Search PubMed⌕ Search

Biomedical subjects

T Skov

Publications and source records attributed to T Skov.

At least 37 records · Page 2Linked to original sources

Differentiation of adenocarcinoma of the lung and malignant mesothelioma: predictive value and reproducibility of immunoreactive antibodies.

A panel of antibodies against keratins, epithelial membrane antigen (EMA), epithelial antigen (Ber-EP4), carcinoembryonic antigen (CEA), tumour-associated glycoprotein (B72.3), vimentin and LeuM1 was applied to sections of adenocarcinoma of the lung and malignant mesothelioma in a randomized design. The proportion of stained tumour cells within each section was estimated independently in five categories by three pathologists (no positive tumour cells, 1-10%, 11-33%, 34-66% and more than 67% positive tumour cells). The kappa values representing the chance corrected interobserver agreement for the different antibodies in such a five group assessment were between 0.38 and 0.72. In two group assessment the kappa values were between 0.53 and 0.94. Nosological sensitivity and nosological specificity were calculated for all antibodies, and diagnostic sensitivity and diagnostic specificity (predictive values) were calculated for the Ber-EP4, CEA, B72.3, LeuM1 and vimentin. The difference between nosological sensitivity and nosologic specificity and the clinically relevant predictive values of positive and negative tests were demonstrated. In respect of the reproducibility and the diagnostic power defined by the predictive values, we demonstrated that a panel of antibodies, including CEA, Ber-EP4 and B72.3 and, to a lesser degree, LeuM1 and vimentin is applicable for the histopathological distinction between adenocarcinoma of the lung and malignant mesotheliomas. Before introduction of new diagnostic tests, including new antibodies, the prevalence of the tested tumours should be estimated. Nosological sensitivity and nosological specificity should be converted to predictive values.

Adenocarcinoma↗

Cancer risk and exposures to carcinogens in hairdressers.

A number of epidemiologic studies have focused on the risk of bladder and lung cancer in hairdressers and beauticians, and the risk of breast cancer, and bladder cancer associated with the private use of hair dyes has also been addressed. The most consistent, although by no means unequivocal, finding is the increased risk of bladder cancer in male hairdressers. The use of brillantine containing p-dimethylaminoazobenzene could be suggested as a relevant exposure. We present recent incidence data on bladder cancer in Danish hairdressers showing relative risk (RR) = 2.05 (men) and RR = 1.75 (women) in 1970-1980 and RR = 1.17 (men) and RR = 0.88 (women) in 1981-1987. Furthermore, in female hairdressers, the risk of non-Hodgkin's lymphoma was increased for the whole period of 1970-1987.

Adult↗

Colorectal cancer in Denmark 1943-1988.

Nation-wide incidence rates are presented of colorectal cancer in Denmark from 1943 to 1988. In Denmark notification of malignant and related diseases is mandatory. The percentage of histologically confirmed tumours is now 95. The annual incidence rate of colon cancer in Denmark has been increasing among men and women combined from 684 cases in 1943-47 to 2020 cases in 1988. In the same period the incidence of rectal cancer has been increasing from 762 cases in 1943-47 to 1108 cases in 1988. We analyzed the effects of age, calendar time, and birth cohort with multiplicative Poisson models. We did not find consistent period effects in the models. We suggest the trends in colorectal cancer incidence rates may be due to changes in environmental factors such as dietary habits and in physical activity. Furthermore, we suggest an etiologic distinction between carcinoma of the rectum, the left colon and the right colon.

Cohort Effect↗

Handling antineoplastic drugs in the European Community countries.

Alkylating antineoplastic drugs (ADs) are carcinogenic to humans and most ADs cause reproductive failures in animal experiments. Studies of occupationally exposed health personnel have shown increased risks for miscarriages (two studies), malformations (two studies) and leukaemia (two studies). During the past decade, work practice guidelines have been issued by authorities in several countries but universal agreement on a set of guidelines which would secure both the work environment and the treatment of patients is yet to come. We reviewed the existing guidelines in the European Community (EC) countries on health personnel's handling of ADs. Five countries had guidelines on the safe handling of ADs. The main principles were to use exhaust cabinets and personal protective equipment. Two sets of guidelines included recommendations for pregnant women. In general, the EC countries' guidelines were less extensive than those issued by the US Occupational Safety and Health Administration. It is argued that the existence of more uniform guidelines in all the member states would be valuable. Specifically, measures should be devised to prevent adverse effects on reproduction.

Antineoplastic Agents↗

Legislation by the European Community on carcinogens.

A brief overview is given of the legislation in the European Community concerning the classification and labelling, marketing and use, occupational exposure, etc. of carcinogenic agents. This includes data on the regulation of 739 agents which have been evaluated for carcinogenicity by the International Agency for Research on Cancer and/or the European Community. These data have been collected in a computerized data base. Although no comprehensive evaluation of the legislation is attempted, it is suggested that a number of carcinogenic agents still need attention, and that the labelling requirements should be supplemented with more restrictive legislation.

Carcinogens↗

Design options and methodological fallacies in the studies of reproductive failures.

Reproductive failures are at first sight well suited for epidemiologic research. The time of pregnancy is closely monitored, and failures such as spontaneous abortions and subfecundity are rather frequent. Although epidemiologists' interest in the field has been growing, there is still disappointingly little new information of relevance for prevention. A number of methodologic shortcomings may explain this. A large part of disease classification is not well suited for etiologic research, reduced fertility has diminished the populations at risk, close medical monitoring tends to mask causal links, and many scientific problems related to this area bring limitations to the research field. Still, much more could be learned from a systematic use of epidemiologic knowledge, existing registers, and the joint effort between different research groups.

Abortion, Spontaneous↗

Survival of Danish cancer patients 1943-1987. Urinary tract.

The 15,160 males and females diagnosed with kidney cancer in Denmark in the period 1943-87, and eligible for inclusion were covered in the analysis. Crude and relative five-year survival from this cancer has improved with calendar time, especially for men. For patients diagnosed in 1943-47, the relative five-year survival was 18% for men and 29% for women; for those diagnosed in 1983-87, it had improved to 35 and 36%, respectively. Patients with localized tumours at the time of diagnosis had a more favourable prognosis than those with disseminated disease, with a five-year survival of 51% for men and 53% for women; people of each sex with metastatic disease had a five-year survival of only 3%. Treatment of kidney cancer throughout the period was surgical removal of the kidney and lymph nodes. The moderate improvement in survival seen with calendar time may be due to better, more efficient surgical techniques. The 32,701 patients diagnosed with cancer of the urinary bladder in 1943-87 and included in the study experienced a marked improvement in crude five-year survival: for both men and women, from 24% for patients diagnosed in 1943-47 to 47% for those diagnosed in 1983-87. Patients whose tumours were localized at the time of diagnosis in 1978-87 had a more favourable prognosis, with survival after 10 years of 36% (men) and 43% (women), than patients with metastatic disease with 10-year survival of less than 1% (men and women). The treatment of bladder tumours underwent a number of changes during the study period. The improvement in survival with calendar time may be due to more efficient treatment, although registration artefacts cannot be excluded.

Age Factors↗

Leukaemia and reproductive outcome among nurses handling antineoplastic drugs.

During the past decades conclusive evidence has accumulated that alkylating antineoplastic drugs (ADs) can cause cancer, most notably acute non-lymphocytic leukaemia, and that most ADs are reprotoxic. Studies on health workers handling ADs have shown significantly increased risks for miscarriages (two studies) and malformations (two studies). The present study monitored the risk for cancer and adverse reproductive outcome among Danish nurses handling ADs. No increased risks were found for miscarriages, malformations, low birth weight, or preterm birth among the offspring of nurses handling ADs during pregnancy. The sex ratio was normal. The relative risk (RR) for leukaemia was significantly increased (10.65) but based on only two cases, one of acute myeloblastic and one of chronic myeloid leukaemia. From the available exposure data occupational exposures to ADs were apparently higher in the studies that have reported increased risks for miscarriages and malformations than in the present one. Regarding reproductive outcome the study gives some confidence that the safety measures which were implemented in the oncology departments around 1980 can protect the health personnel against adverse effects of ADs on reproduction. As the study is as yet the only negative one in a well protected setting, it should be followed up by other studies of well protected health personnel handling ADs. The findings concerning the leukaemia risk, although based on small numbers, encourage larger studies.

Abnormalities, Drug-Induced↗

Cancer of the lung and urinary bladder in Denmark, 1943-87: a cohort analysis.

National data from 1943 to 1987 on the two most frequent tobacco-related cancers in Denmark, lung and bladder cancer, were analyzed with multiplicative Poisson models. The temporal trends in the cohort-specific risks for both sites and sexes were similar: the risks increased in the beginning of the period covered by the analysis, but then levelled off; and there was no increase among cohorts born after circa 1930. Women experienced a smaller increase during the period covered by the analysis in the cohort-specific risk for bladder cancer than men (3.7 cf 6.1 times), whereas the overall increase in lung-cancer cohort-specific risk was the same for both sexes. The difference could not be explained by trends in tobacco consumption, types of tobacco consumed, or occupational exposures. On the basis of these findings, it is suggested that women may be less susceptible than men to developing bladder cancer from tobacco smoking.

Adult↗

Modifications of health behaviour in response to air pollution notifications in Copenhagen.

Ambient air quality is a major issue today in large cities all over the world. On the theoretical background of the health belief model and the health locus of control model, we studied the knowledge and beliefs about air pollution and the modifications of health behaviour brought about by information to the public about projected levels of air pollution, with special emphasis on reduction of outdoor activity and avoidance of car driving. Data were collected with a questionnaire among a sample of residents in the Copenhagen area. The respondents were almost universally knowledgeable about the prime emission source and concerned about the possible health effects of the air pollution in the area. Avoidance of outdoor activity was associated with personal experiences of symptoms ascribed to the air pollution, employment status, and with female sex, but not with knowledge or beliefs about the degree or health implications of the air pollution. The willingness to avoid car driving was positively associated with the belief that one can oneself influence one's health and with female sex. Lung diseased respondents were generally more prone to protect themselves than the healthy, both by avoiding outdoor activity and by being less willing to avoid car driving. The present study was conducted in an only moderately polluted city, and it is not clear whether the findings and conclusions can be generalized to more polluted cities. The study partly supported the underlying theories of the determinants of health behaviour, but also indicated a need for a broader theoretical framework, incorporating aspects of the respondents' life situation and personal experience which would be relevant to the specific type of health behaviour under study.

Adult↗

Non-Hodgkin's lymphoma and occupation in Denmark.

An analysis was made of the occurrence in Denmark of non-Hodgkin's lymphoma among men and women by socioeconomic group and detailed occupation, using a linkage between cancer registry data on incidence (1970-1980) and census data on industry and occupation (1970). No socioeconomic gradient in the risk for non-Hodgkin's lymphoma was found. Significantly increased relative risks were found in a number of detailed occupational groups including female physicians, female family workers in retail trade and transport; and male fitters, and gold, silver, and electroplate workers in metal industry. Also male cowmen experienced a significantly increased risk, whereas the risk was not increased for farming in general. Tabulations of clusters of detailed occupational groups suggested that groups with potential exposure to infections and chemical agents may experience an increased risk for NHL.

Adult↗

Risk for cancer of the urinary bladder among hairdressers in the Nordic countries.

Several studies have indicated an increased risk for cancer of the urinary bladder among hairdressers. In a Danish linkage between census data and cancer register data both male and female hairdressers have an elevated risk for bladder cancer. The risk for lung cancer is close to unity, indicating that occupational factors rather than smoking, may be responsible for the increased risk for bladder cancer among hairdressers. To evaluate this hypothesis we conducted a collaborative analysis of data from similar linkages in Finland, Norway, and Sweden. The combination of high risk for bladder cancer and low or no risk for lung cancer was not found in the other Nordic countries; however, statistically significant increased risks for both bladder and lung cancer were found among male hairdressers in both Norway and Sweden. The relative risks for bladder cancer were of the same magnitude as the relative risks for lung cancer.

Adolescent↗

Reporting of occupational cancer in Denmark.

Many patients with occupational diseases fail to obtain compensation because their disease is not recognized as occupational and reported to the authorities. The present study examined the reporting of pleural mesotheliomas and sinonasal adenocarcinomas--cancers with well-known associations with occupational exposures to asbestos and wood dust--in Denmark in 1983-1987. The estimated underreporting was around 50%. Examination of the medical records of patients who had not been reported in 1986-1987 revealed that in most cases the medical records did not contain sufficiently detailed information about occupational exposures. It was recommended that a formal screening interview be carried out whenever a diagnosis is made of a potential occupational cancer. Medical associations may play a major role by issuing guidelines addressing occupational diseases within the fields of their expertise.

Adenocarcinoma↗