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An evaluation of demographic differences in the utilization of a cancer information service.

A detailed empirical evaluation of the utilization of a cancer public telephone information program was conducted. This paper reports demographic differences between utilizers and the general population. It was found that utilization varied according to socioeconomic status, area of residence, age and sex. The greatest proportion of users were females, from the higher social classes, city residents and 20-39 years of age. Attempts to look at interrelationships among these variables did not produce any consistent findings.

Adult↗

Blood lipids in Greek adolescents and their relation to diet, obesity, and socioeconomic factors.

A study of blood lipid levels in adolescent students in rural and urban areas of Greece was undertaken. Blood samples were drawn from 307 adolescents aged 12 to 18 years attending two rural and two urban high schools of different socioeconomic level (urban/lower, urban/higher). Obesity among adolescents had statistically significant detrimental effects on the lipids profile, being associated with higher total and low-density-lipoprotein (LDL) cholesterol and lower high-density-lipoprotein (HDL) cholesterol levels. Adolescents living in urban areas had substantially and significantly higher levels of total and LDL cholesterol, but among urban residents, higher socioeconomic status was associated with lower levels of total and LDL cholesterol. There was no clear evidence that total, LDL, and HDL cholesterol levels were substantially affected by qualitative aspects of diet as evaluated through a food frequency questionnaire. The results of this study indicate that the traditional Mediterranean pattern of living and eating in the rural areas of Greece is associated with a favorable lipid profile in adolescents, which may explain the very low incidence of coronary heart disease (CHD) in these areas. In urban areas lipid profiles are satisfactory in children of high socioeconomic status but unfavorable in children of low- to middle-class families, which are known to be at higher risk for CHD.

Adolescent↗

Host factors and environmental determinants associated with skin test reactivity and eosinophilia in a community-based population study.

We examined the relationship of host factors (age, gender) and environmental determinants (smoking status, area of residence) to indicators of allergy (skin test reactivity and eosinophil count) in a random population sample in the Netherlands. Positive skin test reactivity was associated with age (decreasing with increasing age), with male gender (versus female gender), and with urban residence (versus rural residence). Positive skin test reactivity was not associated with smoking. Elevated eosinophil counts were associated with male gender (versus female gender), with urban residence (versus rural residence), and with current smoking (versus never smoking). Elevated eosinophil counts were not clearly associated with age (if adjusted for the age-related effects of skin test reactivity). Additionally, this study specifically demonstrates that skin test reactivity increases with increasing eosinophil count and vice versa, indicating that the two traits are interrelated. Furthermore, this interrelationship was demonstrated to be age-dependent (decreasing with increasing age).

Adolescent↗

Cigarette smoking and risk of large cell carcinoma of the lung: a case-control study in Uruguay.

In the time period 1988-2000, a case-control study on large cell carcinoma of the lung was conducted in Montevideo, Uruguay. The study included 149 cases (139 men and 10 women) and 596 controls (556 men and 40 women) afflicted with diseases not related with tobacco smoking. Cases and controls were frequency matched on age, sex, residence and urban/rural status. According to our results, large cell carcinoma was strongly related with cigarette smoking (OR for heavy smokers 155.2, 95% CI: 30.6-786.1). Furthermore, all cases displayed higher risks for intensity compared with smoking duration. Smokers of black tobacco showed odds ratios (ORs) significantly higher than those presented by smokers of blond tobacco and smoking cessation displayed a reduction in risk of 95%, close to the risk of never smokers. Finally, filter use was not associated with any reduction in risk. It could be concluded that undifferentiated large cell carcinoma of the lung could be included among those lung tumors classified as Kreyberg I cancers.

Adult↗

Psychological status at the menopausal transition: an Italian epidemiological study.

OBJECTIVES: To provide epidemiological data about psychological symptoms derived from a large Italian non-clinical sample, and to investigate the correlation with psychosocial factors. METHODS: The study design was a cross-sectional postal survey of a sample of menopausal women recruited from the General Registry Office in Ferrara's province. Four thousands and seventy-three women were sent a questionnaire designed on the basis of the Women Health Questionnaire (WHQ). Together with the WHQ, women were asked to fill out a personal file to define social status, cultural level, family's characteristics, recent menstrual cycles, gynaecological history and operations, drug's assumption, life events in the last year and lifetime depression. RESULTS: Factor analysis resulted in eight clusters of symptoms. Among psychiatric symptoms, three different clusters were identified: depressive symptoms, depressed mood with anxiety symptoms, and anxiety. The cluster "depressive symptoms" was more evident in the postmenopausal period with respect to the premenopausal one. CONCLUSION: The cluster "depressive symptoms" is significantly different in the premenopausal group with respect to the postmenopausal group, with greater levels of symptomatology in the postmenopausal group. On the contrary, the factor "depressed mood with anxiety symptoms" is present to the same extent in the pre-, peri- and postmenopausal groups. Prior depression is the most predictive variable of subsequent depression in postmenopausal women. Factors related to more pronounced depressive symptoms are number of life events, postmenopausal status, place of residence in rural areas and lower cultural level.

Cross-Sectional Studies↗

Disability pension among immigrants in Sweden.

Using large samples, disability pensions among foreign-born and native-born women and men living in Sweden is studied here for the period 1981-1999. The results show foreign-born individuals having higher rates of disability pension. The risk of being on disability pension is very low for newly arrived immigrants, but increases rapidly on a yearly basis after immigration. Higher rates of disability pension are reported for persons born in Greece, Yugoslavia, Turkey and Finland. Results from multivariate analysis indicate that factors such as education, country of residence and marital status cannot fully explain the high rates of disability pension observed among many immigrant groups. Future research needs to address which possible causes are most important for policies to address.

Persons with Disabilities↗

Factors related to autonomy and discontinuation of use of natural family planning for women in Liberia and Zambia.

From 1983 to 1988, natural family planning programs were conducted in Liberia and Zambia. In Liberia 1055 and in Zambia 2709 women used natural family planning to avoid pregnancy. These users could become pregnant, discontinue use of the method, or become autonomous users. Women who changed intention did not stop use of natural family planning and were not treated as discontinuations. In a multivariate analysis, client's age, breastfeeding status, employment, urban/rural residence, time of registration in the program, and visit intensity were significantly associated with the outcomes. The most consistent association was that women who entered the programs in the later time periods were more likely to become autonomous users and less likely to discontinue use of the method or to experience an accidental pregnancy.

Adolescent↗

Inequalities in health: socioeconomic differences in self-reported morbidity.

Socioeconomic differences in self-reported chronic and acute illness were investigated in men and women using data from the General Household Surveys (1981-4). Logit models were used to investigate the influence of age, socioeconomic group, tenure, access to cars, area of residence and marital status on these measures of morbidity. For both measures local authority tenants, whether male or female, reported the most morbidity as did those with no access to cars. Both males and females reported increasing levels of illness the lower their socioeconomic group but similar patterns were not observed with acute illness. The significance of these present day inequalities is discussed.

Adolescent↗

Airways responsiveness and development and remission of chronic respiratory symptoms in adults.

BACKGROUND: Many patients with chronic obstructive lung disease show increased airways responsiveness to histamine. We investigated the hypothesis that increased airways responsiveness predicts the development and remission of chronic respiratory symptoms. METHODS: We used data from 24-year follow-up (1965-90) of 2684 participants in a cohort study in Vlagtwedde and Vlaardingen, Netherlands. Increased airways responsiveness was defined as a PC10 value (concentration of histamine for which challenge led to a 10% fall in forced expiratory volume in 1 s) of less than 8 mg/mL. Information on respiratory symptoms was collected by means of a standard questionnaire every 3 years. Logistic regression was used to control for age, area of residence, cigarette smoking status, and sex. FINDINGS: Participants with increased airways responsiveness (1281 observations) were more likely than those without increased airways responsiveness (5801 observations) to develop the following symptoms during any 3-year follow-up interval: chronic cough (odds ratio 1.9 [95% CI 1.2-2.9]), chronic phlegm (2.0 [1.3-3.0]), dyspnoea (2.3 [1.5-3.5]), asthmatic attacks (3.7 [2.2-6.1]), and persistent wheeze (2.7 [1.7-4.4]). The estimate of the odds ratio for the development of any of the six symptoms was 1.7 (1.2-2.3). Participants with increased airways responsiveness were less likely than those without this characteristic to show remission of these respiratory symptoms. The estimate of the odds ratio for the remission of any of the six symptoms was 0.42 (0.28-0.61). INTERPRETATION: These prospective analyses show that increased airways responsiveness is positively associated with the development of chronic respiratory symptoms and negatively associated with the remission of these symptoms in adults.

Adult↗

Tobacco, alcohol, diet and risk of non-Hodgkin's lymphoma: a case-control study in Uruguay.

To test whether high meat intake is associated with the development of non-Hodgkin lymphoma (NHL) in the Uruguayan population, a case-control study was performed at the Instituto Nacional de Oncologia, Montevideo, Uruguay. After controlling for age, sex, residence, education, urban/rural status and the habit of drinking the beverage 'mate', red meat intake was associated with an increased risk of NHL of 2.5. This finding was similar in both sexes separately. Odds ratios (OR) for the highest tertile of barbecued meat was 1.7 among men, whereas salted meat was associated with an increased risk of NHL (OR 4.9, 95% CI 1.4-17.7). The effect of processed and salted meat among women was of much less magnitude and the OR's were non-significant. Also, cumulative exposure to 'mate' drinking displayed an OR of 2.4 (95% CI 1.0-5.6). Smokers of black tobacco and hand-rolled cigarettes were associated with an increased risk of 3.5 (95% 1.1-10.9), whereas beer drinkers showed an increased OR of 5.5 (95% 1.1-26.7) in men. It could be concluded that red or salted meat intake, smoking of black tobacco, and beer and 'mate' drinking are risk factors for NHL in the Uruguayan population.

Adult↗

Smoking patterns and cancer of the oral cavity and pharynx: a case-control study in Uruguay.

A case-control study of cancer of the oral cavity and pharynx was conducted in Uruguay, between 1992 and 1996. 425 patients microscopically diagnosed with squamous cell carcinoma of the oral cavity and pharynx were frequently matched on age, residence, and urban/rural status with 427 hospitalised controls. The study was restricted to males. Smokers of black tobacco cigarettes were associated with an increased risk of 12.1 (95% confidence interval (CI) 7.6-19.4), when compared with non-smokers after fitting a model which included the matching variables, birthplace, education, and total alcohol consumption. Lifelong smokers of hand-rolled cigarettes displayed an odds ratio (OR) of 8.7 (95% CI 5.6-13.4), compared with non-smokers. When smokers were excluded from the calculations, the OR for smokers of black tobacco cigarettes was 3.0 (95% CI 2.0-4.6), compared with smokers of blond tobacco cigarettes, after controlling for the same variables mentioned above, plus pack-years, years since stopping, and filter use. Hand-rolling appears to be less important than smoking black tobacco in this study (OR 1.6, 95% CI 0.9-2.5). Thus, smoking black tobacco cigarettes appears to be an important habit in oral and pharyngeal carcinogenesis.

Adult↗

Diet and risk of cancer of the upper aerodigestive tract--I. Foods.

In order to examine the risks of cancer of the upper aerodigestive tract associated with food groups, a case-control study was conducted in Uruguay in the period January 1996-December 1997. All patients afflicted with cancer of the oral cavity, pharynx larynx, and esophagus, were included in the study. Cases were frequency matched with hospitalized patients on age, sex, residence, and urban/rural status. A strong association with red meat intake was observed (OR 2.4, 95% CI 1.2-4.8), whereas vegetables fruits and legumes were associated with an inverse association (OR for fruits 0.3, 95% CI 0.2-0.6). Salted meat, a possible source of nitrosamines, was associated with an increased risk of 60% for esophageal cancer. Possible mechanisms for these findings are discussed.

Adult↗

Diet and risk of cancer of the upper aerodigestive tract--II. Nutrients.

In order to examine the risks of cancer of the upper aerodigestive tract (UADC) associated with nutrient intake, a case-control study was conducted in Uruguay in the period of January 1996-December 1997. All patients afflicted with cancer of the oral cavity, pharynx, larynx, and esophagus, were included in the study. Cases were frequency-matched with hospitalized patients on age, sex, residence, and urban/rural status. A strong positive association with protein intake was observed (OR 2.5, 95% CI 1.5-4.4), whereas antioxidants were associated with an inverse association (OR for vitamin C 0.5, 95% CI 0.3-0.8). Non-nutritive substances, like flavonoids displayed a marked reduction in risk of 70%. Possible mechanisms for these findings are discussed.

Adult↗

Tomatoes, tomato-rich foods, lycopene and cancer of the upper aerodigestive tract: a case-control in Uruguay.

In order to study the relationship between tomatoes, tomato products, lycopene and cancers of the upper aerodigestive tract (UADC; oral cavity, pharynx, larynx, esophagus) a case-control study was carried out in Uruguay, in the time period 1996-98. Two-hundred and thirty eight cases and 491 hospitalized controls were frequency matched on age, sex, residence and urban/rural status. Both series were submitted to a detailed questionnaire, including tobacco smoking, alcohol drinking and queries on 64 food items. These data were analyzed by unconditional logistic regression, after adjusting by total energy intake. Tomato intake was associated with a reduction in risk of 0.30 (95% confidence interval [CI], 0.18-0.51), whereas tomato sauce-rich foods displayed a protective effect of 0.57 (95% CI, 0.33-0.96 for the highest quartile of intake). The food group composed of raw tomato and tomato-rich foods showed a strong inverse association with UADC (odds ratio [OR], 0.23; 95% CI, 0.13-0.39 for the highest quartile of intake). Lycopene was also strongly associated with a reduced risk of 0.22 (95% CI, 0.13-0.37). Adjustment of tomato intake for several phytochemicals explained almost completely its protective effect, which disappears in this model. Finally, the joint effect of lycopene and total phytosterols was associated with a significant reduction in risk (OR, 0.11; 95% CI, 0.05-0.23).

Adult↗

Mass media exposure and its impact on family planning in Bangladesh.

This paper analyses mass media exposure and its effect on family planning in Bangladesh using data from the Bangladesh Demographic and Health Survey (BDHS) 1993-94. The findings indicate that radio and television are two important mass media for disseminating family planning information in Bangladesh. However, access to them and exposure to family planning through them are still limited. Slightly more than 40% (42.1%) of respondents reported that they had heard family planning messages via radio, while 17.2% said television, 8.4% said poster and 5.4% said billboard. Respondent's place of residence, education, economic status, geographical region and number of living children appeared to be the most important variable determining mass media exposure to family planning. Multivariate analysis shows that both radio and TV exposure to family planning messages and ownership of a radio and TV have a significant effect on current use of family planning methods. These factors remain significant determinants of contraceptive use, even after controlling socioeconomic and demographic factors. The study reveals that both socioeconomic development policies and family planning programmes with a special emphasis on mass media, especially radio, may have a significant effect on contraceptive use in Bangladesh. The principal policy challenge is to design communications strategies that will reach the less privileged, rural and illiterate people who are by far the majority in Bangladesh.

Adolescent↗

Voluntary sterilisation among Canadian women.

Using data from the 1984 Canadian Fertility Survey, proportional hazards modelling was employed to determine factors associated with the likelihood of voluntary sterilisation among 5315 women of childbearing age, and the trends in timing and differences in the likelihood associated with different age cohorts. Multivariate analysis suggests that educational attainment, parity and duration since last birth at the time of sterilisation, religious commitment, province of residence and marital status at the time of sterilisation, are all important predictors. Education and parity attainment emerged as the best predictors of the timing of voluntary sterilisation in all age cohorts, but the contribution of other covariates varies between cohorts.

Adult↗

Completed suicide and criminality: lack of a direct relationship.

A comparison was made of the crime rate among 181 suicides and 181 controls, representing an unselected sample of the population matched with the suicides for sex, age, marital status, place of residence and occupational level. Sixteen per cent of the suicides and 11% of the controls had a criminal record, a statistically insignificant difference. In addition, no significant differences were found in the proportion of recidivists and of violent offenders, or in the number of their offences and convictions. A significant difference was found regarding the distribution of the offences by particular laws: more than a half of the offences committed by criminal suicides concerned violations of the road traffic laws, this being in agreement with the hypothesis that risky, accident-prone behaviour is a suicidal behaviour equivalent.

Adult↗

Agricultural use of organophosphate pesticides and the risk of non-Hodgkin's lymphoma among male farmers (United States).

OBJECTIVE: Data from three population-based case-control studies conducted in Kansas, Nebraska, Iowa, and Minnesota were pooled to evaluate the relationship between the use of organophosphate pesticides and non-Hodgkin's lymphoma (NHL) among white male farmers. METHODS: The data set included 748 cases of non-Hodgkin's lymphoma and 2236 population-based controls. Telephone or in-person interviews were utilized to obtain information on the use of pesticides. Odds ratios (OR) adjusted for age, state of residence, and respondent status, as well as other pesticide use where appropriate, were estimated by logistic regression. RESULTS: Use of organophosphate pesticides was associated with a statistically significant 50% increased risk of NHL, but direct interviews showed a significantly lower risk (OR = 1.2) than proxy interviews (OR = 3.0). Among direct interviews the risk of small lymphocytic lymphoma increased with diazinon use (OR = 2.8), after adjustment for other pesticide exposures. CONCLUSIONS: Although we found associations between the risk of NHL and several groupings and specific organophosphate pesticides, larger risks from proxy respondents complicate interpretation. Associations, however, between reported use of diazinon and NHL, particularly diffuse and small lymphocytic lymphoma, among subjects providing direct interviews are not easily discounted.

Adult↗