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Biomedical subjects

T Hakulinen

Publications and source records attributed to T Hakulinen.

At least 145 records · Page 8Linked to original sources
PubMed1990

Cancer risk among glass factory workers: an excess of lung cancer?

A total of 3749 workers employed for at least three months in two Finnish glass factories (cohorts A and B) were followed up for cancer in 1953-86 through the Finnish Cancer Registry. In cohort A (1353 men, 1261 women), 106 primary cancers were diagnosed among men, and their standardised incidence ratio (SIR) for all cancers was 99. Among women the risk was low (65 cases, SIR 64). In cohort B (450 men, 685 women), the relative risk of cancer was close to unity for both men (57 cases) and women (75 cases). The risk of cancer was analysed by primary site, type of work, years since first exposure, and age at diagnosis. The only significantly increased risks were those of lung cancer among men (SIR 130, 95% CI 100-167, cohorts A and B combined), and skin cancer among glass blowers (SIR 625, 95% CI 129-1827). An increased risk of lung, stomach, and colon cancer as well as of brain tumours has been reported in previous studies. It is postulated that the excess risk of lung cancer, detected in this study, can also be accounted for by lifestyle, and not only by possible occupational exposures, because a similar excess risk of lung cancer has been found previously for all industrial workers in Finland. Although the risk of stomach cancer in this study was increased among glass blowers, it was not high in the largest groups of plain glass workers. The risks of tumours of the central nervous system and colon were not increased either.

Chemical Industry↗
PubMed1990

Formaldehyde exposure and respiratory cancer among woodworkers--an update.

Respiratory cancer was examined in relation to occupational formaldehyde exposure in a case-referent study (136 cases, 408 referents) nested in a woodworker cohort. Plant- and time-specific job-exposure matrices were constructed for formaldehyde exposure. Over 3 ppm-months of formaldehyde exposure was associated with an odds ratio of 1.4 [90% confidence interval (90% CI) 0.5-4.1]. The odds ratios for lung cancer were near unity, the excess risk concentrating on the upper respiratory tract. That for combined exposure to formaldehyde-phenol exposure (all respiratory cancers) was 1.6 (90% CI 0.6-4.4) but 1.0 for formaldehyde only. No consistent exposure-response patterns emerged for the level, duration, or cumulative exposure. The results are hardly more than debatable support for the hypothesis concerning formaldehyde as a carcinogen in humans, the possible risk seemingly concentrating on the upper respiratory tract rather than the lung.

Case-Control Studies↗
PubMed1989

The survival pattern in male breast cancer. An analysis of 1429 patients from the Nordic countries.

A joint Nordic study was conducted to elucidate the survival pattern in male breast cancer by means of regression analysis of annual relative survival rates. A total of 1429 (98.4%) of all patients diagnosed during a 25-year to 30-year period and reported to the Nordic cancer registries were available for follow-up through 1982. The relative survival rate was lower in older patients; the relative excess risk of dying (from breast cancer) during the first 5 years of observation, calculated by multiple regression modelling, increased in a regular fashion more than three-fold from patients younger than 40 years at diagnosis to those aged 80 years or older. Significantly lower rates were found among males in Denmark and Finland, the relative excess risks of dying (compared with Sweden) being 1.39 (1.06-1.80) and 1.73 (1.22-2.45), respectively, during the first 5 years. The authors concluded first that important differences exist between male and female patients with breast cancer in the relation between survival and age at diagnosis, and secondly that a later stage at presentation or national differences in the natural history are the most likely explanations for the worse prognosis in Denmark and Finland.

Adult↗
PubMed1989

Survival of female breast cancer patients in Finland and in Estonia: stage at diagnosis important determinant of the difference between countries.

The survival experiences of female breast cancer patients diagnosed in 1968-81 in Finland and in Estonia were compared. The series consisted of 18,729 patients in Finland and 4100 in Estonia. The overall estimated 5-year relative survival rate was 67.3% in Finland and 55.9% in Estonia. The stage-adjusted 5-year relative survival rate in Estonia was 63.4% (the Finnish rates used as a standard). Older patients in Finland had much higher survival rates than older patients in Estonia. There was a clear difference in the stage distribution in Estonia between older and younger age groups, with non-localized cases occurring in older age groups. No such difference was noticed in Finland. It seems that the diagnostic lag for older women is longer in Estonia than in Finland. In Estonia older patients seek medical assistance later, or symptoms and signs of younger patients are more effectively studied.

Adult↗
PubMed1989

Outcome-based equity in the treatment of colon cancer patients in Finland.

The differences in survival rates of colon cancer patients between hospital districts were used as an indicator of equity in cancer treatment in Finland. The merits of two different assessment methods were evaluated. The large variation was mainly due to confounding by age and the extent of the disease and to random variation.

Aged↗
PubMed1988

Survival and prognostic factors of patients with skin melanoma. A regression-model analysis based on nationwide cancer registry data.

Survival and prognostic factors of skin melanoma patients were studied using a regression analysis of relative survival rates based on nationwide cancer registry data. The material consisted of 4980 cases of melanoma of the skin diagnosed in Finland in 1953 to 1981 and reported to the Finnish Cancer Registry. In the last diagnostic period, 1974 to 1982, the 5-year relative survival rate for male patients was 61.1% and that for female patients 76.6%. The analysis included variables sex, age, stage, year of diagnosis, follow-up year, and site of the tumor. All of them were needed to explain the differences in survival. The patients had the greatest relative risk of dying from skin melanoma during the second year from diagnosis. However, the difference in death risk due to melanoma by stage was most remarkable during the first follow-up year: the risk of patients with nonlocalized disease was over 12 times that of others. The male-female ratio in the risk of dying from skin melanoma was (to a marked extent) attributable to differences in the distributions of stage and site of the tumor. In all site groups males did worse than females but risk ratio varied from 1.15 (trunk) to 1.89 (limbs). The effect of some important prognostic factors on survival could be quantified with ample material and with a method taking into account the competing causes of death. The results suggest a difference either in biological behavior of skin melanoma or in a patient's delay between males and females.

Female↗
PubMed1988

Serum cholesterol and risk of cancer in a cohort of 39,000 men and women.

Serum cholesterol concentration was studied for its prediction of cancer in 39,268 men and women aged 15-99 years and initially free from cancer. During a median follow-up of 10 years 1381 cancer cases were diagnosed. Serum cholesterol level was inversely associated with cancer incidence among non-smokers. Age-adjusted relative risks of cancer in quintiles of serum cholesterol were in male non-smokers 1.0, 0.81, 0.73, 0.69, and 0.46 and in female non-smokers 1.0, 0.75, 0.84, 0.78, and 0.70. The associations were not found to be confounded by serum vitamins A or E, serum selenium or several other factors. The association between serum cholesterol level and risk of cancer varied from strongly negative to slightly positive according to subpopulation and site of cancer. The strongest negative associations were found to appear during the first years of follow-up, especially for rapidly developing cancers. Thus the increased occurrence of cancer at low cholesterol levels seems mainly to be due to preclinical cancer.

Adolescent↗
PubMed1988

Serum vitamin E and risk of cancer among Finnish men during a 10-year follow-up.

The association between serum alpha-tocopherol levels and the subsequent incidence of cancer was investigated in a longitudinal study of 21,172 men initially aged 15-99 years in six geographic areas in Finland. The baseline examination was conducted in 1968-1972, and during the follow-up of 6-10 years, 453 cancers were diagnosed. The serum alpha-tocopherol levels were measured from stored serum samples from these men and from 841 male controls, matched for municipality and age, who did not develop cancer during the follow-up. The mean levels of serum alpha-tocopherol among the cancer cases and controls were 8.02 and 8.28 mg/liter, respectively. A high serum alpha-tocopherol level was associated with a reduced risk of cancer. The relative risk of cancer in persons in the two highest (threshold 8.70 mg/liter) quintiles of serum alpha-tocopherol was 0.64 (95 per cent confidence interval = 0.49-0.85) in comparison with those in the three lowest quintiles. The association was strongest for the combined group of cancers unrelated to smoking and varied between subgroups of the study population as well as between different cancers. The association persisted when adjusted for serum cholesterol, serum vitamin A, serum selenium, and various confounding factors. It also persisted when subjects with possible signs of cancer at the time when the blood samples were drawn or with cancers diagnosed during the first two years of follow-up were excluded. These findings agree with the hypothesis that high vitamin E intake protects against cancer.

Adolescent↗
PubMed1987

Smoking and cardiac symptoms as predictors of lung cancer.

In 1962, a cohort of 4604 Finnish men was interviewed about their smoking habits and cardiorespiratory symptoms. The cohort was followed up for deaths and incidence of lung cancer from 1963 to 1980 in order to study the effect of smoking and cardiac symptoms on the incidence of lung cancer. When analyzed simultaneously with smoking, the symptoms of angina, possible infarction and shortness of breath were all significantly associated with increased lung cancer risk. For example, the RR of lung cancer among those with possible infarction was 2.4, when age and smoking were adjusted for, and 1.8, when additionally shortness of breath and angina-like chest pain were adjusted for. Among smokers of greater than or equal to 15 g/day, those with symptoms of angina displayed a considerable excess risk (RR 2.5). A broad range of impairments of the cardiopulmonary functions seem to be associated with the carcinogenic processes invoked by smoking.

Angina Pectoris↗
PubMed1987

The joint effect of smoking and respiratory symptoms on risk of lung cancer.

In 1962 a cohort of 4604 Finnish men were interviewed about their smoking habits and cardiorespiratory symptoms. The cohort was followed up for deaths and incidence of lung cancer from 1963 to 1980 in order to study the effect of smoking and respiratory symptoms on the risk of lung cancer. The joint effect of smoking, age and respiratory symptoms on the risk of lung cancer was studied using a log-linear modelling technique. When analysed simultaneously with smoking, the symptoms of phlegm, shortness of breath and wheezing were all significantly associated with increased lung cancer risk. The joint effect of smoking and phlegm as well as that of smoking and wheezing was close to being multiplicative. Even if smoking is a causative factor in both these symptoms and in lung cancer, the symptoms seem to have a separate role as predictors of lung cancer risk.

Age Factors↗
PubMed1987

Is smoking sufficient to explain the large difference in lung cancer incidence between Finland and Norway?

In the 1960s, lung cancer among Finnish men was about 3.5 times as common as among Norwegian men. A study by Pedersen et al. in 1962 indicated that the difference in contemporary smoking habits could account for only part of the difference in lung cancer incidence in men between the countries. In that study, smoking habits in Finland and Norway were investigated via interviews of 8,700 people from six areas of each country. For the present study the Finnish and Norwegian cancer registries have followed lung cancer morbidity in those areas. When the interval between the recording of smoking habits and lung cancer incidence was 15 years, after adjustment for age and smoking habits, the Finnish males had a relative risk between 1.1 and 1.6 compared with Norwegian men. The results suggest that, given a sufficiently long latency period, almost the entire difference between Finnish and Norwegian men could be attributed to smoking habits.

Adult↗
PubMed1987

Cancer incidence of workers in the Finnish pulp and paper industry.

The cancer incidence of 3,545 workers in the Finnish pulp and paper industry was assessed in a retrospective cohort study. The cohort included workers with continuous employment of at least one year between 1 January 1945 and 31 December 1961 and was followed until 31 December 1980. Six subcohorts were formed (sulfite mill, sulfate mill, paper mill, board mill, maintenance department, and power plant). Separate analyses were made for the 2,597 workers hired after 1 January 1945. The smoking habits were surveyed. Among the men, 196 cases of primary cancer were detected versus 203.8 expected [standardized incidence ratio (SIR) 96, 95% confidence interval (95% CI) 82-114], and there were 47 cancer cases among the women versus 57.9 expected (SIR 91, 95% CI 60-108). Lung cancer occurred in 78 men (62.6 expected, SIR 125, 95% CI 98-155), and the excess was the most prominent for the male board mill workers (40 observed, 81.1 expected, SIR 222, 95% CI 158-302), particularly after 20 year's latency (25 observed, 7.8 expected, SIR 323, 95% CI 209-476). Analogous excesses of lung cancer occurred among the men (especially the male board mill workers) who began work after 1 January 1945. The findings were not explained by smoking habits.

Female↗