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PubMed1989

Spectrum of occupational disease in an academic hospital-based referral center in Connecticut from 1979 to 1987.

The inability to characterize the extent of occupational disease in the United States limits clinical diagnosis and public health interventions. We present an 8-year (1979 to 1987) experience with clinic-based reporting in Connecticut. Altogether, 3566 cases were sequentially coded for demographics, diagnoses, workplace identification, and exposures at two academic occupational medicine clinics. The lungs were the principal organs of diagnosed effect, with asbestos-related disorders predominating, whereas the urinary tract, endocrine organs, and cardiovascular systems were rarely involved. Of all diseases, 64.8% were diagnosed as chronic and irreversible. Three common disorders, lead intoxication (acute and chronic), asbestosis, and occupational asthma were selected for illustration. Patients with lead poisoning and asbestosis, although collectively numerous (40 and 504, respectively), came from a small number of worksites and industries. Occupational asthma was more variable: 141 diagnosed cases came from 56 different trades and industries and were caused by 28 recognized agents. While we recognize that clinic-based reporting suffers from obvious problems with referral bias and misclassification, our experience shows that it provides an important index of disease burden. Our data document the effects of legislation and litigation on lead poisoning and asbestosis, and correspondingly helps characterize diseases that will respond to broad intervention. On the other hand, occupational asthma is more pervasive and would require a more specialized, partially clinical approach.

Adult↗
PubMed1989

Screening for colorectal cancer by primary-care physicians in Long Island (New York) and Connecticut.

Postal questionnaires on colorectal cancer screening practices were received from samples of primary-care physicians in Long Island, New York (LI-NY) (N = 190, 66.4% response rate), and in Connecticut (N = 215, 71.7% response rate). About 90% reported ever screening asymptomatic patients 50 years of age or older by fecal occult-blood test (FOBT), and 76-86% reported generally recommending such screening annually. Proportions who generally recommended screening by proctoscopy, 48% in LI-NY and 54% in CT, were higher than those reported in a 1984 survey by the American Cancer Society. About 40-43% of physicians, however, reported using proctoscopy (i.e., flexible sigmoidoscopy [FS]) only if the FOBT was positive. The major factors influencing screening by FS were the low probability of finding a lesion, cost to the patient, and patient fear or discomfort. Training in the use of FS, reported by 25-35% of physicians, was significantly more frequent in younger physicians (i.e., less than 50 vs. 50+ years of age). Differences in responses between physicians in LI-NY and CT were generally small. Over 90% of physicians reportedly obtained information on family history of cancer and 77-80% on family history of colorectal cancer for asymptomatic patients 40 years of age and older. A pragmatic approach to increasing screening for colorectal cancer is discussed, emphasizing higher-risk patients as defined by family history of cancer and personal medical history.

Colorectal Neoplasms↗
PubMed1989

Dysgerminoma: a study of 13 cases from the Connecticut Tumor Registry.

Thirteen cases of patients with dysgerminoma of the ovary, accrued from the Connecticut Tumor Registry from 1974-84, were reviewed. Seven of the 13 patients were stage I at the time of initial surgery. Two of these patients had a diagnosis of dysgerminoma arising within a gonadoblastoma. Five of the seven patients were treated with some form of adnexal surgery; one patient received adjuvant combination chemotherapy consisting of vincristine, dactinomycin, and cyclophosphamide (VAC) and another received radiation therapy. Two of the seven patients were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH/BSO) plus radiation therapy. One patient, whose tumor recurred after initial therapy with unilateral oophorectomy, was successfully treated with radiation therapy. Six patients had advanced disease at the time of initial surgery. One patient with stage II disease and three patients with stage III disease were treated with TAH/BSO plus radiation therapy. One patient with stage III disease was treated with unilateral adnexectomy plus combination chemotherapy consisting of vinblastine, bleomycin, dactinomycin, cyclophosphamide, and cisplatin (VAB-VI). One patient with stage IV disease was treated with decompressive laminectomy with tumor resection, removal of left pelvic mass, radiation therapy and adjuvant combination chemotherapy (VAC). In our series, no patient died from dysgerminoma (one patient died of an apparently unrelated cause). The role of radiation therapy in the treatment of advanced and recurrent dysgerminoma has been demonstrated. However, the use of combination chemotherapy has been playing an increasingly important role in patients treated with conservative surgery in which preservation of fertility is a concern.

Adolescent↗
PubMed1989

Race/ethnicity as a risk factor for HIV-1 infection among Connecticut intravenous drug users.

This cross-sectional study of 341 entrants to drug abuse treatment in four Connecticut cities in 1986-1987 evaluated whether demographic, behavioral, viral serologic, or economic differences explained the disproportionate risk of human immunodeficiency virus type 1 (HIV-1) infection among black and Hispanic intravenous drug users (IVDUs), relative to non-Hispanic white IVDUs. Blacks [odds ratio (OR) = 9.0, 95% confidence interval (CI) = 5.1-15.9] and Hispanics (OR = 4.1, 95% CI = 1.9-8.8) were at increased risk of HIV-1 infection, relative to non-Hispanic whites. Those who lived closer to New York City, injected drugs more frequently, used intravenous drugs for a longer duration, used shooting galleries, had greater numbers of sexual partners, had human cytomegalovirus (CMV) or hepatitis B virus (HBV) antibodies, and had the lowest annual incomes were also at increased risk. However, none of these other factors accounted for the black and Hispanic HIV-1 risk in stratified analysis. Black race, Hispanic ethnicity, proximity to New York City, and number of drug injections in the past year each also remained significant, independent risk factors in a multivariate analysis. The increased HIV-1 risk of nonwhite IVDUs remained unexplained. Behavioral, sociologic, and/or biologic factors not identified in this study may modulate HIV-1 transmission dynamics in IVDUs.

Acquired Immunodeficiency Syndrome↗
PubMed1988

A survey of mosquitoes breeding in used tire stockpiles in Connecticut.

A larval survey of nine used tire disposal sites in Connecticut, was conducted from June through October 1987. No larvae of Aedes albopictus were uncovered indicating that this mosquito is not yet established in the state. However, eight other mosquito species in four genera were found. The most abundant and widely distributed species found breeding in permanent tire dumps were Ae. atropalpus, Ae. triseriatus and Culex restuans. Culex pipiens was the second most common Culex species followed by Cx. territans and Cx. salinarius. Other species included Anopheles punctipennis and Culiseta melanura. Larvae of Ae. atropalpus and Cx. salinarius were most frequently recovered from tire casings exposed to direct sunlight, while Ae. triseriatus and Cs. melanura predominated in tires shaded by bordering trees and low-lying vegetation. The other mosquito species showed no discernable preference for either habitat type.

Aedes↗
PubMedDate not supplied

Trends in hepatitis B surface antigen (HBsAg) prevalence in volunteer blood donors in Connecticut, 1973-1983.

A total of 1,573,769 blood donations from volunteer blood donors from Connecticut were tested for Hepatitis B Surface Antigen (HBsAg) from 1973 to 1983. The prevalence of HBsAg decreased over this 10 year period among first time as well as repeat donors. This decrease was much more pronounced in the first three years of the study (1973 to 1975) in repeat donors. Thereafter, prevalence was stable. In first-time donors, the largest decrease also occurred in the first three years. In contrast to repeat donors, however, marked fluctuations in the prevalence were noted in first time donors. As has been the case in previous studies, HBsAg prevalence in first-time donors was significantly higher than that observed in repeat donors. Our study encompasses the longest period of observation in comparison to previous reports on HBsAg prevalence among blood donors. While it has been previously established that a decrease in prevalence over time does occur among repeat donors, stabilization of prevalence after an initial reduction found in our study has not been previously documented. This may indicate an irreducible minimum prevalence rate in the repeat donor population. In addition, our study for the first time convincingly demonstrates a reduction in prevalence in first-time donors which may reflect better communications at the donor recruitment and nursing level.

Blood Donors↗
PubMed1985

Descriptive epidemiology of the autopsy in Connecticut, 1979-1980.

Knowledge of the differences between deaths for which autopsies are performed and all deaths is pertinent to epidemiologic investigation in such areas as disease trends, chronic disease incidence, and occupationally related disease. A population-based study was undertaken to evaluate these differences for deaths in Connecticut in 1979 and 1980. Analyses for 1979 and 1980 were comparable. Of 28,440 deaths in 1980, 14% underwent autopsy. Differences by sex, race, marital status, age, underlying cause of death, and place of occurrence of death were demonstrated when decedents who underwent an autopsy were compared with all decedents. Non-white men who died at 20 to 29 years of age were the most likely group to undergo an autopsy. Proportions of autopsies, by major category of underlying cause, did not parallel the leading causes of death. Deaths due to trauma accounted for a larger proportion of all autopsies (25%) than of all deaths (6%). If a death certificate indicated a circulatory disorder or neoplasm as the cause of death, an autopsy was less likely to be performed. A disproportionately high number of autopsies were performed for deaths occurring in hospitals; the converse was true for deaths occurring in nursing-convalescent homes. We conclude that knowledge of the ways in which autopsies are biased will permit broader use of the sensitive and specific information that can be obtained from them.

Adolescent↗
PubMed1985

Time period compared to birth cohort in Connecticut incidence rates for twenty-five malignant neoplasms.

Out of necessity and convenience many reports on population-based rates for cancer are limited to analyses by time period of diagnosis, and just how often cohort effects are important in cancer data has not been fully explored. To address this question, Connecticut cancer incidence rates for the years 1940-79 were fitted to the model: Log (incidence rate) = constant + age effect + period effect + birth cohort effect + error term. Data for each cancer site and sex were categorized into 10-year intervals by time period and age group. Significance testing for the curvilinear effects (which are estimable functions) of age (A), period (P), and cohort (C) in the 44 data sets led to no clear choice of model for three data sets; an APC model for 20, an AP model for 7, and an AC model for 14. These choices were corroborated by the RA2 index. Limitations in the interpretation of the results were enumerated. Presentation of population-based cancer rates by implicitly assuming an AP model is valuable (e.g., for studying age distribution in different regions or for age-adjustment in examining international variation or time trends). However, the assumption of an AP model may often be incorrect, as was shown to be the case for most of these 44 data sets. The implications for monitoring trends and generating etiologic hypotheses were discussed in light of the results for cutaneous malignant melanoma and cancers of the cervix, breast, ovary, lung, and bladder.

Adult↗
PubMed1985

Second cancer following cancer of the female genital system in Connecticut, 1935-82.

The risk of second primary cancer was evaluated in more than 25,000 women with cancer of the genital organs diagnosed between 1935 and 1982 in Connecticut. Significant excesses of subsequent cancers were observed following cancers of the cervix (35%, n = 656), uterine corpus (16%, n = 1,060), and ovary (58%, n = 366). When observed and expected second cancers of the female genital tract were excluded, these excesses became 40%, 30%, and 59% after cervix, uterine corpus, and ovary, respectively. Among women with either cancer of the cervix or uterine corpus, the risk of developing a second cancer rose with increasing duration of follow-up, reaching an excess of 61 and 34%, respectively, after 20 years. In contrast, among patients with ovarian cancer, the second cancer risk decreased over time to 41% after 10 years. Cancers related to smoking, i.e., oral cavity and pharynx, esophagus, and respiratory system, were notably increased among cervical cancer patients. The twofold to threefold risks observed for these second cancers are consistent with recent evidence linking cervical cancer to cigarette smoking and seem too large to be artifacts of confounding by low socioeconomic status. An increased incidence of second cancer of the abdominal organs (colon, rectum, kidney, bladder, ovaries) was generally observed for each gynecologic site. However, only rectal cancer was consistently linked with radiation treatment for the first primary cancer. Leukemia occurred in excess after cancers of the uterine corpus and ovary, but not after cervical cancer. The predominant cell type was acute nonlymphocytic leukemia, and the excess was associated with radiotherapy for uterine corpus cancer and with chemotherapy for ovarian cancer. Cancers of the breast and colon were increased following uterine corpus and ovarian cancer and vice versa, which supports the notion that these sites share a common etiology, perhaps related to dietary or hormonal factors. Cervical cancer patients experienced a deficit of subsequent breast cancer, possibly due to ovarian removal or ablation by radiation. Investigators need to explore further the association between the smoking-related cancer sites and cervical cancer, to clarify the role of radiotherapy and chemotherapy in relation to excess cancers, and to define more fully the etiologic factors that link cancers of the breast, colon, uterine corpus, and ovary.

Breast Neoplasms↗
PubMed1985

Second cancer following cancer of the male genital system in Connecticut, 1935-82.

The risk of a second primary cancer developing was evaluated in nearly 20,000 men with cancers of the prostate or testis in Connecticut, 1935-82. Among 18,135 men with prostate cancer, a significant 15% deficit of all second cancers was observed [1,053 vs. 1,241; relative risk (RR) = 0.85; 95% CI = 0.80-0.90], most notably for respiratory (RR = 0.7) and digestive cancers (RR = 0.8). The absence of a colon cancer risk lends little support to the idea of common risk factors such as dietary fat consumption. Only the risk for salivary gland cancer was significantly increased, possibly due to chance. Leukemia was significantly elevated among men observed for 10 and more years (RR = 2.2). In contrast to most other index tumors, the prostate stands out as being associated with an overall low risk of second cancer development. The reasons for these deficiencies have not been explained. Among 1,446 men with testis cancer, a significant twofold risk of second cancers was seen (104 vs. 50.1). A fivefold risk of leukemia (8 vs. 1.5) was not related to treatment or age. Contralateral testis cancer (6 vs. 0.5) was elevated in men treated with and without radiation. Risks for kidney cancer (5 vs. 1.5), bladder cancer (9 vs. 3.4), pancreatic cancer (6 vs. 1.5), non-Hodgkin's lymphoma (6 vs. 1.5), and prostate cancer (12 vs. 5.9) were significantly increased. No trends over time were noted for any cancer. Overall risk of second cancer development tended to be higher in younger men with testis cancer. The relationship of leukemia to testis and prostate cancers should be investigated in future research.

Connecticut↗
PubMed1985

Second cancer following cancer of the urinary system in Connecticut, 1935-82.

The risk of second primary cancer was assessed in persons who developed cancer of the urinary tract in Connecticut during 1935-82. Among 12,384 patients with a first primary tumor of the bladder or urethra, a second cancer was reported in 1,151 (or 9%). A significantly elevated relative risk (RR) of 1.23 was due to excess cancers of the lung, larynx, prostate, and kidney, and acute nonlymphocytic leukemia. Among 5,115 persons with a first primary tumor of the kidney, renal pelvis or ureter, a second cancer was reported in 374 (or 7%) that yielded a significantly elevated RR of 1.54 due to excess tumors of the bladder and prostate and second primary kidney neoplasms. The role of common etiologic factors, such as cigarette smoking, the multifocal tendency of tumors of the urinary tract, and heightened medical surveillance are discussed in relation to these findings.

Connecticut↗
PubMed1985

Second cancer following cutaneous melanoma and cancers of the brain, thyroid, connective tissue, bone, and eye in Connecticut, 1935-82.

The risk of second primary cancers developing was evaluated in individuals with 6 rare tumors in Connecticut between 1935 and 1982. Small but significant excesses of all second cancers occurred in patients with cutaneous melanoma (42%), and cancers of the brain (59%), thyroid (49%), connective tissue (23%), bone (66%), and eye (40%). In individuals with cutaneous melanoma, the highest risks were for subsequent cutaneous melanomas [relative risk (RR) = 8.5] that persisted throughout all intervals of observation. The risk for second melanomas was higher in persons under age 40, consistent with a heritable component. Connective tissue tumors and breast cancers also occurred in excess. Among patients with brain cancer, an increase of melanoma was observed that may represent an underlying neural crest abnormality, although no excess of brain cancer was seen after melanoma. Reciprocal increases of bone cancer after connective tissue cancer and connective tissue cancer after bone cancer point to shared risk factors, such as high dose radiotherapy or genetic susceptibility states. An anticipated high risk of osteogenic sarcoma following Ewing's sarcoma was not seen. An excess of breast cancer (RR = 1.9) after thyroid cancer indicates common etiologic factors. Expected excesses of bilateral retinoblastoma and bone cancer after retinoblastoma were seen. Tumors commonly treated with alkylating agents or nitrosoureas (melanoma, brain, connective tissue) showed slightly elevated risks of acute nonlymphocytic leukemia. Prostate cancer was frequently found to be in excess, but this is likely an artifact due to ascertainment bias.

Bone Neoplasms↗
PubMed1985

Second cancer following lymphatic and hematopoietic cancers in Connecticut, 1935-82.

The risk of developing a second primary cancer was evaluated in approximately 19,000 persons with initial cancers of the lymphatic and hematopoietic system in Connecticut between 1935 and 1982. Significant excesses for all second cancers were observed among patients with leukemia (34%), Hodgkin's disease (70%), non-Hodgkin's lymphoma (25%), and multiple myeloma (24%). In general, the risk of second cancers was greater in males than in females, even for cohorts not showing an excess of surveillance-related prostate cancer. Among patients with leukemia, significant excesses of cancers of the lung, kidney/ureter, and prostate were noted; cutaneous melanoma was elevated only in males. These excesses did not persist in the small number of long-term survivors. Possible etiologic factors included tobacco smoking for lung and kidney cancers, medical surveillance artifact for prostate cancer, and immunosuppression for malignant melanoma and lung cancer. The large number and good prognoses of patients with chronic lymphocytic leukemia strongly influenced the pattern of second cancers when all leukemias were analyzed together; no evidence was found for an increased risk of second cancer in patients with acute lymphocytic leukemia. A disproportionate number of subsequent cancers, particularly those of the kidney and ureter, were diagnosed incidentally at autopsy. Patients with Hodgkin's disease displayed significant excesses of cancers of the buccal cavity and pharynx, lung, female breast, and thyroid. The latter 3 sites remained significantly elevated in long-term survivors (10 yr or more postdiagnosis), so that radiation therapy may have contributed to their development. Among persons with non-Hodgkin's lymphoma, cancers of the stomach, lung, brain, and connective tissue occurred excessively. The first 3 sites, plus cancers of the urinary bladder, remained elevated among long-term survivors. The brain cancer excess, not previously reported, may represent misclassification of central nervous system lymphoma. The risk of gastric cancer is reminiscent of similar findings in patients with both acquired and genetically determined immunodeficiency disorders. The alkylating agent, cyclophosphamide, used extensively in the treatment of non-Hodgkin's lymphoma, is known to cause bladder cancer in man.(ABSTRACT TRUNCATED AT 400 WORDS)

Connecticut↗
PubMed1985

Second cancer following cancers of the buccal cavity and pharynx in Connecticut, 1935-1982.

Patients diagnosed in Connecticut from 1935 to 1982 with cancers of the tongue, gum, floor, and other parts of the mouth, or pharynx experienced twofold to threefold increased risks of developing a second primary cancer. The excesses were most prominent [relative risk (RR) greater than or equal to 10] for subsequent oral and esophageal cancers but also were observed for cancers at other sites in the digestive and respiratory tracts. The increased risks, which affected both men and women and persisted over time, are most likely related to increased alcohol and tobacco consumption in the patients developing second primaries. The proportion of persons developing a new primary was 9% among the 2,120 patients with cancer of the tongue, 14% for the 3,063 patients with cancer in the gum, floor, or other parts of the mouth, and 8% among the 2,637 persons with pharynx cancer. If one considers that the average length of follow-up was only 3.4 years, these percentages are high and indicate the need for continued surveillance of patients with oral and pharyngeal cancers. Small overall excesses of subsequent cancer occurred among patients with initial lip (RR = 1.3) or salivary gland cancers (RR = 1.2), with twofold risks of oral and respiratory cancers evident for both tumors.

Connecticut↗
PubMed1985

Second cancer following cancer of the digestive system in Connecticut, 1935-82.

The risk of developing a second primary cancer was evaluated in approximately 64,000 persons diagnosed with cancer of the digestive system in Connecticut during 1935-82. Significant excesses of all second cancers combined were observed following cancer of the esophagus (58 observed vs. 33 expected), small intestine (41 vs. 24), and colon (2,268 vs. 1,714). A slight excess of multiple primaries was observed following cancer of the liver and biliary tract (47 vs. 40). The observed number of second cancers was nearly equal to the expected number for persons initially diagnosed with cancers of the stomach (251 vs. 258), rectum (952 vs. 941), and pancreas (40 vs. 40). Persons with initial cancers of the small intestine, colon, and rectum also had excess second cancers arising primarily in the colon, which suggested the influence of common etiologic factors or possibly misclassified metastases in some. Shared dietary, socioeconomic, or hormonal factors may explain the excess of uterine and ovarian cancers among patients with colon cancer and the excess of breast cancer among patients with colon and rectal cancers. Oral and respiratory cancers occurred more frequently than expected in persons with an initial esophageal cancer, which is likely due to common risk factors of cigarette smoking or alcohol intake, or both. The elevations in cancer of the prostate among males with cancers of the esophagus, small intestine, colon, rectum, liver/biliary, and pancreas are probably artifacts associated with increased medical surveillance of cancer patients. The prostate cancer excesses were limited to the first year after diagnosis of the initial cancer or decreased over time for all but cancer of the colon and small intestines. Increased medical surveillance may also contribute to the excess renal and bladder cancers seen within 5 years of diagnosis of stomach cancer. Excesses were also seen for second pancreatic cancer among small intestine and liver/biliary cancer patients and second kidney and brain cancers among those with colon cancer. The deficits of stomach and rectal cancer among persons initially diagnosed with the same tumors, respectively, were anticipated because surgical removal of the organ is the primary form of treatment. Patients with rectal cancer also had deficits of stomach and pancreatic cancers. Future research should clarify the role of diet, alcohol, metabolic and endocrine factors, and host susceptibility on the risk of second neoplasms following cancer of the digestive system.

Colonic Neoplasms↗
PubMed1985

Second cancer following cancer of the respiratory system in Connecticut, 1935-1982.

The risk of a person developing a second primary cancer was evaluated in approximately 30,000 persons who developed cancer of the respiratory system in Connecticut between 1935 and 1982. A significant 44% excess of all second cancers was observed following cancer of the lung (614 observed vs. 426 expected). The excess of second tumors was 72% following cancer of the larynx (541 vs. 314) and 34% following cancer of the nasal cavities and sinuses (43 vs. 32). For cancers of the lung and larynx, second cancers arose mainly along the respiratory tract or other sites associated with cigarette smoking (oral cavity, bladder, kidney). A threefold excess of esophageal cancer followed cancer of the larynx, which was indicative of risk factors in common (alcohol and tobacco) and possibly an effect of radiotherapy. Radiotherapy may have contributed also to the increased risk of second lung and breast cancers. A slight excess risk of leukemia after lung cancer points to a possible effect of chemotherapy given for certain histologic types. An unexpected finding was a significant 50% increased risk of colon cancer following cancer of the larynx. Significant excesses of prostate cancer are probably artifacts associated with increased medical surveillance and higher autopsy rates among cancer patients than in the general population. No deficits of any second cancers were observed. The risk of a second cancer developing did not appear to vary by sex or time since initial diagnosis, except that the risks following cancer of the nasal cavities and sinuses returned to normal levels among long-term survivors. Among persons observed for 10 or more years after their initial diagnosis of cancers of the lung or larynx, the risk of developing a second cancer remained high, i.e., on the order of 50% above expectation. Further analytic studies should clarify the role of smoking, alcohol, other life-style and host factors, and various forms of therapy on the risk of second cancers following cancer of the respiratory system.

Connecticut↗
PubMed1985

Second cancer following cancer of the breast in Connecticut, 1935-82.

Among 41,109 women diagnosed with breast cancer between 1935 and 1982 in Connecticut, 3,984 developed a second cancer, whereas 2,426 were expected [relative risk (RR) = 1.64; 95% CI = 1.6-1.7]. This increased risk persisted for 30 years and was highest in women under 55 years of age at the time of breast cancer diagnosis. Second primary breast cancers (RR = 3.0) accounted for almost one-half of all new neoplasms. However, if subsequent breast cancers were excluded, the risk for all other second cancers was only 1.15 (95% CI = 1.10-1.20), and no excess risk was seen among women over age 55 at initial breast cancer. Significant risks were found for cancers of the ovary (RR = 1.7) and uterine corpus (RR = 1.4), possibly linked with shared reproductive factors such as nulliparity or late age at menopause. Malignant melanoma (RR = 1.5), thyroid cancer (RR = 1.6), and colon cancer (RR = 1.2) were also significantly elevated; possible shared risk factors remain to be elucidated. Significant deficits of multiple myeloma and chronic lymphocytic leukemia were noted. Women who received initial radiotherapy compared with those who did not were at slightly higher risk of developing a second cancer, most notably acute nonlymphocytic leukemia, non-Hodgkin's lymphoma, and cancers of the esophagus, kidney, and connective tissue, although the nature of the associations was not always clear. Some of the soft tissue sarcomas were lymphangiosarcomas of the arm, a consequence of the lymphedema that may complicate radical mastectomy (Stewart-Treves syndrome). Women treated with radiation were at higher risk of developing a second breast neoplasm (RR = 3.9) than nonirradiated women (RR = 2.8). Further investigation should focus on the mechanisms underlying the relationships between breast, genital tract, and colon cancers, and on the effects of treatment modalities on the risk of subsequent neoplasms.

Breast Neoplasms↗
PubMed1979

Capillaria hepatica (Bancroft) in select rat populations of Hartford, Connecticut, with possible public health implications.

Capillaria hepatica was found in 82% of 86 Norway rats (Rattus norvegicus) trapped in Hartford, Connecticut between February and November 1975. Adults were parasitized more frequently than juveniles and infection rate did not differ between sexes. Rats demonstrated a low intensity of infection, with 9% having extensive liver involvement. A seasonal variation in infection rate may have been a manifestation of environmental factors, cannibalism, and predation.

Animals↗