by comparing users to non-users in women under 50 years of age after adjusting for other risk factors were 0.8 (95% CI = 0.4-1.4) for less than five years duration and 0.4 (95% CI = 0.2-0.8) for five or more years duration (P less than 0.05 when tested for decreasing trend). There was also no evidence of effect modification between oral contraceptive use and other breast cancer risk factors (viz. family history, nulliparity, late age at first pregnancy, or abstention from breastfeeding). Our results do not indicate that the use of oral contraceptives increases the risk of breast cancer.
Adult↗
Changes in AIDS risk behavior among intravenous drug abusers in New York City.
Forty newly admitted patients to a methadone treatment clinic in New York City were interviewed to assess their patterns of intravenous (IV) drug abuse, sexual activity, and other risk behaviors for the acquired immunodeficiency syndrome (AIDS). The study revealed a marked decline in needle sharing since 1984 (46% to 14%), despite a concurrent doubling of the number of weekly IV drug injections per subject (10 to 21). High rates of promiscuous heterosexual activity were noted among men (80% said they were currently active with more than one woman), while the rates of condom use were low, as reported by both men and women (less than 30%). Recent reduction in weight were reported by 40% of subjects, and the average body mass of all individuals was subnormal. Thus, despite an apparent decline in needle sharing, high risk sexual behavior is apparently persisting, drug use is increasing, and nutritional deficits are prevalent among IV drug abusers. Synergism of these factors should be considered in the manifestation of HIV infection among IV drug abusers.
Acquired Immunodeficiency Syndrome↗
Cancer risk in male veterans utilizing the Veterans Administration medical system.
Age-specific incidence curves, cumulative rates, and relative risks were estimated for selected malignancies among male veterans utilizing the Veterans Administration (VA) medical system during 1970 to 1982. Relative risks for malignant tumors of the lung, bronchus, larynx, oral cavity, and esophagus in males using VA hospitals were approximately double the rates for men of the Surveillance, Epidemiology, and End Results (SEER) cancer registry, thereby supporting the existence of strong effects of chronic cigarette smoking and alcohol consumption on the development of neoplasms at these specific anatomic sites. Relative to the SEER male population, there were significant reductions in the cumulative rates of neoplasms of the colon (15%) and extrahepatic biliary tract (30%), no differences in the rates of cancer of the stomach, small intestine, or pancreas, and a 50% increase in the cumulative rate of liver cancer among the veterans. Rates of malignancies of the genitourinary tract were similar in the VA and SEER registries with the exception of cancer of the penis, for which the cumulative rate was 50% higher in the veterans. These results are consistent with an excess of specific risk exposures among male veterans using VA hospitals, viz., cigarette smoking, alcohol consumption, poor nutrition, and other factors related to low socioeconomic status. The ultimate utility of the VA tumor registry will depend upon its exploitation by epidemiologists to provide leads for etiologic research.
Adult↗
Exposure to cigarette smoke and cervical cancer.
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Female↗
Population screening for plasma cholesterol: community-based results from Connecticut.
Plasma cholesterol levels were measured in 15,892 participants of a cholesterol screening in Hartford, Connecticut. The screenees were typically health conscious as evidenced by the low prevalence of current cigarette smoking (12%). However, more than 25% of the men and 35% of the women over the age of 50 years had cholesterol levels in excess of 240 mg/dl, placing them at moderate to high risk for coronary artery disease. Results showed a pronounced dose-response relationship between cigarette smoking and cholesterol levels in men of all age groups and in women of premenopausal age; however, average cholesterol levels were similar in exsmokers and subjects who had never smoked. Risk analysis revealed a strong positive association between cholesterol and prevalence of nonfatal myocardial infarctions. Notably patients with newly diagnosed hypercholesterolemia reduced their cholesterol levels an average of 40 mg/dl under the care of a physician. These results indicate that cholesterol screening coupled with physician follow-up and treatment can have a substantial impact in lowering cholesterol levels and the attendant risk of cardiovascular disease.
Adolescent↗
Diesel exhaust exposure and lung cancer risk.
The association between lung cancer and occupations with probable exposure to diesel exhaust has been examined in several studies in the past with inconclusive results. We report a case-control study among 2,584 cases and 5,099 hospital controls. The crude odds ratio for probable exposure was 1.31 (95% Cl 1.09, 1.57), but adjustment for smoking and other confounders reduced the estimate to 0.95 (95% Cl 0.78, 1.16). Similar results were observed for truck drivers, the only occupational category large enough for separate analysis. Data on self-reported exposure for a subset of 477 cases and 946 controls revealed a crude odds ratio of 1.45 (95% Cl 0.93, 2.27) which was reduced to 1.21 (95% Cl 0.78, 2.02) after controlling for smoking and other confounders. A duration-response relationship was suggested (P less than 0.12) only for self-reported exposure. Cigarette smoking was the predominant confounder in the analysis. Problems arising from biases and confounding in the present and in other previously published reports on the association between diesel exhaust exposure and lung cancer risk are discussed, and a review on the evidence of human carcinogenicity of diesel exhaust exposure is presented.
Air Pollutants↗
Population screening for plasma cholesterol: community-based results from Atlanta.
Plasma cholesterol was measured in 10,672 participants of a cholesterol screening program in Atlanta, Georgia. The participants were typically health conscious, as evidenced by the low prevalence of current cigarette smoking (13%), but more than 21% of the men and 33% of the women over age 50 had cholesterol levels in excess of 240 mg/dl, placing them at moderate to high risk for coronary artery disease. Results revealed a pronounced dose response relationship between cigarette smoking and cholesterol in men of all age groups and in women of premenopausal age, whereas levels were similar in ex-smokers and those who had never smoked. Risk analysis revealed a strong positive association between cholesterol and the prevalence of nonfatal myocardial infarctions. Notably, patients with newly diagnosed hypercholesterolemia reduced their cholesterol an average of 36 mg/dl under care of physicians. These results indicate that cholesterol screening coupled with physician follow-up and treatment can have a substantial impact in lowering cholesterol and its attendant risk of cardiovascular disease.
Adult↗
Compensation as a risk factor for lung cancer in smokers who switch from nonfilter to filter cigarettes.
The likelihood of increasing the number of cigarettes per day (cpd), a common method of compensation, in smokers switching from nonfilter to filter cigarettes, was examined in newly diagnosed and histologically confirmed lung cancer cases including all cell types; 1,242 lung cancer cases and 2,300 sex and age matched hospital controls were interviewed in 20 hospitals from nine United States cities between 1969 and 1984. The mean increase in cpd for lung cancer cases was about twice that of controls. Using switchers who did not increase cpd as the referent group, there was a linear dose-response relationship between the odds of lung cancer and increasing level of compensation. The odds ratio increased from 1.19 to 2.37 in males and from 1.66 to 3.83 in females corresponding to increases of 1-10 to 21+ cpd after switching. Findings from this study suggest that increasing cpd after switching to filter cigarettes is an important risk factor for lung cancer that needs to be emphasized in epidemiologic studies. Proponents of the idea that switching cigarettes is of some benefit, should also advocate that individuals who continue smoking should avoid compensation after switching.
Adult↗
Population screening for plasma cholesterol: community-based results from Memphis.
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Adolescent↗
Immunosuppressive therapy versus bone marrow transplantation for children with aplastic anemia.
A total of 15 patients 1 to 16 years of age were treated for aplastic anemia (13 of a severe degree) and followed-up for a mean of 24 months (range 2 to 64 months). Six patients had an HLA-matched sibling and underwent allogeneic bone marrow transplantation. Nine patients who lacked a suitable donor were given immunosuppressive therapy. Antithymocyte globulin was the initial treatment for eight of these nine patients. Two patients who failed to respond to antithymocyte globulin were then treated with cyclosporine A. Pretreatment age, hematologic measurements, duration of follow-up, and interval prior to therapy were similar between the two groups. All of the patients receiving bone marrow transplants had a complete response and now have normal blood cell counts. Six of nine patients (67%) responded to antithymocyte globulin and are now transfusion free, although three have mild thrombocytopenia. Both patients given cyclosporine A had a good response and are also transfusion free. Patients who underwent marrow transplantation had a significantly shorter period of transfusion dependence for RBCs (9 v 4 weeks, P less than .005) and platelets (5 v 21 weeks, P less than .05). The patients given immunosuppressive therapy have significantly lesser platelet counts in follow-up but have similar values for both hemoglobin and absolute granulocyte counts. Although HLA-matched bone marrow transplantation leads to a faster and more complete recovery for children with aplastic anemia, immunosuppressive therapy can provide a good outcome for children with this disorder.
Adolescent↗
Does alcohol consumption influence the risk of developing breast cancer? Two views.
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Alcohol Drinking↗
Compensation as a risk factor for lung cancer in smokers who switch from nonfilter to filter cigarettes.
The likelihood of increasing the number of cigarettes per day (cpd), a common method of compensation, in smokers who had switched from nonfilter to filter cigarettes was examined in newly diagnosed and histologically confirmed lung cancer cases including all cell types. There were a total of 1,242 lung cancer cases and 2,300 sex and age matched hospital controls interviewed in twenty hospitals from nine United States cities between 1969 and 1984. Lung cancer cases compensated more (as increased cpd after switching) than the controls. The mean increase in cpd for cases was about twice that of controls. Using switchers who did not increase cpd as the referent group, switchers who increased cpd showed a clearcut dose-response relationship for lung cancer with increasing levels of compensation. The odds ratio increased from 1.2 to 2.4 in males and 1.7 to 3.8 in females corresponding to increases of 1-10 to 21+ cpd after switching. Findings from this study suggest that increasing cpd after switching to filter cigarettes is an important risk factor for lung cancer that needs to be stressed in epidemiologic studies. Proponents of the idea that switching cigarettes is of some benefit, should also advocate that individuals who continue smoking should avoid compensation after switching.
Female↗